State Board of Health rejects numerous attempts to change quarantine, vaccine rules

Efforts to change the powers and authority of local health officers, how quarantine works and what kinds of vaccines can be required in schools all failed to gain support from the Washington Board of Health at their meeting this week.

Washington residents submitted seven rule petitions, alleging that parts of the state law and rules the Board of Health have approved in the past to follow those laws are unconstitutional or violate people’s rights.

The Board of Health is required to accept or deny each petition but does not have to hold specific public comment or hearings about each one.

During the public comment period of the meeting, dozens of Washington residents spoke in support of the petitions, adding to the more than 10,000 pages of public comments the Board received ahead of their Wednesday meeting.

The Board of Health unanimously rejected all seven petitions, however.

Three petitions challenged the parts of Washington state law that give health officers the power to quarantine individuals with infectious diseases, a sometimes necessary action health officers take to protect the public from very contagious and potentially fatal diseases like tuberculosis and measles.

Board members who are currently health officers or have worked in public health said that state law and rules as written provide both due process rights to people asked to quarantine, as well as specific directions to a health officer on how to ask a person to quarantine if necessary.

Local health officers do not regularly quarantine or isolate individuals, but when they do it’s to prevent infectious diseases from spreading.

Board member Patty Hayes, the former director of King County Public Health, said that in her experience it was necessary to work with an individual with TB to prevent them from spreading it further into the community. If a person would not cooperate and take their medications, they put the community at risk because the TB could turn into the type that resists antibiotics and therefore pose an even greater threat to the community.

State law allows for due process in these cases, and a health officer must seek a court order before forcibly making a person quarantine. But most times, a person will voluntarily comply with public health officials.

If a person wants to challenge that court-ordered quarantine, they are given legal representation, as prescribed in state law.

Another set of rule petitions asked the Board of Health to modify their rules by requiring a health officer to get their local boards of health’s approval before making any public health decisions. Local boards of health have the ability to hire and fire health officers under state law, and on Wednesday, the Board agreed that this is enough oversight for that relationship.

“I also have concerns that the petition is unnecessary and harmful: unnecessary because local boards of health already oversee the work of the health officer, and I am also concerned that what the petition proposes would inhibit the timeliness a health officer needs to implement public health intervention,” said Dr. Tao Kwan-Gett, chief science officer at the Department of Health.

A third rule petition repeated a similar request the Board took up earlier this year, asking them to not approve any medication or injection for requirement to attend public schools in Washington if it’s under emergency use authorization and not fully approved. This rule petition is aimed at ensuring the Board does not approve the COVID-19 vaccination for children at child care centers and schools next year.

Currently, the Pfizer vaccine has been fully approved for everyone 16 and older. For those under 16, the vaccine is under emergency use authorization.

The Board rejected this petition as well, noting that there is an accountability process in place with an independent advisory group receiving scientific evidence and making a recommendation to the Board, as well as the potential for future public health emergencies when an immunization approved for emergency use might be important to require for children and teens.

Earlier this month, the technical advisory group did not recommend the Board add the COVID-19 vaccine to the list of required vaccines for school entry. The Board of Health will consider the group’s recommendation and make a decision about adding the COVID-19 vaccine to the list of required vaccines for students in Washington at its April meeting.

The increase of rule petitions this year reflects the broader public sentiment toward pandemic protocols, including parts of state law that have been there for decades but only recently gotten attention.

Snohomish County Health Officer Chris Spitters told the Board of Health that he never had used his emergency public health authority until the pandemic began in 2020.

Keith Grellner, the chair of the Board of Health, said the Washington state laws and rules being challenged by petitions are why the state has seen hardly any outbreaks of viruses and diseases in recent decades.

“We enjoy for the most part health and healthiness that wasn’t available to others, to our predecessors back in the ’80s, ’50s and ’20s, when these rules weren’t on the books,” he told The Spokesman-Review earlier this month. “Our communities suffered needless and preventable illness and death we don’t experience today, and it’s because of these rules.”

Ultimately, the tension between an individual’s constitutional rights and public health are highlighted in many of the petitions filed this year, and it’s a balancing act, Grellner said, adding that there is always nuance to those discussions but ultimately public health is the mission of the Board.

“An individual may have the right to willingly or purposely become infected, and we’ve heard of that in the past with chickenpox or mumps parties,” he said. “But people don’t have the right to infect others, and that’s a very important nuance that I don’t think is well understood.”