Same tired anti-vaxer tropes successful before Virginia Commission studying repeal of religious exemption

Same tired anti-vaxer tropes successful before Virginia Commission studying repeal of religious exemption

Current Virginia law allows medical and religious exemptions to school immunization requirements. The Virginia General Assembly's Joint Commission on Health Care recommended making no changes to that law at its meeting this past Wednesday after hearing a good deal of misinformation about vaccines, including a presentation from the grande dame of the anti-vaccination ideological movement herself, Barbara Loe Fisher.

The issue was before the Commission at the request of two legislators, one Democrat and one Republican, who had introduced a bill during the most recent General Assembly session removing religious exemptions as a valid reason for not having a child immunized against vaccine-preventable diseases. However, they withdrew the legislation and requested that the Commission research whether non-medical exemptions should be tightened. The Commission was established in 1992 to research medically-related legislation to ensure that Virginia adopts "the most cost-effective and efficacious" health care policies. 

In addition to addressing the religious exemption, one of the options studied would also have made medical exemptions more specific:

"providing that medical exemptions can only be obtained from a licensed physician and must say what the physical condition of the child is, which vaccines are being exempted, whether the exemption is temporary or permanent and, if temporary, when the exemption will expire."

For a non-medical exemption, current law simply requires that a parent or guardian fill out a form stating that the

"administration of immunizing agents conflicts with the above-names student's/my religious tenets or practices."

Given the fact that immunization is not contrary to the tenets or practices of the vast majority of religions, and no specifics are required concerning what religious objections the signor is invoking, the religious exemption can be effectively exploited as a philosophical exemption in Virginia, a fact noted by the Commission itself. The exemption is a blanket one, even if objection is to only one particular vaccine.

A Commission study, published in August, did an extensive review of the arguments against mandatory vaccination, including a review of the legal issues and the scientific evidence. The study noted that it is well-settled jurisprudence that exemptions are not constitutionally required. It also found that vaccine efficacy far outweighed safety concerns after thoroughly reviewing objections based on the vaccine ingredients thimerosal and aluminum, the discredited vaccination-autism connection, and use of fetal cells in vaccine manufacture. 

One interesting statistic from the study: the chance of a vaccine-related injury is one in one million (compared to, for example, 1 in 12,000 for being struck by lightning). Another:

"of 140.7 million doses of vaccines distributed each year .021% to .036% will result in a complaint to VAERS [Vaccine Adverse Event Reporting System, which does not indicate causation] and .0000878% will result in a complication severe enough to warrant compensation from the VICP [Vaccine Injury Compensation Program]."

Nevertheless, of the 701 comments received by the Commission, 696 of these wanted no action taken, leaving the "religious" exemption in place. The American Academy of Pediatrics (AAP) wanted the exemption removed, as well as tightening the requirements for medical exemptions, one of the few commenters in favor of changing the law. The AAP recently updated its policy to recommend states remove all non-medical exemptions.

Despite the study's exhaustive review of the legal and medical issues, the objectors came up with exactly the same tired old anti-vaccination tropes that had just been debunked by the Commission's report, promoted by exactly the same people who have been spreading vaccination falsehoods for years. The anti-vaccination crowd is constantly moving the goalposts around, sometimes replanting them in the same old holes.

The "Children's Medical Safety Research Institute" (another Claire Dworkin anti-vaccination effort) said its "constitutionally protected freedom of religion is threatened" by removing the religious exemption, even though it is well-settled that there is no constitutionally protected right to refuse to vaccinate your child. And,

"Mandates without exemptions are wrong in the face of unanswered questions, or when safety concerns are validated by the science, especially given that so many children are suffering from chronic illness and disability with no plausible explanations for their cause."

Right – because we don't know what caused these (alleged) chronic illnesses and disability, it must be the vaccines! And, BTW, "concerns are validated by the science" only if you cherry-pick the evidence, and the "unanswered questions" plaguing Dworkin – aluminum in vaccines – have actually been answered, right there in the Commission's own study (see page 25).

The "Center for Medical Freedom" objects to vaccines because:

"they were developed using cell lines that originally were cells taken from electively aborted babies. The vaccines themselves do not contain fetal cells, but there are significant 'residual' biological components from the fetal cells that have been assimilated into the vaccine, including cell proteins and measurable portions of fetal DNA. . . Residual cell parts from murdered unborn children may be rationalized as a scientific necessity by pharmaceutical companies, for the purpose of growing their antigen, but you can never remove the devastating spiritual consequences of such ingredients."

In other words, as our good friend Orac explains, because vaccines contain DNA from a cell line originally derived from an aborted fetus decades ago and now used to grow the viral stocks employed in the manufacture of some vaccines, we must eschew proven measures to protect real, live children from death and disease. That is one weird deity who would impose "spiritual consequences" on a parent who protected her child from disease with a vaccine because it might contain DNA hundreds of cell divisions removed from its source.

And:

"….many religious exemptions are also based on the parent's concern that not enough is done to make vaccines safe as they could be and that they, the parent, not the state, are ultimately responsible to God, for the utmost protection of their child's well-being."

In other words, the Center for Medical Freedom admits that religious exemptions are invoked, not because one's religion prohibits vaccination, but because of the misinformed notion, which has nothing to do with religion, that "not enough is being done to make vaccines safe," which is simply restating the anti-vaccination stance that, because we can't make vaccines 100% safe, we shouldn't require them. Of course, no medical procedure is 100% safe, and, measured by that impossible standard, most of what constitutes the practice of medicine today would fall.

The National Vaccine (Mis)Information Center's objection echoed this position, unsurprisingly, given that the same fabricated reasons are constantly recycled by various anti-vaccination groups:

"doctors cannot accurately predict who is more susceptible to vaccine harm due to genetic, biological and environmental high risk factors. Despite vaccine science knowledge gaps, federal health officials have narrowed medical contraindications so that no family medical history and almost no personal medical history or condition qualified for a medical vaccine exemption."

In addition to pushing the idea that only risk, and not risk-benefit, should be considered, the NVIC wants all sorts of pseudoscientific reasons for medical exemptions to be accepted. The NVIC also wants to protect those physicians who are willing to hand out exemptions without an adequate medical rationale:

"It is wise to protect . . . the legal ability of individual physicians to exercise professional judgement [sic] and conscience when evaluating whether a child should receive a medical exemption to vaccination to attend school."

Of course, no one is trying to "interfere" with a physician's ability to "exercise professional judgement" by requiring him or her to "say what the physical condition of the child is, which vaccines are being exempted, whether the exemption is temporary or permanent and, if temporary, when the exemption will expire." Indeed, that type of information would be included in the child's medical chart by a competent physician.

As for a physician's "conscience," the NVIC apparently wants to create a new legal right where none exists: one which grants the physician a "right" to give out medical exemptions based, not on the child's actual medical condition but – what? – because the parents don't want their child to be vaccinated? Because the physician has fabricated reasons not to vaccinate that have nothing to do with medical science?

The Virginia Department of Public Health (VDH), which also weighed in, essentially punted on the issue. Because state exemption rates (1.1%) and the morbidity of vaccine-preventable diseases are low, the Department recommended that the law remain as is. However, the Department did admit there was some utility to removing the state's one non-medical exemption:

"religious exemption rates, especially for private schools, are continuing a long term upward trend, it may be reasonable to take action now to address the issue before it becomes a problem."

The Department also prefers that the statutory language for medical exemptions remain the same, despite the AAP's support for a change. The Department noted that the proposed changes "would not allow physician discretion to defer vaccines based on the medical condition of the child." It defies logic that a position supported by the AAP would not allow deferring vaccines if a valid medical reason exists. This leaves one to assume that the Department thought allowing physicians to fudge on the medical evidence by permitting a fabricated "too many, too soon" schedule was preferable to preventing the fiction that a deferred schedule was warranted altogether if that meant children would be immunized, even if not on schedule,

Despite the incredibly favorable risk-benefit ratio of vaccines, and the fact that there is no constitutionally-protected right to expose one's child to vaccine-preventable diseases by refusing to vaccinate him, it is unlikely that a bill removing the religious exemption and tightening the medical exemption will be introduced in 2017, much less pass. That would likely take a Disneyland-type outbreak in Virginia. Of course, then it's too late. 

Points of Interest 1114/2016
Points of Interest 11/12/2016

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