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Public health officials and medical professionals testified Thursday against a state health department proposal that would weaken vaccination requirements at childcare centers for children and staff. 

The amendments are part of a proposed rule change by the state Department of Public Health and Human Services. Under the changes, children would be allowed to attend childcare facilities and daycares without vaccinations against polio, measles, diphtheria and other diseases if they receive a religious exemption based on a declaration of “religious belief, observance, or practice.”

The rule would also strike vaccine requirements for childcare facility staff and volunteers and discontinue the collection of immunization records and documentation for employees. 

Health department staff attorney Allison Drake said the rule change is designed to comply with Senate Bill 215, also known as the Religious Freedom Restoration Act, passed by the Legislature last year.

“The department proposes recognizing a religious exemption for a child attending a childcare program,” Drake said.

She added that the proposal to remove vaccine requirements and documentation for staff is intended to help reduce workforce recruitment challenges for childcare centers. 

No proponents spoke during Thursday’s public comment period. 

About a dozen people voiced opposition to the rule, including medical professionals, attorneys and parents who stressed the importance of vaccinations in preventing outbreaks of serious and deadly diseases among babies and children. Current and retired pediatricians urged the health department to consider that childcare facilities serve vulnerable young children who have not completed their scheduled immunizations, or may be unable to do so because they are immunocompromised. Public health advocates also testified about the impacts disease outbreaks could have on already strained childcare settings, communities and local economies.

“Licensed childcare settings have always been a safe zone for all kids, and Montana’s current childcare immunization requirements provide just that: safety and critical protection against 11 diseases,” said Lisa Casper, executive director of the Association of Montana Public Health Officials. “By adding non-medical exemptions and removing staff immunization requirements, the department is posing an incredible health risk within childcare settings on babies who have not yet completed their vaccine schedule and to children who are immunocompromised.”

Casper and other health experts, including practicing and retired pediatricians, said they understand the importance of accounting for specific religious exemptions, but stressed that broader exemptions undermine the goals of herd immunity, which Casper called “critical” for young children and licensed childcare facilities.

“By adding non-medical exemptions and removing staff immunization requirements, the department is posing an incredible health risk within childcare settings on babies who have not yet completed their vaccine schedule and to children who are immunocompromised.”

Lisa Casper, executive director of the Association of Montana Public Health Officials.

Nick Domitrovich, the state health department’s former acting chief legal counsel, who left his position in July 2021, also testified in opposition to the proposed rule, arguing that the religious exemption language is overly broad. 

“What we’re talking about isn’t an exemption based upon sincerely held religious beliefs,” Domitrovich said, but rather a “broad political exemption” to child care immunization.

“The state health department is throwing all of our babies out with the bathwater of an imaginary oppressed mass,” he continued. “This bad faith proposal undermines the goals and overall mission of this agency and undermines public trust in the agency’s ability to address the public health challenges of the day.”

Other opponents included Maria Wyrock, a prominent activist with Montanans for Vaccine Choice, which opposes vaccine mandates. She said the proposed rule change would improperly lump together a variety of daycare centers and childcare programs, creating more red tape for groups that fall outside the scope of licensed childcare facilities. But she clarified that she disagrees with the health care providers and public health advocates who testified before her about what counts as a religious exemption.

“I’m personally offended by every single person who thinks they know what my religious freedom is and can dictate what some organization or some religious group or clergy has said as the holy grail of religious freedom,” Wyrock said.

Other opponents included Martin Finnegan, a parent who said he typically opposes burdensome government regulation. In this case, he said, one person’s medical choices can significantly affect other members of the community.

“That is definitely not OK,” he said. “My kids could be in that same daycare, and you’re putting them at risk.”

The health department’s legal affairs office will accept public comment on the proposed changes by email and mail until 5:00 p.m. on Friday, Sept. 2. 

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Mara writes about health and human services stories happening in local communities, the Montana statehouse and the court system. She also produces the Shared State podcast in collaboration with MTPR and YPR. Before joining Montana Free Press, Mara worked in podcast and radio production at Slate and WNYC. She was born and raised in Helena, MT and graduated from Seattle University in 2016.