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Posted: 4/16/2014 9:01:42 PM | with 4 comments

Parents and health care professionals filled the Old Supreme Court building in Denver at an Apr. 9, 2014 public hearing of the Colorado Senate Military and Veterans Affairs Committee to testify against a bill (HB1288) to restrict the personal belief exemption to vaccination. The bill is being sponsored by Irene Aguilar (D-District 32) and co-sponsored by Lucia Guzman (D-District 34); Nancy Todd (D-District 28); and Jessie Ulibarri (D-District 21).
 
Testimony for and against the bill went on for nearly five hours. Just like the Mar. 13 House hearing, parents opposing the bill outnumbered those speaking in support of the bill. Unlike the House hearing, however, the Senate hearing was not as extensively covered by the media.
 
Burdening Parents and Judging Personal Beliefs
 
Colorado resident and NVIC Executive Director Theresa Wrangham testified at the hearing that the bill is “discriminatory because it burdens those choosing to take vaccine exemptions with higher education requirements than federal law requires for those choosing to vaccinate. “ She added that “Those harmed by vaccination are as important as those harmed by a disease” and that requiring state sponsored education or a doctor’s signature to obtain a personal belief exemption puts “the state or health care provider in the position of approving another citizen’s religious or conscientiously held beliefs.”  
 
Threatening Medical Privacy and Singling Out Parents for Harassment
 
NVIC Advocacy Director, Dawn Richardson, submitted written testimony on behalf of NVIC and said the bill “threatens the medical privacy of children and sets them up for harassment by requiring their individual school or daycare to publicly release vaccine exemptions rates upon request.” She pointed out that the small number of parents taking exemptions will make it likely the family will be “singled out, harassed and be discriminated against” and said that this is already happening in California where a similar bill restricting personal belief exemption was passed.
 
Parents Testifying About Vaccines Injuries and Health Choices
 
Parents testified that they followed doctors’ orders without questioning and their children suffered vaccine reactions and were left with permanent brain and immune system problems. Ronnie Prine brought his severely vaccine injured adult son to the Capitol in a wheelchair and Kathy Sincere testified that she has four adult vaccine injured children.  Robyn Charron, who has a four year old vaccine injured son and wants to protect her two year old daughter from becoming vaccine injured, expressed the concerns of many parents testifying in opposition to the bill. She said, “This moves us toward vaccinations for everyone and eliminating exemptions altogether.”
 
Health care professionals also testified against the bill, including a doctor of chiropractic with four children. She said, “I Iive in a different paradigm for my family when it comes to their health care.”
 
Watch a report on the hearing by KDVR-TV.
 
Listen to the April 9 hearing in the Senate Military and Veterans Affairs Committee. (Starts at 02:50)
 
 
Colorado residents still have time to contact their elected state representatives and senators and express their concerns about HB1288.  Sign up for the free online NVIC Advocacy Portal and stay informed.
 

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Posted: 4/16/2014 5:03:50 PM | with 17 comments

Barbara Loe Fisher: Parents Should Be Free to Choose.
 
On Apr. 13, 2014, USA Today became the first U.S. national newspaper to call for an end to the personal belief exemption to vaccination in the U.S. and for narrowing of “strictly defined” religious and medical exemptions. In an opposing OpEd, NVIC President Barbara Loe Fisher disagreed and said: “Non-medical vaccine exemptions immunize individuals and the community against unsafe, ineffective vaccines and tyranny.”
 
The OpEds generated a heated online debate among USA Today readers. Within 72 hours, there were more than 15,000 “shares” and 450 comments for the “pro-choice” OpEd and 3,000 “shares “ and 140 comments for the “anti-choice” OpEd. A USA Today reader poll overwhelmingly supported informed consent to vaccination and the freedom to take non-medical vaccine exemptions for religious, philosophical or conscientious beliefs.
 
Below is a fully referenced version of Barbara Loe Fisher’s OpEd that appeared in USA Today on Apr. 13, 2014. To read the USA Today OpEd, click here.
 
Leave Parents Free to Choose Vaccines
by Barbara Loe Fisher
USA Today
Apr. 13, 2014

The public conversation about vaccine safety and choice began after Congress passed the National Childhood Vaccine Injury Act of 1986 shielding drug companies from product liability and doctors from vaccine injury lawsuits.1 Under that law, $3 billion has been paid to the vaccine injured2 while liability-free drug companies enjoy profits from a multi-billion dollar market.3 4     
 
U.S. health officials now recommend 69 doses of 16 vaccines for every child.5 States mandate up to 15 of them - twice as many as 30 years ago.6  7  
 
With 95% of kindergarteners fully vaccinated8 and one child in six in America learning disabled,9 1 in 10 asthmatic10 and 1 in 50 living with autism,11 educated parents and health care professionals are asking legitimate questions about why so many highly vaccinated children are so sick.12 They are examining vaccine science shortfalls13  14  15  and wondering why Americans are coerced and punished for declining to use every government recommended vaccine16 while citizens in Canada, Japan and the European Union are free to make choices.17  
 
Vaccines carry two risks: a risk of harm18 and a risk the vaccine will fail to prevent disease.19  The Centers for Disease Control and Prevention admits that U.S. pertussis outbreaks are not due to a failure to vaccinate but failure of the vaccine to confer long-lasting immunity.20  21    
 
The Institute of Medicine acknowledges major gaps in scientific knowledge about how and why vaccines cause injury and death and who will be more susceptible to suffering harm. 22 23  Vaccine risks are not being shared equally by all because “no exceptions” vaccine mandates discriminate against and penalize those vulnerable to vaccine complications.  
 
Public health officials and pediatricians are not infallible and what is considered scientific “truth” today may not be true tomorrow. When doctors cannot predict ahead of time who will be harmed by a vaccine and cannot guarantee that those who have been vaccinated won’t get infected or transmit infection, the ethical principle of informed consent24  becomes a civil, human and parental right that must be safeguarded in U.S. law.  
 
Non-medical vaccine exemptions immunize individuals and the community against unsafe, ineffective vaccines and tyranny.
 
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Posted: 3/20/2014 8:05:51 PM | with 9 comments

Parents Opposing Colorado Vaccine Bill Outnumber Supporters 3 to 1 at Public Hearing to Restrict Personal Belief Exemption
 

More than 70 Colorado parents and health care professionals attended the Mar. 13, 2014
House hearing to oppose restriction of the personal belief vaccine exemption.
 
In a vigorously debated six hour public hearing in the Colorado House Health, Insurance and Environment Committee on Mar. 13, 2014, more than 70 Colorado citizens attended to testify in opposition to House Bill 1288 that would restrict access to the personal belief vaccine exemption in the state. By 3 to 1, they outnumbered individual citizens testifying in support of the bill.

Even though the Committee voted 9 to 2 in favor of passing the bill out of Committee, the vote did not come until after hours of powerful testimony by parents describing how their children suffered debilitating vaccine reactions that ended in chronic disability or death. Sadly, by 10 p.m. when the hearing ended, many parents opposing the bill had already left without being able to give their three-minute testimony because they were unable to stay into the night. 

The hearing was extensively covered by the national and state media, including Associated Press, the Huffington Post and Denver affiliates of CBS and ABC.

Resource Links

Colorado House Bill 14-1288
House Committee Hearing Mar. 13, 2014 (6 hrs)
House Floor debate Mar. 21, 2014 (40 min) In menu on right, scroll down and click on HB 14-1288
House 3rd Reading of HB 14-1288 (9 min) In menu on right, scroll down and click on HB 14-1288

Dr. Susan Lawson, a Colorado veterinarian and mother, whose child was awarded federal vaccine injury compensation after suffering a severe reaction within eight days of an MMRV vaccination at age one, was quoted in an Associated Press article: "Parents have a constitutional right to parent their children," said Susan Lawson, whose daughter suffered brain damage after contracting encephalitis from a routine vaccine when she was a year old. "I am not an uneducated woman."
 
Bill Passes House, Heads to Senate
 
After a spirited 40-minute debate on the House floor on Mar. 21, the bill passed second reading on a voice vote. On Mar. 24 it was voted out of the House on third reading with a recorded 42-19 vote and sent to the Senate.
 
During the House floor debate on Mar. 21, Republican House Leader Brian DelGrosso (District 51) told lawmakers that he vaccinated his own children but his younger brother did not. "And basically what this bill does is, the sponsor is basically saying that my brother is an idiot, my brother is a moron," he said, adding that the message lawmakers are sending is that they know better than parents. "That's exactly what this bill does," said DelGrosso. “You can spin it any other way you like, but this basically says, 'Parents of Colorado that choose not to get immunizations for their kids, you're too stupid to make this decision on your own.'"
 
Rep. Janak Joshi (District 16), a retired physician, said "We have to give the choice to our parents and whatever they believe in." Joshi noted that while he was vaccinated for smallpox growing up, he wasn't immunized for anything else. "I'm still around," he said.
 
“I stand firmly for parent rights on this issue,” said Rep. Steve Humphrey (R-District 48). “I’m not confident that [education] is the ultimate goal.” Rep. Lori Saine, (R-District 63) agreed. She said the bill isn’t needed because “Parents have done their research.” 

NVIC Leads David and Goliath Battle   

NVIC Executive Director Theresa Wrangham and Colorado State Advocacy Director Cindy Loveland, both Colorado residents, led an effort to bring citizens opposing the bill together to make their voices heard. They held a meeting at a local library in January and kept parents informed through the NVIC Advocacy Portal.
 
At the Mar. 13 House hearing, Theresa handed out CDC Vaccine Information Statements (VIS) that doctors and vaccine providers already are required under the 1986 National Childhood Vaccine Injury Act to be given to parents being offered childhood vaccines. She said the bill “discriminates against a minority of parents by falsely assuming they have not educated themselves, though the evidence base consistently shows these parents are highly educated.”
 
Pointing out that “No vaccine is 100% safe or effective and there is no public health official or provider who can guarantee that the vaccine you get today will protect you and won’t harm you,” Theresa added “There is no public health crisis in Colorado….The CDC has acknowledged that the unvaccinated are not to blame for recent [pertussis] outbreaks, as evidenced by Colorado’s own surveillance data.” Read Theresa’s full testimony here.

Cindy testified that “The State of Colorado has no business mandating that parents must go through additional state education or be forced to get a signature from a medical doctor to exercise their right to do what they think is best for their child. We don’t do that for other medical procedures.”

In written testimony, NVIC Advocacy Director Dawn Richardson said “Under the guise of education, HB1288 makes it legal for the state to brand a minority of citizens as intellectually or morally inferior and serves to harass and coerce citizens making health care decisions for their minor children. This violates the informed consent ethic and is a violation of human and civil rights by the state.” Read Dawn’s full testimony here.

Bill Requires Schools Release Vaccine Exemption Rates 

The bill requires parents filing a personal belief vaccine exemption for their child to obtain a signature from a pediatrician or other state-approved vaccine provider or submit a “certificate of completion” to a child’s school or daycare affirming that the parent has completed an online vaccine education module developed by state health officials. The bill also requires all daycare centers and schools to publicly release the percentage of children with vaccine exemptions attending a particular daycare center or school. An amendment was added to the bill pertaining to children participating in a “nonpublic, home based education program” or those educated through an online education program.
 
In the past several years, Washington and California have passed laws requiring state designated medical personnel to sign personal belief exemptions. Last year, the state of Oregon eliminated the religious exemption and added a legal requirement for parents declining one or more state mandated vaccines to complete an online education module developed by the state promoting compliance with the federally recommended vaccine schedule.
 
Bill Backed by Pharma-Medical Trade–Public Health Alliance
 
The Colorado bill is being backed and promoted by state health officials and wealthy and politically powerful medical trade groups, many of which are allied with pharmaceutical companies that profit from vaccine sales. There are more than 20 organizations lobbying for the bill to pass, including the American Academy of Pediatrics, Colorado Immunization Coalition, Every Child By Two, Voices for Vaccines, Vaccinate for Healthy Schools, Meningitis Angels, Boulder County Health Department, Children’s Hospital Colorado, Colorado Academy of Family Physicians, Colorado Association of Local Public Health Officials, and Colorado Association for School-Based Health Care.
 
Colorado House Bill 1288 (HB 1288) was introduced into the state House of Representatives by Representative Dan Pabon (D-District 4). In the House the bill is being co-sponsored by the chair of the House health committee, Beth McCann (D-District 8); House health committee vice-chair Sue Schafer (D-District 24) and also Representatives Lois Court (D-District 6); Bob Gardner (R-District 20): Cheri Gerou (R-District 25); Joann Ginal (D-District 52);  Jeanne Labuda (D-District 1); Frank McNulty (R-District 43); and Cherilyn Peniston (D-District 35).
 
Parents Describe the Suffering of Their Children After Vaccination
 
Among the parents who testified against the bill was Robyn Charron, who has a bachelor of science in biology and a law degree from Pepperdine and is the mother of a four year-old vaccine injured son. She said: 
“When my son was two months old, he received the standard round of vaccinations. Within four hours he began the high pitched “neuro scream” associated with encephalitis due to have an allergic reaction to vaccines…..within a few weeks my child was covered in eczema and started exhibiting contact rashes to grass, laundry soap and food…at six months old he was diagnosed with a deadly peanut allergy. When I confronted his doctor with information about vaccine ingredients and safety, I was kicked out of the practice for refusing further shots for my child….I am here as the example of the vaccine education level of the parents who chose to execute personal belief exemptions for their children…You do not need to waste my time or any other parent’s time forcing them to get their vaccine education. We know far more about the topic than you ever will.” 
Another parent who testified against the bill was Captain Pam Long, who graduated from the U.S. Military Academy at West Point, and served in the Army Medical Service Corps with NATO as a Medical Intelligence Officer. She pointed out that the bill fails to recognize medical exemptions: 
“I am here representing educated parents on the vaccine issue….I once thought with my medical training that vaccines were safe and beneficial for all children. My son was neurologically injured and immune-compromised by a vaccine. He could die from a person shedding the influenza vaccine. He has a medical exemption because three doctors agreed that he was vaccine injured….Will you mandate that I take my injured son’s sibling every year to a doctor who will impose his personal belief that I should vaccinate my healthy son? Because the medical community does not know all the contraindications for vaccines, you must honor personal belief exemptions without compulsory education for parents like me and others who have educated themselves on vaccine injury and are not willing to take that risk with their young child on the supersized vaccine schedule that we have today.” 
Bill Headed to Senate
 
In the Senate, the bill is being sponsored by Senator Irene Aguilar (D-District 32) and co-sponsored by Senators Lucia Guzman (D-District 34), Nancy Todd (D-District 28) and Jessie Ulibarri (D-District 21).
 
Residents of Colorado need to contact their Colorado state senators immediately and make their voices heard.
 
 Sign up for NVIC Advocacy Portal
 
If you haven’t already, sign up for NVIC’s free online Advocacy Portal to access timely information on legislation moving in your state that will restrict or expand your legal right to make vaccine choices. You will receive email Action Alerts and be connected with your own state legislators on your smart phone, tablet or computer so you can make your voice heard.
 

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Posted: 2/25/2014 9:09:11 PM | with 17 comments

As a resident of Colorado if you want to protect your right to take a personal belief exemption to vaccination for your child to attend daycare or school without suffering harassment from the state, you need to contact your state representative and senator today and make your voice heard on HB 1288. You also need to attend a public hearing in the Colorado House of Representatives House Health, Insurance and Environment Committee on Thursday, March 13th at 1:30 p.m. in Room 0107 of the State Capitol.  
 
THE FACTS ABOUT HB 1288:
 
Colorado House Bill 1288 (HB 1288) was introduced into the state House of Representatives by Representative Dan Pabon (D-District 4) on Feb. 20, 2014.  Co-sponsoring the bill are Representatives Lois Court (D-District 6); Bob Gardner (R-District 4); Cheri Gerou (R-District 25): Jeanne Labuda (D-District 1); Elizabeth McCann (D-District 8); Frank McNulty (R-District 43); Cherilyn Peniston (D-District-35); Sue Schafer (D-District-24) and Senators Lucia Guzman (D-District-34); Nancy Todd (D-District-28) and Jessie Ulibarri (D-District-21).
 
The bill will make it harder for parents to file and obtain a personal belief exemption to vaccination for their children to attend daycare or school. The bill will also require all daycare centers and schools to publicly release the percentage of children at the daycare center or school with personal belief vaccine exemptions.
 
If HB 1288 passes, it will legally require parents choosing to delay or exempt their child from one or more of the vaccines required for school for personal belief reasons to first: 
  • Submit a "certificate of completion" to the school or daycare that the parent has completed an online vaccine education module developed by state health officials; OR
  • Obtain a signature from a physician or other state-approved vaccine provider or an authorized representative of the state health department certifying that the parent has received state-approved vaccine education. 
The bill gives authority to state health department officials to determine the content of the information and how often parents will have to submit to the new requirements.  
 
This proposed legislation is based on recommendations made from a report issued in December 2013 by the Colorado Department of Public Health and Environment (CDPHE) following a vaccine stakeholder public engagement project heavily stacked with members advocating for the exemption process to be made more difficult for parents.[1]
 
MARCH 13 PUBLIC HEARING ON HB 1288
 
The first public hearing in the Colorado legislature on HB 1288 is scheduled for Thursday, March 13, 2014 at 1:30 pm in room 0107 of the State Capitol. If you want to attend and sign in to give a short oral statement of your opposition to this bill, please see the action alert for HB 1288 on http://NVICAdvocacy.org
 
NVIC POSITION ON HB 1288: OPPOSE
 
NVIC opposes HB 1288 because: 
  • The legislation singles out and discriminates against a minority of parents with sincerely held personal beliefs about vaccination by assuming they are uneducated and should be forced into a state approved “education” program;
  • Under the guise of education, HB 1288 makes it legal for the state to brand a minority of citizens as intellectually or morally inferior and serves to harass and coerce citizens making health care decisions for their minor children. This violates the informed consent ethic and is a violation of human and civil rights by the state.
  • The legislation threatens the medical privacy of students by requiring that daycare centers and schools publicly release information about the percentage of children who have filed personal belief vaccine exemptions. This increases the potential for state sanctioned harassment and discrimination against these students and their families.
FALSE ASSUMPTIONS
 
HB1288 falsely assumes that parents taking personal belief exemptions are not educated when published scientific surveys and studies have consistently demonstrated that parents exercising the personal belief exemption for their children are highly educated.[2] [3] 
 
While parents targeted by this bill are being portrayed as being ignorant, thoughtless and selfish, research published after the 2013 vaccine stakeholder public engagement project conducted in Colorado confirms that parents delaying or declining one or more vaccines for their children are twice as likely to proactively begin vaccine decision-making deliberations before their child is born. Parents exercising the personal belief vaccine exemption are also intellectually re-evaluating their decisions eight times more often than parents who give their children every federally recommended vaccine according to the recommended schedule.[4]
 
In addition, surveillance data in Colorado indicates it is unlikely that a decrease in personal belief vaccine exemptions will affect infectious disease incidence in Colorado, including not having a significant impact on pertussis incidence.
 
COERCION AND EROSION OF PARENTAL RIGHTS
 
Colorado HB1288 and others bills like it threaten the legal right of Americans to exercise informed consent to medical risk taking and make voluntary health care decisions for themselves and their children free from government intrusion and coercion. The legislation unjustly creates a vehicle for state-sanctioned harassment of and discrimination against a minority of citizens with values and personal beliefs differing from those held by public health officials and medical trade groups associated with pharmaceutical corporations.
 
Vaccines are pharmaceutical products that carry risks of injury or death and some individuals with environmental, genetic and biological risk factors are more susceptible to harm from vaccination. It is a fact that no public health official or doctor can predict who will be harmed by a vaccine or an infectious disease because known risks have not been fully quantified and there are other unknown risk factors that have not yet been identified by medical science. [5]
 
PERTUSSIS VACCINE IN COLORADO: A VACCINE FAILURE
 
Although Colorado is the fourth most-improved state for a decline in vaccine exemption rates, [6]  surveillance data from Colorado’s last pertussis epidemic in 2005 shows that pertussis containing vaccines (DtaP, Tdap) are failing to control the disease among Colorado’s children.
 
Many gaps exist in Colorado’s disease and vaccine uptake surveillance data but, where vaccination status is available, it reveals that higher pertussis incidence cannot be assumed to be due to children with personal belief vaccine exemptions.
 
In fact, a recently published study on the impact of non-medical vaccine exemptions on state infectious disease incidence found that these exemptions had little to no impact on disease incidence. [7]
 
Just prior to the Colorado vaccine stakeholder public engagement project, NVIC asked a number of questions of the CDPHE regarding disease incidence in the state. Their response to NVIC’s request for data on the impact of personal belief exemptions on disease incidence was that it was “unavailable.”
 
NVIC has asked for clarification from CDPHE because we want to know: Is the data on the impact of personal belief exemptions on disease incidence in Colorado “unavailable” or is it UNKNOWN? At the time of publication of this NVIC Newsletter, we are still waiting for a response.
 
NO PUBLIC HEALTH CRISIS
 
Colorado does not have a public health crisis necessitating a vaccine exemption statute change. While pertussis outbreaks are being used as a hammer to stampede the legislature into passing HB 1288, the CDC has acknowledged that the unvaccinated are not to blame for recent outbreaks,[8] as evidenced by Colorado’s own surveillance data. In addition to exemptions declining in Colorado, the state is also has increased vaccination coverage for all vaccines for children aged 19-35 months old.[9]
 
TAKE ACTION NOW IF YOU WANT TO PROTECT VACCINE EXEMPTIONS
 
NVIC’s Advocacy Portal has issued an ACTION ALERT for Coloradoans to take action to protect the basic human right to make health care decisions free from discrimination, coercion and sanctions by the state.  Every voice counts – your legislators need to hear from you and your friends and family NOW asking them to VOTE NO on HB 1288 or your legislators will assume all their constituents – including you - want them to vote FOR the bill.
 
Your action is needed to protect the precautionary “first, do no harm” and informed consent principles in all of Colorado’s vaccine policies and laws. When you become a registered user of the free online NVIC Advocacy Portal, you are provided with talking points and are immediately able to connect with your own legislators on your smart phone, tablet or computer.
 
If you haven’t already, please sign up for the NVIC Advocacy Portal today (and ask your family and friends to sign up, too) so you can stay up to date on what is happening with HB 1288 and other vaccine bills in your state that affect you and your family. Stand up for your informed consent and parental rights before they are taken away or severely restricted.
 
It’s your health, your family, your choice.
 
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Posted: 2/19/2014 10:43:29 PM | with 4 comments

By Patrice La Vigne

Every so often, a study is published that accurately informs the public discussion about the relationship between vaccination and health. This is the case with "A Longitudinal Analysis of the Effect of Nonmedical Exemption Law and Vaccine Uptake on Vaccine-Targeted Disease Rates," which was co-authored by Vicky Pebsworth-Debold, PhD, RN, and published in the February issue of the American Journal of Public Health.

After conducting a comprehensive analysis of state vaccine exemption and disease incidence data, the study authors concluded that there is no or little measurable effect of stricter vaccine exemption standards on infectious disease incidence in states. This study contributes important information to the small body of empirical evidence on this topic.

"The Devil is in the Details"

Pebsworth-Debold, a pediatric ICU nurse with PhDs in both public health and nursing, noted that literature on this topic is limited. As an expert in health research methods with knowledge related to infectious diseases, vaccine effectiveness and state laws, she also collaborated on the study to help frame it to inform public health policy.

Across the country, state legislators are being pressured by lobbyists connected with pharmaceutical and medical trade groups to pass laws to eliminate or restrict the legal right to file and receive vaccine exemptions for sincerely held religious and conscientious or philosophical beliefs. "Presumably, these efforts are based on the belief that making access to and use of non-medical exemptions will decrease communicable disease rates," Dr. Pebsworth-Debold said.

In an effort to position the topic adequately, for example, Dr. Pebsworth-Debold argued for the use of the phrase "vaccine-targeted diseases" (VTD) instead of the routinely used phrase "vaccine-preventable diseases" (VPD). She pointed out that VTD is more accurate because vaccines are not 100 percent effective and vaccine failures are an inherent part of all vaccination programs.

"Whether or not vaccines actually 'prevent' or merely 'target' particular diseases most likely varies by disease and should also be evaluated," Dr. Pebsworth-Debold said. The extent to which vaccines actually prevent disease or merely produce time-limited antibodies is a "testable hypotheses that should not be assumed to have already been falsified by gold-standard clinical trials."

Vaccine Exemption Effects on Five Infectious Diseases Studied

Using 2001-2008 data across the 50 states and the District of Columbia, the study authors analyzed the potential impact of use of non-medical vaccine exemption provisions as reflected by differences in state vaccine laws and state-specific annual vaccine uptake rates for vaccines typically required for school or daycare against state-specific annual incidence rates for five VTDs: pertussis, measles, mumps, Haemophilus influenzae type B (Hib) and hepatitis B. The four vaccines included in the study were those that corresponded with the five diseases: diphtheria-pertussis-tetanus (DTaP), measles-mumps-rubella (MMR), hepatitis B and Hib.

Dr. Pebsworth-Debold noted there is no valid, direct measure of use of non-medical exemptions at the state level and so they used two proxy measures for use of non-medical exemptions as reflected by the state-level vaccine uptake rates and a five-level measure of state law restrictiveness, which was determined by two groups of public health law experts. The authors assumed that the level of state law restrictiveness and vaccine uptake were correlated, so two different models of use of non-medical exemptions were tested.

All but two states permit non-medical vaccine exemptions based on religious and/or philosophical beliefs. Dr. Pebsworth-Debold defined state law restrictiveness as "the extent to which a state's statues and regulations discourage or prevent parents from claiming a non-medical exemption to mandated vaccinations," taking into consideration the availability of exemption options and the time and effort required to qualify. The least restrictive states included California, North Dakota, Ohio, Oklahoma, Vermont and Washington, while the most restrictive states were Mississippi and West Virginia.

Study Main Take-Home Points

The results showed that neither measure of non-medical exemption use—the restrictiveness of a state's laws or vaccine uptake rates—was associated with annual disease incidence rates for four of the diseases evaluated. There was, however, a statistically significant, but weak, negative association between pertussis incidence and both proxy measures of non-medical exemption use for five of the eight years of data.

The real-world significance of the observed weak signal for pertussis suggests that if ALL states increased the restrictiveness of their exemption laws by one level, the annual number of pertussis cases would only decline by 1.14%, or 0.20 cases per 100,000 persons, resulting in 171 fewer cases nationally. Further, if states increased their pertussis vaccine uptake by 1%, the annual number of pertussis cases would only decline by 0.04%, or 0.01 cases per 100,000 persons, resulting in five fewer cases nationally.

Study Limitations

Dr. Pebsworth-Debold noted that the study is not without its limitations, including not being able to accurately quantify state-level pertussis incidence. Further, the study assumes that pertussis vaccines effectively prevent vaccinated persons from contracting and transmitting pertussis, even though data published after the study was completed suggests that the vaccine's effectiveness wanes more quickly than previously known, which increases the likelihood that vaccine uptake is less likely to be associated with disease incidence.

She added that this study's overall findings suggest that, "making state laws more restrictive as a means to reduce disease burden would be an example of public policy based on beliefs rather than science." She said "to base state-level vaccine exemption laws on such beliefs would not be consistent with modern national efforts to establish evidence-based public health policies and laws."

The study authors concluded, "Thus, policymakers must balance multiple competing requests to not only strengthen public health infrastructures and protect the well-being of populations, but also safeguard the self-determination rights of individuals who choose not to take potentially ineffective medical treatments that can cause serious temporary and permanent adverse events." 1

Vaccine Reactions: The Need to Know More

Dr. Pebsworth-Debold is no stranger to the profound effect that a serious vaccine reaction can have on the lives of the vaccine-injured and those who love and care for them. She has experienced the devastation of vaccine reactions in her own family, which affected her son and her niece. Her son suffered a "catastrophic reaction" to the seven vaccines he received at his 15-month well baby visit. She said she was initially in denial and once she realized what had happened she recalls "feeling deeply ashamed" and "ignorant" for "having had blind trust in the medical system and not having done my homework."

"I assumed that the CDC-recommended vaccine schedule was a well-established, evidence-based clinical practice guideline and that pediatricians and their nursing staff were well-versed on identification and treatment of vaccine reactions," she said. "Had I only known which shot was causing the severe indurations at the site of the injection after previous rounds of vaccinations prior to his 15-month shots and done some homework, I probably wouldn't have given him that particular shot without testing his titers first and most certainly, would have not given it along with everything else he got that day."

She continued, "I eventually realized that there were substantial holes in what was understood with certainty on these topics and that there was a very poor understanding of the types, causes and treatment of vaccine adverse reactions which results in poorly educated clinical practitioners and parents and, no doubt, negatively affected the quality of care my son received. As a nurse and public health professional, I had vaccinated many children and had no reservations about vaccinating my son because I had no reason to believe that he was at risk of harm. Like most other health care practitioners, I was virtually uneducated on how to recognize and immediately respond to a wide variety of known vaccine adverse reactions. His injury might have been much less severe with fewer long-term consequences if we all had been better educated."

After her son suffered serious health deterioration after his 15-month shots, Dr. Pebsworth-Debold conducted her own research in university libraries and on the Internet. She obtained information on NVIC.org that she couldn't find anywhere else. Then, in 2006, she responded to NVIC's call for a nurse to help respond to vaccine reaction reports and phone calls NVIC receives, and today she serves as a Board member and volunteer director of research and patient safety for NVIC.

Dr. Pebsworth-Debold served as the consumer member of the Food and Drug Administration Vaccines and Related Biological Products Advisory Committee for four years. She participated in public engagement projects initiated by the National Vaccine Advisory Committee to evaluate vaccine stakeholder concerns about vaccine safety and was the consumer representative to the independent H1N1 Vaccine Safety Risk Assessment Working Group (VSRAWG). She has also been a consultant to the Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors and reviewed research proposals for the CDC's Special Interest Panels and a Congressionally Directed Medical Research Programs (CDMRP) peer review program administered by the Department of Defense (DoD). 

References:

1 Yang YT and Debold V.  A Longitudinal Analysis of the Effect of Nonmedical Exemption Law and Vaccine Uptake on Vaccine-Targeted Disease Rates. American Journal of Public Health February 2014;104(2): 371-377.


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