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A dose of the measles-mumps-rubella, or MMR, vaccine. (Damian Dovarganes / AP)

As pediatricians, we have seen the benefit of immunization: the elimination of once-common diseases [“It’s time to end all debate on vaccines,” Opinion, Feb. 5]. Every day, we counsel parents about vaccines. We know they want to do what is best for their child. So do we. Most parents accept immunization, but not all. Un-immunized children can acquire and transmit measles — igniting outbreaks and endangering our community.

The public conversation spurred by the current measles outbreak suggests this risk is no longer tolerable. HB 2009 proposes eliminating personal belief exemptions from school immunization requirements. Will this increase immunization rates? Perhaps, but marginally. But it is very likely to channel those who want to avoid immunization to claim religious exemption. If we are serious about reducing the risk of outbreaks, we must allow only valid medical exemptions to measles immunization.

Here’s why: First, Mississippi, which allows only valid medical exemptions, has achieved the highest kindergarten immunization rates. Second, the overall immunization rates of states that allow religious exemptions are not substantially different from states that permit personal belief exemptions. Third, few organized religions oppose immunization.

Most important, the measles vaccine is very safe and very effective, but uptake needs to be more than 90 percent to prevent outbreaks. Concerns about this vaccine’s safety are based on misinformation. The spurious association with autism has been debunked.

We hold dear both freedom of choice and public health. Finding an optimal balance is difficult. We believe removing personal belief exemptions from all school immunization requirements would not strike that balance. Removing personal belief and religious exemptions from requirements for measles immunization does. Protecting public heath must trump personal choice when others are put at risk. We believe such risk now exists for measles in Washington state.

Dr. Edgar K. Marcuse
Dr. Douglas S. Diekema
Dr. Douglas J. Opel