By Katie Kerwin McCrimmon

Opting out of vaccines for potentially deadly diseases like the measles will become much harder in Colorado after the Board of Health on Wednesday voted for a set of tougher rules for parents seeking exemptions.

The new rules mark a striking change in Colorado after a bill that aimed to increase immunizations got watered down during the 2014 legislative session. Then the widely publicized measles outbreak tied to Disneyland in California heightened concerns about highly contagious diseases like the measles.

The Board of Health also voted to require the Colorado Department of Public Health and Environment to collect and report annually on vaccination rates at Colorado schools and day care centers.

The changes will go into effect in July of 2016 and are a radical departure from Colorado’s “one-and-done” system where parents could opt out of vaccines once and never consider the issue again.

Under the new rules, parents who want to opt out will have to do so each time their infant or toddler would need immunizations — so up to five times between birth and kindergarten — then annually once children are in school.

“These new rules are a positive step forward in strengthening our immunization rates and protecting our kids and the communities in Colorado,” Gov. John Hickenlooper said in a written statement.

Hickenlooper said Colorado health officials have more work to do to ensure that parents have the facts about immunizations. Colorado is home to many parents who don’t vaccinate their children or who seek to delay immunizations.

Making it harder to opt out of vaccines could dramatically boost Colorado’s immunizations rates, which are among the worst in the country.

Currently parents of about 4.6 percent of Colorado kindergartners opt out of vaccines while the national average is 1.8 percent.

Dr. Rachel Herlihy, director of disease control for the Colorado Department of Public Health and Environment, was among those who spoke in favor of the new rules and better reporting.

She said states like Colorado that have made it easy to opt out of vaccines have the highest rates of parents who exempt their children. In turn, research shows that children whose parents claim exemptions are more likely to get and transmit vaccine-preventable diseases.

Herlihy said parents who have simply skipped vaccines out of convenience will be more likely to get them now.

“We certainly believe there will be an impact. To what degree, we don’t know yet,” Herlihy said.

Stephanie Wasserman, executive director of the Colorado Children’s Immunization Coalition, said the new rules, along with beefed up funding in Colorado’s budget for vaccine reporting, mark a “really significant change.”

Among the most striking changes will be the new data about school vaccination rates.

The media outlet, Chalkbeat Colorado, was the first to request data from multiple school districts. Now the Board of Health will require that all day care facilities and school districts report their vaccination rates each year.

“Parents will be able to use the information to make informed decisions about where to send their children for child chare and for school, especially parents who have children who are immune-compromised. You want them to be part of routine childhood experiences. But you want to provide them with the safest classroom experiences,” Wassermann said.

“This (will be) timely and accurate information,” she said.

Colorado will remain one of 20 states that will allow what are known as “philosophical exemptions” to vaccines, Wasserman said.

She said it’s critical for parents to get accurate advice from their doctors since scare tactics are so common online.

The measles outbreak spurred some parents who had previously skipped vaccines to seek them, but Wasserman said past focus groups cast doubt over whether Coloradans are ready to bar exemptions altogether.

“Colorado has one big gap in our system: our exemptions,” Wasserman said. “There was some discussion that perhaps we could go even (further). Coloradans don’t seem ready yet to get rid of the personal belief exemption, but people feel strongly that this a step forward. It’s a common-sense, practical approach that will improve our ability to ensure that our children and families are protected from preventable diseases.”