Steven Michaud, president of the Maine Hospital Assn., speaks at a news conference with doctors opposed to Question 1, the religious and philosophical exemptions referendum on vaccinations, at the State House, Tuesday, Feb. 4, 2020, in August, Maine. Credit: Robert F. Bukaty | AP

I have become increasingly concerned over the past several weeks that there remains widespread confusion over Question 1, which seeks to overturn the recently passed Maine law that eliminates religious and philosophical exemptions from vaccination requirements for K-12 and college students, and employees of nursery schools and healthcare facilities. I have also been alarmed by the misinformation and misleading statements being made in campaign literature, in public comments, and by telephone canvassers. Regardless of one’s position on Question 1, I would hope that there is universal agreement that all voters deserve accurate information to help them better understand this important issue before casting their vote.

There are two major misconceptions surrounding Question 1. The first is that a “Yes” vote is somehow a vote against “Big Pharma,” the large pharmaceutical corporations that manufacture prescription and non-prescription drugs and vaccines. Whether or not one believes that prescription drug costs are excessive, or that large drug manufacturers and other larger corporations have too much influence in our political system, this has nothing at all to do with either LD 798 or the choice that Question 1 presents. Vaccine recommendations are driven by independent expert public health consensus, in this country formulated primarily by the Centers for Disease Control and Prevention, and globally by the World Health Organization. Pharmaceutical companies develop and manufacture vaccines in response to those recommendations, not the converse, as is being misleadingly implied by supporters of “Yes” on Question 1.

LD 798 was enacted based on two facts, which are beyond question: First, that the resurgence of serious vaccine-preventable diseases such as measles and pertussis, which we are now witnessing in this country and around the world, is being driven by increasing rates of voluntary vaccine refusal, itself driven largely by continually repeated misinformation.

Second, that the most vulnerable children and adults, who are unable to be vaccinated because of weakened immune systems from underlying illness or treatment, are dependent for their protection on maintaining high levels of immunity in their communities. For example, a healthy unvaccinated child who becomes infected with measles following exposure during travel, and who unknowingly attends school in the early stages of infection, the symptoms of which can mimic a common cold, will almost certainly transmit infection to every susceptible child or adult sharing a classroom, a cafeteria, an assembly or a hallway, even if briefly, as measles is among the most contagious of infectious agents, and is transmitted widely through the airborne route. Measles can be a serious illness even in healthy individuals, but an immunocompromised child or adult with measles virus infection is at high risk of severe illness and death. Vaccination clearly has not only personal health consequences, but is a critical act of social responsibility.

The second major misconception is that the law forces individuals and parents to accept vaccinations that they do not want for themselves or their children. This is clearly not the case. Any individual continues to have the right to decline vaccination for themselves or their children, regardless of the universal recommendations of the medical and scientific community. But exercising this right comes with a fundamental

social responsibility, to not endanger others by one’s personal decisions. The law ensures this by excluding those who make this choice, without a medical exemption, from attending schools or daycare. This is precisely the issue behind the law, and the choice in Question 1.

A “Yes” vote on Question 1 is a vote to permit those who choose to decline vaccination, or children whose parents decline vaccination for them, to attend schools and daycare. A “No” vote is a vote to ensure the safety of the most vulnerable members of our community, without infringing on the personal rights of anyone to decline vaccination if they so choose.

Robert L. Pinsky is a hospital epidemiologist and chairman of the Infection Prevention and Control Committee at Northern Light Eastern Maine Medical Center.