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Religious/moral/ethical conflicts

2019-JAN-JUN:
Vaccines, Anti-vaxxers,
Immunization Programs, and
Potential Epidemics.
New York State eliminates religious exemption.

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2019-JAN: Measles Outbreak in Washington State:

During the week of 2019-JAN-20, Jay Inslee (D), the governor of Washington State, responded to a measles outbreak by declaring a state of emergency.

On JAN-28, health officials reported 36 confirmed cases and 11 suspected cases of measles across Clark and King counties, WA. It is no coincidence that Clark County, in South-West Washington near Portland, OR-- where all but one of the children with measles lives -- has the lowest vaccination rate in the state. According to The Oregonian, more than 22% of public school students there did not complete their vaccinations. 10 Among those who are confirmed to be infected with measles, 25 are under the age of 10, nine are between the ages of 11 and 18 years old, one is between the ages of 19 and 29 years, and one is in his 50s. At least 31 of the confirmed cases had never been vaccinated for measles. The only child in King County, in central West Washington near Seattle with measles is known to have caught it from someone in Clark County. 1

Dr. Saad B. Omer, a professor of global health at Emory University, said:

"We are close to the so-called herd immunity threshold." 1

The threshold value is 92% in the case of measles. If the vaccination rate against a disease is this value or higher, then such a large percentage of people have been made immune to the disease that the rubella virus will have difficulty finding unvaccinated individuals to infect. Thus, a small outbreak will probably fizzle out. A large-scale outbreak is unlikely to occur.

The measles-mumps-rubella (MMR) immunization rates for children in Clark County, WA, as of 2018-DEC-31 were only :

  • 81% of children aged 1 to 5-year-olds, and

  • 78% of children 6 to 18-year-olds. 13

This is well below the herd immunity threshold, so a major epidemic is quite possible.

Unfortunately, there exists a minority of immunocompromised people who cannot be vaccinated for medical reasons. A very high percentage of other children need to be vaccinated in order to have the overall population reach the herd immunity threshold.

Professor Omer said:

"I don’t want to be alarmist. We have robust immunization programs ... and the [Centers for Disease Control and Prevention] have a very proactive program to counter these outbreaks. These ... keep things at bay, but there is still a concern." 1

By FEB-06, at least 55 people in Washington and neighboring Oregon had developed measles. Fifty of them are in Clark County, WA; one is in King County, WA, and four are in Multnomah County, in Northwest OR, near Portland.

Bernadette Pajer, who co-founded a co-founder of Informed Choice Washington, the main anti-vaccine group in the state, said:

"It shouldn’t be called an outbreak. I would refer to it as an in-break, within a community." 12

She argued that the measles has only spread only within a small, self-contained group.

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2019-FEB: Measles Outbreak in New York State:

In New York state, 209 cases have occurred since 2018-OCT. Some of the unvaccinated children who are involved caught measles during their visit to Israel where a major outbreak of the disease is occurring.

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A mother who is opposed to vaccination asked for advice from an anti-vax group.

She wrote:

"My 3-year-old is not vaccinated and there is currently a measles outbreak in my state. Any suggestions for precautions I can take to protect her would be very much appreciated."

She received many answers. Many were humorous, sarcastic and/or vicious. She probably did not expect some of them, :

  • "She's 3 years old. ... never been vaccinated for anything? Well ... that's middle aged ... she's lived a good life."

  • "You could expose her to a weakened or inactive strain of the virus so that her immune system is better equipped to recognize and combat the actual virus she' inevitably will come into contact with with ... which will decrease the likelihood of her getting sick. Oh, wait."

  • "Just between us. ... this kid is not your favorite, right?"

  • "Do not take them to a medical doctor. Facebook is the MOST RELIABLE source of medical information -- particularly when it comes to vaccine science."

  • "Precautions? Don't get to attached to that child."

  • "I was vaccinated, but I also ate kale once. I'll let you decide why I've never had the measles."

  • "Unvaccinated children are like dark humor. ... They never get old."

  • "I'll be over here with my autistic son, listening to his interesting stories, and you, anti-vaxxers, can listen to your children's' eulogies."

  • "[Try] milk bones dog treats. I give them to our dog and he's never had the measles."

  • "What's funny is the vast majority of anti-vaxxers are vaccinated themselves. So they are safe, but put their kids at risk."

And my personal favorite:

  • "Bring her to the edge of the flat earth. The air is cleaner there."

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Vaccines and the anti-vaccination movement:

The measles vaccine was first made available in the U.S. during the 1960s. By the year 2000, the disease was believed to have been eliminated in the country. However, an anti-vaccination movement, which is particularly strong in the U.S. Northwest, has been successful at having vaccine exemption laws passed in some states. They allow parents to decide to leave their children unvaccinated. This permitted a resurgence of the disease. 350 cases were reported across the U.S. in 2018, an increase of almost three times the number detected in 2017.

Those individuals opposed to vaccination are referred to as anti-vaxxers. Many of them believe that a link exists between vaccinations and the rise in autism in children. Symptoms of autism are often not detectable among very young children. They appear suddenly. Sometimes, by coincidence, they might appear shortly after the child has been vaccinated. This has caused some parents to link the two events and to firmly conclude that there is a cause-and-effect relationship between vaccination and autism. Some have blamed Thimerosal, a preservative used in vaccines, as being responsible for causing autism.

During 1995, a British gastroenterologist, Andrew Wakefield, MD, joined 12 co-authors and published the results of a pilot study on measles in the Lancet -- the leading British medical journal. It discussed a possible link between the measles-mumps-rubella (MMR) vaccine, bowel disease, and autism. Their paper stated that they could not demonstrate a causal relationship between MMR vaccine and autism. However, Wakefield released a video stating that a cause and effect relationship did exist.

Various media picked up the story. Many parents became frightened about the possibility that the vaccine could generate autism in their children. Vaccination rates sank.

Dr. Richard Horton, who was then editor of the Lancet, claimed that the group's research was "fatally flawed." Later, the Lancet formally retracted the paper. The UK General Medical Council banned Wakefield from practicing medicine in Britain. A British journalist, Brian Deer, reported evidence that Wakefield had falsified data. 2 He called Wakefield's work an "elaborate fraud."

The Lancet article triggered many studies into the safety of vaccinations:

  • The Centers for Disease Control reports on many studies, including:

    "Three large epidemiological studies that analyzed data from US health maintenance organizations, the UK General Practice Research Database, and the entire country of Denmark failed to find an association between exposure to thimerosal-containing vaccines and autism." 3

  • Studies by the National Academies of Sciences Engineering Medicine I have also shown that the vaccine-autism link does not exist.

  • The Immunization Action Coalition promotes vaccinations and has hyperlinks to many videos, handouts, statements, and web sites. They have also concluded that vaccines do not cause autism. 5

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Sponsored link:

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The World Health Organization (WHO) issued a list of ten serious threats to global health in 2019-JAN that could jeopardize millions of lives. They said that:

"Vaccine hesitancy -- the reluctance or refusal to vaccinate despite the availability of vaccines -- threatens to reverse progress made in tackling vaccine-preventable diseases."

"Vaccination is one of the most cost-effective ways of avoiding disease -- it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved." 6

Julia Belluz, writing for Vox, reported that the vast majority of U.S. children are vaccinated. But the number of unvaccinated babies in the country has increased from 0.3% in 2001 to 1.3% in 2015.

Peter Hotez, director of the Texas Children’s Hospital Center for Vaccine Development at Baylor College of Medicine has an autistic child named Rachel, and has written a book about the experience. He has worked professionally on the development of two vaccines. He said:

"There are pockets across the US where you have a 20-fold increase [of refusal to vaccinate], like we’ve seen in parts of Texas. Although, nationally, immunization rates may not have changed that much, we have pockets where 20 to 40 percent of kids aren’t vaccinated, and that gets you into trouble with measles and other [vaccine-preventable] infections. ..."

"From my experience, a majority of vaccine-hesitant parents are not deeply dug in. They’ve gotten misinformation from anti-vaccine web sites and social media, or they’ve heard something unsavory about vaccines from friends and relatives. I believe my book might reach those individuals. Then there’s another group, maybe 10 to 20 percent who are deeply dug in and believe all of the fake conspiracy theories. Those individuals are really difficult to reach." 7

He notes that:

" ... after smallpox was eradicated in the late 1970s, measles became the leading killer of children in the world: two-and-a-half million children [then] died annually of measles. Now, through aggressive vaccination programs, we’ve brought that down to under 60,000-70,000 deaths a year -- still a lot of deaths, but more than a 90% reduction. Now I’m worried we’re going to reverse those gains because of this anti-vaccine movement in Europe and the US. That’s going to extend elsewhere.' 8

Dr Hotez' book is titled: "Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad." 9 Arthur L. Caplan, of the NYU School of Medicine, writes the book's forward, saying -- in part:

"When Peter Hotez -- an erudite, highly trained scientist who is a true hero for his work in saving the world's poor and downtrodden -- shares his knowledge and clinical insights along with his parental experience, when his beliefs in the value of what he does are put to the test of a life guiding his own child's challenges, then you must pay attention. You should. This book brings to an end the link between autism and vaccination."

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2019-MAR: Fear of measles in New York City suburb:

A measles outbreak in Spring Valley, Rockland County, NY has alarmed many residents and degraded relationship between the ultra-Orthodox Jewish community there and other residents. Scores of people there have become infected with measles recently. Public health officials traced the outbreak to ultra-Orthodox families whose children have not been vaccinated. Public fear has degraded relationships between the Hasidic community and the rest of the population, producing a fear of a rise in anti-semitism.

The first cases of measles in Rockland County involved families who had visited Israel where an epidemic is underway. After the disease spread, unvaccinated students who went to some public schools with low vaccination rates were excluded from attending. This barred about 6,000 students from school during 1018-DEC.

On 2019-MAR-29, county officials took what may be an unprecedented step for any U.S. municipality. They announced a state of emergency and barred unvaccinated persons under 18 years-of-age from public places, including schools, religious buildings, shopping centers, stores, restaurants, movie theatres, busses, etc. 14

Rockland County contains five towns with a total population of slightly over 300,000 people. About 31% of the population is Jewish and includes one of the largest concentration of ultra-orthodox Jews in the U.S.

Aron B. Wieder is a legislator in Rockland County and a prominent member of the Hasidic community. He said:

"The conception that is out there is completely distorted, and that is, that the Orthodox community for the most part don’t vaccinate their children. ... That is not true. The county executive had a moral obligation to point these things out."

During the previous six months, there have been over 17,000 vaccinations using the measles-mumps-rubella vaccine, Between 2018-OCT and 2019-MAR-29, there have been 157 cases of Measles recorded.

Unfortunately, some Jewish information hotlines are feeding misinformation about vaccination -- accusing it of causing autism in children. Ultra orthodox Jews often have no Internet access, and so cannot obtain reliable information about vaccines.

Some readers of a New York Times article posted written comments. Ellen Tabor of New York City wrote:

"This Jewish doctor has had it with people refusing to listen to Science. Whoever they are, if they do not accept Science, do not accept that America is not a bunch of unconnected enclaves (dare I say, ghettos?) but a community of people whose paths cross at random, then they are poor citizens. Some decisions cannot be left to individuals because the harm they cause spreads to the community at large. The refusal to vaccinate is one of these wrong decisions. 'Respect for religious diversity' is no excuse for spreading illness. The State should mandate vaccinations, and I heartily approve of Rockland's decision to require children to be vaccinated, for their protection and for ours. Jewish law mandates health and protecting the body. What all fundamentalist communities do in the name of religion is a sin." 14

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2019-JUN-13: New York State ends religious exemption to vaccine mandates:

Following the most serious measles outbreak in decades in New York City, the primarily Democrat state legislature passed a bill that eliminated the religious exemption to vaccine requirements for schoolchildren. Governor Andrew Cuomo (D) signed it into law immediately. The new law will require each student to show proof that they have had the first dose of each required immunization within 30 days of starting school.

Religious exemptions are also not allowed in Mississippi and West Virginia.

Cuomo said:

"I understand freedom of religion. I have heard the anti-vaxxers' theory. But I believe both are overwhelmed by the public health risk."

The bill was sponsored by Assemblyman Jeffrey Dinowitz. He said:

"I'm not aware of anything in the Torah, the Bible, the Qur'an or anything else that suggests you should not get vaccinated. If you choose to not vaccinate your child, therefore potentially endangering other children ... then you're the one choosing not to send your children to school."

This is a controversial move. Some view the law as restricting religious freedom; others say that public health is being threatened by religious exemptions.

Assemblywoman Deborah Glick, D-Manhattan. said:

"I'm old enough to have been around when polio was a real threat. I believe in science.... Your personal opinions, which may be based on junk science, do not trump the greater good." 15

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References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

  1. Elham Khatami, "Anti-vaccination movement has fueled measles outbreak in Washington, experts say," Think Progress, 2019-JAN-29, at: https://thinkprogress.org/
  2. "Do Vaccines Cause Autism?, History of Vaccines, 2018-JAN-25, at: https://www.historyofvaccines.org/
  3. "Science Summary: CDC Studies on Thimerosal in Vaccines," Centers for Disease Control, undated. File download at: https://www.cdc.gov/

  4. book cover "Immunization Safety Review: Vaccines and Autism," National Academies of Sciences, Engineering, and Medicine, at: http://nationalacademies.org/
  5. "Autism Resources," Immunization Action Coalition, 2017-JAN-21, at: http://www.immunize.org/
  6. Holly Yan, "Superbugs and anti-vaxxers make WHO's list of 10 global health threats," CNN Health, 2019-JAN-21, at: https://www.cnn.com/
  7. Julia Belluz, "This autism dad has a warning for anti-vaxxers," Vox, 2019-JAN-27, at: https://www.vox.com/
  8. Andrew Anthony, "Peter Hotez: ‘What happens when the anti-vaccine movement moves into India?,’ The Guardian, 2018-DEC-08, at: https://www.theguardian.com/

  9. book cover Peter J. Hortez, "Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad," Read reviews or order this book safely from Amazon.com online book store.
  10. "Clark County measles outbreak grows to 16 confirmed cases, 5 suspected,"
  11. Karolina Wv, "Anti-Vaxx Mom Asks How To Protect Her Unvaccinated 3-Year-Old From The Measles Outbreak, Internet Delivers," Bored Panda, 2019-FEB-01 (approx.), at: https://www.boredpanda.com/
  12. Lena Sun & Maureen O'Hagan, " ‘It will take off like a wildfire’: The unique dangers of the Washington state measles outbreak," Washington Post, 2019-FEB-06, at: https://www.washingtonpost.com/
  13. "What are the immunization rates for children in Clark County?," Clark County Public Health, 2019, at: https://www.clark.wa.gov/
  14. Sarah Maslin Nir and Michael Gold, "An Outbreak Spreads Fear: Of Measles, of Ultra-Orthodox Jews, of Anti-Semitism," New York Times, 2019-MAR-29, at: https://www.nytimes.com/
  15. "New York State eliminates religious exemption to vaccine requirements," CBC, 2019-JUN-13, at: https://www.cbc.ca/

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Copyright Ontario Consultants on Religious Tolerance
Author: B.A. Robinson
Originally posted on: 2019-JAN-30
Latest update: 2019-JUN-18

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