Tide turn­ing on vac­cine crit­ics

Law­mak­ers tackle is­sue af­ter measles out­break in na­tion

South Florida Sun-Sentinel (Sunday) - - Front Page - By Lena H. Sun

The resur­gence of measles across the coun­try is spurring a back­lash against vac­cine crit­ics.

WASH­ING­TON — The resur­gence of measles across the coun­try is spurring a back­lash against vac­cine crit­ics, from con­gres­sional hear­ings prob­ing the spread of vac­cine mis­in­for­ma­tion to state mea­sures that would make it harder for par­ents to opt out of im­mu­niz­ing their chil­dren.

In Wash­ing­ton state, where the worst measles out­break in more than two decades has sick­ened dozens of peo­ple and cost over $1 mil­lion, two mea­sures are ad­vanc­ing through the state Leg­is­la­ture that would bar par­ents from us­ing per­sonal or philo­soph­i­cal ex­emp­tions to avoid im­mu­niz­ing their school-age chil­dren.

In Ari­zona, Iowa and Min­nesota, law­mak­ers have for the first time in­tro­duced sim­i­lar mea­sures. The ef­forts have sparked an emo­tional, some­times ugly re­sponse from those protest­ing what they see as ef­forts to tram­ple on their rights. Op­po­nents of the Ari­zona bill, which died quickly, have de­scribed the toll of stricter vac­cine re­quire­ments as a Holo­caust and likened the bill’s spon­sor, who is Jewish, to a Nazi.

In Ver­mont, leg­is­la­tors are try­ing to do away with the state’s re­li­gious ex­emp­tion four years af­ter elim­i­nat­ing the philo­soph­i­cal ex­emp­tion. In New Jer­sey, where law­mak­ers have sought un­suc­cess­fully to tighten re­li­gious ex­emp­tions, a bill to re­peal it was re­cently amended on the Gen­eral Assem­bly floor.

While it’s too early in the leg­isla­tive sea­son to say how many of the state ef­forts to tighten vac­cine ex­emp­tions will be signed into law, some pub­lic health ad­vo­cates say the rash of vac­cine-pre­ventable ill­nesses is cre­at­ing a

shift in pub­lic think­ing.

“The wave is start­ing to turn back,” said Michelle Mello, a pro­fes­sor of law and health re­search and pol­icy at Stan­ford Univer­sity.

Diane Peter­son of the Im­mu­niza­tion Ac­tion Coali­tion, a Min­nesota non­profit group, said that “there is a grow­ing con­sen­sus for state au­thor­i­ties to make the bold move to re­quire all chil­dren to be vac­ci­nated, with the only ex­cep­tion be­ing those who can­not be given the vac­cine for med­i­cal rea­sons.”

Amid mount­ing pub­lic pres­sure, web­sites that have been a plat­form for the anti-vac­ci­na­tion move­ment’s mis­lead­ing claims are also mak­ing changes. Pin­ter­est has blocked all searches on vac­ci­na­tions to stop the spread of mis­in­for­ma­tion, while Face­book is con­sid­er­ing re­mov­ing anti-vac­ci­na­tion con­tent from its rec­om­men­da­tions. YouTube said it is also pulling ads from anti-vac­cine videos, claim­ing they vi­o­late its poli­cies against “harm­ful or dan­ger­ous” acts.

The U.S. House and Se­nate have sched­uled rare bi­par­ti­san hear­ings to in­ves­ti­gate the rea­sons be­hind re­cent out­breaks.

“If vac­cine hes­i­tancy per­sists — or even ex­pands — it could se­ri­ously un­der­mine these im­por­tant ad­vances,” Sens. La­mar Alexan­der, RTenn., and Patty Mur­ray, D-Wash. — the Se­nate Health, Ed­u­ca­tion, La­bor and Pen­sions Com­mit­tee’s chair­man and rank­ing Demo­crat — wrote to fed­eral health of­fi­cials.

All those ac­tions are hap­pen­ing against a back­drop of ris­ing global con­cern about vac­cine hes­i­tancy as cases of measles have surged be­cause of gaps in vac­ci­na­tion cov­er­age. For the first time, the World Health Or­ga­ni­za­tion listed vac­cine hes­i­tancy as one of the top 10 global threats of 2019.

No measles deaths have been re­ported in the United States since Jan. 1, but the virus can be deadly, es­pe­cially for chil­dren.

In Europe, measles cases are at a 20-year high, with

60,000 cases and 72 deaths. A quar­ter of those are in Italy, where anti-vac­cine groups al­lied with pop­ulist politi­cians won pas­sage last year of a law to end com­pul­sory vac­cines — a law re­pealed a short time later be­cause of soar­ing measles cases.

Such fears are not go­ing away soon.

The in­tro­duc­tion of com­pet­ing anti-vac­cine bills in state leg­is­la­tures re­flect con­tin­u­ing alarm about vac­cine safety, said Barbara Loe Fisher, who heads one of the old­est and best-es­tab­lished anti-vac­cine groups, the Na­tional Vac­cine In­for­ma­tion Cen­ter.

“You can­not bring down the ham­mer on peo­ple and force them to obey one size fits all when the risk is not be­ing shared equally,” she said, adding that in­di­vid­u­als have dif­fer­ent ge­netic risks.

While 11 states are con­sid­er­ing bills to re­strict or elim­i­nate vac­cine ex­emp­tions, her group sup­ports 60 out of 141 vac­cine-re­lated state mea­sures, “which is the most bills we have sup­ported in a

leg­isla­tive ses­sion,” she said.

Groups such as Fisher’s frame their mes­sage in terms of in­di­vid­ual rights, in­sist­ing that par­ents, not the gov­ern­ment, should de­cide whether to vac­ci­nate their chil­dren — an ar­gu­ment cham­pi­oned by af­flu­ent, well-ed­u­cated par­ents that res­onates with lib­er­als and con­ser­va­tives.

Those re­spon­si­ble for pro­tect­ing pub­lic health counter that im­mu­niza­tions are de­signed to pro­tect whole com­mu­ni­ties, not just in­di­vid­u­als — es­pe­cially those com­mu­nity mem­bers who can­not get the shots, such as young chil­dren, preg­nant women and those with com­pro­mised im­mune sys­tems. When im­mu­niza­tion rates fall be­low a cer­tain level — 93 to 95 per­cent for measles — the vul­ner­a­ble are at much higher risk. It is a ra­tio­nale that has re­peat­edly per­suaded judges to up­hold manda­tory vac­ci­na­tion pro­grams.

And the en­force­ment of such man­dates re­sulted in the elim­i­na­tion of measles

from the United States in

2000.

As pub­lic mem­ory of the ter­ror of measles epi­demics has faded, how­ever, doubts about vac­cines have grown — of­ten stoked by de­bunked as­ser­tions link­ing the shots to autism. Be­tween 2009 and

2013, the use of non­med­i­cal ex­emp­tions for kinder­gart­ners in­creased by 19 per­cent na­tion­wide, ac­cord­ing to a

2014 study.

That cre­ated pock­ets such as the one in Clark County, the epi­cen­ter of Wash­ing­ton state’s out­break, where rates fell far be­low the thresh­old needed to cre­ate com­mu­nity im­mu­nity.

Since this year be­gan, there have been 159 measles cases re­ported in the United States — more than the to­tal re­ported for all of 2017, ac­cord­ing to data from the Cen­ters of Dis­ease Con­trol and Pre­ven­tion.

New York has been scram­bling to con­tain its largest measles out­break in decades, with more than 200 peo­ple sick­ened since it’s start in Oc­to­ber.

RACHEL LA CORTE/AP

Op­po­nents protest bills that would bar par­ents from us­ing philo­soph­i­cal ex­emp­tions to avoid im­mu­niz­ing their chil­dren Feb. 20 in Olympia, Wash.

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