Interesting Facts About Anti-Vax

Photograph from the 1950s before the widespread application

of the anti-polio vaccine developed by Dr. Jonas Salk

On September 9^th, California enacted a new law that severely undercuts the ability of doctors to grant medical exemptions to the state’s vaccination requirements for school-age children. Doctors catering to parents with a strong belief that mandated vaccinations are health-challenges that can create diseases like autism – a scientifically disproven myth – can now face disciplinary review based on a pattern of issuing too many such exemptions. 

The summary of the new bill from the Legislative Counsel tells us: “This bill would require a parent or guardian, by January 1, 2021, to submit to the department a copy of a medical exemption granted prior to that date for inclusion in a state database in order for the medical exemption to remain valid. The bill would require the department to annually review immunization reports from schools and institutions to identify schools with an overall immunization rate of less than 95%, physicians and surgeons who submitted 5 or more medical exemption forms in a calendar year, and schools and institutions that do not report immunization rates to the department. The bill would require a clinically trained department staff member who is a physician and surgeon or a registered nurse to review all medical exemption forms submitted meeting those conditions. The bill would authorize the medical exemptions determined by that staff member to be inappropriate or otherwise invalid to be reviewed by the State Public Health Officer or a physician and surgeon designated by the State Public Health Officer, and revoked by the State Public Health Officer or physician and surgeon designee, under prescribed circumstances.”

Protestors in the state capitol were loud and passionate. Six were arrested. The reaction of the irate parents is well-summarized by this statement from one anonymous protestor: “No one is listening, what does it take? I have pictures of injured kids in my pocket.”  Sponsoring State Senator Richard Pan (himself a pediatrician) noted: “It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable because a few unscrupulous doctors are undermining community immunity by selling inappropriate medical exemptions.”

But the emphasis of today’s blog is not the California experience but of what happens when mythology overtakes common sense in this immunization battle. It is the story of the nascent resurgence of an incurable and seriously debilitating disease (a potential lifetime of paralysis or death): polio. “[The] virus can be stamped out through regular doses of an oral vaccine. It was eliminated in the United States four decades ago.

“The global effort [to eradicate polio], which includes UNICEF, foreign donors and international charities, has made huge strides from 2014, when nine countries recorded new infections… In Pakistan, the door-to-door campaign to inoculate all children younger than 5 has been hampered by insecurity and lack of government authority in certain areas. This year alone, five polio workers have been killed.

“Experts compared the struggle to that of Nigeria, which was thought to have eliminated the virus until an outbreak in 2016 in a state that had been overrun by the Boko Haram militant group. Nigeria has not recorded a new polio case in three years and is on track to be certified polio-free in 2020.” Los Angeles Times, September 13^th.

Still, there is deep suspicion of modern inoculation efforts, particularly in Pakistan and Afghanistan, often linking greedy pharmaceutical companies that manufacture the vaccine to political corruption to get governments to buy their products and implement forced immunization. Especially in the most conservative Islamic communities. Rumors that the polio vaccine can seriously harm a child and that getting polio is lesser risk, false reporting of children seriously injured from the vaccine alone, have placed village-level healthcare workers at great personal risk as they try to convince locals to inoculate their children.

“Polio is making a troubling comeback in Pakistan, and it is being driven by some of the same forces spreading measles in the United States… Two years after health officials declared they were on the verge of eradicating the crippling childhood disease from Pakistan, one of the last countries where it remains endemic, at least 58 children here have tested positive for the virus since January.

“That is nearly five times the total of all of last year, and the most in a calendar year since 2014 — a major setback for a $1-billion-a-year global eradication campaign… Some 2 million Pakistani households have refused immunizations for children since April, when reports circulated on television channels, Facebook and Twitter that children had fallen ill after a vaccination drive at a school in the northern city of Peshawar.

“None of those adverse reactions were serious enough to require hospitalization, according to health officials. But the rumors revived long-standing myths about the dangers of vaccinations in Pakistan that the decades-long eradication effort has fought to dispel…

“Pakistani health officials have been baffled by the idea that parents would risk exposing their children to the virus in order to make a political statement… ‘It’s a joke,’ said a frustrated Aziz Memon, national chairman of the PolioPlus program in Pakistan led by the charity Rotary International. ‘But these are just blackmailing tactics. The government is taking care of this in a serious way.’…

“Memon said the government has replaced anti-polio officials in poor-performing districts and redoubled efforts to win over tribal and religious leaders, some of whom have denounced vaccinations as a Western plot to sterilize Muslims. At the request of Pakistani officials, Facebook said it deleted 36 posts for spreading vaccine misinformation ‘that had the potential to incite violence against health workers on the ground.’” LA Times.

Anti-vax protestors cite religious reasons (e.g., Islam vs Western Medicine), conspiracy theories, the right to control their children’s bodies and provide Internet-driven false accusations and fake photographs as tangible proof of the clear and present danger of vaccinations. But inoculations tilt the balancing act between individual freedom and a health threat to the millions of innocents around them who become exposed to disease by reason of this purported “personal choice.” The greater good, the overall health of us all, has to outweigh individual choice no matter how passionate the plea.

              I’m Peter Dekom, and self-righteous indignation cannot work to expose an entire community to an easily eradicated disease under a notion of “I’m right and everyone else is wrong.”