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Hurt feelings over herd immunity?

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I read with great interest the opinion piece published on Monday from Sen. Paul Boyer in support of SB1115. It started with a story about how a pediatrician told him “shut your mouth” when he asked a simple question about a vaccine. He told a similar story to a packed room during a Senate Education Committee meeting on February 19 in support of yet another bill designed to reduce vaccinations.

If the story is, indeed, true and Sen. Boyer was treated rudely, that is most unfortunate. However, what strikes me in his telling and retelling of this anecdote is that he somehow feels it is justification, even in part, for sponsoring several bills, which would curtail vaccinations. This is legislation that the Arizona Medical Association (ArMA) and a coalition of influential health care organizations, experts, and business groups believe would endanger the lives of thousands of Arizonans, including some of our most vulnerable citizens. There may be passing “outrage” at someone’s impolite outburst, but surely it cannot outweigh the fact that vaccinations have saved millions of lives around the world, and are hailed as one of the significant public health accomplishments of the last century?

Libby McDannell

Libby McDannell

I guess that question is up to the Legislature to decide, but I sure hope our lawmakers listen to Arizona’s Governor, Doug Ducey, who stated last week that he is “pro-vaccination and anti-measles” and declared that he would veto bills that erode vaccination coverage. ArMA joins Gov. Ducey in the fervent hope that scientific facts, rather than internet-perpetuated myths, prevail in this vaccination debate.

Here are the scientific facts: Along with sanitation, clean food and water, and antibiotics, vaccinations stand as one of the most important pillars of health improvement for the human species in our entire history. Diseases, such as smallpox, polio, and diphtheria that previously killed and maimed thousands of people, are now relegated to the history books – thanks to vaccinations.

More facts: A recent measles outbreak in Clark County, Washington, led that state to declare a public health emergency. Clark County has been dubbed an anti-vaccination “hot spot” with 68 confirmed cases of measles as of February, predominantly among those who were not immunized. Moreover, the CDC so far in 2019 has also seen reported cases of measles in California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon and Texas.

And more: As recently as 2015, the CDC determined that Arizona babies were the least likely in the country to be vaccinated against measles, mumps, and rubella. In the CDC survey, only about 84 percent of the state’s children between the ages of 19 and 35 months have received the MMR shot, far below the national average of 91.5 percent.

So, the trends are all clear: outbreaks of dangerous yet preventable diseases like measles are on the upswing, and Arizona’s vaccination rates are already low. Accordingly, we should be doing more, not less, to encourage vaccinations and maintain community immunity. These bills do the opposite.

Specifically, SB1115 would mandate that all persons receiving a vaccine receive a tremendous amount of information (for a flu shot, up to 54 pages!), including but not limited to the vaccine manufacturer’s product insert and the CDC’s vaccine excipient and media summary. This unhelpful requirement applies to everyone getting a vaccination, including those wanting regular flu shots and people seeking vaccinations for overseas travel – whether they want it or not. This “Big Government” intrusion into the physician-patient relationship disregards that physicians already must discuss vaccine facts with their patients and obtain informed consent from them or their parent/guardian before proceeding with any vaccination. Most importantly, federal law already requires physicians to provide a Vaccine Information Statement prepared by the CDC to explain both vaccine benefits and risks. SB1115’s requirement is not only excessive but unnecessary – a “solution” to a problem that doesn’t exist.

To make a larger point, ArMA strongly believes that the effects of SB1115 and related bills will be to increase “vaccine hesitancy” in patients, which the World Health Organization lists as one of the top 10 threats to public health in the world. Groups pushing legislation that curtails vaccinations using dubious or discredited pseudo-science in support of their claims have gained traction in some quarters. ArMA and its coalition partners hope that Arizona legislators also hear the scientifically-supported facts, and the voices of the great majority in this debate: the millions of children and adults whose lives have been saved through vaccines; the many who have suffered and died due to the lack of vaccinations; and, the physicians and families who have had to deal with the tragedy of someone succumbing to an entirely preventable disease. For all of us, the choice is clear: we vaccinate.

Libby McDannell, CAE, is Executive Vice President of the Arizona Medical Association

8 comments

  1. Ms. McDannell,
    While I certainly agree with your position, I don’t believe your argument will sway the antvaxers. The facts you cite tell us how an effective vaccination program will fight dread diseases. However the medical community has failed to effectively counter the arguments against vaccination. Antivaxers are hearing that the high dosages of multiple vaccines containing toxic amounts of adjuvants such as aluminum in young infants contribute to syndromes such as autism. If you don’t squarely address this with facts, figures and science, they will continue to believe that the facts, figures and science don’t exist or are being withheld. The medical community is failing to communicate that the fears are unwarranted because these factors have certainly been studied by independent researchers…. I hope.

  2. Art Petersen - Concerned Conservative

    Very few will bother to read the “up to 54 pages” Way too much info and a total waste of paper. We get this kind of paper work nonsense when Optum RX sends out prescriptions. If you request more info ok,
    otherwise forget the paper work. Government interference with what citizens can do legally is over the top.

  3. Let me get this straight, Ms. McDannell. Requiring a complete disclosure of a vaccine’s content and effects is a “‘Big Government’ intrusion into the doctor-patient relationship” but forcing someone to ingest something against their will is not? Here’s a fact for you: neither the federal nor state Constitutions convey authority to government to force someone to take a vaccine.

    If you want more people to be vaccinated, the solution is to teach people the benefits and work to address the concerns of those who don’t want them. Education is the answer, nor legislation.

  4. Thank you, Libby McDannell. Please keep speaking out.

  5. Ms. McDannel’s letter is spot on. Regarding some of the concerns expressed in the comments, a recently published study looked at over 650,000 children born from 1999-2010 who received the MMR. No increased rates of autism were seen. The MMR vaccine has been available since 1971. Over 500 million doses of the MMR have been given worldwide since 2001 and no direct relationship between autism and the vaccine have become evident. Other studies have suggested multiple potential other causes or associations with autism, including parental age, maternal medical issues during pregnancy, exposure to cigarette smoking and many more. Assuming that vaccines are the cause of autism is irresponsible.

    While vaccines are not 100% effective in preventing diseases or the spread of disease in/from a vaccinated individual, they are still exponentially better at preventing them than no vaccination. The diseases treated by these vaccines can threaten the fetus of a pregnant woman and immunocompromised patients, like those on chemotherapy or who are unable to be vaccinated due to a medical reason where they can’t have the vaccine. Others not being vaccinated places these people at risk.

  6. It is not surprising that parents are hesitant to trust doctors if they decline to answer questions or if they deny care to patients who don’t agree to the rigid, one-size-fits all CDC vaccine schedule. Getting informed consent is an ethical requirement, reinforced by the Nuremberg Code. Like everything else in medicine, vaccines have risks as well as benefits, which vary with disease prevalence and severity, vaccine safety, and individual patient factors. Intelligent parents are not satisfied with platitudes.

  7. Libby McDannell’s excellent letter covers the points correctly. There are plenty of studies confirming that the vaccines do not cause autism or other disorders and the net reduction in pain, suffering and death from a population vaccination program is so exponentially greater than the rare vaccine related incident. Understand, no one has ever removed the right for someone to say “no” to a vaccine but the public via the school system may have some rights also. Rather than bills that will result in the children of antivax parents miss-out on public school, let’s have the legislators promote the actual science. There is no mercury in vaccines, any traces of thimerosal, which is proven safe, have been removed since 2001 in single use vials to temper the false fears. One serving of most foods especially fish that we eat chronically have 100 times more mercury than the single shot of vaccine had even before 2001. There is no aluminum added to vaccines. We consume more aluminum from Packaged food eaten chronically than any trace contamination in a medicine. The parents who are against vaccines are good people that are being victimized by falsehoods from the internet and cult-like science. It is very difficult for doctors to educate patients when these bills play into this fear . AntiVax legislators who have never seen a measles epidemic or watched a child suffocate from diptheria really would serve their constituents well to help. The science is there, the data of how life was before vaccines is plentiful. ‘Those who do not learn history are doomed to repeat it.’ Or in AZ, those who learn history and those that don’t…are doomed to repeat it. The immunocompromised children whom wish to be vaccinated but cannot also get to be victimized by false fear as we lose herd immunity.

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