California Passes SB 277: No more personal or religious exemptions for vaccines

After many weeks of debate from legislators and stakeholders on both sides of the vaccine issue, Gov. Jerry Brown (D) signs California State Bill 277 into law on Tuesday June 30th. This bill co-authored by state Senators Richard Pan (D-Sacramento) and Ben Allen (D-Santa Ana) requires that all children in the state are to be vaccinated prior to entering public or private school with no exemptions granted for religious or personal reasons. California now becomes the third state to allow only for medical exemptions to vaccination.  The law will go into effect on July 1, 2016, but until that time what will happen among those who opposed the bill? Could this possibly be an opportunity for reflection on the outcome of this bill by those who oppose it? The data is clear, vaccines work.

The legislature, hearing the will of the people who first hand saw the effects (directly and indirectly) of a measles outbreak sought and achieved a solution that will protect children in the long run and promote a healthier state of California. But for those who continue to hold on to the gross misinformation that vaccines are harmful, cause autism or are ineffective, that “naturally acquiring” the disease is the “way it was intended” are more of a danger to a society that has become more mobile and has increased exposure to many more populations that may or may not have been properly vaccinated from preventable disease. At this point in civilization, we have access to levels of knowledge not seen in eras past. The problem is that many either do not know how to synthesize what sources are proper or in most cases don’t care to hear nor accept that vaccines are an unprecedented success and that in order to live together in a society, disease is a fact of life. Many diseases we have not yet controlled, we only have the means to cure, others we have neither control nor cure. What is so difficult about being proactive not just for oneself but to be a member of a society who is vaccinated and vaccinates their children? That is responsibility. Plain and simple.

As ruled in Jacobson v. Massachusetts (197 US 11 1905), the defendant Mr. Jacobson felt that his 14th Amendment rights were violated when the city of Cambridge, MA required that he be vaccinated for smallpox. The Supreme Court ruled that under the police powers of states in times of medical emergency (in this case a high prevalence of smallpox in the city of Cambridge) that the city was well within their right to implement compulsory vaccination. The opponents of this legislation are planning their next move and I think that this matter could be taken up by the Supreme Court at some point in the future. Jacobson v. Massachusetts provides a seminal example in case law that will be a major influence and reference if this law is challenged in the courts. Groups such as A Voice for Choice is planning to ask for a public referendum that will put a hold on the law. It will be interesting to see if this will be a successful effort and if not will the courts be the next step. Resisting the law is unfortunate, more time and effort could be spent engaged in dialogue among the stakeholders. If we understood the resistance a bit better, the education and outreach could be better. Instead, Senator Pan has been receiving threats for his efforts and a new fight is brewing due to this new law. California is the new testing ground for laws such as these that only grant medical exceptions and if (and potentially when) it reaches the courts, this will provide a new case law precedent that will serve as the guideline for future efforts to solidify vaccination efforts nationally.

Background information for this blog was obtained via the San Jose Mercury News


Rubella elimination in the Americas and the Vaccine effectiveness argument

Vaccines are arguably the most successful public health intervention of the 20th Century. The successes that have been noted in reducing disease and deaths are immeasurable and hopefully there are many more successes to come with the current work being done with Polio. Within the last 15-20 years, the anti-vaccine movement has become a major player not only in debating the effectiveness and safety of vaccines, they have become an entrenched force that has driven down the community (Herd) effectiveness of vaccine through their non-compliance with vaccination standards. Many of their main arguments are invalid (autism/vaccine link) and their stubbornness to comply claiming personal exemptions bring harm to children. Each position previously mentioned is one in the same since many anti-vaxers forgo vaccines because of a personal belief and/or their rights are being infringed upon by a paternalistic governmental force.

This week, it was reported that Rubella has been eliminated from the Americas. This is highly historic as the efforts and gains made in the Americas can begin the worldwide elimination of Rubella worldwide. To what can we thank for this development? It would have to be the MMR vaccine! Through the use of the MMR vaccine, we have the power to eliminate vaccine prevenatble disease worldwide to end major suffering. Vaccine preventable diseases can be eliminated from out world and bring about a higher standard of health, improving life expectancy, reducing infant and child mortality due to these diseases and have a major effect on health costs.

Preventative health from a vaccination standpoint makes sense as we look not only to reduce disease burden, but we also want to reduce health costs for treatments later in life. Vaccination is an investment, there are costs to vaccination but those paying the costs must see these costs as investments in individual and community health. These investments MUST be made at the beginning of life to control health costs at the end of life. More investment at the front end keeps health costs low, improves overall coverage for all and can allow for coverage more more acute and complex health issues later in life. There is no excuse for not wanting to vaccinate when we can see that their effects on disease burden are obvious!

The tug-of-war between pro-vaccine and anti-vaccine movements continue. With smallpox declared eradicated 35 years ago and two other diseases heading towards eradication, another check can be placed in the column for the pro-vaccine movement while the foundation of the anti-vaccine movement suffers another blow.

The Jenny McCarthy Mistake

ABC today announced that Jenny McCarthy will replace Elisabeth Hasselbeck as a co-host of the daily talker, “The View.” I normally don’t talk pop culture here but this is a significant hire for many of the wrong reasons. Many know Ms. McCarthy from her days on MTV and Playboy but I think her most infamous activities have been as an active anti-vaccine crusader due to the misinformed view that vaccine use caused autism.

Since the refutation of this link, there has been a gradual ramping down of the rhetoric linking the two but the damage has been done. It is amazing how in the age that we live in, we have gone from an era of little information, trusting our medical professionals almost blindly to information overload and the potential to spread total misinformation. The age of the internet provides all of us with powerful tools to question many things around us but it is the validity of the information that we acquire that makes the difference. Jenny McCarthy is now a figurehead in an already uphill battle in maintaining herd immunity or more simply a high, constant level of people within a population who are vaccinated against controllable diseases. Giving her this forum I think is highly irresponsible on ABC’s behalf and could act as a soapbox for more widely disseminated discussion and misinformation to a population that is overloaded with all types of information from many questionable sources. 

Protect yourself, protect others during this flu season

Lately I have moments where I ask myself why am I still on Facebook. It was so much better in college, now it has lost it’s luster and fun. But I remind myself that the major reason I hang on is to keep in touch with friends and most importantly family. It was family that prompted me to write this blog entry as you can learn and get so much from a Facebook status. As I scrolled my timeline yesterday, one of my cousins stated that she was sick but she was going to press on to church. Hmmmm…now don’t take this the wrong way as I do not want to make this a blog entry about going to church. Nor do I want to pick on church but I want to talk about going places like church when we are sick and in the midst of a horrific flu season. I understand the need and the desire to attend church weekly as we are taught. However,  I have always been very uncomfortable sitting in a service in the middle of winter with multiple people within earshot and far away coughing as if a lung is going to pop out and/or sneezing into tissues, sleeves or their hands. I know if I am sick, honestly the last thing I am thinking about is going anywhere but most especially I would not want to expose any mass gathering of people to my germs. 

I cannot think of any minister, pastor or bishop who would tell you to not come to church under any circumstances. These folks are constantly encouraging you to come in, take your seat and worship. When you enter, you should feel that you are entering not only a sacred space, but a stress-free space where the worries of the day and the week past and coming can melt away. But then the coughing starts behind you, the sneezes start next to you and your stress level increases. As your stress level increases, your immunity drops and leaves you more susceptible to getting sick. No one wants you to NOT come to church, but when you are sick I think the man upstairs will truly understands if you sit one out in order to not only get yourself well but to also reduce the chance to getting others (the very young, the elderly and everyone in between) sick with your germs. That’s right, the population that you encounter in church, on your job and in other public places vary and many like the elderly and the young have immune systems that may not be as vigorous and robust enough to shake off exposure to cold and flu viruses. Or think about this another way if you go to church sick: If you were healthy, how would you feel if you were near someone who had the potential to make you sick from a cough, a sneeze, a handshake or touching a surface that may have germs on them? Not a good feeling thinking about it that way is it?

Many denominations have been very proactive in speaking to their member churches and providing guidance on gently encouraging parishioners to not attend services when sick, reducing contact among members during services and in some cases modifying communion protocols to reduce germ spread. Many of these items are common sense but because of our commitment to attending services, it unfortunately has to be said in order to show the importance keeping the chances of spreading disease to an absolute minimum. I ask you to heed these recommendations if they have been shared in your church community. If they have not been, use sound judgement and don’t go to church when you are very sick. Remember, if you don’t want someone to make you sick, why would you do that to someone else? 

Influenza Research update

It’s been a busy week for Influenza researchers. A multitude of reports have been released documenting new findings.

– A group of NIH scientists have developed a vaccine that protects mice from the 1918 flu strain. This was accomplished by identifying antibodies (Ab) which neutralize the virus.

– A H5N1 live vaccine has also been shown to be effective in lab studies. More encouraging news from this discovery is that this particular live vaccine could be effective against different variants of H5N1.

– The vaccine strategy using Virus Like Particles (VLPs) to induce an immune response can make the immune response more robust when confronted against a real virus. VLP strategy can have a wider affect across a wide variety of viruses which vaccines are being developed for.

All of these strategies are just a small number of ways by which vaccines are being developed to combat influenza. There are a couple of general strategies for vaccine development, using the virus itself or using the DNA of the virus to develop a vaccine.  The work being done to combat influenza can have a influence on development of vaccines for other viruses of medical importance.

Reports via: