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.
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
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.
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.”
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?
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.
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
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.
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?
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.
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.
Breaking News – There are now six cases of measles in the San Francisco Bay Area, all unvaccinated, in an ongoing outbreak that has also spread to Nevada.
Is anyone surprised that a student in California has measles?
Actually, a lot of folks are probably surprised. After all, didn’t lawmakers in California recently pass a law that mandated everyone in school get vaccinated?
Well yeah, but SB277 didn’t apply to all students. Only new students and those transitioning to a new grade span (for example, moving from K-6th to 7th grade) have to meet the new minimum immunization requirements. That means it will take more than a few years until all of the kids already in school whose parents have skipped or delayed any vaccines have gotten caught up or have graduated.
When you think of measles and California, most people probably think of the 2015 Disneyland outbreak, which was linked to:
134 cases in California, including at least 50 cases without a known source
13 cases in Arizona, Nebraska, Utah, Colorado, Washington, and Oregon
1 case in Mexico
159 cases in Canada
The Disneyland outbreak included a lot of intentionally unvaccinated kids and kept unvaccinated kids from school, closed daycare centers, and led to hospitalizations of more than a few people.
“The ongoing measles outbreak linked to the Disneyland Resort in Anaheim, California, shines a glaring spotlight on our nation’s growing antivaccination movement and the prevalence of vaccination-hesitant parents.”
Majumder et al. on Substandard Vaccination Compliance and the 2015 Measles Outbreak
The Disneyland outbreak wasn’t the first big measles outbreak in California in recent years though.
No, I’m not talking about the really big outbreaks from the pre-vaccine era. Or even the outbreaks in the late 1980s, just before we started giving an MMR booster. Believe it or not, 75 people died between 1988 and 1990 with measles – just in California.
More recently, there was the 2008 outbreak in San Diego that was triggered by an unvaccinated 7-year-old boy who had traveled to Switzerland with his family.
He returned with measles and got at least 10 other unvaccinated children sick, including four infants who were too young to be vaccinated and were unknowingly exposed at their pediatrician’s office.
“Almost 100 children (including babies who were too young for the MMR vaccine) were quarantined or hospitalized after they were exposed at the pediatrician’s office, Whole Foods or day care. In all, 11 children caught the measles. As it turns out, the boy who spread measles is a patient of Dr. Bob Sears…”
OC’s Dr. Bob Sears discusses measles outbreak on NPR
One of those infants was hospitalized when his fever spiked to 106 degrees and he wouldn’t eat or drink.
“We spent 3 days in the hospital fearing we might lose our baby boy. He couldn’t drink or eat, so he was on an IV, and for a while he seemed to be wasting away. When he began to be able to drink again we got to take him home. But the doctors told us to expect the disease to continue to run its course, including high fever—which did spike as high as 106 degrees. We spent a week waking at all hours to stay on schedule with fever reducing medications and soothing him with damp wash cloths. Also, as instructed, we watched closely for signs of lethargy or non-responsiveness. If we’d seen that, we’d have gone back to the hospital immediately.”
Megan Campbell on 106 Degrees: A True Story
Measles cases also began rising in 2011, as unvaccinated travelers brought measles back from trips to Europe, Asia, and Africa, where there were large outbreaks. There were 31 measles cases in California in 2011.
While 31 cases might not seem like much, consider that between 2001 through 2006, there were just 66 cases in California, with only 4 cases in 2005!
Will we ever get to a year with just 4 cases in California again?
It didn’t happen in 2017.
Last year started with a big outbreak in Los Angeles County that grew to include at least 24 cases and a few surrounding counties. There was also a case involving an unvaccinated student at Laguna Beach High in Orange County which led to the quarantine of at least 6 unvaccinated students.
The Latest California Measles Outbreak
What kind of a measles year will we see in 2018 in California?
It started when an unvaccinated student returned from a trip to Europe and developed measles, exposing others between February 28 through March 2 in Santa Clara County at a school in Campbell and at the Westgate Center food court in San Jose.
With an average incubation period of 10 to 12 days, that means exposed people might begin to show symptoms by March 14. Keep in mind that the incubation period can be as long as 21 days though, so be on the watch for measles symptoms until at least March 23 if you could have been exposed.
Since we don’t know when the new cases began to show symptoms, it is hard to know how much longer we can expect to see new cases. Hopefully these folks were already in quarantine and didn’t expose anyone else.
Would you recognize measles?
It is important to understand that the first symptoms of measles don’t include a rash. Instead, you get a high fever, runny nose, cough, and pink eye. The measles rash comes a few days later, as the high fever continues.
It is also important to understand the the MMR vaccine is safe and works very well to prevent measles.
This exposure is a great reminder that vaccines are necessary and that you shouldn’t wait for your kids to get exposed to get them caught up and vaccinated and protected.
What to Know About Measles Outbreaks in California
A recent outbreak of measles in California, this time in Santa Clara County, is a good reminder that the MMR vaccine is necessary to keep your kids protected.
Even before you get to talk about problems with flu vaccine effectiveness, it becomes clear that everyone wants a better flu vaccine.
One big problem with the current generation of flu vaccines?
You have to get them each and every year.
Developing a Better Flu Vaccine
So what would we all want in a new and better flu vaccine?
last longer, so you didn’t have to get a new vaccine every year
be more effective
cover more flu vaccine strains, so it wasn’t a “guess” about which flu strains to include in the flu vaccine each year and we didn’t have to worry about drifted flu vaccine strains or new and emerging strains for which there is no vaccine
A universal flu vaccine, which covers all possible flu strains, would be ideal.
So why haven’t we been working on developing a universal flu vaccine?
Well, we have.
It just isn’t that easy.
Many different research teams have been working on a universal flu vaccine for years and some have already had some success.
Does that mean we will see a universal flu vaccine soon?
Unfortunately, of the almost 40 organizations working on improved flu vaccines, including a universal flu vaccine, about 30 are still in preclinical or phase 1 trials. So the answer is no, we will not see a universal flu vaccine soon.
The Strategic Plan to Develop a Universal Influenza Vaccine
Maybe that will change now that more and more folks are pushing for a better flu vaccine and we see the effects of severe flu seasons without a good vaccine.
Of course, talk isn’t enough.
“A priority for the National Institute of Allergy and Infectious Diseases (NIAID) is development of an influenza vaccine providing durable protection against multiple influenza strains, including those that may cause a pandemic, i.e., a universal influenza vaccine. To invigorate research efforts, NIAID developed a strategic plan focused on knowledge gaps in three major research areas, as well as additional resources required to ensure progress towards a universal influenza vaccine. NIAID will use this plan as a foundation for future investments in influenza research and will support and coordinate a consortium of multidisciplinary scientists focused on accelerating progress towards this goal.”
Erbelding et al on A Universal Influenza Vaccine: The Strategic Plan for the National Institute of Allergy and Infectious Diseases
That’s why it is also encouraging that we have seen the:
the Pathway to a Universal Influenza Vaccine workshop convened by the National Institute of Allergy and Infectious Diseases (NIAID) in 2017
the Strategic Plan for Developing a Universal Influenza Vaccine by the NIAID that was announced in 2018
U.S. Sen. Ed Markey (D-MA) introduced the Flu Vaccine Act, which would invest $1 billion towards development of a universal flu vaccine
Knowing that developing a universal flu vaccine is a priority of the NIAID and that so many organizations are already working towards this goal is very reassuring.
Hopefully we are a lot closer than some folks thing.
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.
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?
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.
Another situation where you might need to do some catching up is if you move, and instead of following the CDC schedule, you were just getting the minimum number of vaccines that were required to attend school where you used to live. For example, your kids could have been all set to start kindergarten in Arkansas, but if you suddenly moved to Texas, they might need a second MMR, a booster dose of Varivax, and two doses of hepatitis A vaccine, as none of those are required in Arkansas.
Immunization Requirements to Start Daycare and Preschool
Since many new parents have to go back to work when their baby is only about two to six weeks old, they won’t have time to get their first set of vaccines at two months.
That won’t keep them out of daycare, but delaying too much longer, usually more than a month, probably will.
To start daycare or preschool, infants and toddlers need to get most of the vaccines on the CDC immunization schedule. This includes DTaP, hepatitis B, Hib, Prevnar, and IPV (polio), and then once they are 12 months old, booster doses of the primary series of vaccines and the MMR, Varivax (chickenpox), and hepatitis A vaccines.
The only vaccine that is missing from many state mandates is the rotavirus vaccine. And that simply has to do with the strict timing requirements of when you need to start (before 15 weeks of age) and finish this vaccine (by 8 months).
Some states do require rotavirus though, and simply state that kids must follow “age appropriate dosing.” That way, if they are too old, they just don’t need to get it.
Immunization Requirements to Start Kindergarten
In addition to most of the vaccines they needed to start daycare or preschool, to start kindergarten, kids need their 4 to 6 year old boosters:
the fifth dose of DTaP to protect them against diphtheria, tetanus, and pertussis
the fourth dose of IPV to protect them against polio
the second dose of MMR to protect them against measles, mumps, and rubella
the second dose of Varivax to protect them against chicken pox
If using combination vaccines, these four immunizations can be combined into just two shots – Proquad (MMR + Varivax) and either Kinrix or Quadracel (DTaP + IPV), which your preschooler will appreciate to help reduce the pain from getting these shots.
If your kids were missing any vaccines, they will also need to get caught up on those before starting school.
Immunization Requirements to Start Middle School
Preteens and teens get a few vaccines when they start middle school when they are around 11 to 12 years old, including:
a dose of Tdap to protect them against diphtheria, tetanus, and pertussis
a dose of Menactra or Menveo to protect them against meningoccocal disease
Although not required by most schools, the HPV vaccine is also usually given around this time.
Immunization Requirements to Start College
And then, before going off to college, at around age 16 years, kids will usually need:
They can also get the MenB vaccine, although it isn’t yet required for all students. This vaccine (Bexsero or Trumenba) has a “permissive” recommendation, in that parents are told they can get it if they want their kids to avoid meningococcal B disease, but it is not required yet.
While an extra dose of the MMR vaccine is now being given in some situations, it is mainly if your child is at high risk because of a current mumps outbreak. A mumps booster shot is not currently recommended just because your child is going off to college.
What to Know About Immunization Requirements for Incoming Students
If you have been following the latest immunization schedule and your kids are up-to-date on all of their vaccines, then they will likely be ready to start daycare, kindergarten, high-school, and college without needing any extra vaccines.
More on Immunization Requirements for Incoming Students