The head of the U.S. Food and Drug Administration is warning that states might “force the hand of the federal health agencies” if they continue to allow vaccine exemptions amid an ongoing measles outbreak.
FDA Commissioner Scott Gottlieb told CNN on Tuesday that the federal government might intervene if “certain states continue down the path that they're on.”
"Some states are engaging in such wide exemptions that they're creating the opportunity for outbreaks on a scale that is going to have national implications," Gottlieb warned.
An outbreak of the measles has torn through Washington state leading to a declaration of a public health emergency.
The outbreak has hit Clark County, which has been dubbed an anti-vaccination “hot spot,” especially hard. There have been 62 confirmed cases in the county as of Tuesday, predominately among those were are not immunized against the infection.
Washington is one of 17 states that allow “philosophical-belief” vaccine exemptions because of personal, moral or other beliefs, according to the National Conference of State Legislatures. The vast majority of states — 47 — allow parents to opt out of vaccines for religious reasons.
Nearly all states allow children to attend school even if they are not vaccinated, CNN noted.
An estimated 7 percent of students in Clark County were exempt from compulsory vaccines upon entering kindergarten by claiming personal or religious reasons in the 2017-2018 school year, according to state data.
Gottlieb said he is “deeply skeptical” of exemptions that are not for medical reasons.
He did not specify what kind of action the federal government could take against mandatory vaccine exemptions.
"You could mandate certain rules about what is and isn't permissible when it comes to allowing people to have exemptions," he told CNN.
Axios first reported on Gottlieb's criticism of "lax" vaccine laws.
Dr. Adam Ratner, director of the Division of Pediatric Infectious Diseases at Hassenfeld Children's Hospital at NYU Langone, described Gottlieb’s push against vaccine exemptions as “fantastic news.”
"I think some of the states may need that kind of push,” Ratner told CNN.
Others, such as pediatrician and California state Sen. Richard Pan (D), said federal intervention in state laws could cause legal trouble.
"Traditionally, school entry requirements have been the role of the states, so there might be a constitutional challenge if the federal government tried to mandate by law those school requirements," he said.
Some states themselves have been moving toward banning personal or philosophical vaccine exemptions.
A bill passed through the Washington state Health Care and Wellness Committee on Friday to ban exemptions for the vaccine against measles, mumps and rubella (MMR).
An additional bill proposed in the Washington state Senate would ban personal or philosophical exemptions for all school-required vaccines, not just MMR.
The Iowa state Senate rejected a bill Tuesday that would have prohibited health insurance providers and insurance companies from discriminating against people who refuse to get vaccinated.