Who knew? My state's vaccine personal belief exemption rate stinks! (Part 2: What to do.)

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After yesterday's post on the depressingly high (and increasing, apparently) rate of personal belief exemptions to vaccination requirements for entering school in the state of Michigan, I felt the need to pontificate a bit further. The reason is that MLive.com has posted some followup stories. Also, I didn't have a lot of time last night to write because I had the pleasure of attending the CFI-Michigan Solstice dinner to hang out with fellow skeptics and heathens. Unfortunately, the topic of the high exemption levels in Michigan came up.

First up on the follow up story parade is one entitled Why some Michigan parents choose not to vaccinate their children. It's depressingly familiar reading to anyone who's been following the antivaccine movement as long as I have. Worse, it falls into the utterly aggravating lazy journalistic trope of "telling both sides" of a story that, scientifically at least, doesn't have two sides. Antivaccine parents ignorant of basic biology are allowed to spew nonsense about "toxins," dismissive comments about justifiable concerns that their failure to vaccinated their children endangers others, conspiracy theories about "big pharma," and braggadocio about how they've "done their research." If you want to know how bad it is, consider this: "Media Editor" and controller of the flying antivaccine monkeys who go into a dive bombing run flinging their poo at any pro-vaccine article she comes across likes this MLive.com article.

The article starts right off with a mother whose brain does what human brains are so good at. It confuses correlation with causation:

A registered nurse who once worked in the pharmaceutical industry, Gretchen Perry didn't question the potential risk of vaccinations until she became a mother.

Her son was born 11 years ago, and was a sickly infant and toddler, she said. He had a series of gastrointestinal issues, didn't sleep through the night until he was in kindergarten, and showed language delays and socialization problems consistent with autism, said Perry, who lives in Rochester.

Her daughter, who is now 10, had similar problems, although not as severe, she said.

Perry said she thinks her children were born with compromised immune systems and suspects vaccinations were aggravating their health problems.

She swore off vaccines a decade ago, and says her children's health has improved considerably, thanks to their diet and health supplements that have "detoxified" their systems.

Or, as is so often the case, there's likely something genetic going on, given that both of her daughters were born "sickly" to varying degrees and suffered from GI issues and socialization issues "consistent with autism." Of course, I couldn't help but notice that nowhere does it say whether either of her daughters actually has a diagnosis on the autism spectrum. In any case, her second daughter suffered from similar problems to those of her first daughter even though she apparently didn't have any vaccines, given that her mother "swore off vaccines a decade ago." Naturally, confirmation bias led Perry to see any improvements in her children's health being due to the supplements and the "detoxification quackery" to which she appears to have subjected her children. (Yes, detoxification in the absence of an acute poisoning is quackery.)

In any case, in Michigan as in California and elsewhere, irresponsible non-vaccinating parents, who endanger not only their own children but every child with whom their children come in contact, tend to be clustered in affluent communities like Rochester. Similar gambits to the ones I've discussed time and time again come up in this article, all of them infused with distrust of pharmaceutical companies, the naturalistic fallacy, and pure pseudoscience. Indeed, every parent interviewed in this article mentioned vaccines being tested by pharmaceutical companies as a reason why they don't trust the strong scientific consensus that childhood vaccines are safe and effective. Perry mentions how the Internet has made it easier for such vaccine-averse parents to gather online and trade misinformation and strategy. (Yes, I know she didn't use the word "misinformation" but that's what these parents are doing, just as the not-so-merry gang of "activists" and "journalists" at the antivaccine crank blog Age of Autism do):

We all talk about this, and we're all on social media reading the information from the good nonprofits that educate us on the dangers of vaccination," Perry said, adding her belief that the mainstream medical establishment "ignores the very real adverse events" associated with vaccinations.

Yep. The antivaccine nonprofits are "good" and the mainstream medical establishment is covering something up, conspiratorial thinking at its finest. Then, of course, there's the Dunning-Kruger effect, in which parents think that a few hours on the Internet, coupled with a degree in something else, qualifies them to question the findings of scientists who have spent their entire lives studying vaccines, autism, and infectious disease and, because of their incompetence and lack of knowledge, are unable to acknowledge that they do not know what they are talking about. In other words, they think they know and understand far more than they, in fact, actually do know and understand:

Heather Stevens, the mother of a preschooler in Oakland County, doesn't buy those assurances.

She has a master's degree in environmental engineering and has helped conducting human health risk assessment for environmental pollutants. She says vaccine safety studies are typically conducted by pharmaceutical companies who have an interest in downplaying safety issues, and says there hasn't been adequate research into the "cumulative and sometimes synergistic effect of chemicals on the human body," especially over the long term.

"The media tends to stereotype us as this random, scared/fearful, mob-crew bunch of crunchy hippies," Stevens said. "At least speaking for myself, and my parent friends that choose to selectively vaccinate or not vaccinate at all, we are all very well-educated prior to becoming a parent and have spent a significant amount of time researching vaccines for the most important people in our life."

Stevens added that "so much of this is a gray area" and she recognizes the downsides of going unvaccinated.

That's nice, except that it's not a "gray area." Stevens wants it to be a gray area. She believes it's a gray area. But it's not a gray area. Dunning-Kruger. Being an environmental engineer does not qualify you to evaluate vaccine safety studies. Being "highly educated" does not mean you aren't a scared "mob-crew bunch of crunchy hippies." Once again, researching vaccines does not mean perusing Mercola.com, Age of Autism, The Thinking Moms' Revolution, and the numerous other antivaccine blogs and websites that peddle pseudoscience dressed up as science. I don't blame Stevens for not being capable of properly evaluating the evidence, and I don't doubt that she is well-intentioned and loves her children. It's just that she's wrong, and the arrogance of ignorance inherent in the Dunning-Kruger effect leads her to view her knowledge of vaccines as being on par with real experts and herself as someone whose knowledge qualifies her to reject the overwhelming evidence that the current vaccine schedule is safe and effective and thereby endanger her children and others, rather than what she is: A non-expert victim of the Dunning-Kruger who, despite her many hours at Google University, still doesn't know what she's talking about.

I do have to admit, there was one quote here that made me laugh out loud when I read it:

Marcel Lenz, a Traverse City resident with two young children, shares similar concerns.

"I thought vaccines were magical, but then I started looking into it," said Lenz, who has a doctorate in horticulture and a big interest in homeopathic medicine.

Given that Lenz believes in homeopathy, which is basically sympathetic magic made into a system of medicine, apparently he was disappointed to find out that vaccines weren't actually magic; so he rejected them. Of course, someone who believes in homeopathy is highly unlikely to be persuaded to change her antivaccine views; so Lenz is almost certainly a lost cause. After all, when last we met Lenz, he was peddling the antivaccine trope I've dubbed the "toxin gambit," and this time around he repeats the same sort of misinformation. However, learning that he's into homeopathy does explain a lot, as do his sources of information: Bob Sears and Neil Z. Miller.

We then have a variant of the "toxin gambit," one that I like to call the appeal to yuckiness. (It's a term I've applied to The Food Babe before.) Generally, the appeal to yuckiness is a scientific fallacy in which disgust at the yucky-sounding nature of an ingredient in medicines, food, or vaccines leads one to think that it must be bad. Here, we see Hollie Heikkinen repeating that gambit:

Hollie Heikkinen, of Howell, also says she carefully weighed the risks in deciding not to vaccinate her four children, ages 7 to 19.

She said the idea of injecting viruses into her children seems like "playing Russian roulette," and thinks it's far better to ward off disease by living an "extremely healthy lifestyle."

She acknowledged that some parents are critical of her decision.

"There's a couple of people who don't want their children playing with mine, but if your child is vaccinated, why should you worry?" Heikkinen said.

Yes, killed viruses are yucky to Heikkinen; so she doesn't like them and won't inject vaccines into her children. Like so many other antivaccinationists, she also doesn't understand that vaccines are never 100% effective. It's a common misconception that feeds into the "Nirvana fallacy" about vaccines wherein if vaccines aren't perfectly protective and perfectly safe antivaccinationists reject and demonize them. It's a standard that, I bet, they apply to no other product, medicine, or intervention in their lives, but they apply it to vaccines. That seeming belief leads her not to understand why even parents of vaccinated children don't want her children around, because, apparently, either Heikkinen thinks they're perfectly protected against her disease vector offspring or she thinks that vaccine believers should have "faith" in vaccines. Personally, I'm with the parents who refuse to let Heikkinen's kids play with theirs because her kids are unvaccinated. I'd do the same. It's a reasonable precaution.

Finally, no antivaccine trope greatest hits would be complete without downplaying the seriousness of the diseases being vaccinated against. For instance, Sue Waltman, who runs the local antivaccine group

Wow. Note how she says "most of us" survived, meaning "some of us" died of these diseases. She's basically implicitly admitting that these diseases could kill children, but she doesn't think we should vaccinate against them. Then she trots out the intellectually dishonest "vaccines didn't save us" gambit as a rationale for not vaccinating.

As I said, this is all depressingly familiar to anyone who's covered the antivaccine movement for years. Clearly, people like Marcel Lenz (into homeopathy), Sue Waltman (an antivaccine political activist), and Gretchen Perry (heavily into "natural health" and "detoxification") are not likely to be dissuaded from their antivaccination views. It's not impossible, but it's incredibly unlikely. So I'm glad that Michigan is apparently going to get it right where California tried to get it right but was sabotaged by Governor Jerry Brown's signing statement on the bill implementing this requirement.

Starting January 1, vaccine waivers will be harder to get in Michigan:

The Michigan Department of Community Health is working to force parents to think twice before opting out of getting their children vaccinated.

Under new rules that will take effect Jan. 1, Michigan parents will still have the right to refuse the required shots for their children. But they will have to:

  • Be educated by a local health worker about vaccines and the diseases they are intended to prevent.
  • Sign the universal state form that includes a statement of acknowledgement that parents understand they may be putting their own children and others at risk by refusing the shots.

On Thursday morning, the Joint Committee on Administrative Rules approved the new requirements.

In making the changes, Michigan is following the example of other states, such as California, Vermont and Colorado, all of which recently have made it more difficult for parents to opt out of vaccination requirements.

When California passed AB 2109, which was designed to do the same thing, Governor Brown gutted the requirement by ordering health officials to add a line where the parent could just affirm that vaccination is against her religion and avoid even having to be counseled by a physician or other specific health care professional. Here, Michigan appears to be getting it right.

Some, including MLive.com despite its having succumbed to the darker side of medical reporting by giving antivaccine parents such an open forum to promote their pseudoscience, are arguing that Michigan should go even further, having set up a Change.org petition to Governor Rick Snyder and the legislature urging them to:

  • Remove the philosophical exemption. Allowing parents to opt out of vaccinating their children for any reason sends a strong and dangerous message that vaccines aren’t really necessary. Science tells us that vaccines are absolutely necessary if we wish to keep our communities free of these diseases. Eliminating this exemption would go a long way toward restoring herd immunity to our communities that are currently in danger.
  • Strengthen religious waivers. It’s almost certain that if the philosophical exemption is removed, a number of parents will claim certain religious beliefs. Therefore, it’s imperative that the rules be strengthened to discourage skirting of the law. Religious waivers should be signed by a representative of the parent's religious organization, asserting vaccination is contrary to religious beliefs. They should also be signed by a medical professional verifying the parent has attended an educational session about vaccination. Signatures should be notarized, and waivers should be renewed annually.
  • Strengthen medical waivers. A tiny fraction of children can’t be vaccinated for medical reasons. Removing the philosophical exemption could prompt more parents to seek unwarranted medical waivers. Therefore, medical waivers should be signed by a medical doctor verifying the patient has a true medical condition preventing vaccination, and that a parent has attended an educational session about vaccination. Signatures should be notarized.
  • Make vaccination rates public. Schools should be required to publish their vaccination rates on their websites, and update them every year. Parents have a right to know which schools have high numbers of parents opting out and putting everyone at risk.

These are good ideas, but problematic. I fully support removing the philosophical exemption, which in practice amounts to letting parents refuse vaccinations for their children for any reason whatsoever. However, verifying what is and isn't a "real religious exemption," on the other hand, will be highly problematic in practice. Moreover, allowing a religious exemption while not allowing philosophic exemptions in essence discriminates in favor of the religious. You belong to a church that says vaccines are evil? (They're rare, but apparently do exist.) Great! You don't have to vaccinate! You're an agnostic or atheist who doesn't want to vaccinate because you think vaccines are full of evil toxins and believe in keeping your child's body "pure"? Tough luck. Both reasons for not vaccinating are divorced from reality, but one would be accepted as a valid reason not to vaccinated because it's a "religion," and one would not.

That's why, unfortunately, I've been reluctantly forced to conclude over the last couple of years that states need to treat philosophical and religious exemptions the same: Either allow both or ban both. To do otherwise, allowing religious exemptions but not philosophical exemptions privileges religion above non-religion. That's why the proposal in the Change.org petition is a start, but it doesn't go far enough. Neither philosophical nor religious exemptions should be permitted.

In the meantime, trying to educate parents who don't want to vaccinated about what they are doing before letting them do it is a reasonable first step.

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I think you have to sign in to see the 800+ comments already on website. I've already posted several comments:

http://www.mlive.com/news/index.ssf/2014/12/anti-vaccination_parents_mi…

Every time an anti-vaccine nurse (or a doctor) is interviewed and provides inaccurate information about vaccines and the seriousness of vaccine-preventable-diseases, it adds credence to the rank pseudoscience being spread by crank bloggers.

Wow, Lilady--that's an awful article by MILive and about an AV set of comments as you'll see. I posted some well deserved insolence their way just now (not as good as here, but it'll do.)

By Chris Hickie (not verified) on 12 Dec 2014 #permalink

Whoa. There's a comment by a commenter by the 'nym michigangirl1 that says:

By the way...If I do vaccinate my child, she has a 80% risk of becoming paralyzed for the rest of her life. (And I'm not here to debate that as well) So I apologize for not wanting to take the chance to put my childs life at risk for yours. I bet if the situation were reversed, you wouldn't either.

WTF? On what possible basis can she make that claim?

I agree with your view about religious exemptions, but increasingly, I lean towards a narrow, hard to get philosophical exemption (I think "personal belief" is a better term). I am worried about the negative effects of no out whatsoever for the dedicated and extreme minority, as I've said elsewhere. Basically, I thin the most extreme, if faced with no choice, will do one of three things, none of them good:
1) Fake their children's records - with the result that we won't know who is unvaccinated.
2) Detox those children, as is sometimes done now to children in foster care when anti-vaccine people have to vaccinate them - and I worry about what that might do.
3) Homeschool - depriving those children of a benefit of structured education, with - hopefully, and it might be a false hope - some reasonable science component.

I think the exemption should be hard to get, so it really will be limited to the extreme, but I think there should be an out. A half day course with a short exam in the end, for example.

By Dorit Reiss (not verified) on 12 Dec 2014 #permalink

Folks out West have long not-so-affectionately referred to Jerry Brown as "Governer Moonbeam." His aura smiles and never frowns.

The subject came up at my dept.'s holiday party yesterday, too. Luckily, there don't seem to be any anti-vaxxers among our ranks. One of my colleagues, though, said that, when it comes down to it, she doesn't think the government should be forcing people to put anything in their bodies. For adults I'm in agreement with that statement 100%. But when it comes to kids... I don't know, I think the government has a responsibility to protect their rights to live to adulthood, when they might well have different religious or philosophical beliefs from their parents. I do think the state should "force" Jehovah's Witness parents to allow their children to get blood transfusions, for example. I mean, the "you can't put that in my body" argument basically assume that children are extensions of their parents? I beg to differ.

I mean look, I get it, I'm a freedom-loving, totalitarian-regime-hating, red-blooded American myself. But... I also really don't like it when kids get sick and/or die, especially if it's just because their parents believe something stupid.

So, in a ideal world, I'd say nix both exemptions. We don't live in ideal world, though, and I agree with Dorit @5 about what would likely happen if we did nix both exemptions. If the anti-vaxxers are good enough at spreading their misinformation and hysteria, too, it might cause a mighty backlash against vaccination among the public.

Grrr.

"Governor Moonbeam," that is.

I agree with your view about religious exemptions, but increasingly, I lean towards a narrow, hard to get philosophical exemption (I think “personal belief” is a better term). I am worried about the negative effects of no out whatsoever for the dedicated and extreme minority, as I’ve said elsewhere. Basically, I thin the most extreme, if faced with no choice, will do one of three things, none of them good:
1) Fake their children’s records – with the result that we won’t know who is unvaccinated.
2) Detox those children, as is sometimes done now to children in foster care when anti-vaccine people have to vaccinate them – and I worry about what that might do.
3) Homeschool – depriving those children of a benefit of structured education, with – hopefully, and it might be a false hope – some reasonable science component.

I think the exemption should be hard to get, so it really will be limited to the extreme, but I think there should be an out. A half day course with a short exam in the end, for example.

I agree. I've never been a fan of requiring anti-vaccine parents to go to a physician's office to get a non-medical waiver because it's like putting cats and dogs in the same room (and I've been in that room and it's not pretty). It's also a waste of the doctor's time to try and convince somebody who just isn't going to change their mind about not wanting to vaccinate their child. I think it would be much better to have parents who don't want to vaccinate have to attend a mandatory half day course like you propose, Dorit--just like you have to go to defensive driving school when you get a speeding ticket. I'd be completely fine with making them have to attend it each school year they don't want to vaccinate their child, too

Re: non-vaccinating parents being allowed to be foster parents for children-- that should not be allowed. I say that knowing full well Arizona just passed a law last year allowing this, and it has done nothing to increase the number of foster parents like the governor claimed it would. It does however pose a grave risk to newborns placed in foster care should they be put in a home full of older unvaccinated children.

By Chris Hickie (not verified) on 12 Dec 2014 #permalink

I understand your argument, Dorit, but it introduces the problem of drawing the line in a way that reasonable people would agree is fair. "Always deny, except for medical contraindication" does not discriminate against anybody. "Always allow" is problematic for other reasons Orac has discussed at length, but at least it makes exemptions equally available to anybody. Draw the line anywhere between, and somebody's going to have good reason to complain about it; e.g., allowing religious exemptions but not non-religious exemptions unduly favors the religious, as Orac notes.

In any case, we can look at the two states that currently only allow medical exemptions to see if the issues you raise really are problems.

By Eric Lund (not verified) on 12 Dec 2014 #permalink

Thanks for the religion sentences. I gave my usual "who will you make your inquisitor" comment.
I don't think the mlive article you dealt with first was trying to put the women in a good light, but was just showing what we have out there in the wild. Their own statements were enough to utterly discredit them. Perhaps that interpretation depends on the reader though.

Implicating pharmaceutical companies as not being trustworthy, implies that vaccines are theoretically a good thing, if not marketed by big pharma.

So, I'd ask, how should vaccines be developed? Who should manufacture and distribute these safe non-pharma vaccines?

I'm with Eric Lund on this topic. I say we look at West Virginia and Mississippi, where only valid medical contraindications as verified by the child's physician, are permitted.

IIRC, when my children entered school, there was a requirement that the children had (very) recent physical examinations along with documentation for every childhood vaccine, for registration a few weeks before the start of kindergarden (and before my son entered his special early intervention program). My daughter was required to undergo a physical prior to entering junior high and high school, as well. I think most states now follow the CDC recommendations for a Tdap booster vaccine prior to entering junior high school.

There are ways to verify the legitimacy of vaccine records...all we need is the will to provide school staff to enact stricter regulations about vaccine exemptions.

In New York a few years ago, someone pointed out that requiring a connection to, or documentation from, a "recognized religious denomination" was almost certain to be unconstitutional, because the state has no business "recognizing" some, or even many, religious denominations, while telling other people that no, their religion doesn't qualify. From my viewpoint as an atheist, a religious exemption is a subset of philosophical anyhow: "yes, there's scientific evidence that this is the right way to do things, but I believe we shouldn't do it anyway" isn't significantly different because someone called "minister" persuaded you rather than someone called "activist mother" or just "my brother-in-law."

So, medical exemptions because those make scientific and medical sense, and maybe allow religious/philosophical ones after the objectors demonstrate (or at least sign a statement claiming) that they understand the value of vaccination and the risks of avoiding it.

I'm not a lawyer Vicki, but on this matter the law and "makes any sense to me" might not agree. I surely agree with you about what should be, but worry that's different that was is. I think we have "sincerely held religious belief" in a few laws - we will judge based on what we think the inner workings of your mind are. Judges say dogs know if they were kicked by accident or not - it's bullshit - self-congratulatory, we're-so-cool, pretentious bullshit.

There are a few states that allow religious exemptions that are very hard to get and it seems to work well. In those states there has not been an increase in pertussis cases.

By Sullivanthepoop (not verified) on 12 Dec 2014 #permalink

Here again, the list of every State and links to the individual State laws which provide the types of vaccine exemptions permitted:

http://www.ncsl.org/research/health/school-immunization-exemption-state…

NY State has a "strict" religious exemption. Parents have to prove that they have a "sincerely held religious belief" against vaccinations.

Calling Narad...who has all the recent NY State Education Department case law on sincerely held religious belief exemptions.

Those should all help. As I posted in comments yesterday, WA state rates are improving because of our exemption law. California's law is not strict enough but hopefully the pertussis problem there right now will lead Brown, etc, to tighten it back up the way it was originally written.

@Kathy #17:

but hopefully the pertussis problem there right now will lead Brown, etc, to tighten it back up the way it was originally written.

Wouldn't that be tantamount to admitting he was wrong? Does he have a good record (even for a politician) of acting in the public's best interest regardless of his own beliefs?

By Rich Woods (not verified) on 12 Dec 2014 #permalink

@Vicky: Alicia Novak, in a 2005 article, addressed that, and I addressed it in another article. The question is whether looking at sincerity violates the Lemon test, which determines when a government is allowed to pass a law related to religion. There's an argument that the answer is yes, because it leads the state to too much entanglement with religion.

You can see more on that here: http://www.hastingslawjournal.org/wp-content/uploads/Reiss-65.6.pdf pp. 1562 and a little on.

@ Eric: the problem is identifying those who fake records and those that detox. I guess we can look at homeschooling rates.

@Kathy: let's wait on the California rates. The law just became effective January 2014, so we don't really know what the law will actually do to exemption rates. It could be stronger, but I think it's premature to say it's not effective enough.

By Dorit Reiss (not verified) on 12 Dec 2014 #permalink

@Orac

Regarding the requirement going into effect on Jan. 1, my good friends at the Vermont Coalition for Vaccine Choice are claiming that the requirement is illegal. I would ask them on what they base their legal opinion, but they blocked me after I showed their claim that taxpayers (as in, people like you and me, not manufacturers) fund VICP was false.

Chris Hickie

It would seem the language "educated by a local health worker " wouldn't necessarily send parents to a Dr. for a non-medical waiver. It looks like the 'education' part and the waiver are separate things. It seems not clear enough on the who, what and how of the education requirement, including who's going to pay for it. Will insurance cover it? Is there a required curriculum, or can a parent go to a quack for a quick 'yes, they've been educated' signature. It would seem Dorit's idea of a driver's-school-like class would offer some uniformity and efficiency.

Rich #18

Jerry Brown's been in the game so long he's changed position's on a number of issues. I don't think he worries much about accusations of inconsistency. He's basically weathered every kind of attack that could be made on him, so I'd say he's among the least image-consciouss of politicians.

I would say he has the public's best interests at heart, balanced as every pol has to, with the realities of what can get done in the given political climate. I have no idea whether he might be persuaded to tighten the exemption law, but, no he wouldn't hold a position just to save face.

Besides, there's enough empirical evidence in the pertussis outbreaks to provide cover for any poltiician, "Given this new information, we must do somethnig different..." is not a big problem for public figures.

balanced as every pol has to

sadmar,
Jerry Brown is Polish? I did not know that... I'll come up with a conspiracy theory to explain why I did not know that and was fooled all this time because of his outstanding, almost invisible tupee.

sadmar@22: Isn't Jerry term limited? He was just re-elected last month, and I understand that most states limit their governors to two four-year terms. (I live in one of the exceptions to that rule: there are no gubernatorial term limits in New Hampshire, but she has to run every two years.) Between that and Jerry's age, I expect that he will never be campaigning for office again, so he doesn't have to worry what the voters think.

By Eric Lund (not verified) on 12 Dec 2014 #permalink

just like you have to go to defensive driving school when you get a speeding ticket. I’d be completely fine with making them have to attend it each school year they don’t want to vaccinate their child, too

Chris Hickie,
My past experience with ordered 'defensive driving' classes each had in the live instruction and the 'correct answer' on the test was to never exceed the speed limit even when passing. I was early-ingrained into accepting that this *one type/behavior* indoctrination was part of the problem around here.. It is not exactly 'shaken baby' but there do seem to be a disproportionately large number of unexplained head-on collisions.
++++++++++++++++++++++++++++++

@Orac #4,
That lady does sound more than just a little bit confused. But if I had to guess, she probably meant something more analogous to getting a CT scan at a young age... Genetic damage is done and the younger you get it then the more likely you are to have abnormal cell proliferation over a lifetime.

Are there likely to be any 70 year studies generating *no evidence to show* over vaccination and myasthenia gravis or other autoimmune disorders, for instance??

I am gratified that my home county (Delta) is on the lower end. I am mortified and mystified by Houghton, Leelenau (if i am identifying it correctly), and Mackinac counties! Leelenau makes an iota sense once i remember there are a ton of hippies* there, plus it's a relatively low population county? So a small community of non-compliance would skew the data? But the entire UP is low population as well, especially compared to downstate. Heck, the entire UP is still around 300,000 people, correct? That's probably less than most Detroit-area counties.

Houghton county i would think would be more compliant because of the giant major technical university located there! And Mackinac county i can't even begin to contrive of a hand-waving explanation. A lot of the areas i think of as being highly Calvinist, Mennonite, or Amish don't seem to be that elevated in the grand scheme of things.

Not looking for a solid scientific explanation here, just musing on some unexpected results based on my personal knowledge of my home state.

*As a hippie myself i do not consider the term to be an insult on it's face. I love the heck out of nature. I also do science (drug discovery) for a living so i trust science, too.

By Double Shelix (not verified) on 12 Dec 2014 #permalink

I think all information about a school's vaccination rate should be mandatory and easily found. In addition, parents should be allowed to insist that their child be shielded from non-vaxxed kids in the same way that nut allergy kids are, for example. This way parents of non-vaxxed kids can't claim that their kids are being denied an education. Sure they might squall about their kids being singled out but then so are the nut allergy kids. It could have some potential to go the way of smoking by this sort of action.

Slightly OT: This little gem about mumps in the NHL from a longer AP article:
The illness [mumps] even felled Minnesota ironman defenseman Ryan Suter, the rare American-born player to be affected.

Every Wild player was offered a booster shot last month when the virus surfaced. Suter decided not to take it, and paid the price. He was the fifth Minnesota player — all defensemen whose cubicles are next to each other — to come down with mumps.

Suter, who hadn't missed a game since joining the Wild in 2012, led the NHL in ice time each of the past two seasons.

"I probably wash my hands more than anybody," he said. "I go out of the way to make sure I'm a clean guy. So for me to get it, it stunk. I always tell these guys, 'You've got to be mentally strong and you'll never get sick.' So they're all giving me a hard time."

Why am I having a hard time feeling sorry for Suter??

By brewandferment (not verified) on 12 Dec 2014 #permalink

The Vaccine inquisition by ORAC. Sad that one Pharma paid minion can work to undermine the constitutional rights of others. Must be a pinko-commie.

By Vaccines Maim Kill (not verified) on 12 Dec 2014 #permalink

Why not simply move all the anti-vax, anti-science, anti-cop, anti-capitalist and anti sliced bread protesters (gluten delivery device, you realize) to one place and allow them to live in joy, peace and harmony?

I hear there's a swath of Iraq that is not beholden to, erm, international bankers and Big Pharma. They even have a zero autism rate*.

*that one may speak of

By Spectator (not verified) on 12 Dec 2014 #permalink

That sounds like a nice place, Spectator. That is, unless one starts to worry about all the really messed up-looking kids there -- It is probably only anecdotal that it is due to all the depleted uranium Big Neocon fortified them with.

Having watched Arizona's elective non-vaccination rate for children entering Kindergarten go from being a tolerable 1% a decade ago to horrible 4.9% this year (as well as seeing pertussis skyrocket in AZ these last 2 years), I looked into how one could change the state law in Arizona to make vaccine exemptions allowable only for valid medical reasons (like it is in West Virginia and Mississippi).

Arizona's legislature would never approve such a law--heck, they won't even approve a law requiring public disclosure of vaccine rates for all schools yearly, as happens already in many states such as California. The only way one could get vaccine exemption laws changed in Arizona is through a ballot initiative--which would require at least 172,000 registered Arizona voter to sign a petition for the proposed law (initiative) to get it on the ballot of the next state election (which happen every 2 years, so you wind up needing 172,000 signatures in 20 months). If you can get enough signatures to get an initiative on the ballot, it becomes law (without needing legislative approval or governor signature) if it has more than 50% of those voting on it voting "yes" on it.

This is not a trivial task, with the signature gathering being the most expensive and time-consuming part (well, at least up to when/if it gets placed on the ballot, and then you have to campaign for it). I have asked some of the medical societies in Arizona about consideration for collection of signatures at doctor's offices, whee you are most likely to find people in support of pro-vaccine legislation. I estimate roughly 1,000 primary care offices in Arizona. So if each office collected 200 signatures in a 20 month period, that would easily meet the 172,000 signature requirement. That works out to collecting a whopping 10 signatures a month or 1 signature every 3 days per office I've still been told that is a lot to ask/hope for--which I have a hard time understanding given that we are talking 30-60 patient visits per office per day.

When I get this lack of enthusiasm coming from medical groups, I have to wonder just how many doctors care much about anything anymore. It's really quite depressing.

By Christopher Hickie (not verified) on 12 Dec 2014 #permalink

or 1 signature every 3 days per office I’ve still been told that is a lot to ask/hope for–which I have a hard time understanding given that we are talking 30-60 patient visits per office per day.

Maybe it is a matter of trust and not of the validity of the science. Maybe people are really afraid of getting on yet another list. Maybe people are secretly thinking "Wait, there may be a time when I can't fit in this exact schedule should something come up.. Won't they have an excuse to take my kids away?" I'm sure even those in fervent favor of vaccination don't want yet another statutory, bureaucratic, Dongle of Damocles dangling over them like more line-standing, mouth-shutting tag renewal.

Maybe those that do sign think it is part of not pissing off their doctor -- People must have access to more than a 10 min, in-out "doc-in-a-box" sometimes; If that former relationship becomes broken all kinds of things can compound seemingly out of control when least expected in an awful big way.

Yes. I believe there is much mistrust and miscommunication. There is probably much more just 'acquiescing' and keeping one's mouth shut (yes, apparently some people are able to do that) than some realize. There is probably much more *learned helplessness* than is properly diagnosed -- As with the voting booth; Keep pulling that lever, it seems there is not power for anything to change in favor of the individual.

An interesting aside on learned helplessness
http://onlinelibrary.wiley.com/doi/10.1002/ddr.430170306/abstract

@Christopher #29

A depressing number of physicians, many of them family practice docs or GPs, are antivaxxers. I see this in the comments sections of places like Medscape, and even have heard it in person.

I can't understand how the group of people who are exposed to the best educational opportunities and who ought to actually be able to read and interpret the many studies on vaccinations can fall into this false belief . . . but they do.

Then I remember the old joke: what do you call the guy who graduates last in his class from med school?

Answer: Doctor.

Health care professionals are not immune to woo.

What I propose:

Determine the herd immunity rate that's required to prevent outbreaks. Let's say for purposes of this example, that it's 95% or children in a population.

Subtract the percentage of children with valid medical exemptions. Let's say for purposes of this example, that it's 1% of children in a population.

Take 1/2 of the remaining number and issue the exemptions on a basis similar to that of pacifism exemptions to the military draft. Parents wishing an exemption would have to apply to a community health board spelling out their objections in detail. These would be individually approved or denied. (Hint: 'vaccines cause autism' objections will be denied on the grounds that the 'facts' underlying the application are false.)

Once the allotted number was reached, no more exemptions would be available. Those parents would have the choice of vaccinating their kids or home-schooling them.

This bypasses the entire 'religion vs. philosophy' thrash, which is guaranteed to lose anyway. Both religion and philosophy have to comport with reality or they are delusional and potentially dangerous. And whilst there is no viable empirical test for the existence or nonexistence of a deity (thus leaving that issue up to individual belief), there are valid empirical data about herd immunity, vaccines/autism, etc.

Example: A town has a population of 100,000 school-age children. 95% immunisation is needed for herd immunity, which is 95,000 kids. 1% are medical exemptions: 1,000 kids. Now you have 4,000 kids who could remain un-immunised before herd immunity is compromised.

So you issue 2,000 exemptions (half of the 4,000), where each exemption requires making a special application on a first-come / first-served basis. After the 2,000 are used up, any further vaccine objectors have to either get vaccinated or have to home-school their little disease vectors.

Alternately, publish the names of vaccine refuseniks in the local newspapers and in their District Council web pages. Thus anyone could look up who the little vectors were in their towns. 'No, you can't play with BillyBob, he hasn't got his jabs so he could give you the measles.'

---

Re. JP @ 6, 'government forcing things into peoples' bodies.' In general I believe that 'the state stops at your epidermis,' and that gov has no right to determine what you can, can't, or must or must-not put in your body. Your body is not 'propriété de l'état' (property of the state).

However, vaccines are one of a very small number of exceptions to that, because the empirical science is so strong _and_ the threat is so clearly foreseeable, that these factors trump the philosophical principle in this case.

Another exception is for mind-altering drugs that present major hazards to public safety, by which I mean methamphetamine, cocaine, and 'crack,' and arguably opiates including heroin, and arguably alcohol for persons diagnosed with alcoholism. The point about public safety is that the use of these substances leads directly to violent behaviour, that is a threat to the lives and safety of the public. If someone wants to poison their own body and brain, that's their business, but if their doing so turns them into a violent and dangerous person, then it's everyone's business.

Oh yes.

Every Saturday, if I am not otherwise engaged, I traipse over to AoA to survey Dan's latest blatherings : today my weekly scrutiny was richly rewarded with unspeakably luscious Schadenfreude:

he begins: " If you're in the journalism world, you know how easy it is to really mess things up"; it seems that all Rolling Stone magazine required was an astute "article editor or copy editor" before it blazed forward with the rape story. (They suffered from "confirmation bias" involving stereotypes about frat boys in southern universities and didn't question additional people who might have shown how the story was unlikely to be true). He continues, " We try to be journalistically scrupulous". Although it might be difficult: " But we do insist on facts".

Dan elaborates about intricate editorial issues which he oversees complete with perceptive input from his colleague, Kim, and then confesses that he is " proudest" of their stories about the treatment of Alex Spourdalakis and Poul Thorsen.

Indeed. His type of "collaborative and cautious editing might have saved Rolling Stone".

I think that this is one of the most incredible things I've read in years and I've read a lot of altie tripe.

Anyone who has ever reported, interviewed or written up anything in order to inform others should now be either rolling in the aisles with uncontrollable laughter or weeping profusely.

By Denice Walter (not verified) on 13 Dec 2014 #permalink

publish the names of vaccine refuseniks in the local newspapers and in their District Council web pages. Thus anyone could look up who the little vectors were in their towns. ‘No, you can’t play with BillyBob, he hasn’t got his jabs so he could give you the measles.’

^^And that would be pretty good example of one form of 'ostracize'.

#33 Lurker: Intriguing suggestion. Another possibility is that antivaxers would have to bid competitively in a kind of public auction for a (very) small number of vaccination exemptions. This would have several beneficial effects - money would be raised by the state, antivaxers would be publicly identified, and the prospect of having to pay thousands of dollars would, I'm sure, deter many of them. Think of it as a kind of tax on imbecility.

@ Denice Walter: Dan Olmsted brags about AoA's finest journalism; Poul Thorsen's padding his expense account and the intervention of the biomeddling mommies and Andrew Wakefield during Alex Spourdalakis' hospitalization...which resulted in Alex's brutal murder by his mother and his "godmother". There's no mention about the serialized on AoA "Amish Anomaly", which earned him an entry in Wikipedia and the derision of the science community.

http://en.wikipedia.org/wiki/Amish_anomaly

lilady, in the article's comments Parker chimes in with:

" I don't think that false reports are that rare, I think that there are a lot of unstable people seeking attention who make false reports..."

I swear that's nearly as rich as alt media entrepreneurs complaining about psychopaths/ sociopaths having power over others' lives, misleading the public. enriching themselves at others' expense etc.

Life must be exhilarating for those lacking the capacity for self-reflection.
And yes, we have a name for it.

By Denice Walter (not verified) on 13 Dec 2014 #permalink

Take 1/2 of the remaining number and issue the exemptions on a basis similar to that of pacifism exemptions to the military draft.

Whose conscription system would this be?

Life must be exhilarating for those lacking the capacity for self-reflection.

Get this:

"The young cashier at the health food store here was reading a book when I checked out two weeks ago: I asked him what he was reading, and he said Immunity, by Eula Biss. I said Oh, yeah, she's one of the bad guys who's really pro-vaccine.... I'll have to see how much it costs on Amazon, maybe read it and put up a review."

That's right, we're going to give random shіt to shop clerks about their reading habits and then think about maybe looking at the fυcking book later.

Most of your suggestions to eliminate religious and personal belief exemptions are interesting...but impractical.

The individual States have their own health department and education laws and regulations for vaccination requirements for entry into licensed day care and public schools.

There are pockets of non-vaccinating parents in every State and those areas have State legislators who are quite responsive to the voters in their districts. If those elected State legislators want to get reelected, they are not going to introduce any bills...or vote for any bills that tighten up those vaccination laws. That's politics folks.

Dorit: Nice, real nice, FB page.

Narad - I've been listening to Bliss' book and pro-vaccine isn't exactly the word I'd use to describe her. Thoughtfully vaccinating perhaps. Interesting book, not surprised an AOA'er is willing to pass judgement without basis.

You have still good situation in USA when it comes to nurses.

Here in Finland only 40% of our nurses seasonal-vaccinate him/herself against influenza.
Secretary of health tried to get through some of these:
-patient has right to know if nurse is vaccinated
-unvaccinated nurses should have mask

But Union got angry and tries to prevent those. Reason ?
Vaccination is personal infomation that should not leak to outsiders (!).

I'm angry too as I belong to risk group..

"Folks out West have long not-so-affectionately referred to Jerry Brown as “Governer Moonbeam.” His aura smiles and never frowns."

Soon he will be Pres-i-dent!!

(how prophetic...)

I'm all for the rule (that once had teeth) of "no vaccines, no school" with no exceptions. Pandering to idiots makes you an idiot too.

By alcaponejunior (not verified) on 17 Dec 2014 #permalink