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Momentum grows for closing gaps in US vaccine requirements

HARTFORD, Conn. — A law adopted this week in Connecticut adds momentum to the push to strengthen vaccination requirements for schoolchildren, but efforts to give families more leeway are brewing in statehouses around the country in debates that go back more than a century.

The arguments over mandates, and when to allow exceptions, are expected to become more heated as authorities decide what expectations should be for COVID-19 vaccinations once they are approved for young children.

Religious exemptions like the one eliminated by Connecticut’s new law are facing particular scrutiny amid fears of new measles outbreaks and concerns the growing number of families claiming religious exemptions for their children are opposed because of scientifically discredited claims about the dangers of vaccines. Leaders of Islam, Judaism and major Christian denominations say vaccination is consistent with their belief systems.

“The truth is there is no major religion that prohibits vaccinations,” said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine. “The argument has really very little to do with religion and everything to do with the anti-vaccine, vaccine-choice movement.”

Proposals to expand or limit immunization exemptions pop up every year in state legislatures, although it’s rare for any to win passage. Nationwide, the National Conference of State Legislatures (NCSL) is tracking about 270 bills related to childhood immunizations.

They include a bill in West Virginia, one of the six states that ended religious exemptions, to allow students with “conscientious or personal” objections to opt out. A bill in Minnesota would add religious reasons to existing exemptions, and Vermont lawmakers have proposed a bill to end the state’s religious exemption.

The debates often do not break down along traditional political divides, according to Robert Bednarczyk, a professor at Emory University’s Rollins School of Public Health.

“I do think when you see vaccine refusal, it really does run across the population,” he said. “Regardless of the reason, the endpoint is always the same. It’s children that are being left unprotected from infectious diseases.”

For as long as there have been vaccination requirements, there has been pushback.

In Massachusetts, a Lutheran minister in 1902 refused to comply with a mandate by the Cambridge Board of Health for all adults to get smallpox vaccinations. The U.S. Supreme Court in 1905 upheld the state’s mandatory policy, and in 1922 upheld a school system’s power to refuse admission to students who failed to heed a vaccination order.

Gradually, statewide vaccination mandates took hold in every state. In 1966, however, as New York lawmakers were considering a vaccination requirement for schoolchildren, it became the first state to include a religious exemption in its law. Christian Scientists were among the main advocates of the exemption, arguing that the requirement violated their belief in prayer rather than medical treatment.

Other states followed New York’s example; before long there were only two states that didn’t provide a religious exemption. Some state laws said the exemptions could be claimed only by people who belonged to an organized or established religion. Other policies were looser, allowing a child to be exempt based on the individual family’s religious beliefs.

In recent years, the momentum has shifted. California decided in 2015 to get rid of its religious exemption following a measles outbreak in Disneyland. Maine and New York have taken similar steps, joining West Virginia and Mississippi. Connecticut Gov. Ned Lamont, a Democrat, signed his state’s new law eliminating the religious exemption on Wednesday.

Forty-four states and the District of Columbia currently allow religious exemptions to immunizations, while 15 states also permit philosophical exemptions for children whose parents object due to personal, moral or other beliefs, according to the NCSL.

A spokeswoman for the Christian Science church in Connecticut, Linda Ross, testified against the measure that scrapped the state’s exemption. She suggested the exemption could be left in place, but with stricter policies allowed temporarily for schools with worrisomely low vaccination rates.

“Christian Scientists don’t view vaccination as something to fear or get out of, but generally prefer the greater sense of health, protection and well-being they find through their Bible-based religious practice,” she said in written testimony.

Two groups that oppose the new Connecticut law are planning to challenge it in court.

“The notion that somehow the state government gets the right to cram its version of virtue down the throats of every citizen in this state is and ought to be offensive to every Connecticut resident,” said Norm Pattis, an attorney representing the organizations.

The pandemic is having an influence on the vaccine debate. In Kentucky, which already has religious and other exemptions to childhood vaccinations, state lawmakers approved a bill that would bar health officials during pandemics from requiring vaccinations for the pandemic diseases. The legislation was signed by the governor in March.

Kentucky state Sen. Mike Wilson, a Republican from Bowling Green who sponsored the bill, said his office received many phone calls and emails from constituents who were leery of the COVID-19 vaccines and didn’t want state officials to order them to get vaccinated.

“It’s enough to make you stop and say, ‘You know what? We have exemptions for other areas. We don’t have one for this,’” Wilson said. “They don’t want to be mandated to take it.”

Bednarczyk said discussions around coronavirus vaccinations for children likely will follow familiar contours.

“I don’t think it’s necessarily going to be a different set of issues or circumstances,” he said. “But I think that it probably will get a lot more attention because everything around COVD-19 has garnered more attention.”

WV records 7 new COVID-19 deaths Sunday; vaccine clinics planned at local senior centers

CHARLESTON — Seven new COVID-19 deaths were reported by the West Virginia Department of Health and Human Resources on Sunday, raising the statewide total to 2,686.

DHHR has confirmed the deaths of a 73-year old female from Pocahontas County, a 93-year old male from Jackson County, a 70-year-old male from Lincoln County, a 76-year-old female from Nicholas County, a 77-year-old male from Logan County, a 63-year-old female from Marion County and a 67-year-old female from Brooke County.

“The length of this pandemic may cause some of us to grow weary of continued prevention practices. But for all families who have lost a loved one, each day it continues bears a painful reminder of someone loved who was lost,” said Bill J. Crouch, DHHR Cabinet Secretary. “We must stop COVID-19 by working toward increased vaccination for community immunity in West Virginia.”

COVID-19 vaccination clinics will take place at the Underwood Senior Center, 632 9th Ave. in Huntington, from noon to 2 p.m. Monday, May 3; the Marie Redd Senior Center, 1750 9th Ave. in Huntington, from noon to 2 p.m. Tuesday, May 4; the Salt Rock Senior Center, 5490 W.Va. 10 in Salt Rock, from 1:30-3:30 p.m. Wednesday, May 5; and at the Milton Senior Center, 1032 Church St. in Milton, from noon to 2 p.m. Monday, May 10.

Anyone in need of transportation can call 304-529-4952.

There have been 2,735,731 total confirmatory laboratory results received for COVID-19, with 153,918 total cases, according to DHHR.

Cases per county: Barbour (1,411), Berkeley (12,122), Boone (1,965), Braxton (898), Brooke (2,169), Cabell (8,595), Calhoun (284), Clay (473), Doddridge (573), Fayette (3,375), Gilmer (791), Grant (1,266), Greenbrier (2,748), Hampshire (1,765), Hancock (2,761), Hardy (1,501), Harrison (5,591), Jackson (2,021), Jefferson (4,526), Kanawha (14,657), Lewis (1,157), Lincoln (1,443), Logan (3,034), Marion (4,322), Marshall (3,374), Mason (1,983), McDowell (1,545), Mercer (4,722), Mineral (2,817), Mingo (2,510), Monongalia (9,115), Monroe (1,112), Morgan (1,137), Nicholas (1,592), Ohio (4,141), Pendleton (698), Pleasants (857), Pocahontas (661), Preston (2,846), Putnam (5,025), Raleigh (6,626), Randolph (2,531), Ritchie (691), Roane (602), Summers (801), Taylor (1,212), Tucker (523), Tyler (687), Upshur (1,843), Wayne (3,009), Webster (471), Wetzel (1,284), Wirt (406), Wood (7,687), Wyoming (1,962).

As of Sunday, Kentucky reported 368 new COVID-19 cases for a total of 445,139, along with three new deaths.

In Ohio, there are 903,229 confirmed cases of COVID-19 as of Sunday.

After a year of canceled shows, HHS theater seniors give final production their all

HUNTINGTON — Huntington High School’s theater students gave it their all one last time in 2021 as they presented their Senior Showcase over four days.

“Because of COVID-19, this year has been all over the place. So, for this year’s Musical, the seniors have decided to put on a production to match the energy!” explained Huntington High theater teacher Helen Freeman in an email. “They have made a production of their own creation, pulling pieces from all sorts of popular plots.”

Freeman said COVID-19 had made the 2020-21 school year rough for everyone, especially the seniors, who had their proms canceled and extracurricular activities restricted. Since last spring, multiple shows have been canceled, making the Senior Showcase especially captivating, Freeman said.

Performances began April 29, with the final show on Sunday afternoon at the high school.

Employers, insurers push to make virtual visits regular care

Make telemedicine your first choice for most doctor visits. That’s the message some U.S. employers and insurers are sending with a new wave of care options.

Amazon and several insurers have started or expanded virtual-first care plans to get people to use telemedicine routinely, even for planned visits like annual checkups. They’re trying to make it easier for patients to connect with regular help by using remote care that grew explosively during the COVID-19 pandemic.

Advocates say this can keep patients healthy and out of expensive hospitals, which makes insurers and employers that pay most of the bill happy.

But some doctors worry that it might create an overreliance on virtual visits.

“There is a lot lost when there is no personal touch, at least once in a while,” said Dr. Andrew Carroll, an Arizona-based family doctor and board member of the American Academy of Family Physicians.

Telemedicine involves seeing a doctor or nurse from afar, often through a secure video connection. It has been around for years and was growing even before the pandemic. But patients often had a tough time connecting with a regular doctor who knew them.

Virtual-first primary care attempts to smooth that complication.

The particulars of these programs can vary, but the basic idea is to give people regular access to a care team that knows them. That team may include a doctor, nurse or physician assistant, who may not be in the same state as the patient. Patients can also message or email the caregivers with a quick question in addition to connecting on a video call.

People who choose this option may have to give up a doctor they’ve been seeing in person. They also will need a smartphone, tablet or computer paired with a fast internet hookup.

The goal of the virtual-first approach is to make patients feel more connected to their health and less reliant on Google searches for advice or the nearest urgent care center to treat something minor.

“We have a large portion of the population that is avoiding going to a primary care doctor because they don’t have time or they think they can’t afford it, even though its generally covered under their benefits,” said Arielle Trzcinski, a health care analyst with Forrester who works with insurers.

Amazon Care pairs patients with a regular care team and in some markets also sends providers like nurses to them if they need in-person care. The retailer developed the program for its employees but said in March that it would expand it to other employers nationwide.

Insurers like Oscar Health, UnitedHealthcare and Kaiser Permanente also have started or expanded virtual-first care plans this year. Priority Health in Michigan began selling a plan for people without employer-sponsored coverage after the insurer noticed that customers weren’t visiting doctors as much as they expected.

A vice president, Carrie Kincaid, said Priority Health found that some customers didn’t have time to leave work for appointments. Another group, early retirees, travels frequently and isn’t able to make it back to Michigan for in-person visits.

She said the new plan, run with virtual care provider Doctor on Demand, blew past enrollment projections and had more than 5,000 people signed up on the first day.

“When members get exposed to virtual care in general, they really, really like it,” she said.

Wendy Katje signed up for a Priority Health virtual-first primary care plan by accident online, but she plans to stick with it.

The 60-year-old multiple sclerosis patient said the doctor she got through the program has helped adjust her cholesterol medications and made sure she stays connected with a neurologist she usually sees in person.

Katje said the virtual-first approach makes sense during the pandemic, when she wants to avoid waiting rooms.

“It’s not quite as personal as sitting in an office with someone, but for what I’ve needed to have done it was perfectly adequate,” the Otsego, Michigan, resident said.

Walter Woodberry, of Albuquerque, New Mexico, signed up for a virtual-first plan through his employer, ABF Freight, after he tried telehealth and grew used to its convenience.

He said he doesn’t have to leave work early for an appointment, and he feels more comfortable giving medical information to someone who knows him.

“I’m not trying to schedule my life around a doctor’s appointment,” he said.

Consumers have grown used to shopping for clothes, gifts or groceries online. But Carroll, the family physician, noted that patients sometimes need an in-person visit.

He said he once had a patient diagnosed virtually with pink eye. In person, Carroll could see that the patient actually had a form of glaucoma and was in danger of blindness.

Doctors are still sorting out what can be treated virtually and what demands in-person care. These new plans generally reserve those visits for emergencies or if the doctor or patient requests them.

Virtual-first proponents say they aren’t trying to eliminate in-person visits. They are focused on improving health.

Patients are more likely to follow a doctor’s orders, get laboratory tests or take prescribed medicine when they receive care from someone they’ve gotten to know and trust, said Doctor on Demand CEO Hill Ferguson.

“That’s what we need to get back to in this country,” he said.

Stanford University’s Dr. Megan Mahoney estimates that about half of primary care visits can be done virtually, depending on whether insurers and other payers reimburse for the care.

The family physician says her practice still does 30% to 40% of its visits virtually, months after reopening its offices. The pandemic has changed how patients view care, she said.

“We had made assumptions about consumers’ willingness to adopt telehealth, yet we see 89-year-olds who are on video visits with their providers every other week with no problem now,” she said.