Mandates, Ben Franklin, and Vaccine Injury

On Monday (President’s Day), I flew to Philadelphia to be part of a panel at the Franklin Institute discussing whether or not we should mandate vaccines. The other panelists were Dr. Paul Offit (you may have heard of him) and Dr. David Ropiek. It was an exciting conversation, I learned a ton, and I was grateful to the good people (both for and against mandates) who drove through the evening’s sleet and snow storm to attend.

As you can imagine, before the event began, it was the sources of some controversy. One chiropractor/blogger went to great lengths to explain why the esteemed Franklin Institute should not provide a forum for such a discussion. Most of her letter, of course, was an exhortation about how awful Paul Offit is and how much she disagrees with his science-based approach to vaccines. Her letter, of course, had no effect on the evening at all, but I mention it because we knew going in to the evening that the audience would include people who were not only opposed to vaccine mandates but also opposed to the very existence of vaccines at all.

As a side note, as much as Paul Offit is vilified, he really does deserve none of it. He is as kind a person as you could imagine, spending the time before the event asking how my children were doing and providing updates about his children. He truly cares about children not in the abstract, but about your children and mine (and his).

Because we were prepared for backlash, no questions were taken live. Instead, people used the Twitter hashtag #TalkFI to submit their questions. And that brings me to the one question I want to answer more completely.

Screen Shot 2016-02-18 at 9.10.30 AM
Tweet: What do you say to parents who do have a vaccine injured child?

To provide a little bit of context, the question was presented to the panel as “What do you say about mandates to parents who say that their child is vaccine injured?” Phrased that way, the question really could have come from anyone–pro-vaccine, anti-vaccine, vaccine-ambivalent. I did not know that I was answering someone who found what we were saying offensive.

So my answer was, in essence, “Vaccines don’t cause autism.” And why was that my answer?

  1. Vaccines don’t cause autism.
  2. 90% of the time, when someone asks me about “vaccine injury,” they mean autism. Parents whose children have had adverse reactions to vaccines that match what the science tells us to expect usually do not refer to their children as “vaccine injured.”

From there, Dr. Offit took up the question and gave a fantastic explanation about what a true adverse effect from vaccination entails and how honestly rare it is. His answer was far more eloquent than my blunt response, and I think it provided parents some real insight into why it really is okay to require that children who attend school are vaccinated.

But what about mandates? The problem with a panel discussion is that often one panelist brings up a point that launches a new discussion before the answer can be completely discussed. So here is what I would say to a parent whose child suffered a real and debilitating adverse event after vaccines.

I am sorry that your child had a reaction to a vaccine. In an attempt to protect your child, a medication caused harm, and that was certainly both unintended and unfortunate. Because your child cannot receive this vaccine, or potentially any vaccines, a medical exemption will keep him in school. I will work very hard to make sure all the children around him who can be vaccinated are vaccinated because if a vaccine can injury your child this way, it is possible a disease can do something much worse.

That’s my complete answer. It’s important to note that parents whose children have suffered real adverse effects confirmed by science and evidence often agree that other children should be vaccinated to protect their children. David Salamone is one such child. He contracted polio from the Oral Polio Vaccine and has been permanently disabled since. And yet, he says:

I’m not against vaccinations. I’m pro-vaccinations. We had thousands of people contracting polio prior to the vaccination. We came out with the vaccination, and that number decreased significantly. So less people are getting sick, less people are getting affected, and that’s a good thing.

None of this, of course, will make any difference to the people who came out to the Franklin Institute to confront Dr. Offit or who wrote letter to them ahead of time protesting the forum at all. At the end of the evening, after trying to refute on Twitter the points we were making, Carol had one last point:

Screen Shot 2016-02-18 at 9.10.12 AM
Tweet: It’s more than one in a million. Don’t allow them to keep lying.

Could I have given any answer to appease her? No. I look at the evidence about vaccines and think, “This makes sense, and we must shape our policies based on what we know and how we can best protect children.” Vaccine opponents like her look at the evidence about vaccines and say, “This evidence doesn’t line up with what I believe, so there must be other evidence people are hiding. We must make policies based on the evidence we cannot see.”

Policies made to appease people who have beliefs that fly in the face of evidence or who have fallen prey to the misinformation of the anti-vaccine movement are unwise. They are policies that appease the fears of adults rather than protect children against the real and dangerous threat of disease. And while fear can be a powerful motivator, protecting our vulnerable must be more powerful.

P.S. Don’t forget to use the hashtag #BeLikeBen this week to highlight Ben Franklin’s commitment to public health. And if you’d like to watch the entire panel discussion, here you go:

Why You Shouldn’t Shop for Medical Exemptions

Recently, filmmaker Leslie Manookian wrote a post for vaccine hesitant parents about how to pester physicians into giving them an inappropriate medical exemption. This interest in medical exemptions stems from the newly passed law in California that eliminates all non-medical exemptions. Parents who are now too scared to vaccinate their children are forced to make some tough choices. (Well, tough for them because of their misperceptions of the risks of diseases and vaccines.) They can either vaccinate their children or homeschool them.

Anyone following the anti-vaccine movement can understand how an otherwise reasonable but vaccine-hesitant parent feels about this choice. For them, the choice feels like deciding between certain death or certain economic doom. After creating the fears about vaccines, woopreneurs like filmmaker Leslie Manookian (and Bob Sears) have stepped in to capitalize on this fear by offering parents a way out of the vaccinate-or-homeschool conundrum. Thus Manookian’s “How to Claim a Medical Exemption in CA.”

Of course, the decision to shop for a medical exemption is unwise. To get a greater understanding about medical exemptions and how unwise they are, I asked two friends to weigh in. I talked to Dr. Anna Saporito, a family physician from New York, and Dorit Reiss, a professor of law in California.

Manookian claims:

More and more research is showing that individuals with a variety of conditions and genetic mutations are more susceptible to vaccine reactions.

These conditions and disabilities include already existing or a family history of previous vaccine reaction, eczema, food and environmental allergies, asthma, gut issues such as Crohn’s and IBS, autoimmune disease such as diabetes, lupus, MS, rheumatoid arthritis, ASIA, and others, chronic ear, sinus, strep or other infections, Lyme disease, PANDAS, POTS, learning disabilities, speech delay, ADD, ADHD, autism, seizures, bipolar, schizophrenia, thrombocytopenia, genetic variance, impaired methylation, detoxification impairment, and more.

Of course, most of us recognize this claim as fishing for an exemption. After all, can you imagine asking a doctor to forego vaccines for your child because he is prone to strep throat? (Why isn’t there a vaccine for that?) My supposition about this laundry list was right, according to Dr. Saporito, “There are actually very clear guidelines written by the ACIP and CDC outlining medical contraindications for vaccines.” You’ll notice that almost everything listed in Manookian’s litany is missing from the CDC’s guide to who cannot be vaccinated. In fact, many are actually listed on the CDC’s Commonly Misperceived as Contraindications list, including autoimmune diseases (such as diabetes, lupus, MS, etc.). Other items on her list are not included because learning disabilities and neurodevelopmental disorders are not contraindications to vaccines.

Manookian moves on to claim that parents can demand allergy and genetic testing before being vaccinated (with the assumption that something will pop and be used as reason for a medical exemption.) Again, Dr. Saporito notes that this approach is not warranted:

There is no evidence that genetic testing would provide any useful information in the prediction of vaccine reactions. Allergy testing might make sense, but not genetic testing. (If SCID [severe combined immunodeficiency] is suspected, that should be tested for, but usually that diagnosis is already known.) The American Association of Allergists and Immunologists have great guidelines about allergies and vaccines.

It is important to note that the American Association of Allergists and Immunologists’ document discusses how to test for allergies to vaccines after a vaccine is administered. It is not a standard of care to test children without a history of allergies for possible allergic reactions to vaccines they have never received.

Finally, I asked Dr. Saporito her stance on parents shopping for doctors who are more willing to provide medical exemptions for conditions that are not contraindications and whether or not family physicians are more likely to provide a spurious exemption:

The science is quite clear that vaccines are safe. I have vaccinated myself and my own child for this reason. I find it suspect that the doctors who offer this “service” of vaccine exemptions often do no take insurance. It seems there is more of a profit motive than a motive towards public and personal preventative healthcare, something I signed up for when I took my medical oath. In fact the AAFP [American Academy of Family Physicians] just this month came out against non-medical exemptions for vaccines.

From a medical perspective, the answers about medical exemptions to vaccines are as clear-cut as the case for vaccines themselves. However, I did want to find out about a legal perspective. What could happen, legally, to a parent or a doctor who presents a school district with a spurious medical exemption to vaccine requirements?

Dorit Reiss, who is becoming the foremost legal expert concerning vaccine issues, told me:

Manookian’s post is assuming someone can just pressure or get a doctor to give an exemption on false premises. First of all, I think doctors can and should consider reporting parents who are asking them to act dishonestly. The physician’s signature on a medical exemption should be based on true concerns/facts.

A parent getting a medical exemption based on things that don’t justify it doesn’t deserve the exemption.

But what about the doctors? What issues might they face if they become a mill for false medical exemptions?

The reality is that the doctor can probably get away with some of that. There is no mechanism in place for oversight now, and if doctor only gives a few, no one will look.

If a doctor is suddenly giving a lot of medical exemptions, there are a number of things that can happen. First, the Department of Health can try denying them as unjustified – which will probably be challenged in a court, and the department might lose. Second, the Department can bring a complaint with the medical board – and prove the problem. Third, the law can be changed to provide a penalty for abuse.

The doctor has to specify the conditions for exemptions. If a doctor is found to have lied, that could be a reason for disciplinary action.

Arguably, if a doctor provides an argument based on something that clearly shouldn’t be a contraindication that’s also reason for potential action. Most of the conditions Manookian lists aren’t caused by vaccines and are not contraindications. For example, a doctor choosing to help a parent not to protect a child with asthma from pertussis is arguably violating their responsibility.

The legal issues surrounding inappropriate medical exemptions for vaccine requirements, but there is enough gray area that parents should reconsider shopping for a family physician who will give them an exemption when none is warranted. Of course, the greatest disincentive to seeking an inappropriate medical exemption is the consequence of disease for a child left unprotected.

For a parent who has fallen prey to anti-vaccine scare tactics, skirting ethics and the law might seem a risk worth taking, but the real risk comes from the diseases that have historically sickened, maimed, and killed children.

Doublespeak: A Dr. Bob Special

Dr. Bob Sears is the author of a bunch of books, the salesman of supplements, a Fellow of the American Academy of Pediatrics, and a master of doublespeak about vaccines. According to Dr. Bob, he gives vaccines in his office every day. Why, then, does he work so hard to frighten parents about vaccines and downplay the effects of the diseases they prevent?

His newest venture, a supposed non-profit organization called Immunity Education Group (Do Not Link hyperlink), is a case in point. The website itself says almost nothing useful to anyone, but it appears that the real meat of his work is on the associated Facebook page, co-adminned by self-proclaimed data analyst Melissa Floyd.

The past few weeks, I have been ignoring Dr. Bob’s new Facebook page because sometimes ignoring them makes them wither and fade away. But one post last week drew in my attention (and some of my precious time and efforts):

Screen Shot 2015-08-31 at 12.34.23 PM

Since Dr. Bob is so long-winded, I didn’t screen capture the entire post. But this is the part that caught my attention:

Do you see it now? This press conference wasn’t about disease information; it’s the beginning of a hunt for pockets of vulnerability. And, I gotta hand it to them, the CDC’s answer was sheer brilliance. “No, we’re not the bad guys. We won’t share the data. School vaccine laws and sharing exemption information is a STATE and local matter. We’re are staying out of that.” The quotes are my paraphrase of the CDC answer. But the CDC wrapped it up this this statement (my quotes again, but it’s almost word for word):

“We encourage parents to find out their local vaccine exemption levels so that they can work together to help everyone do what’s good for their community.” Yes, they actually said that. It sounded so righteous, useful, and proper yesterday. But when you look at the whole picture, I worry that it’s a portend of what’s to come.

This is why we must work hard to come together, understand one another, start having conversations, accept one another’s varying medical beliefs, and learn to live together in peace and harmony. The current system is working well; diseases are under control, and we have very high vaccination rates. Less than 1% of families make the medical decision to forego vaccines. Coercion is unnecessary and divisive. The alternative, as laid out by the Centers for Disease Control and Propaganda, almost seems like the beginnings of a which hunt: which kids are unvaccinated in YOUR neighborhood, and what are YOU going to do about it?

– Dr. Bob Sears, Immunity Education Group

In other words, Dr. Bob doesn’t want vaccination rates at the school level (or district level, county level, whatever level) shared because he is afraid that it will turn into a “which hunt” for his patients. Or unvaccinated patients in general.

So much about this caught my attention since I was on that same CDC media call. Here’s a screen grab of my less-alarming notes:

Screen Shot 2015-08-31 at 12.40.56 PM
Yes, I cannot use less than symbols properly when typing quickly.

You’ll note the lack of CDC intimating that parents should go out and harass the parents of their children’s unvaccinated classmates. Since 21 states now offer this information, you would think the anti-vaxxers would be recounting these incidents if they were happening. But they aren’t. In fact, most parents I know who seek out this information want to know their child’s chances of being exposed to measles or chickenpox. Others want their children going to schools with high science literacy.

In fact, I’d venture to guess that most parents looking up immunization rates for their schools are using them far more legitimately than those looking up free and reduced lunch rates at schools. All sorts of data is available to parents in ways that preserves the privacy of students.

At one point on Facebook, Melissa Floyd, who is not a doctor, took over the reins of moderating the thread. And things went downhill.

Screen Shot 2015-08-31 at 12.52.17 PM

At that point, I asked Melissa for a citation showing that the CDC claims that immunity against measles lasts for a maximum of 15 years after MMR. I also pointed out that a woman in Washington died from measles. My comment asking for a citation seems to have disappeared, and Melissa moved on claiming that no school district with high PBEs was part of the measles outbreak and other such fabricated bologna. Fortunately, others asked her for a citation, and Dr. Bob jumped in to correct this piece of misinformation, right?

Screen Shot 2015-08-31 at 12.58.31 PM

Oh dang.

So we know that Dr. Bob isn’t very good at math (by his own admission) or at getting information about vaccines correct. He’s not good at social media, and he’s not good at choosing which side has the larger market base (hint: it’s the side with the 95% of parents who vaccinate).

But he’s great at doublespeak.

See, it’s not that measles lasts a lifetime. It’s that the package insert shows antibodies after 11-13 years. Dr. Bob still has antibodies from his MMR. But some adults might not have antibodies. How many adults? Not important. But the vaccine wears off and the CDC recommends boosters for people like pregnant women because of their rubella immunity. Oh, and if you spread misinformation, he will ban you.

It’s almost magnificent, the amount of obfuscation. In fact, he’s saying almost nothing. He is saying both that immunity from measles lasts 13 years, and that it lasts for much longer. He is saying that immunity from the MMR wanes and that it doesn’t for most people. And he is using pregnant women and their need to be immune to rubella as proof that measles immunity…something.

He might as well have posted a William Carlos Williams poem and told people to interpret it as they see fit.

His comment regarding the woman who died in Washington, though, was much clearer. He says we cannot know if she died from measles, and his actions show that he would prefer to believe that she didn’t because then he can’t lull people into believing that protection against death from measles is a matter of nutrition.

But here’s the thing. The coroner and the state department of health think she died from measles:

The death of a Clallam County woman this spring was due to an undetected measles infection that was discovered at autopsy.

The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County. She was there at the same time as a person who later developed a rash and was contagious for measles. The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death. The cause of death was pneumonia due to measles.

Dr. Bob can dissemble and juggle with the truth all he likes, but had this woman not been exposed to measles because of unvaccinated people, she wouldn’t have died.

That one fact, that someone in the United States in the year 2015 has died from an illness we can easily and safely prevent, is not something to ploy coy with. And because of her senseless death, parents want to make sure that their children are in places where such diseases are not spread. And I think that it’s every parent’s right to know how vulnerable their schools are to the spread of preventable disease.

Vaccine Refusal and Responsibility to Other Children

A common belief about anti-vaxxers is that they think they are only responsible for their only children. This belief is perpetuated by anti-vaxxers themselves. In fact, while perusing the stats of this blog last night, I found a link to a Mothering.com forum discussing a previous post I’d written comparing clusters of vaccine refusal to clusters of people refusing to pick up litter at a ballpark. The Mothering folk didn’t like it:

Screen Shot 2015-07-16 at 2.52.25 PM

The “lame social contract kind of argument” doesn’t resonate with vaccine refusing parents in the same way that picking up garbage other people have thrown out doesn’t resonate with middle school students. It’s a sort of “If it’s not mine, why should I care” mentality that puts children who cannot be vaccinated at risk for the very worst complications of diseases that are preventable.

The first time I heard an anti-vaccine mother argue that she was not responsible for other people’s children, I thought perhaps I had encountered a particularly horrible person. I asked her if she would save someone else’s child in the street about to be hit by a car if it meant leaving her own child on the sidewalk for a moment. I was trying to prove to her that we all feel a compulsion to protect children, whether or not they are ours, but she refused to answer my question.

Since then, I have seen more often the argument that we are only responsible for our own children and therefore do not need to worry about vulnerable people in our communities. Anti-vaccine doctor Jack Wolfson gained a lot of publicity for this stance, telling a local news station:

It’s not my responsibility to inject my child with chemicals in order for [another child] to be supposedly healthy…I’m not going to sacrifice the well-being of my child. My child is pure. It’s not my responsibility to be protecting their child.

Long-winded blogger Megan Heimer also made this argument:

Although I sympathize with your situation, pray healing for your child, and wish your circumstances on no one, that does not give anyone the grounds to trump my parental rights. My obligation as a parent is to my children, not yours and I will always (always) put them first.

These are only the examples of those publicly expressing this sentiment. Privately, many parents feel that their children are perfect and that they do not need to sully them in order to protect sick children–especially when anti-vaxxers often blame vaccines for whatever illness comes along.

Even so, the question isn’t whether or not we have any obligation to protect other children. Even in Megan Heimer’s loquacious exhortation on why she shouldn’t have to vaccinate her children to protect a child undergoing chemotherapy, much of her mental gymnastics seems to be justifying an unjustifiable position. She spends a lot of time blaming vaccinated people for spreading disease and urging vulnerable children to stay out of public places. She doesn’t argue very much, though, that the other child matters less than her child.

Don’t get me wrong. Many anti-vaxxers do believe that their children matter more than other people’s children, such as one woman who interrupted Assemblywoman Lorena Gonzalez‘ testimony in California by shouting “That child is my child, and he is more important than your child!” Some believe that their pure children have a specialness that exceeds that of others. In fact, in her research into mothering practices and vaccine rejection, Dr. Jennifer Reich describes these mothers are particularly intense in their parenting methods:

As experts on their own children, women saw their efforts as superior to the generic recommendations made by medical professionals who did not know their children. Although many of these practices are not shown to affect vulnerability to infectious disease, mothers worked hard in time and resource-intensive ways to protect their children without vaccines.

The take home message from many of these anti-vaxxers is that they are doing the better job of parenting their children, and were others doing what they were doing, those children could be healthy, too. These beliefs help them conclude that they cannot be held responsible for the health of other children since the parents are using inferior practices to keep them healthy.

When we flip this belief over to see the stitching on the back, the fear that weaves it together becomes obvious. It’s not that feeding your child organic foods, breastfeeding, and buying MLM oils is superior. It’s that the alternative, in their eyes vaccinating their child–is particularly dangerous. Let’s look at again at Megan’s interminable post and what always lies beneath the surface:

I dare not sway opinion with an emotional story of my son, who was vaccinated with MMR, almost died, and was subjected to a 240% increased risk of developing autism. No, I won’t show the photo of his sick, emaciated body lying in my arms after we flew across the world to be with him.

Do you see it? It’s right there, just like it always is. Autism. Even though ridiculous numbers of studies have shown that vaccines do not cause autism, the fear of autism always (needlessly and offensively) lurks beneath the surface. Vaccine refusing parents do not want to sacrifice their children, rendering them autistic, in order to protect the life of someone else’s more vulnerable child. Even though such a sacrifice could never happen.

As I’m told Dr. Greg Poland once said, fear is more contagious than measles.

You Do Not Own Your Children

Nothing irks me more than the anti-vaccine rally cry of “My Child, My Choice” or the insistence by parents of unvaccinated children that their decision to eschew preventative care is a parental right.

The moment the nurse hands your baby to you, you cannot help but examine every square centimeter of her. Those tiny fingernails, those puffy eyelids, those little ears–every piece of the baby needs a nibble or a nuzzle. The feelings of being forever tied to this little body and this young life or overwhelming.

But those feelings do not give you ownership rights over your child. As your child grows, it becomes obvious that you cannot make your child be or feel or live the way you choose. Your child’s life belongs to your child. Your child ultimately owns his own body and is growing into the responsibility of caring for himself. As your child grows, it is your responsibility to take care of him. You are not your child’s owner; you are his caretaker.

Yet, the anti-vaccine movement gets far in framing the vaccination as a freedom-of-choice and parent rights issue. Mothering magazine maven Jennifer Margulis argues:

Unlike in the United Arab Emirates, in America we believe parents are capable of making their own decisions about their children’s health. We believe in freedom of choice. This freedom of choice extends to when — and even whether— parents vaccinate their kids.

Her wording is clever. We aren’t those terrible un-American Arabs, we are American (cue John Philip Sousa). Either you believe in some sort of vague, repressive, Sharia law philosophy, or you are for freedom, America, and allowing parents to refuse vaccines.

What exactly is this choice that anti-vaccine activists think they have a right to? One conservative magazine published an article that claimed: “If parents think that getting measles is a lot better than acquiring a lifelong mental disorder, they should be able to make that choice, especially for diseases that aren’t generally deadly.”

In other words, if parents believe, despite all evidence to the contrary, that vaccines cause autism and that autism is worse than measles, it is only American to give them to right to make medical decisions based on these falsehoods. The right to refuse vaccines for your child is the right to believe fear-mongering about autism, to believe that autism is the worst possible outcome while also believing that measles isn’t a big deal, to deny that globally, 17 people die from measles every hour every day. It is to think that those measles deaths happen to the other people far away and to choose to believe that the woman in Washington state who just lost her life to measles is part of some conspiracy.

Anti-vaccinationists assert that they have the God-given right to make medical decisions about and for their children, but basing these decisions on the worst possible misinformation casts doubt on whether or not they are capable of making such decisions.

In the end, however, their capabilities are irrelevant. No parent has complete and unfettered rights to making medical decisions for their children. Just ask the parents of Daniel Hauser, who were ordered by the court in 2009 to bring their son in for chemotherapy for his Hodgkins Lymphoma.

The Journal of Ethics summed up the issue of medical care and parental rights well:

Medical neglect statutes examine whether appropriate care was provided, not how it was provided. A parent who refuses care based on an objection to treatment, whatever the basis, is just as likely to have the state intervene to make medical decisions as a parent who is not physically able to provide care or not mentally capable of making decisions.

Anti-vaxxers love their children and their beliefs are sincere, but they don’t own them and they do not have complete, unobstructed say over their children.

But what of choice? Isn’t choice American, even if the choice is wrong? After all, many people choose to listen to Nickleback or cheer for the Packers. Isn’t it American to defend the wrong choices of others because we believe in freedom?

Unlike putting cheese on your head or listening to bad music, the choice to refuse immunization for your children has consequences for other people: people going through chemotherapy or people who have undergone organ transplants or people who are new and too young to be immunized. America might be about freedom, but we are also about responsibility. If Nickleback carried the potential to kill children with cancer, we would outlaw them forthwith.

Lastly, children have rights. Parental rights are equal to the rights of the child, not greater than them. Children have the right to be taken care of and to be protected against things which might harm them. For this reason, we mandate by law car seats, educational standards, and bicycle helmets for children. A parent’s belief system is never factored into the freedom to choose these mandates. If we hand over full ownership of a child to any parent, we might as well erase decades worth of work gaining rights for children.

I have no doubt that anti-vaccine parents want the best for their children and want to protect them. However, their intentions and beliefs ought not to overrule the rights of their children to best medical practices. Though an anti-vaccine parent wants the best for her child, the science tells us that they are not providing the best for their child. The issue has nothing to do with freedom or choice or parental rights. It’s about keeping kids from getting sick.

Don’t Use Your Religious Beliefs to Endanger Your Community

Talking about vaccines as we come off Memorial Day and consider what people have sacrificed in the name of freedom only seems natural. I figure as long as I am mixing patriotism and vaccines together, I might as well add a discussion about God.

People who know me know that I am a religious adherent–the type who even goes to church on Sundays. I believe that people should be allowed to exercise their religious beliefs freely as long as they do not harm others. Most arguments against a religious exemption focus on this last bit: not harming others. Vaccine refusal puts both a child and her community at risk for harm, and ought not be protected by the right to practice religion freely.

People who are religious often feel nervous, however, with the idea of eliminating a religious exemption to school vaccine requirements. Even if they vaccinate their children and want others to do the same, they might worry that giving no exemption on the basis or religious belief will, at some point down the line, be used to limit their free practice of religion. It’s a fair worry, but one that I think is short-sighted.

In fact, the way I see things (as a non-lawyer and a non-scientist), religious exemptions to vaccine requirements weaken religious freedom in the United States. Currently, forty-five states in this country offer a vaccine exemption based on religious beliefs. (I happen to live in one of the states which does not offer an exemption based explicitly on religion, which delights me.)

The way that these religious exemptions are granted differs wildly from state to state. Some states, like Florida, allow unvaccinated students to attend if parents fill out a form that indicates that vaccines are somehow against their religious beliefs. Such a cavalier use of religious beliefs is a threat to anyone who holds any religious belief because religion is not a blank check to opt out of community responsibilities. Can you imagine if you were pulled over for speeding, and you told the officer that as a Lutheran, you sincerely believe that limiting speed is something the state should not impose on you?

If the religiously affiliated play the religious beliefs card too often, we would deserve to have our freedoms closely scrutinized. After all, why should a Methodist be able to send her unvaccinated child to school when an Atheist cannot? (And Agnostics should be able to speed if Lutherans can!)

In the case of religious exemptions, the scrutiny is fair. Which major religious faiths, as a matter of doctrine, advise their adherents to avoid immunization? People often point to Christian Science as the religious that forbids vaccination, but during a round of compulsory smallpox immunization, the founder of Christian Science, Mary Baker Eddy, advised her followers to follow the laws and submit to vaccination. So supporting a religious exemption is not really about allowing the free practice of religion as much as it is allowing people to believe misinformation about immunization and use their religious beliefs as a defense. When the science so clearly supports immunization, such a cynical use of religious beliefs ought not to be supported by law.

Other states, like New York, make it more difficult to obtain a religious exemption. There, a school has the right to accept or reject a religious exemption. In some cases, courts have been called in to rule on whether or not a religious belief was sincerely held in regard to opting out of immunization requirements. Dina Check was one such mother whose religious exemption was denied by the school because her religious belief was deemed insincere, and the court upheld this decision.

When people claim rights based on religious belief, they also potentially subject themselves as to the sincerity of their belief. This sincerity testing has all sorts of potential ramifications legally, I am sure, but even practically–I am not certain how to test whether or not someone sincerely believes something. And I fear handing over to the courts the power to adjudicate on how sincerely someone believes anything.

If we want religious freedom (or freedom from religion), we need to be careful about which rights we ask for on behalf of our religion. Protecting anti-vaccine parents who want to claim religious beliefs against vaccines is not carefully protecting religious rights. It is protecting the right to opt out of protecting a child and a community against diseases that harm children and other vulnerable people. And there’s nothing particularly religious about that.

The Most Egregious Example of False Balance

Discussions about vaccines are not debates, and the science behind vaccines does not have two sides any more than the science behind the roundness of the Earth does. So why are journalists still trying to balance their reporting about immunization with “the other side”?

I am somewhat sympathetic to journalists. Sometimes, when people in a community are making noise about their vaccine denialism, a journalist might have a hard time ignoring their noise in a story, even if their noise, while loud, represents a micro-minority of the community.

Today, however, I found one article about which I can muster no sympathy. It was a story about a boy out of Ft. Myers, Florida who had undergone a liver transplant due to cancer and then caught chickenpox from an unvaccinated child. Predictably, because of his compromised immune system, chickenpox nearly cost him his life.

It started off so promising, and it is really important for people in a community to be able to put faces to the abstract idea of “immunocompromised” and understand that real children need the real protection from community immunity. Our vaccines protect our friends and neighbors, too, after all.

In this very important story about a child who was already sick and whose community failed to protect him, the journalist included this quote from a chiropractor with no expertise in vaccines, immunology, or infectious diseases:

So, NBC2 spoke with Doctor Brienne Gindele.

She’s a family chiropractor in Fort Myers who does not believe in vaccinating young children.

‘The risks do not outweigh any benefits as far as I’m concerned, the neurological changes it makes to on especially an infant,” Dr. Gindele explained.

Gindele does believe it is the parents [sic] responsibility to make sure their children are immune to certain viruses though, whether a vaccine is used or not.

“If people choose to immunize then they need to be educated enough to understand that they need to get their children’s immunity checked,” Dr. Gindele told NBC2.

Dr. Gindele can believe all the livelong day anything she wants, but her beliefs are not supported by science, and they certainly are not newsworthy any more than the beliefs of a person who doesn’t like how seatbelts wrinkle his clothing would be relevant in a story about a near-fatal car accident. In fact, some of Dr. Gindele’s beliefs are factually wrong. Vaccines do not make neurological changes on an infant (and yes, that is code for autism).

Furthermore, this poor boy’s parents did not need to get his immunity checked. His parents knew he was completely vulnerable to chickenpox because he had undergone treatment for cancer and an organ transplant. They knew they were relying on the community to protect him. The community failed, and one chiropractor who uses fear of vaccines to sell her own services and is making excuses for this failure is completely irrelevant to this boy’s plight.

The journalist ends the piece with a quote from the parents, but she introduces it this way:

But, the Bells believe differently.

I can’t speak for the Bells, but their perspective is not about beliefs. As a matter of evidence and reality, their child actually suffered from a disease that he caught because charlatans continue to promote the idea that vaccines cause autism–something they (insultingly and incorrectly) frame as a fate worse than death. In a community where parents fell prey to this misinformation and endangered the life of a boy who deserved protecting, one journalist decided to continue to make the world a dangerous place by giving the purveyors of misinformation another platform.

Avoiding false balance isn’t just about being accurate. It’s also about not creating a world that endangers the lives of children.

UPDATE: If you tried clicking on the hyperlink to the article in question, you will notice that it has been taken down after numerous people emailed the producers at NBC-2 in Ft. Myers and Tweeted to the journalist in question. I have archived the article here. Together, we can eliminate false balance in media stories about vaccines.