Vaccine-preventable diseases: out the front door, in the back door?

Vaccine-preventable diseases: out the front door, in the back door?

You could become easily dismayed by scanning the list of pro-CAM bills over on the "Legislative Updatespage.  Licensing naturopaths as primary care providers, giving prescribing privileges to chiropractors, and so on, leaves one with a distinct impression that none of the state legislators who introduced these bills, or who will vote for them, would know science if it bit them on the behind.  

So let me cheer you up a bit.  It seems that when it comes to protecting children from vaccine-preventable diseases, the state legislatures are starting to get it. A review, published in a recent edition of JAMA, found that not one of 36 bills either creating or expanding personal belief exemptions from school vaccination requirements introduced between 2009 and 2012  passed. None!  At the same time, 3 of 5 bills tightening exemptions did pass. One of these was in Washington State, which we'll return to in a minute.

You'll also be pleased to learn that the survey was based on the database of an organization called the Immunization Action Coalition, a terrific group dedicated to providing accurate, science-based information to the public and health care professionals.  It is a much-needed antidote to the celebrity-fueled, fear-mongering, science-free attempts of the anti-vaccination crowd to hype imaginary vaccination dangers. 

Only Mississippi and West Virginia do not allow anything other than medical exemptions from school vaccine mandates.  The rest of the states either allow religious belief exemptions or both religious and personal belief exemptions.  While the religious belief exemption is easy enough to slip by, the personal belief exemption is so porous it can serve to exempt pretty much any child whose parents will take the time to fill out a form.  Some states do require that parents go through some sort of education about the importance of vaccination.  But the firm believer will remain undeterred. 

 

Perhaps it is faint praise to congratulate legislatures for not making it even eaiser to exempt children from vaccination.  After all, non-medical exemptions should never have been passed in the first place.

Vaccine exemption legislation is not CAM legislation per se.  But CAM and anti-vaccination go hand-in-hand.  A study of Washington State insurance records found that children who saw chiropractors were less likely to be vaccinated against vaccine-preventable diseases.  Even worse, children who saw naturopaths were also less likely to be vaccinated and more likely to have actually acquired a vaccine-preventable disease. (Naturopaths are licensed as primary care physicians in Washington.) Both chiropractic and naturopathy are historically opposed to vaccination and none of their U.S. schools or trade associations will come out fully and unequivocally in favor of vaccination.  Instead, they hide behind vague statements about parents being "fully informed" and free to make thier own choices. 

One likely ingredient in the successful pushback against exemptions is the fact that medical professional organizations and public health officials are all over it when exemption bills come up.  To their credit, organizations like the American Academy of Pediatrics will flock to the state capitol to testify against these bills.  Unfortunately, the same can't be said for pro-CAM legislation.  

Which brings us to another news item and the disturbing, and growing, disconnect between medicine and science.   Points of Interest recently featured a Bastyr University announcement that it is expanding its "integrative oncology" services. (Bastyr awards, among others, degrees in naturopathy, Ayurvedic "Sciences" and acupuncuture.) As the article proudly announces, Bastyr's research is funded by NCCAM and it "has partnered with Fred Hutchinson Cancer Research Center and the University of Washington on groundbreaking cancer studies." 

I wonder how long it will take for one of these Bastyr clinic cancer patients to come into contact with someone who is infected with a vaccine-preventable disease?  If you search Bastyr's website for immunization information, you'll get a decidedly lukewarm response to the idea of vaccination against infectious diseases.  There is certainly no unequivocal statement that the public should follow the CDC-recommended schedule.  For example, here's a dicey bit of immunization advice currently available if you search for information about vaccination:

If you are a fairly healthy individual who is not at high risk of developing a life-threatening case of pneumonia, I don't believe you need to get a flu shot. 

The author does allow that anyone who is on chemotherapy or other cancer drugs "might also benefit" from a flu shot.  Might?  And here's the description of a book on vaccinations recommended for parents by Bastyr:

Deciding whether or when to vaccinate a child is one of the most important--and most difficult--health-care decisions a parent will ever make. The recent increase in the number of vaccinations recommended and the concurrent controversies about whether vaccinations are safe or even effective have left many parents confused and concerned. 

The book, written by a midwife and "herbalist," also boasts information on how to "boost" your child's immune system with substances such as homeopathy.  

As some state legislatures belatedly come to the realization that immunization exemptions may not be such a good idea, these same legislatures let immunization opposition in the back door in the form of naturopathic licensing legislation.  And, of course, there are the good Washington oncologists who, while undoubtedly in favor of vaccination, will send their patients over into the virus-friendly atmosphere of Bastyr.  Because if there is anything an oncology patient needs more than an infectious disease-free environment, it is certainly "integrative oncology."

Points of Interest: 3/5/2014
Needless Death