Massachusetts influenza vaccine mandate withdrawn – an analysis

Massachusetts influenza vaccine mandate

This article about why Massachusetts withdrew its influenza vaccine mandate for children was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who 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 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 is also a member of the Vaccines Working Group on Ethics and Policy.

On August 19, 2020, the Massachusetts Department of Public Health announced that the influenza vaccine will be required from all children “6 months of age or older who are attending Massachusetts child care, pre-school, kindergarten, K-12, and colleges and universities.”

The requirement was only for children attending in-person (not online) education and had a deadline of December 31, 2020. A lawsuit was filed against the mandate, apparently, according to the anti-vaccine organization Informed Consent Action Network (ICAN), funded by that organization, and brought by the law firm they habitually employ, Siri & Glimstad LLP (In 2019, ICAN paid the law firm $1,263,432 for “legal services” out of over $3.4 million the organization took in as income, according to their 990 filings).

After the Massachusetts Department of Public Health pushed off that deadline to February, they decided to withdraw the influenza vaccine mandate on January 15, 2021.

The Public Health Department explains in a letter:

Preliminary data show that this has been a mild flu season to date, presumably as people have received their seasonal flu vaccine and have been adhering to mask-wearing and social distancing due to COVID-19. Given the intensive Commonwealth-wide efforts regarding COVID-19 vaccination, DPH wants to alleviate the burden to obtain flu vaccination and focus on continuing our COVID -19 vaccination efforts. DPH continues to strongly recommend that everyone age six months and older receive their seasonal flu vaccine each year.

ICAN is celebrating this as a victory of their lawsuit. We do not know which other considerations went into the decision, and the lawsuit may have had an effect, if only by adding to the already full plate of the department during a pandemic.

But the reality is that given the jurisprudence on vaccine mandates, and given the deference most courts show public health authorities during a pandemic, if there were good grounds to insist on the mandate, the department would likely have held its grounds. A number of other factors likely fed into the decision, including, as pointed out, a relatively mild flu season (in part thanks to public health measures against COVID-19), Massachusetts stated desire to bring children back to in-person education, which may have led the department to seek to remove barriers, and the need to focus on the COVID-19 vaccine effort.

Plus, it is mid-January. The benefit of being distracted by a fight over an influenza mandate this late is probably less than the harm to other important efforts.

Flu vaccine and COVID-19 infections – some evidence it might lower risk

flu vaccine and COVID-19

Recently, I have been discussing the flu vaccine and COVID-19 infections. First, I debunked anti-vaccine myths. Second, I explained that the seasonal flu vaccine might be helpful in improving outcomes for patients who contract the coronavirus.

However, at that time, I wanted to make it clear that:

Once again, I am not making any claim that the seasonal flu vaccine will prevent a coronavirus infection. It’s just about comorbidities, that is, other health conditions that increase one’s risk for dangerous outcomes from the disease.

Because COVID-19 is a respiratory disease, anything that weakens the respiratory system could (and again, we don’t have solid information on the pathophysiology and comorbidities for the disease) lead to a worse course for the disease. And that would include a higher risk of mortality.

The flu vaccine can reduce the risk of one coronavirus comorbidity since the flu is a respiratory disease. So, the flu vaccine isn’t going to help reduce your risk of coronavirus infection, but it will reduce your risk of complications, including death, from COVID-19.

In addition, preventing the flu may help to reduce hospitalizations and ICU admissions, allowing for more capacity for patients who have contracted COVID-19.

But again, I assumed that the flu vaccine would have little effectiveness against SARS-CoV-2, the virus that causes COVID-19. This seemed biologically plausible because, as opposed to what Donald Trump claims, the flu virus and coronavirus are vastly different organisms. The two viruses are actually in two different phyla, meaning that the influenza virus and coronavirus are as closely related as a human is to a lobster. 

There appeared to be no scientifically supported reason to believe that the flu vaccine actually prevents COVID-19. However, there seems to be some intriguing, preliminary, and potentially convincing evidence that the flu vaccine may have some effect on the risk of COVID-19. Continue reading “Flu vaccine and COVID-19 infections – some evidence it might lower risk”

Flu vaccine deniers – the annual epic rant from Dr. Mark Crislip

flu vaccine deniers

Since we’re entering the 2020-21 flu season, it’s time for the annual epic rant from Dr. Mark Crislip about flu vaccine deniers. No, Dr. Crislip does not write a new one each year, I just republish it every year, because it still makes me laugh. And each year I know there is someone out there who will also love re-reading it for fun. Or maybe it’s your first time.

This diatribe is about “Dumb Ass” healthcare workers who invent flu vaccine fallacies, tropes, and myths in an effort to justify their belief that the flu vaccine is dangerous, useless, or whatever else that hits their science-denying brain.

Dr. Crislip’s humorous compilation of these flu vaccine myths, which were originally published in A Budget of Dumb Asses, describes the different types of flu vaccine deniers among healthcare worker Dumb Asses.

Any nurse, pharmacist, therapist, physician, or surgeon that are flu vaccine deniers by using pseudoscientific nonsense about the vaccine rather than protecting their patients and themselves is appalling. 

Of course, flu vaccine deniers aren’t just healthcare workers. I’m sure you know neighbors, friends, family, and even fellow vaccine supporters who are flu vaccine deniers. And they rely on the same ridiculous myths as healthcare workers.

These flu vaccine deniers believe that the flu vaccine is not necessary because the disease is not dangerous. Nothing could be further from the truth, especially in the world of COVID-19, where the flu vaccine may actually provide benefits to those who contract the coronavirus.

 

During the 2019-2020 flu season, 194 American children died of the flu. But, there’s more:

  • 39 – 56 million Americans contracted the flu
  • 18 – 26 million of those had a medical visit because of the flu
  • 410 – 740 thousand of those had to be hospitalized as an inpatient
  • Finally, 24,000 – 62,000 died
  • Worldwide, it is estimated that there will be approximately 290-650 thousand deaths. 

We are getting started with this new flu season, hopefully by wearing masks and social distancing, which along with the flu vaccine might make this an “easy” year for the flu. Except, you know what’s going on with the world and masks.

If you think you can prevent or cure the flu with vitamin C, echinacea, or bone broth (yes, it’s a thing), they don’t work. You are not going to be able to boost your immune system to destroy the flu virus unless you get vaccinated.

We’ve dispensed with many of the cherished flu vaccine fallacies of the anti-vaccine religion. Moreover, many studies have shown that getting the flu vaccine can improve health outcomes.

Too many people, including healthcare workers, are flu vaccine deniers. 

Continue reading “Flu vaccine deniers – the annual epic rant from Dr. Mark Crislip”

Flu vaccine and COVID 19 – are they actually associated?

flu vaccine and COVID-19

If you’ve been watching recent claims of the anti-vaccine world, you may have noticed a belief that the flu vaccine and COVID-19 are related. This new trope is based on a recent article that is making the rounds with both COVID-19 and flu vaccine deniers (a special subset of anti-vaxxers).

Let’s see if this paper about an association between the flu vaccine and COVID-19 mortality has any merit. To save you some reading time, it has none, except to give me something to write about. Continue reading “Flu vaccine and COVID 19 – are they actually associated?”

June 2020 ACIP meeting – meningococcal, influenza, COVID-19 vaccines

June 2020 ACIP meeting

This article about the June 2020 ACIP meeting was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who 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 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.

During June 2020, the Advisory Committee on Immunization Practices (ACIP) held its second annual meeting for the year. Because we are in the middle of the COVID-19 pandemic, and traveling is challenging for many – including, I suspect, for several of the Committee members, not all of which live near Georgia – the meeting, like most conferences this year (those which were not canceled) was held virtually. The CDC still provided an opportunity for oral comment, though there were some logistical challenges with their new system.

The June 2020 ACIP meeting discussed meningococcal vaccines, influenza vaccines, and then had the opportunity for public comment. The entire afternoon was devoted to COVID-19 and COVID-19 vaccines.

As with previous meetings, ACIP is a geek’s dream meeting and everyone else’s – except the experts, and I suspect – hope – most experts are geeks –  boredom feast. I learned a lot.

One of the most important lessons is that the committee takes vaccine safety very, very seriously. The other is that decisions on vaccines – like most policy decisions – are always made on incomplete knowledge. We never know everything. That is where expert judgment comes in. Incomplete knowledge does not mean there is not enough knowledge to assess benefits/risks, though any such assessment should be reassessed when new knowledge comes in.

Finally, it’s important to remember – and something the anti-vaccine observers of these meetings seem unaware of, but that doctors treating patients likely are not – that a decision not to use a vaccine is a decision with costs and risks – the costs and risks of the disease the vaccine prevents.

The choice is never between no risk and the vaccine because we don’t have vaccines unless a disease causes substantial mortality and morbidity. The choice is always whether, given the information, an informed decision can be made and which risks that information suggests are higher – those of the vaccine or those of not vaccinating.

Finally, my notes are over 14 pages of text for the June 2020 ACIP meeting, and that’s because my computer crashed at the end and I lost my last two pages of notes, which is really frustrating – and I have 153 screenshots of slides (yes, I am surprised too). I really want this post to be shorter. So I’m going to try and be very brief, and I’m happy to share my full notes, just email me at [email protected] Continue reading “June 2020 ACIP meeting – meningococcal, influenza, COVID-19 vaccines”

February 2020 ACIP Meeting review – Ebola, influenza, and coronavirus

february 2020 acip meeting

This article about the February 2020 ACIP meeting was written by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who 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 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.

I attended a large part of the February 2020 ACIP meeting (Advisory Committee of Immunization Practices) in Atlanta, GA. I had planned to stay throughout, but my airline changed my return flight and I had to leave before the end on the second day. I did, however, watch the first day and the first two parts of the second.

The coronavirus crisis changed some things. For example, there were multiple international groups visiting the CDC (there was also at least one group that was there for other reasons and sat on part of the meeting). And we had a presentation on the topic from Dr. Nancy Messonnier.

I will describe the meeting in the order it happened, though this is the very abbreviated version. As I said before, an ACIP meeting is a geek’s dream – there’s a lot of data provided and in-depth discussions of details. The committee has a heavy and important responsibility, and since it was targeted by anti-vaccine activists is carrying it out under tricky circumstances. Continue reading “February 2020 ACIP Meeting review – Ebola, influenza, and coronavirus”

Flu vaccine for COVID-19 – why you should be vaccinated soon

Flu vaccine for COVID-19

Yes, this article will discuss the flu vaccine for COVID-19 (the current coronavirus outbreak). But for those of you who don’t just read headlines, no, I am not suggesting that the flu vaccine will prevent a coronavirus infection.

As I wrote recently, a coronavirus vaccine is years away from reality. Any suggestion otherwise depends upon magical thinking and beliefs, not in evidence. But there are many things we can do that may prevent the most severe complications from the disease. Continue reading “Flu vaccine for COVID-19 – why you should be vaccinated soon”

Maternal flu vaccine – it protects the health of both mother and baby

maternal flu vaccine

I know that many people, even healthcare professionals, make lame excuses about a maternal flu vaccine. We have heard everything from “the vaccine gives me the flu” to “I never get the flu” to “the flu isn’t dangerous.” These anti-vaccine beliefs betray the overwhelming facts about the safety and effectiveness of the flu vaccine, especially for pregnant mothers.

A new study published in a real high-quality biomedical journal supports the claims that the maternal flu vaccine protects the health of the mother, the developing fetus, and the newborn child. Let’s take a look. Continue reading “Maternal flu vaccine – it protects the health of both mother and baby”

Flu vaccine facts – countering those anti-vaxxer myths and tropes

flu vaccine effects

It’s that time of year again, where we urge you to get the flu vaccination. And it’s time to provide you with the flu vaccine facts to debunk the anti-vaxxer fear, uncertainty, and doubt. Or we can just call them lies.

This article is not going to focus on every pseudoscientific anti-vaccine claim about the flu vaccine. It would take 10,000 words, and none of you, no matter how loyal you are to this old dinosaur, is going to read that many words. The goal of this post is to present flu vaccine facts for the biggest myths we read every year about the vaccine.

So, here we go. Continue reading “Flu vaccine facts – countering those anti-vaxxer myths and tropes”

Flu vaccine beliefs – the annual epic G-rated Mark Crislip rant

Since we’re entering the 2019-2020 flu season in the Northern Hemisphere, it’s time for the annual epic Mark Crislip rant about flu vaccine beliefs. For the past eight years at the start of the flu season, I reprint Dr. Mark Crislip‘s hysterical and outstanding rant about “slow-witted Equus africanus asinus” healthcare workers who invent flu vaccine fallacies, tropes, and myths in an effort to justify their belief that the flu vaccine is dangerous, useless, or whatever else that hits their brain.

Dr. Crislip’s humorous compilation of these flu vaccine myths, which were originally published in A Budget of Dumb Asses 2011, describes the different types of vaccine-refusing healthcare worker individuals. I resurrect this list every year at the beginning of the flu season not only for humor (because it is funny) but also to point the finger at flu vaccine deniers who also happen to be healthcare workers.

Any nurse, pharmacist, therapist, physician, or surgeon that refuses the flu vaccine by relying upon pseudoscientific nonsense about the vaccine rather than protecting their patients and themselves is appalling. I may be harsh, but maybe their employment ought to be terminated for their lack of concern about patients.

But the true adherents to the flu vaccine beliefs aren’t just healthcare workers. You know neighbors, friends, family, and even fellow vaccine supporters who refuse to get the flu vaccine. And they rely on the same ridiculous myths as healthcare workers.

These vaccine deniers believe that the flu vaccine is not necessary because the disease is not dangerous. Nothing could be further from the truth.

flu vaccine fallacies

During the 2018-19 flu season, 129 American children died of the flu. But, there’s more:

  • 37.4 – 42.9 million Americans contracted the flu
  • 17.3 – 20.1 million of those had a medical visit because of the flu
  • 531-647 thousand of those had to be hospitalized as an inpatient
  • Finally, 36,400 – 61,200 died
  • Worldwide, it is estimated that there will be approximately 290-650 thousand deaths. 

The flu season is just starting, and it’s almost impossible to not find a place to get the vaccine. Your family doctor, clinics, pharmacies, and many other places currently have the flu vaccine. And I am not a hypocrite – I will my flu vaccination next week. Of course, my healthcare insurance provides them out for free to all members.

And if you think you can prevent or cure the flu with vitamin C, echinacea, or bone broth (yes, it’s a thing), they don’t work. You are not going to be able to boost your immune system to destroy the flu virus unless you get vaccinated.

We’ve dispensed with many of the cherished flu vaccine beliefs of the anti-vaccine religion. Moreover, many studies have shown that getting the flu vaccine can improve health outcomes.

But too many people refuse this life-saving vaccine.

Continue reading “Flu vaccine beliefs – the annual epic G-rated Mark Crislip rant”