Editor’s note: This op-ed is by Dorian Yates, a Vermont resident.
Medical freedom and choice are hanging in the balance. On Tuesday morning the Vermont House Committee on Health Care is going to vote on whether or not to uphold Vermont’s philosophical exemption to vaccines — a law Vermont has had for over 32 years.
Since 1979 when the law was enacted, Vermonters have had the medical choice and freedom to decide which vaccines required for school would be administered to their children. With the addition of required chickenpox and hepatitis B vaccines in 2008, philosophical exemptions have increased. This is because some people choose to opt out of the chickenpox vaccine, and instead, let their children get the disease and acquire natural immunity. Others like to postpone the hepatitis B vaccine since the risk factors are sexual activity and drug use. Most get the measles, pertussis and polio vaccines as evidenced by the state’s rates for these at over 90 percent for those entering school. In fact Vermont is ranked as the healthiest state in the nation.
In over 32 years there has never been a problem with the law allowing philosophical exemptions — no epidemics nor pandemics. While there have been cyclical outbreaks of pertussis, none have been epidemics. The Department of Health figures for 2010-11 show that of the 349 public and 115 private schools in Vermont, 257 of them reported zero philosophical exemptions. Ninety-five had just one philosophical exemption per school. And only 23 schools reported higher than five philosophical exemptions each.
So why is the law being questioned now? The Vermont Department of Health and its commissioner, Harry Chen, seem to feel that there is an urgency to repealing this law — that Vermonters are all of a sudden in grave risk of being unprotected from infectious disease and that “herd immunity” is endangered by having less than 95 percent of children vaccinated.
The argument assumes that vaccines are the only factor contributing to “herd immunity” which they are not — genetic resistance and natural immunity are just as, if not more, critical to herd health, evidenced by the CDC determining that those born before 1957 have natural life-long immunity to measles — something vaccines do not provide. Herd immunity figures depend on disease type and other factors ranging from 50 to 95 percent. Herd immunity expert Paul Fine explains for example that polio “herd immunity threshold ranges from 80 to 97 percent depending on the level of hygiene.” These are large ranges and not as clear cut as the 95 percent suggested levels used in trying to mandate universal vaccinations.
The ranges for “herd immunity” make sense. Consider travelers to Africa or Asia where measles and polio — the diseases many Americans are vaccinated against — are endemic. No doctor or agency tells you that you cannot travel to those continents or live there because the “herd immunity” is well below 95 percent. The CDC Traveler’s Health site advises, “People who cannot show that they were vaccinated as children and who have never had measles should probably be vaccinated” — “probably” not even “definitely.”
Philosophical exemptions do not mean that all those exempted have no immunity. Exemption numbers can include children who are naturally immune to chickenpox as well as those who have received some or most vaccinations. CDC figures state that 5 to 15 percent of vaccinated children are not protected — that is the vaccines do not work for them — but unlike those claiming an exemption, there is no way to know who those children are. According to the Vermont Department of Health 67.5 percent of the children in the 2011 outbreak of pertussis were vaccinated. Those unprotected vaccinated children present a far higher number than those claiming philosophical exemptions, as do those with “provisional status” — almost twice the percentage of philosophical exemptions — who are not yet up-to-date on their vaccines but are allowed to attend school. If there is a problem with “herd immunity” it does not lie with those in the philosophical exemption pool.
So while I agree with Commissioner Chen in his March 27 opinion that “Myths and misinformation swirl around the issue of vaccine safety …,” it is he who is fanning the flames of fear and misrepresenting the threat of imminent loss of safety due to an inflated definition of “herd immunity” and increased philosophical exemptions. As Vermonters we deserve honest transparent numbers and assessments from our government.
Again I agree with Commissioner Chen when he says, “It is imperative that we make informed health decisions for ourselves and our families …” Exactly, Commissioner Chen. Let us continue to make those informed decisions for ourselves and our families as we have done for the past 32 years. Let’s keep Vermont’s philosophical exemption intact and maintain our freedom in health care.
