Tag Archives: vaccination

How the philosophical exemption was lost

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.

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Missed it by that much

Anne Donahue had a clever plan.

Notice I say “clever,” not “smart.” The Donahue amendment was a last-ditch attempt to derail H.98, the bill that would end the philosophical exemption for childhood vaccinations.

The amendment would have combined the philosophical and religious exemptions, and put more obstacles in the way of those seeking an exemption: reading educational materials, watching a video, having an in-person consultation with a health care practitioner. Donahue argued that these obstacles would achieve the goal of raising immunization rates without sacrificing parental choice.

It was clever because it played on lawmakers’ fears of taking a definitive stand, fears that are always amplified when there’s a loud and focused opposition.

It wasn’t smart because it would have done nothing to raise immunization rates.

I can say that with confidence because if the House had adopted the amendment, it would have been at odds with the Senate. With the Legislature careening toward adjournment and many pressing issues still unresolved, it’s a virtual certainty that H.98 would have been quietly shelved.

Of course, Donahue had to know that.

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The case for vaccination

As the legislature moves ever closer to adjournment (still scheduled for Friday the 15th), one of the unanswered questions is, Will the House take up a Senate-passed bill that would eliminate the philosophical exemption to childhood vaccinations?

If you ask me, I suspect the House will leave it hanging till next year. Lawmakers could plausibly argue that the issue hasn’t gotten a full airing this time around, since the Senate passed the provision as an amendment to a barely-related bill.

Although, on the other hand, no amount of discussion and airing will satisfy the anti-vaxxer crowd, so why not just lance that boil?

We’ll see. But while the issue is still pending, I thought I’d present a short-form version of the argument for vaccination.

Vaccines work.

Well, maybe a slightly longer-form version.

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Bad day to be a pro-science liberal

As reported earlier, the State Senate has passed a bill that would strike the philosophical exemption for childhood vaccines. And unfortunately for my faith in Senate liberals, opposition to the measure was led — on the flimsiest of grounds — by some of the chamber’s leading lefties. To wit, David Zuckerman, Anthony Pollina, and Ann Cummings.

The bill itself faces an uncertain future. The House briefly considered ending the philosophical exemption earlier in the session and did nothing; supposedly, House leadership is disinclined to stop doing nothing, so this whole thing might have been an elaborate shadow play produced, God knows why, by Senate President Pro Tem John Campbell.

(It was he who raised this idea from the dead and allowed it to be attached to H.98, a “housekeeping” bill enacting a bunch of minor changes to various parts of state government including the vaccine registry. Thus the justification for grafting the philosophical exemption ban, Frankenstein-style, to a wisp of a bill. Kind of a crappy way to change the law, but not exactly unusual in the annals of lawmaking. Why Campbell went out of his way to do this in a very busy session, I have no idea.)

The bill passed on a very one-sided voice vote. Before that, there was a standing vote on adding the amendment to the bill; the tally was 18 yes, 11 no.

The “noes” brought together some strange bedfellows: some of the most liberal solons joined some of the most conservative in opposing the amendment.

Preceding the vote was about a half hour of rather weird debate in which some folks I usually admire came up with flimsy pretexts for their opposition. Leading this parade was Zuckerman, who offered a science-free amendment to the amendment.

On the grounds that some children may be genetically predisposed to allergic reactions to some vaccine ingredients, he proposed requiring “quick genetic tests” to screen out the allergic.

My scientist readers may be laughing their asses off right now. A “quick genetic test” to screen for allergies to the, what, hundreds of ingredients in various vaccines? As I understand it, such testing is in the very early stages of development. But even if it were well-established, I doubt it would be “quick.”

Thankfully, the Zuckerman Amendment was shot down on a voice vote.

Cummings then raised the specter of uncounted Vermont schoolchildren being forced into “truancy” because their parents refused to let them be vaccinated. She argued that in a time when student counts are in decline, we shouldn’t do something that might mean more kids are “forced out of school.”

Uh-huh. I can just imagine the legions of parents who would actually take their kids out of school rather than allow them to be vaccinated.

Zuckerman followed the same line, predicting lower student enrollments, higher taxes, and even widespread school closures because so many refusenik parents would keep their kids home.

Pollina doubled down, arguing that we shouldn’t require vaccinations because “people might move out of state” rather than see their kids vaccinated.

Okay, let’s see now. First, all our neighboring states — Massachusetts, New York, and “Live Free Or Die” New Hampshire don’t allow philosophical exemptions. So the claptrap Pollina is peddling is that legions of vaccine refuseniks will uproot their lives and move to a distant state that offers a philosophical exemption. (There are only 18 others that do.)

One of the primary arguments made by exemption supporters is that it doesn’t hurt anybody because so few people actually seek an exemption; less than four percent of Vermont parents have done so. How many of them would take the extreme step of dislocating their lives or home-schooling their kids rather than let them be vaccinated?

It wouldn’t be a mass exodus, let’s put it that way.

Zuckerman produced a map, showing that some small districts have high rates of philosophical exemptions. He said that those schools would be especially vulnerable if exemptions were limited. He contradicted himself, of course, when he argued against the idea that those districts are also especially vulnerable to outbreaks of vaccine-preventable diseases.

Which is it, Senator? No harm (from contagious illness), or catastrophic consequences (in enrollment)?

The three Senators were desperately grabbing at any pretext, no matter how absurd, to preserve the philosophical exemption — without coming right out and saying that they are anti-vaxxers themselves. Or worse, that they support vaccination and are merely placating the anti-vaxxers in their constituencies.

If they’d come irght out and argued against vaccination, at least they would have been intellectually consistent. The closest any of them came to such an argument was when Zuckerman asserted that “there is disputed evidence” on both sides of the issue. Which is the kind of thing we usually hear from the anti-climate change crowd: “There are arguments on both sides, and who am I to judge?”

These are people I usually admire and agree with. Today, I saw a completely different side to them — a desperate, evasive, rhetorically bankrupt side. It wasn’t pretty.

A festival of preconceived notions (UPDATED)

Update: The full Senate has approved H.98 as amended, to end the philosophical exemption. Details below.

Well, the Senate Health and Welfare Committee held a purely-for-show hearing this morning on whether to remove the philosophical exemption for vaccinations. The anti-vax crowd got an hour, and the pro-vax (I call it “science”) crowd got one.

No one’s mind was changed. And the schedule clearly indicated that “changing minds” wasn’t the purpose of the hearing: the committee held a very brief discussion immediately afterward, expressed its sentiment in favor of removing the philosophical exemption, and sent it to the Senate floor for action — immediately after lunchtime. Talk about your fast track: Committee chair Claire Ayer (good to see her back at work, BTW) had barely enough time to grab some lunch and formalize the committee’s findings for presentation to the Senate.

The committee didn’t take a formal vote because technically, all they were doing was reporting to the full Senate on a couple of key questions:

— What are the benefits and/or risks of immunization?
— How does the philosophical exemption affect the efficacy of vaccination?

Although there was no vote, each member stated their positions. Four were in favor of ending the philosophical exemption (Ayer, Jeanette White, Brian Collamore, Dick McCormack) and one was opposed (Anthony Pollina).

It’s widely believed that the full Senate will approve the measure on a pretty one-sided vote this afternoon. But the debate should be interesting, and the “No” votes may include an unusual coalition of the very liberal and very conservative.

The real action will come after today, when the House and Senate will have to resolve their differences. The original House bill did nothing to the philosophical exemption. Which chamber will carry the day? And how vociferous will the anti-vax lobbying effort be?

More on the Senate vote later.

UPDATE. The Senate has approved the amendment to H. 98 ending the philosophical exemption for child vaccinations. The vote on the amendment was 18 for, 11 against, and managed the neat trick of uniting some of the most liberal and conservative members of the body.

The issue now goes, presumably, to a House-Senate conference committee, since the original H.98 didn’t include the philosophical-exemption language.

More on all of this coming later. I think.

New vaccine poll probably accurate, but deeply flawed

A new survey shows strong support for new limits on a parent’s ability to opt out of childhood vaccinations, but it probably won’t do much to move the debate.

The poll was commissioned by Every Child By Two, a national nonprofit that supports vaccinations. It found that 68% of Vermonters do not believe there should be a philosophical exemption available to parents, and that 73% of respondents support changing state law to eliminate the philosophical exemption.

The poll results are probably an accurate reflection of public sentiment (the anti-vaxxer crowd is a noisy minority), but the poll’s value is greatly diminished by the wording of the questions. They almost constitute a push poll — a series of questions designed to elicit a predetermined response.

The first question is objective: “Do you believe that parents should be able to opt out of vaccinating their children for school for philosophical reasons, also known as personal belief exemptions?” 68% say no, 20% say yes, and the rest are unsure. That result is almost certainly valid.

But then the survey grabs respondents by the nose and leads them down a preset path. It brings up the recent measles outbreak centered in California and raises the possibility that it could spread to Vermont. It then highlights the danger to “people with compromised immune systems… for lack of a vaccinated population.”

Then, a leading question, “Now that you are aware that people with cancer and other medical disorders are at risk, are you more concerned about a person’s decision to vaccinate?”

After that comes the clincher: “Should children whose parents have opted not to vaccinate be allowed to attend public schools and licensed daycares, potentially putting other children at risk?” (Emphasis mine.)

The final question asks if you would now support a bill that would allow exemptions for medical reasons only, “and keep the same vaccination requirements as most other states“. (Emphasis mine.)

After all that, support for limiting the exemption rises from 68% to 73%, while opposition falls from 20% to 13%.

I agree with those who sponsored the survey: Vermont’s vaccination rates are falling, the bulk of scientific evidence supports the safety and efficacy of vaccines, and the potential loss of herd immunity poses a serious threat. In these circumstances, I believe we should end the philosophical exemption.  But this deeply flawed poll won’t help the cause.