The Cost of Vaccine Misinformation

April 18, 2014 10 comments
This guest post was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of  the Law in San Francisco, CA.  In this post Dr. Reiss responds to questions we have received regarding who is liable when harm occurs as a result of a parent’s decision not to vaccinate – a decision often based on misinformation from a third party. 

Imagine the following situations:

Image courtesy of the Refutations to Anti-Vaccine Memes Facebook Page

Image courtesy of the Refutations to Anti-Vaccine Memes Facebook Page

In the midst of a measles outbreak a doctor who encourages selective vaccination, or vaccine rejection, sends a letter to his patients suggesting that there is no need for concern. The letter states that there has not been a measles death in the United States for over ten years. It goes on to say that the risk of contracting measles is small and makes the claim that measles does not pose a risk to healthy children. The information is incomplete, even inaccurate: measles is extremely contagious, it can kill or seriously harm a previously healthy child, and the unvaccinated are at very high risk.

Now imagine parents, relying on the content of this letter, decide not to vaccinate against measles. If their child contracts measles and (1) becomes permanently disabled or dies, or (2) infects an infant that suffers a very serious and permanent complication of measles, can the doctor be liable?

Alternatively, during the same outbreak, a member of an anti-vaccine organization publishes an article claiming that measles occurs mostly in the vaccinated, is actually caused by the MMR vaccine which also causes autism, and is a mild disease that should be seen as good for a child. None of these claims are true.

Previously I’ve suggested that, in certain circumstances, parents relying on such advice could sue the organization for misrepresentation if their child is hurt. But if the article is what convinces a parent not to vaccinate, and then their child contracts measles and infects an infant who suffers serious complications, can the parents of the injured child sue the anti-vaccine organization? Read more…

Mainstream Media Covers the Not-So-Mainstream Decision to Skip Vaccines

April 17, 2014 86 comments

Over the past few weeks there seems to be a shift in the way that national news organizations have been covering immunization issues.  Rather than focusing on the myths that drive parental concerns and the alleged uncertainties of vaccine safety and efficacy, reporters are increasingly focusing on dangerous outbreaks of vaccine preventable diseases like measles, mumps, pertussis and meningitis.  They’re often interviewing families who have suffered at the hands of vaccine preventable diseases and talking to health care professionals about the dangers of these diseases.  And interestingly enough they are clearly attributing these outbreaks to people who are delaying or refusing vaccines for themselves and their children.

ABC recently covered this concern in a segment entitled Opting Out on Vaccines? in which Chief Health and Medical Editor Dr. Richard Besser emphasized the value of school vaccine requirements in helping to protect our public health.  The segment highlighted the current measles outbreaks in CA and explained that almost 16,000 CA kindergarteners started school last year without the required measles vaccine.  With CA measles vaccine exemptions up 15% from the previous year, and double the amount from just six years ago, the concern is that pockets of unvaccinated students are creating a dangerous risk to our students and our communities.

 

Just last week the USA Today printed a front page article and corresponding video that claimed diseases are getting a second life due to those who refuse to be immunized.  The article explained that even though there are fewer than 1% of Americans who refuse all vaccines, pockets of unvaccinated students are creating a risk in certain populations.

“… in some states the anti-vaccine movement, aided by religious and philosophical state exemptions, is growing, says Paul Offit, chief of infectious diseases at Children’s Hospital of Philadelphia. He points to states like Idaho, Illinois, Michigan, Oregon and Vermont — where more than 4.5% of kindergarteners last year were unvaccinated for non-medical reasons — as examples of potential hot spots. Such states’ rates are four times the national average and illustrate a trend among select groups.”

Unvaccinated populations can be the source of outbreaks.

Read more…

Take Action to Protect Student Health in Colorado

April 11, 2014 1 comment

Earlier this week ABC News’ Dr. Richard Besser explained that children deserve to be protected from disease while in public school.  With rising school vaccine exemption rates and pockets of unvaccinated students, our children and our communities are at risk of suffering from unnecessary disease outbreaks.  It’s what Dr. Besser explains as a “ticking time bomb“. Several states, such as WA, OR, VT and CA, have already taken measures to help increase immunization rates by modifying the way parents file for school vaccine exemptions.  By ensuring parents understand the benefits and risks of vaccines, and by requiring more than just a parental signature to secure an exemption, these states are beginning to see a rise in student immunization rates.  And Colorado is the latest state to stand up for student health with the introduction of Colorado House Bill 1288.

CCICOver the past few months the Colorado Children’s Immunization Coalition has been keeping us informed about HB 1288 and how it is progressing through the state legislature.  The bill preserves parental rights and continues to allow for parents to make choices for their children, but it also protects public health by ensuring parents are making well-informed and carefully considered decisions about immunizations.  Under Colorado law today, parent signature is the only requirement to elect a personal belief exemption.  This means it’s easier and more convenient to elect a personal belief exemption than to uphold the requirement to provide immunization records to a child care provider or school.  It’s time we create a fair process for all parents, which will reduce the likelihood of parents are opting out of vaccinating their children as a matter of convenience.

What House Bill 1288 does:

HB 1288 requires that parents electing a personal belief exemption demonstrate that they understand the benefits and risk of vaccination, both for their child and the community. This is done by submitting a personal belief exemption that includes the signature of a health care provider licensed to administer vaccines, or by taking an online education module and submitting the certificate of completion to the child care provider or school. One of the most critical components of HB 1288 is that it also allows parents the right to access vaccination rates for all Colorado child care centers and schools.  Every parent has a right to know the percentage of unvaccinated students are attending their child’s school so that they are free to make the best choice for the health of their child.

Why House Bill 1288 is important to everyone, not just for children in Colorado:

Read more…

Vaccines and Autism: Something Old, Something New

April 8, 2014 62 comments
Photo credit:  Emily Willingham

Photo credit: Emily Willingham

The following post is an adaptation of a previous article written by Shannon Des Roches Rosa for Thinking Person’s Guide to Autism entitled Keep Calm and Think Critically.  Shannon is a mother of three and an autism advocate extraordinaire.  She writes extensively about parenting and autism on the Thinking Person’s Guide to Autism and Squidalicious blogs, and serves as a contributing editor on BlogHer.  Shannon critically evaluates new autism data and explains that even though a few misguided people will attempt to use this data to try to put a new spin on an old myth, it won’t change the fact that vaccines don’t cause autism.

 

The U.S. Centers for Disease Control and Prevention (CDC) held a recent media briefing to announce and discuss readjusted estimates for autism prevalence, with a new rate of 1 in 68 children. This announcement caused instant furor in anti-vaccine autism groups, which started claiming the 30% rate increase was proof of a vaccine-autism link, despite longstanding evidence (also from the CDC, along with many other resources) that no link between autism and vaccines has ever been established by legitimate research.

Shot@Life Champions with Walker Zorensky,  Legislative Research Assistant, Office of Senator Barbara Boxer

Shot@Life Champions with Walker Zorensky,
Legislative Research Assistant, Office of Senator Barbara Boxer

I found this information-twisting especially irksome, because it reinforced to me that the anti-vaccine autism community — as few in numbers as they are — would rather endanger children’s lives than admit they’re wrong. I feel horribly guilty about the harm such misplaced fears about autism have wreaked on immunization rates. And so I work very hard as an autism parent advocate, a writer, and now a UN Foundation Shot@Life Champion to educate people about vaccine-preventable disease, and the critical importance of immunizations.

I want people to remember that vaccines save lives. To acknowledge that while Americans get to bicker about whether or not to vaccinate their children, in other parts of the world children who don’t have access to vaccines are still dying from preventable disease — one child death every 20 seconds, in fact. I want them aware that even here in the United States, unvaccinated kids, and infants too young to be vaccinated are at risk from current measles outbreaks. And it makes the job of everyone who stands on the side of children’s health and legitimate science harder when vaccine denialists light their torches and do their damnedest to spread misinformation.

But what does that new 1 in 68 estimate actually mean? Well, that takes some critical analysis, digging, and sifting, which I’ll walk you through, starting with the CDC’s Dr. Colleen Boyle’s opening statement: Read more…

Thoughts on World Autism Awareness Day

April 2, 2014 41 comments

Originally posted on Momentum - The Baylor College of Medicine Blog:

Dr. Peter Hotez and his daughter Rachel.

Dr. Peter Hotez and his daughter Rachel.

Today is the seventh annual World Autism Awareness Day, a day when organizations committed to autism research, advocacy, or policy promote awareness through events and public discussions.

As both a scientist and a father of four – one of whom is an adult child with autism (as well as other mental and physical disabilities) and a second who is actually doing her Ph.D. on the developmental psychology of autism – I am often asked to speak or provide public comment about the autism spectrum conditions, especially their causes.

Indeed, the fact that I lead a multidisciplinary team that develops neglected disease vaccines while also serving as President of the non-profit Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development often places me front and center in the dialogue about purported links between autism and vaccines.

For me, the issue is…

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Say #NoWayDrJay: Don’t Bring Measles Back

March 31, 2014 31 comments

The CDC has recently reported that the United States is experiencing a record number of measles cases this year with outbreaks spread from New York to California.  Despite the fact that measles was once declared eliminated in this country, 14 years later we’re on track for a record high year with 89 cases so far in 2014.

Due to various media outlets covering these outbreaks, we’ve begun receiving quite a few inquiries from concerned parents on our Vaccinate Your Baby Facebook page.  Some have infant children under one year of age who aren’t old enough for their first dose of measles vaccine.  Others have children who have yet to receive their second dose at age 4-6 years of age and they’re wondering if their children can be vaccinated earlier.  Others have children with medical conditions that prevent them from receiving the measles vaccine.  These children are completely dependent on others being vaccinated to help provide a protective community immunity and their parents are understandably concerned about these outbreaks.  Still others have fully vaccinated children, but are infuriated by the statements being made by irresponsible physicians that have tried to downplay the significance of the outbreaks and encourage vaccine refusal.

Last week we highlighted comments Dr. Bob Sears’ made on his Facebook page that suggested that measles infection was not dangerous.

Now we’ve seen a similar message from Dr. Jay Gordon, a well known pediatrician in Los Angeles, who sent this letter to his patients last week.

Greetings!

Our office has received a large number of phone calls and emails about measles.   There are 21 reported cases in Orange County.  I’m not aware of the number of cases in our immediate area. In July, 2014, we celebrate the 30th year at 901 Montana and we have never had a child in our office contract measles.  As many of you know, I use the MMR vaccine more sparingly than most pediatricians so I’m a bit surprised that the number is zero, but it is.

The media, as they often do, are covering this story quite heavily and the headlines make it appear that there is imminent great danger.  In fact, the last fatality from measles in the USA was eleven years ago in 2003. Headlines speak of “ten times more measles in 2014.”  The newspaper articles often don’t mention that California had very few cases of measles in the past five years so the 35 cases reported among 38,000,000 Californians is not a frighteningly large numerical jump.  There have been about 80 cases of measles in the United States this year.  All of these cases began with importation by travelers and then spread to close contacts.  Measles is unlikely to be spread by a brief encounter or sharing a BART train.

If you would like the MMR vaccine, please feel free to get it.  My personal reservations have nothing to do with Dr. Wakefield’s “Lancet” article and are not supported by published medical research.  These reservations are supported by observation and anecdotal evidence only.

The CDC defines outbreak as two cases spread from the same source.  The measles outbreak of 2014 does not pose a risk to your healthy child. Best, Jay

Jay Gordon, MD, FAAP

Read more…

Flu Vaccine Mandates Work to Boost Immunization Rates

March 26, 2014 15 comments

There is plenty of evidence that demonstrates the value of vaccines - from reducing hospitalizations and deaths to saving money.  And it’s frightening to imagine what would happen if we stopped vaccinating.

Vaccine_benefit-cost_ratio_-_3Yet, we are often reluctant to mandate vaccines. Instead, we prefer that people decide for themselves how best to ensure their good health. But we can’t ignore the data that proves vaccine mandates are an effective tool in boosting immunization rates.

Take for instance a mandate created in September 2010, in which Connecticut became the second state in the U.S. that requires children, age six months to six years, to receive an annual influenza vaccine in order to attend a state-licensed childcare program. According to a study conducted at the Yale School of Public Heath, Connecticut’s vaccination rate for children aged six months to six years increased significantly after the mandate, spiking from 67.8% during the 2009–2010 influenza season to 84.1% during the 2012–2013 flu season.   And better yet, the number of children hospitalized for the flu plummeted.  In fact, compared to nine other states without mandates, Connecticut saw the largest percentage decrease in the influenza-associated hospitalization rate among children aged four years and younger.

MNchildrens_infographic_fluAnd there have been indirect societal benefits as well.  James Hadler, lead study author and clinical professor of epidemiology at the Yale School of Medicine explains that hospitalization rates for the entire community likely decreased as well. He goes on to say that although the mandate applied only to young children, other studies have demonstrated that protecting a subset of the population decreases circulation of the virus more generally. Which translates to this simple concept: less disease circulating means vaccination is impacting a larger population than can even include those who haven’t been vaccinated.

Read more…

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