Dr. Robert Sears vaccine info misleads parents about measles

This article is by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy and the law. 

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

Today, on Friday, January 16, 2015, Dr. Robert (Bob) Sears, a California pediatrician and author of a controversial book on vaccines (critiqued here, pdf, or here by the fine folks at Science Based Medicine) wrote in his Dr. Bob’s Daily and published on his Facebook page that measles is only rarely fatal in developed countries and that serious complications are rare. (In the likely event that Dr. Sears decides to delete his misleading comments, it’s archived here permanently.)

Dr. Sears’s comments were false. And they were irresponsible. In a way that can put people – including children, including his patients – at serious risk. This is not the first time Dr. Bob Sears has made inaccurate claims about a vaccine preventable disease, but on the background of the current measles outbreaks, the risk from his behavior is more imminent and more obvious. It is appropriate to react. Continue reading “Dr. Robert Sears vaccine info misleads parents about measles”

Maine Coalition for Vaccine Choice legislation–bad premises, bad law

This article is by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy and the law. 

Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease.

In the United States, the Centers for Disease Control (CDC) recommend certain vaccines. CDC cannot, and do not, mandate vaccines. However, states can and do require their residents to have received certain vaccines on the CDC recommended schedule in order, most notably, for children to enroll in school. All states, however, also offer exemptions from school immunization requirements, and some – like Maine – offer very easy-to-get ones.

A bill was proposed by Maine legislator Richard Farnsworth adopting an informed refusal requirement before a parent can make use of Maine’s philosophical exemption to send their child to school without the required immunizations. In response, the Maine Coalition for Vaccine Choice (MCVC), an antivaccine advocacy group, proposed its own law, the “Maine Vaccine Consumer Protection Act.” Proposing an alternative law is not inappropriate.

There are, however, two significant problems of the Maine Coalition for Vaccine Choice legislation – the premises underlying the alternative law, and the content of the proposal. The proposal is based on premises that are either simply untrue or inaccurate and misleading. And it’s extremely bad law. Continue reading “Maine Coalition for Vaccine Choice legislation–bad premises, bad law”

Andrew Wakefield keeps trying–another appeal

On September 19, 2014 the Third Court of Appeals of Texas rejected Andrew Wakefield’s appeal against the decision of a Texas trial court that it had no jurisdiction to hear his libel suit against The British Medical Journal (the original article), Brian Deer, and Fiona Godlee. The details of that case and the suggestion that Andrew Wakefield was strategically using litigation to both rally supporters and deter critics have been previously addressed.

Andrew Wakefield had 45 days to appeal the decision to the Texas Supreme Court (Tex. R. App. P. 53.7). That time ended on November 3–an appeal was not filed by Mr. Wakefield within that time. Continue reading “Andrew Wakefield keeps trying–another appeal”

Litigating as “debate” tactic? Wakefield appeal was denied

Andrew Wakefield was wronged

In January 2012 Andrew Wakefield, a British citizen residing in Texas, sued Brian Deer, a British journalist, the British Medical Journal (BMJ), and Dr. Fiona Godlee, the British editor of BMJ, in a Texas trial Court for libel. Wakefield claimed that a series of articles titled “Secrets of the MMR Scare” written by Brian Deer, edited by Fiona Godlee and published in the BMJ were defamatory. The articles detailed serious scientific misconduct by Andrew Wakefield.

On August 3, 2012, Wakefield’s suit was dismissed based on a lack of jurisdiction. Wakefield then appealed the dismissal. On September 19, 2014 the Texas Court of Appeals for the Third District ruled that the Andrew Wakefield appeal was denied (pdf).

The decision itself is focused on issues of civil procedure that may be less of interest to non-lawyers, though these issues are crucially important to litigants and lawyers. But this story is a good demonstration of strategic use of litigation by Andrew Wakefield and an opportunity to discuss the advantages and potential problems of that approach. Continue reading “Litigating as “debate” tactic? Wakefield appeal was denied”

Review of anti-vaccine legislative efforts – 1998-2012

The published article that is the core of this post is a review of anti-vaccine legislative efforts– how the success of the anti-vaccine movement in achieving its legislative goals changed over time. The authors use the term “vaccine critiques”, and I will follow their terminology, though I think the anti-vaccine label fits many of the actors they describe.

The peer reviewed article does two extremely valuable things: describes patterns, and suggests a causal explanation. While the authors are, justifiably, confident in their descriptive analysis, they appropriately warn us that their conclusions about causation are tentative. Their points are, however, very plausible.

This post proceeds in three parts: describing the patterns the authors found, describing their causal conclusions, and asking for a wish-list of further research (an easy enough and somewhat unfair things to do when you don’t have to actually do it).

Note: the authors have expressed their willingness to provide the full paper to individuals, upon request. I recommend it. The paper also states that the database will be made available on request. Continue reading “Review of anti-vaccine legislative efforts – 1998-2012”

Poll: your preferred legal tool for vaccination

adult-vaccinationIn Dorit Reiss’ critical analysis of the legal tools that could be employed to improve vaccination uptake, she outlined six different legal strategies that could be employed. Do you have a favorite? Do you think one might actually work to increase vaccinations? Vote, and comment below if you have other thoughts.

 

 

 

 

 

 

 

Improving immunization rates – what can the Law do? 

vaccine hate debate

Many of us are concerned at the rise of cases of preventable diseases and the role played in that by the decision by a minority of parents not to vaccinate their children. One question is what, if any, effects would legal tool have on improving immunization rates? This article attempts to map out the available tools.

Note that the focus of this article is what the law can do, not what the law should do. The fact that a legal tool is available – i.e. Constitutional, can be enacted or used by the courts – doesn’t automatically mean it should be. I would, in fact, argue that some of the tools discussed here shouldn’t be used in the context of immunization – in most circumstances, forced vaccination and criminal law are inappropriate. But mapping out what’s available seems like a useful first step in the discussion of what the law should do. The goal of this post is to provide a menu of options and a more or less logical way to classify them. My hope is that setting out what’s possible would help us think through what is desirable.

 

Continue reading “Improving immunization rates – what can the Law do? “

Hobby Lobby and religious exemptions – good, bad and ugly

In the recent Burwell v. Hobby Lobby Stores, Inc. (Hobby Lobby) decision, a majority of the Supreme Court ruled that the Department of Health and Human Services (HHS)’s requirement that qualifying employer health plans under the the Patient Protection and Affordable Care Act of 2010 (ACA) include coverage for all FDA approve contraceptives cannot be applied to at least certain corporations stating religious objections.

The Court found that the regulations violated the Religious Freedom Restoration Act of 1993 (RFRA)’s prohibition on burdening exercise of religion. The majority made every effort to make that decision narrow as possible – but it still has concerning implications for the future, and Justice Ginsburg’s ringing dissent raises very important questions.

When the Skeptical Raptor asked me to write about this decision, we intended that I would discuss Hobby Lobby and religious exemptions for vaccines. But this decision is too important to stop there, so while I also address the vaccination aspect, my discussion is about the decision generally.

From my point of view – as a secular individual who believes reproductive freedom is crucial to women’s equality – the decision has some positives, but also much to be concerned about (I hope the analysis will also be useful to those whose views are different from mine, however). It’s not, however, a decision that turns the United States into a theocracy, as some of the more impassioned posts I’ve seen on Facebook suggest. In some ways, actually, just the opposite.

Continue reading “Hobby Lobby and religious exemptions – good, bad and ugly”

Allowing teenagers to choose HPV vaccines – constitutional

It is morally painful when anti-vaccine sentiment goes so far as to put children at risk of disability, suffering and death. But, that is exactly what a letter written by North Carolina attorney and vaccine critic Alan G. Phillips would do. The problem is that in laying out his case against the enactment of legislation that would protect the health and well being of adolescents in New York State he fails to make one.

The New York assembly is considering A497, a bill that would allow adolescents to receive treatment – including allowing teenagers to choose HPV vaccines for prevention of those infections – against a sexually transmitted disease without their parents’ or guardians’ knowledge or consent. The goal is clearly a laudable one; to insure teenagers don’t leave themselves at risk of sexually transmitted diseases or neglect treating one because they are worried about their parents’ reaction.

Or, sadly, in some instances, because they fear seeking permission to get vaccinated from a parent or family member who may be sexually abusing them. By allowing adolescents to consent to vaccines or other treatment on their own, the bill minimizes the potential for serious harm such as liver cancer (from Hepatitis B), anal cancers or cervical cancer (from HPV infections).

Several other states have passed such laws. They are consistent with long-established laws granting greater decision-making authority to minors with regard to reproductive health and contraception. Phillips disagrees. He sent a letter to NY State legislators arguing that the bill violates federal and state laws and should not be enacted. Not so. Here is why. Contrary to his claims: Continue reading “Allowing teenagers to choose HPV vaccines – constitutional”

Court upholds policy denying religious exemption to vaccines

Last week the Federal District Court of the Eastern District of New York rejected a claim brought by three plaintiff families against various aspects of New York’s school immunization requirements. The decision did not include any legal innovation: it was completely based on well-established precedent that schools can deny a religious exemption to vaccines. But it offers a chance to reflect on what that precedent is, why it is in place, and what it means for us.

The take-home point? Our immunization jurisprudence gives states substantial leeway to protect the public health via vaccination requirements, specifically, in this context, by allowing states to decide whether, and under what conditions, to exempt students from school immunization requirements. But states have to actually use that power to achieve anything. By leaving the floor to the passionate, if passionately wrong, anti-vaccine minority, we are allowing them to undermine the right of the rest of us to be free from preventable diseases.

In other words, those who vaccinate need to speak up and make it clear to their elected representatives that they want state law to protect their children – and the community – against outbreaks of preventable diseases. The laws will not enact themselves, and our representatives need to know the public wants this protection, that the public does not want high rates of measles cases or other diseases.

Just like the diseases, anti-vaccine legislative successes are preventable. And just like the diseases, doing nothing won’t prevent them.  Continue reading “Court upholds policy denying religious exemption to vaccines”