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In Perspective: Measles 2015

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F Edward Yazbak MD, FAAP

 

Fifty-one measles cases reported between December 28, 2014 and January 21, 2015 effectively started a nationwide contrived scare campaign to curtail parental rights by abolishing philosophic vaccine exemptions in the 17 states where they are still allowed.

Eleven (11) measles deaths were reported in the United States since 1995, the last in 2005.

According to the CDC, only .7% of US toddlers have not received any vaccine.

The current California MMR vaccination rate of +/- 96.1% among pre-K children is the highest ever and it exceeds the national arbitrary goal of 95%.

It is a sad reality that no one mentioned that over 1500 autism cases may have been diagnosed during the 24 first days of the present measles outbreak.

To date, NO ONE including the CDC knows what causes autism (Autism/ASD), the fastest growing disability in the United States, where some 24,000 new cases of the disorder are diagnosed yearly. 

For unknown reasons, less than 5% of the United States research funding has been allocated to autism.     

____________________________________________________

The CDC’s new logo clearly describes its functions: CDC 24/7: Saving Lives - Protecting People.

In order to save lives and protect people 24/7, the CDC investigates disease outbreaks and propagates vaccination practices.

In addition, the CDC has an essential role in “Emergency Preparedness and Response” including the investigation and reporting of Natural Disasters, Bioterrorism, and Chemical and Radiation emergencies. http://emergency.cdc.gov/

I had the pleasure and privilege to work closely with CDC investigators in 1960 -1961 and I can say without hesitation that they were superbly trained, most knowledgeable and extremely effective.

Through its Health Alert Network (HAN), the CDC regularly distributes official “CDC Health Advisories”.

When I started writing this commentary, the most recent three advisories were:

# 374 (12/3/14): “CDC Health Advisory Regarding the Potential for Circulation of Drifted Influenza A (H3N2) Viruses.” In this advisory the CDC announced that “Influenza viral characterization data indicates that 48% of the influenza A (H3N2) viruses collected and analyzed in the United States from October 1 through November 22, 2014 were antigenically "like" the 2014-2015 influenza A (H3N2) vaccine component, but that 52% were antigenically different (drifted) from the H3N2 vaccine virus.” http://emergency.cdc.gov/han/han00374.asp

# 375 (1/9/15): “CDC Health Update Regarding Treatment of Patients with Influenza with Antiviral Medications.” In this advisory, the CDC reported: “In addition, approximately two-thirds of H3N2 viruses that have been tested at CDC are antigenically or genetically different from the H3N2 vaccine virus.”

The CDC then went on to encourage the early use of antiviral medications. http://emergency.cdc.gov/han/han00375.asp

[Interestingly, the Washington Post published on the same day an article titled “CDC: Flu vaccine only 23 percent effective this season, but still better than nothing.”]

# 376 (1/23/15): “U.S. Multi-state Measles Outbreak, December 2014-January 2015” and in large gold letters:
“This is an official CDC HEALTH ADVISORY” http://emergency.cdc.gov/han/han00376.asp

The first case of the “Disney Measles Outbreak” was reported on December 20, 2014, more than two weeks before the CDC’s Advisory # 375 of January 9, 2015 that was still urging more influenza vaccinations and antivirals. It was evidently felt at the CDC that using some of the unused expensive and not too effective seasonal Influenza vaccine was still more of a priority than a few cases of measles.

CDC Advisory # 376 - January 23, 2015

According to the CDC, “The United States is experiencing a large multi-state measles outbreak that started in California in December 2014 and has spread to six additional states and Mexico. The initial confirmed case-patients reported visiting Disneyland Resort Theme Parks in Orange County, CA, from December 17 through December 20, 2014. From December 28, 2014, through January 21, 2015, 51 confirmed cases of measles linked to this outbreak have been reported to CDC, 42 from California and 9 from six other states (3 in UT, 2 in WA, 1 in OR, 1 in CO, 1 in NE, and 1 in AZ). In addition to the U.S. cases, one case was reported from Mexico in an unvaccinated child who visited Disneyland Resort Theme Parks on December 17 and December 20, 2014. At this time, no source case for the outbreak has been identified, but it is likely that a traveler (or more than one traveler) who was infected with measles overseas visited one or both of the Disney parks in December during their infectious period.”

It is not exactly clear why 42 measles cases among 38,802,500 Californians suddenly deserved so much attention that day when 58 confirmed California cases of measles between January 1 and April 18, 2014 hardly made the national news. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a6.htm

Harder to understand was the fact that the “Ebola-style” frenzy of 2015 was about a few cases of measles that all recovered when according to the CDC “The United States experienced a record number of measles cases during 2014, with 644 cases from 27 states reported to CDC's National Center for Immunization and Respiratory Diseases (NCIRD). This is the greatest number of cases since measles elimination was documented in the U.S. in 2000...The U.S. experienced 23 measles outbreaks in 2014, including one large outbreak of 383 cases, occurring primarily among unvaccinated Amish communities in Ohio. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak.” http://www.cdc.gov/measles/cases-outbreaks.html

A CDC Morbidity and Mortality Weekly Report (MMWR) cited more specific information about the 288 confirmed measles cases reported in The United States between January 1 and May 24, 2014.

Confirmed measles cases are reported by state and local health departments to CDC using a standard case definition. A measles case is considered confirmed if it is laboratory-confirmed or meets the clinical case definition (an illness characterized by a generalized rash lasting ≥3 days, a temperature of ≥101°F [≥38.3°C], and cough, coryza, and/or conjunctivitis and is linked epidemiologically to a confirmed case. Measles cases are laboratory-confirmed if there is detection in serum of measles-specific immunoglobulin M, isolation of measles virus, or detection of measles virus nucleic acid from a clinical specimen. Cases are considered imported if at least some of the exposure period (7–21 days before rash onset) occurred outside the United States and rash occurred within 21 days of entry into the United States, with no known exposure to measles in the United States during that time.

An outbreak is defined as a chain of transmission of three or more confirmed cases. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm?s_cid=mm6322a4_w

Since “Measles Elimination” in the United States was declared in 2000, the median annual number of measles cases has been 60 cases (range 37 to 220). There were 140 cases in 2008 and 220 cases in 2011. There were 159 reported cases of measles from 16 states and NYC from January 1 to August 24, 2013. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm

In a CDC Telebriefing about “Measles in The United States, 2015” on 1/29/15, Dr. Anne Shuchat, Assistant Surgeon General, United States Public Health Service and Director, National Center for Immunization and Respiratory Diseases stated that “From January 1 until January 28, 2015, a total of 84 people in 14 states have been reported as having measles. Most of these cases are part of an ongoing large multistate outbreak linked to the Disneyland theme parks in California. CDC is working with state and local health departments to control this outbreak which started in late December.” http://www.cdc.gov/media/releases/2015/t0129-measles-in-us.html

It is not clear how many of the reported cases were later confirmed.

A few days later, the California Department of Public Health (CDPH) reported 99 confirmed measles cases in the State by February 4, 2015. http://www.cdph.ca.gov/HealthInfo/discond/Pages/Measles.aspx

Information regarding age and vaccination status of the cases has been inconsistent and it is still not clear how many infants required hospitalization - if any.

What was clearly evident since the first days of the 2014-2015 measles outbreak was that someone in high places had decided to create a new "Ebola Crisis"in order to further stimulate MMR vaccination rates and crush parents who dared have any concern about the absolute safety of vaccines.

Even before Disneyland had become the epicenter of medical attention, Californians had been accused of having low vaccination rates because they had too many “Personal Beliefs Exemptions” sometimes referred to as “philosophic waivers”.

It is not clear when, where and why it was decided that vaccination rates had to be maintained at 95% or higher in order to prevent a disease

The CDC reported in 2013 that the national vaccination rate among children aged 19-35 months for ≥1 MMR dose was 91.9%. The California vaccination rate of 90.7% (+/- 5.3%) surpassed that of 10 other states. Nationwide, only 0.7% of children had not received any vaccine, clearly demonstrating how small is the percentage “anti-vaccine parents. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6334a1.htm

During the present school year, California vaccination rates are distinctly better and personal beliefs exemptions are lower than in 2013.

According to the 2014-2015 CDPH Child Care Immunization Assessment Results: 89.4% of the 434,922 children 2 years to 4 years 11 months of age enrolled in reporting child care facilities received all required immunizations. There were 2,734 (0.56%) children with permanent medical exemptions and 12,981 (2.67%) with personal beliefs exemptions down from 2.94% in 2013-2014. The MMR vaccination rate of +/-96.1%, up from +/-95.7% last year,was actually better than the vaccination rates for DPT, Polio, Hepatitis B and Varicella. http://tinyurl.com/lj6su4a

The CDC surveyed exemptions among Kindergarten students in 2012-2013. The Editor of the report warned that “An exemption does not necessarily imply a child was not vaccinated. More than 99% of the 2006–2007 birth cohorts who became kindergarteners in 2012–13 received at least one vaccine.” http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6230a3.htm

The fact is that banning of philosophic exemptions does not necessarily result in lower total exemption rates.

California (Pop. 38.8 million) where philosophic exemptions are allowed has a lower total exemption rate than Alaska (Pop. 737,259) and Illinois (Pop. 12.9 Million) where they are not. California does not allow religious exemptions.

 

Med. Ex -%

Rel. Ex.-%

Phil. Ex.-%

Total Exemptions-%

 

 

 

 

 

California

923-0.2%

0

14,921-2.8%

15,845 -3.0%

Alaska

162 – 1.6%

415-4.0%

0

564- 5.6%

Illinois

2017-1.2%

8082- 4.8%

0

10,099 – 6.1%


Vaccine Effectiveness

According to the FDA, “Clinical studies of 284 triple seronegative children, 11 months to 7 years of age, demonstrated that M-M-R II is highly immunogenic and generally well tolerated. In these studies, a single injection of the vaccine induced measles hemagglutination-inhibition (HI) antibodies in 95%, mumps neutralizing antibodies in 96%, and rubella HI antibodies in 99% of susceptible persons.”

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM123789.pdf

During serious mumps outbreaks among well-vaccinated individuals in 2009-2010, CDC officials informed doctors and other medical professionals that “The MMR vaccine is very effective against measles, mumps, and rubella…The vaccine against mumps is effective, with the 2-dose effectiveness estimated at 80% to 90%. The 10% to 20% of people who have received 2 doses of MMR but are still susceptible to mumps is sufficient to sustain occasional mumps outbreaks”

So: While the FDA and the vaccine manufacturer were proclaiming that one dose of MMR provided 96% immunity against mumps, the CDC was stating that the hundreds of cases of mumps were due to the fact that 2 doses of MMR were only 80% to 90% effective in preventing mumps outbreaks.

The CDC officials went on to add: “During mumps outbreaks in highly vaccinated communities, the proportion of cases that occur among people who have been vaccinated may be high (see example below). This should not be interpreted as meaning that the vaccine is ineffective. The way to assess the effectiveness of the vaccine is by comparing the attack rate in people who are vaccinated with the attack rate in those who have not been vaccinated. In outbreaks in highly vaccinated populations, the relatively few people who have not been vaccinated against mumps usually have a much greater mumps attack rate than those who have been fully vaccinated. During the outbreak in 2006, most of the mumps cases occurred in those who had received 2 doses of the MMR vaccine because most of the affected population had received 2 vaccine doses. However, the attack rate was much higher in the unvaccinated people, and 2 doses of the vaccine were estimated to be 88% (range: 66-95%) effective in preventing mumps….”

Example: Let’s say that an outbreak occurs among 1,000 people and that 950 of these 1,000 people have received 2 doses of the vaccine and 50 are unvaccinated (i.e., vaccine coverage = 95%). If there is a 30% attack rate among people who haven’t been vaccinated, 15 unvaccinated people would get the disease. Among the 950 vaccinated people, the attack rate would be 3%, so 29 vaccinated people would get the disease. Therefore, of the 44 people who got sick during the outbreak, the majority (29, or 66%) would have been vaccinated. This doesn’t imply that the vaccine didn’t work—in fact, the people who hadn’t been vaccinated were 10 times more likely to get sick as those who had been vaccinated, it’s just that there were a lot fewer unvaccinated people at risk. Furthermore, if none of the 1,000 people had been vaccinated, the outbreak would have resulted in 300 cases rather than only 44. In this scenario, we would say that the vaccine is 90% effective in preventing the disease after 2 doses, which is the same as saying that the attack rate in the unvaccinated group is 10 times higher than the attack rate among people who have received 2 doses of vaccine. The formula to calculate vaccine effectiveness is (attack rate in unvaccinated group minus attack rate in vaccinated group) divided by attack rate in unvaccinated group, or (ARU-ARV)/ARU.

http://www.cdc.gov/mumps/outbreaks/outbreak-providers-qa.html

At the January 29, 2015 Telebriefing (above), Assistant Surgeon General Schuchat was asked: “There is a pretty sizable percentage it looks like in Disneyland outbreak who were vaccinated including something like 13% in California who had had two doses of the vaccine so I’m wondering, is there any indication or are you looking into at all into the possibility that vaccine effectiveness or immunity may wane with age?

Dr. Schushat answered: “Now in terms of the vaccine history, the coverage of MMR is very high and the higher the coverage that you have, the more chances that you will have some fully vaccinated people get measles even though the vaccine is highly effective. We think two doses is probably like 97 percent effective but if you have really, really high coverage, if 95 percent or more are protected you will get some people who are two-dose failures. We're at too early a stage to measure whether there is a problem of waning immunity or some unexpected vaccine efficacy but based on what we have seen so far we are not suspecting that. We like to keep an open mind and fully investigate but so far what we are seeing is consistent with a highly effective vaccine and a number of people that have not been vaccinated.

When asked about alternative vaccination schedule and its risks, Dr. Schuchat answered: “We do know that some of the reported measles cases this year had exempted from vaccines. We don't have all the details yet to know what proportion had delayed vaccine. We just, you know, had not yet gotten around to it yet versus who didn't want it. We do know that the measles cases we have been seeing have generally been in people who have been unvaccinated and many of them not vaccinated due to personal belief exemptions.... In 2014, 79 percent of the unvaccinated cases of measles in the U.S. were unvaccinated due to personal belief exceptions. Whether that data will hold up this year we don't know.

The next questioner asked: “I wanted to follow up on the 79 percent. Do you have any good data of the number of people, the percentage of people in the United States who have chosen not to get the vaccine? Not the medical reason? Personal beliefs?“

Dr. Schuchat responded: “No. In terms of the general population, we don't. We have been tracking a number of things over time. One of the things we have been tracks something the percent of infants and toddlers who get no vaccines at all. There is a misunderstanding that when we talk about vaccine acceptance that everybody is dropped out of the system. We continue to have less than 1% of toddlers in the U.S. have received no vaccines at all. Almost every toddler is getting vaccinated with some vaccine most of the time. We don't have data on, for the whole nation on exemptions. We do track kindergarten entries in every state. And we report that every summer. Our website has that information. So state by state you can see what percent of kindergartners have gotten MMR vaccine as recommended and what percent are exempting due to medical or other exemptions. That is a number that we are following. Our effort has been to make the data easier to compare state to state and year to year. Measles is still around with 20 million cases around the world and this year we're off to a bumper start. I strongly recommend people make sure their children are appropriately vaccinated and that they are vaccinated before travel or are protected against measles. Thank you for following the story and we will be updating our website on a weekly basis with the latest numbers. And thank you to the state and local health departments that are working day and night to follow up on all of the cases."

Dr. Schuchat’s statement: “No. In terms of the general population, we don't” and “We don't have data on, for the whole nation on exemptions” when the CDC is well informed about childhood vaccinations and exemptions, are likely to attract a lot of attention. Interested readers are encouraged to read the whole transcript. http://www.cdc.gov/media/releases/2015/t0129-measles-in-us.html


The California Paradox

While the relatively small measles outbreak was being orchestrated as a huge health emergency and getting all the attention, the California Department Public Health (CDPH) was very busy with a much more serious epidemic that had killed infants and affected thousands.

In a “January 7, 2015 Pertussis Report”, CDPH admitted that California was experiencing a pertussis epidemic and that the overall incidence of the disease had increased in the last 25 years.

The report stated: “One reason for the increase is the use of acellular pertussis vaccines, which cause fewer reactions than the whole-cell vaccines that preceded them, but do not protect as long.”

CDPH revealed that 10,831 cases with onset in 2014 had been reported, that 376 patients required hospitalization with 85 (23%) of them in intensive care and that 227 (60%) of the hospitalized patients were infants <4 months of age.

There were two deaths with disease onset in 2014, both infants < 5 weeks old and two additional deaths in 2014 with disease onset in 2013, both were <2 months old. http://www.cdph.ca.gov/programs/immunize/Documents/Pertussis_Report_1-7-2015.pdf

CDPH filed 14 “Pertussis Reports” in 2014 and 53 reports since January 1, 2010 http://www.cdph.ca.gov/programs/immunize/pages/pertussissummaryreports.aspx

[I had discussed the issues with DTaP and warned about the resurgence of whooping cough in “A not so perfect vaccine” in December 2003[i] 

In a state where over 10,000 cases of whooping cough (and 4 related infant deaths) were reported in one year, the furor over a limited measles outbreak is clear indication of how hurtful and contrived the present persecution of parents has become.

The Autism issue

California DDS has consistently reported accurate and significant increases in the number of cases of Autism and ASD in California from year to year.

Skeptics have maintained that the increased prevalence of the disability was not a “true increase” and that it was due to several confounders.

A recent reliable Autism Epidemiology Study has effectively put those skeptics’ claims to rest by demonstrating:

  • That 90% of children reported by the Regional Center System as having CDER status 1Autism met DSM-IV criteria for autism. (CDER is the Client Developmental Evaluation Report)
  • That increases in the State population account for less than 10% of the rise in case reports and that most children with autism served by the Regional Center System were born in California
  • That there was no evidence that the rise in autism cases could be attributed to artificial factors, such as loosening of the diagnostic criteria for autism; misclassification of autism cases as mentally retarded in the past; or an increase in immigration of children with autism to California.

The authors concluded by reiterating that the observed increased prevalence was indeed a true increase in Autism-ASD cases and that the number of cases presenting to the Regional Center System was not an overestimation of the number of children with autism in California. http://www.dds.ca.gov/Autism/docs/6conclusion.pdf

Autism has been a world pandemic for years and one of the worst disabilities of our time.

According to the CDC, about 1 in 68 children born in 2002 in the United States has an autism spectrum disorder compared to 1 in 150 of children born in 1994. http://www.cdc.gov/ncbddd/autism/data.html

  • Autism (Autism/ASD) is the fastest growing disability in the Nation
  • There are now over 1.8 million cases of Autism in the United States.
  • One new case of Autism is diagnosed every 20 minutes
  • 24,000 new cases of Autism are diagnosed in the US per year
  • Possibly over 4 million individuals will develop Autism in the next decade
  • It costs about 3.2 million dollars for the lifetime care of an individual with autism/ASD
  • Autism care costs $35 billion per year to the U.S.
  • The total national impact of Autism is estimated at > than 90 billion and expected to more than double in next decade
  • Autism receives less than 5% of the research funding of many less prevalent childhood diseases. http://tinyurl.com/lodwkmz

It is a fact that NO ONE, including the CDC, knows what causes Autism.

Fifty-one cases of measles were reported extensively between December 28, 2014 and January 21, 2015. According to the above figures, some 1,560 new cases of Autism may have been diagnosed nationwide during the same period of time.

Everyone, including the lucky people whose life has not been touched by Autism, SHOULD WONDER why good, honest and unbiased research has not yet been done to discover what is causing this dreadful disease before half the people of the world are affected and the other half must care for them.

Those who criticize parents for filing vaccine waivers seem to forget that many have children with Autism and/or are acquainted with families with affected children and that many, rightly or wrongly, believe that some vaccine reaction precipitated the autistic regression that they witnessed. Telling them that a small number of studies produced by conflicted authors has not demonstrated such a link does not seem to convince them much.

Strangely, some aggressive vaccine supporters have convinced themselves that they are eminently better qualified than the parents in determining when the affected child or his baby brother needed to be vaccinated again and again and again.

Just as strange is the fact that some vaccine supporters who believe that better educated parents are more likely to request waivers and avoid or delay certain vaccinations also claim that those same parents are not smart enough to know what is best for their children.

It would be quite interesting to know how the parents of two Tennessee toddlers feel about measles in general, , the Disney measles outbreak and the issue of the vaccine waivers that some California parents dare request. 

The first of those toddlers (VAERS ID: 537090), an 18 month-old male, received a dose of MMR-II vaccine (Lot J006955), a dose of Infanrix vaccine (Lot T3PM5) and a dose of Varivax (Lot J006693) on 7/11/14 and expired unexpectedly on 7/12/14.

The second toddler (VAERS ID: 546331), a 16month-old male received a dose of MMR-II vaccine (Lot J006955), a dose of Infanrix vaccine (Lot T3PM5) and a dose of Varivax (Lot J009728) on 8/27/14 and expired unexpectedly on 9/24/14. It should be mentioned that the lot number of the Infanrix vaccine this child received was wrongly recorded as “T3PMS” when the correct GSK lot number is T3PM5.

There was a third VAERS “death report” filed in 2014 (VAERS ID: 527309). This Foreign report was completed by a Sanofi Pasteur investigator and included information about a 16-month-old girl who received a dose of Priorix, the M.M.R. vaccine by GSK (Lot A69CD402A) and a dose of Varivax (J006318) on 3/10/14 and expired on 3/14/14.

The CDC and the FDA who created VAERS have always warned that VAERS reports of adverse events should not be interpreted as proof of causation.

Autopsies were performed on both Tennessee toddlers but their results are not likely to be made public. Lacking that information, it seems difficult to attribute to chance the death of two healthy babies from the same state expiring shortly after receiving a dose of two vaccines from the same lot in addition to a dose of the same third vaccine.

I suspect that the parents may have filed with VICP where a death benefit is capped at $250,000 and the cases often settled for less.

Outside the VICP, lives are worth more. Recently, a $10-Billion Class-Action suit was filed against GM for 29 deaths related to a faulty ignition switch.

By March 2014, of 923 MMR-related cases (866 for injuries and 57 for deaths) filed with VICP, 367 had been compensated and 489 dismissed. http://www.hrsa.gov/vaccinecompensation/statisticsreports.html

Over 4700 cases filed by parents who suspected that MMR or Thiomersal or both somehow contributed to their children’s autistic regression were never heard.

The CDC has reported that the last measles death in the United States was in 2005 and that only 11 deaths from the disease and its complications had been reported since 1995. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases-deaths.pdf


DISCUSSION

As the Assistant Clinical Director of the leading New England Infectious Disease Hospital at the time, I examined, diagnosed and treated a significant number of patients with complicated infections in addition to teaching and training rotating pediatric residents.

I coordinated with the CDC and RIDOH, the first and only state-wide IPV vaccination campaign and later two area-wide measles and meningitis vaccination campaigns. In 34 years of private pediatric practice, many of them pre-VICP, I personally administered all required vaccines to my little patients, literally thousands of doses.

I patiently instructed parents on vaccines’ risk and benefits because I was supposed to and because ultimately I was personally liable for any serious vaccine reaction.

I respected parents’ reasonable wishes and never threatened to discharge them from my practice just because they dared request the omission or delay of a vaccine dose. I strongly felt that I spent years of training in order to be able to properly examine, diagnose and treat children, support and inform their parents and administer the needed vaccinations when they were due, in that order. I was and remain pro-judicious vaccination and all my own children were fully vaccinated.

Presently, some pediatricians who are totally protected by VICP, are acting as if their primary “raison de vivre” is the administration of the numerous pediatric vaccines recommended by the National Vaccine Advisory Committee (NVAC), whose members can never be held liable and manufactured by companies that are also immune from liability, when all other drug manufacturers are fully exposed.

Some angry pediatricians are publicly threatening to discharge families from their practice for non-vaccine compliance, forgetting that the American Academy of Pediatrics has clearly stated that “In general, pediatricians should endeavor not to discharge patients from their practices solely because a parent refuses to immunize a child.” http://pediatrics.aappublications.org/content/early/2013/04/24/peds.2013-0430.full.pdf

For some 24 years, as a school physician in two school districts in Northern Rhode Island, I reviewed students’ vaccination records and encouraged parents to make sure that all required vaccinations were administered as soon as possible unless there was a medical contraindication.

School Health was the only part of the school system under the jurisdiction of both the Department Of Education and the Department of Health. We always informed DOH about disease outbreaks or health issues but we were also often reminded by DOE that a school’s primary function was EDUCATION and that children should be allowed and encouraged to attend school unless they were sick or likely to get sick.

I expect that the present 2015 Disney measles outbreak will be less significant than the 2014 outbreaks and their 600+ cases.

It is certainly advisable that parents in all 50 states talk to their pediatricians, get informed, weigh risks and benefits and have their children vaccinated, if they so wish.

The CDC requires physicians to provide Vaccine Information Statements (VIS) to parents and guardians who must read them before signing the always required consent form.

The VIS describes the disease and its complications, informs parents about expected adverse events and outlines how to report such adverse events to VAERS, the Vaccine Adverse Events Reporting System. It also outlines how to contact the National Vaccine Injury Compensation Program in case of a significant adverse event. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/multi.html

The CDC thus guarantees that parents are fully informed before they decide to sign or not sign the vaccine consent form.

Parents who want to protect their children should certainly have them properly vaccinated but they cannot and should not force others to do the same.

Vaccination is a medical intervention. Forcing parents to have their children vaccinated is a restriction of their right to free choice. It also seems illogical if it is intended to protect other already fully vaccinated children. 

There is no law in the United States that can force an adult to receive a vaccine during normal times.

There is also no law that limits the ability of parents to make decisions for their children regarding religion, education, activities, diet, health issues and medical treatments in general.

It is certainly reasonable to have laws to inform parents about the benefits of vaccines and their side effects.

It is unreasonable to have a law that strips parental rights in normal times.

 

F Edward Yazbak MD, FAAP

Falmouth, Massachusetts

 

[i] /content/not-so-perfect-vaccine-diphtheria-tetanus-and-acellular-pertussis-vaccine-investigation

 

ADDENDUM February 19, 2015

 According to the CDC’s most recent update: “From January 1 to February 13, 2015, 141 people from 17 states and Washington DC were reported to have measles…” (Provisional data reported to the CDC’s National Center for Immunizations and Respiratory Diseases)

 Apart from the fact that the figures were still “provisional” and the cases were “reported” and not yet confirmed, the following is noted:

-In the provided colored map, California is in the 20+ cases group and Illinois is next, in the 15-19 cases group

-In the accompanying bar graph, the 2015 bar is still a fraction of the 2014 bar


In perspective: During the same 44 days, it is likely that more than 2,500 cases of autism were diagnosed in the United States, forever changing the lives and dreams of a lot of people.

 At the CDC, Autism and Autism research are the responsibility of the National Center on Birth Defects and Developmental Disabilities (NCBDDD). The present autism web page states: “…ASD continues to be an important public health concern. Like the many families living with ASD, CDC wants to find out what causes the disorder. Understanding the factors that make a person more likely to develop ASD will help us learn more about the causes….”
http://www.cdc.gov/ncbddd/autism/facts.html

 I will respectfully comment:

  • Autism is not an important public health concern. Autism is the most important public health concern
  • If our best and brightest still don't know what causes autism, could it be because they did not look at everything?
  • When I needed to understand what happened to a sick baby, the first thing I did was to ask his parents: “What happened?”

 May be it is time to try that?

FEY