And folks who continue to scare parents away from vaccinating and protecting their kids.
What’s the truth about California’s immunization rates and the reason they are still having outbreaks of measles and other vaccine-preventable diseases?
“Oh, but wait! What do you mean we have higher vaccination coverage NOW than we did back then? How can that be? I thought rates have been declining steadily for two decades putting us in a terrible position of falling wayyyy below herd immunity levels!?
I thought the reason we are now “in danger of disease outbreaks” is because of the increasing number of children being exempted from vaccines? Hold on, wait. You’re telling me there are LESS kids exempted now than there were in the year 2000 when we were free of outbreaks because of “high vaccination rates”? That can’t be right…can it?”
Why Should Medical Exemptions Be Based on CDC Contraindications?
As many people know though, some people have been taking advantage of the fact that medical exemptions weren’t clearly defined in California’s vaccine law.
Are there just a few doctors taking advantage of the California law?
“But at 105 schools in the state, 10% or more of kindergartners had a medical exemption in the school year that ended last month, according to a Los Angeles Times analysis of state data.”
Pushback against immunization laws leaves some California schools vulnerable to outbreaks
Is 10% a lot?
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 US was just 0.2%, with a range of <0.1 to 1.5%.
In West Virginia and Mississippi, states that don’t allow non-medical exemptions and where criteria for medical exemptions are fairly strict, the rates were 0.1 and 0.3% respectively.
So yes, 10% is an awful lot and that’s a good sign that it is more than just a few doctors taking advantage of the law.
“If a child has a medical exemption to immunization, a physician licensed to practice medicine in New York State must certify that the immunization is detrimental to the child’s health. The medical exemption should specify which immunization is detrimental to the child’s health, provide information as to why the immunization is contraindicated based on current accepted medical practice, and specify the length of time the immunization is medically contraindicated, if known.”
Dear Colleague letter regarding guidelines for use of immunization exemptions
Why do most other states have so few medical exemptions?
Mostly because there are very few true medical reasons to skip or delay a child’s vaccines!
They include, but aren’t limited to, the contraindications and precautions listed in the package insert for each vaccine (the contraindications and warnings sections…) and by the Advisory Committee on Immunization Practices.
They don’t include many other things that are “incorrectly perceived as contraindications to vaccination,” such as things in the family medical history of the child, eczema (unless they are getting the smallpox vaccine), colic, sleep apnea, or being a picky eater.
One extra consequence of the rise in cases of vaccine-preventable diseases we have been seeing lately, in addition to the fact that more kids are getting sick, is that we are seeing more kids being quarantined and kept out of school.
“The parents of 42 children affected by the ban at the school, the Green Meadow Waldorf School, sued the Rockland County health department, asking a federal judge to issue an injunction to allow the children to return.”
Parents Wanted Their Unvaccinated Children in School, but a Judge Said No.
And in a few cases, we are seeing lawsuits trying to get some of these kids, mostly intentionally unvaccinated kids, back into school.
Why Is a Kentucky Teen Who Refused to Get Vaccinated Suing His School?
While most outbreaks are related to measles, in Kentucky, a large outbreak of chickenpox at Our Lady of the Sacred Heart/Assumption Academy in Walton has led to the quarantine of a number of unvaccinated students.
One student, a senior and the starting center on the school basketball team, is suing to get him back in school.
“The Kunkels filed their lawsuit Thursday in the Boone County Circuit Court alleging that the Northern Kentucky Health Department had violated Jerome’s First Amendment rights. Accepting the chickenpox vaccine would be “immoral, illegal and sinful,” they said, according to their Catholic beliefs. The lawsuit also alleges that the health department violated due process when officials enacted the extracurricular and school attendance bans without declaring an official emergency, which would have triggered the involvement of the state legislature.”
God, country and chickenpox: How an outbreak entangled one school in a vaccine showdown
So they are actually suing the health department, not his school, to get him back into school…
“Since there is no Catholic teaching that the use of these vaccines is sinful, schools cannot allow Catholic parents to claim a religious exemption from the requirement of immunization.”
National Catholic Bioethics Center on Vaccines and Exemptions Granted by Schools
Are they against the chickenpox vaccine?
“One is morally free to use the vaccine regardless of its historical association with abortion. The reason is that the risk to public health, if one chooses not to vaccinate, outweighs the legitimate concern about the origins of the vaccine. This is especially important for parents, who have a moral obligation to protect the life and health of their children and those around them.”
National Catholic Bioethics Center
No, they aren’t, which is why most Catholics vaccinate and protect their kids.
“In the event that the county health department or state health department declares an outbreak of a vaccine-preventable disease for which proof of immunity for a child cannot be provided, he or she may not be allowed to attend childcare or school for up to three (3) weeks, or until the risk period ends.”
Kentucky Parent or Guardian Declination on Religious Grounds to Required Immunizaitons
A judge will have to decide the merits of the case, but from a moral standpoint, it seems like they are on shaky ground.
More on Quarantines for Intentionally Unvaccinated Kids
“Although we give vaccines in my office every day, I oppose HB 3063. As you consider HB 3063, I thought you should have the real-world data from the largest pediatric practice in Oregon with the most patients who will be affected by your proposed bill.”
Paul Thomas goes on to explain why his patients haven’t received all of their recommended vaccines.
One reason is that he doesn’t even offer the rotavirus vaccine, although he doesn’t mention that. But how do you make an informed choice about a vaccine when the vaccine isn’t even available to you?
“Most of my patients make the educated decision not to give one vaccine-hepatitis B – to their infants. This is because you catch hepatitis B from sex and IV drug use so if a child is born to a mother that does not have hepatitis B, the child is at no risk of getting this disease. Preschool and young school-aged children are not at risk for hepatitis B, which is why most countries in the developed world only recommend this vaccine for at-risk groups and not for everyone.”
Since he doesn’t think they are at any risk when they are younger, does Dr. Thomas advocate that his patients catch up on their hepatitis B series when they are older? Does he mention that until we switched to a universal vaccination program, some infants were missed and developed perinatal hepatitis B? Or the risks of needle sticks, etc.?
“These are the kinds of details and nuances that we must discuss with every vaccine. Whether we are talking about vaccines, antibiotics, ADD medication, or even a surgical procedure, we spend a good deal of time with our patients providing what we in medicine call “informed consent.” We explain the risks and benefits of the recommended medical intervention, the risks and benefits of not doing the intervention, and the alternatives. These conversations are best had in the privacy of a doctor’s office, not in the state legislature. As each child is different, we do not believe there should be any one-size-fits-all medicine. “
“Finally, I am also concerned that thousands of families will either leave Oregon-as tens of thousands of families have left California – or leave the public school system and homeschool instead. While I have nothing against homeschooling, I believe this would result in a large and unfortunate loss of revenue for Oregon’s already underfunded public schools. “
It’s a good reminder that the one lesson Oregon can learn from California is to make stricter rules on what counts as a medical exemption…
“We all have the same goal, which is to help Oregon’s children survive and thrive. No one wants a recurrence of infectious diseases in Oregon or anywhere in the United States. “
If Paul Thomas’ real motivation was to stop the outbreaks of vaccine-preventable disease and keep states from passing new vaccine laws, then maybe he should stop scaring parents away from vaccinating and protecting their kids.
“I hired an independent data expert, Dr. Michael Gaven, MD, to analyze the outcomes from my practice as part of a quality assurance project. Dr. Gaven studied the outcomes for those patients born into my practice during the past decade, since I opened my doors on June 1 2008.”
What outcomes? Is it how many of the kids in his practice developed vaccine-preventable diseases unnecessarily?
No, Paul Thomas published data that he thinks says that his unvaccinated kids get less autism than everyone else, except that there is a lot of bias in the numbers, we don’t know how many kids left his practice (especially any who might have developed autism), or even what criteria he uses to diagnose kids with autism. The numbers likely aren’t even statistically significant.
So while you are thinking about whether or not your state legislators should be taking away your personal belief vaccine exemption, a better question would likely be why they added them in the first place.
The Editorial Boards of the leading newspapers in the United States are making sure we know their views about vaccines and vaccine hesitancy.
It started with The New York Times, but certainly didn’t end there.
In addition to two hearings before Congress, many other major newspapers have published vaccine editorials of their own.
“It’s no mystery how we got here. On the internet, anti-vaccine propaganda has outpaced pro-vaccine public health information. The anti-vaxxers, as they are colloquially known, have hundreds of websites promoting their message, a roster of tech- and media-savvy influencers and an aggressive political arm that includes at least a dozen political action committees. Defense against this onslaught has been meager. The C.D.C., the nation’s leading public health agency, has a website with accurate information, but no loud public voice. The United States Surgeon General’s office has been mum. So has the White House — and not just under the current administration. That leaves just a handful of academics who get bombarded with vitriol, including outright threats, every time they try to counter pseudoscience with fact.”
The New York Times on How to Inoculate Against Anti-Vaxxers
“The wretched pox is getting closer. We hope you and yours are vaccinated.”
Chicago Tribune on Major new study adds to our plea: Vaccinate your children against measles
“But a child with fragile health, whose doctor advises to delay vaccines for health reasons, could be in extreme danger in Washington state because so many parents use philosophical exemptions. Vulnerable children are much more likely to be exposed to measles than they should be because Washington allows parents to skip required immunizations based solely on their personal beliefs.”
The Seattle Times on End philosophical vaccine exemption
“We can get kids vaccinated, or we can be in danger together.”
Chicago Sun-Times on Measles, anti-vaccine myths and some advice for Illinois
“Treating a disease like measles and stopping its spread is an expensive proposition. Not to mention, it endangers those who can’t get vaccinated, including vulnerable newborns.”
The Baltimore Sun on It’s about time for a backlash against anti-vaxers
“Recent outbreaks underscore the risks of allowing nonmedical exemptions.”
USA Today on Measles outbreaks underscore risks of allowing nonmedical vaccination exemptions
“The point is, people who do not get vaccinated are threatening the whole population, and DeFoor’s letter is a reminder that failing to get vaccinated can have lifelong consequences.”
The Gainesville Sun on Anti-vaccine myths are dangerous
“The best solution, however, is for parents who are tempted to claim a religious exemption to look at the facts. If your fear of vaccines is based on information repeated in social media or by an anti-vaccine group, you need to try again. Look at medical studies or talk to your doctor.
The measles vaccine can save your child’s life, and it can save the lives of those who are medically unable to take the vaccine.”
Tuscaloosa News on Measles vaccine a must for your child and others
“This isn’t one of those scary epidemics in which the cause and solution are unclear. The cause is a reckless embrace of myth over scientific fact. The solution is vaccination.”
St. Louis Post-Dispatch on Measles is back, thanks to misinformation and loopholes in vaccination rules.
“Yet the distrust of anti-vaxxer parents is a threat to everyone’s children and not just their own.”
The Guardian view on vaccination: a duty of public health
“The anti-vaxxers’ hypothesis rests largely on the shoulders of bunk science that has been discredited and disproven by a number of sources. But this hasn’t stopped their ideas from taking hold.”
Pittsburgh Post-Gazette on Preventable problems: Anti-vaxxers rely on bunk science
“We identify with parents’ desire to protect their children. But shunning proven vaccinations is making families and communities less healthy, not more so. We urge lawmakers to champion educational efforts to help parents understand that lesson before a major outbreak strikes here.”
Austin American Statesman on Austin’s anti-vaccination rate is nothing to brag about
After reading these Op-Eds, it is even more amazing to realize how far we have come from when the media used to be part of the problem.
Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media.”
Having to get vaccinated to attend school isn’t a new idea.
In 1827, Boston mandated that all children attending public school must receive the smallpox vaccine.
Believe it or not, it wasn’t until the 1980-81 school year that there were laws in all 50 states mandating that children receive vaccinations before starting school. The smallpox vaccine wasn’t one of them…
A Legislative Guide to Advocating for Stronger Vaccine Laws
Not surprisingly, as vaccines did their job and rates of vaccine-preventable diseases dropped, politicians were able to weaken our vaccine laws.