Pro-vaccine physicians terrorized by anti-vaxxer hate speech

pro-vaccine

The LA Times reported recently that pro-vaccine physicians have been 
“terrorized into silence” by hate-filled online harassment from anti-vaccine activists. Since they have almost no scientific evidence supporting their anti-vaccine ignorance, the anti-vaxxers must resort to hate speech to try to shout out the facts about vaccines.

For years, I have watched some of my favorite writers, like Dorit Rubinstein Reiss (who frequently posts content to this blog) and the insolent Orac (yeah, most of us know who Orac is, but it’s hysterical to read articles where the science deniers think Orac is me, Dr. Paul Offit is me, or Dr. David Gorski is me. Oh, wait, Dr. Offit is me again?

But what is not very funny is the unceasing, uncivilized, and ignorant attacks on pro-vaccine physicians. These physicians are promoting vaccines not for fame or fortune, but as a critical public health statement. They don’t deserve this. Continue reading “Pro-vaccine physicians terrorized by anti-vaxxer hate speech”

Anti-vaccine trolls use internet to connects the dots and always get it wrong

This blog, and by extension this writer, has been skewered by anti-vaccine trolls so many times, it has become a badge of honor. I mean, I don’t really take myself too seriously, the whole point of this blog is mock pseudoscience.

Let’s see. I’ve been accused of being a shill of Big Pharma (about a thousand times), Kaiser Permanente, and Monsanto (another thousand times). These anti-vaccine trolls certain believe I must be rolling in the gold bullion from these companies.

I’ve been called a sock puppet of Dorit Rubinstein Reiss (who’s a nice person, a description that could be used for me only if you’re stoned). I’ve been called an astroturfer by the antivaccine “journalist,” Sharyl Attkisson.

One more silly accusation and I believe I get the skeptic merit badge for Laughing at Ad Hominem attacks. I’ve been working hard on it thanks to the anti-vaccine trolls.

But most of the junk science that comes my way is fairly easy to mock. It writes itself, as they say. Frankly, there’s just too much out there on the internet. I bet most skeptics ignore 99% of the silliness on the internet. I mean Natural News would require 24/7 debunking.

So that brings me to something that showed up on my email this morning. It’s a blog post, by a blogger named Marco Cáceres di Iorio, entitled “Internet Trolls Attack Anyone Resisting Vaccine Party Line.” Read away if you want, it’ll probably be the most hits his blog will get ever.

Usually, I ignore this stuff. But hey, he called me “troll.” Oh no. Except, this new member of the anti-vaccine trolls connected the dots in such a way that I’m not sure if I should feel honored. Or insulted. Possibly both? What Continue reading “Anti-vaccine trolls use internet to connects the dots and always get it wrong”

Another SB277 lawsuit rejected – anti-vaccine Voice for Choice loses

SB277 lawsuit rejected

On 20 November 2018, the California court of appeal for the third appellate district, in a strong decision, rejected a challenge by the anti-vaccine organization A Voice for Choice and three individual plaintiffs to SB277, California’s law removing the personal belief exemption to school immunization mandates. The decision included scathing criticisms of the arguments and a powerful endorsement of school vaccines mandates. This article will examine yet another SB277 lawsuit rejected by courts.

Background

The first iteration of the lawsuit in question here was first discussed in November 2016, and it was then filed with a federal district court. After the initial rejection of that lawsuit, it was refiled with a state court, and after that was rejected, the plaintiffs appealed. 

The court opened by stating that “Plaintiffs’ arguments are strong on hyperbole and scant on authority.” Its decision drew extensively on the California Court of Appeal, Second Appellate District’s decision in Brown v. Smith, and on the federal district’s court decision in Whitlow v. California (discussed here). 

The Court opened with the California Supreme Court decision in Abeel v. Clark (1890) 84 Cal. 226, in which the Court upheld a school immunization requirement, and the extensive jurisprudence, state and federal, that upheld vaccines mandates since. It reminded us that for over a century, courts upheld school mandates in the face of challenges, and cited Brown v. Smith to explain that “[t]his is another such case, with a variation on the theme but with the same result.” 

Setting the ground, it explained the act, and its purpose “to provide “[a] means for the eventual achievement of total immunization of appropriate age groups against [certain] diseases.” (§ 120325, subd. (a).)” It explained the need for the act – the measles outbreak centered on Disneyland and the warning it provided that vaccine rates are too low, and exemption rates increasing too fast, and in some areas are dangerously high.

It set out the standard of review for a demurrer. A demurrer is a claim that the complaint does not raise a cause of legal action – in some jurisdictions, it would be titled a motion to dismiss. Because sustaining – accepting – a demurrer means a case is kicked out without going through fact-finding, without plaintiffs having their full day in court, the standard is pretty high, and appellate review is aggressive: 

We review the complaint de novo to determine whether it alleges facts sufficient to state a cause of action. For purposes of review, we accept as true all material facts alleged in the complaint, but not contentions, deductions or conclusions of fact or law. We also consider matters that may be judicially noticed.” (Brown v. Smith, supra, 24 Cal.App.5th at p. 1141.) We may affirm a trial court judgment on any basis presented by the record whether or not relied upon by the trial court. 

De novo means the appellate court is not bound by the finding and conclusions of the court below but reevaluates the claims from scratch. As the court explained, it is assuming factual claims are true, though if there’s judicial notice of well known, external facts, it can reject clearly implausible claims.

Note that a demurrer is usually sustained with a “leave to amend” because the court thinks it is possible for the plaintiff to state facts sufficient to constitute a cause of action. In this case, the demurrer was sustained without leave to amend because the court believes that the plaintiffs’ claim is so weak that no amending of the complaint will solve the fundamental problems.

SB277 lawsuit rejected – substantive due process

A substantive due process claim argues that the government overstepped in interfering with individual rights, beyond a legal standard. 

Here, there are three parts to this argument, as addressed by the Court – plaintiffs claim that SB277 violates their right to bodily autonomy, conditions their right to attend school on giving up bodily autonomy, and interferes with their parental rights. The court rejected the argument both because plaintiffs did not provide any legal authority supporting it (they couldn’t – there are none) and because they did not succeed in convincing the court that the law violates either of the possible legal standards. A substantive due process claim that affects a fundamental right (like bodily autonomy) would be held to the high standard of strict scrutiny. Under it, a law is “upheld only if it is narrowly tailored to promote a compelling governmental interest.” In other claims, a much lower bar – rational-basis review – applies. The court found SB277 would meet either standard. The court said that:

“It is well established that laws mandating vaccination of school-aged children promote a compelling governmental interest of ensuring health and safety by preventing the spread of contagious diseases.”

It cited multiple cases upholding vaccine mandates and criticized the plaintiffs for not addressing them and responding to them. I’m not sure that’s completely fair – the plaintiffs did try to address at least one of the cases the court pointed to, Zucht v. King and the decision later responded to that. But the court is completely right that plaintiffs did not succeed in providing a convincing reason to reject that abundant jurisprudence. 

Addressing bodily autonomy, the court rejected plaintiffs’ effort to argue that the vaccine cases are before cases upholding bodily autonomy, and therefore invalid. The court said: “We are aware of no case holding mandatory vaccination statutes violate a person’s right to bodily autonomy.”

I agree with the court’s conclusion, but I would support it differently. First, at least one famous bodily autonomy case – Schloendorff v. Society of New York Hospital  dates to 1914, while Zucht is a 1922 case, so the timing does not fit the plaintiffs’ claim. But more importantly, while I think the bodily autonomy cases would be important if a state were to impose an adult mandate, that’s not the issue here. These are children who are required to be vaccinated – and bodily autonomy does not work quite the same way. The children are not capable of making autonomous decisions, and the issue is not their autonomous choice not to be protected from diphtheria, measles, hib, etc. – it’s their parents’ choice not to protect them.

There are other arguments against the cases, but I want to keep this short, so I will not go into detail about them. 

The more tricky prong of the strict scrutiny standard for this purpose is that a law limiting rights has to be narrowly tailored. Here, plaintiffs – as they should have – argued that there are other, less aggressive means to prevent outbreaks. And the court – correctly, in my view – rejected it, drawing on Brown v. Smith and Whitlow again. The court pointed out that the state’s objective – total immunization of the relevant age groups – is ambitious, and lesser means won’t achieve it. It then quoted language from Brown strongly endorsing mandates (pdf):

“This argument fails, of course, as compulsory immunization has long been recognized as the gold standard for preventing the spread of contagious diseases. As is noted in the legislative history, studies have found that ‘when belief exemptions to vaccination guidelines are permitted, vaccination rates decrease,’ and community immunity wanes if large numbers of children do not receive required vaccinations.”

The court gave short shrift to the plaintiffs’ claim that SB277 violates privacy, because when dealing with health matters, the review is under rational-basis review, and the desire to prevent dangerous diseases trumps it (to those interested in a longer analysis, I engaged in one here).

Probably the strongest claim plaintiffs had is the claim that SB277 violates the right to education – though even that is not particularly convincing. But the Court rejected this claim easily, too, because the two previous decisions – Brown v. Smith and Whitlow – already dealt with the issue. The court found that the precedent enshrining the right to education – Serrano – did not apply, for two reasons.

First, it was not applicable on the facts:

[quoting Brown] “Serrano struck down a public school financing scheme as violating equal protection guaranties ‘because it discriminated against a fundamental interest — education — on the basis of a suspect classification — district wealth — and could not be justified by a compelling state interest under the strict scrutiny test thus applicable.’ ” (Brown v. Smith, supra, 24 Cal.App.5th at p. 1145.) Like the plaintiffs in Brown, the plaintiffs here “cite Serrano to support their claim that Senate Bill No. 277 . . . violates their constitutional right to attend school, but fail to explain its application here. There is no ‘suspect classification’ underlying Senate Bill No. 277.”

Second, and just as important, even assuming the statute was held to strict scrutiny because education is a fundamental right, the court already explained that it can pass strict scrutiny. 

Finally, in a very short statement, the court agreed with the Brown court that SB277 did not violate religious freedom. 

In short, this decision agreed with previous jurisprudence that school mandates are constitutional and valuable.

SB277 lawsuit rejected – what next?

A Voice for Choice has two choices. It can accept the loss and go home, or it can try and appeal to the California Supreme Court. Not appealing has advantages: this is an unpublished decision, and as such, does not serve as a precedent – it cannot be cited or relied on. It is, however, binding on the parties to the case. A Supreme Court decision, if one happens, could well echo the strong endorsement of mandates, based on strong evidence that they work and an extensive jurisprudence, and would change the legal situation for the worse – it would end the issue in terms of California law (since the claims in this lawsuit are mostly state claims, the California Supreme Court is the last word on them). On the other hand, not appealing gives up a chance to change the legal situation, leaves SB277 intact, and leaves in place the other appellate court decision – Brown v. Smith – supporting it. 

If A Voice for Choice appeals, the Supreme Court will get to decide whether to take the case. The California Supreme Court takes very few civil law cases, and this one is based on extensive jurisprudence rather than breaking new ground – so there is a strong chance it will not be taken up. On the other hand, the court may want to address the question of immunization mandates in current times. 

We will see. 

8 December 2018 Update

The state requested that the court’s decision be published. On December 6, 2018, the court granted the request, giving the decision precedential force.

14 March 2019 Update

The Love Plaintiff requested the Supreme Court of California to review the case. The California Supreme Court, like the majority of the highest courts in the states, generally has discretion on whether or not to hear cases. On 13 February 2019, the Supreme Court declined to review the case, making the court of appeals decision final.

Christopher Bunch – another tragedy blamed on the HPV vaccine

christopher bunch

On 14 August 2018, fourteen-year-old Christopher Bunch died from acute disseminated encephalomyletis (ADEM), leaving his loving, devoted family reeling. The family blamed his death on the HPV vaccine that Christopher received, and they were quickly surrounded and courted by anti-vaccine activists.

My heart goes out to Christopher’s family. I followed the case since he was in the hospital, hoping and praying with them for a good outcome, and I feel their heartbreak. I was also deeply impressed by their initial reaction, which was to create a positive legacy for Christopher, making him visible and famous.

I would rather not write about this, which is why this post is so long after the fact. But Christopher’s death is since being used to try and scare people away from HPV vaccines or vaccines generally, putting others at risk of cancer and death. With very little basis: the timing and the epidemiological evidence do not support a link between Christopher’s death and HPV vaccines. Christopher Bunch deserves a better legacy than that. Continue reading “Christopher Bunch – another tragedy blamed on the HPV vaccine”

Anti-vaccine liability – should they pay for the harm they cause?

Recently, Professor Dorit Rubinstein Reiss wrote an editorial in the San Francisco Chronicle about anti-vaccine liability – should parents who refuse to vaccinate their children be financially liable for the harm they cause to others? Professor Reiss lays out a compelling case as to why it should happen.

Professor Reiss, a frequent contributor to this website, is a Professor of Law at the University of California Hastings College of the Law (San Francisco, CA). She writes extensively in law journals about the social and legal policies of vaccination–she really is a well-published expert in this area of vaccine policy. Additionally, Reiss is also a 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.

She has written other articles about anti-vaccine liability – here and here. This is an issue that many of us think about when anti-vaxxers put not only their own children but also many others, at risk of dangerous diseases. 

Continue reading “Anti-vaccine liability – should they pay for the harm they cause?”

Anti-vaccine terrorists – maybe it is the time to call them that

anti-vaccine terrorists

In a recent article in Without a Crystal Ball on Patheos, Katie Joy, an anti-pseudoscience writer after my own heart, laid out a powerful case to label vaccine deniers as anti-vaccine terrorists. I think I’m on board. I know, it’s tough but deserving.

Katie wrote:

Fringe conspiracy-theorist terrorists, called ‘anti-vaxxers’ are multiplying so fast that some counties, cities, and states have vaccination rates below community or ‘herd’ immunity levels across the U.S. With more parents buying into the  conspiracy that vaccines contain toxins, cause autism, and are unsafe, children, the elderly, and immunocompromised are suffering. These people need to be called out for what they are; anti-vaxxers are terrorists that kill and harm our children.

Even if you oppose anti-vaxxers, you might think it’s too extreme to use the “terrorist” label in this case. I do not. Though there is no single agreed-upon definition of terrorism, most agree that it consists of using fear as a tool to achieve political or social change while disregarding harm done to others in the process. I think anti-vaxxers meet every part of that definition.

After giving it much thought, I think I’m going to have to change my description of these nutjobs from anti-vaccine religious extremists to anti-vaccine terrorists. Maybe it’s harsh. But it’s deserving.

I want to make a case for this “anti-vaccine terrorists” label. Maybe you’ll agree, or maybe you’ll think I’m over-the-top, even if you’re pro-science. But these vaccine deniers are putting children at risk of harm, it’s becoming difficult for me to excuse their lies and misinformation.  Continue reading “Anti-vaccine terrorists – maybe it is the time to call them that”

Measles causes SSPE – child pays price for anti-vaccine misinformation

On 7 March 2015, a four-year-old Italian girl dubbed “Clara” by the media (real name hidden to protect her privacy) died from subacute sclerosing panencephalitis (SSPE), a complication of measles, after prolonged suffering (the girl was in the hospital in which she died for over 4 months, and has been sick at least since last October, and hospitalized elsewhere). Continue reading “Measles causes SSPE – child pays price for anti-vaccine misinformation”

HPV vaccine fear mongering in an anti-vax book – a critical review

hpv vaccine

In 2018, “The HPV Vaccine On Trial: Seeking Justice For A Generation Betrayed”, was published. It was written by attorneys Kim Mack Rosenberg and Mary Holland, and Eileen Iorio described as a “health coach.”

As the title suggests, the book concluded that the HPV vaccine (from the first vaccine, licensed in the U.S. in 2006) was a betrayal, because it was unjustified, harmful, and with no health benefits. As the authors’ first chapter lays out, their opinion is in tension with statements from health authorities and cancer authorities worldwide – and goes against a large amount of data.

It is no exaggeration to say that the book is ill-founded, misleading, and anti-vaccine to the core. HPV vaccines have been especially signaled out by anti-vaccine activists since their creation. This book draws on anti-vaccine claims made over the years, including most of the older anti-vaccine tropes (claims, by the way, that are not always consistent with each other – for example, is the problem aluminum in vaccines, or a novel and different adjuvant?) and offering new (and ill-founded – see the discussion of chapter 8 below) ones.

To explain the problems with it, three of us divided the subjects in the book, and are reviewing it as a team. A review by Dan Kegel, who has an undergraduate degree in biology from Caltech and maintains a comprehensive site with the data on HPV and HPV vaccines, is found here. A review of the chapters on autoimmunity, aluminum, and a few more by John Kelly, a career biochemist, and molecular biologist and a survivor of HPV+ cancer, will be added later.

The book has four parts. I will not cover all of it, out of concern of making this review overly long. But I will raise some of the highlights. I am putting chapter 2 and 15 aside to address in my discussion below of the general use of anecdotes. Continue reading “HPV vaccine fear mongering in an anti-vax book – a critical review”

The motives of anti-vaccine voices on social media

anti-vaccine voices

A common claim of anti-vaccine voices is that pro-vaccine voices on social media speak for “industry” (apparently, lumping all doctors, health insurance companies, HMOs, health departments, and yes, vaccines manufacturers, into one big industry, and assuming that all those speaking for vaccines are part of that industry). On the other hand, they try to claim that they are simply parents, with no ulterior motives for speaking up (downplaying the part that vast majority of parents are pro-vaccine).

This post provides a different perspective. There are many reasons anti-vaccine voices are so loud – at least some are not as innocent as what is claimed. This post draws on my observations in over 5 years of encountering and listening to anti-vaccine activists.

Anti-vaccine people can feel passionately and speak up about their beliefs out of ulterior motives, including financial or emotional motives. Let’s take a look at the motives of the anti-vaccine voices. Continue reading “The motives of anti-vaccine voices on social media”

Vaccine exemptions and private schools – what are the facts?

vaccine exemptions

As measles outbreaks – centered on unvaccinated children – continue to pop up in areas with low vaccine rates,  one approach private schools and daycares reach to is keeping out unvaccinated children. An Ohio Jewish school announced it will not accept unvaccinated children, and I know other private facilities are considering this. So what does this all mean with respect to vaccine exemptions within private schools?

Note that this is a separate issue than the question of whether unvaccinated children can be kept home during an outbreak. All states have a provision in law to keep unvaccinated children at home during an outbreak, and some of the affected states – like New York – are doing that.  Continue reading “Vaccine exemptions and private schools – what are the facts?”