On September 4, 2019, Senator Rebecca Rausch filed bill S.2359, titled “An Act promoting community immunity,” with a companion bill, H.4096, sponsored by Representative Paul Donato. The “Community Immunity Act” is being advertised as a way to standardize and centralize immunization requirements and exemption processes, in part by transferring more administrative power to the Massachusetts Department of Public Health (DPH). This bill affects children in public, private and charter schools, child care centers, any school activities, including those open to home-schooled children, recreational camps, and institutes of higher learning (both public and private).


Health Choice 4 Action has identified several aspects of this bill that violate basic human rights, medical ethics, and principles of informed consent. Provisions in this bill would allow vaccination without parental consent, limit medical exemptions for medically-fragile children, and limit religious freedom with respect to vaccination exemptions. Additionally, provisions in this bill would increase the risk of discrimination and bullying for those who use medical and religious exemptions. Finally, the taxpayer cost and administrative burden of this bill are not justified given the historically low incidence of vaccine-preventable illness in the Commonwealth and the current processes in place already working to safeguard public health in Massachusetts. The Legislature and DPH should be focused on more significant public health threats, including the opioid crisis, rising rates of chronic illness in children and adults, and the surge in psychiatric and neurodevelopmental disorders among children and adolescents.

OPPOSE s.2359/h.4096

"the community immunity act" 

The bill allows ‘providers’ to administer ‘preventative care,’ including vaccinations, to children without parental consent or knowledge. Additionally, mature minors can consent to vaccination without parental consent. It allows a ‘provider’ to provide ‘preventive care’ for a child they deem immature if believed to be in the child’s best interest. The provider is not required to have an established relationship or consult the child’s medical history, records of this care will be kept confidential from parents and providers are protected from liability. Outside of emergencies, providers are not allowed to make medical decisions without adequate medical history and informed consent.

Religious exemption requires you to state that you are putting your child’s life at risk. The RE requires parents to sign a statement that ‘refusing to immunize the participant may result in serious illness or death of the participant,’ and others. This statement conflicts with the beliefs of many utilizing this exemption and exposes families to future legal action. It may constitute impermissible compelled speech, imposing unconstitutional conditions to access education and exercise the right to claim a RE. Religious exemption requirements more narrowly define acceptable religious beliefs. RE language changes from ‘immunization conflicts with sincere religious beliefs’ to ‘sincere religious beliefs prohibit immunization,’ narrowly defining how a religion may view vaccination; therefore, limiting free exercise of religion guaranteed by the MA constitution.

Medical exemptions can be denied for anything outside of ‘generally accepted contraindications.’ DPH will review all MEs with reasons falling outside of ‘generally accepted contraindications,’ granting authority to approve or deny the exemption to an ‘expert licensed provider of the stated justification.’ This removes the parent and doctor as the ultimate authorities on the child’s health and allows a government official to be the arbiter of the child’s health.

Medical exemptions will require disclosing private medical information of medically fragile children. To obtain a ME from the DPH, all applications must include a statement of health conditions of the participant substantiating the exemption. Submission of additional health records may be required. Current law does not require a statement of the reason for MEs and, outside of emergencies, the government is not typically granted access to private medical information.

DPH can change medical and religious exemptions without legislative process. DPH may add elements to the medical and RE forms, allowing the department to change or add exemption requirements or further restrict MEs and REs. Private schools do not have to accept exemptions. Private ‘covered programs,’ including childcare facilities, schools, camps and other programs, may implement ‘more stringent’ immunization requirements provided they maintain a written policy, allowing private programs to no longer accept exemptions or to require additional immunizations, which may severely limit school options for early education and specialized services.

Schools below herd immunity thresholds will be required to inform parents. ‘Elevated risk programs,’ will be required to send notice of status to parents, creating environments of unnecessary fear, leading to discrimination and bullying of under-vaccinated children and families. These medically fragile children and religious minorities should be protected from discrimination rather than being exposed to it, just as children with diseases such as HIV or Hepatitis B are protected and religious minorities are protected from discrimination under law.

Doctors will be required to sign religious and medical exemptions with no liability protection. Doctors would be required to sign religious and ME forms, enabling the DPH to track these doctors. Many doctors will be unwilling to sign since doctors with unvaccinated patients already feel limited in their ability to write MEs and at-risk of losing their medical license. Additionally, doctors are mandatory reporters of child neglect; therefore, signing a document in which a parent attests to putting their child at risk for illness or death would create a conflict of interest and potential liability for the doctor.

Significant administrative and financial investments will be required. This bill would require a significant, yet unwarranted, financial investment, given the current high immunization rates, proven quarantine and school exclusion protocols and the absence of any emergency.



© 2019 Health Choice 4 Action