Crisis situations, real or contrived, lead to new, intrusive laws the public would never accept otherwise. We supposedly cherish freedom, but if we believe the world will end if we don’t act now, we may clamor for the government to save us. Cynical politicians bent on increasing their power never let a crisis go to waste.
Something like the Green New Deal—the end of our comfortable, prosperous lifestyle—requires a truly apocalyptic threat. But to eliminate our freedom to decline a medical treatment, the threat that “millions will die” of measles is evidently enough. Let’s not forget most older people had measles and recovered fully.
There are several hundred cases of measles nationwide, more than in 2014, and bills are being pushed through state legislatures to eliminate all but very narrow exemptions to the 60 shots now mandated for school attendance.
In New York City, people are receiving summonses based on Mayor Bill de Blasio’s emergency order. Everybody, adult or child, who lives in one of four ZIP code areas must get a Mumps Measles and Rubella shot, prove immunity, or face the prospect of a $1,000 fine ($2,000 if you don’t appear as ordered). Your religious exemption is overridden. The threat of six months in prison and the prospect of forcible vaccination were removed before a hearing on a lawsuit brought by five mothers. The judge dismissed the case.
New York City Health Commissioner Oxiris Barbot said the purpose of the fines is not to punish but to encourage more people to proclaim the message that vaccines are safe and effective. Get it? If you say something to avoid a fine, that makes it true.
It’s about the need for herd immunity, they say. We need a 95 percent vaccination rate to achieve herd immunity to measles. With only 91 percent or so, we are having outbreaks! If we could just vaccinate another 4 or 5 percent!
Mayor De Blasio has a point about vaccinating everyone. Adults are getting measles because their shots have worn off. It is likely that we have survived for decades with a large part of the adult population vaccinated but not immune. So where do the mandates stop?
False Outbreak Alarms
Outbreaks have occurred in populations with a near 100 percent vaccination rate. Was it vaccine failure? Or was the vaccine not refrigerated properly? Or was a claimed outbreak not real?
Alarm over an “outbreak” in Ann Arbor, Michigan was called off when a special test, a reverse transcriptase polymerase chain reaction, showed a strain related to a vaccine rather than a wild-strain measles virus. Some 5 percent of people vaccinated may get an illness that looks like measles, but it is just a “vaccine reaction,” which appears to have been the case in Ann Arbor.
Can vaccinated people shed live virus? Yes. Should you keep your immunocompromised child away from recently vaccinated people? Just asking.
Safe and Effective?
Like all medical treatments, vaccines are neither 100 percent effective nor 100 percent safe. Read the FDA-required, FDA-approved package inserts. Arizona legislators failed to move on a bill that would have required making these available to parents in obtaining informed consent. (You can get them on the internet.)
There are tradeoffs with vaccines: risks and benefits. But in the panic about measles, the right to give or withhold informed consent—fundamental in medical ethics as well as U.S. and international law—is being sacrificed. And so is free speech.
The threat of infectious diseases is real and increasing. We need more robust public health measures, better vaccines, and improved public knowledge and awareness. Deploying vaccine police and shutting down debate will erode trust in health authorities and physicians, although more people may get their shots.
Such heavy-handed measures will not defeat the real enemy: measles and worse diseases.
Jane Orient, M.D. ([email protected]) is an internist and executive director of the Association of American Physicians and Surgeons. Reprinted with permission.