Can a child be exempt from the measles, mumps, and rubella (MMR) vaccine in Washington state?

Vaccine Exemptions for Measles in Washington State

In Washington State, children can only be exempt from the measles vaccine for medical or religious reasons, as personal belief exemptions for MMR vaccination were eliminated by Washington's 2019 Engrossed House Bill 1638. 1

Current Exemption Options in Washington

• Medical exemptions: Available when a healthcare provider determines that a vaccine is not advisable for medical reasons
• Religious exemptions: Available when parents have religious objections to vaccination
• No personal belief exemptions: As of 2019, Washington State no longer allows philosophical or personal belief exemptions specifically for the MMR vaccine 1

Impact of Washington's Policy Change

The 2019 legislation (EHB 1638) that removed personal belief exemptions for MMR vaccination has had significant effects:

• 5.4% relative increase in kindergarten MMR vaccine series completion rates
• 41% decrease in overall MMR exemptions (from 3.1% to 1.8%)
• 367% increase in religious exemptions (from 0.3% to 1.4%), indicating some parents shifted from personal belief to religious exemptions 1

Importance of MMR Vaccination

The Advisory Committee on Immunization Practices (ACIP) recommends that school-aged children receive two doses of MMR vaccine 2. This recommendation is based on:

• Protection of individual children from measles, mumps, and rubella
• Prevention of outbreaks through community immunity
• Reduction in morbidity and mortality associated with these diseases

Consequences of Exemptions

Children who are exempted from vaccination:

• Are at greater risk of developing vaccine-preventable diseases
• Put vaccinated children and medically exempt children in the same area at risk
• May contribute to outbreaks of vaccine-preventable diseases 2

During outbreaks, unvaccinated children face additional restrictions:

• Children exempted from measles vaccination for religious or medical reasons may be excluded from schools and other educational institutions during outbreaks until 21 days after the onset of rash in the last case of measles 2

Safety Profile of MMR Vaccine

Recent safety studies of MMR vaccine show:

• Serious adverse events are rare (≤6 per 100,000 doses)
• Non-serious outcomes like injection site reactions and rash are more common but generally mild 3

Navigating Exemption Requirements

For parents seeking exemptions in Washington State:

1. Medical exemptions: Require documentation from a licensed healthcare provider
2. Religious exemptions: Require parents to demonstrate that vaccination conflicts with sincerely held religious beliefs
3. No personal belief option: Parents cannot exempt children based solely on personal or philosophical objections to the MMR vaccine

Public Health Implications

The American Academy of Pediatrics, American Medical Association, and Infectious Diseases Society of America support eliminating non-medical exemptions for childhood vaccines 2. This position is based on:

• The risk unimmunized children pose to other children in schools and communities
• The need to maintain high vaccination rates to prevent outbreaks
• The importance of protecting children who cannot be vaccinated for medical reasons

Conclusion

While Washington State has eliminated personal belief exemptions specifically for the MMR vaccine, parents can still seek medical or religious exemptions. However, during outbreaks, unvaccinated children may be excluded from schools regardless of exemption type to protect public health.