Tag: SB277

Who is the Controlled Opposition in the Anti-Vax Movement?

Anti-vax folks are big on conspiracy theories.

How far do they go?

They think that some anti-vax folks are part of a controlled opposition.

Who is the Controlled Opposition in the Anti-Vax Movement?

Controlled opposition?

“The best way to control the opposition is to lead it ourselves.”

Vladimir Lenin

Have folks who support getting kids vaccinated and protected actually become leaders of the anti-vaccine movement?

Robert Kennedy, Jr is the only one in his family to ever come out against vaccines...
Robert Kennedy, Jr is the only one in his family to ever come out against vaccines…

Why would they do that?

One reason might be to control the opposition. Get them to do what you want. Another might be to do things that are so outrageous that you make the opposition look bad.

Getting arrested for pushing Senator Pan?

Is Kenneth Austin Bennett a part of the controlled opposition?
Is Kenneth Austin Bennett a part of the controlled opposition?

That guy must be part of the controlled opposition!

Wait, is Austin Bennett controlled opposition or is it Joshua Coleman?
Wait, is Austin Bennett or Joshua Coleman the controlled opposition? Is WAKEsheep alerting folks that Andrew Wakefield is being controlled?

Lose a lawsuit to repeal SB 277.

The lawyer must be a part of the controlled opposition!

Who organized the march?
Who organized the march?

Is everyone in the anti-vax movement a part of the controlled opposition?

Who started the infighting between Larry Cook and Brandy Vaughan?
Who started the infighting between Larry Cook and Brandy Vaughan?

Is there anyone in the anti-vax movement that you think vaccine supporters are controlling?

Is there a conspiracy theory that this guy doesn't believe? Have nanobots in vaccines turned him into a member of the controlled opposition without him knowing???
Is there a conspiracy theory that this guy doesn’t believe? Have nanobots in vaccines turned Chris Kirckof into a member of the controlled opposition without him knowing???

Does this whole idea just seem silly?

I’m sure that’s what “they” want you to think!

More on Conspiracy Theories in the Anti-Vax Movement

Does SB 276 Eliminate Medical Exemptions?

Why do some folks think that SB 276, a new vaccine bill in California, will eliminate medical exemptions to getting vaccinated?

SB 276 will not eliminate medical exemptions.
SB 276 will not eliminate medical exemptions.

Oh, more misinformation from the usual suspects…

Does SB 276 Eliminate Medical Exemptions?

To be clear, SB 276 does not eliminate medical exemptions.

So what does California’s new vaccine bill do?

“This bill pressures doctors into giving more vaccines to a child you may know might have a severe reaction, and that’s a tragedy.”

Bob Sears SB 276 Assembly Health Committee Testimony

Despite Bob Sears‘ testimony when he appeared as an expert witness for anti-vaccine folks and gave testimony against SB 276, it basically helps to stop some doctors from writing fake medical exemptions.

“I would imagine a lot of you would not want to give your child more doses of the vaccine if they had a seizure, or a nerve injury, or severe eczema, or any other kinds of dozens of other severe reactions. So that’s all under SB 277 and that’s how I’m practicing now.

My concern with this bill, is that it’s going to take every exemption I’ve ever done under those guidelines, which are not restricted to CDC contraindications – under those old guidelines, they can now review every single one of my exemptions I’ve done and disqualify each and every one of them and kick those kids out of school. They are sort of retroactively changing the guidelines – so all of the exemptions that I’ve ever done, and other physicians have ever done, and to me that’s a very very concerning precedence for a government to go back like that and negate years of medical care that’s been done legally and properly under the guidelines of 277. “

Bob Sears SB 276 Assembly Health Committee Testimony

Legally and properly?

Another complaint has been filed against Bob Sears with the California Medical Board for writing inappropriate medical exemptions.

I would imagine that a lot of parents are scared into thinking that seizures, nerve injuries, and severe eczema are vaccine reactions.

And that’s why some of them might not want to keep vaccinating their kids in these situations.

So that kids aren’t put at risk to get a vaccine-preventable disease though, it’s incredibly important to understand that these aren’t typically vaccine reactions, except maybe if a child has febrile seizures. But even then, having febrile seizures wouldn’t usually be a reason to stop getting vaccinated.

“It’s incredibly important to understand what those CDC guidelines are and that the Senator did answer that the only CDC family history guideline is if a mom or dad, a first degree relative, has a severe immune deficiency, and that the children might have that. And that only exempts you from MMR and chickenpox vaccine.

That’s the only family history factor in all the guidelines that are in this bill.”

Bob Sears SB 276 Assembly Health Committee Testimony

Since severe immunodeficiences, like SCID, can be inherited, it is important to know about a family history of a severe immune system problem before a child gets a live virus vaccine, like MMR or the chicken pox vaccine.

Fortunately, we typically do know about these conditions by the time a child is ready to get these vaccines. And no, it’s not just by asking about the child’s family history. These types of immune system problems cause severe symptoms that have usually showed up well before a child gets these vaccines.

“There’s a small family history factor about seizures. If someone’s had seizures, you can’t get this one brand of vaccines, but you can get other brands that qualify, so that doesn’t work.”

Bob Sears SB 276 Assembly Health Committee Testimony

What is he talking about?

“A personal or family history of seizures is a precaution for MMRV vaccination; this is because a recent study found an increased risk for febrile seizures in children 12-23 months who receive MMRV compared with MMR and varicella vaccine.”

Vaccine Recommendations and Guidelines of the ACIP

The warning is about febrile seizures and ProQuad, the combined MMR and chickenpox vaccine. You can safely get the vaccines though, as the separate MMR and chickenpox vaccines.

This works well!

And parents should know that if their child is having seizures, they will easily qualify for a temporary medical exemption.

“Vaccination should be deferred for persons with a moderate or severe acute illness. This precaution avoids causing diagnostic confusion between manifestations of the underlying illness and possible adverse effects of vaccination or superimposing adverse effects of the vaccine on the underlying illness.”

Vaccine Recommendations and Guidelines of the ACIP

In addition to not giving the DTaP vaccine to a child with a progressive neurological disorder or uncontrolled epilepsy, the general guidelines about deferring vaccination for children with moderate or severe acute illness would likely mean that they wouldn’t get other vaccines either.

“So there’s only one family history factor. So you guys have to realize for example, I’ll see a family, the mom had a seizure after vaccines, her first child had a seizure after vaccines — and she has a new baby and she doesn’t want to give that baby vaccines. And as her doctor, I would agree. That’s a good family history reason not to vaccinate that child — or maybe do we delay them, or do we wait until years later, I don’t know. Maybe it’s temporary exemption because they’re a baby.

There is no single CDC guideline that would allow me to write that exemption under this new law. There is no family history involved whatsoever that that would justify me writing and exemption for that family because that is not in the CDC or the AAP or the ACIP guidelines.

And I appreciate that that the assembly members have asked a lot about family history. You have to realize how narrow that is. This new amendment did not broaden that in any way except for the select few as in the ladies example. Right, so there’s so many – but I mean I could list so many severe reactions I’ve seen moms or dads have or their first kids have after vaccines that I will use as legitimate family history to write an exemption for new baby in that family that will all go away under this new bill – those will all be disqualified. I think that’s important for you guys to understand that…”

Bob Sears SB 276 Assembly Health Committee Testimony

Why does he think “that’s a good family history reason not to vaccinate that child” and leave them at risk to get a vaccine preventable disease?

What are all of these severe reactions he has seen?

Is 6th nerve palsy a vaccine injury?
Is 6th nerve palsy a vaccine injury?

Does he see a lot of serious reactions after vaccines because he thinks everything is a vaccine injury?

There is a reason that having a family history of a vaccine reaction shouldn’t be a reason to skip or delay your child’s vaccines. It certainly shouldn’t be a reason for a doctor to write a medical exemption.

And that’s simply because the risk of having a severe vaccine reaction, even if a family member has had a severe vaccine reaction, is very low.

While Dr. Bob might think a family members having seizures after they were vaccinated is a legitimate reason to put a baby at risk to get one or more vaccine-preventable diseases, it isn’t.

Not only is a family history of an adverse event to a vaccine not a contraindication to getting vaccinated, it is commonly listed a false contraindication!

These are the type of medical exemptions, only those based on invalid criteria, that would be eliminated under SB 276.

“Of the cases that the Board has investigated to date, there have been no fraudulent medical exemptions found. The idea of rampant fraud is a scare tactic to advance SB 276, and a fantasy.”

Mary Holland on SB 276 Will Violate the Doctor-Patient Relationship by Eliminating Medical Exemptions

Interestingly, Bob Sears, who is already on probation, is still under investigation by the California Medical Board for writing fraudulent medical exemptions. So are many other doctors. Why hasn’t any fraud been found? The California Medical Board has had a hard time getting medical records to prove their cases! SB 276 will change that.

More on SB 276 and Medical Exemptions

Vaccines and Homeschooling Myths

Do many parents homeschool their kids because they don’t want to get them vaccinated and comply with vaccination laws?

Vaccines and Homeschooling Myths

Opponents to a vaccine law in California that removed personal belief vaccine exemptions, SB277, claimed that it would lead all children currently receiving personal belief exemptions to leave those schools and become homeschoolers.

One problem with this idea is that even though 32 states don’t allow personal belief vaccine exemptions, avoiding vaccines laws is not a top reason for why most parents choose to homeschool their kids.

“Parents cite a number of different reasons for choosing to homeschool, including concerns about the school environment and desires to provide religious/moral instruction.15 In fact, a Department of Education study says that 38.4 percent of respondents claim they are homeschooling for religious reasons,16 while Christopher Klicka suggests in his book, The Right to Home School, that it is closer to 85 percent.”

Khalili et al on Off the grid: vaccinations among homeschooled children

Instead, most parents homeschool because of:

  • academic reasons – thinking they can provide a better education for their kids at home and dissatisfaction with public or private school
  • family reasons – such as a child with special needs, not being able to get into the right school, transportation issues, or simply wanting more family time
  • religious reasons – including providing religious instruction at home
  • social reasons – including negative social activity and exposures at public and private schools

The availability of virtual education, cyber schools, and charter homeschools has likely also been a factor in some parents choosing to homeschool their kids.

What about vaccines?

In one article, Homeschooling parents’ practices and beliefs about childhood immunizations, only five parents (4%) included a desire not to vaccinate children as a reason for homeschooling.

Also, homeschooling rates are about the same in every state, just over 3% of students. A few outliers include Delaware (2.1%), North Carolina (7.7%), Pennsylvania (1.1%), West Virginia (4.6%), and Wisconsin (1.6%).

Of these states, only West Virginia doesn’t allow non-medical exemptions. But neither does Mississippi, which has very average homeschooling rates (3%).

Are Anti-vaxxers Turning to Homeschooling?

If anti-vaxxers are truly turning to homeschooling to avoid getting their kids vaccinated, we might have expected to see it happen in 2015, when California passed SB 277. That law eliminated non-medical vaccine exemptions and has been in effect since the 2016-2017 school year.

Orange County was the site of several large measles outbreaks before SB 277 took effect.
Orange County was the site of several large measles outbreaks before SB 277 took effect.

Although California is dealing with fake medical exemptions, there has not been a lot of evidence that many folks are homeschooling, leaving schools, or leaving the state after SB277 because they now have had to vaccinate and protect their kids.

“The law, however, does not apply to children who are home-schooled, a loophole that parents seem to be increasingly exploiting. Over the past three years, the number of kindergartners who were home-schooled and did not have their shots quadrupled, according to a Times analysis of state data.”

Parents who won’t vaccinate their kids turning to home-schooling in California, data show

While there were more homeschoolers last year in California (3%), the rise in homeschooling in California is also being seen in many states without new vaccine laws.

“Home-schooling mothers were concerned about SB-277 but did not report that it was directly impacting their children, their vaccine decisions, or reason to home school.”

McDonald et al on Exploring California’s new law eliminating personal belief exemptions to childhood vaccines and vaccine decision-making among homeschooling mothers in California

And, according to the Los Angeles Times, only “1.2% of the state’s kindergartners were home-schooled and unvaccinated in the last school year.”

The Homeschool Vaccine Loophole

It is also important to note that many states already have laws requiring homeschooled students to be vaccinated!

So yes, it is correct to say that the parents who are switching to homeschooling to avoid vaccinating and protecting their kids are exploiting a loophole.

“Submit proof of vaccination and receipt of any health services or examinations as required by law.”

Home Schooling in Tennessee

Interestingly, North Carolina, with one of the highest rates of homeschoolers, requires that homeschooled children be vaccinated.

Is being able to homeschool without vaccines a loophole that will have to be closed?

“And though most of their schooling may take place at home, many are part of programs that meet several times a week with other students. If one contracted a disease such as measles, they could still spread it at the park, or the grocery store, or anywhere they come into contact with other people, said Dr. James Cherry, a UCLA expert on pediatric infectious diseases.”

Parents who won’t vaccinate their kids turning to home-schooling in California, data show

It will likely depend if we end up seeing outbreaks among clusters of unvaccinated homeschoolers…

“During the six weeks after the gathering, a total of 34 cases of measles were confirmed. Of the patients with confirmed measles, 94 percent were unvaccinated, 88 percent were less than 20 years of age, and 9 percent were hospitalized. Of the 28 patients who were 5 to 19 years of age, 71 percent were home-schooled. “

Parker et al on Implications of a 2005 measles outbreak in Indiana for sustained elimination of measles in the United States.

Few people will remember the 2005 measles outbreak in Indiana that occurred mostly among intentionally unvaccinated homeschoolers and cost over $167,000 to contain. At the time, it was “the largest documented outbreak of measles in the United States since 1996.”

And it is likely that few people know about the two unvaccinated homeschooled kids in Oklahoma who got tetanus in 2012, including an 8-year-old who was in the ICU for 18 days…

What to Know About Vaccines and Homeschooling

Parents who homeschool their kids should get their kids vaccinated and protected on time and on schedule and follow all of the other AAP recommendations for preventative health care.

More on Vaccines and Homeschooling Myths

Does the CDC Determine Medical Exemptions for Vaccines?

California’s new vaccine law has some folks arguing about medical exemptions again.

Yes, the CDC does not determine medical exemptions for vaccines. That's not news.
Yes, the CDC does not determine medical exemptions for vaccines. That’s not news.

Some want very broad guidelines and are confused about how doctors determine who should get a medical exemption.

Does the CDC Determine Medical Exemptions for Vaccines?

Bob Sears even thinks he has a bombshell revelation that clears everything up.

An email from the CDC!

You can be sure that the "medical provider's prerogative" does not include any reason they think up, even those that have no evidence to back them up.
You can be sure that the “medical provider’s prerogative” does not include any reason they think up, even those that have no evidence to back them up.

The thing is, no one has ever said that ACIP contraindications and precautions to vaccination are the one and only factor that should determine whether or not a child should get a medical exemption.

“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

So no one should really be surprised by an email that says the CDC does not determine medical exemptions.

What Qualifies as a Vaccine Medical Exemption?

What are the other big factors, in addition to ACIP contraindications and precautions?

“A medical exemption is allowed when a child has a medical condition that prevents them from receiving a vaccine.”

What is an Exemption and What Does it Mean?

Medical exemptions for vaccines should be based on AAP and ACIP guidelines, current accepted medical practice, and evidence based medicine.

“Medical exemptions are intended to prevent adverse events in children who are at increased risk of adverse events because of underlying conditions. Many of these underlying conditions also place children at increased risk of complications from infectious diseases. Children with valid medical exemptions need to be protected from exposure to vaccine-preventable diseases by insuring high coverage rates among the rest of the population. Granting medical exemptions for invalid medical contraindications may promote unfounded vaccine safety concerns. Although states may wish to allow parents who make decisions based on poor science or perceptions to withhold vaccines from their children, these exemptions should be distinguished from valid medical exemptions.”

Salmon et al on Keeping the M in Medical Exemptions: Protecting Our Most Vulnerable Children

For example, in addition to kids who may have had a severe allergic reaction to a vaccine, there are often children with immune system problems or who have a moderate or severe illness who can’t get one or more vaccines, at least temporarily.

These are among the common conditions that the AAP says should NOT delay vaccination and which are often mistakenly thought to qualify someone for a medical exemption.
These are among the common conditions that the AAP says should NOT delay vaccination and which are often mistakenly thought to qualify someone for a medical exemption.

Medical exemptions for vaccines should not be based on anecdotes or simply because a vaccine-friendly doctor has scared a parent away from vaccinating and protecting their kids.

There are very few family history issues that would make a child have to skip or delay getting a vaccine.
There are very few family history issues that would make a child have to skip or delay getting a vaccine.

They should rarely be done based on family history of reactions or what some people think are vaccine reactions.

This is what a fake medical exemption will get you - a life-threatening disease.
The child’s medical exemption was for “cytotoxic allergies secondary to immunization,” without any evidence that it was necessary. In addition to a fake medical exemption, he got tetanus.

In general, they should rarely be given, as the AAP states in their policy statement, Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance, “only a very small proportion of children have medical conditions prohibiting specific immunizations…”

That’s why rates of medical exemptions should be low.

“Between the 2009-2010 and 2016-2017 school years, the national median prevalence of medical exemptions has remained constant, between 0.2% to 0.3%, with state-level ranges showing little heterogeneity over time, never exceeding the range of 0.1% to 1.6% over this period.”

Bednarczyk et al on Current landscape of nonmedical vaccination exemptions in the United States: impact of policy changes

And why you shouldn’t have schools with high rates of medical exemptions or doctors writing a lot of medical exemptions.

More on Vaccine Medical Exemption Guidelines