Op-Ed: Misinformed Dissent Against Medical Advice on Immunizations

The following ediorial appeared in the News & Observer on March 26/27 concering SB 346.

Vaccines have become a victim of their own success. Few doctors today have even seen a case of measles or polio. We’ve become complacent. The recent Disneyland measles outbreak is a wake-up call. Religious or personal beliefs, no matter how sincerely held or well intentioned, are no excuse to martyr children or endanger public health.

A rare bipartisan group of state senators have introduced a modest bill (SB 346) to enact stricter immunization requirements (with a medical exemption) in North Carolina. As currently written, the bill would repeal the religious exemption, revise vaccination requirements to make them more consistent with CDC recommendations, and require all students be screened for severe combined immunodeficiency prior to immunization. This is a step in the right direction, but we should go even further.

The current version of the bill unnecessarily excludes the HPV vaccine (Gardasil 9) which has the potential to prevent approximately 90 percent of cervical, vulvar, vaginal and anal cancers according to the FDA. And it does nothing to address the “home school loophole” in which we don’t verify whether the state’s 98,000 home-schooled students receive any mandatory immunizations at all (Sylva Herald, February 6).

But the reaction to this modest bill was swift. While some saw it as the latest political fight for “religious freedom,” others saw the issue in a more conspiratorial or pseudoscientific frame. Vocal vaccine opponents quickly lashed out at the co-sponsors of the bill on their Facebook pages, and several dozen protestors rallied in Raleigh holding signs comparing mandatory vaccination to Nazi Germany, war crimes and terrorism (WRAL, March 24). The more “reasonable” voices share anecdotes about families who were compensated by the federal no-fault vaccine court for “table injuries” after a vaccination. For them, the science is uncertain, and the issue is one of informed consent, parental choice, and vaccine injury liability.

The problem is our physicians have come to dread informed consent discussions driven by fear, uncertainty, and doubt and a crash course in epidemiology from the University of Google. And to minimize their own liability they increasingly require patients to sign a release to decline medically indicated vaccines. The American Academy of Pediatrics tells us that “vaccines are very safe, but they are not risk free; nor are they 100% effective.” However, they have “eliminated smallpox infection worldwide, driven polio from North America, and made formerly common infections like diphtheria, tetanus, measles, and invasive Haemophilus influenzae infections rare occurrences.” And serious reactions to vaccines are so rare that they are difficult to accurately identify or track. We can only hope that this proposed legislation leads to a more rational, evidence-based public discussion about the true risks and benefits of vaccinations and better informed consent conversations between doctors and patients. Enacting stricter immunization requirements is necessary but not sufficient to save us from misinformed dissent against our best medical advice on immunizations.

Senators Jeff Tarte (R-Mecklenburg), Tamara Barringer (R-Wake), and Terry Van Duyn (D-Buncombe) should be applauded for introducing this bill and starting an important conservation about immunizations and public health in North Carolina. The HPV vaccine and the “home school loophole” still need to be addressed, but we should do so and pass a bill as quickly as possible based on the best medical knowledge and evidence - not on our fears. When it comes to vaccinations, we’re all in the same herd and share in the responsibility for public health.

By William Keener, on behalf of the Secular Coalition for North Carolina.