A bill before the Maine Legislature is embroiled in two classic arguments. How do we use science to support political decisions, and how do we balance our individual rights versus those of society?
Hundreds of Mainers showed up in Augusta last week to testify on LD 798, An Act to Protect Maine Children from Preventable Diseases by Repealing Certain Exemptions from the Laws Governing Immunization Requirements. The exemptions the bill would repeal are those based on “religious or philosophical beliefs.” The bill does continue to provide exemptions for those with medical conditions that make vaccination contraindicated.
The impetus behind the bill is outbreaks of childhood diseases thought to be eradicated, or nearly so, in the United States. In 2000, measles was considered eliminated in the United States, but in 2019 in Washington state, more than 60 cases of measles were identified, more than the average number of cases reported in the entire country in a year. Fifty-four of those affected had not been immunized.
At one time, fewer than 20 cases of mumps were reported each year in the United States. In 2006, more than 6,000 cases were reported. A chicken pox outbreak occurred in 2012 in Indiana, sourced to an unvaccinated child. Here in Maine, we have the dubious distinction of the worst pertussis (whooping cough) rate in the nation. Reported cases more than doubled in month-to-month comparisons from last year to this. The greatest number of cases so far this year were in Hancock County.
An article in 1998 linked vaccinations to autism. Even though later discredited, it is still cited as the rationale for significant numbers of parents to opt out of vaccinations for their children, despite a study through the National Institute of Medicine at the National Institutes of Health finding no “causal association between MMR vaccine, or any other vaccine or vaccine constituent, and autism.”
The link between vaccinations and autism, particularly with the MMR (measles, mumps, rubella) vaccine, is labeled “critically flawed” by Children’s Hospital of Pennsylvania (CHOP). In a vaccine safety publication, CHOP distinguishes between the terms “safe” and “harmless.” The latter, taken literally, is a test few life activities could pass. “Having been preserved from a real danger” is the safety definition CHOP finds most applicable, in that “a vaccine’s benefits must clearly and definitively outweigh its risks.”
Vaccines cannot be called 100 percent harmless, as there are certainly documented, untoward effects for those vaccinated. However, most are mild and innocuous, especially as compared to the effects of the diseases they prevent. Risks inherent in those diseases are far greater.
The other part of the vaccination debate is whether government has a right to intervene in a parent’s decision not to vaccinate his child. Parental rights are among the most protected in our society, but what about the rights of the rest of our kids to attend a school where the students are least likely to transmit childhood diseases by virtue of having been vaccinated?
Does a child with a known communicable disease have the “right” to go to school, putting all the other students at risk? Most often, symptoms become obvious only after a child has actually contracted the disease. They are exposing their friends, babysitters and schoolmates in the early days, already contagious but without the cough, fever or spots to make it apparent.
For the public hearing last week, 527 items were filed in testimony. All the testimony is posted online. There were pleas to require broad vaccination to protect those who, for medical reasons, cannot receive certain vaccines, as well as parents who felt that vaccination would adversely affect their children and opposed the bill.
Most Maine medical leaders were fully supportive. They are worth naming: The Maine Hospital Association, the public health director for the city of Portland, the Maine Children’s Alliance, the pediatric hospitalist at Maine Medical Center, the Maine Nurse Practitioner Association, the Maine Primary Care Association, the American Nurses Association, the American Medical Association, the American Academy of Pediatrics, the Maine Medical Association and other medical, educational and civic organizations.
Several health care providers, including a few physicians, did oppose the bill. Some opined that it is the pharmaceutical companies and the health care industry that promote vaccinations to enhance their bottom lines. The Maine Pharmacy Association was among those testifying in support.
It is difficult, if not impossible, for the average citizen to follow the detailed arguments and statistics presented by both sides. Most parents want nothing but what is best for their children, and most have decided that the benefits of immunization outweigh the risks. Unvaccinated children are also protected by those children who are vaccinated. The weight of the argument is in favor of vaccinating our kids for a healthier society.