I support L.D. 798, the proposed legislation to repeal philosophical exemptions for vaccination.

Funding for public health services, including vaccination, has declined since the 1980s. Programs that deliver vaccines and consumer information about them have not kept up with the changing situation. In 2019, vaccination rates have declined, distrust in programs has risen and there are an estimated 10 million immunocompromised people in the U.S. We have outbreaks of preventable diseases, combined with more vulnerable people who would fare poorly if exposed.

However, to continuously balance the trade-offs between community safety and individual rights, we must:

• Fund health care provider education about medical exceptions. The Maine Medical Association and Center for Disease Control and Prevention and national bodies such as the U.S. CDC must collaborate to clearly define exceptions, including the category of immunocompromised persons.

• Commit funding to implement effective social marketing campaigns that promote vaccines for physicians, parents and children. These must be professional, innovative and ongoing.

Public health at all levels has ceased providing the type of advocacy that is required to maintain vaccine coverage. Just as Pepsi and Coca-Cola continue advertising, so, too, social marketing of effective health programs must spread the message about what can be done and how to do it, including the risks.

• Monitor and evaluate vaccines in collaboration with the Maine CDC, the U.S. CDC and the Food and Drug Administration, which collect reports about vaccine adverse events and side effects from professionals and the public. The trust of the community and providers will be gained by ongoing efforts to collect current information and to approach these ongoing concerns with vigor.

We must act to address the years-long reduction in vaccination and the appearance of predicted outbreaks. Vaccines can save countless lives in the future, but the entire health care system must be part of the effort to realize this goal.

Sharon McDonnell