Later On

A blog written for those whose interests more or less match mine.

Why Jessica Biel Is Wrong about Science and Vaccines

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James Hamblin writes in the Atlantic:

One morning in 1934, panicked passengers jumped from the deck of the SS Morro Castle as it sank just off the coast of New Jersey. The ocean liner had caught fire, and the passengers had rushed to grab personal flotation devices. But some improperly wrapped the life preservers around their necks. As they fell and hit the water, the torque snapped their spines.

Personal flotation devices save exponentially more lives than they cost. Of the catastrophic boating accidents that occur daily, 84 percent of people who drown were not wearing one. But etch the details of this horrific wreck sceneinto one’s mind, and a person might become a life-preserver skeptic. Our basic tendency toward short-term thinking means we judge risk based on whatever is in front of us. We draw anxiety disproportionately from wherever we happen to be focusing our attention.

The same psychology applies throughout public health. At the moment, much attention in the U.S. is being paid to vaccines—rather than the diseases they prevent. This week, the actor Jessica Biel drew fiery eyes for lobbyinglegislators in California to kill a bill that would standardize the process of exempting children from required vaccinations. Biel, perhaps best known for her leading role in 2006’s The Illusionist, expressed concern for the well-being of a friend’s child. She has responded to accusations of being “anti-vax” by contending in an Instagram post that she “believes in vaccinations,” but wants to protect personal freedom: “I believe in giving doctors and the families they treat the ability to decide what’s best for their patients.”

Like life preservers and everything else, vaccines do come with some fleeting risk of unintended adverse outcomes: mostly rashes or fevers, and in extremely rare cases, seizures. But these risks pale in comparison with those of the diseases vaccines prevent. Before the advent of vaccination, measles alone killed some 6,000 children in the United States every year.

This year has already seen more measles cases than any other since the disease was declared eliminated two decades ago. The trend stems from low rates of vaccination, which are making exemptions from vaccine requirements a flash point. California has triggered a reckoning with why exemptions exist at all—and why belief came to factor so heavily into a question of science. When is a health issue a matter of belief, and when is it simply wrong? When is it so wrong that it’s neglect?

No federal law requires vaccination. But every state mandates that in order to send a child to public school—to have that child sit in close quarters with other children all day, every day—parents must take preventive measures to ensure the child does not carry certain dangerous infections. Requirements are implicit in the legal precedent that withholding vaccination constitutes “medical neglect” of a child. Legally, for example, it’s considered neglect to let a cut on a child’s arm get infected and then refuse antibiotics. If that infection had been airborne, as with measles, declining treatment as a child gasps for air would also be textbook neglect. It has been deemed neglect in cases where infectious diseases could have been easily prevented, but weren’t.

Researchers at Ohio State recently reviewed cases across the country from 1905 to 2016 and found that a majority of the time, refusing vaccination was found to be neglect. There was a curious caveat, though. In states with “religious exemptions,” parents did not have to follow public-health mandates to vaccinate their children against measles and other diseases if the parents cited “genuine and sincere religious beliefs.” The Ohio State researchers found that in these states, vaccine refusal did not constitute neglect—or it was considered neglect only if someone’s belief was deemed insufficiently “sincere.”

Religious exemptions have slowly expanded in the United States, to the point that now, in almost every state, parents can opt out of school requirements—and leave a child open to catching and spreading lethal diseases to other children—if doing so is guided by what the state considers a sincere belief. In such cases, the same behavior is not neglect.

Exemptions have expanded to include “personal or philosophical belief” exemptions as well, which are currently offered in 17 states. When the standard is sincerity of belief, the thinking goes, it shouldn’t have to be drawn from a major religion (or even a minor one).

Accordingly, the number of people taking up belief-based exemptions has been steadily increasing, and rates of vaccination declining. The constitutionality of vaccine requirements is well established, and courts have found states are not obligated to grant religious exemptions. Nevertheless, the overall effect of such respect for the concept of personal belief has been that, gradually, vaccine requirements have become requirements in name only.

The return of measles, though, is forcing a breaking point. In 2015, a measles outbreak was traced back to a single child at Disneyland. California health officials saw that the outbreak happened not simply because of one unvaccinated child, but because only 90 percent of kindergartners in the state were fully immunized. To establish herd immunity for measles, a community needs 94 percent of people on board. . . .

Continue reading. There’s much more, including the rise of rogue doctors who sell immunization exemptions.

Written by LeisureGuy

15 June 2019 at 1:40 pm

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