Mississippi ranks 50th in the nation in infant mortality, 50th in physical activity, 50th in heart disease deaths and 49th in overall health.
We in Tennessee rank only slightly better, prompting one of my public health colleagues to remark, “Thank God for Mississippi.”
Yet Mississippi does rank No. 1 on a health measure that matters greatly, as this year we in Shelby County battle the largest measles outbreak in the nation. Mississippi has a 99.7 percent vaccination rate for measles compared to the national median of 94.7 percent for children who enter kindergarten.
How can this be?
Well, it has to do with a law — a law that does not allow parents in Mississippi to send their children to school unless they have been vaccinated for measles even if they claim an exemption “due to personal and religious beliefs.”
Here is some background. Measles vaccinations are mandatory for all school-going children across the nation. However, parents can submit an exemption. While all states allow exemptions due to medical reasons, such as AIDS or an immune deficiency, states differ on allowing exemptions based on personal or religious beliefs. And this affects the vaccination rate.
In states like Washington, where the law was lax and only a signed document from a parent was required, nearly 25 percent of the parents in certain counties chose an exemption. When the bar was raised, requiring a signature from a health provider, the exemption rate dropped by a quarter. And in states where there is no exemption, such as Mississippi, the exemption rate due to personal and religious belief is nearly zero.
The personal beliefs issue seems to be used somewhat arbitrarily: Even as Mississippi does not allow personal beliefs to opt out of childhood vaccination, it does allow doctors to discriminate against gay people by refusing treatment.
As a society, we are at a crossroads. We are contending with a fundamental and even a constitutional question: How do we balance public health and safety (as in the case of the measles vaccine) and personal choice?
In Mississippi, a state Supreme Court came down on the side of public safety. “To the extent that (vaccines) may conflict with the religious belief of a parent, however sincerely entertained, the interests of the schoolchildren must prevail,” it found.
I say provide freedom but raise the bar. If a parent wants an exemption based on their beliefs, then they must home-school their children so as not to put others at risk, as the Mississippi measles exemption law does. I do not believe an individual’s personal choice trumps the public interest, especially when it comes to spreading disease.
Here’s why it matters: California had one of the most lax rules for vaccination exemptions, and thousands of parents filed petitions for exemptions each year. Then in 2014 a measles outbreak led to over 100 cases. And now California, like Mississippi, has a law not allowing vaccine exemptions for religious and personal beliefs.
It may not be every day that Mississippi can say it leads the nation. The state should be proud that it has not seen a single case of measles in the past two decades.