A packed room at the Joint Committee for the Review of Administrative Rules (JCRAR) hearing on Tuesday, March 7, 2023. Many attendees wore red to show their opposition to updated health rules on vaccine requirements for students. (Baylor Spears | Wisconsin Examiner)
Republicans will likely block updated rules for student vaccination requirements implemented by the state Department of Health Services for a second time, following a public hearing Tuesday packed with vaccine skeptics wearing bright red clothes.
The recent DHS changes announced last month included a shift in when children receive the Tdap (tetanus, diphtheria, and acellular pertussis) vaccine, a new requirement that kids be vaccinated against meningitis and a requirement that cases in which children have had varicella — or chickenpox — be verified by a medical professional. The updates didn’t change Wisconsin’s current broad vaccine exemption rules. Parents can still request an exemption from vaccines for health, religious or personal convictions reasons.
The GOP-controlled Joint Committee for the Review of Administrative Rules (JCRAR) will vote soon about whether to suspend updated portions of the rules.
Republicans legislators who blocked similar rules last session have called the changes “unnecessary and capricious” and said they imposed an “undue burden” on parents.
“The committee will make a decision on this and I think I know where the votes will be,” Committee co-chair Sen. Steve Nass (R-Whitewater) said towards the end of the nine-hour hearing.
The agency first tried implementing the changes in 2019. But the committee suspended them in a 6-4 party-line vote in May of 2020, then filed a suspension bill that was never taken up. Legislation not acted on by the end of session is dead, which allowed DHS to reimplement the rules to go into effect for child care centers on Feb. 1, 2023 and plan for them to be enforced for school-age children in the 2023-2024 school year
Democrats on the committee questioned why the committee was considering suspending the rules again.
“It seems odd considering this is a function of what DHS does to make sure that the public is safe and adjusting ages as it seems appropriate,” Sen. Chris Larson (D-Milwaukee) said during the hearing.
Larson said in a statement to the Wisconsin Examiner prior to the hearing that any suspension of DHS rules would be an overreach of the committee’s power.
“Vaccines save lives. Not only that, they are the most cost-effective public health tool available,” Larson said. “Any changes that weaken our vaccine requirements for children in Wisconsin is an outrageous overreach of the authority of this committee and will put Wisconsin in a small minority of states that choose ignorance and politics over the health and safety of our kids.”
DHS representatives explained the reasoning behind the recent changes and emphasized the safety and importance of vaccines while speaking to lawmakers Tuesday.
“We stand before you today, not just as representatives of DHS, but as parents, family, friends and people of faith and can say without reservations that vaccines are safe, effective and save lives,” H.J. Waukau, DHS legislative director, told the committee. Several attendees who opposed the DHS rules laughed in reaction.
While a previous rule allowed parents or adult students to report a history of chickenpox as an acceptable exception to vaccination, a new DHS rule requires that a medical professional document each case.
Dr. Stephanie Schauer explained that the chickenpox update is a result of high vaccination rates and growing unfamiliarity among people of what chicken pox symptoms look like.
Chickenpox prior to the vaccine used to be a “right of passage,” Schauer said. “Chickenpox parties” — or gatherings to purposefully infect children with chickenpox — were mentioned several times throughout the hearing to underscore how common the disease used to be.
That has changed since the vaccine became widespread. Schauer said one study showed that parents who indicated that their children had chickenpox were only correct about 75% of the time. The update is meant to improve accuracy and ensure people can make informed decisions when it comes to vaccination.
“It’s also important to know that we do not recommend going to a neighbor’s house and intentionally becoming infected,” said Dr. Ryan Westergaard, the state’s chief medical officer, at the hearing. “For young healthy children, generally risk is low, but this is a disease that can cause severe illness, it can cause acute hepatitis and infect the liver.”
Those against the DHS update insisted that parents can sufficiently verify the disease.
“Parents are already verifying their children’s history of chickenpox based on symptoms,” Erin Runk, a co-founder of Wisconsin United for Freedom, said to the committee. “So why does it suddenly become accurate if they provide those details to a doctor?”
DHS added the meningococcal vaccine, which prevents against the rare, serious illness caused by bacteria that can cause meningitis, as a required vaccine for students. Students in the seventh grade would receive the first dose and then a booster would be given in the 12th grade. The vaccine was not previously required for students.
Meningitis, while rare, is “one of the most feared illnesses in medicine,” Westergaard told the committee. He said the disease can make a previously healthy person seriously ill within a matter of hours.
Westergaard said the best way to prevent rare diseases and serious health problems and protect vulnerable people is to cast a wide net when it comes to vaccination to reduce the level of these viruses on a population level.
“We have to do everything that we know how to do, apply every tool that has been shown to be effective and safe to keep our communities healthy,” Westergaard said. “We believe that the only acceptable number of childhood deaths from vaccine preventable diseases is zero.”
Republican lawmakers focused on DHS actions during the COVID-19 pandemic to explain their skepticism of additional rules.
Nass called Westergaard the “Dr. Fauci” of Wisconsin, asking him “When we look at the past… how do we trust you?” Members of the public who had come to testify at the hearing applauded.
Westergaard said trust is built through communication and conversation, and emphasized that the rules created by DHS are meant to help protect people.
“The people in public health aren’t nameless people creating rules arbitrarily or capriciously, but people who truly care about preventing bad things from happening to people in Wisconsin,” Westergaard said.
The group Wisconsin United for Freedom, which protested COVID-19 protective measures in 2021, organized opposition to the DHS changes. The group posted an online “call to action” that urged people to attend the hearing and wear red “in solidarity.”
“We’re here today to stand for freedom, and I do not believe one needs to have letters after our name in order to do so,” Tara Czachor, a co-founder of Wisconsin United for Freedom said, “We are tired of governmental overreach over our lives. We are tired of the past three years of mandates. We are tired of being bombarded with constant recommendations by the top bureaucratic health agencies in our country and in our state.”
Some testified about not vaccinating their own children due to concerns there would be adverse effects and described experiences with “vaccine injury.” Others insisted that schools don’t do enough to promote awareness of exemptions from vaccines to parents.
“We are very well aware that Wisconsin has options in order to opt out of one or more required vaccinations,” Czachor said. “But that specific information absolutely is not willingly provided to Wisconsinites via their health care providers, nurses or school districts. It’s not provided, because many of the aforementioned individuals actually don’t know that we have exemptions or they pretend not to know.”
Immunization experts say DHS implemented long awaited updates, not an undue burden
The changes made by DHS were “pretty minor tweaks,” and a part of the “natural evolution of how vaccine policy needs to keep up with changes,” said James Conway, a pediatric infectious disease specialist with University of Wisconsin-Madison. He told the Examiner in an interview that Wisconsin made the changes very deliberately, and the changes mostly just catch the state up with policies other Midwest states already implement.
According to Immunize.org, Wisconsin is the only state in the Midwest that doesn’t require at least one dose of the meningitis vaccine for students.
Conway said the benefit of making a vaccine a requirement is it can force the system to help people who otherwise might have problems accessing a certain vaccine.
“When we think about the school entry requirements, for the people that have plenty of time, money and access, getting these vaccines isn’t that hard,” Conway said. “But it actually forces the system to figure out ways to help those that don’t have great access to be able to get those vaccines because the last thing you want is an urban lower socioeconomic family that’s working multiple jobs to basically choose to take an exemption from a vaccine because it’s too inconvenient to get their kid the vaccine.”
Daniel Koster, a family physician from Green Bay, told the committee that he looks at the pros and cons of each individual vaccine for each patient rather than recommending vaccines in a blanket approach. “A one size fits all approach isn’t going to cut it,” Koster testified.
Dr. Margaret Hennessy, the immunization representative for the Wisconsin chapter of the American Academy of Pediatrics, said in an interview that she was excited when DHS announced the recent changes.
“People that are vaccine advocates have wanted this type of change, because we know vaccine mandates do help increase vaccine coverage, which in turn, decreases risk of illness, so to protect the kids, this is really the right thing to do,” Hennessy said.
She also compared vaccines to wearing a seatbelt, saying “hopefully you never have to worry about a car accident. But if you’re in a car accident, you want to make sure you have your seatbelt.”
Hennessy said the only realistic burden of a new vaccine is needing to physically go to receive it.
“There isn’t any, any cost to vaccines for kids for two reasons: If you’ve got insurance, they’re covered; they have to be according to the Affordable Care Act,” Hennessy said. “For kids that don’t have insurance, we have the vaccine for children’s program that covers those.”
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