California’s UC system of universities, from UC Davis in the north to UC San Diego down south, will make several vaccinations mandatory for all students in the Fall of 2017. Personal belief exemptions, including those based on religion, will not be accepted. Medical exemptions will be narrowly based on a contraindication to a specific vaccine or a previous severe adverse reaction to a vaccine and will be subject to approval by the university.
UCs, at their individual discretion, may choose to implement this policy for this coming academic year (2016), although most are waiting until Fall 2017 (which UCs are choosing to do so is not known at this time). A one-semester grace period will also be allowed so that students won’t officially be barred from registration until the Winter 2018 semester.
The required vaccines are:
- 2 doses of MMR vaccine or laboratory evidence of immunity to measles, mumps, and rubella (a positive blood titer test)
- 2 doses of Varicella (Chicken Pox) or laboratory evidence of immunity (a positive blood titer test)
- 1 dose of Tdap (Tetanus, diphtheria, pertussis) after age 7 (it is technically allowed for 7 years and older, but the current UC form incorrectly states after age 7)
- 1 dose of Meningococcal conjugate vaccine against serogroups A, C, Y, and W-135 given at age 16 or older, but only required for students 21 and younger
The list of acceptable contraindications is very small, and includes a severe, life-threatening anaphylactic allergic reaction (shock, severe wheezing, emergency life-saving care administered) to a previous dose of any vaccine, encephalopathy (coma or severe brain injury) within 7 days of a Tdap or DTaP vaccine without any other identifiable cause, and for MMR and Varicella, pregnancy or severe immune deficiency disorders. The universities will consider other severe reactions on a case-by-case basis.
The UC health department discusses the new policy and the reasons behind it on their website. Yet, some aspects of the policy operate outside of established medical practices, contradict some CDC and CA Department of Public Health findings, and require vaccines which do not reduce disease transmission:
- Chicken Pox: Historically in medicine, a blood test to confirm Chicken Pox hasn’t been required. A confirmed visual diagnosis by a physician is the accepted standard of care. Many unvaccinated incoming students will have had a documented case of disease, particularly international students. The UC does not mention this allowance, however, and instead requires a blood test to prove a history of disease.
- Pertussis (whooping cough): Immunity from the Tdap vaccine, administered at 12 years of age, wears off quickly. Two recent studies show immunity wanes to about 34% within 2 to 4 years. By the time a student reaches college age, immunity will be gone for most vaccinated students, thereby making vaccination status moot for this particular disease. In addition, the CA Department of Public Health reports that 90% of children who caught whooping cough during the 2014 outbreak were vaccinated. Finally, the CDC makes it very clear on their website (FAQ 6 and 7) that unvaccinated people are not the cause of outbreaks: rather, it is the waning immunity from the vaccine and the germ’s emerging resistance to the vaccine. This vaccine doesn’t prevent the spread of whooping cough from person to person; it only protects an individual from feeling sick.
- Meningitis: The CDC states this disease is not transmitted by casual contact, and that is why it is not easily spread within a populous of people.
The UC states the first reason as to why this policy is being implemented is that “there has been an increase in outbreaks of vaccine-preventable illnesses over the past five to ten years, and now many illnesses which we thought were disappearing are returning.” This statement is a media sound bite, not a statement of medical fact. Illnesses are not returning, and there has been no increase (except for whooping cough, which cannot be controlled by the vaccine). Tetanus isn’t on the rise, and it isn’t even contagious. Measles has all but disappeared in the U.S. this year (19 U.S. cases in 2016 so far). Rubella and diphtheria have long been eliminated. Mumps comes and goes, but virtually all cases are in vaccinated adults. Chicken Pox is lower than ever, and meningitis has remained at very low, but constant, levels for many years.
The UC Immunization Policy FAQ page states that this plan was created by representatives from every campus, a leading medical ethicist, and members of the California Department of Public Health. There is no mention of consideration of the above factors or of any representation from medical professionals to discuss and debate the medical facts involved in this policy. Even if a student’s personal pediatrician, who has been caring for that child for 18 years and knows the complete personal and family medical history, believes that repeated vaccines won’t be safe for the student, the university board of inquiry makes the medical decision for the student instead.
A one-size fits all approach cannot work in medicine; every student’s body is different, and informed consent for each student, without holding education hostage, takes precedence over any pharmaceutical agenda. Vaccination policies in the United States should be based on accurate and correct information, not on rhetoric and fear. It is our hope that university policy-makers will revise this plan, and that other universities and educational institutions will make more scientifically-sound decisions in the future.
View the new UC Immunization Policy here.
Read FAQs about the new UC policy here. (Santa Cruz used as an example)
View the UC Medical Exemption form here.