SUNDAY, DECEMBER 8TH, 2019

Background

Hundreds of parents and activists clad in red shirts lined the halls of the state Capitol, hoisting signs that read ‘DO NOT BULLY DOCTORS INTO NOT PROTECTING THEIR PATIENTS!’ and chanting ‘YES TO EDUCATION, NO TO MANDATION!’ Some even facing arrest for their actions, the protesters all had one thing in common — they opposed a groundbreaking new law making it more difficult than ever for parents to keep  their children from being vaccinated against childhood diseases. The divisive law, which originated as Senate Bill 276 and was signed by Gov. Gavin Newsom in September, reignited the controversy surrounding vaccination mandates, fueled by parents, doctors and activists on both sides of the issue. With California already being one of five states to eliminate personal or religious beliefs as a valid exemption for vaccination, the even tougher law has been met with both support and pushback, with one concern at the center of the debate — the safety of children and communities. The law grants the state the authority to review medically related vaccine exemptions in certain cases, such as if the child with the exemption attends a school with a vaccination rate under 95%, if the doctor issuing the exemption has given five or more exemptions or if the school did not provide its vaccine rates to the state.

Pro-Vaxx — Political

In 2014, a widespread outbreak of measles in New York prompted the state’s health officials to issue a warning urging residents to ensure that they were vaccinated against the disease. This incident was not isolated: According to the CDC, the number of reported cases of measles in the United States triped in 2014 from the previous year, and this year is on track to reach a recent high of more than 1,300 cases.

After another measles outbreak in late 2014  was traced to what was thought to be a safe and welcoming place for families, Anaheim’s Disneyland, sickening nearly 150 people, then-Gov. Jerry Brown signed into law landmark legislation that limited the types of valid vaccination exemptions to only medical exemptions.

According to state Sen. Scott Wiener, the law, SB277, had loopholes that allowed doctors to grant fraudulent exemptions, creating the need for another bill.

“This law is being undermined by a small handful of unethical doctors that are putting children at risk for disease while profiting from selling inappropriate medical exemptions to misinformed parents,” State Sen. Richard Pan said when explaining the need for a second law. “The lack of community immunity at schools with students granted inappropriate medical exemptions is contributing to the spread of preventable diseases.”

In April 2019, Pan proposed Senate Bill 276. This marked the start of chaos at the Capitol. SB 276 was written in reaction to the increase in what its supporters believe are  fraudulent medical exemptions; it also aimed to maintain high vaccination percentages in schools to achieve community immunity, which is obtained when 95% or more of the student population is vaccinated against a disease.

The number of unscrupulous medical exemptions increased rapidly after the passage of SB 277, with many of the exemptions occurring in the same communities, creating the possibility of a rapidly spreading disease in one geographical area, according to Assemblymember Marc Berman, a Paly graduate. 

Berman supports the stricter regulations around what constitutes a valid exemption from vaccinations, saying  “SB 276 provides state-level oversight and standardization of exemptions, which were lacking before.”

Berman believes the new law can help regions attain community immunity quickly and safely.

“SB 276 simply standardizes and provides greater oversight of the exemption process, which will make all students safer from preventable diseases,” Berman said.

According to Emmalee Ross, public information officer of the Medical Board of California, the  stricter law was in part a reaction to the rise in complaints to the California Medical Board about doctors filing inappropriate vaccination exemptions over the last four years. Depending on the board’s  findings when investigating, the board may file an accusation against the doctor for not following the standard of care when providing vaccine exemptions.

Currently, the board has filed formal accusations on these grounds against three doctors —  Dr. Robert Sears of Orange County, Dr. Kenneth Stoller of Sonoma County and Dr. Tara Zandvliet of San Diego County, Ross said.

According to Ross, the board is not allowed to discuss investigations that have not yet resulted in an accusation. However, the legal processes that take place in conjunction with  investigations are public.

In June, the Department of Consumer Affairs, the agency that oversees the medical board, sued in state court to acquire medical records for patients of Dr. Kelly Sutton and Dr. Michael Fielding Allen, doctors who were revealed to be under investigation by the California Medical Board for alleged unmerited vaccination exemptions. Sutton, who works as a family practice physician at Raphael Medicine in Fair Oaks, near Sacramento, is also a physician for some Palo Altans. Court documents show the Board received numerous complaints from other California doctors about Allen and Sutton, which triggered the investigations.

Ross said the Board believes  that the state’s added ability to review medical exemption requests  will reduce  the time and resources spent investigating complaints.

“The law will make it easier for the Board to identify physicians who may be inappropriately granting medical exemptions and obtain medical records for complaints,” Ross said. 

People against vaccination mandates, or anti-vaxxers, often cite the Vaccine Adverse Event Reporting System Harvard Pilgrim Study published in 2009 to validate their concerns regarding the safety complications associated with vaccinations. The study concludes that 2.6% of vaccines result in varying forms of vaccine-related injuries. Operated by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration, VAERS provides a reporting system that explains “adverse event” reports from various medical officers and the public.

The CDC, however, did not adopt this statistic as the national average for vaccine injuries, as it is based upon public complaints and not official medical reports.

Anti-Vaxx — Political

Vote for Choice founder Christina Hildebrand advocates for the public’s right to know the composition, quality and short-and long-term side effects of all food and pharmaceutical products.

“Our mission statement is to educate and advocate for informed choice and transparency of anything that goes into your body,” said Hildebrand, who lives in the Bay Area.

The bill signed by Newsom incited what she considers a “witch hunt” against doctors who have given unwarranted medical exemptions to children at the doctor’s discretion.

According to Hildebrand, the plan of the assistant director of the California Department of Public Health to obtain the medical records of vaccine-exempted students is a ploy to provide the Medical Board with the names of doctors who issued those medical exemptions.

“Once you’ve got doctor’s names, then you’re going to file complaints with the medical board,” Hildebrand said. “Then the medical board can take it from there. And once it’s in the investigative process, everything else is covered up.”

Hildebrand said the Medical Board sent notice to doctors who had issued medical exemptions warning that they would effectively be under close watch after the new bill became law.

“I would say before that letter came out we probably had about 150 doctors in the state of California that were willing to do medical exemption evaluations … after that letter, we dropped to probably 20,” Hildebrand said.

Hildebrand believes breaking the standard of care should not be an act punishable by investigation and the potential loss of a medical license.

“Standard of care is what 95% of doctors would do in that situation to treat those symptoms. What standard of care does not include is the people that are on the cutting edge of research,” Hildebrand said. “I agree with the medical board. They’re not in the standard of care, but why should they be penalized for being on the cutting edge research and being on the cutting edge of vaccines?”

Hildebrand also takes issue with the composition of the bill, pointing out the lack of regulatory process open to public comment in earlier drafts of the bill.

“You know, that’s probably the biggest issue we had and we were just like, look, and it’s where we came up with our amendments and we said, look, if there’s no regulatory process, then the bill has to be really, really succinct,” Hildebrand said.

Hildebrand attributes the ugly protests in Sacramento to parents who are legitimately fearful of vaccines.

“It comes out of fear,” Hildebrand said. “Absolutely fear. Because I would say that the majority of parents who have medical exemptions are parents that have had vaccine reactions either in their own family or in these children.”

Another leader of the anti-vaxx movement, Robert F. Kennedy Jr., an environmental attorney and president of the Children’s Health Defense, says that fellow concerned parents have inspired him to further his investigative work into the safety of vaccines.   

“Women who had vaccine-injured children would approach me after I was speaking, all around North America, Canada, the United States,” Kennedy said. “Almost every speech there were women who had intellectually disabled children who had been injured by vaccines who would approach me and say, ‘If you’re genuinely concerned about mercury exposure to children, you need to look at vaccines.’”

Kennedy,  nephew of the late President John F. Kennedy, was drawn into the controversy through people he met while traveling.

“One of them came to my house, with a big pile of scientific studies a foot deep, and she put them on my front porch and said she wasn’t going to leave. Her son had gotten autism from a vaccine and had gotten a $20 million award … which acknowledged that the child had gotten autism from the vaccine.”

After reviewing scientific studies, Kennedy said he was  struck by the disparity between what science said and what public health regulators said.

“Public health regulators were not being well informed in these cases or they were being dishonest in other cases … I was shocked by how clear that science was,” Kennedy said. “And I thought if people really understood this, nobody’s reading it. ”

Kennedy said vaccines are unnecessary for healthy people.

“I think we need to do that cost-benefit analysis for every vaccine,” Kennedy said. “I had 11 brothers and sisters and nobody had an allergy. I had 70 cousins and nobody had an allergy. Why do all my children have allergies? Well it’s from the vaccines they received.”

Kennedy believes some companies issuing vaccinations are falsifying science.

“We’re living in a weird world right now where we are having forced, coerced medical interventions against unwilling people,” Kennedy said. “Vaccines is the only place where they can commit crime and never get caught. ”

Pro-Vaxx — Personal

Most doctors, backed by medical literature, believe vaccinations are completely safe, and that the controversial presence of various forms of aluminum in some vaccines is not toxic, but rather used to enhance their immunogenicity, or their ability to provoke an immune response to fend off a virus.

The debate surrounding the safety of aluminum in vaccines continues to wage because some studies indicate aluminum exposure can impede cellular and metabolic processes, resulting in various neurological diseases.

Anti-vaxxers think that children, because they receive a large number of vaccinations, can be susceptible to aluminum-linked abnormalities. 

But according to the National Library of Medicine at the National Institutes of Health, aluminum in vaccines is safe enough for repeated injection as well as effective in the  immunization process. Another concern held by anti-vaxxers is the notion that childhood immunizations can lead to the development of autism. This idea is thought to have been introduced by British physician Andrew Wakefield and anti-vaxx leader, who wrote an article in the 90’s which has since been retracted. The article had used manufactured evidence to falsely link the MMR vaccine to the development of autism. Though Wakefield and his findings have since been discredited, the notion that childhood vaccinations cause autism is still spread by parents worldwide.

Yet according to board-certified pediatrician and geneticist Dr. Robert Wallerstein who worked at Santa Clara Valley Medical Center, the likelihood of a complication following a vaccination in a healthy child is insignificant, and the benefits of a vaccine significantly outweigh the unlikely probability of an issue. Vaccines in short, he said, are safe.

Wallerstein said the link drawn by  parents between  autism and  the MMR vaccine likely occurs because the events follow one another chronologically. Generally, Wallerstein said,  autism is  diagnosed in children when cognitive development begins, between the ages of 18 months and two years, which is shortly after they received the MMR vaccine.

“Because the autism diagnosis can usually follow the MMR vaccination, people can make the assumption that their child was well, and then they had the MMR vaccine, and then they got diagnosed with autism,” Wallerstein said. “There isn’t one sole cause for autism, so for people to assume the reason for autism to be vaccines is incorrect.”

Wallerstein supports California’s strict new vaccine exemptions standards because of the impact vaccinations have on the health of others, because he believes that immunocompromised people are more likely to fall ill to a virus.

“People who are immunocompromised are at risk of getting a virus from an unvaccinated child. That idea is indisputable,” Wallerstein said. “At this point, this is when vaccines become a matter of public concern and not just of personal preference. By vaccinating children, you’re protecting not only yourself and your family, but also kids who medically can’t get vaccinated.”

His point hits close to home for  Palo Alto mother Meredith Goldsmith, whose son was diagnosed with high-risk neuroblastoma, a cancerous tumor that matures with the fetus, in nerve cells called neuroblasts.

Goldsmith said the treatment her son, now 4 years old, received for his diagnosis consisted of two back-to-back bone marrow transplants, leaving him highly susceptible to viruses.

“His immunity was terrible for a while after his treatment, so he had to stay completely isolated like a prisoner for eight months,” Goldsmith said. “It depends on each child, but they could lose the benefit of their prior immunizations, and they can’t have new vaccinations for possibly years afterward. Regardless of the severity of treatment on his immune system, my son could possibly not be able to receive vaccinations for quite some time and can become more at-risk than other kids in catching a virus.”

According to Palo Alto Unified School District’s Lead District Nurse Rosemarie Dowell, Goldsmith’s concerns are warranted, and she said the best way to support immunocompromised children is through community immunity or herd immunity.

“With the stricter laws in California about immunization exemptions, (immunocompromised children) who should not receive some or all vaccinations are protected to be able to attend school, while others will need to receive the vaccinations and in turn keep our community immunity levels high enough to keep our risk of outbreak low,” Dowell said.

Because of their potential interaction with immunocompromised children, like Goldsmith’s son, a medical exemption must be completed by a California-licensed physician and must state the specific nature of the physical condition for which the physician does not recommend an immunization.

“Your choosing not to vaccinate your child poses a risk for all the other children to get sick,” Goldsmith said. “It’s not fair to the other parents in the school not to vaccinate your child.”

Anti-Vaxx — Personal

Regardless of the generally accepted medical point of view, Sutton believes the concerns most parents have regarding the potential complications from the MMR vaccination are justified, and that the vaccine increases the risk to a child with an underlying genetic mutation.

In response to the argument that vaccinations protect the immunocompromised, Sutton said although immunocompromised people are more likely to catch a virus, unvaccinated individuals pose no more of a risk to their health than vaccinated people.

“A healthy, unvaccinated person is no more of a risk than a vaccinated person to the immunocompromised person or any neighbors,” Sutton said. “The immune system needs exercise to be at its best, meaning that it needs to naturally fend off viruses without the aid of vaccinations to create antibodies in order to fight off recurring viruses.”

Moreover, Sutton supports California families who continue to argue that religious and personal beliefs should be viable reasons for a vaccine exemption.

“A religion or strong belief should be accepted as an exemption,” Sutton said. “The fundamental idea that makes us healthy is not vaccines, but the basis of public health is sanitation, nutrition, education and last vaccines in that order. It’s not like we depend on vaccines to have a defense against germs. Instead, in general, the responsibility of each person taking care of their own health, without vaccines and just through cleanliness, will contribute enough to keep the community healthy.”

In response to being under investigation, Sutton believes that the risks exponentially increase from exposures to substances that trigger adverse events following immunization.

“I support the selective use of vaccines,” Sutton said. “In the face of a vaccine mandate, it is very important to have medical exemptions available from doctors who are free to act in the patient’s best interest.”

According to Sutton, measles, an extremely infectious disease, is now considered extremely rare. The decrease in cases of this disease, says Sutton, was not because of vaccines.

“The history of dropping mortality from measles is clearly not from vaccines, as the drop occurred 60+ years before the vaccine was introduced,” Sutton said. “Eat plenty of vitamin A foods, and you will not have complicated measles. As many as 92% of the patients hospitalized with measles complications were deficient in vitamin A. ”

A Palo Alto mother who asked to stay anonymous to avoid implicating her children with her own beliefs agrees with the concerns brought up by Sutton, Kennedy and Hildebrand, saying  vaccinations she had in adulthood caused her severe health problems.

“I was physically disabled,” she said. “And then a few months after [my vaccinations] I was brain-damaged. I couldn’t remember anything I was reading anymore.”

Some of the symptoms she said she had following her injections include arthralgia, neuropathy, vertigo, tachycardia, dyspepsia and eczema. She said that she suffered ongoing nausea and headaches directly following her vaccinations. She cites the Hepatitis B vaccine with the development of her most disruptive symptoms, affecting her personal and professional life.

“I lost my job and my entire career,” she said. “I was running a worldwide group. I have an MBA from a top 10 school. I can’t tell you how much I’ve suffered.”

Her greatest concern stems from the aluminum in most vaccines. She said because of aluminum’s immunotoxicity, any level of it in the human body is detrimental to a person’s health, especially a child’s.

“There should never be any aluminum in the human body at all, and it shouldn’t even exist in the environment,” she said. “The idea of taking aluminum out of the ground and injecting it into someone’s body is madness.”

In addition, she believes that forcing people to be vaccinated when they could be injured in order to protect the immunocompromised is no more ethical than it is to remain unvaccinated.

“If anybody wanted to make me have a vaccine to prevent… an immunocompromised child from getting a vaccine preventable disease, I’d say no way. I can’t go through that again.”

Many anti-vaxxers claim the CDC’s decision to not endorse the Harvard Pilgrim study is part of an elaborate plan to hide the truth about vaccine safety. The mother points out that the CDC disregarded the study after reviewing the data, the same data that the scientific community found to be inadequate.

“When they reported the results in this paper, suddenly the CDC stopped calling them back because they didn’t like the results,” she said.

According to the mother, the paper tracked the amount of vaccine injuries: 2.6% of vaccines result in vaccine injury within 30 days.

“My guess is one-fourth of the population is vaccine injured and doesn’t even know it,” she said, citing the study. “Vaccines can cause debilitating injuries, temporary or permanent.”

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