Legislation Introduced That Would End California’s Vaccine Exemption Loophole

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Senator Ben Allen announcing legislation to close the vaccine exemption loophole, jointly authored with Dr. Richard Pan., with concerned parents at a press conference in the State Capitol, February 4, 2015 - photo courtesy Senator Allen's office
Senator Ben Allen announcing legislation to close the vaccine exemption loophole, jointly authored with Dr. Richard Pan, with concerned parents at a press conference in the State Capitol, February 4, 2015 – photo courtesy Senator Allen’s office

The Disneyland measles outbreak is seen by many as the warning shot across the bow. All it took was one infected park visitor and dozens of unvaccinated bystanders to unleash a potentially lethal disease that had been all but eradicated in this country. As a result, it has spread throughout California and several other states.

“As recently as 2000, federal health officials had declared that the U.S. had eliminated measles, though that disease, like others, continues to be a problem in Southeast Asia, parts of Europe and elsewhere,” the Sacramento Bee’s editorial board wrote in mid-January.

“Then came the rise of the anti-vaxxers,” they continue. “Waving discredited scientific reports that falsely tie vaccines to autism, these foolish parents, many from affluent enclaves like Disneyland’s Orange County, stopped immunizing their children. Ignoring the continuing risk of infection from Third World travelers and the importance of the ‘herd immunity’ that protects everybody, they have undermined years of progress.”

Warns the Bee, “Since 2006, the percentage of California kindergartners vaccinated for measles has fallen from 95 percent to 92.6 percent, perilously close to the 92 percent threshold. Predictably, the disease has returned: Between 2013 and 2014, cases more than tripled nationally and nearly quadrupled in California.”

On Wednesday, Senator Richard Pan and Senator Ben Allen introduced legislation that will repeal the personal belief exemption that currently allows parents to effectively opt their child out of vaccines in our schools.

“As a pediatrician, I’ve been worried about the anti-vaccination trend for a long time,” said Dr. Richard Pan, a State Senator representing Sacramento. “I’ve personally witnessed the suffering caused by these preventable diseases and I am very grateful to the many parents that are now speaking up and letting us know that our current laws don’t protect their kids.”

“The high number of unvaccinated students is jeopardizing public health not only in schools but in the broader community.  We need to take steps to keep our schools safe and our students healthy,” said Senator Ben Allen.

“Here in California, we are currently suffering from yet another epidemic of whooping cough, and now an outbreak of measles – both are completely preventable,” said Leah Russin, a mother from Palo Alto during a press conference. “My husband and I worry our son will get sick if we put him in daycare – many day cares in my area have vaccination rates well below what’s necessary to protect the community.”

According to the press release, under current law, with California’s personal belief exemption, “a parent may choose to opt their child out of school vaccine requirements that bi-partisan legislative majorities passed to protect students.”

Under a measure authored by Dr. Pan in 2012, “parents who exempt a child from school vaccinations must first talk with a licensed health care practitioner about the impacts to their child and community.”

In the first year the state law was implemented, 20 percent fewer parents used the personal belief exemption, said Dr. Pan’s office. However, in many communities across the state, over 10 percent of parents are using California’s personal belief exemption.

“When a contagion spreads in a community with immunization rates below 90 percent, the protection provided by ‘herd immunity’ can be at risk. This means many people are at risk of becoming infected including people who cannot be immunized, including infants, chemotherapy patients and those with HIV or other conditions,” said the release.

Assemblywoman Lorena Gonzalez, who represents San Diego and has signed on as an early co-author of the measure, said, “As a mother, I know the decisions we make about our children’s healthcare are deeply personal. And, while I respect that fundamental right to make medical decisions for your own family, a parent’s decision to ignore science and medical facts puts other children at risk. We as a state can’t condone that.”

If this legislation is passed, the senators state that California will join thirty-two other states that don’t allow parents to opt out of vaccination requirements using a personal belief exemption.

Senator Pan’s office back in late January put out a release claiming that the 2013 legislation “has led to a dramatic 20 percent decrease in parents opting out of vaccinating their kindergarteners, reversing a decade-long trend, [and] he has announced plans to introduce a bill to notify parents of their child’s school vaccination rates.”

“As a pediatrician, I have personally witnessed children suffering life-long injury and death from vaccine-preventable infection,” said Dr. Richard Pan, a physician and senator representing Sacramento and West Sacramento. “While I am pleased that more families are choosing to immunize their children and the statewide rates are going in the right direction, it is important to know that there are pockets of the state where the low vaccination rates continue to put children at risk.”

“Vaccines prevent serious and potentially life-threatening diseases and parents deserve to know the rates at the school they trust to protect their child,” Dr. Pan continued.

Under AB 2109, starting in January of 2014, parents who exempt a child from school vaccinations must first talk with a licensed health care practitioner about the impacts to their child and community. In the first year the state law was implemented, 20 percent fewer parents used the personal belief exemption compared with last year.

“Of course the intent of AB 2109 was to increase vaccination rates, but it is nice that the outcome was what we had hoped,” said Dean Blumberg, Associate Professor and Chief of Pediatric Infection Diseases at UC Davis. “And much like the first bill was about providing parents with correct information, it is also important for parents to know the vaccination rates at their child’s school.”

“As health care advocates, we have an obligation to ensure that accurate information about vaccines is getting to parents and the public – AB 2109 helped make that happen,” said Catherine Flores-Martin, Director of the California Immunization Coalition.

Senator Pan plans introduce a measure this year to notify parents of their child’s school immunization rates as well as what public health officials recommend the vaccinate rate should be in order to protect people who cannot be vaccinated for medical reasons, including chemotherapy patients, babies or those with HIV or other conditions.

As stated above, “When a contagion spreads in a community with immunization rates below 90 percent the protection provided by ‘herd immunity’ can be at risk. This means not only those who choose to be unimmunized may become infected, but also people who cannot be immunized, including infants, too young to have received important vaccines,” said Kris Calvin, Chief Executive Officer of the American Academy of Pediatrics, California.

Recent reports show that only two Davis public schools have vaccination rates above 95 percent among kindergartners entering school this year. That is below the level needed to prevent outbreaks of various diseases that were thought to have been eradicated in this country.

The report notes that 44 of 724 children who entered kindergarten in Davis were unvaccinated, with only three having religious exemptions and none having medical ones.

—David M. Greenwald reporting

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About The Author

David Greenwald is the founder, editor, and executive director of the Davis Vanguard. He founded the Vanguard in 2006. David Greenwald moved to Davis in 1996 to attend Graduate School at UC Davis in Political Science. He lives in South Davis with his wife Cecilia Escamilla Greenwald and three children.

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66 thoughts on “Legislation Introduced That Would End California’s Vaccine Exemption Loophole”

        1. Barack Palin

          Liberals don’t want this to point at illegals, they’d rather it point at people who chose not to vaccinate their children.  Even though many parents haven’t been vaccinating their children for at least 10 years is it coincidence that a short while after Obama let 60,000 illegal children come into our country and attend our schools that we now are experiencing outbreaks?

          http://www.examiner.com/article/measles-outbreak-likely-from-illegal-immigrant-children

        2. Eric Gelber

          From Barack Palin:

          is it coincidence that a short while after Obama let 60,000 illegal children come into our country and attend our schools that we now are experiencing outbreaks?

          A classic case of post hoc ergo propter hoc. I could say, for example: Is it coincidence that this outbreak occurred so soon after Republicans took control of the Senate? And, the “article” cited to is from Examiner.com, a right-wing blog site owned by Phillip Anschutz, not a serious news site. In the same edition as the cited blog entry is an entry entitled “Was Michelle Obama Really Born as a Man?”

        3. Sam

          I don’t think Barack Palin has spent much time at Disneyland. You about have to be a 1%er to afford it. I doubt many of the children that recently made the trip across the border are in that category.

        4. Tia Will

          BP

          Although I think that your view that the major issue involved is illegal immigrants has been thoroughly debunked by other posters, let’s pretend for the moment that you have a valid concern.

          If illegal immigrants were indeed to be demonstrated to be a major source of these viral illnesses, the best approach would be medical outreach at all points in which they come in contact with our system,( schools, churches, places of employment) to provide immunization where these people congregate rather than simply pointing fingers or wringing our hands. So if you have evidence that this is the case, especially locally, I would be happy to bring a proposal to the health council or the Board of Supervisors. Please post your evidence.

          1. Don Shor

            Click on the article I linked. Find the sentence I quoted. Continue reading the next four paragraphs.
            That will explain why it is probable that it came from overseas.

          2. Don Shor

            http://www.theyucatantimes.com/2015/02/while-the-u-s-faces-the-largest-measles-outbreak-in-recent-history-mexico-has-had-not-a-single-case-since-1996/

            But, when talking about measles prevention, the USA should look into one of the best immunization systems in the world. It is just down the border.
            Since January the 1st, the federal Centers for Disease Control and Prevention (CDC) have confirmed 84 measles cases in 14 states.
            Only 2 have been reported at the same period in México.
            Both were imported. Both were from the USA. Both were unvaccinated patients.
            México has had not a single case of autochthonous measles since 1996 and is about to be recognized by PAHO as a measles-free country.

            Why does it work? It’s universal, it’s free, and it’s mandatory.

          3. Matt Williams

            Don’s information on Mexico would appear to debunk the “immigrants have brought the Measles to California” hypothesis.

        5. TrueBlueDevil

          Don, three Central American countries have reported their immunization rates dropping into the 80s (%) in 2013.

          Also, not sure how much weight I put into their reporting figures, especially Mexico which seems to have a decent degree of general corruption and lawlessness.

          1. Don Shor

            Since there are almost no cases of measles in Mexico, I wonder why you keep trying to pin the disease outbreaks on illegal aliens when you have zero evidence pointing in that direction.

        6. TrueBlueDevil

          Don, we have multiple infections / illnesses that have re-emerged, not just one.

          I am not “pinning” it on anyone, nor am I giving anyone an automatic pass, as many of the liberals here want to do.

          It could be a factor, and we should be open to new data and research.

          1. Don Shor

            I am not “pinning” it on anyone, nor am I giving anyone an automatic pass, as many of the liberals here want to do.

            The problem is, you don’t even look it up before you make the assertion. The ‘data’ shows that illegal aliens aren’t the source.

      1. South of Davis

        David wrote:

        > The problem seems to be native anti-vaxxers rather than illegals

        The problem is ALL the parents that don’t vaccinate their kids and the three biggest groups of people that don’t have vaccinated kids in CA are:

        1. Left leaning anti-vaxxers

        2. Right wing we are not going to do what the government says people

        and

        3. Illegal aliens that come from poor countries that don’t vaccinate as much

        Yelling at each other saying “our side” is not the problem does not change the fact that ALL the parents that don’t vaccinate are the problem.

        I’m all for personal choice, but just like I support the rights of nudist families to hang out naked all day I’m glad that we make their kids wear clothes when they come to public school.  I can’t figure out why we don’t do the same for the (as David calls them) “anti-vaxxers” telling them that they are free to home school their unvaccinated kids but if they want to come to public school they need to be vaccinated (and to wear clothes)…

        1. Sam

          I too lean to the more personal choice side of things. The problem is you can’t get vaccinated until you are 12 months old. So any baby at Disneyland during the outbreak was at risk. So this is less of a personal choice issue because it will effect others.

          Can we all take a moment to thank Jenny McCarthy for using her “celebrity” status to dispense “medical advise” and bring back a disease that was almost nonexistent in the US.

           

        2. sisterhood

          “So any baby at Disneyland during the outbreak was at risk.” 

          Spent 3 summers and holiday seasons working at Disneyland. IMHO, plz do not take your newborn. Wait until your toddler can walk on her own. If you insist on taking a family vacation with a newborn, one partner should stay in a nice hotel with a day spa that allows infants. The other partner should take the older kids to the park. Spend two days. The second day, the other partner can enjoy the day spa with the newborn. Extra naps all day in the hotel room, with just your infant, should make for a well rested and happy union.

          Toddlers should walk if they’re physically able. In the old days, we lent out free strollers. Then we started charging a minimal amount. The strollers were designed to fit inside the food lines. Then fancy folks started bringing their own thousand dollar strollers. They push those things around, running into elderly folks, and toddlers. They usually don’t apologize. The strollers are too wide, and some do not fit in the food lines. Parents have to stand guard over them while someone orders food. (You don’t have to stand guard over a Disneyland stroller. They’re all the same.)Toddlers should be walking. It tires them out, but it makes them less cranky in the long run. Take them back to your hotel room for a nap, or a dip in the pool. Then finish the evening with the fireworks or parade. With or without exposure to all kinds of germs, infants will be hot, cranky and miserable in Disneyland.

  1. sisterhood

    Ashland, Oregon is a long way away from Anaheim, California. Ashland has one of the highest percentages of children not immunized in the entire U.S. And I don’t believe Ashland, OR is a hot bed of “illegals”, whatever that word means.

  2. Anon

    From http://patch.com/california/missionviejo/legislators-move-make-vaccines-mandatory-without-excemption

    State and federal legislators are rethinking a parent’s right to choose not to vaccinate their children thanks to the national measles outbreak epicentered in Orange County.
    As California’s measles toll reaches a 15-year high of 99, two state senators, including Sen. Ben Allen, D-Redondo Beach, said they plan to introduce legislation that would eliminate the ability of parents to receive a “personal belief” exemption from immunizing their children.

    Not only is there a push at the state level in CA to remove the personal exemption in regard to childhood vaccinations, but the federal gov’t may step in and do the same.

  3. hpierce

    I’m such a dinosaur… I got “immunized” against  the measles the old fashioned way… I had them.  I had “horrible” side effects… I lost some hearing in the very high frequencies.  Has never been an issue in my life (or my spouse’s, who also had the measles as a kid), except I’ve saved money in that a $200 audio system sounds as good to me as a much more expensive one.  And we vaccinated our children, except for chicken pox, (where, we and a VERY liberal, very ‘hippy’ family deliberately exposed their children with ours, to get it ‘out of the way’ when one of the kids had it).  And yes, Tia, that decision might not be the recommended method today, but this was over 25 years ago, no discernible problems, and yes I got the shingles vaccine (@ Kaiser), spouse intends to do so, and will let the kids know.

    Personally, looking at the MAJOR risks of measles, according to wikipedia there is ~ 0.1 % chance of that happening.  Perhaps, if we offer parents the choice between the vaccination or exposure to the virus (after all, we’re all “pro-choice”, right?) more parents would opt for vaccination.

    Remember, there are two types of ‘measles’.  Rubella (‘German’ measles’), and Rebeola.  The first can have devastating results to pregnant women (still births, miscarriages, birth defects), the latter not so much, but still are risks either way.

    Haven’t seen anything in the press/media as to whether this is rubella or rebeola.  Can any one shed light on this?

    1. Matt Williams

      I got “immunized” against the measles the old fashioned way… I had them. I had “horrible” side effects… I lost some hearing in the very high frequencies.

      Pierce, your statement above piqued my interest. Like you I am old enough to effectively predate measles vaccine, and I too had measles as a child. Late in life (after I turned 50) I came to realize that my high frequency hearing was severely impaired, and upon reflection (in discussion with my audiologist and ENT doctor), I came to the conclusion that I have had my high frequency hearing impairment since elementary school … and just didn’t know it, but rather compensated in the way I “listened” to what others were saying in conversations. I’d love to talk with you about your experience and how you knew that measles complications were the culprit for your impairment.

    2. Miwok

      My mother reminded me of when I got measles and Chicken Pox at the same time. She said I was “pretty sick”, so maybe I was like you, hp. There were also kids who had hearing aids at young ages for it too.

      What is interesting to me, is this article says a 2014 “law” reduced exemptions by 20 %, but now we need a new law? There are only 99 cases, out of 35 million people who did not die, only contracted measles. Won’t this episode get more of the 80% vaccinated?

      I would say even if 99 died, it is a smaller percentage of kids who disappear, are molested, or killed in accidents. No one wants to pass a law for them?

      1. Tia Will

        Miwok

        I would say even if 99 died, it is a smaller percentage of kids who disappear, are molested, or killed in accidents. No one wants to pass a law for them?”

        I am quite sure that there are advocacy groups working on strengthening laws to protect all of these groups. I know for example that Mothers Against Drunk Driving is a powerful advocacy group for children killed by drunk drivers. We also have Amber Alerts and other laws to prevent or detect child molesters.

        Having a passion for immunization in no way detracts from the desire to protect children from other preventable causes of harm. I am not sure in view of the publicity engendered by all of these efforts why this would even come to mind for you.

        1. Miwok

          I am not sure in view of the publicity engendered by all of these efforts why this would even come to mind for you.

          Tia –

          I am sure it did, but I remember a wise Transportation Secretary who once said something about air bags and seat belts. He said his agency will spend the money where it affects the most people. When school bus crashes cost 8 lives per year, and car crashes were 40K lives per year, he was spending his time on auto seat belts first.

          Spending millions of dollars and wasting time on sick kids with measles is like legislating against the cold. It is, as they say, a victimless crime, like drug use. And in a couple weeks it is over.

          Just like seat belts, some will not use them. Too bad for them.

      2. sisterhood

        I tend to agree with you about passing new laws. We have so many on the books now, and how will we fund enforcement? Re: protectng children: I’d rather see stricter punishments, jail time, mandatory lifetime anger management therapy for anyone arrested for any kind of physical abuse, not just sexual abuse. Also would like to see more public awareness campaigns for shaken baby syndrome and fetal alcohol syndrome.

    3. Davis Progressive

      isn’t rubella “german measles” and not actually measles?  my memory is foggy on that probably because no one gets that stuff anymore, but i remember german measle scares and keeping pregnant women away from schools.

      i don’t get the complacency here.  vaccinations work.

  4. sisterhood

    Memories flooding my thoughts today. Bringing home my first born. His beloved Jewish pediatrician dying in a plane crash in the wine country. Feeling immense loss. Fear. Reading everything I could get my hands on about infants, between insomnia ridden euphoria of receivng a healthy, beautiful gift from God, and an occasional nap. Choosing to breastfeed (Mother Nature’s first IZ) AND immunize. Hearing my uber educated pal scare the crap out of me for the latter. Hearing my mom’s horror story of thalidamide and DES. Watching my little precious gift for any sign of side effects Going through it all over again when God gave me a healthy daughter 21 months later. I don’t want to judge the choices other parents make. Both decisions are agonizing.

  5. Tia Will

    I would like to weigh in with some comments, both factual, and my  opinion.

    Rubeola ( also known as “measles”), Rubella ( also known as German, or 3 day measles) ,And Mumps are the three conditions covered in the vaccination known as the MMR.

    There are some important factors in considering risk associated with any particular virus.

    1. Mode of transmission – as the recent Ebola outbreak has illustrated, diseases that cannot be passed through the air have a much lower infectivity than those which are airborne. Measles can be transmitted through aerosolized particles which can remain airborne for several hours and also can remain transmissible in droplet form for several hours on moist surfaces. Thus, no direct person to person contact is necessary.

    2. Infectivity – of the common diseases in our area, measles and pertussis have the highest infectivity with measles affecting an estimated 75-90 % of those who are not vaccinated or who are sub-optimally vaccinated.

    3. Incubation period – the time lapse from when an individual is exposed to the virus to         onset of symptoms. For measles this interval is up to 6-19 days  with a mean of 13. This is highly significant since it means that an exposed individual can come in contact with many others, potentially over a broad geographic range before they are diagnosed and presumably isolated.

    4. Seriousness of the illness

    Measles complications — Complication rates associated with measles infection are variable. In the 1990 United States outbreak, the following complication rates were observed [19]:

    Overall complication rate – 22.7 percent

    Diarrhea – 9.4 percent

    Otitis media – 6.6 percent

    Pneumonia – 6.5 percent

    Encephalitis – 0.1 percent

     

    Death – 0.3 percent – with pneumonia as the most common cause of death followed by encephalitis.

    United States — In the decade before the measles vaccination program began, there were as many as 500,000 reported cases of measles per year in the United States; by one estimate, there may have been as many as four million cases per year [40]. About 48,000 were hospitalized, 1000 were chronically disabled, and nearly 500 died.

    The live attenuated measles vaccine was introduced in 1967 and, by 1985, had prevented about 52 million cases of measles, 5200 deaths, and 17,400 cases of mental retardation attributable to measles [40]. Since that time, the number of cases has fallen by approximately 99 percent, and measles is no longer considered an endemic disease in the United States [41-43].

    All factual information presented is from Up To Date and was updated as of 2/3/15.

     Now for my opinion ( which is solely my own and does not reflect the opinion of the Vanguard, the members of the editorial board, or any member of my health care organization ).

    1. The single best defense we have as a society against these viral illnesses is vaccination.

    2. The safety and efficacy of these particular vaccinations is well demonstrated science.

    3. There is no credible evidence that these vaccines cause autism. The side effects beyond a sore arm, mild temperature elevation, and transient aches are vanishingly rare. There are a very few medical exceptions such as true allergy to an ingredient in the vaccine.

    With regard to the issue of individual rights. I am in complete agreement with those who favor individual rights. I am a strong believer in individual rights. I am an equally strong believer in individual responsibility. This leads me to the conclusion that it is an individual’s right to refuse immunization and to refuse immunization of their child. I have no problem with the individual who chooses to home school their children, not take them to public places including church, restaurants, amusement parks, sporting venues, movie theaters, and basically anywhere else where they may come in contact with others. If this sounds draconian, or Orwellian to you, consider my right to not have myself or my children exposed to a potentially lethal illness that is nearly 100% preventable with a safe and inexpensive vaccine. For those who consider vaccines “toxins” or against their personal or religious beliefs, fine, don’t vaccinate. But stay out of public places and publicize your intent so that I can keep myself ,my family members, and my patients away from you and yours.

      1. Tia Will

        sisterhood

        Is there an allergy test that could be performed prior to administering the vaccine?”

        Good question. Allergy testing is not necessary since allergic individuals are those who are allergic to eggs since egg albumin is used in the manufacture of the most common type of flu vaccine. This is why the questionnaire provided prior to immunization contains the question about eggs. Fortunately this is not the only vaccine available. Again, from Up to Date:

        ALTERNATIVE METHODS OF VACCINE PRODUCTION — Most influenza vaccines are produced in fluid from embryonated eggs. Alternative methods of influenza virus propagation have been developed that should not pose an increased risk to patients with egg allergy [18-25].

        A trivalent inactivated influenza vaccine (IIV) (Optaflu) produced using cultured mammalian cells was approved for use in adults in the European Union, Iceland, and Norway in 2007, although it was not available in all European Union countries during the 2007 to 2008 influenza season. This same vaccine (called Flucelvax) was approved by the US Food and Drug Administration (FDA) in November 2012 for individuals ≥18 years of age (table 1) [26,27]. The seed strain used to make this vaccine is passaged in hen’s eggs, and therefore the vaccine may contain minuscule amounts of ovalbumin, in the range of 5 x 10-8 micrograms per 0.5 mL dose [28]. The package insert does not mention egg allergy as a precaution or contraindication. This virtually egg-free vaccine has been evaluated in 6281 adults in seven randomized trials [27]. The efficacy of Flucelvax was 84 percent in one of the trials, which is comparable with that reported for standard available influenza vaccines. In addition, rates of serious adverse events in the cell-based vaccine groups were similar to that seen in the egg-based vaccine groups and placebo groups.

        A second trivalent influenza vaccine that is not produced in eggs (Flublok) was approved by the FDA in January 2013 for patients aged 18 to 49 years [29], and was approved for patients 50 years and older in 2014

  6. ryankelly

    I’m going to guess that it is true that immigrant children are lacking in up-to-date vaccinations or, at least, there is no record of immunizations.  Closing the loophole for parents to opt out of having their kids vaccinated before starting to attend public school will help in ensuring that the parents do not linger in getting these kids vaccinated.   However, if all of the current American kids were protected by immunizations, then there would be much less risk of these diseases taking hold and spreading while these newcomers receive their immunizations.  BP is making a very good argument in support of having all children who can medically receive them, and young adults whose parents chose to opt out over the years,  immunized.

     

    1. Anon

      Spot on!  I heard a doctor on the news state the reason for the recent outbreak of childhood diseases like measles and whooping cough were two-fold.  1) Unimmunized children of illegal aliens would come to this country, and infect people.  When everyone received immunizations or already had the disease, such outbreaks were usually short-lived, and would die out quickly.  However, because too many parents feel they don’t need to vaccinate their children because the disease is no longer occurring, the outbreaks are now becoming much more widespread.  Eternal vigilance is the key to eradication of any disease.  A perfect example of this is polio, which is having a resurgence in third world countries that refuse to vaccinate their children against polio for religious reasons.

      1. Don Shor

        1) Unimmunized children of illegal aliens would come to this country, and infect people.

        Really? You heard a doctor say that? I wonder what country he thinks they’re coming from.

  7. sisterhood

    I wish all daycare providers & parents took all illnesses more seriously. I wish daycares & schools would be held to a higher standard.

    Most daycares have the rule of child is nauseous, or has sore throat or green mucous, they must be sent home. But clear runny nose & cough okay. I disagree with these practices. I was fortunate to have ample paid sick leave. But I know I would have stayed home with my child, or hired a nurse if faced with termination. Many parents dose their kids with children’s cold meds & send them off to infect others. Not nice. Not healthy.

  8. Tia Will

    Many parents dose their kids with children’s cold meds & send them off to infect others. Not nice. Not healthy.”

    And frankly, downright dangerous. Given the long incubation period, the possibility of low grade symptoms in some children who “fly under the radar”, the relatively late appearance of rash, the high infectivity of the measles virus, the only way to be truly protected from transmitting this disease is a high rate of immunization ( estimated at over 92%).

    Again, I believe in both autonomy and responsibility. It is highly irresponsible for parents who do not want to immunize their children to make the choice to expose vulnerable members of the community to their un immunized, potentially disease carrying children. And it doesn’t matter to me the moral, religious, personal or ideological rationale. As an individual, you have the absolute right to place yourself and your family at risk. You have no right to make that decision for everyone else’s family.

  9. TrueBlueDevil

    We have recently seen large outbreaks of previously tamed infections or illnesses like whooping cough, measles, and even Enterovirus-D68. We have had a 50-year high outbreak of whooping cough, and other infections we thought we had beaten have now suddenly re-emerged and in some cases skyrocketed in numbers. Some of these infections can kill.

    I see no issue with exhausting all possibilities as to why these outbreaks have occurred, and importing 30-40 million illegal immigrants is one possible major contributing factor.

    Tia Will has suggested that we provide medical resources near where these illegal immigrant groups live. Another option would be to follow our traditional immigration process and path, and to test individuals before they come into our country. This seems like basic common sense.

     

    1. Don Shor

      Well, the data I presented rules out Mexico as a source for measles. Mexico has also not had any pertussis outbreak, and uses a different vaccine for pertussis which is apparently more effective than what is used in the US. Pertussis has never gone away from the US, but what has changed is the percentage of Americans who get vaccinated and the efficacy of the vaccine (Tia can probably confirm that).
      So we should look within for the sources of our outbreaks. Other countries, particularly Mexico, do a better job than we do of controlling vaccine-preventable diseases.

      1. KSmith

        I got pertussis back in 2010 when that outbreak happened in NoCal. I found out later that my vaccination had probably worn off (I think I had last had a booster about 8 or so years prior to that).

        Luckily, I was relatively healthy, but it was still one of the worst illnesses I had ever had in my life. I was sick for a good 5 or so months, and the after effects lingered for a long time after that. I have permanent damage to my vocal cords from the coughing (the coughing spasms I had went on for months).

        And, unfortunately I could not just take off work for that long, so I had to continue doing my job, which meant having to leave my classroom (sometimes during the middle of lecture) for coughing fits.

        I ended up being OK, but others (particularly infants and older people) have died from this disease, which had largely been eradicated.

        I’m all for individual choice, but when those choices effect others to the point where they cause “material harm,” that’s when we have to think about some of the things Tia mentions above.

        Also, I’m not understanding why those who elect for the “personal exemption” must consult with a licensed healthcare practitioner before their children are given the OK to enroll in public school, but those claiming a “religious exemption” don’t have to do anything. It doesn’t seem equitable to me. So, someone claiming a religious exemption is more free than anyone else to potentially infect others with their diseases?

         

    2. Tia Will

      On the basis of the statistics regarding immunization, I agree that Don has this one right.

      I am not sure what vaccine is currently in use in Mexico, so I cannot speak to that point, but I do know that the rate of immunization has fallen here and that this is a major factor in the persistence of epidemic conditions.

      I think that one underlying misconception here is that the US always does a superior job. This is simply not true with preventative health care. While we do a good job at the top end with high tech equipment and research, we do a very poor job with preventive health care including immunizations, pregnancy prevention, prevention of drug abuse, poverty related health issues and health problems associated with a sedentary life style. We just can’t bring ourselves to admit the truth and target the roots of the problems which in this case happen to be citizens who either through personal belief based on erroneous information, or through religious beliefs, or through lack of access to full immunization or laziness in terms of fully immunizing themselves or their children combined with unwillingness to isolate themselves and their children spread their illness to others. This is where we should be focusing our efforts, not on our southern border.

      1. TrueBlueDevil

        I think we should follow the facts and the data where they lead us, and not discount possible causes because of political pressures.

        As one example, thousands of men died in San Francisco because politicians didn’t want to close down the bath houses due to political pressure for one constituent group. These same political groups / pressures communicated to us for years that everyone was at risk of catching AIDS, when in reality it is a difficult disease to catch.

        I have a college-educated friend who bought into the  “vaccinations cause autism”, and was going to pass on having his new baby vaccinated for certain infections / illnesses. His wife from Central America wasn’t in agreement, and at the same time – this was maybe 5 or 6 years ago – a doctor acquaintance of mine told me that the first case of whooping cough had been diagnosed in the East Bay. He told me to relay that to my friend. When I did, they had their child vaccinated.

         

  10. Tia Will

    On the basis of the statistics regarding immunization, I agree that Don has this one right.

    I am not sure what vaccine is currently in use in Mexico, so I cannot speak to that point, but I do know that the rate of immunization has fallen here and that this is a major factor in the persistence of epidemic conditions.

    I think that one underlying misconception here is that the US always does a superior job. This is simply not true with preventative health care. While we do a good job at the top end with high tech equipment and research, we do a very poor job with preventive health care including immunizations, pregnancy prevention, prevention of drug abuse, poverty related health issues and health problems associated with a sedentary life style. We just can’t bring ourselves to admit the truth and target the roots of the problems which in this case happen to be citizens who either through personal belief based on erroneous information, or through religious beliefs, or through lack of access to full immunization or laziness in terms of fully immunizing themselves or their children combined with unwillingness to isolate themselves and their children spread their illness to others. This is where we should be focusing our efforts, not on our southern border.

     

    1. TrueBlueDevil

      Tia wrote: “I think that one underlying misconception here is that the US always does a superior job.”

      I thought we did a good job until recently.

      “pregnancy prevention,” – What do you suggest in a free country, especially when we reward young women for getting pregnant?

      “prevention of drug abuse,” – What do you recommend, especially in a rich country with plentiful access to cheap drugs? I know one way to help is border enforcement, which would reduce supply, and increase costs. That is two positive effects that hit all users.

      “poverty related health issues” – What do you recommend? I’d say number one is encouraging marriage, education, and closing the border, which would reduce the supply of cheap labor and thus drive up wages and benefits. Basic economics.

      “We just can’t bring ourselves to admit the truth and target the roots of the problems” – I’d say root problems include government programs that encourage bad choices, and government programs which encourage / support single-parent families.

      ” laziness” – How do we legislate against laziness? Maybe hold the welfare check until the children get their shots?

      I would think any scientist or doctor would look at all factual data and follow it to it’s logical conclusions.

  11. Tia Will

    TBD

    I can only address the issue in which I have expertise, so I will , although I have already done so many times.

    1. I would make long acting reversible contraceptives, birth control pills, the nuvaring and the patch freely available to all women of reproductive age. I would also make them readily available without prescription over the counter, at student health centers. I would strongly encourage pediatricians to discuss this with their patients before they transfer the care of their female patients to me at age 18.

    2. I would recommend that appropriate anatomy and physiology be taught in the schools in an age appropriate manner using a thoroughly trained health care professional or science teacher comfortable with the subject matter and I would have it treated just like any other class vital for health, well being, and independence.

    3. I would recommend that the above classes be offered on an opt out rather than an opt in basis and that providers keep records as part of prenatal care to see whether the parents to be had been involved in such classes or not in order to monitor for effectiveness.

    4. I would “flip” the rewards system as Rich has proposed in the past. I would offer an annual stipend to girls for each year past age 15 in which they had not conceived, and the same to boys who had not fathered a child payable at the end of each calendar year. I would further structure these stipends in such a way that they would be maximized if saved to use to pay for higher education. I am sure that some business oriented individual would be able to propose a means to achieve this.

  12. Anon

    Don Shor: “Well, the data I presented rules out Mexico as a source for measles.  Mexico has also not had any pertussis outbreak…

    From http://www.phac-aspc.gc.ca/tmp-pmv/notices-avis/notices-avis-eng.php?id=98

    In the Region of the Americas (North, Central and South America and the Caribbean), measles has been eliminated; however, outbreaks continue to occur when the virus is imported into this region from other countries.

    The United States is currently reporting a sudden increase in the number of cases of measles in California, which started in December 2014. Related cases have since been reported in other states and in Mexico.

    From http://www.ncbi.nlm.nih.gov/pubmed/23623448

    Pertussis infections and vaccinations in Bolivia, Brazil and Mexico from 1980 to 2009.

      1. Anon

        From http://www.huffingtonpost.ca/2013/03/08/mexico-measles-case_n_2839690.html

        TORONTO – Public health officials in Toronto are reminding doctors to consider the possibility of measles when examining patients who return from spring vacations feeling under the weather.
        The warning is inspired by the discovery of a man infected with measles after he returned from a trip to the Mexico beach resort of Playa del Carmen.”
        From http://www.usnews.com/news/articles/2013/12/05/50-years-after-vaccine-creation-measles-still-threatens-us
        Before 1990, most imported cases of measles to the United States came from Mexico, but in 2013, half of all the imported cases came from Europe, according to the CDC.
        From http://www.latimes.com/local/orangecounty/la-me-measles-huntington-beach-20150121-story.html#page=1
        The move came as officials confirmed that five Disneyland employees were diagnosed with measles, part of what officials described as the worst outbreak in California in 15 years. There are now a total of 54 patients across California as well as three other states and Mexico.
        From http://www.washingtonpost.com/blogs/fact-checker/wp/2015/02/06/is-there-a-link-between-the-measles-outbreak-and-illegal-immigration/
        Vaccination rates of US vs Mexico:
        United States: 92 percent (2010); 92 (2011); 92 (2012); 91 (2013)
        Mexico:  95 (2010); 98 (2011); 99 (2012); 89 (2013)
        From http://www.frontpagemag.com/2015/dgreenfield/why-blame-anti-vaxxers-instead-of-immigrants-for-measles-outbreaks/
        “A study published in the Journal of the American Medical Association — Pediatrics last year found that 88 percent of measles cases in the country “were internationally imported or epidemiologically or virologically linked to importation.”
        There were a few cases not linked to any kind of importation over a period from 2001 to 2011, but they did not seem to be endemic, researchers said. The study ultimately found that while endemic measles was still eliminated, international importation remained a serious risk.
        As long as people are traveling to and from other countries, and as long as some of these people may be unvaccinated and they may come into contact with other unvaccinated people, the risk remains of measles cases in the United States.”

  13. Anon

    To True Blue Davis and Tia: on the issue of “pregnancy prevention”, one aspect that is hardly ever discussed is the huge number of women who are left by their spouse to raise the children conceived all alone.  These woman often have been out of the workforce or don’t have commensurate job skills as those of their significant others.  Divorce is one of the huge causes of poverty in this country.

    See http://www.familyfacts.org/briefs/8/marriage-and-poverty

    Marriage appears to reduce adult and child poverty. Children in non-intact families face a higher risk of poverty through childhood, and the negative economic consequences of divorce tend to be greater for women and children than men.

    1. TrueBlueDevil

      Anon, good links showing multiple positive effects of marriage.

      Married women are less likely to experience poverty. Compared to never-married peers, women who had ever been married were substantially less likely to be poor—regardless of race, family background, non-marital births, or education. Ever-married women have a poverty rate that was roughly one-third lower than the poverty rate of never-married women. Currently married women had an even lower probability of living in poverty—about two-thirds lower than other women.4″

      You’re right that divorce is one separate, large issues, just as out of wedlock births.

    2. Tia Will

      Anon

      While I agree that divorce or abandonment leaving a parent ( usually the mother ) to care for children alone is a big issue, this does not detract from the point that 50 % of pregnancies in this country are unintended. That does not mean that the children are unwanted, just unplanned. A key tenant in ensuring that children are able to be cared for is to plan ahead. This involves contraceptive planning whether you are married, unmarried, in a committed relationship or not.

      Primary prevention is always the most effective. Only having children that you have planned for and can afford is primary prevention.

      Keeping families together certainly helps prevent children from growing up in poverty, but does nothing to prevent unwanted pregnancies from occurring in the first place and therefore is at best secondary prevention which is always less effective.

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