Last week the governor of California signed into law a good vaccination bill, Senate Bill 276, which stipulates a standardized procedure for requesting medical exemptions from childhood vaccination:
Existing law prohibits the governing authority of a school or other institution from admitting for attendance any pupil who fails to obtain required immunizations within the time limits prescribed by the State Department of Public Health. Existing law exempts from those requirements a pupil whose parents have filed with the governing authority a written statement by a licensed physician to the effect that immunization is not considered safe for that child, indicating the specific nature and probable duration of their medical condition or circumstances, including, but not limited to, family medical history.
This bill would instead require the State Department of Public Health, by January 1, 2021, to develop and make available for use by licensed physicians and surgeons an electronic, standardized, statewide medical exemption request that would be transmitted using the California Immunization Registry (CAIR), and which, commencing January 1, 2021, would be the only documentation of a medical exemption that a governing authority may accept. The bill would specify the information to be included in the medical exemption form, including a certification under penalty of perjury that the statements and information contained in the form are true, accurate, and complete. The bill would, commencing January 1, 2021, require a physician and surgeon to inform a parent or guardian of the bill’s requirements and to examine the child and submit a completed medical exemption request form to the department, as specified. By expanding the crime of perjury, the bill would impose a state-mandated local program.
Note that the major thrust of this bill is to standardize via an electronic form requests for exemptions that were already allowed. There are no new criteria added for getting such an exemption. There’s also a right of appeal (adjudicated by a panel of physicians and surgeons), and, instead of a one-time filing, the certificate must be re-filed annually. It’s electronic, so it’s not onerous.
You can read the whole bill at the link above, but it seems remarkably tame to me. That is, of course, unless you’re an anti-vaxer or someone who opposes vaccination on religious or philosophical grounds. And exemptions based on religion or philosophy are allowed in 45 of the fifty states. The ProCon.org site gives a map and says this:
No US federal vaccination laws exist, but all 50 states have laws requiring children attending public school to be vaccinated against diphtheria, tetanus, and pertussis (generally in a DTaP vaccine); polio (an IPV vaccine); measles and rubella (generally in an MMR vaccine); and varicella (chickenpox). All 50 states allow medical exemptions, 45 states allow religious exemptions, and 15 states allow philosophical (or personal belief) exemptions. DC allows medical and religious exemptions. While reasonable effort has been made to ensure the accuracy of the information provided, do not rely on this information without first checking with your local school or government. This chart was last updated on June 14, 2019.
Now I’m not sure what a philosophical exemption could consist of, but 15 states allow that. To my mind, the welfare of the child, and of other children who could contract diseases from an unvaccinated child, trumps religion and philosophy. (Of course children who have good medical reasons not to be vaccinated should be exempt.) Only California, Mississippi, West Virginia, New York, and Maine have sane policies on this; the rest bow to either religion or philosophy.
The Washington Post details the objections of Californians to this bill in a story from two days ago (click on screenshot):
The protests include these:
First, protesters blocked the entrance to the state capitol Monday and repeatedly shut down the legislature with their demonstrations as Gov. Gavin Newsom (D) signed the bill, the San Francisco Chronicle reported.
Then, a candlelight vigil Wednesday for children allegedly harmed or killed by vaccines included a photo of Ethan Lindenberger, who chose to be vaccinated against his parents’ wishes and has testified before Congress. Jonathan Lockwood, executive director of the anti-vaccine group Conscience Coalition, which organized the vigil, did not immediately respond to a question about why the photo was used.
The state legislative session closed Friday with a dramatic display from the gallery: A woman threw “a feminine hygiene device containing what appeared to be blood” at the senators from a balcony, the California Highway Patrol said.
The protestors and the liquid-throwing woman (I couldn’t ascertain if it really was blood) were arrested. The Post reports that there is a new “wave of hesitancy” about getting children vaccinated, a trend also highlighted by the World Health Organization as one of the ten global threats to health in 2019. WHO notes that “The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy.”
But vaccinations should be required for all children, religious or not. Should a two-year-old really go unvaccinated when its parents have philosophical or religious qualms? That’s a form of child endangerment, and the child has no say. And even for older children (I’m not sure up to what age mandatory vaccinations are given), there’s still the chance of epidemics starting with the unvaccinated. That’s not just a theoretical risk, either; as the Post adds:
The United States is experiencing the greatest number of measles cases in a single year in 27 years. Fueling the outbreaks are anti-vaccine groups that have spread misinformation that lowered vaccination rates in vulnerable communities. New York City’s ultra-Orthodox Jewish community was hard hit by misinformation about the safety and effectiveness of the measles, mumps and rubella vaccine, officials have said.
Religion doesn’t just poison everything; it kills innocent children.
sub
Discourage antisocial behavior with sanctions. For example, require insurance for people who refuse to get their children vaccinated (exempting those with valid medical reasons). Sanction lack of insurance as we do for drivers.
This could also work for guns. Requiring insurance to own a gun would let insurance companies vet potential gun owners using data bases. Nothing like the profit motive to get things done right! If you have to have insurance to drive a car, why not insurance for guns?
I like your thinking there Charles.
Very, very good idea as far as guns go, but insuring a no-Vaxx, how would that work? How can one child (or rather it’s parents) be held liable for the local epidemic the anti-vaxxers are collectively causing? That will be very difficult, but I still like the idea.
Who will be recipients? Well, that question is not as difficult as attributing liability: parents of children that could not be vaccinated for medical reasons and those that lost their children before they were due for vaccination according to the scheme, and vaccinated children that still get sick, despite vaccination.
I understand the aim is mainly a deterrent effect, but for a deterrent to be effective, the law should be as watertight as possible.
“How can one child (or rather it’s parents) be held liable for the local epidemic the anti-vaxxers are collectively causing? That will be very difficult, but I still like the idea.”
It won’t just be difficult – it will be impossible. There is simply no way one could draw a direct line from unvaccinated children to the exclusion of all others. This is not a good path forward.
Well, there might be a construction imaginable where every individual shares part of the collective quilt. All parents in the area, that did not vaccinate for spurious (religious of philosophical) reasons, should share in the guilt.
I’m sure some legal minds are very able to construct such a way.
Somehow I think that circle needs squaring, or you angle neds trisecting, all with straight edge and compasses.
Looking at that map, I doubt there is another issue on which New York, California, Maine, West Virginia, and Mississippi stand together in opposition to the policies of the other states of the Union.
I should think that allowing religious exemptions for immunizations, especially in states that do not allow “philosophical” exemptions (whatever that may entail) could raise some legal issues under the religion clauses of the First Amendment.
This also seems like a matter on which a national standard would be appropriate. Congress’s Commerce Clause authority should provide a sufficient basis for federal legislation on the topic.
Yes, I was pleasantly surprised to see Mississippi and West Virginia in that group. West Virginia, of all states!
I don’t understand that reference to the “Congress’s Commerce Close”, care to elucidate for this ignoramus?
The United States congress has limited, enumerated powers under Article 1, Section 8 of the US constitution. One of these powers, set out in clause 3, is to regulate interstate commerce, a power that has been interpreted very broadly by the US Supreme Court, to permit legislation in a wide variety of fields, such as the sale and distribution of medicine, that have any impact upon interstate commerce.
Powers that are not delegated to congress by the US constitution are reserved for regulation by the individual states.
Thank you for the effort, Ken. But I’m sorry, I’m still drawing a blank. I guess I’ll need some education for dummies on the Commerce Clause here. I feel really stupid.
I fail to see how legislation on vaccination and exemptions is possibly impacted by Congress’s legislation on the sale and distribution of medicine, and how it impacts on interstate commerce.
It’s one of those legalistic subterfuges whereby an obviously necessary and sensible measure, which would be enacted without question by the government of any country with a sensible constitution, has to be imposed on the ungovernable rabble that is the Fifty States.
cr
So much for the glass-is-half-full view of things. 🙂
Nobody ever accused me of being an optimist.
😎
(Well, actually I did commit optimism, just once. I once said “Maybe tRump, when elected and he doesn’t have to win a campaign, will have the savvy to take advice from knowledgeable people and make sensible decisions”. This is not a mistake I am likely to make again.)
cr
“Religion doesn’t just poison everything; it kills innocent children.”
I think it’s a stretch to lay anti-vaccine in the lap of religion. The only two religious groups that openly discourage vaccination are the Christian Scientists and the Dutch Reformed Church—hardly a landslide of opposition. The Catholic Church supports vaccination on the same grounds that you do—namely, that the risks of not vaccinating outweigh any religious/philosophical concerns of using them. Whether religious or not, most “anti-vaxxers” are either mistrustful of the science, suspicious of Big Pharma (“follow the money”), defending parental rights, or simply opposed to vaccinations being mandatory (as you yourself recently said in another context: “I hate coercion”). Religion per se has very little to do with it.
Yes, but there are many “splinter” religions that don’t take vaccinations or give their children medical care; I talk about some of these in Faith Verus Fact. And religions can give people a solidarity to doubt vaccinations beyond even these faiths, as in the Muslim communities discussed in this Vox article, “Religion and vaccine refusal are linked. We have to talk about it.”
Oh, and you forgot the Orthodox Jews.
While there was a measles outbreak among Orthodox Jews in New York, where I don’t recall much of a push by the rabbinate for vaccination, there was also a measles outbreak in the Midwest among Orthodox Jews and there the local rabbinate told their members to vaccinate as a civic and religious duty – I believe Orac (of Respectful Insolence) wrote about it – so it does not seem that there is an objection to vaccination that is based on Orthodox Judaism.
And the California anti-vax crowd did not seem to be religiously motivated, rather just entitled.
This is not to say that there aren’t some anti-vax/anti-medical care religions, as you point out.
What I was trying to say is that closed religious communities can be breeding grounds for anti-vaxers, even if the religion itself doesn’t prohibit vaccination.
And besides, your point remains. There are religions that do not allow children to be vaccinated. Those religions therefore potentially kill innocent children.
I don’t see why people are protesting the statement.
We have a major measles outbreak in NZ at the moment. It’s mainly in south Auckland, but it’s spread elsewhere too. Hundreds have gotten sick. It’s because of people not vaccinating their kids, mainly because they believe it’s dangerous. Children and the elderly have died.
My vaccinated nephew got measles c. 5 years ago because herd immunity broke down in his Hamilton school due to the large number of unvaccinated kids.
It makes me really angry when this happens because it’s usually because of the selfishness of those who believe it’s dangerous and are relying on herd immunity to protect their unvaccinated child.
The is a pertussis outbreak almost every year in the rural region I used to live in. A few years back, I knew multiple (vaccinated) teens to came down with it. Months out of school, broken ribs and for what? Apparently we had enough of a pool of unvaccinated folks that the virus was able to mutate in that population and then spread and put vaccinated folks at risk. Pure selfishness.
Yep. I tend to rant on this topic, so I’m going to repeat it again too. Pure selfishness.
“because of the selfishness of those who believe it’s dangerous”
Yes, but whatabout, whatabout…I mean, if you love your kids, and don’t love other peoples kids quite as much, it kind of makes sense that you’d be willing to advantage your kids over the welfare of others. Not overtly, as in a public declaration of preference for ones own, but covertly as in thinking that avoiding vaccinating ones kids can never be definitively associated to your unvaccinated kid. It could have been the fault of any number of other kids in the unvaccinated pool. So, there is some protection there for parents with worries. That’s why, collective (governmental) action (which is coercive) is the way to go. There is a fringe area where individual liberty and societal benefit has to be weighed and decided.
Kindergartens etc have mandatory vaccination rules. Not sure about schools. A big part of the problem is the location, but I don’t want to get into that here as it’s a really complicated issue.
I always thought it was mandatory through grade school. But, I think it’s actually a state by state issue here in the US. Perhaps we need federal legislation.
“If you love your kids, and don’t love other peoples kids quite as much, it kind of makes sense that you’d be willing to advantage your kids over the welfare of others.”
Exactly. it’s the natural extension of the self-preservation instinct to one’s own children over the children of others. So definitely “selfish” in that sense.
I agree and disagree, there are two ‘poles’ of anti-vaxxerism, and fundamentalist religion is one of them.
Why would so many states allow for exemption on religious grounds if religion is not anti-vaxx?
However, I agree it is not only religious.
This is the case. The anti-vaxxers I’ve run into have not been religiously motivated. (I don’t run in religious circles, so this is no surprise.) What does seem to motivate them is a form of Dunning–Kruger bias where an otherwise intelligent person (say a software engineer) with little understanding of biology thinks they know more than all of those bought-off-gy-big-pharma professional epidemiologists.
“. . .thinks they know more than all of those bought-off-by-big-pharma professional epidemiologists.”
I agree, GB, but there’s a difference between thinking you’re smarter than the epidemiologists and suspecting them of being bought off by Big Pharma. I don’t think the latter qualifies as Dunning-Kruger bias.
There is a difference but the two are strongly correlated, in my experience.
This bill closed a major loophole in the exemption requirements that were in the vaccination bill passed 3 years ago. By all credible accounts anti-vaxx doctors in California were selling medical exemptions, which have quadrupled since the original bill was passed.
California could have avoided this if they had just followed the lead of Mississippi, which set the standard over 30 years ago when they banned all but medical exemptions, each of which must be approved by the State Epidemiologist.
Agreed. I believe in WV the exemptions are approved at county level, and that would make sense – keep the process of gaining the approval sufficiently local to be easily doable for those who actually need them. But Governor Newsom watered down both the vaccination bills – this second one twice – with threats of veto, something that has, rightly in my opinion, drawn significant criticism in the press.
This is, I think, what they’re really protesting about. They don’t like that they won’t be able to game the system in future.
Let’s not put too much faith in the adequacy of making doctors responsible for medical exemptions. How does a doctor know whether a further vaccine given to a particular child will be harmful? It’s very rare that there will be a clear cut case. A parent might report that their child had a stiff neck and seemed drowsy for a few days after the last one, but there is no documentation that supports it. What do you do? It comes down to the mindset of the physician; does he generally assume his patients tell him the truth unless proved otherwise (he will grant the exemption) or is he a jaded world-weary type who assumes his patients are trying it on (he will deny it). The latter course also opens him to liability if a vaccine related adverse event does occur, which will certainly be a consideration.
It seems to me that this bill, well-meant and certainly on the right side of public healthcare, is just placing hurdles in front of vaccine shy parents, and places the burden on doctors to certify things they probably cannot know. This might be done cynically, simply to make vaccine avoidance more difficult but not really sorting the sheep from the goats. I’d hate to think anyone thought doctors so omniscient that they really can tell.
My advice in practice was always statistical. Sure, vaccines sometimes do harm. So do preventable diseases. Choose the smaller risk. You are many times more likely to die from measles than from the measles vaccine, so the choice is easy. I likened having a vaccination to buying a lottery ticket with the intention of not winning the prize, since the odds are in the same league.
Anti-vaxxers include both deeply reactionary religious fanatics and some pop-Left icons like Cynthia McKinney (presidential nominee of the Green Party in 2008). In the latter cases, the anti-vaccine posture is no doubt part of the same hostility to “colonialist” Western science and technology that is so fashionable in some sectors of Academia. Thus, an affectation can graduate to becoming a public health problem. [BTW, the insurance idea for both non-vaccination and firearms possession is brilliant. Has it been seriously proposed in the political world?]
I think the ‘pop-left’, New Age, science distrusting, and particularly Big Pharma distrusting, vegan, macrobiotics anti-vaxx movement was initiated -and if not initiated, seriously boosted- by the small ‘study’ by Andrew Wakefield that somehow got published in The Lancet, associating the MMR vaccine with autism.
His publication was withdrawn, the contents debunked over and over, dozens of times, it was shown he doctored results (and even had some financial interests IIRC), he was stripped of his physicians title, but the damage was done.
He was instrumental in the outbreak of measles in the Somali community in Minnesota, where he peddled his nonsense, his virus. Although he did not threaten immediate violence, his speeches caused several deaths of small children (vaccination rates dropped vertiginously in the Somali community after his indoctrination).
Should his totally debunked and dangerous speech be protected by the First Amendment? (No, I have no clear answer).
Andrew Wakefield is alive and well and still proselytizing his dangerous ‘theory’ right here in America. Just google “Andrew Wakefield” and set the date range to one year.
I know Jenny, hence my question.
You know and I know (and I didn’t know until earlier this year) but there are many who are completely unaware that he’s in America and is still actively spreading his gospel of death.
For the curious, this is a good article about he’s reconstituted himself here in the US in the present anti-scientific political climate. https://www.theguardian.com/society/2018/jul/18/how-disgraced-anti-vaxxer-andrew-wakefield-was-embraced-by-trumps-america
He was struck off the medical register in the UK for his fraudlent and undisclosed financial interests in a treatment for the cases he was diagnosing. Does that mean that he’s also barred in the US, or is he allowed to continue extracting money from people in return for medical advice?
The damage was done: that reminds me of Mr Barr’s total whitewashing of Mr Trump in his ‘creative summary’ of the Mueller Report.
It is clear that the Mueller Report is severely damaging to Mr Trump, but Mr Barr’s initial whitewashing still is widely accepted. Exonerated! Hoax! Coup attempt!
Time for a counter-protest, like we did here to be anti-anti-GMO.
The major single crime of religion, to me, is that it discourages rationality. It encourages magical thinking styles that lead to irrational decisions and actions that harm society. The anti-vaccine movement is a prime example of religious and superstitious ways of thinking encouraged by religious indoctrination. I think even moderate churches are guilty of this.
Yes, that’s it.
This article https://www.verywellfamily.com/religious-exemptions-to-vaccines-2633702 gives a good overview of the religions that are for and against vaccination.
I think that in this post we’re speaking mainly about the situation in the US. Globally, religion and politics re vaccination are frequently difficult to disentangle, especially in underdeveloped areas of the world.
But as per PCC(E)’s statement above, religion enters into the controversy mainly with respect to splinter groups, sects, and outright cults (though, to me, all religions are cults).
To expand a little:
For a number of years – around a decade, if I recall correctly – one of the major delays in the global programme to exterminate poliovirus in the wild was a combination of political opportunism fanning the flames of religious conflict in Nigeria (and adjoining countries), where a political separatist movement (Boko Haram) calling for independence of the Islamic-majority states (northern) from the Christian-majority states (southern) latched onto the polio-eradication campaign as a stick to beat the (Christian-dominated, southern-dominated) government with, by claiming that polio eradication was a pretext for variously, chemical sterilisation, religious contamination (the old “pig parts” trick, q.v. the First Indian War of Independence a.k.a. “Sepoy Mutiny”) and killing off people with AIDS.
Those tactics certainly held up the eradication programme by several years, but I saw recently that Nigeria has now managed a year without a wild case of polio disease, so they might have got past the problem. Boko Haram themselves are still certainly around though, both in Nigeria and in surrounding countries.
Whether the anti-vaxers are religiously inspired or not, battling this ignorance is like playing whac-a-mole.
I rather fear that the only way we’re going to lose the anti-vaxx movement for even a generation is after a really thorough-going pandemic. Since losing several million people to malaria doesn’t have an appreciable effect on the anti-vaxx people, an effective pandemic would probably need to be killing tens of millions of people in the developed world, so probably several times more in the developing world.
We’re in the centenary three-year period of the last pandemic on that scale. You can understand the twitchiness of the WHO. Despite keeping several hundred miles and several strict protocols away from the 2014/5 Ebola outbreak, we were getting decidedly twitchy about it, particularly when it spread into a country (Nigeria) from (or through) which about 10% of our crew came.
No, we only need to kill the anti-vaxxers. Can’t we develop an intelligent virus that only targets them? 😉
(Oops, I think I just outlined the plot of another conspiracy theory. Evil drug company X develops a virus that only X has the cure for. Nobody tell Monsanto).
cr
Hmmm, I’ll think about it. A virus with a “come hither” signal to the immune system which switches on if it encounters (genes for) proteins in common vaccination strains) would get far enough for a book plot, but to actually design one …
A better law would be a simple requirement that unvaccinated kids — and adults — must be *quarantined*. The Amish pretty well quarantine themselves; let the JWs do likewise. When the kids reach legal age they can choose to get themselves vaccinated or not — if they survive that long.
Works for Foot and Mouth disease. 🙂
cr
PS: In these days of AIDS, any thrown liquid could be a deadly weapon. Therefore, arrest anybody who throws any kind of liquid and charge them with deadly assault — until and unless they can prove in court that their liquid was really harmless, in which case they can have the charges reduced to simple assault. Give the “protesters” enough standard sentences in jail, and they’ll drop the tactic.
My daughter in law is an OB nurse in Pittsburgh and we were talking about anti-vaxxers. She tells me that things have gotten so nuts that there are those, and I gather that N = considerably more than one here, who will decline Vitamin K shots (helps coagulation), BUT go for circumcision!