Science Policy For All

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California governor signs strict vaccination requirements into law

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By: Amy Kullas, PhD

photo credit: Vaccinate Your Child via photopin

On June 29 of this year, the California Senate passed SB277, one of the nation’s strictest vaccination laws. The very next day, California’s governor, Edmund Brown, Jr., signed the bill into law. SB277 transforms California – previously one of the most liberal states in terms of vaccination requirements – into one of the strictest. This bill makes California the third state (after Mississippi and West Virginia) to eliminate religious and other personal exemptions for vaccination. Under the bill, unvaccinated children without a medical exemption would have to study at home or in organized, private home-schooling groups rather than attend public school. Beginning January 1, 2016, schools will begin verifying that children entering kindergarten or advancing to seventh grade for the upcoming school year are vaccinated. On and after July 1, 2016, in order to attend public or private schools, students will need to have received vaccines for: diphtheria, Haemophilus influenza type b (Hib meningitis), measles, mumps, pertussis (whooping cough), poliomyelitis, rubella (German measles), tetanus, hepatitis B and varicella (chickenpox).

Infectious diseases are not new and have been killing since the dawn of mankind. However, in the 18th century, a revolutionary scientific innovation was identified: vaccination. Edward Jenner is accepted as the ‘grandfather’ of the modern vaccine. After hearing stories of how dairymaids were seemingly naturally protected from smallpox after having suffered from cowpox, he hypothesized that cowpox could be used as a deliberate mechanism of protection. In May of 1796, Jenner located a dairymaid, who had fresh lesions on her hands and arms and inoculated a young boy with material drawn from one of her pustules. The boy reportedly developed mild symptoms, but after about 10 days felt much better. That July, Jenner inoculated that same boy again, this time with pustules from a fresh smallpox lesion. After no disease development, Jenner concluded that the boy was protected from smallpox based on his earlier exposure to cowpox. This groundbreaking discovery of transmitted protection was the start the concept of immunization.

The controversy around eliminating the “personal belief exemption” was ignited in California after a measles outbreak started in at Disneyland last December and quickly spread to seven states and internationally into Canada and Mexico. Though the outbreak sickened approximately 150 people in the United States, fortunately no deaths were reported. The majority of the individuals infected by the measles outbreak were either unvaccinated (71 or 45%) or their vaccination status was unknown (60 or 38%). Only 28 people or a dismal 18% had reported receiving the measles vaccine! Further, of the U.S. residents who caught measles and were unvaccinated, 29 (43%) gave philosophical or religious objections to vaccination while 27 (40%) were ineligible because they were too young to receive the full course of vaccines, or they had a medical condition that prevented vaccination. Amidst the measles outbreak, Californian senators, Barbara Boxer and Dianne Feinstein wrote to state health officials, saying that “while a small number of children cannot be vaccinated due to an underlying medical condition, we believe there should be no such thing as a philosophical or personal belief exemption, since everyone uses public spaces…. As we have learned in the past month, parents who refuse to vaccinate their children not only put their own family at risk, but they also endanger other families who choose to vaccinate.”

Dr. Annie Sparrow, Deputy Director Human Rights and Assistant Professor of Global Health at Icahn School of Medicine at Mount Sinai in New York, highlighted another important consequence of infectious diseases making a global comeback: “measles, long forgotten, is ‘back’ in the United States and far too few doctors know how to recognize it.” Alarmingly, if people go to their doctor or to the hospital when they’re feeling sick and a diagnosis at that early stage is missed, the number of people potentially exposed to the disease could increase exponentially. Many early symptoms of diseases often present themselves in similarly with fever, rash, or both, making a diagnosis difficult. Doctors may also no longer consider some of the formerly common childhood diseases, since they have been generally accepted as eradicated due to vaccine development, and this unintentional oversight could have grave public health consequences.

Vaccination is an extremely effective strategy for preventing infectious diseases. However, this strategy is only successful when the vast majority of individuals are immunized against a particular pathogen in order to offer some protection to individuals who are not medically able to receive the vaccine. When a high percentage of the population is vaccinated, it becomes more difficult for the infectious diseases to spread because there are so few people who could potentially be infected in a concept called community immunity or herd immunity. The people who are unable to get vaccinated for medical reasons include infants, pregnant women, and immunocompromised individuals. But for those individuals who are healthy enough to get vaccines, but choose not to, why don’t they vaccinate?

The misguided “anti-vaccination movement” began with a paper published by Andrew Wakefield in The Lancet in 1998. The impact of this now-retracted paper still ripples through the scientific community and beyond, to within the general public in the United States. In the paper, the authors alleged that eight children (out of a very small sample size of 12) developed autism and bowel disease shortly after receiving the measles, mumps and rubella (MMR) vaccine. However, the MMR vaccine had been widely used since 1968, which begs the question of why would it take 30 years for this ‘association’ to be made? After numerous researchers continually failed to replicate Dr. Wakefield’s results, the scientific community uncovered that it was a fraudulent study. However, it still took over 10 years for the retraction to be published. Wakefield has since lost his medical license and in 2010 wrote a book disputing the charges against him. He has been described as the “father of anti-vaccine movement.” Because Dr. Wakefield’s fraudulent conclusions continue to be perpetuated by some, the medical community, scientists, and lawmakers must take a united stance to correct the damage done by one paper.

By signing SB277, the Californian government has mandated vaccinations for all school-aged children regardless of their parents’ personal or religious beliefs. Kudos to California, West Virginia, and Mississippi for passing such strict vaccination laws! My hope is that the other 47 states and the District of Columbia will follow suit for the good of us all.

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Written by sciencepolicyforall

July 8, 2015 at 9:00 am

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