Shortsighted Tennessee law may mean fewer children will be protected by vaccines
Imagine. Your 9-month-old child has a high fever, rash, cough, and is lethargic. She develops meningitis and is admitted to intensive care, infected with measles. She became infected by a child, prohibited from receiving the MMR vaccine, because "Nana" was raising her. Impossible? In the near future maybe not!
In the United States, routine, tested and approved vaccinations have prevented about 2.5 million deaths per year . Polio and smallpox have been eliminated. Pertussis no longer kills one out of every 100 infants hospitalized with whooping cough. Haemophilus Influenza B no longer infects, kills or disables more than 10,000 children annually.
However, due to the COVID pandemic Tennessee’s children’s immunization rate declined up to 26%. In 2021, the number of children receiving no immunizations increased approximately five-fold. To date, multiple “catch-up” vaccinations have not occurred.
On May 17, Gov. Bill Lee signed into law — effective immediately — the Mature Minor Doctrine Clarification Act . Now only birth parents (in most instances) may consent for a child less than 18 years of age to receive immunizations. Consequently, Tennessee’s children and communities may now become more vulnerable to vaccine-preventable disease.
More: How new 'informed consent' law is complicating vaccines for children in Tennessee
What happens to the child when the birth parent is not available?
Under the due process clause of the 14th Amendment to the Constitution of the United States, courts have upheld the rights of parents to raise their children as they see fit .
Protecting parents’ rights is appropriate and reasonable. However, the Mature Minor Doctrine Clarification Act allows little exception when a birth parent is not available. In fact, the Tennessee Department of Children's Services’ agents and employees may only provide consent for foster children if parental rights have been terminated. Otherwise, a judge, not a medical professional, must decide if vaccines are appropriate.
Shortsightedly, Tennessee legislators have failed Tennessee’s children by not recognizing and considering the reality Tennessee’s families face today. Many children live in single- or split-parent homes. Due to employment or illness, a birth parent often cannot take the child to the health care provider.
At the parent’s request the child frequently comes in with another family member. Frequently, grandparents, great-grandparents, or foster parents are raising children. The restrictive language of this law may delay timely immunization. Tennessee’s children will become susceptible to catching preventable and deadly disease.
This law will impact the daily care and education of Tennessee’s children. State law requires full immunization by 18 months to attend a licensed day care. All childhood vaccines must be current before the first day in Kindergarten unless certain exemptions apply (i.e., vaccine allergy). Students entering seventh grade must also update their Tetanus.
Non-vaccinated children create education and child-care challenges
According to EducationWeek, many children are reading below grade level as school systems suspended all or part of in-person learning during COVID. Marginalized communities (Black and brown, rural, and inner-city populations) and younger grades are at risk for greater negative impact and will demonstrate poorer outcomes.
When law and policy delay children’s vaccinations, working parents will struggle to find and retain affordable childcare. Under-immunization may delay entrance into kindergarten or seventh grade. Tennessee, currently 33rd in the nation, will fall further behind in education. The implications affect Tennessee’s current and future generations; life-long earning potential, career choice, and standard of living will decline significantly.
As a certified pediatric nurse practitioner for 35 years, I have personally witnessed vaccines improving children’s health. I am deeply concerned that Tennessee’s legislators did not consider the impact of this law on our children’s health and our communities’ economic stability. In the post-COVID era, public health should be bipartisan, and not subject to the politicization that the 74-25 vote, split mostly along party lines, represented. Tennessee must do more.
Four things that need to happen now on the vaccination front
Legislators should immediately amend the Mature Minor Doctrine Clarification Act to allow caregivers with medical powers of attorney, temporary guardianships or en loco parentis attestations to consent to immunization.
Tennessee Department of Health should promptly propagate the regulations in concert with health care providers, clearly and succinctly defining the content, scope, and frequency of vaccination consent.
The Departments of Health and of Education should rapidly address how to ensure childcare and education for children whose vaccines are delayed by this law.
Parents and caregivers please be patient with health care providers as we navigate this landscape and partner with you to ensure your child receives vaccinations that you want them to receive. Together, we are better than this, and must ensure our children’s health does not fall victim to any further partisan politics.
Laurice McCord is a certified pediatric nurse practitioner in Union County, Tenn.
This article originally appeared on Nashville Tennessean: Vaccines: Shortsighted law may mean more Tennessee kids are at risk
