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Wednesday, November 20, 2013

Comments

Megan Lee

Very well said. I've said it before, and am quite happy to say it again. The only exemptions that should be allowed, are VALID medical exemptions. I don't personally think religious exemptions should be permitted. Too many anti vaccine proponents are using bogus religious exemptions to get out of vaccinating their children, when in reality, the reason for not vaccinating is that they have 'heard' vaccines are not safe. The scientific evidence shows, beyond a shadow of a doubt, that NOT vaccinating, is far more dangerous, far more costly - in monetary and health - than vaccinating can ever be. Community Immunity is not just a fairy story. It's a fact.

Liz

Thanks for the comment, Megan. I come down on the side of having a personal choice exemption available, but hard to get.

I'd vote for an exam, modeled on the driver's license exam. The person wanting an exemption for herself, or for her child, would have to show that she had actually mastered the facts about the risk of disease and vaccine safety and efficacy, even if she chooses not to believe them.

Doritmi

I was thinking of a similar model, Liz, though with a day-long course before: a day of study and an exam to make sure you really know what you're doing.

Harriet Huestis

I am in favour of only medical exemptions. Why should religion have any say in public health decisions. Why should religion mean you can neglect your child. Why should everyone have to pay for irrational personal choices. I am Canadian and we have public health care so all the costs of illnesses are borne by everyone. But even in the US this would be true. There are enormous public health expenditures necessary to control outbreaks. Insurance rates would have to be high enough to cover the costs of treatment. Even though it is private doesn't mean that someone is not paying. In Canada it is our tax dollars. In the US it is taxes and insurance costs. My single case of encephalitis has cost taxpayers millions of dollars and will be millions more before I die. This may be the dollar sign argument but allowing any non-medical exemptions is not financially solvent. I would not support forced vaccination but there should be limits on the unvaccinated. The current outbreak in Alberta started after a traveler to the Netherlands returned, most likely a member of the Dutch Reform Church as it is common in this area. Why should they have been allowed to travel on aircraft open to the public even locally let alone internationally. What about the children's rights? Religion is an adult choice not something that should be applied automatically from the parent to the child.

Science Mom

Excellent post Prof. Reiss and thoughtful comments. I have proposed (informally) on prior occasions that religious exemptions be eliminated and have only medical and philosophical. With some caveats though; philosophical exemptions should be restricted to maintain herd immunity threshold. Allow a certain percentage of exemptions, say 2% in any given district, county or what have you (a substantial geographic or populated region). This would allow for selective vaccination and should be tracked. It can be done.

I would also propose that strict adherence to outbreak exclusions be in place. I also agree with the idea of making them more difficult to get via testing as has been suggested. I believe that such a proposal would balance the needs of individuals and public health in the fairest way possible.

Doritmi

Harriet: I understand your point of view, and it makes a lot of sense. I still hesitate, because of the reasons in my post. Mostly, the effects of those that just won't.

Science Mom: The only problem with restriction is that every time you have a quota, you need to consider how to allocate it. I agree with the goal - keeping the numbers to around 2% - but I've been thinking and am still thinking on what is a fair way to implement this. I have my own thoughts, but am curious to hear yours before voicing them...

Science Mom

I would suggest first-come-first-serve although I would imagine the lines that would form in places like Marin county CA. My idea is premised upon single vaccines, not blanket refusals although are also included. For example, set the 2% to each vaccine so no more than 2% can refuse MMR but any vaccines they do get will be accounted for. This has multiple benefits, first we can get a better count of vaccine uptake, not just count exemptions because many or even most states now don't allow people to exempt certain vaccines, it's all or nothing. Secondly, it may even help to increase uptake; for example if a child is only short their Varicella and DTaP for school entry and the exemption quota is met, the parent is probably going to just fulfil the requirement.

I think states may vary on how often one needs to fill out an exemption, some or possibly all are every school change, i.e. elementary, middle and high school while some may be once for the entire district. I would make it every year. I hope I clarified instead of muddy the waters even more.

Joy Davis

Religious belief is a core constitutional right for all of the citizens of America. Taking away freedoms that are intrinsic to the human race to gain a perception of uniform safety through conforming to a medical procedure that has been defined as, "unavoidably unsafe", is not sustainable. The vaccine industry has been exempted from any and all liability and accountability so they have little to no incentive to make a safe or effective product. As for educating people who wish to use their religious freedoms when it comes to opting out of a known dangerous medical procedure-they usually know far more than the doctors or nurses administrating the shot or shots. The fear circulating over the risks for massive outbreaks of the measles, or chicken pox has most families scrambling for the shots. The ones that abstain usually have done the homework and have a medical, philosophical or religious reason for not going through with the procedure. I generally have to educated the doctor and nurse about vaccinations and my medical history which according to the manufacturer insert creates a contraindication. An individual with a family member who has had stroke, a seizure, migraine headaches, neuropathy, or autism (just to name a few) should not receive a DTaP vaccination. To sum it up: I am at serious odds with this article as It is not for anyone else to decide what religious belief is "valid". Fear has been the greatest push behind all large scale hate crimes. The fear of a measles outbreak should never propel people in this Country to strike down such a fundamental liberty as our Religious liberties.

Science Mom

"Religious belief is a core constitutional right for all of the citizens of America. Taking away freedoms that are intrinsic to the human race to gain a perception of uniform safety through conforming to a medical procedure that has been defined as, "unavoidably unsafe", is not sustainable."

The guarantee of religious freedom, up to a point, is constitutionally-protected. Refusing vaccination is not. Besides you just proved a point in that it isn't your religious beliefs at all that deter you from vaccination; it's an irrational belief that they will cause harm.

"The vaccine industry has been exempted from any and all liability and accountability so they have little to no incentive to make a safe or effective product. "

Demonstrably false. Pharmaceutical companies have not been fully exempted from liability. There is stringent oversight and risk huge fines and even shut down of production facilities if non-compliance is found. Since vaccines are administered to healthy people as a preventative and not a therapeutic drug, the safety standards have to be even higher. This is continually monitored and in part by the Vaccine Safety Datalink.

"As for educating people who wish to use their religious freedoms when it comes to opting out of a known dangerous medical procedure-they usually know far more than the doctors or nurses administrating the shot or shots."

Gleaning some non-filtered information from the internet is not "more educated", just arrogantly ignorant if you think that you will ever know more than a physician or scientist.

"I generally have to educated the doctor and nurse about vaccinations and my medical history which according to the manufacturer insert creates a contraindication. An individual with a family member who has had stroke, a seizure, migraine headaches, neuropathy, or autism (just to name a few) should not receive a DTaP vaccination."

Again false. None of those are contraindications to DTaP but feel free to show me your Google-U education.

"To sum it up: I am at serious odds with this article as It is not for anyone else to decide what religious belief is "valid"."

When your "religious freedom" imposes upon the health and well-being of others, it is absolutely right to curb your "freedoms". You are free to practise your "religion", just don't let it interfere with everyone else's right to live without some infectious diseases.

lilady

@ Joy Davis:

"As for educating people who wish to use their religious freedoms when it comes to opting out of a known dangerous medical procedure-they usually know far more than the doctors or nurses administrating the shot or shots."

And...

"I generally have to educated the doctor and nurse about vaccinations and my medical history which according to the manufacturer insert creates a contraindication. An individual with a family member who has had stroke, a seizure, migraine headaches, neuropathy, or autism (just to name a few) should not receive a DTaP vaccination."


None of the examples you provided are medical contraindications to receiving DTaP vaccine...or any of the vaccines that are listed on the CDC/AAP "Recommended Childhood Vaccine Schedule"

Here, for the actual medical contraindications for each childhood vaccine:

https://www.cdc.gov/VACCINES/recs/vac-admin/contraindications-vacc.htm


lilady, BSc-Nursing, Public Health Nurse Clinician-Epidemiologist (retired)

Joy Davis

Science Mom -

I am interested in why you believe that I am basing my opinions on "non-filtered information from the internet, and Google-U education." Assumptions are not productive.

I am not sure what your research background is but you can start with the books by the Institute of Medicine on Adverse Events Associated with Childhood Vaccines and the Manufacturers insert for ProQuad by Merck which states,"Use caution when administering ProQuad to children with a history of cerebral injury or seizures or any other condition in which stress due to fever should be avoided." and Merck & Co, "Due caution should be employed in administration of M-M-R II to persons with a history of cerebral injury, individual or family histories of convulsions, or any other condition in which stress due to fever
should be avoided." You can also look into the National Immunization Program for their guide to Contraindications.

BTW-The definition of Cerebral injury can be found on the CNS (CENTRE FOR NEURO SKILLS) site and confirms that Cerebral injury includes, vascular disruption (migraine headaches and stroke), metabolic disorders (autism), and toxic exposures.

It is easier to "believe, or have faith" that a vaccine will act like a "magic bullet" and keep children from all disease and only one child in every million will have a small red swelling at the site of injection, but that is magical thinking and not reality. Instead of having blind faith in a medical procedure, I choose to do the research and learn how to protect my child and others in a way that works with the immune system and is truly effective without the adverse events associated with the childhood vaccination program.

Dorit Reiss

Just two points to add to the analysis above: A. as the post explains, you don't have a constitutional right to a religious exemption. B. Here is an explanation of what unavoidably unsafe actually means, and how the Supreme Court did not apply it to vaccines in the way you suggest: https://momswhovax.blogspot.com/2013/11/vaccines-and-unavoidably-unsafe-products.html

Dorit Reiss

Autism is not a metabolic disorder, by the way. And I notice you do not address the risks of diseases to which you are leaving your child exposed - risks much higher than those of the vaccines.

Joy Davis

Dorit Reiss-

Autism and Metabolic Disease.
Journal of Child Neurology, Volume 23, Number 3

Risk of Disease vs. Risk of the Medical Procedure, Vaccination is a great discussion and one of the most important topics of our current day and deserves it's own article with accurate information.

One tidbit of information-
CDC states:
During Jan 1- Aug.1st 2013, 159 cases of Measles were reported Nationally from the ages of 0-61 years of age. Out of the 159 cases 17 people had to go to the hospital for pneumonia and no deaths were reported. 157 of the 159 were import associated.

The number of cases that the VAERS reporting service shows had an adverse effect resulting from the MMR vaccine with an ER visit-395 people.

This for a disease that my husband, all of his friends and their friends and parents had that cleared up in 7-10 days with proper fluids and bed rest with the bonus of lifelong immunity, unlike the vaccine which gives waning immunity within 10-15 years.

Dorit Reiss

Joy Davis,
A. Your article does not say autism is a metabolic disease - in fact, it expressly says otherwise. It does say some metabolic issues are associated with autism at higher rates than in the population, but causation is unclear. https://jcn.sagepub.com/content/23/3/307.short
B. Note that the measles cases are on a background of very high rates of vaccination, with most of them in the unvaccinated. With the rate of death being about one in a thousand, it's not surprising there were none yet. Should we let this grow until people start dying? Sounds like a bad idea. I'm glad your husband cleared the disease. Of course, those who died from it are not here to testify, are they? I am sorry you see fit to dismiss the deaths and suffering from diseases. And by the way, immunity from MMR is probably lifelong.
C. VAERS data does not show causation. Here is an explanation of what it can and cannot be used for: https://www.harpocratesspeaks.com/2013/11/vaers-few-things-we-need-to-discuss.html
D. Here is the data on the relative risks of the disease v. the vaccines: https://www.health.gov.au/internet/immunise/publishing.nsf/Content/D35CD18A3985212ECA2574E2000F9A4F/$File/quick_sideeffects.pdf. As is easy to see, the harms of the disease are an order of magnitude greater.

Science Mom

I am interested in why you believe that I am basing my opinions on "non-filtered information from the internet, and Google-U education." Assumptions are not productive.

Joy Davis, it is no assumption. If you were actually using IOM reports you wouldn't have made this obvious gaff:
"I generally have to educated the doctor and nurse about vaccinations and my medical history which according to the manufacturer insert creates a contraindication. An individual with a family member who has had stroke, a seizure, migraine headaches, neuropathy, or autism (just to name a few) should not receive a DTaP vaccination."

No where in any IOM report are these contraindications for vaccination as you claim. If this is what you are using to "educate" physicians and nurses then my assumptions as to your information is correct.

BTW-The definition of Cerebral injury can be found on the CNS (CENTRE FOR NEURO SKILLS) site and confirms that Cerebral injury includes, vascular disruption (migraine headaches and stroke), metabolic disorders (autism), and toxic exposures.

Autism isn't tacit for a metabolic disorder nor is it brain injury. You are seriously misrepresenting CNS' mission and treatment programmes: https://www.neuroskills.com/brain-injury/brain-injury-overview.php

It is easier to "believe, or have faith" that a vaccine will act like a "magic bullet" and keep children from all disease and only one child in every million will have a small red swelling at the site of injection, but that is magical thinking and not reality. Instead of having blind faith in a medical procedure, I choose to do the research and learn how to protect my child and others in a way that works with the immune system and is truly effective without the adverse events associated with the childhood vaccination program.

Clearly your "education" fails you if you believe this. No one says vaccines are a "magic bullet"; that's a strawman people like you have to set up so you can look as though you are actually correcting a misnomer (which doesn't even exist to begin with). The magical-thinking is yours to believe that, "I choose to do the research and learn how to protect my child and others in a way that works with the immune system and is truly effective"

Please illuminate me as to how you achieve this; I'm always curious when someone makes these types of claims.

Science Mom

The number of cases that the VAERS reporting service shows had an adverse effect resulting from the MMR vaccine with an ER visit-395 people.

This for a disease that my husband, all of his friends and their friends and parents had that cleared up in 7-10 days with proper fluids and bed rest with the bonus of lifelong immunity, unlike the vaccine which gives waning immunity within 10-15 years.

With all of your education you haven't figured out how VAERS works nor where anecdotes are on the evidence scale? Please tell me Joy how VAERS reports have established causation? What would you use for a denominator to calculate a risk ratio? Attack rate? Prevalence rate? Why would you weight a passive surveillance system like VAERS higher than an active surveillance system like the VSD?

Facts

You say vaccines are safe- others disagree.. Shouldn't people be free to choose how they live their life? 100 Compiled Studies on Vaccine Dangers

Activist Post

There is no shortage of research regarding the negative effects of a wide variety of vaccines. From Gardasil to the seasonal flu shot, studies have proven that the extreme risks associated with vaccinating oftentimes outweigh the minor benefits. Here is a fraction of the research (over 100 studies) tying vaccines to a host of health conditions, broken down by category: https://www.activistpost.com/2011/09/100-compiled-studies-on-vaccine-dangers.html

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