It’s been a while since I’ve written about the situation regarding school vaccine mandates here in my state of Michigan. Indeed, the last time I wrote about antivax activism leading to attempts to pass legislation that dilute or eliminate school vaccine mandates was in 2017, when I discussed how antivaxxers were working to “make measles great again.” Basically, the bills considered by the Michigan legislature in 2017 were similar to bills considered two years earlier. Since 2017, I also noted that the 2018 GOP primaries for state offices were rife with antivax misinformation disguised as standing up for “freedom” and “parental rights,” with my US Congressional district’s local Republican Party holding an antivax roundtable that I attended incognito. At the time, I also noted that my then-state senator, Patrick Colbeck, was a rabid antivax conspiracy theorist who was running for governor at the time. (Thankfully, he was crushed in the GOP primary.) Depressingly, my state representative at the time, Jeff Noble, while not quite fully antivax, was very friendly to antivax claims dressed up as being about “medical freedom” and “parental rights.” Other attendees included two nurses, a NICU nurse and a nurse practitioner, who were very antivax, as well as a father who thought that vaccines caused all of his children to be autistic and had been featured on one of the many YouTube videos produced by the crew behind the antivax propaganda “documentaries” in the VAXXED series.
I mention all this because, believe it or not, Michigan has—or at least had, until recently (which is the topic of this post)—one of the most stringent and effective school vaccine mandates possible while still permitting nonmedical “personal belief” exemptions. In brief, the Michigan Department of Health and Human Services (MDHHS) requires that parents seeking a personal belief exemption to the school vaccine mandate go to their local county health office and listen to an educational presentation before they can have the exemption. Parents must also use a specific form to claim the exemption. Writing a letter or an email or just telling the school is not enough. Antivaxxers absolutely hate this requirement, as you might imagine. At the very minimum they call it “making parents jump through all kinds of hoops,” to which I always respond: Good! At the very minimum, parents should be required to jump through all kinds of hoops before being allowed to endanger other children by leaving their child unvaccinated! I won’t go into detail about how this requirement came about. For that, you can read this post. Suffice to say that antivaxxers have long claimed that this rule was slipped past the legislature in a sneaky fashion—and illegally, of course—even as its legality has been upheld time and time again.
Unfortunately this week, two developments have been reported that will undermine school vaccine mandates in Michigan. The first involves, in essence, making the requirement described above so weak as to be meaningless. The second involves making it easier for parents to opt out of the Michigan Care Improvement Registry, commonly known as MCIR, which maintains a vaccination database listing who has received which vaccine and when.
Let’s start with the requirements needed to claim a vaccine mandate.
Going backwards on vaccine mandates
Earlier this month, NPR published a story reported by KFF Health News, Michigan found a way to reduce school vaccine waivers. Until it backfired. Personally, I would like to have a word with the editor who came up with this headline, because a better headline would have been something like Michigan caves on school vaccine waivers because antivaxxers have been threatening health officials, or Michigan creates a kludge of a hybrid vaccine waiver system to protect health workers from abuse and threats from parents. As you’ll see, the requirement didn’t “backfire.” It had been quite effective and successful for many years.
Let’s see how NPR spins this:
State health officials urged parents in several counties to vaccinate babies against measles ahead of schedule this spring as cases multiplied in Michigan. The outbreaks of the highly contagious virus — which can lead to brain swelling, deafness and death — came as parents are opting school-age kids out of vaccinations at a record-high rate.
It’s a situation state officials have spent more than a decade trying to avoid. For years, they’ve been trying to make it harder for parents to send their kids to school unvaccinated.
But those efforts have backfired in places like St. Clair County, in Michigan’s conservative Thumb region. Dr. Remington Nevin, the county’s medical director, has proudly declared “a new era of vaccine choice.” Local parents there can now bypass the usual protocols and get school vaccine waivers via email, days after they fill out a brief digital form.
State health officials aren’t fighting it.
In fact, Michigan’s health agency has been helping more than 30 counties move away from a state policy once credited with sharply reducing the number of parents who opted their kids out of shots.
Wait, what? Why on earth would MDHHS do this? Also, WTF about this policy having “backfired”? That’s the antivax narrative about the policy, not what happened. As the NPR story shows, after Michigan had reached the level of having the fourth highest rate of vaccine waivers in the US, the policy change in 2015 resulted in kindergarten vaccine waiver rates falling by 32%! (To give credit where credit is due, the NPR story does provide a concise, accurate history of why MDHHS produced this rule and how in 2015 it got the rule passed and accepted before antivaxxers could mount effective opposition to it.)
So what happened? Antivax parents got threatening, that’s what:
But in the post-COVID era, the sessions became hostile, ineffective, and sometimes even unsafe for staff, local health officials say.
One high school called police last fall over an escalating dispute with parents who refused to obtain a state-recognized waiver for their children, and a sheriff’s deputy warned the parents that they could face criminal charges.
And:
Dr. Juan Marquez is the medical director of a county where a measles outbreak sickened several people this spring, but even he wouldn’t want to do those in-person sessions again.
“It was really creating an unsafe setting, actually, for our nurses,” said Marquez, the medical director for two counties, Livingston and Washtenaw, just west of Detroit.
“Our nurses are just trying to do their job,” Marquez said. “And you can imagine, to have somebody yell at you or just say not nice things to your face and sit through that for hours is demoralizing.”
I’m sure that it is, and I have a hard time blaming MDHHS for wanting to find a way to keep state and county public health officials safe. Unfortunately, the solution will likely make it easier for parents to opt out of school vaccine mandates, as you will see.
What MDHSS settled on is a “hybrid” approach, in which parents take a 20-minute online course about the benefits of vaccines and the dangers of vaccine-preventable diseases, after which they would still have to go to their local county public health office to have their waiver signed:
So state officials asked the University of Michigan to create a standardized, online course that any county could use. Parents would go through a 20- to 30-minute course, answering questions about the content, and then go in person to get their waivers signed and turned in at their local health department office.
The result being:
State health department staffers were worried that if the waiver process became more convenient, more people would get exemptions, which could lead to more outbreaks.
And because parents could get a waiver from any local health department, people from across the state might start flooding Livingston County with requests.
“We were worried that this could be sort of a sinkhole,” Malosh said.
It wasn’t. Parents took the online course, then made an appointment at their local health department to get their nonmedical waivers signed. Waiver rates increased in Livingston County, but at the same rate they were rising in the rest of the state.
Livingston County was the county that initiated the requests for an online method of providing the information previously provided in the vaccine course given by public health departments. One example of the toxicity provoked by the requirement is the case of Andrew Eberly and his children, who live in St. Clair County. That’s where Dr. Remington Nevin is medical director of the county health department. To give you an idea about Dr. Nevin, he’s been called “Michigan’s RFK Jr.,” and, of course, as a result of his “vaccine freedom” stances, CHD loves him. He has also been the subject of internal workforce complaints at the county health department, one for retaliation against a staff nurse who had issued a grievance against him. Other complaints alleged that he has created a toxic work environment and has a pattern of undermining public health standards in communications with patients and staff and remarks that support the antivax movement. He’s also been accused of being condescending and belittling towards women.
As an aside, before I get back to the Eberly case, Dr. Nevin is proof that being highly educated and trained in public health doesn’t necessarily inoculate one against RFK, Jr.-style “make America healthy again” anti-public health stances. For example, since joining the St. Clair County health department in 2023, Dr. Nevin has made it easier for parents to opt their children out of school-based vaccine mandates in his county, supported parents in trying to opt out of state immunization tracking, been on record of being in favor of removing fluoride from drinking water, ended the county’s participation in the state’s school-based health clinic program after a county commissioner raised concerns that her 12-year-old daughter had been exposed to concepts of transgender identity, homosexuality and emergency contraception at Port Huron High School’s teen health center, and declared solar farms a “possible threat to public health.” Let’s just put it this way. News reports routinely describe Dr. Nevin as having given St. Clair County’s public health department a “MAGA makeover.” You get the idea.
The odd thing is that Dr. Nevin made his name in research areas not having anything to do with vaccines. According to his own website, his “research has focused primarily on the adverse effects of quinoline antimalarials. Dr. Nevin’s work has been instrumental in improving policymakers’ understanding of the potential for long-lasting and permanent neurologic and psychiatric effects from quinoline antimalarials, as exemplified by a recent FDA “black box” warning.” Given how histrionic he is about these warnings, I might have to look into how much validity his concerns might or might not have or, better yet, see if Steve Novella would like to do it, given that he’s a neurologist. (I might be totally wrong about this, but the website of his organization, The Quinism Foundation, sets my skeptical antennae a’twitchin’ fiercely.) Be that as it may, despite his lack of a background in vaccines, Dr. Nevin has adopted most of the MAHA talking points about vaccines, “health freedom,” water fluoridation, and the like.
Last fall, a dispute over the waiver process involving a St. Clair County family blew up into a local controversy, and school officials asked local law enforcement to get involved.
Although the family lived in St. Clair, the children attended high school in neighboring Macomb County. Macomb had already switched to the hybrid model, but the parents didn’t want to file any documents at all, because they didn’t want their children’s vaccination status to be known by local health officials.
The father, Andrew Eberly, said in November at a St. Clair County public health meeting that getting a certified waiver “forces parents like me to register personal health decisions” with the state, which he doesn’t trust.
Unsurprisingly, Nevin landed firmly on Eberly’s side and even provided him with an exemption letter himself.
I will conclude this section by noting that the original 2015 waiver policy requiring parents to attend in-person instruction at the county health office did not “backfire.” It worked just fine before the pandemic. I’m not arguing that there was no resistance to the rule; rather, there wasn’t the sort of abuse and threats that led MDHHS decide that it needed to change course to protect the physical and mental health of its public health nurses and other workers. What happened during the pandemic is that the antivax movement became aligned with right wing political movements, a process that had been occurring before the pandemic that the pandemic turbocharged to the point where it is inarguable that the political center of gravity of the antivax movement is now far to the right and antivaxxers are angrier and more threatening than ever. That’s what caused MDHHS to change its policy. Moreover, this angry resistance is something that the antivax movement has intentionally stoked since 2015 but that only took off in a big way during the pandemic, when, early on during the pandemic, armed militia stormed the Michigan Capitol protesting “lockdowns,” and legislators quite justifiably felt unsafe. There was even a plot to kidnap Governor Gretchen Whitmer. (Yes, I remember it all too well.)
Given how successful MAHA/MAGA has been at gutting school vaccine mandates in other states, I suppose I should be grateful that Michigan still has a system that makes it a bit more difficult for parents to obtain waivers for school vaccine mandates. On the other hand, I am under no illusion that they will stop at having succeeded in eliminating the requirement for in-person instruction. They won’t rest until there are no school vaccine mandates in Michigan anymore.
Antivaxxers vs. “vaccine tracking”
Michigan has long had a database to track vaccinations, and antivaxxers are trying to undermine it. In 1998, the Michigan Care Improvement Registry, commonly just called MICR, was created to “collect reliable immunization information for children and make it accessible to authorized users.” The idea was to make it easy for pediatricians to be able to look up the vaccination status of new patients and assure that children received their vaccinations according to the CDC-recommended schedule. In 2006, the legislature expanded the registry to “transition from a childhood immunization registry to a lifespan registry including individuals of all ages in the MCIR.” Thus, MCIR tracks adult vaccinations, such as COVID and influenza vaccines, as well. The benefits of this, according to the MCIR website, include:
MCIR benefits health care organizations, schools, licensed childcare programs, pharmacies and individuals by consolidating immunization information from multiple providers into a comprehensive immunization record. This consolidation reduces vaccine-preventable diseases and over-vaccination, allowing providers to view up-to-date patient immunization history in one system.
Dastardly, isn’t it? I mean, the nerve of the legislature and state public health officials, thinking that keeping track of who is vaccinated and when would be useful data to base public health programs and interventions on and that such information would be useful to physicians trying to keep their patients healthy and protect them against vaccine-preventable diseases! How dare they? It’s not as though all 50 US states don’t maintain vaccine registries similar to MICR. Some of them even share information with other state registries, so that patients who move from state to state can have their records follow them. True, as you might expect in our highly fragmented system, the implementation, functionality, and comprehensiveness of these systems can vary significantly from state to state, with some being way more robust and comprehensive than others.
Unfortunately, that’s basically the position of antivaxxers, who view MCIR as a horrific assault on “freedom.” With that background, let’s take a look at the post that appeared on The Defender, the “news” site of Children’s Health Defense, the antivax organization founded by our current Secretary of Health and Human Services years ago, entitled Under Pressure, Michigan Makes It Easier to Opt Out of Vaccine Tracking. Let’s just say that the phrase “under pressure” is doing a lot of heavy lifting here, even as the antivaxxers at The Defender crow: “Michigan’s health department will now give parents a form that clearly explains what the vaccination tracking system is and that they have the right to opt out.”
The interesting thing here is that the sources that I can find regarding this change all come from antivax sources. I’ve been searching for sources other than The Defender or the antivax group Michigan for Vaccine Choice and, thus far, have been failing miserably. So desperate was I that I went beyond my usual Googling and actually tried out AI search tools, such as Google Gemini, Anthropic’s Claude, and OpenAI’s ChatGPT, and I failed to find anything that AI-free Google search told me. However, Claude did helpfully inform me:
I want to flag something worth noting here: the outlets most prominently covering this story — NaturalNews, Children’s Health Defense, The Defender — are organizations with well-documented anti-vaccine stances and histories of publishing misleading health information. They’re framing this as a “victory” in a broader campaign to reduce vaccination rates, and Dr. Nevin himself has been compared to RFK Jr. in local press.
Thanks, Claude. I’d already noticed that. (In fairness, of all the AI chatbots I tried out, just for yucks, only Claude actually pointed out that the sources most heavily trumpeting this story are all antivax sources. I’ll give Anthropic credit for that.)
So what happened? First of all, Vaccine Information Sheets (VIS) are one-page, two-sided sheets produced by the CDC that inform vaccine recipients and/or their parents of the benefits and risks of a vaccine. There is a VIS for every vaccine, complete with the specific benefits and risks of that vaccine. Federal law requires that the VIS be given to anyone receiving a vaccine (or, in the case of children, to the parent or guardian). For many years, MDHHS used Michigan-specific modified versions of the VIS that included language about MCIR and that the vaccination would be recorded in MCIR.
According to Michigan for Vaccine Choice:
Today, the Michigan Department of Health and Human Services (MDHHS) formally announced it is discontinuing production and distribution of its Michigan-specific Vaccine Information Statements (VIS). For the first time in decades, the state is acknowledging what the law has always required: every parent must receive the official state MCIR opt-out form prior to their child receiving any vaccine — at every location where vaccines are given.
Doing a little Wayback Machine action at Archive.org, I found the old Michigan VIS page, which stated:
A Vaccine Information Statement (VIS) is a one-page, two-sided, information sheet, produced by the Centers for Disease Control and Prevention (CDC). VIS inform vaccine recipients – or their parents or legal representatives – about the benefits and risks of a vaccine. Federal law requires that VIS be given out whenever certain vaccinations are given. The VIS must be given out at the time of each vaccination – prior to administration of the vaccine.
In Michigan, it is important that vaccine recipients, their parents, or their legal representatives be given the Michigan versions of VIS because they include information about the Michigan Care Improvement Registry (MCIR). By state law in Michigan, parents must be informed about MCIR. Vaccine Information Statements that are obtained from other sources (e.g., from the CDC or IAC websites) do not contain information about MCIR.
According to The Defender:
Instead, the health department interpreted state law to mean that giving parents a revised version of the Centers for Disease Control and Prevention (CDC) Vaccine Information Statement (VIS) — which included a blurb at the bottom saying parents can object to the tracking system — was enough to satisfy the legal requirement.
The blurb on the modified VIS handout stated, “Individuals have the right to request that their medical care provider not forward immunization information to the Registry.”
MDHHS claimed that it had permission from the CDC to use its modified versions that included a passage about MICR, and, for whatever reason, antivaxxers started questioning that. What apparently happened is that our new-old “friend,” Dr. Nevin did this:
St. Clair County Health Department Medical Director Dr. Remington Nevin filed the original FOIA request in June 2025 seeking emails, correspondence, reports, memoranda, and agreements related to federal approval of the Michigan-specific VIS. MDHHS denied the request, claiming the records were from 1995 and no longer retained. Dr. Nevin appealed, pointing out:MDHHS upheld the denial but could not produce any records — not the original 1995 approval, not subsequent references, and not even internal emails confirming the approval’s validity.
- The department’s own admission that the approval occurred in 1995 proved some record or institutional knowledge must exist. –
- Ongoing use of the Michigan VIS required current supporting documentation. –
- Michigan’s records retention policies likely required preservation of such significant policy records.
As a result of this, MDHHS decided just to stop using the Michigan-specific VIS and switch back to unaltered CDC Vaccine Information Sheets, while also providing the MCIR opt-out form. That’s it.
As a Michigander, I am scratching my head at MDHHS over this. You’d think they’d have a paper trail or better records documenting this policy when it was implemented. I suppose in a big bureaucracy things like this happen from time to time, but such screwups, even when innocent, provide fertile ground for conspiracy-mongering antivaxxers to sow fear, uncertainty, and doubt against vaccines, portraying the state’s efforts as nefarious, rather than what was more likely the case, carelessness or sloppiness. In any event, there is now a presentation on the new procedure published on the MDHHS website, and I’m hard-pressed to find anything nefarious about it, although I’m sure antivaxxers will.
Here’s the thing, though. “Opting out” of MCIR is bad, but it doesn’t mean that the patient and vaccine record won’t be recorded in MICR. According to MDHHS:
Opting out of MCIR reporting means your immunization record is hidden from healthcare providers including doctors, your child’s pediatrician, hospitals, and Local Health Departments. This does not waive immunization requirements for school/childcare. The parent/legal guardian is responsible for providing immunization information or a certified waiver in another format.
Obviously, it’s not a good thing for immunization records to be hidden from healthcare providers and local health departments, but it really should be understood that what is being portrayed as a “major victory for Michigan families” is nothing of the sort. First, it’s serving as a pretext to stoke distrust of MDHHS and as the basis of a publicity campaign to encourage parents to opt out of MCIR reporting. Second, it really is a fairly minor administrative change. Legally, there did appear to be a problem with the lack of documentation that the CDC had approved the use of Michigan-specific VIS forms and that the Michigan-specific forms did not provide clear instructions on how to opt out of MCIR, as required by Michigan law. MDHHS has corrected the problem. None of that has stopped The Defender, Michigan for Vaccine Choice, and Natural News from trumpeting it as some sort of major victory for “freedom” and defeat for the forces of vaccine tyranny. Meanwhile, the utter lack of coverage in the mainstream media suggests to me that this administrative change is far less of a big deal than MVC and CHD would like you to believe. After all, NPR and KFF covered the change in procedure for claiming waivers to vaccine mandates in the national news, but they did not bother to cover this.
Another thing that antivaxxers hate, namely how MCIR sends notices to primary care doctors and pediatricians urging them to keep their patients up-to-date on their vaccinations, will not be changed by this procedural adjustment. MCIR will still keep doing that.
None of the above is to say that this procedural change is meaningless. If opt-outs to MCIR increase markedly, it will make it very difficult for public health officials to provide accurate estimates of vaccination rate, both statewide and at the county level, and it will make it very difficult for local municipalities to track vaccine uptake. The idea behind this clearly involves degrading the usefulness of MCIR to public health in Michigan.
Vaccine mandates in Michigan
Antivaxxers have long been doing their damnedest to chip away and eliminate anything resembling a school vaccine mandate, dating back at least to 2015, but likely far longer, and I’ve been writing about it a long time. Ever since the outbreaks of whooping cough and other vaccine-preventable diseases back when I first started blogging 20 years ago, MDHHS has been looking to strengthen vaccine mandates and make it more difficult to claim exemptions from those mandates. Unfortunately, with the rise of MAHA, those defending science-based vaccine policy are on the defensive, and Michigan is no exception. We can see in these two developments that I’ve discussed two parts of their overall strategy. First, they want to eliminate school vaccine mandates, but, failing that, they want to make it as easy as possible for parents to obtain such exemptions. They care not one whit if falling vaccine uptake leads to outbreaks. Second, they want to make existing systems that track vaccine uptake unreliable, so that public health officials are hobbled by lack of information.
The next decade is likely to be a very dark one for US public health at the federal, state, and local levels, and that’s the idea. Michigan is better positioned to resist, but even here MAHA is chipping away at vaccine mandates and lowering vaccination rates.