http://www.nvic.org/NVIC-Vaccine-News/February-2011/College-Bound---Navigating-Vaccine-Choices.aspx
College Bound - Navigating Vaccine Choices
By Theresa Wrangham, NVIC Executive Director
Recently, I responded to one of our reader’s
vaccination choice concerns regarding college
bound young adults and many of these young
adults will soon be deciding which college to
attend in the fall. I have these concerns myself
now, as my youngest is also off to college this
year. As a parent, I have learned that the
informed consent movement that NVIC founded and
the values we in turn have taken into our home
really transfer to our college bound daughter.
It is not easy to step aside, but as we do, we
are empowering our daughter to ask the right
questions as she decides which college to
attend.
This article will address concerns held by
families and young adults who are college bound
and choose to alternately vaccinate, or do not
vaccinate at all. As they enter college, they
will face pressure to receive vaccines for
meningitis, HPV, and influenza, among others.
Whatever decisions our sons and daughters make
in this respect, make no mistake - it is their
decision to make and defend.
Although parents are no longer directly involved
with these healthcare decisions, parents can
help their sons and daughters find accurate
information and resources regarding:
* the risks of the vaccine they are being asked
by the college to receive;
* the risks of the disease for which they are
considering vaccination;
* and their rights to informed consent in the
vaccine decision-making process.
For reliable facts helpful in evaluating the
risks discussed in the first two points above,
our
webpage on diseases and vaccines is an
excellent resource and should be recommended to
prospective college students. When a decision is
made to decline a
vaccine, it is crucial for the incoming college
student to understand what the legal and policy
requirements are in order for them to be able to
continue to be enrolled and meet their program
requirements.
College Vaccination – What is Required?
Understanding college vaccination policies and
state exemption laws are a critical part of the
information gathering process. Having taken
calls from parents of students suspended from
attending college until their vaccinations are
up to date, we are not leaving admission to our
daughter’s dream college to chance. We have
personally found it helpful to proactively:
*
ask the admissions officer for the school’s
vaccination policy in writing (should be on the
institution’s letterhead);
* and research the state’s exemption laws when
considering colleges.
In general, college vaccination policies must
comply with the legal exemptions to vaccination
outlined in each state's public health laws.
Unforeseen trouble may come up later if the
student is going into a health profession that
requires clinical practice during their course
of study. In that instance, the facility
providing the clinical experience necessary for
graduation requirements could have vaccination
requirements
for students, who are in direct contact with
patients. It is better to have this information
in advance. There are times when exceptions are
made for medical contraindications and/or proof
of existing antibodies, but these exceptions are
on a case-by-case basis and policies governing
vaccination could change before graduation.
Helpful Tips for Gathering Information
Below are guidelines to assist families in
gathering information that empowers their
college bound student’s understanding of the
vaccination landscape in their state. Much of
the information below can be found on our
website under FAQs and although
NVIC continually updates our website, state laws
and rules change frequently and the website
content may not reflect all recent changes to
laws.
* Research the state exemption laws for colleges
under consideration. Le gal requirements of
vaccination laws differ state to state.
Recognized legal exemptions are medical,
religious and conscientious, philosophical or
personal belief exemptions. Wording and scope of
exemptions can differ from state to state, so do
your homework!
* State laws that govern exemptions sometimes
don’t extend to private schools, which can
institute any vaccine requirements they deem
appropriate. Exemptions differ state to state
and are dependent on the laws of each state.
* Be aware of the difference between a legal
requirement and a recommendation. For example,
while vaccine policymakers at the Centers for
Disease Control (CDC) have included the
meningitis vaccine in their recommendations for
first year college students living in
dormitories, the state of
Alaska requires only that college students
receive
information on the disease, vaccine and their
increased risk of contracting meningitis if
living in student housing. In this example the
student must either agree to be vaccinated for
meningitis, or sign a waiver verifying that they
received the information and have waived
vaccination.
* Some states allow exemption from vaccination,
or revaccination, if there is proof
of existing antibodies. These antibodies can
sometimes be determined by a private laboratory
with a blood test to check titers. Titer tests
are not available for all diseases for which a
vaccine is available and acceptance of titer
test results vary state to state. Again, check
with the public health laws governing the state
in question to determine what titer tests are
acceptable.
* Stay up-to-date on state exemptions and
vaccination issues in the state of attendance,
as requirements can change! NVIC maintains a
webpage updated with state-by-state
exemption information. NVIC has also recently
launched its
State
Advocacy Portal and individuals can sign up
to receive free eNewsletters on vaccine policy
and law changes underway in their state, as well
as tips for protecting your legal right to
obtain an exemption to vaccination.
There are three types of vaccination exemptions:
* Philosophical Exemption:There are
18 states which allow exemption to
vaccination based on philosophical, personal or
conscientiously held beliefs. In many of these
states, individuals must object to all vaccines,
not just a particular vaccine in order to use
the philosophical, conscientious or personal
belief exemption. This type of exemption is
being threatened in some state legislatures due
to pressure from government health officials,
drug company lobbyists and medical organizations
to revoke this exemption.
* All states except Mississippi and West
Virginia allow for a religious exemption to
vaccination. The religious exemption is intended
for people who hold a sincere religious belief
opposing vaccination but those beliefs can be
personally held and church membership or
adherence to an organized religion is not
required. However, you should be able to
articulate in your own words why your sincerely
held religious or spiritual beliefs do not allow
you to vaccinate yourself or your child with one
or more vaccines. Sometimes obtaining a letter
from your pastor or spiritual advisor attesting
to the sincerity of your religious beliefs about
vaccination is helpful, as well. Some religious
exemptions are broadly defined and similar to
philosophical or conscientious belief
exemptions.
* Medical Exemptions: All 50 states allow
medical exemption to vaccination. Proof of
medical exemption must take the form of a signed
statement by a medical doctor, or doctor of
osteopathy that the administering of one or more
vaccines would be detrimental to the health of
an individual. Some states will accept a private
physician's written exemption without question.
Other states allow the state health department
to
review the doctor's exemption and revoke it if
health department officials do not think the
exemption is justified.
My advice to our readers is to take the time to
research the vaccination laws of the state in
question, the specific policies of the college
and program being considered and empower your
student with information well in advance of
selecting the college of their dreams and
beginning their journey into adulthood.
