Tag: 23andMe

Update on Vaccine Exemption Rates in California

Vaccination rates in California are dropping.

Wait, what?

Didn’t they recently pass a vaccine law that removed non-medical exemptions? How could vaccination rates be dropping?

Update on Vaccine Exemption Rates in California

While SB 277 did indeed remove all non-medical exemptions to getting vaccinated, some folks found a way around it. Since 2015, when it passed, some doctors are giving kids fake or unnecessary medical exemptions. These extra medical exemptions are likely making up for their previous personal belief vaccine exemptions.

The result?

It isn’t fewer exemptions since 2015.

Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?
Explain to me how it is ethical to misrepresent the rates of medical exemptions during a measles outbreak?

While personal belief exemptions are certainly down, medical exemptions keep going up.

In addition to the 0.9% of medical exemptions, another 1.5% of kids, also up as a percentage, are unvaccinated “for other reasons specified under SB 277.”

There are also about 1.7% of kids in kindergarten who enroll as conditional entrants.

Why is that important? Among those conditional entrants are kids with temporary medical exemptions.

And how many kids aren’t vaccinated simply because they are “receiving IEP services?”

So it is not only wrong, it is unethical to try and say that only 0.9% of kids have vaccine exemptions in California this year.

Update on Vaccine Exemption Rates in California’s Clusters

Still, the big story continues to be what’s going on in the clusters of intentionally unvaccinated kids in California and other parts of the United States.

Are they getting vaccinated and protected under SB 277?

Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!
Wait, I thought Dr. Bob said that the vaccine exemption rate was just 0.9%. What happened at this Waldorf school? 30% of the kids have medical exemptions!

Some actually are!

The MMR rate at the Waldorf school in San Diego was just 44% back in 2014, as a whopping 56% of kids had a personal belief exemption. As sad as it sounds, even though it is still below herd immunity levels of protection, their current MMR vaccination rate of 68% is a big improvement!

Unfortunately, there are many schools with even lower immunization rates. And of course, that means even more students with “medical exemptions” at those schools.

SchoolPMEs
Marin Waldorf School31%
Yuba River Charter64%
Westside Waldorf School37%
Sebastopol Independent Charter45%
Muse Charter50%
Live Oak Charter41%
Nevada City School of Arts31%
Sunridge Charter47%
Santa Cruz Waldorf School34%
Cedar Springs Waldorf School30%
Journey33%
Waldorf School of Orange County33%
Coastal Grove Charter36%
Mariposa School of Global Ed31%
Waldorf School of the Peninsula36%
Maple Village Waldorf School30%

In addition to these permanent medical exemptions (PMEs), some schools also have high rates of temporary medical exemptions.

Medical Exemptions for Vaccines in California are Unusually High

What’s the usual rate of medical exemptions?

As there are few reasons to skip or delay a child’s vaccines, it is lower than those rates.

A lot lower.

In one recent report, Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School Year, the median rate of medical exemptions in the U.S. was just 0.2%, with a range of <0.1 to 1.5%.

Also unusual is that in some cases, many of those exemptions are written by just a few doctors. In fact, families often go to these doctors just to get their kids their medical exemptions!

“…the removal of nonmedical exemptions in California was initially effective in increasing vaccination rates, but the substitution between exemption types may render the repeal partially ineffective in improving immunization coverage and preventing VPDs over time.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

How do we fix this and get more kids vaccinated and protected?

“Beyond fostering compliance, tightening the requirements around medical waivers will also aid in promoting public policies that protect public health.”

Richwine et al on Do Stricter Immunization Laws Improve Coverage? Evidence from the Repeal of Non-medical Exemptions for School Mandated Vaccines

In addition to closing the loopholes that allow some doctors to abuse medical exemptions, it will be important to help parents be more skeptical and see through the anti-vaccine propaganda that other doctors use to scare parents away from vaccinating and protecting their kids.

Vaccines are safe, with few risks, and are obviously necessary.

More on Vaccine Exemption Rates in California

Autoimmunity as a Contraindication to Getting Vaccinated

Can your kids get vaccinated if they have an autoimmune disease?

Can your kids get vaccinated if you or another family member have an autoimmune disease?

Folks shouldn't be using 23andMe DNA testing to justify their not wanting to vaccinate their kids.
Folks shouldn’t be using 23andMe DNA testing to justify their not wanting to vaccinate their kids.

Can your kids get vaccinated if you did one of those 23andMe genetic risk type tests?

“Risks associated with use of the 23andMe GHR tests include false positive findings, which can occur when a person receives a result indicating incorrectly that he or she has a certain genetic variant, and false negative findings that can occur when a user receives a result indicating incorrectly that he or she does not have a certain genetic variant. Results obtained from the tests should not be used for diagnosis or to inform treatment decisions. Users should consult a health care professional with questions or concerns about results.”

FDA allows marketing of first direct-to-consumer tests that provide genetic risk information for certain conditions

Not surprisingly, in almost all cases, the answer is yes.

Autoimmunity as a Contraindication to Getting Vaccinated

That doesn’t mean that there aren’t some true medical reasons that kids shouldn’t be vaccinated.

“Contraindications (conditions in a recipient that increases the risk for a serious adverse reaction) and precautions to vaccination are conditions under which vaccines should not be administered. Because the majority of contraindications and precautions are temporary, vaccinations often can be administered later when the condition leading to a contraindication or precaution no longer exists. A vaccine should not be administered when a contraindication is present; for example, MMR vaccine should not be administered to severely immunocompromised persons. However, certain conditions are commonly misperceived as contraindications (i.e., are not valid reasons to defer vaccination).”

Vaccine Recommendations and Guidelines of the ACIP

Which autoimmune diseases are listed as contraindications to get vaccinated?

None.

Which autoimmune diseases are listed as precautions to get vaccinated?

There are just a few, including Guillain-Barré syndrome (DTaP, Tdap, and flu vaccines) and thrombocytopenic purpura (MMR), but they typically don’t mean that you can’t still get vaccinated. And the general precaution to avoid getting a vaccine during “moderate or severe acute illness with or without fever” would apply to a time when you are acutely sick with your autoimmune disease, but you would get vaccinated once your symptoms were under better control.

Other things about autoimmune diseases are simply misperceived as being contraindications or precautions to getting vaccinated. Or they are pushed as anti-vaccine propaganda to scare you away from getting vaccinated and protected or to help you get a fake medical exemption.

“…vaccines are able to prevent some infections in MS patients known to accelerate the progression of the disease and increase the risk of relapses.”

Mailand et al on Vaccines and multiple sclerosis: a systemic review

For example, not only do vaccines not cause multiple sclerosis, they are recommended because they can prevent vaccine-preventable diseases that can make the disease worse for many people.

And flu shots and other vaccines are highly recommended for kids with diabetes, as they are at high risk for flu complications.

Vaccines are safe and necessary, even, and sometimes especially, if you have an autoimmune disease.

And having a predisposition for an autoimmune disease, either because of your child’s family history, or because of the results of some genetic testing kit you ordered on the internet, certainly isn’t a reason to skip or delay your child’s vaccines and leave them unprotected. You’re not avoiding any of the triggers that can cause autoimmune disease and simply increase the risk that they will get a vaccine-preventable disease and get others sick.

More on Autoimmunity as a Contraindication to Getting Vaccinated