Scribblings and Geekery

Earlier this year there was a court decision in favor of several schools in New York state wherein the court determined that the schools could legally prevent unvaccinated children from attending school when another student has a vaccine-preventable disease:

Citing a 109-year-old Supreme Court ruling that gives states broad power in public health matters, Judge William F. Kuntz II of Federal District Court in Brooklyn ruled against three families who claimed that their right to free exercise of religion was violated when their children were kept from school, sometimes for a month at a time, because of the city’s immunization policies.

The Supreme Court, Judge Kuntz wrote in his ruling, has "strongly suggested that religious objectors are not constitutionally exempt from vaccinations".

This was the right decision, and while I'm glad it was decided as such, I'm anxious to see where it goes next. The plaintiffs are appealing, and as the chain of appeals goes in the US, I will be really interested to see if this lawsuit eventually makes it to the Supreme Court. Affirming that public health concerns over-rule 1st amendment claims seems like an important precedent to be set at the federal level.

Dr. Aaron E Carroll, a prolific health policy blogger and vid-caster, in addition to being a pediatrician and professor of medicine¹, wrote a nice piece about this for CNN Opinion. He made several very good points about herd immunity, which is an often neglected point in conversations with those who are either uncomfortable with, or opposed to, vaccinating their children for whatever reason. For instance, regarding the Varicella² vaccine, he wrote (emphasis mine):

What's notable is that from 2004 through 2007, not one child less than 1 year of age died in the United States from chicken pox. None. This is remarkable, because we cannot give the varicella vaccine to babies. It's only approved for children 1 year or older.

In other words, all those babies were saved not because we vaccinated them against this illness. They were saved because older children were.

I've read many of the objections to vaccination. Every single one of them is, in my opinion, without any merit. There is simply far too much research showing that vaccines are only positive, that they save lives, that they eradicate disease, and that avoiding them can cost lives.

Bottom line: If you are not having your children vaccinated, or you elect to delay vaccination to be on an alternative schedule which "makes sense to you"³, you are putting your children and everyone else's children at risk. This is conscious negligence, not "exercising your parenting freedom".

I have friends who vehemently disagree with me on this topic. Some day I will not be surprised if that disagreement becomes irrelevant and states begin enforcing vaccination by law. It's my hope that this decision reinforces precedent allowing states to consider just that.⁴ I would not be surprised if the first state to attempt to do so is California, given that they declared a Pertussis epidemic last month, and this was not the first time it has done so this decade. Pertussis is a disease that should have been eradicated from the planet, and was technically near extinction, until folks stopped vaccinating their kids against it. Considered possible in 1975, eradication of Pertussis moved from a scientific challenge to a public health (enforcement) challenge in the late 1990s. That challenge seems to have failed, even with a vaccine with a 70% efficacy rate.

I still think Penn and Teller said it best.