New Brunswick moves to ban non-medical exemptions to school immunizations in wake of measles outbreak

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Facing a measles outbreak, New Brunswick is moving to ban non-medical exemptions to its school-based immunization program, meaning parents who won’t vaccinate their children for personal-belief or religious reasons would be forced to keep them home.

If enacted, the ban on non-medical exemptions would give the province the strictest vaccination policies in Canada. Only New Brunswick and Ontario have mandatory school immunization programs and both allow parents to opt out for personal reasons in addition to medical ones. British Columbia plans on introducing a similar program in September.

New Brunswick Education Minister Dominic Cardy said the province needs to find new ways to improve vaccination rates, given that preventable illnesses such as measles are on the rise. New Brunswick is facing an outbreak of measles that has so far infected 11 people. Most of them were exposed to the virus at a high school near Saint John. Mr. Cardy said just as officials don’t allow weapons in schools, neither should they allow unvaccinated children.

“When we’re talking about public schools, public safety comes first,” he said in an interview. “[Parents] cannot and do not have the right to send their children to school to endanger others.”

Mr. Cardy said the focus is on getting the measles outbreak under control, so there is no timeline for when the non-medical exemptions could be phased out.

With the number of measles cases on the rise worldwide and public-health experts sounding the alarm about parents who refuse or are reluctant to have their children vaccinated, officials are scrambling to find ways to increase confidence in vaccines and boost immunization rates.

A growing number of jurisdictions are turning to vaccine exemptions as the answer. Medical exemptions are given to children with allergies or health conditions that don’t allow them to be vaccinated. But non-medical exemptions are granted to those who object to vaccination because of their religious beliefs or personal convictions. In some cases, such as in Ontario, non-medical exemptions were created after lobbying by antivaccination advocates.

Last week, Maine became the latest state, behind California, West Virginia and Mississippi, to ban non-medical vaccination exemptions in schools.

Delegates at the Canadian Medical Association’s 2016 annual meeting voted in support of ending non-medical exemptions. Earlier this year, leaders of the American Academy of Pediatrics called on officials to stop allowing parents to opt out of vaccination programs based on personal belief.

Despite growing support, banning non-medical exemptions remains a controversial aspect of immunization policy. Bonnie Henry, B.C.'s provincial health officer, said strict mandatory vaccination policies can force some students out of the school system when their parents won’t allow vaccination, and that can have lasting negative consequences.

“We’re not having a mandatory-vaccination program for school kids,” Dr. Henry said. “I don’t believe they should suffer for their parents’ decisions, even though I might not agree with those decisions.”

This fall, B.C. is expected to launch a new mandatory vaccination-reporting system for schools, which would require students to have up-to-date records. While the details have yet to be finalized, Dr. Henry said the aim is to ensure officials have vaccination records for as many students as possible. This will help during potential outbreaks and allow officials to identify pockets of students who may be unvaccinated.

Dr. Henry said she is recommending the province allow families to opt out of the vaccination program. Under that scenario, parents who don’t vaccinate their children would have to be told the risks and sign an informed consent form, she said.

“I think right now, we need to take a balanced approach,” she said. Dr. Henry added the province could always move to eliminate non-medical exemptions if the need arose.

In a statement, a spokeswoman for Ontario Health Minister Christine Elliott said the province is not considering eliminating non-medical exemptions at the moment and is instead focusing on education about the benefits of vaccines.

In New Brunswick, the Education Minister said in addition to cracking down on vaccine exemptions, the province is also increasing enforcement of the mandatory school-vaccination program. Mr. Cardy said the existing legislation had not been enforced “for a considerable amount of time,” which means many students haven’t provided vaccination records and officials don’t know how many aren’t up-to-date.

Mr. Cardy said the province is looking at a number of options to tighten the legislation and that unvaccinated students will have to face consequences if they don’t comply. This could, in some cases, lead to school suspensions.

“We’re absolutely looking at making it as difficult as possible for students to come into public schools without vaccination,” Mr. Cardy said.