Vaccination: the next victim of political polarization?

[Econoline]

Charlie Pierce poses the question:

Coming after Chris Christie's similar comments over the weekend, it is now incumbent upon us to ask whether the anti-vaccination theories are on their way to becoming one of those conservative conjuring words, like "Keystone XL pipeline" or "school choice." This is especially true since both Christie and Paul have framed their remarks with boilerplate conservative defenses of parental rights and personal freedoms. So is the measles virus the new handgun? Will dozens of sick kids in California join dozens of dead kids in Connecticut as the price we have to pay for our freedoms? Are we going to Teach The Controversy on this one, too? Is this, like The Bell Curve was for Andrew Sullivan and The New Republic, Open For Debate?

It's one thing to dance away from science on global warming. It's quite another to have one of our only two political parties line itself up against medical science. If the voices in your head and the clamor of your own ambition can drown out the simple fact that we had measles defeated in this country in 2000, and now, after a long stretch of know-nothing propaganda, measles are back with a vengeance, then you can quite simply use politics to defeat public health in the lives of us all. For a physician like Rand Paul, the son of Crazy Uncle Liberty (!), who also is a doctor, lending your credibility to the quack healers of the Internet bespeaks a certain contempt for learning that has become all too common.

[BoSoxGal]

I simply cannot fathom any parent being so incredibly selfish as to put her child at risk for measles, mumps, rubella, etc. The fact that it's becoming a political issue?

[Long Run]

It's a non-issue being blown out of proportion by political bloggers like Charles Pierce and a manipulated and manipulative media who are looking to create some news. "Pay attention to this nonsense, and don't worry about the mess of the Obamacare tax credits having to be repaid or the $500 billion dollar deficits as far as the eye can see."

[Big RR]

BSG--sadly, IMHO big pharma has brought this on itself by trying to get more and more vaccines mandated by law. Clearly, dangerous diseases and public health risks should be vaccinated against, but there are many vaccines that have been developed for diseases that are neither. And face it, every vaccines poses a risk to the patient--not the pseudo science thimerisol/autism one, but a very real (and miniscule) risk of autoimmune reactions and complications from interaction of other compounds in the vaccine. For serious diseases, this is a pretty easy decision to be made, but for less serious diseases where the vaccines are given more for convenience than public health risks, it might well tip the other way. Properly informed people will choose vaccination (the response to Gardasil proves that), but some would prefer that the people have no choice and just be forced to have the vaccines.

Those on the other side are every bit as idiotic; some would not vaccinate against any diseases at all and try the same scare tactics pharma did to get the vaccines mandated in the first place (so instead of the Merck commercial of the child getting chickenpox and being hospitalized (and no doubt this can happen, but is very rare), we get the kid who gets serious complications (which may or may not be related to the vaccine).

After sanitation and antibiotics, I believe vaccines have done the most to enhance civilization; but let's not fuel the polarization by making a statement like putting a child at risk for a mild disease like rubella is wrong or selfish (there are serious public health concerns about the affect on contracting rubella while pregnant which justify mass immunization IMHO). And let's also recognize that permitting a few to choose not to vaccinate is not going to create a public health crisis (mainly because of herd immunity).

[Sue U]

It's a non-issue being blown out of proportion by political bloggers like Charles Pierce and a manipulated and manipulative media who are looking to create some news. "Pay attention to this nonsense, and don't worry about the mess of the Obamacare tax credits having to be repaid or the $500 billion dollar deficits as far as the eye can see."

Yeah, forget the spiking rates of preventable illness (including the recent measles outbreak and a prior outbreak of whooping cough), or the last 15 years of anti-vaxx campaigning by idiots like Jenny McCarthy and Jim Carrey, or the fact that the issue is actually in the news currently, or that Chris Christie is cravenly pandering to the know-nothing vote in his presidential bid. It's all just a liberal media conspiracy to distract the public from Obama's budget priorities -- yeah, that's the ticket.

[Lord Jim]

It's quite another to have one of our only two political parties line itself up against medical science.

Now just a minute there Cochise....

There are plenty on the left buying into this completely discredited "vaccines cause autism" hooey, as I pointed out earlier. In California the science deniers on this are overwhelmingly Liberals:

Rich, educated and stupid parents are driving the vaccination crisis

The most shocking and disheartening story you'll read in the Los Angeles Times today may be our piece on the stunning decline in vaccination rates among California's kindergarten-age children.

Kids are coming to school with immunization exemptions at twice the rate of seven years ago. As my colleagues Paloma Esquivel and Sandra Poindexter document, high rates of "personal belief" exemptions from child immunizations are correlated with high median incomes. They write:

"In Los Angeles County, the rise in personal belief exemptions is most prominent in wealthy coastal and mountain communities, The Times analysis shows. The more than 150 schools with exemption rates of 8% or higher for at least one vaccine were located in census tracts where the incomes averaged $94,500 — nearly 60% higher than the county median."

That 8% exemption level is the point at which lack of immunization threatens herd immunity, an important factor in preventing and constraining disease outbreaks.

We can see signs of damaged herd immunity in stark statistics: California, which has experienced 61 cases of measles so far this year, four times the level at this point a year ago, has been identified by the Centers for Disease Control as a national trouble spot. California is also currently dealing with a whooping cough epidemic, at least partially because of declining vaccination rates.

State law requires entering kindergartners to be vaccinated against measles, whooping cough, polio, mumps, rubella, hepatitis B, chicken pox, diphtheria and tetanus. Parents can get personal belief exemptions, but the standards for allowing these have clearly become unacceptably loose in recent years. Nor does the state appear to have a policy governing the circumstances under which an unvaccinated child be permitted to attend school.

Let's be plain about a personal belief exemption: It's based on nothing. Parents may claim it because of something they've heard, or something they've read, or something they've been told by an indulgent pediatrician whose license should be scrutinized with great care by medical regulators. But it's not based on science, which tells us that, except under certain very specific conditions, vaccines are safe. (Those with medical reasons to forgo vaccinations can also obtain exemptions, but these are rare and often temporary.)

The childhood diseases that immunizations guard against are what are dangerous, and allowing inchoate personal beliefs to introduce unimmunized children into schools is a distinct threat to public health.

Esquivel and Poindexter quote Tammy Murphy, superintendent of the Montecito Union School District in Santa Barbara, a district that has an astonishing 27.5% exemption rate, stating that she tries to respect parents' decisions.

"I don't think they make this decision out of a place of ignorance," Murphy told them. "It's one they've thought about deeply. They're reading all about this and making what they feel is the best-informed decision they can for their child."

Murphy sounds like she may be part of the problem; the district itself has been irresponsibly tolerant in handing out exemptions. The parents are indeed making this decision out of ignorance. They haven't thought about it deeply -- certainly they haven't given a dime's worth of thought to the effect their anti-immunization decision has on their neighbors, on other children, and on their own children.

The median income in the Montecito district is nearly $103,000, and the median home price is more than $1 million: proof that you can be rich and successful, yet not have a clue.

If we were talking about parents without access to healthcare or adequate medical information, the decline in vaccinations might be understandable; anti-vaccination claptrap has been hawked by television personalities such as Katie Couric and Jenny McCarthy as though it's just another entertainment segment. They should be ashamed. (We discussed Couric's peculiar brand of irresponsibility here and here.) But for it to take root among parents with access to established scientific facts is inexcusable.

But there's no reason for state and local school officials to buy into this trend. The rules for personal belief exemptions should be tightened up and made crystal clear. Citing something you've heard on Katie Couric's show won't cut it.

http://www.latimes.com/business/hiltzik ... olumn.html

Here's another example:

The anti-vaccination movement is centered along California's wealthy coastal and mountain communities; the highest numbers of personal-belief exemptions are among children who attend private schools. At a Santa Cruz Montessori school in Aptos, for example, 22.6 percent of kindergartners had belief exemptions from vaccination. In 2007, the number was seven percent.

These aren't parents who don't have access to information - they're true believers who can't be convinced.

http://www.sfgate.com/opinion/editorial ... 732013.php

I can guarantee you that the parents at that school vote overwhelmingly Democratic...

And one candidate making an ill advised statement (that he's been backpedaling from ever since) and another candidate making completely idiotic and crazy statements (Rand Paul, a physician no less; he's just as nuts as his father but most of the time he does a better job of hiding The Crazy...it delights me when he doesn't...) does not mean "the party is lining up":

Less equivocal was Wisconsin Gov. Scott Walker, who made it clear that he has no problem with immunization. "Study after study has shown that there are no negative long-term consequences," he told ABC News.

"And the more kids who are not vaccinated, the more they're at risk and the more they put their neighbors' kids at risk as well," The New York Times reported Walker saying.

Pierce is being dishonest and disingenuous; trying to create complete straw man.

[oldr_n_wsr]

Excuse my ignorance, but when did vaccinations become a choice? Growing up we all were vaccinated and had to be in order to go to school. We used ot show each other our vaccination scar on our arms (although my sister has hers on her thigh).
In fact, while attending night school (1998 grad) I remember having to get a booster for measles (I think it was for measels) in order to go to college.

And that was my next question. Here on LI there is a bunch of Obamas south american children who, by law, have to be let into the schools. Don't they have to be vaccinated?

[Big RR]

oldr--generally vaccines have always been a choice, although the public schools systems in many localities mandated some vaccines which needed to be completed before you could be enrolled; private schools were on their own. And even in the public schools, those who had a belief against vaccines were exempted (I recall a classmate of mine who was a christian scientist and never had a vaccine or went to the doctor).

And let's not forget, when we were kids the vaccines were few--most people had the normal childhood diseases (measles, mumps, rubella (german measles)) and got vaccines for smallpox, polio (after it came out), diphtheria, whooping cough (both now in the DPT)--that's about it. Look at what some schools require now and you'll see what we had (with the exception of smallpox), the childhood diseases, pneumonia, HIB, hepatitis (A, B, and C), and a host of others.

[Lord Jim]

You have two very different groups of people making up the anti-vaccine crowd:

Libertarian loonies on the right who will be goddamned if the government is going to interfere with their God given right to endanger the health of other people's children...(these are the types Paul is trying to appeal to)

And New Age loonies on the left who are convinced that the pharmaceutical companies are out to poison their kids...

One group is paranoid about the government; the other is paranoid about "big pharma"....

But collectively they're a bunch of crackpot paranoiacs who are endangering the health of their kids and those of others.

[oldr_n_wsr]

Thanks for that BigRR. Never knew there were "exemptions". I don't think rubella was in our first vaccination regiment as I remember seeing ads on TV that we should go and get the vaccination when I was young. They especially targetted kids of parents who were or may become pregnant.

[Gob]

And New Age loonies on the left who are convinced that the pharmaceutical companies are out to poison their kids...

Bane of my fucking life, the number of well to do hippy bloody parents we see who tell us; "I'd prefer that my (clearly psychotic,) child wasn't put on these "Western" medications. We'd like her to try .............. (insert crackpot cure i.e. Reiki/herbal/acupuncture/Bach flower remedy/dowsing, here,) first, as we've heard that these medicines have nasty side effects"

Never mind that without medication the condition can intensify and get a tighter grip, nor that said child can be a risk to themselves or others while they are playing Dr Natural.

[Big RR]

Yep oldr, I remember those "rubella umbrella" commercials as well.

Jim--a lot of the resistance from the right reminds me of the water fluoridation resistance--no one is going to force medicate me or mine. But I still think we need to have a public discussion of the value of vaccines and the cost/benefit of those which the government decides to mandate for schools, etc. The silly pushback occurs when ordinary citizens are left out of the discussion.

[rubato]

There really isn't a right-left polarization about vaccination. There is the libertarian position against requiring vaccination but not against the practice itself and there is the scientific illiterates (Janna McCarthy) who claim vaccination is harmful.




Yrs,
Rubato

[Econoline]

Every anti-vaxxer needs to see this:


...and at least one pediatrician has had enough:

[Lord Jim]

There really isn't a right-left polarization about vaccination. There is the libertarian position against requiring vaccination but not against the practice itself and there is the scientific illiterates (Janna McCarthy) who claim vaccination is harmful.




Yrs,
Rubato

I could've sworn I said that...

[Econoline]

Well, I just hope you're both right.

[BoSoxGal]

Great post by the pediatrician! If only more would have the balls to stand up to crazy parents - especially the ones who demand antibiotics for every sniffle, which is sending us quickly into a post-antibiotic world.

oldr, the rates of vaccination in Central and South America are as high or higher than the US. It is unlikely that the kids don't have their vaccinations, and if they need boosters, it's unlikely that their parents will decline them. People in developing nations have seen the unnecessary deaths of children from these diseases and embrace vaccinations for the miracle that they are.

Big RR, from what I recall, vaccinations are the #1 cause of improved life expectancy, with sanitation and antibiotics coming second.

I don't buy the argument from the anti-vaccination nutters that Pharma is just out to make money on vaccinations - yes, they make money on them, but not nearly as much as from lifestyle drugs. When you were a child they didn't have the same vaccines they did when I was a child, and they have more now for my great-nieces and nephews than they did when I was a kid. That's progress in medical science. So far as I understand it, they've all been tested and found safe and have been given to hundreds of thousands of millions of children with very, very rare incident of harmful side effects.

I remember hearing a radio program about this issue way back in the early 90s and being just bewildered by the idiocy of the arguments put forward by the anti-vaccinations crowd. The link to autism has been entirely discredited and there is really no other good reason. As the good doctor put it in Econo's post, these folks are putting at risk the children who can't be immunized, for no good reason.

The worst thing is that I can't wish them the ill they deserve, because that would mean them having to watch their children suffer in pain from diseases that are entirely preventable, and of course, it's not the child's fault that his/her parent(s) are fucking idiots, so I cannot wish it upon an innocent child just to teach an idiot parent a lesson. But some of them will learn that lesson, very painfully.

Roald Dahl's 7 year old daughter died from measles encephalitis in 1962. He wrote an excellent essay urging immunization that is very well worth reading: http://roalddahl.com/roald-dahl/timelin ... ember-1962

[Gob]

Thanks to New Jersey Governor Chris Christie's off-the-cuff statements in the UK on Monday endorsing "a measure of choice" as to whether to immunise their children against measles, several of his fellow high-profile presidential aspirants have decided to weigh in on the topic.

On Monday evening former US Secretary of State Hillary Clinton came down firmly on the pro-vaccine side, tweeting: "The science is clear: The earth is round, the sky is blue, and #vaccineswork. Let's protect all our kids."

She ended her message with the hashtag "#GrandmothersKnowBest", yet another hint that her newly minted grandmaternal status could be leaned on heavily to provide her with a softer image as she gears up for her possible campaign for the Democratic presidential nomination.

Meanwhile Kentucky Senator Rand Paul took a decidedly different tack on Monday, reiterating his position that most vaccines should be "voluntary" and that parental choice is "an issue of freedom".

"I don't understand the point of why that would be controversial," the Republican told a CNBC interviewer, adding that he's a "big fan" of vaccines. But, he said: "I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines".

"The state doesn't own your children," Mr Paul, who has placed near the top of many polls of Republican primary voters, concluded. "Parents own the children."

The latest political debate started on Monday morning, when Mr Christie noted that while he and his wife decided to have their children vaccinated, that solution may not be best for all parents.

[rubato]

There really isn't a right-left polarization about vaccination. There is the libertarian position against requiring vaccination but not against the practice itself and there is the scientific illiterates (Janna McCarthy) who claim vaccination is harmful.




Yrs,
Rubato

I could've sworn I said that...

When in fact you said the opposite:

Libertarian loonies on the right who will be goddamned if the government is going to interfere with their God given right to endanger the health of other people's children...(these are the types Paul is trying to appeal to)

And New Age loonies on the left who are convinced that the pharmaceutical companies are out to poison their kids...

Libertarians are not against it because they are on the right (their ideology spans both right and left anyway) but because they are Libertarians. Leftists are not against vaccination at all (although they are mixed about the degree of compulsion which is allowable, liberalism invented the idea of a limitation on state power) and "new age loonies" is just a slur with no identifiable group.


For the record I'm certain we can achieve the levels of vaccination required without absolute compulsion by the state because we did so before and for a long time. Public health education campaigns, a little light social shaming, and the friendly persuasion of pediatricians (like above) will be enough.

We had done it too well and for long enough that everyone forgot the stakes and started making bad decisions.


yrs,
rubato

[Lord Jim]

I apologize rube...

I thought we had essentially said the same thing, but now I realize that you didn't know what the hell you were talking about and didn't understand what I was saying...

Of course I should have realized that was likely to be the case from the outset, given the record...