| Perspectives on Texas

In discussions around any important movement affecting society, words matter. That's why advocacy groups often change the name of a campaign or its supporters to gain more sympathy for their side.

Nothing wrong with that. But one of the phrases used in the public discussion about vaccination does more than generate sympathy for parents who refuse to vaccinate their children — it's downright inaccurate. It misleads the public and gives a false impression of those who refuse to vaccinate their children, as well as those who do make sure their children are immunized.

That incorrect phrase, "exemptions of conscience," is even embedded in Texas state law.

The law allows exemptions to school vaccine requirements for medical reasons such as life-threatening allergies to vaccine components or immune deficiencies. No one would disagree that waivers should be allowed for these children. But these make up a tiny portion of the unvaccinated school children. The much larger share are the "exemptions of conscience" for parents who don't want their children vaccinated because they simply don't like vaccines.

Let's be clear: There is nothing conscientious about rejecting vaccines for non-medical reasons.

School vaccine requirements protect the health and safety of schools, benefiting not just individual students but also classmates who, because of medical conditions or allergies, cannot receive vaccines themselves, or those who don't derive immunity from a particular vaccine, which happens to a small percentage of vaccinated children. And protecting those classmates might also mean protecting the people with whom they come in contact — their grandparents, for example, or a sibling too young to have been vaccinated.

Conscience is defined as our inner sense of obligation to behave in morally good, caring and ethical ways. People might choose not to vaccinate their children because they misunderstand the solid science, or aren't educated about the great benefits of immunization, or even because they selfishly figure they don't need to vaccinate because the immunized children will protect their children for them.

What they are not doing is making a moral choice.

Decades of scientific evidence demonstrate that vaccines are necessary for maintaining the health of our schools and communities. This is why almost no religions reject vaccinations.

Since the introduction of the chickenpox vaccine into Texas' 7th grade requirements, the number of cases of the disease has fallen by 62 percent. Meningococcal vaccine requirements have been followed by a 66 percent reduction in cases.

Yet that progress toward protecting the health of our children and our schools is being jeopardized by an increase of parents choosing to opt out of vaccines for their kids. In 2003, the first year students in Texas were permitted to opt out for non-medical reasons, roughly 2,300 did so. Last school year, roughly 45,000 students had filed an exemption, a 19-fold increase.

This matters because these students tend to cluster in the same communities. About 40 percent of all students at the Austin Waldorf School in Travis County had an exemption on file last school year, as did more than 37 percent of the students in Nacogdoches County's Regents Academy. Such high rates of unvaccinated children leave the entire school — not just the unvaccinated — vulnerable to disease outbreaks.

It's important to remember that there are real consequences to skipping vaccinations. Measles, once nearly eradicated in the United States, is on the rise. Cases of the mumps are popping up at one university after another. All of these issues could have been prevented if fewer people opted out of vaccines for non-medical reasons.

Immunizations are not just a personal issue, but a community one. The true decision of conscience is to realize that we have a responsibility to prevent potentially deadly illnesses from afflicting our children and communities.

The term "exemptions of conscience" makes it sound as though the decision to vaccinate is somehow morally ambiguous, when the opposite is true. It's time for the media and policy makers to be transparent and call these waivers what they really are: non-medical exemptions.