Public Health Committee
JOINT FAVORABLE REPORT
Bill No.: SB-568
AN ACT ELIMINATING THE NONMEDICAL EXEMPTION TO THE
Title: IMMUNIZATION REQUIREMENT.
Vote Date: 3/31/2021
Vote Action: Joint Favorable
PH Date: 2/16/2021
File No.: 555
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
The Public Health Committee
REASONS FOR BILL:
This bill eliminates the religious exemption from immunization requirements for individuals
attending (1) public and private schools, including higher education institutions, and (2) child
care centers and group and family day care homes. Additionally, this bill grandfather's
students enrolled in grades kindergarten or higher who possessed a religious exemption
before the bill's passage. The grandfathered exception continues if students transfer to
another public or private school in the state.
Students with prior religious exemption and enrolled in a pre-kindergarten or preschool
program must comply with state immunization requirements by September 1, 2022, or within
14 days after transferring to another public or private program. These children may extend
the compliance timeframe with a written declaration from their physician, physician assistant,
or advanced practice registered nurse outlining the recommendation for an alternative
vaccination schedule. The Department of Public Health (DPH) must create medical
exemption certificates by October 1, 2021, for providers to complete for students medically
contraindicated for vaccination based on physical condition.
This bill requires the DPH to release non-identifiable information with annual immunization
rates from each public and private K-12 school. It creates an 11-member DPH Vaccine
Advisory Committee to advise the commissioner and report their findings to the Public Health
Committee. The bill also requires the DPH to work with the Department of Education and the
Office of Early Childhood to evaluate vaccine exemption data and report their findings to the
Public Health and Education Committees.
Health insurance policies that cover prescription drugs must cover at least a 20-minute
consultation appointment between parents and their child's health care provider to discuss
immunizations and the parent's concerns.
RESPONSE FROM ADMINISTRATION/AGENCY:
Senator Martin Looney, 11th District:
I support House Bill 6423 and Senate Bill 568, eliminating the non-medical exemption for
vaccinations in grades Pre-K through 12, daycare settings, and higher education institutions.
A significant number of parents across the United States are choosing not to have their
children immunized. These decisions, combined with the lack of vaccine access in some
areas of the world, have created international concern. We have seen outbreaks of deadly
diseases, like measles, once declared eliminated in the United States. The unfounded fears
of vaccines contributed to a measurable decline in immunization rates, and in 2019 alone,
1,282 individual confirmed cases of measles confirmed in 31 states.
Connecticut should not exempt children from vaccination requirements solely on the religious
beliefs of their parents. Adult rights to freely practice religion do not extend to damaging the
welfare of their children or other children in the community. Children depend on their parents
and guardians to protect their health and well-being. A parent's choice not to vaccinate their
child significantly increases the probability of the child suffering from easily preventable
diseases. However, this decision may have an even more devastating effect on children who
cannot be vaccinated for medical reasons and depend on "herd immunity" for protection.
2019 Department of Public Health data revealed vaccination rates for measles, mumps, and
rubella vaccine for kindergarteners fell below the 95% federal recommendation rate in 134
schools.
In 2019, New York and Maine removed their religious exemption for immunization in
alignment with California, West Virginia, and Mississippi. California eliminated non-medical
exemptions in 2015 following the "Disneyland" measles outbreak which ultimately infected
131 people. By 2017, California's vaccination rate, which had fallen to 92.3% in 2013, was up
to 96.9%.
According to Attorney General William Tong, there is "no serious or reasonable dispute as to
the State's broad authority to require and regulate immunizations for children: the law is clear
that the State of Connecticut may create, eliminate or suspend the religious exemption in
accordance with its well-settled power to protect public safety and health. The exercise of this
authority is fully consistent with the Constitutions of the United States and the State of
Connecticut."
By eliminating non-medical exemptions to mandatory vaccination policies, we stand up for
our children and medically fragile people in our communities who cannot be vaccinated
against preventable diseases. It's well past time that we pass this critical legislation.
Representative Jay Case, 63rd District:
House Bill 6423 and Senate Bill 568 are two legislative proposals that hit close to home for
me both as a father and Connecticut resident. Parents and individuals should be able to
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maintain their right to make informed decisions regarding their health and safety and for their
children. The State has the right to intervene on behalf of the welfare of a resident or
community. The State does not have the right to intervene if a child is not vaccinated.
Government should not dictate if someone can embrace particular religious beliefs or natural
and alternative medicine modalities. Connecticut is a freedom state. Enacting legislation that
infringes on the rights of citizens is not in alignment with our call to be representatives of the
public's best interests.
Forty-five states and Washington D.C. allow exemptions for people who object to
immunizations due to their religious beliefs dating back to the 18th century to protect religious
freedom. There is no documented evidence that unvaccinated school children are causing
outbreaks in our schools. I believe the issue of allowing equal access to an education
regardless of race or religious beliefs deserves protection. This is more important now than
ever as we navigate the COVID-19 pandemic.
These two proposals are an invasion of our most important rights, religious freedom, and the
right over our health and bodies.
Senator Rob Sampson, 16th District:
I am submitting testimony in opposition to House Bill No. 6423 and Senate Bill No. 568. While
I am not opposed to immunizations, I am passionately opposed to the idea of the government
forcing immunization upon the populace and the attack on personal freedom that it
represents.
This type of legislation is nothing more than a thinly veiled attempt to eliminate the individual
liberty of parents to make health choices for themselves and their children. I believe
legislation like this is a dangerous course for the General Assembly to pursue as it
disproportionally targets a minority population and forces them to choose between their
personal religious or health beliefs and the ability to offer their children a public education.
I urge the committee to not move forward with these pieces of legislation.
NATURE AND SOURCES OF SUPPORT:
Benjamin Cherry, MD, Health and Public Policy Co-Chair, Connecticut Chapter of the
American College of Physicians (ACP):
The ACP support H.B. No. 6423. Public health and safety measures are based on the age-
old idea of a social contract, in which we sacrifice some freedoms for the greater benefit of
society.
Unscientific (and in some cases, theologically dubious) claims of liberty to decline school-
entry immunizations have led to declining vaccination rates in Connecticut, inviting tragedy to
our state. Connecticut granted religious exemptions from vaccination for 2.5% of new
kindergarten and 1.2% of new 7th grade students for the 2018-2019 school year, totaling
1.8% of so-called new school enterers. This is a six-fold increase in students claiming
religious exemptions since the state began distinguishing exemption types in 2003.
Over the same time frame, by contrast, medical exemptions have stayed flat at 0.2%. The
results of this increase are predictable and worrisome: overall measles, mumps, and rubella
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(MMR) vaccination rates have fallen below 95%a threshold recognized to be critical for
outbreak preventionin more than 130 Connecticut schools, with a steady decline observed
over the last decade.
Vaccines have proven to be safe and extremely effective in establishing herd immunity,
protecting infants and children for whom vaccines may be genuinely unsafe. People of all
ages were among the 649 people affected during the measles outbreak in New York City.
These were primarily young children who were not fully vaccinated (including 34 children <5
years old) and older people who had lost some of the protective effects of earlier vaccination.
Opponents of this bill are largely well-meaning parents who have been exposed to
misinformation about vaccine safety and misattribution of medical problems following
vaccination. Such injuries are about 1 per 2.4 million vaccines given.
It is our obligation to stand with you in protecting Connecticuts most vulnerable citizens, and
we asked that you eliminate non-medical vaccine exemptions this session.
Connecticut Academy of Physician Assistants (ConnAPA):
Connecticut Academy of Physician Assistants (ConnAPA) supports HB 6423. Vaccinations
have proven to be one of the most successful and effective public health initiatives. There is
scientific proof that rebukes the often-propagated concerns by those who do not support
vaccinations.
The inclusion of PAs in areas of certification and as a member of the advisory committee
established by this legislation is greatly appreciated. PAs work across all specialties and
practice settings, assessing, diagnosing, and treating disease while providing preventative
and primary care.
Paul Pescatello, Senior Counsel and Executive Director of the Connecticut Bioscience
Growth Council (CBGC):
The Connecticut Bioscience Growth Council (CBGC) is in support of HB 6423 and SB 568.
CBGC established the "Science Matters Work Group", to better understand public health
policy surrounding vaccine science. Connecticut has invested in life sciences as a means to
help patients and their families find effective treatments and cures and build a new pillar for
job creation across the Connecticut economy.
CBGC is about advocating for scientific inquiry and following the hard data that flows from it.
In the case of childhood immunizations, the data is clear and the following three areas will
illustrate just how critical it is to ensure that Connecticut children receive life-saving
immunizations:
Immunization saves nearly six million lives each year. The basic science and decades
of clinical research surrounding immunizations demonstrate the safety of vaccination.
Immunizations benefits dramatically outweigh the strikingly small risks associated with
it. We often forget the misery caused by diseases such as measles, mumps, rubella
and polio.
Immunization prevents long-term disability. People who survive preventable diseases
such as measles, mumps, rubella and polio often suffer lifelong and life-diminishing
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 complications. Many of us are unaware of the children who cope with lifelong cognitive
impairment resulting from brain swelling (encephalitis) caused by a measles infection.
Since 2000, because of vaccination, more than 20 million children (worldwide) have
avoided death from measles.
Immunization protects those who for medical reasons cannot be vaccinated or for
whom vaccination is not effective.
Community or herd immunity only works if 95% or more of the community is vaccinated.
Unfortunately, there are now 120 Connecticut schools with a student population below this
95% threshold for the measles, mumps, and rubella vaccines. There are 26 schools below
90%. Disregarding the science and sound public policy behind childhood vaccination puts at
risk those who cant be vaccinated for medical reasons.
Connecticut Association of Boards of Education (CABE):
The Connecticut Association of Boards of Education (CABE) supports HB 6423 and SB 568.
Concerns for the health and well-being of students and staff compelled board of education
members to approve a resolution at the November 2019 Delegate Assembly to urge the
General Assembly to remove the religious exemption from vaccinations for measles, mumps,
and rubella for students attending k-12 public schools.
Having a student body with immunization rates that fall below the CDC federal guideline of
95% is alarming and dangerous to those individuals who are prohibited from receiving the
vaccine based on their medical frailty.
As the COVID-19 pandemic has illustrated, the outbreak of disease, should it necessitate
closing school, puts ALL students behind in their achievement and has serious impact on
their social emotional needs. It jeopardizes state and federal funding due to a reduction in the
annual student count. Vaccination of our students, unless they have a medical exemption is
essential to maintaining our public education system.
Connecticut Hospital Association (CHA):
The Connecticut Hospital Association (CHA) supports HB 6423 and SB 568 which would
eliminate the Nonmedical Exemption to the Immunization Requirement. All Connecticut
hospitals strive to improve the health of our communities, whether it is partnering with
community-based organization to address social determinants of health, treating a patient in
need of care at 2:00 a.m. in the Emergency Department, or employing science-based best
practices for infectious disease control.
Vaccines are one of the success stories of modern medicine, spanning the 19th, 20th, and
21st centuries, with millions of lives saved because of vaccines. Vaccines continue to be
developed and utilized for a range of infectious diseases, and now vaccines are even used to
prevent cancer, with the use of the HPV (Human Papillomavirus) vaccine shown to decrease
not only the rate of infection, but also the rate of multiple cancers associated with HPV
infection.
Vaccines are being used to stop the spread of COVID-19 across the world, with a
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growing rate of trust in COVID-19 vaccines in the United States. The influenza vaccine has
recently been shown to be associated with reduced hospital mortality in patients treated in
states where influenza vaccine is mandated.
Immunizations, or vaccines, are used to develop immunity to an illness and have been
embraced across the globe as a prevention strategy for illness. Over 116 million children
worldwide were immunized against diphtheria, pertussis, and tetanus alone in 2018,
preventing two to three million deaths. Polio is close to being eradicated worldwide, and
thanks to immunizations, the United States has been polio-free since 1979.
Measles-related deaths declined between 2000 and 2017 by 80 per cent worldwide, with
more than 20 million children avoiding death from measles infection. Measles was declared
eliminated in the United States in 2000, but because of travel from endemic countries, lack of
immunization, and lack of herd immunity, measles is starting to reappear. Herd immunity is a
population response to vaccination and the level of vaccination needed to achieve herd
immunity varies by disease and ranges from 83 to 94 percent.
Controversy over the need for immunizations is not new and there is a long history of science
denial and distrust for evidence-based medicine that can skew public discourse and confuse
consumers. When the benefits of immunization are compared to the risks of immunization,
the science in favor of immunizations is overwhelming.
The science behind the development of vaccines and the practice of immunization are proven
to save and improve the lives of countless citizens around the world, in the U.S., and in the
state of Connecticut. Hospitals are committed to providing care that is based on the best
clinical practices that yield the very best outcome.
Selina K. Bell:
As a mother of three children, I fully support the elimination of the non-medical exemption for
vaccines for children attending school and day care. For too long, we have allowed parents to
use non-medical/religious exemption to endanger the lives of their own children and others.
All children deserve the "choice" of a healthy life, and by continuing to surrender to the anti-
science/anti-vax movement, we are stealing that "choice" from many children. Not only do the
children of the anti-science crowd lose their "choice" to live free from the threat of infectious
diseases, but the children around them who cannot be immunized for actual medical reasons
lose their "choice" to attend school without the fear of becoming seriously ill.
Life expectancy rate has increased from 54 in 1920 to 79 in 2020; the U.S. cancer mortality
rate declined by 27% in 25 years, and the infant mortality rate decreased by 80.5% from 1950
to 2018. The chances of having a serious, adverse reaction to the MMR is 0.000001%.
The 2019 measles outbreak in Samoa is a classic example of the damage that can be
caused when vaccine rates drop. An outbreak like that in Connecticut would be devastating,
especially during a pandemic. Religious freedom should not include the "choice" to harm or
kill another human being. Over 90% of all the scientists and medical experts in the world
understand that vaccines are our best defense against infectious diseases.
CONNECTICUT CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS:
The Connecticut Chapter of the American Academy of Pediatrics is in support of HB 6423.
Following are facts about vaccines: