Tag: mandates

Why Don’t People with HIV or HepB Have to Wear Badges?

There is a very good reason why people with HIV and hepatitis B don’t have to wear distinctive badges.

Have you ever thought that people with HIV should wear badges???
Have you ever thought that people with HIV should wear badges???

And whether or not they work in a hospital, it has nothing to do with the fact that they don’t pose a risk to others, and it has nothing to do with health care workers who refuse to get a flu shot and have to wear a mask.

Confidentiality Rules and Civil Rights

Hopefully we have gotten over a lot of the misinformation and stigma that once kept kids with HIV and hepatitis B out of schools and teens and adults out of work.

“Ryan White confidentiality guidelines have helped allay the fears that many people living with HIV have around unwanted disclosure and HIV discrimination.”

Building Trust: Confidentiality and the Ryan White HIV/AIDS Program

And of course, that’s why people with HIV and hepatitis B don’t have to “wear any distinctive badges or clothing.”

The Americans with Disabilities Act (ADA) is the most powerful law safeguarding the rights of children in public and private schools and daycare centers. The law also prevents any organization or business from discriminating against a person because of a real or perceived disability, such as an infectious disease.

A second law, Section 504 of the Rehabilitation Act, bars schools, colleges and other organizations receiving federal funding from discriminating against children with disabilities. Section 504 identifies chronic liver disease as a “hidden disability.”

Legal Protections for Children with Viral Hepatitis

In fact, laws protect people with HIV/AIDS and other conditions, so that no one would try and make them “wear any distinctive badges or clothing.”

“Almost 30 years after the onset of the epidemic, HIV stigma and discrimination—fed largely by ignorance and animus—persist and continue to have a forceful impact on people living with HIV.”

HIV Stigma and Discrimination Persist, Even in Health Care

Or at least you would hope no one would try and make them wear a badge…

More on Rights of People with HIV and Hepatitis B

Why Do Some Folks Wear a Mask During Flu Season?

Wearing a surgical mask is very common when people are sick and want to avoid spreading their germs to others. They are also commonly worn when people are healthy and are just afraid of getting sick.

Why Do Some Folks Wear a Mask During Flu Season?

Is that why you see some folks wearing masks during flu season?

If you are worried about your privacy, why announce something on Facebook?
If you were worried about your privacy, would you talk about it on Facebook?

Maybe, but some folks actually have to wear a mask during flu season.

Well, they have to because they decide they don’t want to get a flu vaccine, but still want to keep their job that could put others at risk if they got sick with the flu. So basically, it is unvaccinated health care personal and others who work around sick and vulnerable people who might have to wear a mask when they are at work.

Why don’t they just get vaccinated and protected against the flu?

That’s a good question…

Some other questions to consider as you think about flu vaccine mandates include:

  • Do unvaccinated health care workers pose a risk to others in the course of their jobs? Of course they do. Health care personal are at high risk to get the flu, since they are often around people who are sick with the flu, and are at higher risk to get the flu if they are unvaccinated.
  • Does wearing a mask protect anyone? – Yes, they actually do and recent studies have concluded that “surgical face masks worn by infected persons are potentially an effective means of limiting the spread of influenza.”
  • Does getting a flu shot prevent you from catching the flu? – Flu shots aren’t the most effective vaccine we have, but they are the best way to avoid catching the flu, being 10 to 60% effective since 2004.
  • Does getting a flu shot prevent you from spreading the flu to others? Yes, and several studies have shown lower rates of nosocomial cases among hospitalized patients as more health care personal get vaccinated!
  • Does getting a flu shot just cause you to have milder symptoms? The flu vaccine does has many benefits besides preventing the flu, but it is certainly not limited to just causing milder symptoms.
  • Does wearing a mask violate your HIPAA rights? No. Unless you announce it, no one knows why you are wearing a face mask. Maybe you have herpes or a cold or are just afraid of getting sick. And the Health Insurance Portability and Accountability Act only protects patients, not employees.

So why don’t all health care personal get a flu vaccine each year?

Most do.

And while some people seem to be against the idea of mandates for health care workers getting flu shots, most think it is a great idea.

“I support this requirement. I think it is a good idea. Ethically, it makes total sense. First, every doctor, nurse, and HCW knows that they are supposed to put patient interests ahead of their own interests. Whatever you think about flu shots, it is good for patients that their healthcare providers are vaccinated against the flu, particularly among patients who cannot themselves be vaccinated, such as some of the elderly, babies, people with immune diseases, and people who just received transplants or are getting cancer treatment. Vaccination does not help them. They are all immunosuppressed.”

Art Caplan on The Law: Get a Flu Shot or Wear a Mask, Healthcare Workers!

In fact, most think that there is both an ethical and a legal rationale for flu vaccine mandates for health care workers.

“Doctors and other healthcare providers have an ethical obligation to make decisions and take actions that protect patients from preventable harm. 5 Many patients are highly vulnerable to flu, so choosing not to be vaccinated is choosing to do harm—a choice that has no place in healthcare.”

Doctors choosing not to be vaccinated is choosing to do harm

It is hard to imagine that some doctors and nurses not only skip getting vaccinated, putting others at risk, but then don’t even want to wear a mask.

More on Wearing Masks During Flu Season

Measles Deaths in Italy

Breaking News – there are reports of two new deaths in Italy, including a young patient who died of measles encephalitis in 2017 and a young adult with leukemia just last month.

There have been a lot of measles deaths in Europe over the last few years?

How many?

Would you believe over 100?

Measles Deaths in Italy

Among those measles deaths in Europe, there have been at least twelve measles deaths in Italy (five in 2017 and seven in 2018, among just 7,697 cases), all either unvaccinated or partially vaccinated, including:

  • a 6-year-old boy with leukemia who caught measles from an intentionally unvaccinated sibling (2017)
  • an intentionally unvaccinated 9-year-old girl with chromosomopathy, which is not a contraindication to getting vaccinated (2017)
  • a 16-month-old girl with chronic medical problems who caught measles while hospitalized for persistent fever and a subsequent bleeding disorder (2017)
  • a 27-year-old woman (2017)
  • a young patient who died of measles encephalitis (December 2017)
  • a 25-year-old unvaccinated mother
  • a 10-month-old unvaccinated boy who likely caught measles when he had been hospitalized for an RSV infection
  • a 38-year-old
  • a 42-year-old unvaccinated man who was immunocompromised
  • a 51-year-old in Sicily
  • a 29-year-old in Sicily
  • a 23-year-old with leukemia in Trieste who had received one dose of the measles vaccine (October 2018)

Why so many deaths in a developed country with a well-nourished population?

Dr. Bob Sears actually reassured parents that measles wasn't deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe - another well-nourished population with lower vaccination rates than the U.S.
Dr. Bob Sears actually reassured parents that measles wasn’t deadly in developed countries, neglecting to mention the dozens of people who have died in outbreaks in Europe – another well-nourished population with lower vaccination rates than the U.S.

If you haven’t guessed yet, as in other countries in Europe, we are seeing more deaths from measles simply because folks aren’t vaccinated and more people are getting measles.

Measles is a life-threatening disease, even in an age of modern medicine, indoor plumbing, sewage systems, clean water, whole foods, vitamins and minerals, etc.

Italy, with about 1/5 the population of the United States, but about equal to the size of California, has had over 600 times as many cases of measles as we have had in the United States over the last few years. To put it in perspective, that would be like having 33,000 cases of measles in the United States.

Think it couldn’t happen? During the measles outbreaks from 1989 to 1991, when vaccination rates had dropped, there were 55,622 cases and 123 deaths in the United States.

Measles in Italy

Again, in Italy, as in other places, almost all of the measles cases, about 90%, have been in those who aren’t vaccinated.

In response to a post praising Italy's decision to dilute their new vaccine laws, some folks thought it was funny that people were dying of measles.
In response to a post from Dr. Bob Sears praising Italy’s decision to dilute their new vaccine laws, some folks thought it was funny that people were dying of measles.

That’s why they passed new vaccine laws – to get back to herd immunity levels of vaccination.

But shouldn’t folks have a choice about getting vaccinated?

Of course.

Even with the new vaccine laws, parents have a choice. As with vaccine laws in the United States, Italy’s new vaccine mandates had nothing to do with forced vaccination.

That’s unlike most of the people who died of measles in Italy. Most of them didn’t have a choice about being vaccinated and getting measles. Some were immunocompromised and couldn’t be vaccinated and at least one was too young to be vaccinated.

Parents had been set a July 10th deadline to provide schools with the relevant documentation, but it will now be possible for parents to simply submit their own confirmation that the child has been vaccinated, according to Giulia Grillo, Italy’s Health Minister, who was speaking at a press conference on Thursday.

Mandatory vaccinations: Italian parents will no longer need to provide doctor’s note

And that’s why it’s unfortunate that the a newly elected government severely watered down a vaccine law that had made getting vaccinated mandatory to go to school.

And it’s unfortunate that people continue to push misinformation about vaccines and vaccine-preventable diseases.

What to Know About the Measles Deaths in Italy

A drop in vaccination rates has led to measles outbreaks and a number of measles deaths in Italy.

More on Measles Deaths in Italy

Updated November 7, 2018

Did Sweden Ban Mandatory Vaccination?

Have you heard the “news” that Sweden banned mandatory vaccination in their country?

Is that true?

Did Sweden Ban Mandatory Vaccination?

Like most other anti-vaccine myths, this one isn’t true.

Sweden did not ban mandatory vaccination.

“…vaccination coverage is still high and stable, that the diseases covered by the programs are under control…”

Riksdag Social Committee report 2016/17: SoU7

In March 2017, the Riksdag, or Swedish parliament, did vote against a proposal that called for mandatory vaccination. This came as other countries in Europe are seeing lower rates of immunization, rising rates of vaccine-preventable disease, and calls for vaccine mandates. In fact, France and Italy recently implemented vaccine mandates.

“The general vaccination program has a good coverage, and most children are protected against measles and polio, for example. There are, however, skepticism about vaccinations, both the vaccinations included in the basic program and others. In our view, however, it is of societal interest that the vaccination program is implemented in its entirety, and many of the myths and incorrect data circulating about the vaccination program need to be treated and pinned. We therefore consider that the government should provide the appropriate authority with the task of designing an information campaign on the benefits and necessity of the childhood vaccination program.”

Riksdag Social Committee report 2016/17: SoU7

Although the Swedish parliament voted against a motion that would have started a mandatory vaccination plan, there was nothing to ban. Sweden has never had a mandatory vaccination.

The Riksdag passed a motion to add the rotavirus vaccine to the immunization schedule in Sweden.
The Riksdag did pass a motion to add the rotavirus vaccine to the immunization schedule in Sweden.

It is also clear that they see the problem that anti-vax groups are causing in their country and are working to combat them.

That will hopefully keep them from needing a mandatory vaccination program.

What to Know About the Myth of Sweden Banning Mandatory Vaccination

Sweden, with good immunization levels and low rates of vaccine-preventable disease, did not ban mandatory vaccination.

More on the Myth of Sweden Banning Mandatory Vaccination

Why Did France Take the Rotavirus Vaccine off Their Schedule?

Have you heard that France took the rotavirus vaccine off their immunization schedule?

Why?

It was supposedly because two babies died of intussusception after being vaccinated.

Rotavirus Vaccines and Intussusception

Intussusception? Wasn’t that just a risk from RotaShield, the original rotavirus vaccine?

While the risk was higher with RotaShield, the current rotavirus vaccines do have a small risk of intussusception.

france-immunization-schedule
The French immunization schedule is published in the Bulletin épidémiologique hebdomadaire and has never included the rotavirus vaccine.

So did France take the rotavirus vaccine off of their schedule?

Technically, France hadn’t yet added the rotavirus vaccine to their schedule, but it had been available since 2006 and they did formally recommend infants get vaccinated beginning in November 2013.

That recommendation was suspended in April 2015, after they recorded 47 cases of intussusception over an 8 year period. This included 14 cases that required surgery and tragically, two deaths, including one child who died at home without getting any medical care. The other developed intussusception after the third dose of vaccine, which is not usually linked to any increased risk.

It is important to note that at least 80 other countries, including the United States, Finland, Germany, Norway, and the UK, haven’t stopped using the rotavirus vaccine.

Why not?

Because the risks of a natural rotavirus infection are much greater than the risk of intussusception. In other words, the benefits of the vaccine exceed its risks.

In France alone, for example, it is estimated that rotavirus vaccines could prevent 30,000 emergency room visits, 14,000 hospitalizations, and 8 to 17 deaths each year, all in children under the age of three years.

And even without the rotavirus vaccine, there are about 200 to 250 spontaneous intussusceptions each year in France. Fortunately, infants with intussusception can almost always be successfully treated, often without surgery.

Why Did France Take the Rotavirus Vaccine off Their Schedule?

It actually makes no sense that France stopped recommending that infants get vaccinated with one of the rotavirus vaccines.

The decision was widely condemned and there are calls to reassess the decision and put the rotavirus vaccine back on the schedule in France.

“After the surprising decision of the CTV-HCSP of April 2015 to suspend its own recommendation for widespread vaccination against Rotavirus (following a false and misleading pharmacovigilance report) against the international recommendations, we advise you to read the meta-analysis on efficacy (in comparative studies) and the effectiveness (field efficacy) of these vaccines.”

InfoVac Bulletin Novembre 11/2016

The benefits of the rotavirus vaccines far outweigh its risks.

“The estimated benefits of vaccination in our study greatly exceed the estimated risks and our results should contribute to provide further evidence for discussions around rotavirus vaccination in France.”

Larmrani et al A benefit–risk analysis of rotavirus vaccination, France, 2015

Why did France take the rotavirus vaccines off their schedule?

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
In 1885, four boys from New Jersey went all of the way to France to get Pasteur’s new rabies vaccine, which wasn’t yet available in the US.

That’s a good question.

Another good question? How many infants have died of rotavirus infections since they did? And when will they put the vaccine back on the schedule? Fortunately, the rotavirus vaccines are still available in France, they weren’t banned as some folks say.

Of course, this isn’t the first time that France impulsively suspended a vaccine.

In 1998, France suspended the routine vaccination of teens against hepatitis B because of the possible association of the vaccine with multiple sclerosis. This was done amid “pressure from anti-vaccine groups and reports in the French media have raised concerns about a link between HBV immunisation and new cases or relapses of MS and other demyelinating diseases,” even though “scientific data available do not support a causal association between HBV immunisation and central nervous system diseases, including MS.”

“In 1998, official concerns were first voiced over a possible association between hepatitis B virus (HBV) vaccination and multiple sclerosis (MS). Despite a number of studies that have demonstrated no such association, ten years on the French population’s confidence in the vaccine remains shaken and immunization rates of infants have stagnated beneath 30%. With a chronic carriage of the virus estimated at 0.68%, it seems unlikely that France will be able to control the circulation of the virus. ”

Marta Balinska on Hepatitis B vaccination and French Society ten years after the suspension of the vaccination campaign: how should we raise infant immunization coverage rates?

Do you know where all of this has left France now?

With high rates of vaccine-preventable disease (15,000 cases of measles in 2011, with 16 cases of encephalitis and 6 deaths) and a move towards vaccine mandates. As of January 2018, all infants and toddlers in France must receive DTaP, Hib, HepB, pneumococcal, MMR, and meningococcal C vaccines.

What to Know About France Taking the Rotavirus Vaccine off Their Schedule

In no longer recommending the rotavirus vaccines, officials in France actually put infants at greater risk for sickness and death.

More on France Taking the Rotavirus Vaccine off Their Schedule

 

Do Vaccine Mandates Force Parents to Vaccinate Their Kids?

Listening to some parents talk about new vaccine laws, you would think that pediatricians are going to start kidnapping babies or simply hold them down to force them to get vaccinated and follow the latest immunization schedule.

Is there any truth to that?

Of course not.

The History of Vaccine Mandates

There have been vaccine mandates in the United States since 1827, when Boston became the first city to require all children attending public schools to be vaccinated against smallpox.

Surprisingly though, it took a long time to get vaccine mandates protecting more children. It wasn’t until the 1980-81 school year that there were laws in all 50 states mandating that children required vaccinations before starting school.

This followed continued measles outbreaks in the mid-1970s and studies showing that states with vaccine mandates had much lower rates of measles than states that didn’t. And it likely explains why there were 10 measles deaths in the United States as late as 1980, even though the first measles vaccine was introduced in 1963.

It took even longer for the vaccine mandates to cover kids in all grades and not just those entering school, to cover kids in daycare, and to cover kids in college. And tragically, it didn’t take long for politicians to chip away at those vaccine mandates. Over just a few years, from 1998 to 2000, 15 states added personal belief vaccine exemptions.

Still, even before the addition of personal belief vaccine exemptions and without the abuse of religious exemptions and medical exemptions, vaccine mandates have never equaled forced vaccination.

Even the Vaccination Act of 1853 in the UK, which required everyone to get a small pox vaccine, didn’t actually force them to get vaccinated. It originally levied fines on people until they got the vaccine, but they soon allowed a conscientious exemption to vaccination, which many people took advantage of. Over the years, so many people were claiming conscientious vaccine exemptions in the UK, that in 1946, they repealed their vaccine requirements altogether.

What Is a Vaccine Mandate?

Since a mandate is typically defined as an official order to do something, a vaccine mandate would be an order to get a vaccine. But it is hardly an order to hold down and force a vaccine on someone.

Likewise, state laws that mandate vaccines aren’t forcing kids to get vaccinated. They are typically mandates to get vaccinated before attending daycare, public and private schools, and/or college.

Is your child going to camp this year? They might mandate certain vaccines if kids want to attend.

Do Vaccine Mandates Force Parents to Vaccinate Their Kids?

Do vaccine mandates take away a person’s choice about getting vaccinated?

Anti-vaccine folks go to great lengths to scare you into thinking that someone is going to force you to vaccinate your kids. They aren't...
Anti-vaccine folks go to great lengths to scare you into thinking that someone is going to force you to vaccinate your kids. They aren’t…

Of course not.

Again. We are not talking about forced vaccination.

For example, if you work in a hospital that requires a yearly flu vaccine, you can decide to work somewhere else. Sure, you no longer simply have the choice between getting vaccinated or leaving yourself unprotected and continuing to work at the same job, but you can still decide to skip the vaccine and look for another job.

These are mandates with a choice.

The same is true with vaccine mandates for kids to attend school or daycare. If you choose to skip one or more vaccines for a non-medical reason, then even if you are in a state that doesn’t allow religious or philosophical vaccine exemptions, you won’t be forced to get vaccinated. While it may not be an option you are happy with, homeschooling is an option for those who don’t want to vaccinate their kids.

That is your vaccine choice.

Public education is a benefit of those who comply with mandates or compulsory vaccination laws.

These state immunization laws and vaccine mandates have nothing to do with forced vaccination. They also don’t take away your informed consent, are not against the Nuremberg Code, and are not unconstitutional.

Have kids ever been forced to get vaccinations?

Not routinely, but there have been cases of health officials getting court orders to get kids vaccinated and protected, usually during outbreaks of a vaccine-preventable disease.

In 1991, for example, a judge ruled that parents of unvaccinated children who were members of the Faith Tabernacle Congregation in Pennsylvania had to get a measles vaccine. As a measles outbreak spread through Faith Tabernacle, an associated church, and the rest of the city, there were at least 486 cases of measles in the church, mostly among children, and 6 deaths.

“Parents are free to become martyrs themselves. But it does not follow that they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice for themselves.”

Prince v. Massachusetts

In addition to being unvaccinated, these children didn’t get any medical care, as their families instead relied on prayer. Finally, after the order was appealed all the way to the state Supreme Court, only nine children got vaccinated.

When parents disagree about vaccines, a judge might also step in decide that a child be vaccinated over one parent’s objections. A child might also get vaccinated against their parents wishes if they have lost custody for reasons that have nothing to do with the child’s medical issues and so a legal guardian, which might be the state, is making those decisions now.

Still, these are not the usual circumstances we are talking about with state vaccine laws. They are simply laws to get kids vaccinated and protected before they are allowed to attend daycare or school.

What to Know About Vaccine Mandates and Forced Vaccinations

Vaccine mandates do not force parents to vaccinate their kids.

More on Vaccine Mandates and Forced Vaccinations

 

What Is Vaccine Choice?

Have you heard about the idea of vaccine choice?

The “right to choose” is being pushed by anti-vaccine groups in many states because they think that laws mandating kids to have vaccines to go to daycare, school, and college violates their parental rights and civil liberties.

“Their claim that vaccines are 100% safe and effective for all people all of the time is not based in science and is not supported by facts or evidence, making it more of a religious belief than an adequate basis for their mandate argument.”

Texans for Vaccine Choice

And of course, they use a lot of anti-vaccine talking points to try and scare parents into believing them. Vaccines are safe and they work, but no one says that they are 100% safe or that they are 100% effective.

What Is Vaccine Choice?

Right away, you should see another big problem with the vaccine choice movement.

No one is forcing anyone to get vaccinated. Everyone has a choice. It’s just that some folks don’t like the consequences that come with that choice of not vaccinating their kids – having to home school their kids instead of going to a public or private school.

So basically, vaccine choice is just the anti-vaccine movement moving the goal posts yet again.

“If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the f–king measles.”

Jenny McCarthy

Study after study showed that vaccines are not associated with autism and what did we get, measles outbreaks in unvaccinated kids.

What’s Missing In the Vaccine Choice Argument?

In addition to facts, one big thing that is missing from the vaccine choice argument is that by pushing the idea that unvaccinated kids should be allowed to skip or delay any or all vaccines without consequences, that takes away the choice for the rest of us who want to keep our kids protected from vaccine-preventable diseases.

Can’t we just vaccinate our kids?

Many children with cancer and other medical conditions benefit from herd immunity.
Many children with cancer and other medical conditions benefit from herd immunity. (CC BY 2.0)

We do!

But that doesn’t take away all of the risk if you don’t vaccinate your kids.

“…the increased risk of disease in the pediatric population, in part because of increasing rates of vaccine refusal and in some circumstances more rapid loss of immunity, increases potential exposure of immunodeficient children.”

Medical Advisory Committee of the Immune Deficiency Foundation

There are kids who are too young to be vaccinated or fully vaccinated, kids who can’t be vaccinated because of true medical vaccine exemptions, and folks whose vaccine didn’t work, after all, vaccines aren’t 100% effective.

The “choice” folks don’t talk about those things though.

Make an informed choice about vaccines before you think about leaving your child unvaccinated and unprotected.

What To Know About Vaccine Choice

Listen to anti-vaccine propaganda, skip or delay vaccines and leave your kids unprotected or do your research and understand that vaccines work and are safe and necessary and get them vaccinated and protected – that’s your vaccine choice.

More on Vaccine Choice