A few weeks ago, the state legislature had apparently decided not to open the Pandora’s box of vaccination policy. The general feeling was, let’s let the 2012 law play out a while longer and see where it goes.
And then, for reasons still unexplained, a couple of key state Senators (Kevin Mullin and John Campbell) grabbed that box and threw it open. They amended a barely-related Health Department housekeeping bill, H.98, to include an end to the philosophical exemption on childhood immunizations. The Senate Health Care Committee gave it a mere two hours of hearings, one for and one against; it sailed through the committee and the full Senate.
Even so, it seemed likely that the House would let the amended bill lie. Leadership decided to have the House Health Care Committee hold hearings on H.98, even though the bill was never officially given to that committee. Those hearings were quickly scheduled, and they were quite extensive. At the time, it seemed like a ploy to run out the clock. Even more so as the hearings continued through the penultimate week of the session.
Funny thing, though: the more time passed, the more things seemed to shift entirely. By the end of last week, the momentum was clearly on H.98’s side. A House vote seemed certain and passage seemed likely, if not a sure thing. Monday’s public hearing was a chance for all parties to sound off, without actually affecting the process.
Which brings us to Tuesday, covered in my previous post. The Donahue amendment lost by the narrowest of margins, and then H.98 passed the House with ease.
This time, I’m here to explain why this happened. Not how it happened; you’d have to get John Campbell and Shap Smith into a rubber room and fill ’em full of truth serum to find that out. As for the why, here’s my two cents. Or three, if you prefer.
1. The widespread belief that Vermont’s vaccination rates are dangerously low. You heard it over and over again during Tuesday’s debate: even lawmakers reluctant to change the exemption rules were very concerned that the state (or at least pockets thereof) could see outbreaks of preventable diseases at any time.
State health officials carried a uniform message: Vermont ranks near the bottom in immunization rates. Surrounding states without a philosophical exemption (all of New England except Maine) had substantially higher rates. Research shows that educational efforts like those codified in our 2012 law are ineffective. Vermont’s rates had certainly not improved since 2012, and the trend is in the wrong direction.
2. An overwhelming sense of fatigue with the issue. Many Representatives who didn’t want to repeal the philosophical exemption wanted something else even less: another round on the issue in 2016. That would have been a certainty if the House had either failed to pass H.98, or passed a substantially different version.
The fatigue became more palpable as the Health Care Committee hearings went on. Members were tired of the same arguments and even more tired of all the drama, and they definitely wanted the deluge of phone calls and emails to stop. Monday’s tense, emotional, standing-room-only public hearing may have been the last straw.
By itself, “fatigue” isn’t a good reason to vote one way or the other. But it was combined with a sense that all the arguments had been made and there was no point to prolonging the agony. At one point during the floor debate, the usually quiet Warren Kitzmiller rose to say he doubted that anyone’s mind had been, or would be, changed, and it was time to just vote already. (For the record, Kitzmiller voted against H.98, so he wasn’t on the winning side.)
3. The vaccine-choice forces couldn’t stop themselves from overreaching. Their stated goal was preserving parental choice, but they consistently promoted the anti-vaccine agenda. If they could have stuck to the choice argument, they would have won. But when they attacked vaccination itself, they undercut their own case.
How so? First, they affirmed the narrative (from people like me) that they were fringey cranks. Bringing in people like Robert F. Kennedy Jr. almost certainly hurt their cause. Another anti-vax witness, Dr. Toni Bark, was almost a caricature of the True Believer: she talked endlessly, almost babbling at times, and her views on vaccination were clearly extreme. (The witnesses who helped the cause were the individual Vermonters who expressed concern — warranted or not — about safety and their ability to choose.)
Their rhetoric amplified concern number 1 — that vaccine rates were going in the wrong direction. Although their current argument was to preserve choice, they made it clear they thought vaccination itself was evil. Their ultimate goal was to convince more people to opt out. And that fed into the concern about Vermont’s low vaccination rate.
The philosophical exemption was acceptable to most lawmakers, but only as long as its use was limited. The more parents who sought the exemption, the more of a public health threat it became.
Their zeal also amplified factor 2, the widespread fatigue with the issue. The more they talked, and wrote, and called, the more lawmakers wanted an end to the whole thing.
The vaccine-choice advocates couldn’t help themselves, because they honestly believe that vaccination is a profit-making venture of Big Pharma and a fundamental cause of social and medical ills. They can’t help but express their ardently-held beliefs. But in doing so, they undermined their own cause. They themselves played a key role in turning the tide against the philosophical exemption.