Ohio is the only U.S. state that does not have any requirements for children enrolled in child care or preschool to be vaccinated, but that distinction could change with the introduction of a House bill that came in the wake of measles and mumps outbreaks in the Buckeye State.
Ohio House Bill 536, currently awaiting action from the Health and Aging Committee after it was introduced May 13, would require all children enrolled in preschool and childcare facilities licensed by Job and Family Services to be vaccinated through the age-appropriate schedule released by the Centers for Disease Control and Prevention.
Though an opposition to mandated vaccinations exists in regards to parent choice, the bill has garnered support from child care providers and health officials as a way to combat the spread of infectious disease like measles, the flu and hepatitis B.
JACKIE RUNION The Marietta Times
Child care teacher Theresa Huck serves lunch to a class of preschool-aged children Thursday at the Evergreen Child Development Center at Washington State Community College, one of several licensed child care facilities in the area that would be mandated to require Pre-kindergarten immunizations under Ohio House Bill 536.
"We are lucky in Washington County not to have any outbreaks currently," said Barb Piehowicz, director of nursing for the Washington County Health Department. "But if parents want to put their kids in child care facilities, they need these vaccinations for everyone to be protected."
Every other state, five U.S. territories and the District of Columbia all have at least some specific vaccination requirements for Pre-kindergarten children, typically for highly dangerous diseases like childhood pertussis and hepatitis B, but Ohio has none.
Sponsored with bipartisan support by State Reps. Nickie Antonia, D-Lakewood, and Ryan Smith, R-Bidwell, the law would align Ohio more closely with its fellow states. Legislators say this is partly in response to the recent April outbreaks of measles centered in Columbus and mumps centered in particular counties throughout Ohio.
At a glance
Ohio House Bill 536:
Introduced: May 13.
Latest Action: In Health and Aging Committee.
Sponsors: Reps. Nicki Antonio, D-Lakewood & Ryan Smith, R-Bidwell.
Bill would require children enrolled in state-licensed child care to be immunized based on age-appropriate scheduling by the Centers for Disease Control.
Includes vaccinations like hepatitis A and B, MMR, varicella, polio.
Immunizations: What they Prevent
DtaP - diphtheria, tetanus, pertussis.
Hep B - hepatitis B.
IPV - polio.
Hib - H. influenza.
PCV - pneumonia.
Rota - rotavirus (oral).
Influenza - "flu."
MMR - measles, mumps, rubella.
Varicella - chickenpox.
Hep A - hepatitis A.
CDC Birth to Pre-K immunization schedule
Birth: Hep B #1
2 Months: DtaP #1, IPV #1, Hib #1, PCV #1, Hep B #2, Rota #1
4 Months: DtaP #2, IPV #2, Hib #2, PCV #2, Rota #2
6 Months DtaP #3, IPV #3, Hib #3, PCV #3, Hep B #3, Rota #3, Influenza (during flu season)
1 Year MMR #1, Varicella, Hep A #1, Influenza (during flu season)
15-18 Months DtaP #4, Hib #4, PCV #4, Hep A #2 (6 months after first dose), Influenza (during flu season)
4-6 Years DtaP #5, IPV #4, MMR #2, Varicella #2, Influenza (during flu season)
Source: Centers for Disease Control and Prevention.
"What alarms me is that there are a lot of parents that don't immunize, then they take kids to libraries or baseball and functions where there's lots of children," Piehowicz said. "It's dangerous for their child and it's dangerous for other kids."
As of May 31, 411 mumps cases were reported in Ohio by the state's health department, alongside 239 measles cases.
Though none of the cases came from Washington County, the Ohio Health Department has been urging parents to update immunizations as summer approaches and children go off to new camps and attend parties and get-togethers.
"Activities that bring large groups of people together can accelerate the spread of these diseases," said ODH State Epidemiologist Dr. Mary DiOrio in a press release.
Ohio currently has the standard requirements in place for kindergarten through 18-year-olds, like the regular MMR, tetanus and polio vaccines.
Sharon Gregory, the administrator for Child of Wonder Daycare in Vincent, said she thinks parents still ought to have the freedom to decide when a child is at that young of an age.
"Kids are going in and getting five or so shots at a time," she said. "They say there is no risk, but when you're giving them that many, how do you know that won't hurt them?"
The bill, if passed, would require the CDC's recommended series of shots for children that fall in the regular preschool and daycare age groups, including Hep A and B, MMR, the pertussis and chickenpox vaccines and the Hib-or influenza type B-vaccines.
"I always encourage people to keep shots up to date, but this bill would further that," Piehowicz said.
Gregory said with so many children constantly getting sick, having them all immunized will not completely solve the problem.
"I've seen kids with chickenpox vaccines that still get chickenpox, and my own daughter got measles before she was even old enough to be immunized," she said. "And we have had kids here that have had bad reactions, and you never really know what will happen to them."
Piehowicz said it is the recent trend of research and fear rhetoric about the possibility of a children developing autism from vaccines that contributes to outbreaks.
"We serve up to 64 children at one time, and when you're around that many children, and they share all the toys, as much as we clean and sanitize, they share the germs," said Amy Beardmore, director of the Evergreen Child Development Center at Washington State Community College. "So many things children get are preventable, and I am a strong believer that it can help."
According to the 2012 National Immunization Survey, 66.8 percent of Ohio's 19 to 35-month olds received the full series of early childhood vaccinations, which is 2 percent below the national average.
"We have had one or two families at the most at one time that have refused immunization, due to certain beliefs, and we have some that got all but the MMR, and they said there could be risk down the line," Beardmore said.
Piehowicz said that except for the highly publicized flu season, there is not one particular time that an outbreak of any kind could occur, but wintertime and during the school year are typically considered periods of higher risk.
"You have the heat on, and bacteria is growing, and little ones are always putting things in their mouths," she said.
Gregory said her own daughter, who has a 10-month-old, is one of the reasons she believes parents should have a choice.
"Who is the government to say you have to do it?" she said. "We give birth to our children, not them."
Brittany Sampson, administrator at Little Steps Childcare Center in Waterford, said the center highly recommends Pre-kindergarten vaccinations, and does not tend to see much of an issue with parents who are reluctant to do so.
"I've only had one case with a family for religious reasons in three years," Sampson said. "We still let them come, but they did write a letter explaining their reasoning."
House Bill 536 does still allow children to be exempt for medical or religious reasons, and would also mean that a line would be included in any application for child care to write in immunization records and a physician's sign-off.
Sampson said her center serves children from birth to age 12, which makes the immunizations even more crucial.
"This would reduce the risk, especially if you're too young," she said. "Those kids don't have a choice, so if you can vaccinate the ones that can that protects everyone."