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Mississippi, a Vaccination Leader, Stands by Its Strict Rules

JACKSON, Miss. — The Mississippi state epidemiologist, Dr. Thomas E. Dobbs III, stood in a crowded room at the State Capitol this week and waited for a legislative verdict on the law that fostered what he regards as a public health triumph in a place that has few of them: the country’s highest immunization rate among kindergarten students.

But in recent weeks, the nearly unbending nature of Mississippi’s law requiring students to be vaccinated has been in jeopardy, with two dozen lawmakers publicly supporting an exemption for “conscientious beliefs.”

The debate, coming as other states grappled with a measles outbreak, turned Mississippi into one more battleground between medical experts who champion vaccinations and parents who fear the government’s role in medical decision-making.

“We have been a victim of our success, and people don’t realize how bad these diseases are,” Dr. Dobbs said in an interview before lawmakers met on Tuesday to consider a bill that would have expanded exceptions to the vaccine requirement. “But by and large, I think there’s an increasing understanding of how important it is to maintain our invaluable defense against unnecessary illnesses.”

Members of the education committee for the House of Representatives, in effect, endorsed the state’s current approach on Tuesday. By a voice vote, they advanced a heavily amended version of the bill that now calls for only technical changes to Mississippi’s law, which has been largely untouched since the late 1970s. The law requires all children in public and private schools to have certain immunizations, including for chickenpox, hepatitis B and measles. Generally, children must have the vaccines by the time they are in kindergarten.

Mississippi — one of the states with the worst rates of smoking, obesity and physical inactivity — is seldom viewed as a leader on health issues. But it is one of two states that permit neither religious nor philosophical exemptions to its vaccination program. West Virginia is the other. Only children with medical conditions that would be exacerbated by vaccines may enroll in Mississippi schools without completing the immunization schedule, which calls for five vaccines.

For the 2013-14 academic year, Mississippi reported that nearly all of its 45,719 kindergarten students had been adequately immunized, and the state’s measles, mumps and rubella vaccination rate was about five percentage points higher than the national median of 94.7 percent.

For kindergartners that year, Mississippi approved just 17 medical exemptions, the Centers for Disease Control and Prevention said. Neighboring Arkansas, which had about 3,100 fewer kindergarten students than Mississippi that year, recorded 24 medical exemptions, along with 468 religious or philosophical exemptions.