Vaccine exemptions bill waits in the West Virginia House of Delegates
'At the end of the day for children, there's very close interactions and there's a lot of spreading of different germs,' Dr. Lisa Costello, an assistant professor in General Pediatrics at the West Virginia University School of Medicine. 'That's why having immunization policies in place — every state has immunization requirements for school entrance, with the differences based upon the exemptions to these requirements. In West Virginia, we get it right. Other states look to us as leaders in this area because of only allowing medical exemptions.'
Senate Bill 460 seeks to add philosophical or religious exemptions to the state's vaccine requirements for children who attend public school. The bill passed out of the West Virginia Senate on Feb. 21 on a vote of 20-12 and was sent to the House of Delegates, where it has resided since Feb. 25. The House Health and Human Resources Committee holds the bill and after a hearing on Feb. 24, the bill is in markup discussion.
Bailey Kuykendoll, operations director for the Naples, Fla.-based Stand for Health Freedom, a national nonprofit that advocates for reduced vaccination requirements, submitted a comment in favor of the bill. The comment frames vaccine requirements using the language of personal freedom and religious conviction.
'No student should be forced to choose between their conscience and their future,' Kuykendoll wrote. 'SB460 ensures that individuals retain the right to make personal medical decisions without facing exclusion or discrimination in schools and universities.'
However, that framing omits any mention of the consequences to public welfare, or the danger of resurgent diseases long thought eliminated, such as polio or measles. An unvaccinated New Mexico resident died from a suspected case of measles on Thursday, a week after a 6-year-old child died of measles in Texas. New Mexico reported 30 measles case a day. According to the US Centers for Disease Control and Prevention, there's already been over 220 cases of measles just three months in 2025. In 2024, there was a total of 285 for the whole of the year.
So, what is measles and why is there a vaccine for it?
Measles, which is airborne, can lead to 'ear infections, pneumonia, and encephalitis or inflammation of the brain that can lead to permanent neurologic damage and even death. On average, measles kills between one and three of every 1,000 infected children,' according to Johns Hopkins Medical.
The current measles outbreak centers around a county in Texas where vaccinations are low due to a high number of personal belief exemptions allowed under state law.
Costello said medical exemptions are important, and some individuals can't receive childhood immunizations for different reasons, such as allergic reactions or difficult treatments like cancer treatment. West Virginia has medical exemptions on the books.
'When you start talking about any other type of exemption, it's really for me, nonmedical exemption, and it can be really hard to delineate what that means,' Costello said.
She added that strong policies like the kind West Virginia has, has afforded the state protections which have prevented outbreaks of preventable diseases like those that have happened in other parts of the country, including neighboring states.
Moreover, Cathy Stemp, former W.Va. State Health Officer and Commissioner, pointed out in a letter to the committee, that West Virginia Parochial schools note the bill is not a religious freedom bill, since it mandates action against their religious tenet of honoring health and protecting those in their learning community.
Dan Salmon, professor at John Hopkins University's Division of Global Disease Epidemiology and Control, studies optimizing the prevention of childhood infectious diseases through the use of vaccines, with an emphasis on determining the risks of vaccine refusal. He also looks at the factors that impact vaccine acceptance as well as evaluating and improving state laws that give exemptions to school immunization requirements.
'Philosophical exemptions, or personal belief exemptions, are associated with increasing rates of exemptions, higher rates of exemptions and higher rates of disease,' Salmon said. 'When you have states that have fairly narrow exemptions, and how you implement and enforce that — it's pretty complicated, not easy — but when they're stricter, you see less disease. When states have really easy exemptions, you see more disease.'
However, there is nuance. While Maryland has religious exemptions that are easier to get than it is to get a child vaccinated, the state still has low exemption rates. Salmon said that largely reflects that most Marylanders want to vaccinate their kids. It could also be because when some parents read the religious exemption, they think it doesn't apply to them because their issue isn't religious. Salmon emphasized the importance of educating parents on the subject of vaccines and their kid's health.
Salmon said if SB460 does pass in West Virginia, education will become more important. But there are concerns.
'My concern is there's so much misinformation out there and things have become so polarized we're really going to see drops in immunization coverage,' he said. 'We're going to see a return of measles and we're going to see a lot more pertussis and other diseases and that's what my concern really is.'
However, he did have some suggestions for states that expand vaccine exemptions past medical. One is annual renewal in order to encourage the parent to revisit the issue. Views can change over time. It also ensures exemptions are legitimate. Another thing he's seen states do is mandate education before granting exemptions.
Costello said what motivates a lot of parents around the issue of vaccination is love and doing what's best for children. Costello is a mother herself, and as a pediatrician, she sees individuals do what they think is best for their child. Unfortunately, she said, there's a lot of misinformation and disinformation out there.
'When it comes to immunizations, this is one of the cases where one individual's choice does impact the community, and that's something that needs ongoing education,' she said. 'I get that this is very complex. There's a lot of complexities in regards to immunology, and, a lot of trying to make it understandable. So that's an ongoing effort. We need to continue to try to educate and have those discussions in ways that make sense.'
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