Parents claiming an exemption from state-mandated immunizations now must clear another hurdle to keep their children in school.
A bill signed into law last June and going into effect in March requires that parents must either meet with a health care provider or watch an educational video about immunizations before declaring their child exempt.
Previously, a parent's signature claiming a religious exemption was all that was needed.
For preschool, day care or Head Start: Diphtheria/tetanus/pertussis (4 doses), polio (3), chickenpox (1), measles/mumps/rubella (1), hepatitis B (3), hepatitis A (2), Hib (3 or 4).
To enter kindergarten through fifth grade add: Diphtheria/tetanus/pertussis (1 dose), polio (1), measles (1). Hib no longer needed.
To enter sixth grade, add: Hepatitis B (3 doses). Hepatitis A no longer needed.
To enter seventh through 12th grade, add: TdaP (1 dose).
Doses required could vary by age and amount of time between vaccinations.
— Information from the Oregon Health Authority
"I think it will be challenged. They're trying to make it so difficult for people," said Cynthia Cournoyer, a Grants Pass resident and author of "What About Immunizations?," now in its seventh edition.
Cournoyer, who didn't immunize any of her three children, said forcing parents to see a traditional health care provider is unfair and hopes there will be little effect from the new law.
"For people who choose alternative health care, this is really unfair," she said. "I was kind of hoping for things to stay the same."
The law requires that parents wanting to claim their child as exempt from even one required immunization will either have to meet with a health care provider who administers immunizations and have the provider sign off on the exemption, or watch an educational video on immunizations and provide a certificate to prove they watched it.
Though Cournoyer's children are now adults, her philosophy not to immunize is one of a growing number of Oregonians, leaving the state with the highest kindergarten exemption rate in the country — 6.4 percent, according to the most recent statistics from the Centers for Disease Control.
In Jackson County, 8.5 percent of kindergartners claimed a religious exemption in 2013, with religion classified as "any system of beliefs, practices or ethical values."
In Ashland, the numbers are even higher, with about 1 in 4 children in public schools claiming a religious exemption.
The Ashland Immunization Team is an organization working to bring down the number of exemptions in Ashland by providing unbiased information about vaccinations to the public.
"I get it — it's really scary for some parents to put that many shots into their kids," said Becky Sherman, a nurse at La Clinica and project coordinator for the AIT.
A parent herself, Sherman kept her two daughters up to date on immunizations, and believes other parents should do the same.
The medical community believes too many immunization exemptions eventually will lead to a resurgence of preventable diseases.
An open letter from the Oregon Health Authority and endorsed by hundreds of Oregon medical providers urges the public to remember we are not immune to disease outbreaks.
Cases of whooping cough and Hib — a cause of severe bacterial infection — are preventable by vaccines but have instead increased in recent years because of a lack of immunization, according to the OHA.
"It's really to protect the child. We do it when the kids are most at risk," said Sherman, who sat on the advisory panel for the exemption bill last year.
Sherman said she understands that parents feel overwhelmed with getting so many immunizations for their child.
"We want to support the decision-making process. I can imagine that parents are feeling bombarded with information," Sherman said.
Sherman said she's hopeful the new law will have a measurable impact on the number of parents claiming an exemption.
Since the law doesn't take effect until March, and Feb. 19 is exclusion day in Oregon — the deadline for children to get immunized or claim an exemption or be asked to leave school — the law may not have any significant impact until next year.
Washington state adopted similar legislation in 2011, requiring parents to get a doctor's signature before claiming an exemption. A year later, the rate of exemptions fell by 25 percent.
Jim Shames, medical director of Jackson County Health and Human Services and part of the Ashland Immunization Team, said he believes Ashlanders who were unsure of whether to immunize have trusted word-of-mouth over medical advice.
"People talk to each other, and they begin to share common values," Shames said.
The Ashland Immunization Team has held public gatherings to spread information about vaccines, and the team is currently working on a website they hope to launch in the next few months.
Teresa Ristow is a freelance writer living in Ashland. Email her at email@example.com.