Today, February 21, it’s “School Exclusion Day” in Oregon. As noted by the state’s Health Authority, “parents must provide schools, child care facilities with kids’ vaccine records”. If their “records on file show missing immunizations”, their “children will not be able to attend school or child care” from this date forth.

As spotted by Newsweek, today’s the day that, if you’re a child in Oregon and you don’t have a suite of vaccinations – including MMR, Polio, Hepatitis B, and more – you won’t be given an education, nor will you be allowed to risk the health and possibly lives of other schoolchildren. Similar enforecement initiatives are in operation in other states, from Texas to Illinois.

Authorities explained that, in 2017, nearly 30,000 letters were sent to parents and guardians letting them know their children’s inoculations weren’t up to date. Ultimately, 4,646 children were kept out of educational facilities until things changed – and the state is hoping this year will feature a decrease in said numbers.

There is a caveat here, though: vaccines in this regard aren’t entirely mandatory just yet, for both practical and morally defunct reasons. According to Oregonian state law, all children in any form of education, both public and private, preschools, and certified care facilities, must have up-to-date records or – and here’s the important bit – have an “exemption”.

Generally speaking, these exemptions are medically based. In very few cases, certain children with severe allergies, weakened immune systems, or so on cannot have certain vaccinations, but thanks to the principle of herd immunity, if everyone else is vaccinated, they remain essentially protected from the disease in question.

In some cases, nonmedical exemptions are also allowed for “personal, religious, or philosophical reasons”. Although these aren’t obtainable immediately upon request, they are given out – and according to a 2014 review on such matters, nonmedical exemptions are showing a rate increase across the nation.

“Most exemptors questioned vaccine safety, although some exempted out of convenience,” the study noted.

In 2016, one-in-10 children in communities all over the world weren’t given vaccines. A resurgence in anti-vaxxer sentiment – sometimes with the tacit support of certain government officials – in certain countries, along with a lack of resources and immunization coverage in others, has led to unnecessary headlines.

The World Health Organization (WHO) this week noted that Europe has seen a huge uptick in measles cases, something the MMR vaccine’s use should be stamping out. After a record low in 2016, 2017 has seen a four-fold increase, which the WHO, per BBC News, has referred to as a “tragedy”.

Largely in response to anti-vaxxer movements and unfounded vaccine distrust, governments around the world are introducing or expanding various forms of mandatory vaccination, from Australia to France to Italy. The focus is generally on school-aged children, and with that in mind, Oregon is no exception.

As aforementioned, the Beaver State isn’t quite alone in this sense: all 50 US states have legislation that requires a range of vaccines to be given to students, with details on exemptions varying from state to state. As of 2017, 18 states allow “philosophical exemptions” for those who wish not to vaccinate their children.

According to the WHO, immunization programs around the world prevent up to 3 million premature deaths every single year. Millions of children still require vaccinations, however, and most of them are in countries with “fragile humanitarian settings”.

Simply having access to vaccines in such communities is a significant problem, but not in wealthy nations, where rejection is often a personal choice, not one borne out of access. Those seeking philosophical exemptions, then, clearly lack a grasp of how fortunate their circumstances are.