Approved Minutes of April 23, 2025

Browse Search

MINUTES ORANGE COUNTY BOARD OF HEALTH April 23, 2025 unvaccinated due to religious exemption. It is likely that this is where an outbreak will occur in NC. • To prepare for a potential measles outbreak, the Orange County Health Department is trying to be immediately available to provide MMR vaccines to any who want them. However, there are concerns about sustained funding due to the federal climate regarding public health. In response to Dr. Royce's question about vaccine stockpiles, Carla Julian, Public Health Nursing Director, said that there are some reserves at the state level in the event of an outbreak, while private supply is purchased by the Health Department based on demand. Dr. Pettigrew added that there is no guarantee of continued funding for vaccines at the state or federal level, including for vaccine reserves. • Dr. Pickett asked how one gets a religious exemption from a vaccine, to which Dr. Pettigrew explained that in NC only an attestation of religious objection is required to obtain a religious exemption, it does not need to be sanctioned by anyone, and it is not allowed to be reviewed. She added that medical exemptions to vaccination are more complex and require documentation from a medical provider. In response to Dr. Pickett's follow-up question, Dr. Pettigrew explained that no major religions have a blanket objection to vaccines, but there is a legal precedent allowing people to refuse treatment due to their religious beliefs. She added that some people may object to certain vaccines due to their ingredients—some vaccines were developed using fetal cells or use bovine/porcine ingredients — but that no religion she is aware of objects to vaccinations on principle. Dr. Pettigrew shared that the Children's Hospital Philadelphia Vaccine Education Center is a great resource for discussing religious objections to vaccines. She added that at UNC, they require anyone with a religious objection to a vaccine to specify which vaccine(s) they object to and why. • Dr. Jonnal observed that many people may reject vaccines due to misplaced fears about vaccines causing autism, and a religious exemption may serve as a convenient way to avoid vaccinations. Dr. Royce noted that if this is the case, understanding people's fears about autism and vaccination is critical to addressing the problem. Dr. Pettigrew shared that some of her colleagues are researching vaccine hesitancy, though their ongoing funding is not guaranteed. • In response to Dr. Crandell's question about targeting outreach to those who are not up to date on their MMR vaccines, Dr. Pettigrew explained that Orange County is doing well at reaching these populations, so it's harder to address gaps in vaccination. • Dr. Royce asked if certain groups may need to be revaccinated, to which Dr. Pettigrew explained that anyone born before 1957 is most likely naturally immune due to the pervasiveness of measles before the vaccine was introduced. She added that those who were vaccinated in the 1960s may need to be revaccinated as there was a live and a killed version of the vaccine being used then, and the killed vaccine proved less effective than the live version. However, Dr. Pettigrew said that she is most concerned about young children and their parents being influenced to forgo vaccination because of non- evidence-based information on social media. • Dr. Pickett mentioned that when she was growing up, they would have communicable disease parties (e.g., chicken pox parties, measles parties)to spread immunity. Dr. Pettigrew shared that some parents are doing this today instead of vaccinating. • Jean Phillips-Weiner, Board of Health Strategic Plan Manager, recommended reading the book On Immunity by Eula Biss to get more perspective on the concepts of vaccine hesitancy and how people think about illness and purity. • Dr. Pettigrew invited board members to attend the upcoming measles symposium on May 301h, 2025. S:\Managers Working Files\BOH\Agendas &Abstracts\2025 Agenda and Abstracts/ April Page 7