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Philadelphia To Ask Court To Mandate Measles Vaccinations

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for Preschoolers Philadelphia city officials last week said they would seek court orders requiring measles vaccinations for some half dozen preschool children whose families belong to churches that shun medical treatment.

The Feb. 26 decision followed the deaths of eight young measles victims--four of them children whose families are members of the Faith Tabernacle Congregation and a fifth whose family attends an affiliated congregation, the First Century Gospel Church.

Since November, the city has battled a measles outbreak that included some 560 cases in January and February alone, health officials said.

The outbreak forced the closing of the Faith Tabernacle Congregation school--which enrolls some 200 students in grades 1 through 12--for more than a week and of the First Century Gospel school--which has about 150 students in grades 1 through 10--for a day, said Dr. Robert Ross, the city's deputy health commissioner.

When the health department learned that children at the schools were not being immunized, they obtained court orders to visit their homes and remove sick children for treatment. Doctors examined 470 children from the two congregations, and took four for medical care, all of whom survived.

By the time city health officials discovered the disease within the two congregations, immunizing school-age children was a "moot point," Dr. Ross said. Yet, "approximately a half dozen" preschoolers who probably have not been exposed "would indeed benefit from measles vaccine," he said.

"In order to protect these children as best we could, we would want to minimize the danger [despite] the religious objections of the families," Dr. Ross said.

The city's effort to require immunizations will be "a tougher row to hoe" than the first legal effort, Dr. Ross said. "This is a much different story."

Dr. Ross noted that the churches and families have been advised to retain legal counsel.

Officials expressed hopes for court action before the end of this week.

Robert Levenson, who directs the division of disease control in the city's public health department,4pointed out that 353 of the measles cases thus far this year have involved members of the two churches. The multi-racial, mostly middle-class congregations are free-standing churches that cite biblical passages as authority for not seeking medical aid, he said.

City sources reported that about 190 children in the Philadelphia public schools have not, for religious reasons, been immunized.

Of the 120,000 to 150,000 Philadelphia preschoolers there are "thousands" unimmunized and "every bit as much at risk," Mr. Levenson said.

In regard to the two churches, the assumption "is that if the children develop measles, it by definition would be a life-threatening situation" because the parents would not seek medical assistance, he added.

Robert Snyder, a public-health adviser with federal Centers for Disease Control in Atlanta, said that only Mississippi and West Virginia do not allow religious or philosophical exceptions to immunization.

"Does the public weal ... have the right to impose requirements when an epidemic occurs?" he said. "Yes, basically the commonwealth or state has that authority because they are protecting the common good," he said.--ml & lsa

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