Respectful Insolence

About a year ago, I became aware of the latest celebrity antivaccinationist with a penchant for saying truly stupid things and thus making an even bigger fool of himself than he usually does. I’m referring to Rob “makin’ copies” Schneider, who most recently has been making waves for narrating a misinformation-packed “viral” video about the Vaccine Court and the National Vaccine Injury Compensation Program (NVICP). It’s a video that’s so mendacious that it even amazes me, and I’ve been watching the antivaccine movement for a decade now.

However, back in 2012, Rob Scheider, apparently being a California resident, was outraged at what he viewed as an assault on freedom so horrific that, if allowed to stand, it would obviously produce a slippery slope that would lead straight to fascism and medical experimentation on par with what Josef Mengele did at Auschwitz. (No one ever accused Rob Schneider of subtlety—or much intelligence.) I’m referring to California Bill AB 2109, which ultimately passed the legislature to be signed by Governor Jerry Brown. AB 2109 was a simple bill, based on a simple concept, designed to try to alleviate the problem of increasing rates of school vaccine exemptions being claimed by parents. California is a state that allows both religious and philosophical exemptions, and the use of philosophical exemptions was increasing. In certain areas, it was increasing to the point that vaccination rates were falling below herd immunity levels, a development of much concern to public health officials. There’s a reason I’ve said that, when the outbreaks begin, they’ll probably begin in California.

In any case, the idea behind AB 2109 was this. The old California vaccine exemption form made it too easy to get a philosophical exemption. Basically, all a parent had to do is to check a box on a form, and that’s that. In fact, it was so easy that many public health and school officials believed that some parents were claiming the exemption because it was easier to do than to actually make sure their children got their shots as required. Originally, AB 2109 was designed to bring informed consent and a minor hoop to jump through to the process by requiring a parent to speak to a health care practitioner (physician, nurse practitioner, or physician’s assistant) for a discussion of the risks and benefits of vaccines—and vaccine refusal. The doctor would then have to sign the form, attesting that such a conversation took place. It was a case of trying to provide true informed consent versus the misinformed consent that antivaccinationists generally provide, to make it just a little more difficult to claim a philosophical exemption by requiring at least one trip to a health care provider. Not surprisingly, the antivaccine-friendly Dr. Bob Sears and the rest of the antivaccine movement blew a proverbial gasket, attacking the bill as a horrific assault on parental rights and freedom, one example being Rob Schneider, as mentioned above.

They probably needn’t have worried. AB 2109 in action is probably going to be next to useless to decrease the number of philosophical exemptions, as I found out from the California Immunization Coalition, Emily Willingham, and Harpocrates. Of course, I was concerned with one major amendment to the bill before it passed that expanded the list of health care practitioners (see text of bill) who could counsel parents. While I approved of the addition of school nurses to the list, unfortunately the bill was also amended to include “naturopathic physicians” (i.e., quacks), which are the favored health care provider of many antivaccinationist because naturopaths tend to be antivaccine themselves. (Indeed, it is rare to find a pro-vaccine naturopath, and most of them are barely pro-vaccine.) Harpocrates and Emily don’t dwell on this enormous loophole, which is probably enough to neuter the law just by itself, but unfortunately, as I mentioned before, because it would allow parents to see whatever antivaccine quack they wanted for “counseling,” thus avoiding any uncomfortable science-based information.

Even worse, though, when Governor Brown finally signed the law he added this signing message:

This bill is about explaining the value of vaccinations – both the benefits and risks – for an individual child and the community. Whether these are simple “information exchanges” or more detailed discussions, they will be valuable even if a parent chooses not to vaccinate.

I am signing AB 2109 and am directing the Department of Public Health to oversee this policy so parents are not overly burdened by its implementation. Additionally, I will direct the department to allow for a separate religious exemption on the form. In this way, people whose religious beliefs preclude vaccinations will not be required to seek a health care practitioner’s signature.

As I said at the time, arrrrrggggh! This statement seems to say that just requiring a religious person to talk to a health care provider is some sort of massive violation of his religious freedom. There was also nothing in the law that authorized the governor to add any such statement to the form. But what did Brown mean? Now, thanks to the California Immunization Coalition, we’ve found out. I’ve seen the California Department of Public Health press release, which includes a link to the actual form to be used.

And I say again: Argggggghhhh!

Or maybe I should just throw in a facepalm as well:

jiFfM

The form is pretty minimalist in its design, which is what one would expect from the law. Basically, there’s a statement for the health care practitioner to sign:

Provision of information: I have provided the parent or guardian of the student named above, the adult who has assumed responsibility for the care and custody of the student, or the student if an emancipated minor, with information regarding 1) the benefits and risks of immunization and 2) the health risks to the student and to the community of the communicable diseases for which immunization is required in California (immunizations listed in Table below).

There are boxes for the parent to check to attest that she got the information from her health care provider and boxes to choose either affirming that the child got all his shots or that the parent is claiming a philosophical exemption:

Immunizations for which exemption is requested: An unimmunized student and the student’s contacts at school and home are at greater risk of becoming ill with a vaccine-preventable disease. I understand that an unimmunized student may be excluded from attending school or child care during an outbreak of, or after exposure to, any of these diseases for the protection of the student and others (17 CCR §6060). I hereby request exemption of the student named above from the required immunizations checked below because such immunization is contrary to my beliefs.

What follows is a list of required vaccines that the parent can then refuse. So far, nothing unexpected. However, there is also a box that can be checked that says this:

Religious beliefs: I am a member of a religion which prohibits me from seeking medical advice or treatment from authorized health care practitioners. (Signature of a health care practitioner not required in Part A.)

WTF????

What on earth does this mean? It basically seems to sanction child abuse. As we’ve seen before, while competent adults have the right to refuse medical care for any medical condition for basically any reason at all, they do not have the “right” to medically neglect their children. True, in this country, as I’ve pointed out before, parental rights seem to trump all, and it takes a child in danger of dying from a deadly disease like lymphoblastic lymphoma to get the child protection authorities to act. Oh, wait. They didn’t, even in that case. A hospital did. The principle is there, though. The state of California has basically said on its vaccine exemption form that it’s OK not to take your child to see a doctor and even gone so far as to allow parents to use the claim that their religion doesn’t let them take their children to see a physician, NP, PA, school nurse, or “naturopathic physician.” Of course, the number of religions that include such beliefs is vanishingly small, as is the number of people who belong to such religions. Small though they may be, such religions cause enormous harm, leaving dead children in their wake. One wonders why Governor Brown felt the need to bend over backwards to show such deference to such fringe beliefs? It’s a misguided concept of religious freedom that privileges beliefs that

Also, as Harpocrates has pointed out, this is not in the text of AB 2109. There is no provision for religious exemption in the bill that allows parents to opt out of even seeing a health care professional to have the form signed. The law requires a:

…signed attestation from the health care practitioner that indicates that the health care practitioner provided the parent or guardian of the person who is subject to the immunization requirements of this chapter, the adult who has assumed responsibility for the care and custody of the person, or the person if an emancipated minor, with information regarding the benefits and risks of the immunization and the health risks of the communicable diseases listed in Section 120335 to the person and to the community. This attestation shall be signed not more than six months prior to the date when the person first becomes subject to the immunization requirement for which exemption is being sought.

How can this form not be against the law? Worse, this form reinstates the very problem that AB 2109 was designed to correct: The ability of parents to gain an exemption from school vaccine requirements simply by checking a box on a form, something easier than actually taking their children to the doctor to get them vaccinated according to school requirements. We know that antivaccinationists have no compunction about lying about their religion in order to claim vaccine exemptions. This form will facilitate that.

The California Department of Public health claims that “the form also allows for constitutional freedom of religious expression.” I suppose that’s true in a way, but in reality the form goes far beyond constitutional requirements to protect freedom of religious expression. As I said, it basically bends over backwards and ties AB 2109 into a pretzel, all to protect “freedom of religious expression” above and beyond what other laws do. One wonders if the state of California would view it in such a benign fashion if, as in the case of Catherine and Herbert Schaible, who through medical neglect let two of their children die of pneumonia rather than take them to a doctor because their religion proclaimed that prayer, rather than medicine, would heal them?

Harpocrates and Emily also bring up another rather dicey issue. By signing the form, parents are stating that they believe in a religion that forbids them from from seeking medical advice or treatment from one of the five classes of health care practitioners, four science-based and one quack. That’s not just vaccines, but all medical treatment, leading Harpocrates to ask:

What happens if Timmy needs a doctor’s note to be excused from school or participation in some school activity (e.g., gym)? Will a note from some unauthorized health care practitioner (i.e., quack) be accepted, or will the parent have to “go against their religious beliefs” and see an authorized health care practitioner? Or perhaps Timmy gets sick or injured. What if he breaks a bone and requires medical attention to ensure it is set correctly? Do the parents do it themselves, or do they take Timmy down to the local health center for treatment, against their professed religious beliefs? And in any of these situations, if the parent goes to an authorized health care practitioner for medical advice or treatment for the child, does that mean that the form is invalidated, since they have demonstrated that they can and will go to a provider despite stating religious objections to the contrary?

While it’s true that these are issues that the state of California, through its misguided desire to please the religious, created, I really doubt that there will be a problem here. I don’t express doubt because I don’t think these are legitimate issues. I express my doubts because I’m betting that these forms will be treated as nothing more than a piece of paper and that, once the parents check the religious exemption box and sign the form, no further attention will be paid to it for anything other than vaccines. I’d really love to see a school official challenge such parents if their child ever needs a note from a doctor or the child becomes ill or injured at school, forcing the parent to acknowledge that little Timmy will be taken to the doctor after all, but I know it will never happen. Similarly, I’d love to see a school, the first time one of these children are taken to the emergency room or hospitalized for any reason, go to the parents and ask them about their so-called “religious beliefs” preventing them from utilizing modern medicine—after the child recovers, of course.

AB 2109 was a good idea, and it could have worked simply by making it a little more difficult for parents to claim an philosophical exemption—and it did. However, it more than neutered that requirement by allowing quacks (naturopaths, many of whom are antivaccine) to be health care providers on par with physicians, PAs, NPs, and DOs who provide vaccine counseling before signing the exemption form. As if that weren’t enough, Governor Brown, privileging religious beliefs above all else, finished the neutering by instructing the CDPH to add this inane checkbox, with a statement that is so vague, so obviously not well-thought out, and that is likely to be fraught with unintended consequences, that California might not have even bothered to pass AB 2109 in the first place. It’s so obviously against the intent of the law, that one wonders why the CDPH obeyed the governor; it almost certainly doesn’t have to. The law is the law, after all, whatever the governor said in his signing statement. By kowtowing to extreme religious beliefs the governor and the CDPH have betrayed all of those who fought so hard to get AB 2109 passed. Worse, they have betrayed the children of the state of California.

Comments

  1. #1 David S
    November 7, 2013

    Wow, what a surprising turn (sarcasm font).

  2. #2 T.
    November 7, 2013

    I am an evil woman. In case Timmy would get sick or injured at school I would let him be in pain and if the parents dare to say something I would wave in front of them the signed form and protest that I was just trying not to infring their “religious belief”.

    Worse, I would create a database of all those oh-so religious family and would send it to every hospital and doctor in the country, and claim that, since it is against their religion, neither them nor their precious children will ever be admitted in one of said hospital.

    Actually, we had something similar around here. If you refused to make the military service -once mandatory- because you objected to it, you weren’t allowed to own gun, for any reason, nor to join the police. Fair is fair.

    I am evil, as I said.

  3. #3 Science Mom
    http://justthevax.blogspot.com/
    November 7, 2013

    @ T. while I understand the frustration, the child shouldn’t be left to suffer because of their parents’ stupidity and selfishness. The fair thing to do would be to invalidate the religious exemption if it is found that the parents do use medical care and never allow them an exemption again.

  4. #4 Michael Finfer, MD
    November 7, 2013

    My hospital now requires all employees and physicians to get a flu shot every year, subject to very limited exemptions. Claims for religious exemptions are reviewed by the on staff clergy to verify that they are valid.

    I do not see this as onerous as it happens without the involvement of the person seeking the exemption. Would this work in public schools? The school boards would probably not be able to pay the clergy, but I don’t think it would be too difficult to find volunteers. Doing this might help to put a stop to this nonsense.

  5. #5 AnObservingParty
    November 7, 2013

    Worse, I would create a database of all those oh-so religious family

    Hospitals track declinations, why not schools? Monkey wrench, though….it may potentially delay treatment that kids actually need because their parents are contrary morons to prove a point. Unless the school would then require another waver AFTER said fact allowing for medical treatment that would nullify the original exemption.

  6. #6 T.
    November 7, 2013

    @SM I agree with you, SM, I just believe that actually many of those idiots wouldn’t use the religious or filosophical exception at all if it would truly mean “discard modern medicine” instead than just “discard vaccines” *sigh*

  7. #7 Todd W.
    http://www.harpocratesspeaks.com
    November 7, 2013

    @Orac

    I agree that it’s unlikely that the form would ever come up again outside the context of vaccinations, but the possibility is there. It’s a potential issue that should never have been created in the first place.

    Oh, and yeah, the naturopath bit alone renders the new law next to meaningless. I mentioned it briefly last year (here and here), but didn’t dwell too much on it, since I don’t have a huge amount of experience addressing naturopath claims, etc.

  8. #8 AnObservingParty
    November 7, 2013

    I can only speak for my health plan, but naturopaths are most definitely NOT covered in any capacity. Whether or not insurance is taken may come into play with more middle-class people, at least in that sense; people can be a lot more agreeable when the alternative is paying $200 and up. Ditto Dr. Jay’s logic reasoning that more parents will just flock to him because of that law; yeah, most of us can’t so readily drop money like that, when the alternative is a $25 copay.

  9. #9 Todd W.
    http://www.harpocratesspeaks.com
    November 7, 2013

    Oh, and as an aside, the Facebook group Californians Against AB2109 has people already exchanging information on anti-vaccine-friendly docs to sign the form, as well as talk about religions you can join, even if you’re an atheist.

  10. #10 ruthq
    November 7, 2013

    All parents fill out an emergency medical form for their children at the beginning of each school year with the child’s pediatrician listed. Schools could require that parents listing a physician on the emergency form may not claim the religious exemption, and that this physician must be the one who provided the counseling required for exemption.

  11. #11 Eric Lund
    November 7, 2013

    A major problem with “religious freedom” as it’s generally understood in this country is that often the people claiming “religious freedom” are effectively imposing their religious beliefs on other people who may not share those beliefs, making it a quite Orwellian phrase. It’s one thing to ask society to respect your religious beliefs when it does not impose on their rights (e.g., not requiring orthodox Jews to work on the Sabbath if that can be reasonably accommodated). But there are laws that allow doctors and pharmacists to refuse to provide necessary medical services (and in some cases, actually prohibiting the provision of such services) based on alleged religious beliefs[1]. Brown’s actions have the same effect: those who claim a religious exemption are allowed to endanger others who do not share those beliefs. It’s bad enough that AB2109 allowed NDs to sign the form, but at least the parents still had to schedule a visit with an ND to get the form signed. The religious exemption doesn’t even impose that hurdle. And contra #4, I have no confidence that any follow up will take place. IIRC there is a prominent anti-vaxer (whose name escapes me, but he has been mentioned previously on RI) who is/was employed by a Bay Area school district to teach middle school science.

    As an amendment to T’s suggestion @2, I would word the religious exemption box, if it must be there, to state that the parents signing the form are claiming that exemption under penalty of perjury. Then charge the parents accordingly when little Timmy shows up with a note from his doctor, or let him be treated by a doctor if he becomes ill or injured at school.

  12. #12 Chris HIckie
    November 7, 2013

    Perhaps the pediatricians of California (sans the moronic idiotic anti-vaccine ones like Sears and Gordon) could turn this into a voter referendum, collecting signatures to get an “absolute form” of AB2109 on the ballot, including the exact format of the form to be used (which would not have the religious exemption box). I would like to think there should be a large enough majority of parents in California who do vaccinate and understand its importance, and a lot of them see pediatricians.

    Is anyone from the Caifornia AAP listening?

  13. #13 Mu
    November 7, 2013

    Anyone signing that religious exemption statement should be declared an unfit parent right of the bat. It’s well established that the welfare of the child trumps the religious position of the parent, and with signing that statement you’re professing to going against that.

  14. #14 Shay
    November 7, 2013

    I can’t think of a single mainstream religion that forbids vaccines, so anyone who signs that religious exemption statement should be required to list their denomination, where they worship, and contact information for their pastor.

    That Susan B Anthony quote applies here as well.

  15. #15 Denice Walter
    November 7, 2013

    @ Todd W.:

    And the Vaccine Machine Facebook page has been continuing to assist parents exchange information about evading vaccinations and finding enabling doctors – its proprietor lives in CA but he welcomes any like minded person to participate.

  16. #16 Chris HIckie
    November 7, 2013

    All parents fill out an emergency medical form for their children at the beginning of each school year with the child’s pediatrician listed. Schools could require that parents listing a physician on the emergency form may not claim the religious exemption, and that this physician must be the one who provided the counseling required for exemption.

    That is interesting–here is an example of the form required by the LA Unified School District, and it clearly requires listing a physician which would directly contradict the religious exemption check box on the vaccination form:

    http://home.lausd.net/pdf/Families_Forms/Student_Emergency_Information_Form_English.PDF

  17. #17 oldmanjenkins
    Wooville, FL
    November 7, 2013

    Calling a naturopathic “physician” (can anyone even say that without laughter?) a healthcare provider is like calling a circus shoveler of elephant dung a refuse requisitioning engineer.

  18. #18 Dorit
    November 7, 2013

    A. Orac, I don’t want to underplay the problem with that, but note that not any naturopath can sign the bill – only “(5) A naturopathic doctor who is authorized to furnish or order
    drugs under a physician and surgeon’s supervision pursuant to Section 3640.5 of the Business and Professions Code.” So supervised naturopaths – and there aren’t a lot of them. http://www.leginfo.ca.gov/cgi-bin/displaycode?section=hsc&group=120001-121000&file=120325-120380
    B. The form, problematic as it is, is also annoying anti-vaxers – Dawn Winkler, who you wrote about before, said on Linderman unleashed that they will bring a lawsuit. I almost hope so. Here is her letter to parents. http://www.lindermanunleashed.com/News.html

  19. #19 oldmanjenkins
    Wooville, FL
    November 7, 2013

    And I am tired of those who feel religiously oppressed when in fact they are quite the opposite. This freedom is not absolute. The limits of such freedom end when it impacts my freedom. This is why the constitution has as its first amendment that no religion is given preferential treatment. These “laws” that are passed allowing people to exempt based upon religious opinions are impacting those of us who are either of other religions denominations or atheists. By design they are unconstitutional. And of course these deluded individuals love to travel and of course bring back whatever communicable disease the vaccine was designed to protect against (Eagle Mountain International Church in North Texas). Which then gets them running around to get the vaccine they should have already gotten. Every day I appreciate more that nurse mother was grounded in evidence and science based medicine.

  20. #20 Roadstergal
    Sadly, in CA
    November 7, 2013

    @Science Mom #3:
    “@ T. while I understand the frustration, the child shouldn’t be left to suffer because of their parents’ stupidity and selfishness.”

    What about the parents, though? Shouldn’t any parent who checks that box be disallowed science-based treatment?

    Oh, if only there were a mechanism for that.

  21. #21 Kelly M Bray
    November 7, 2013

    A bit OT but there is a good article about doctors needing to stand up against AV’rs in the LA Times. Chris Hickie is doing good work in the comments but he is outnumbered by the purveyors of derp.

    http://discussions.latimes.com/20/lanews/la-ol-vaccines-doctors-20131105/10

  22. #22 Orac
    November 7, 2013

    Orac, I don’t want to underplay the problem with that, but note that not any naturopath can sign the bill – only “(5) A naturopathic doctor who is authorized to furnish or order
    drugs under a physician and surgeon’s supervision pursuant to Section 3640.5 of the Business and Professions Code.”

    I’m really not sure what your point is. Sadly, California is one of the states that license NDs, and from my reading of the relevant parts of the code, pretty much any ND who graduates from an “approved” naturopathy school, passes the NPLEX (hilariously, the naturopathic board examination), and keeps up his—cough! cough!—continuing medical naturopathic education would qualify for licensure. Licensed or not, they’re still quacks.

  23. #23 Science Mom
    http://justthevax.blogspot.com/
    November 7, 2013

    What about the parents, though? Shouldn’t any parent who checks that box be disallowed science-based treatment?

    @ Roadstergal, presumably that would be assumed but you know what they say about assumptions. I get the impression that the CDPH worded it that way to say, “if you can’t be arsed to go to an approved practitioner to get your PBE signed then you must adhere to a religious belief that eschews medical care so have at it”. What they intend to do with these religious waivers is another matter all together.

  24. #24 Politicalguineapig
    November 7, 2013

    Shay: I can’t think of a single mainstream religion that forbids vaccines, so anyone who signs that religious exemption statement should be required to list their denomination, where they worship, and contact information for their pastor.

    Um, Islam doesn’t permit vaccinations, Jehovah’s Witness’s don’t get vaccinated, and I don’t think the Catholic Church likes vaccines either. Most Muslims and Catholics tend to ignore the prohibitions, so it tends not to be an issue.

  25. #25 Dorit
    November 7, 2013

    My point is that it is not enough to be a licensed naturopath. Some naturopaths – and not others – may issue medication supervised by an MD. The point is: this applies to a sub category of naturopaths that are under the supervision of an MD for several things.
    There is some MD control over the naturopaths that qualify for the form.

  26. #26 Dorit
    November 7, 2013

    Here’s the code section – section d addresses the required supervision: http://www.oclaw.org/research/code/ca/BPC/3640.5./content.html#.UnwTZ6V8C5c

  27. #27 Johanna
    November 7, 2013

    Somewhat OT, but not entirely – how are the “vaccines cause autism!’ crowd going to spin this?

    http://www.bbc.co.uk/news/health-24837462 – “Autism can be identified in babies as young as two months, early research suggests.”

  28. #28 MI Dawn
    November 7, 2013

    (sigh) @PGP: the Catholic church is very much in favor of immunizations. I can’t speak for Islam nor Jehovah’s Witnesses. The only religion that I am aware of that doesn’t vaccinate are Christian Scientists.

    (and before you pop off at me: I’m an atheist. But I will speak the truth about what religions teach.)

  29. #29 Science Mom
    http://justthevax.blogspot.com/
    November 7, 2013

    The only religion that I am aware of that doesn’t vaccinate are Christian Scientists.

    Even they don’t have any formal policy against vaccination. No organised religion does in fact have a policy against vaccination even though individuals or even entire congregations may make their own rules.

  30. #30 AnObservingParty
    November 7, 2013

    @PGP and I don’t think the Catholic Church likes vaccines either.

    Catholics have no problem with vaccination, the “controversy” lies in questions about the MMR developed in cell lines derived from fetal tissue. The official statement is here, and essentially states *paraphrase* abortion is bad, yada yada, but…..since the alternate is worse until they are able to make better vaccines, get your shots to protect yourself and the rest of the population, idiot. *end paraphrase* http://www.immunize.org/concerns/vaticandocument.htm A nice little retort to shoot at antivaxxers who scream “fetal tissue! Wah!” is that if they Catholic Church can look at it and say, “yeah, ok…” and look the other way, then perhaps your argument is worthless.

    I also have some anecdotal experience: I spent grade school, high school, and undergrad at Catholic institutions, being schooled by Jesuits and Basilians alternately. There were no non-medical exemptions allowed. You got your shots–even scary cell line MMR–or you didn’t go to school there. It was Diocese-wide. My undergrad was one of the first to downright REQUIRE the meningitis vaccine to set foot in the dorms.

  31. #31 Denice Walter
    November 7, 2013

    @ Joanna:

    They tend to disregard whatever doesn’t confirm their position. There have been other studies that show early indicators of autism ( infants’ patterns of gaze, brain waves, physiognomic differences like head size,intra-facial proportions)- they ignore them or declare them invalid. They also pooh pooh non-vaccine environmental/ demographic indicators.

    I wouldn’t be at all surprised if they find a way to attribute very early indicators as being due to even earlier vaccines ( first day of life), the mother’s prenatal vaccines or ever her own childhood vaccines.

  32. #32 AnObservingParty
    November 7, 2013

    @ Denice
    Already in some comments threads people are blaming toxicity of the mother’s childhood vaccinations. I imagine someone blowing a whistle and yelling, “time to move the goalposts again, folks!”

  33. #33 Ausduck
    among the gum trees
    November 7, 2013

    @Johanna

    The spin will be simple – they’ll claim that the ebil world order conspiracy is just adjusting and re-naming in order to hide the troof. Again.

    ;)

  34. #34 Sastra
    November 7, 2013

    I can’t think of a single mainstream religion that forbids vaccines, so anyone who signs that religious exemption statement should be required to list their denomination, where they worship, and contact information for their pastor.

    Ah, a “real” religion then. As opposed to … those fake ones?

    One of the problems with this form is that it seems to place the government into a position where it has to decide what is and isn’t a religion. This is a big sticky mess.

    When it comes to opposing vaccines the significant aspect from religion which is involved in this exemption is going to concern beliefs about the supernatural and/or God which are known through faith or mystical experience. And you can have someone who is very devout indeed, living their life in a faith-based fog of constant communication with the divine — and they’re neither mainstream nor church-going. Gosh, shouldn’t the State give them the stamp of religious legitimacy?

    Denomination? “Spiritual.”

    Ok, there goes California.

  35. #35 Shay
    November 7, 2013

    The government already does decide what is or is not a “real” religion. Just ask the IRS.

    Oh, and PGP? Islam does NOT forbid vaccinations nor is the Catholic Church opposed to them.

  36. #36 Kausik Datta
    United States
    November 7, 2013

    …Islam does NOT forbid vaccinations

    Erm, Shay, Islam-as-religion may have nothing to say anything about vaccinations (very naturally, vaccines weren’t around when Islam started), but Political Islam is on record in many countries, including in Southeast Asia, for advocating against vaccinations – which were propounded by certain Islamic leaders as instruments to sterilize Muslim men and women.

  37. #37 Vicki
    November 7, 2013

    California *really* does not want to get involved in questions of what is a mainstream religion, or to be caught privileging the Roman Catholic Church or the First Church of Christ, Scientist above the New Reformed Druids of North America, the Five Percent Nation of Islam, or the Church of Happyology.

    Just to complicate matters, the Society of Friends is a small but well-established and respectable Protestant Christian denomination that has no clergy. As far as I know, the Quakers are fine with vaccination, but you can’t ask a Quaker for a note from his/her minister. (Well, you can ask, but you might as well ask for a note from his/her time machine repairperson.) Quaker marriage licenses are signed by the entire meeting–everyone who goes to the wedding.) My (thoroughly vaccinated) partner’s Jewish congregation doesn’t have a rabbi, because they can’t afford the salary. Members take turns leading services. (This is unusual but not problematic, since the Jewish priesthood is considered to be in abeyance until the Jerusalem Temple is rebuilt, and in the meantime either any adult, or any adult male [depending on the denomination] can lead services.

  38. #38 Todd W.
    http://www.harpocratesspeaks.com
    November 7, 2013

    @PGP

    Ugh…there you go making broad generalizations again without knowing what you’re talking about.

    None of the three major religions in the U.S. (Christianity, Judaism or Islam) prohibits vaccination, nor do their major sects prohibit vaccinations. Some are even vocally very supportive of vaccines (including Islam). Even the Mormons and Jehovah’s Witnesses support vaccination. (I have links at the end of this post.) The only place I’ve seen clear prohibitions against vaccines from a religion are among the really, really fringe groups, like the Church of Illumination.

  39. #39 Politicalguineapig
    November 7, 2013

    Todd: I did point out that these prohibitions were widely ignored- at least in the US.

  40. #40 AnObservingParty
    November 7, 2013

    @ PGP and by the Vatican. The document is an explain-away of abortion to support vaccination. The Catholic Church has a lot of problems, but not supporting vaccination is NOT one of them. That is hardly “widely ignored.” The RCC sponsors vaccine clinics for the un- or under-insured. Using “Roman Catholic” on the exemption form if denomination wouldn’t fly, and I’d put money down that if a the local Diocese found out someone did that, they’d denounce it.

  41. #41 Khani
    November 7, 2013

    They’re not ignored; they don’t exist.

    If you want to cite a specific papal bull that forbids vaccination — that is still current — I will certainly admit you’re wrong, though. I’m not Catholic, so I well may have missed it somehow.

  42. #42 Khani
    November 7, 2013

    Ugh. Admit I’m wrong. (See. I’m wrong sometimes. :) )

  43. #43 Science Mom
    http://justthevax.blogspot.com/
    November 7, 2013

    @ AOP et al. but that’s not how religious exemptions work. One can be of any denomination of any religion, organised or fringe and obtain an exemption even in the state of NY which has the most stringent religious exemption (no PBE) in the country. http://www.p12.nysed.gov/sss/schoolhealth/schoolhealthservices/fieldmemoreligiouseximmunprocedures.html

    One need only to demonstrate a sincere religious belief against vaccination be it they’re Catholic, Jewish or Fundie.

  44. #44 Shay
    November 7, 2013

    I did point out that these prohibitions were widely ignored- at least in the US.

    WHAT prohibitions?

  45. #45 AnObservingParty
    November 7, 2013

    @ Science Mom,

    For sure, and it wouldn’t change the person’s status or claim if the state rep appointed to the case determined it was true. BUT, if for some reason listing specific denomination was required and it got out, and the RCC found out people were using fetal cells and Catholicism to avoid a shot, Bill Donahue would have his cronies all up in their shiz for associating the church with anti-vaxxers. I merely wanted to point out that PGP was making a generalization that wasn’t remotely true, and frankly offensive to this lapsed Catholic. They’re a lot of things, but anti-vax is not one of them.

  46. #46 Krebiozen
    November 7, 2013

    I’m reasonably well-educated regarding Islam: I have spent a fair amount of time in various Muslim countries, I live in a part of London where I am outnumbered by Muslims, have Muslim friends, own an English translation of the Koran etc., but I have never come across any prohibition against vaccination. There have undoubtedly been specific instances when vaccination has been suspected of being used for political ends, but in principle? Not to my knowledge. In fact the Muslims in my area seem particularly keen on vaccinations, presumably because many of them are from parts if the world where the dangers of contagious diseases are all too well-known.

    Tangentially related – UK BBC showed an excellent TV program this evening featuring the inimitable Hans Rosling with his 3D data presentations, this time about population growth. Population has stabilized in most developing countries, mainly because of better education and because infant mortality has fallen so dramatically. He focused on Bangladesh and Mozambique; a man who had seen his two sons die of measles was interviewed. The program is well worth watching if you get the chance – I’m sure it will soon surface on YouTube or PBS. The title is ‘Don’t Panic: The Truth About Population’.

  47. #47 MarkL
    November 7, 2013

    Krebiozen,

    I believe you are correct, there was a period when Islam rejected immunization because of the use of Pork gelatin in some formulations, but even that objection was overturned by Islamic scholars in 1995 who stated that:

    “The seminar issued a number of recommendations, included in the attached statement, stipulating that ‘Transformation which means the conversion of a substance into another substance, different in characteristics, changes substances that are judicially impure . . . into pure substances, and changes substances that are prohibited into lawful and permissible substances’.”

    Consequently, the scholars determined that the transformation of pork products into gelatin alters them sufficiently to make it permissible for observant Muslims to receive vaccines containing pork gelatin and to take medicine packaged in gelatin capsules.

  48. #48 Politicalguineapig
    November 7, 2013

    AOP: How much are you willing to part with?

    Krebozien: There have undoubtedly been specific instances when vaccination has been suspected of being used for political ends, but in principle?

    Considering that people have been killed for conducting vaccination campaigns in Pakistan, Afghanistan and Nigeria, that there’s denunciations of vaccines in Malaysia and India and that polio’s been found in Syria, I am not convinced that vaccination is supported by that particular religion. Like I said, individuals do not have to abide by that prohibition, but that doesn’t mean it doesn’t exist.

  49. #49 Denice Walter
    November 7, 2013

    Recently, we’ve heard reports of extremists who oppose vaccination on political grounds in isolated instances-
    such as:
    Sept 2013 ‘ Taliban threats against immunisation raise polio epidemic risks in Pakistan’ ( from asianews.it)
    which has been happening in N & S Waziristan.

    More likely the exception than the rule, I’d guess.

  50. #50 Shay
    November 7, 2013

    And fueled by a belief that the vaccine campaigns are being used as “cover” for intelligence-gathering activities.

    http://www.nytimes.com/2012/06/19/world/asia/taliban-block-vaccinations-in-pakistan.html

  51. #51 lilady
    November 7, 2013

    Test post…comment lost in moderation?

  52. #52 meg
    November 7, 2013

    To wade into the Islamic debate here. . .

    my experience is very similar to Krebiozen’s – Muslims I know are mostly from refugee families, where mum/dad/grandma know full well the dangers of disease, and are more than happy to tell you why vaccines are a good (in one case, an Afghani’s friend grandmother calls them a wonderful gift from Allah, and a blessing on all children. She lost 3 siblings and 2 children to various preventable diseases.)

    We’re forgetting that Islam is like Christianity – there is no ‘one’ form, but rather numerous ‘denominations’. There are progressives through to fundamentalists. Shay and Denice are right with where the current opposition lies. Often, it’s the extremists who are the loudest, or are the ones likely to carry the weapons. For every extremist who denounces vaccines, there are probably 10 other Muslims who are working hard to distribute them.

  53. #53 Chemmomo
    wondering whom to contact now . . .
    November 8, 2013

    AnOberservingParty @5

    Hospitals track declinations, why not schools?

    The schools already do, as they are required by law to exclude those with exemptions if there is a disease outbreak. Unfortunately, I don’t have the specific references to CA law at my fingertips at the moment (I’m on the wrong device).

  54. #54 Julian Frost
    Gauteng East Rand
    November 8, 2013

    Politicalguineapig @24:

    Um, Islam doesn’t permit vaccinations…

    It has been pointed out to you on another thread that this is false. Stop with the lies.

  55. #55 Chris,
    November 8, 2013

    PGP: “Considering that people have been killed for conducting vaccination campaigns in Pakistan, Afghanistan and Nigeria, that there’s denunciations of vaccines in Malaysia and India and that polio’s been found in Syria,”

    That is usually only by stupid people with a political agenda. You need to learn to differentiate from actual religious dogma and actions by “stupid people.”

    Trust me, there is a difference. Do not generalize on the actions of a few “stupid people.”

  56. #56 Antaeus Feldspar
    November 8, 2013

    Considering that people have been killed for conducting vaccination campaigns in Pakistan, Afghanistan and Nigeria, that there’s denunciations of vaccines in Malaysia and India and that polio’s been found in Syria, I am not convinced that vaccination is supported by that particular religion. Like I said, individuals do not have to abide by that prohibition, but that doesn’t mean it doesn’t exist.

    *headdesk*

    This is the same “logic” as saying “The law of the United States lets you sell political office. This is proven by the ex-governor of Illinois, Rod Blagojevich, trying to sell a Senate seat. Therefore, it’s the law that you can do that, although in practice most people don’t take advantage of this opportunity they possess under the law.”

  57. #57 AnObservingParty
    November 8, 2013

    That is usually only by stupid people with a political agenda. You need to learn to differentiate from actual religious dogma and actions by “stupid people.”

    Exactly. And I don’t need to part with anything, PGP, what do you think my link was? It was the Vatican addressing a group wanting to opt out.

  58. #58 Krebiozen
    November 8, 2013

    Like I said, individuals do not have to abide by that prohibition, but that doesn’t mean it doesn’t exist.

    But it doesn’t exist. You appear to have invented it.

  59. #59 Renate
    November 8, 2013

    I suppose the polio-outbreak in Syria has a lot to do with the civil war, with lots of refugees living in unhygienic conditions and are hardly reached by vaccination programs, throw in some Muslim fundamentalists who probably are against vaccination and you have a problem.

    I suppose there are always fundamentalist groups in every religion that are opposed to vaccination. Mostly these are small groups. We have some funcamentalist Christian groups that are opposed to vaccination. Problem is, they mostly live in communities where they are mostly on their own, so less protection of herd immunity.

  60. #60 Todd W.
    http://www.harpocratesspeaks.com
    November 8, 2013

    A lot of the anti-vaccination stuff in places like Pakistan and Syria isn’t so much about the vaccines as about anti-U.S./anti-Western political ideologies. The CIA’s idiocy did not help that situation at all. The opposition is political, not religious.

  61. #61 Gray Falcon
    November 8, 2013

    I’m pretty sure PGP wouldn’t allow someone to use Stalin and Pol Pot as proof that atheism leads to immorality. Why does he think he can use the same tactics for religion?

  62. #62 Mark McAndrew
    November 8, 2013

    Taliban rejected vaccines after it was found that the CIA (in the most unforgivable cock-up in their illustrious history) used a vaccine campaign to obtain DNA of Bin Laden or, more likely, his progeny.

    Wouldn’t have been a problem had the CIA followed up with the necessary second round of shots, which would have both properly immunized the kids and also maintained their cover. But they bugged out after the first round of shots, raised local suspicions, and kids – and health workers – started dying soon after.

    Happy ending though; the Taliban actually saw sense (well, dying kids) and reversed their position. But someone at the CIA has a lot of innocent blood on their hands, and history will not judge them kindly.

  63. #63 Todd W.
    http://www.harpocratesspeaks.com
    November 8, 2013

    @Mark McAndrew

    It also would have helped if the CIA hadn’t gone against the local leaders’ wishes (the leaders were approached for permission to do a vaccination campaign, the request was denied, then CIA went ahead with the operation anyway).

  64. #64 Lawrence
    November 8, 2013

    @Todd / Mark – not one of our more “enlightened” activities overseas…..

  65. #65 Jenora Feuer
    November 8, 2013

    @Mark #62:
    the most unforgivable?

    Not that I’m saying it wasn’t unforgivable, just noting that there’s a whole lot of competition for that spot from among the CIA’s various activities.

  66. #66 Politicalguineapig
    November 8, 2013

    Chris: You need to learn to differentiate from actual religious dogma and actions by “stupid people.”

    The problem is that ‘dogma’ and the actions of ‘stupid people’ tend to be indistinguishable. And it’s a mistake to characterize them as ‘few.’ Stupid people are legion. They outnumber us.

  67. #67 Krebiozen
    November 8, 2013

    PGP,
    The point here is that the term “religious prohibition” has a well understood meaning. It would be accurate to say, for example, that Christianity prohibits murder, or that Islam prohibits the consumption of pork. It is not accurate to say that Islam prohibits vaccination.

    Though vaccination didn’t exist when the Koran and associated verses were written, I have little doubt that had Mohammed known about vaccination he would have endorsed it. For its time Islam was quite enlightened, and the Koran states that followers should do whatever necessary to benefit their health and that of their children. It states, for example, that where possible breast feeding should be continued until a child was 2 years old.

    There is quite enough misinformation about Islam around without adding to it. My wife’s crazy racist uncle used to regularly send us outraged emails about what Muslims believe, including verses from the Koran that inevitably turned out to be made-up until, I assume, he got fed up with me sending him rebuttals.

  68. #68 Narad
    November 8, 2013

    California is a state that allows both religious and philosophical exemptions

    I’m rather late to the party, but California was and is one of the four states without a religious exemption for school immunization requirements, the others being Arizona,* Mississippi, and West Virginia. Even the “exemption” purportedly created by executive fiat here is to the requirement of Section 120365(b), not to the immunization mandate, which is somewhat crafty.

    As already noted, any scheme that requires “membership” in a religion is very likely constitutionally toast if actually enforced. What the likes of Dawn Winkler apparently don’t grasp is that the immediate upshot of this is not expansion of the religious loophole, but elimination: statutory religious privileges are inherently suspect.

    * For whatever reason, Arizona does have a religious exemption for child care and preschool.

  69. #69 sid offit
    November 9, 2013

    You’re actually quoting “Harpocrates Speaks?” That’s pathetic even for you.

  70. #70 sid offit
    November 9, 2013

    You’re actually quoting “Harpocrates Speaks?” That’s pathetic even for you.

  71. #71 sid offit
    November 9, 2013

    You’re actually quoting “Harpocrates Speaks?” That’s pathetic even for you.

  72. #72 Chris,
    November 9, 2013

    Mr. Schecter, your computer hates you. It caused your little comment to post three times. That is pathetic.

    Even more pathetic than pretending to be a respected author.

    So, Mr. Schecter, what religion will you claim as yours that is against preventative medicine like vaccines? Will it be Reformed Rand or the Church of the Special Snowflake?

  73. #73 lilady
    November 9, 2013

    It’s a religion I’ve never heard of Chris…where they sacrifice little babies and children because of their ignorance.

  74. #74 Chris Hickie
    November 9, 2013

    @-Narad #68–I didn’t realize that the checkbox was for different reasons for preschool and younger (religious–http://azdhs.gov/phs/immunization/documents/school-childcare/religious-belief-exemption.pdf) and “personal beliefs” for kindergarten and up (http://azdhs.gov/phs/immunization/documents/school-childcare/personal-belief-exemption.pdf)..

    Somehow I bet that doesn’t make a difference since it is just a checkbox. But it’s consistent with AZ, which is, I believe, the only state not to require the varicella booster for kindergarten entry.

  75. #75 Trottelreiner
    November 9, 2013

    actually, even with pork in vaccines, one could argue there would be little problem with it in islam, since there are quite some rulings that say alcohol is ok when used in medicines.

    and generally, not using a life-preserving medical method, even if it violates some dietary laws, is seen as akin to suicide, a big no in judaism, islam and christianity. as is harming others. the main problem with medical procedures are with jehovah’s witnesses and blood transfusions, citing some biblical prohibitions, which is somewhat funny, since

    a) judaism, which adheres to the prohibitions in question, has no problems with transfusions. they slaughter kosher, though, which jw somewhat neglect.

    b) the dietary laws in question are not binding for gentile christians, as stipilated with the council of jerusalem with petrus and paulus. my agnostic spider sense thinks this was more something of political brockering, still, there are no questions about that.

    good luck putting that to a witness, though. or an anti-transfusion quack arguing jews ands muslims don’t do transfusions…

    that being said, as for vaccinations under the taliban, anybody else felt remembered about one general kurtz musing about the aftermath of a vaccination in vietnam in apocalypse now? hardly a proof similar happened, but with this logic it’d mean communism is against vaccination…

    and last but not least, anbody else felt like singing “i’m governor jerry brown, my aura smiles and never frowns…”?

  76. #76 jaia
    November 10, 2013

    @AnObservingParty Thanks for posting the link to that Vatican document. I particularly like the last endnote, which is part of the discussion of the need to get vaccinated to protect others. “This is particularly true in the case of vaccination against German measles, because of the danger of Congenital Rubella Syndrome. This could occur, causing grave congenital malformations in the foetus, when a pregnant woman enters into contact, even if it is brief, with children who have not been immunized and are carriers of the virus. In this case, the parents who did not accept the vaccination of their own children become responsible for the malformations in question, and for the subsequent abortion of foetuses, when they have been discovered to be malformed.”

  77. #77 lilady
    November 11, 2013

    (From my totally useless trove of trivia and minutiae) Jerry Brown was on his way to becoming a Catholic priest; he left a Jesuit seminary after three years.

    Here, an informative website about Islamic law, pertaining to health care. There are no strict prohibitions to receiving vaccines…or porcine heart valves, porcine-derived heparin or porcine-derived insulin…as long as the heart valve is the type deemed medically appropriate for the patient and the medicine is live-saving.

    http://ethnomed.org/cross-cultural-health/religion/health-care-in-islamic-history-and-experience

  78. #78 Calli Arcale
    November 11, 2013

    One merely has to look at the reasons given by the imams who preach against vaccination to see that it has nothing to do with Islamic doctrine. They do not denounce the concept of vaccination and would probably be fine with a vaccination campaign run out of Saudi Arabia. It’s the *West* they have a problem with, not vaccines, and there are various conspiracy theories making the rounds about the vaccination campaigns funded by Western governments and NGOs. In Nigeria, the conspiracy theory was that secret poisons had been added to the vaccines to render children sterile, and that the polio protection was just a cover story. In Pakistan and Afghanistan, of course, the conspiracy theory was fear of Western spies among the Western doctors and nurses running the vaccination campaigns — and of course it turned out they weren’t entirely offbase with that one.

    Turns out, it’s hard to get people to trust you when you have drones flying overhead and firing missiles into houses and vehicles from time to time. This has nothing to do with religion.

  79. #79 Bradley
    Earth
    December 17, 2013

    Have you ever looked into the nazi war criminals who became CEO’s of companies like IG Farben and Bayer in America, after being convicted in the Nuremberg trials. The nazi’s lost the war but ultimately won in spreading their fascist corporate welfare ideology. Now we are all being forced to support them with endless frivolous vaccines. Thank you vaccines for iradicating polio, Amazing! however, the flu vaccine is a joke proven time & again & increasingly being pressured onto us.

  80. #80 Narad
    December 17, 2013

    Have you ever looked into the nazi war criminals who became CEO’s of companies like IG Farben and Bayer in America, after being convicted in the Nuremberg trials.

    Bet you never did the “Kenosha,” kid. Snap to.

  81. #81 novalox
    December 18, 2013

    @bradley

    [citation needed].

    Judging from your comments, do you live in Htrae?

  82. #82 Renate
    December 18, 2013

    I know of German rocket scientists working for the US, but I can’t combine vaccines and the nazi’s. Part of their ideologie was weeding out the weak, while vaccines are about protecting the weak.

  83. #83 Calli Arcale
    December 18, 2013

    Well, Bayer, for one, isn’t actually an American company. “Bayer” comes from “Bayern” — Bavaria. So it should be absolutely zero surprise that they’ve employed Nazis at some point. It would be true of any German company of note that was around prior to 1945.

    I would think the Nazis would’ve been fine with vaccines, actually — they were in favor of eugenics, but they weren’t stupid. I”m sure they knew vaccines would help protect their precious Aryan race.

  84. #84 Renate
    December 18, 2013

    Actually Bayer doesn’t come from Bayern. They started in Barmen (now part of Wuppertal) and one of the founders was Friedrich Bayer.

  85. #85 JGC
    December 18, 2013

    Wow! Zero to Godwin in seven words–take a victory lap.