The discussion of communicable illness in the camp environment often centers on the very significant issue of foodborne illness. Every summer significant cases of E. coli, salmonella, and others are spread through inappropriate handling of food. Similarly, every so often there are communicable illness outbreaks, such as the swine flu or Zika, that make national news and present problems for camps and their management.

Most of these issues fade away with time as the underlying issue is resolved. One communicable illness-related issue that will always be front and center — and must be addressed in the policies and procedures of every camp — is that of vaccination of campers and staff for known illnesses.

As you all have seen in the news recently, a major outbreak of measles is ongoing in the United States. It is hard to imagine how such a thing takes place today when the clear majority of people have been, or should have been, vaccinated. This reality points to a disturbing trend. “Vaccine hesitancy” has been declared by the World Health Organization as one of the prime health threats in 2019. Moreover, they indicate that the anti-vaccination trend has continued to grow in recent years.

In 1998, an article was published on a study connecting certain vaccinations to causing autism in children. The uproar this article created continues today. Although the study has been discredited by scientists, social media has given anti-vaccination groups the platform to share thoughts, reshare old articles, and obtain support. Many parents believe the original study continues to be substantiated and have made the vaccination issue into one of protected choice. They have sued schools and municipalities that require vaccinations as a requirement for enrollment, claiming it is a violation of their constitutionally protected rights.

Most recently, in Rockland County, New York, officials tried to use their emergency powers to bar unvaccinated minors from public places. In New York City, officials ordered individuals to be vaccinated unless they could document they were immune or medically exempt. Litigation is now pending, which will again debate century-old case law (Jacobson v. Massachusetts, 1905) that upheld the authority of states to enforce mandatory vaccination laws under their police powers. The Jacobson Court recognized that some individuals could be exempt for medical reasons where the vaccine would be unduly harmful to the individual. In subsequent case law, the courts supported a school system’s refusal to enroll a student who wasn’t vaccinated, finding there was no violation of the 14th Amendment, and agreed that religious exemptions offered by states are elective and not mandated by the First Amendment right to free exercise of religion. Today, all 50 states require children to be vaccinated to enroll in school, yet every state has an exemption clause for medical conditions that heighten the risk of a vaccine. Some states have religious opt-out exemptions and even personal opt-out exemptions for philosophical reasons. It is important to know what the law is in your state on this issue.

What if someone did contract the measles at your camp this past summer? A couple of summers ago, we responded to a situation where two counselors, who had recently arrived from England, came down with the mumps just prior to the start of the camp season. Luckily, they had not been exposed to any campers and very limited camp staff. The camp faced another problem, however: what to do with them. Who would put them up? Who would take care of them? How did the camp get them home? Was this the camp’s responsibility? This event required creative solutions to keep them sequestered until they were legally able to return either to camp or home. It is against the law to fly with a known contagious illness.

Every camp needs to have a communicable illness policy. This policy must include the camp’s position on vaccinations for campers and staff and how they will handle individuals who contract illnesses at camp. Those camps who choose not to require vaccinations should notify families of this fact prior to a child attending camp. While not required by law, the negative publicity surrounding a failure to notify would be problematic and could raise issues of trust in the future with camp families. What else aren’t they telling us?

In today’s world, where medical records are easily obtained and are often in electronic format, it is easier to verify that a child or staff member has been vaccinated. Making this a clear requirement as part of the application process, both for employment and enrollment, is an easy thing to do in advance. Is it possible that you might have a family who objects? Certainly. But ask yourself another question. Would you rather lose the enrollment of one camper or face the reality of dealing with a communicable illness outbreak at your camp that is covered by the national press?

One of the things all camp families are looking for — before, during, and after their children’s attendance at your camp — is verification that the safety and security of their children are paramount within the culture of your camp. Very few parents would agree with or understand why you are allowing unvaccinated staff to interact with their children. Similarly, as they went to the effort of getting their children vaccinated, they do not want their children unnecessarily exposed to unvaccinated individuals.

There is no reason for any child to be exposed to mumps, measles, whooping cough, polio, or any other disease that has been predominantly wiped out. The current measles outbreak is unacceptable in the camp environment. Having your camp on the national news because of an outbreak would require significant crisis communications and consequence management.

That said, it could happen in camp seasons to come. Consider contacting your local hospital to learn about what to do if you have an individual who contracts the measles (or another communicable disease) at your camp. Contact your regulator to find out what your reporting obligations are. Contact your insurance agent to determine where you will find crisis management support if needed.

After each season, review what happened during the summer as well as your policies and procedures for next year. Consider taking a more affirmative position on vaccination. When you do, remember that many immunizations, like measles and mumps, require two or three doses. Make sure you are up to speed on the requirements to ensure none of your staff or campers create a vulnerability for your camp.