Tag: morality

Who Is Arthur Caplan?

Plenty of folks claim to be experts on vaccines.

Some are experts because they study epidemiology, others because they study immunology or infectious disease.

And then there are the experts in vaccination ethics.

Who Is Arthur Caplan?

With a Ph.D. in the history of philosophy of science, Dr. Art Caplan went on to co-found The Hastings Center, a bioethics research institute.

Arthur Caplan does a good job of calling out folks who push anti-vaccine misinformation.
Arthur Caplan does a good job of calling out folks who push anti-vaccine misinformation.

He has since written dozens of books and nearly a thousand articles in peer-reviewed journals, working most recently at New York University’s Langone Medical Center, where he is the founding head of the Division of Medical Ethics.

“When politicians ignore the evidence, fail to cite appropriate medical authorities, and rely on hearsay and rumor, with the result that people — out of ignorance or error — don’t vaccinate their children, we can and should deny them elective office. When a doctor does so, we should demand that he forfeit his right to use his medical degree to misinform, confuse or lie.”

Arthur L. Caplan on Revoke the license of any doctor who opposes vaccination

It shouldn’t be a surprise that Art Caplan has a lot to say about vaccines.

“Faulty ethical thinking is to blame. We are elevating parents’ rights to make misinformed decisions over the rights of children to get important vaccines. Infants and young children are blocked from receiving their routine childhood immunizations by parents who espouse an aberrant ideology of choice or are being duped by anti-vaccine groups. In so doing, they are violating children’s rights to health, welfare and equal opportunity.”

Arthur L. Caplan and Peter J. Hotez on Anti-vaccine misinformation denies children’s rights

He also has a lot to say about measles, other vaccine-preventable diseases, and how to get control back before these outbreaks turn into true epidemics.

“What should we be doing to protect our communities, our children, and ourselves? We should halt the spread of anti-vaccine misinformation and take steps to stop nonmedical vaccine exemptions. We need to restore vaccines and vaccinations as the “new normal” in America.”

Arthur L Caplan on Let’s Treat Measles Seriously

Are you still thinking about skipping or delaying your child’s vaccines?

After reading some of Dr. Caplan’s work, you should know that it’s not safe, has no benefits, and isn’t the ethical thing to do.

More on Arthur Caplan and Vaccine Ethics

Is the MMR Vaccine Licensing Being Called into Question?

Why do some folks think that the MMR vaccine licensing is being called into question?

Yup. That’s what the usual suspects are trying to make you think.

Is the MMR Vaccine Licensing Being Called into Question?

Taking advantage of the fact that many sites publish all press releases, these folks want you to think that a major news site is following their latest bombshell, which of course is just another dud.

The MMR was licensed in 1971. The ICAN papers are from 1978…

You mean there really isn’t an FDA coverup?

“Clinical studies of 284 triple seronegative children, 11 months to 7 years of age, demonstrated that M-M-R II is highly immunogenic and generally well tolerated.”

MMR II Package Insert

Not only is the package insert very transparent about the studies used to approve the MMR II vaccine they are talking about, since only a minor change was made to the original MMR vaccine, which was approved in 1971, it isn’t surprising that larger trials weren’t required at the time.

So there were earlier, larger trials?

Yup.

But did they use a saline control group?

Nope.

A Vaccinated vs Unvaccinated Study - Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies.
A Vaccinated vs Unvaccinated Study – Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies

The control group was actually unvaccinated.

It is also important to keep in mind that this study, and a few other MMR studies, followed much, much larger studies of the individual measles, mumps, and rubella vaccines.

“The large majority of children in the United States have been vaccinated against measles and a sizable portion have been given mumps and rubella vaccines. It is estimated by us based on vaccination distribution that about 41 million children have received measles vaccine, 7 million mumps vaccine, and 21 million rubella vaccine. The combined triple vaccine provides a simple, safe, and effective immunization procedure using a single vaccine dose against three important diseases in children who have not yet been immunized.”

Stokes et al on Trivalent combined measles-mumps-rubella vaccine. Findings in clinical-laboratory studies.

Much larger double-blind, placebo-controlled studies of the individual measles, mumps, and rubella vaccines.

This is why you don’t routinely do vaccinated vs unvaccinated studies anymore. It is unethical to let kids get measles, mumps, rubella or other diseases.

The bottom line is that the measles (1968), mumps (1967), and rubella (1969) vaccines were safe when they were approved by the FDA.

The MMR (1971) was safe when it was approved by the FDA.

And MMR-II (1978) was safe when it was approved by the FDA.

Since then, there have also been studies showing that getting a second dose of MMR-II is safe and effective and that ProQuad, the combination measles, mumps, rubella, and chickenpox vaccine is safe and effective, although it is associated with a small increased risk of febrile seizures if given as a first dose.

There is no FDA coverup. No bombshell.

Just anti-vaccine folks continuing to try and scare you away from vaccinating and protecting your kids.

More on the Licensing of the MMR Vaccine

Why Should Medical Exemptions Be Based on CDC Contraindications?

Getting a medical exemption for vaccines isn’t controversial.

Or at least it shouldn’t be.

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.

Who are the doctors handing out fake medical exemptions in California?
Who are the doctors handing out fake medical exemptions in California?

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.

And that’s about what you would expect, as there are very few true contraindications or precautions to getting vaccinated.

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.

Is everything a vaccine injury?
Is everything a vaccine injury?

It should be obvious.

Medical exemptions for vaccines should be based on CDC criteria because some folks think that everything is a vaccine injury.

More on Medical Exemptions

What’s the Worst That Can Happen If You Lie About Vaccinating Your Child?

We have heard about anti-vaccine parents forging their unvaccinated children’s vaccine records to get them in school.

What’s the harm, right?

What’s the Worst That Can Happen If You Lie About Vaccinating Your Child?

Most of us can think of an awful lot of things that can go wrong in this scenario and we know exactly who’s going to be harmed!

An immunocompromised child got chicken pox after her mom lied about getting her vaccinated.

Yeah, if you lie about getting vaccinated, your kid can get sick.

They can also get other people sick

We found that out last year when an unvaccinated teen returned from a trip overseas and developed measles.

“Although patient A’s parents had chosen not to vaccinate him, his immunocompromised brother, an organ transplant recipient, had received intravenous immunoglobulin to protect him against measles before traveling overseas. When patient A’s illness was reported, SCCPHD recommended that his brother receive additional intravenous immunoglobulin and be quarantined 7 additional days; the family followed both recommendations. Patient C’s unvaccinated sister, aged 17 years, received parental permission to choose to receive MMR vaccine when her brother was quarantined; she opted to receive the vaccine.”

Notes from the Field: Measles Outbreak in an Era of Stricter Immunization Requirements — California, March 2018

While that isn’t so surprising, it is that instead of cooperating with health department investigators, so that they can find and quarantine contact, several people lied. That led to more people getting sick and the outbreak going on longer than it should have.

It is also amazing that they hadn’t already vaccinated their kids, having a high risk, immunocompromised child in the house who couldn’t receive the MMR vaccine!

More on the Worst of the Anti-Vaccine Movement