Earlier this month the New Mexico Department of Health announced that it was changing the childhood vaccine exemption form. New Mexico allows medical and religious exemptions to vaccines and, according to the Department of Health,
The old form did not require written affirmation of a religious-based objection to immunization, and it was not possible to discern the basis for the exemption request and therefore impossible to ascertain whether affiants were complying with NM law.
For over 30 years, the state of New Mexico has accepted conscientious objection to vaccinations as is called for in the law,
A parent or guardian who cannot obtain an affidavit from an officer of a recognized denomination as described in Section 7-1, but whose religious beliefs, held either individually or jointly with others, do not permit the administration of vaccine or other immunizing agents, may apply for an exemption from immunization by submitting a certificate of conscientious objection to immunization.
New Mexico parents who claim vaccine exemptions are scrambling to comply with the new Department of Health form and several have had their forms rejected for the first time. Vaccine exemptions in New Mexico have increased from 1,148 in 1999 to 3,372 in 2011, according to the Department of Health.
VACCINE DEVELOPERS DEMONIZE PARENTS
The move by the NM Department of Health to tighten the reins on the vaccine exemption procedure occurs within a national climate increasingly hostile to vaccine exemptions. Vaccine developer, Paul A. Offit, for example, has written two recent books, Autism’s False Prophets and Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, both of which characterize parents who forgo vaccines as irresponsible and deluded. Offit is in favor of mandatory vaccines and opposed to vaccine exemptions of any kind.
Billionaire Bill Gates, whose Global Fund has pledged $10 billion to provide vaccines to children around the world within the next ten years, also demonizes those who question vaccines, “…the people who go and engage in those anti-vaccine efforts–you know, they, they kill children.” Gates recently funded an anti-vaccine surveillance and alert system: Seth Kalichman of the University of Connecticut
will establish an Internet-based global monitoring and rapid alert system for finding, analyzing, and counteracting communication campaigns containing misinformation regarding vaccines to support global immunization efforts.
Vaccine developers, Offit and Gates, have been criticized for conflict of interest because of the enormous influence they wield over immunization practices and public policy. According to Genetic Engineering & Biotechnology News,
The world vaccines market is predicted to increase at a compound annual rate of 9.3% during 2010–2015, reaching $39.5 billion in 2015 as new product introductions continue and usage of current products expands further.
STATE EFFORTS TO ELIMINATE PHILOSOPHICAL EXEMPTIONS
The demonization of parents who exercise freedom of conscience regarding vaccines has fueled recent efforts in several states to limit parental rights. Currently there is a bill on California governor Jerry Brown’s desk that will require parents who seek philosophical exemptions to vaccines to consult with and get a signature from a licensed healthcare provider before receiving the exemption.
Vermont won a hard fought battle earlier this year when, in March, the Vermont Senate voted 25 to 4 to eliminate the philosophical exemption, in response to concerns from doctors over declining immunization rates: the state’s rate for seventh-graders is about 96%. However, persistent emails, phone calls, and personal visits from parents with the Vermont Coalition for Vaccine Choice influenced legislators to retain the exemption.
Also in March, the New Jersey state legislature approved a bill that requires stricter guidelines for exemptions. The new law reads, “…a general philosophical or moral objection to the vaccination shall not be sufficient for an exemption on religious grounds.”
Parents in West Virginia—which is one of two states with only a medical exemption—lobbied the Legislature unsuccessfully this summer for a religious exemption. According to the National Vaccine Information Center, just 17 states have philosophical exemptions: Arizona, Arkansas, California, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, North Dakota, Ohio, Oklahoma, Texas, Utah, Vermont, Wisconsin and Washington.
DECLINING VACCINE RATES AND DISEASE
State legislators and state health departments are worried about declining vaccination rates. While New Mexico, for example, has child vaccination rates above the national rate, the NM Health Department is concerned that
…some communities in NM have significantly lower vaccine coverage than other communities. These communities with lower coverage are at higher risk for vaccine preventable diseases.
In New Mexico this year 515 cases of whooping cough have been reported—a record number—up from 149 in 2010. Twenty-five thousand cases of pertussis were reported to the CDC through August 24, 2012, the worst epidemic in 50 years. The recent epidemic of pertussis has been blamed on those who don’t vaccinate, however, according to the CDC, this is a worldwide epidemic and the high rates of pertussis suggest
early waning of immunity from acellular vaccines… Although acellular pertussis vaccines provide excellent short-term protection, early waning of immunity might be contributing to increasing population-level susceptibility.”
Some think that the parents of conscience who refuse vaccines hurt others by decreasing our herd immunity, but herd immunity was originally meant to refer to natural immunity from natural diseases, not from vaccines. Vaccines, by their nature, confer temporary immunity, as noted above by the CDC, and diseases have a cyclical nature. According to Barbara Loe Fisher of the National Vaccine Information Center:
“The original concept of herd immunity is that when a population experiences the natural disease… natural immunity would be achieved – a robust, qualitatively superior natural herd immunity within the population, which would then protect other people from getting the disease in other age groups. It’s the way infectious diseases work…
The vaccinologists have adopted this idea of vaccine induced herd immunity. The problem with it is that all vaccines only confer temporary protection… Pertussis vaccine is one of the best examples… Pertussis vaccines have been used for about 50 to 60 years, and the organism has started to evolve to become vaccine resistant. I think this is not something that’s really understood generally by the public: Vaccines do not confer the same type of immunity that natural exposure to the disease does.
DO UNVACCINATED CHILDREN PUT OTHERS AT RISK?
Not everyone agrees that unvaccinated children hurt others. Pediatricians Bob Sears, MD and Jay Gordon MD, among others, support parents’ right to choose. Dr. Gordon says:
In the absence of facts, doctors and others are trying to frighten people into vaccinating or not vaccinating. That fear includes the notions that unvaccinated children pose a great threat to others and that parents of these children are not being responsible. In fact, these parents are choosing what they consider to be the safest course of action for their children and pose very little, if any, danger to other children and adults.
While it is true that unvaccinated children get pertussis at a higher rate than fully vaccinated children, it is the waning effectiveness of the vaccine, and the cyclical and ever evolving nature of the disease, not unvaccinated children, that puts people at risk. According to the CDC in regards to the Washington pertussis epidemic,
…because in most of the cases the patients were vaccinated, the 4.5% of Washington school children who were exempted from vaccination during 2011–2012 represented only a small proportion of those at risk for pertussis in the state.
FREEDOM OF CONSCIENCE
No one knows if frightening parents by tightening vaccine exemptions will increase vaccine compliance. Parents of conscience may choose to home school or to move to a state with philosophical exemptions. Changing the law does not change conscience. As the only medical procedure mandated by law, vaccinations pose unique questions in regard to personal liberty and public health and inevitably pit one against the other.
The US has a century old tradition of accepting conscientious objection to medical procedures and all medical associations support, in principle, the doctrine of informed consent. Informed consent specifically states that one must not be coerced into making a decision and that one may decline a treatment or procedure. Further, the right to decline a treatment is not contingent on the effectiveness of that treatment. Does our tradition of informed consent not apply to vaccines?
Are we prepared to limit a citizen’s right to informed consent for vaccinations, and vaccinations alone? Do we afford informed consent to citizens only for those decisions we approve of? Where do we draw the line when the line no longer exists?
Tags: Barbara Loe Fisher, Bill Gates, Bob Sears, California, CDC, Genetic Engineering & Biotechnology News, herd immunity, immunizations, Informed Consent, Jay Gordon, Jerry Brown, MD, National Vaccine Information Center, New Mexico, New Mexico Department of Health, Paul A. Offit, philosophical exemptions, Seth Kalichman, vaccinations, vaccine exemptions, Vermont Coalition for Vaccine Choice