Bangor Daily News Vote on mandatory vaccinations for kids: Results 50:50

Fewer Maine children getting fully vaccinated; new program hopes to reverse trend

Jeff Barnard | AP

Sitting in her home in Ashland, Ore., on Nov. 14, 2011, Jennifer Margulis shows off empty vials of vaccine that she saves in case one of her children has a bad reaction. An author of books on parenting who has written about childhood vaccines, Margulis is one of a growing number of parents questioning the government's schedule of mandatory vaccinations for children.

By MIKE STOBBE, The Associated Press

Posted Nov. 29, 2011, at 4:59 p.m.

More parents are opting out of school shots for their kids. In eight states now, more than 1 in 20 public school kindergartners aren’t getting all the vaccines required for attendance, an Associated Press analysis found.

That growing trend among parents seeking vaccine exemptions has health officials worried about outbreaks of diseases that once were all but stamped out.

The AP analysis found more than half of states have seen at least a slight rise in the rate of exemptions over the past five years. In Maine, the rate is gradually climbing, and a new program seeks to boost children’s access to vaccinations.

“It is a concern here,” said Peter Smith, director of the state’s Division of Infectious Disease. “We have concerns both about parents choosing not to vaccinate and other barriers to vaccinations, such as cost.”

States with the highest exemption rates are in the West and Upper Midwest.

It’s “really gotten much worse,” said Mary Selecky, secretary of health for Washington state, where 6 percent of public school parents have opted out.

Rules for exemptions vary by state and can include medical, religious or — in some states, including Maine — philosophical reasons.

Worries about the cost of immunizations prompted Maine lawmakers in 2010 to pursue free vaccines for children.

“The full series of vaccinations from birth to 18 years of age runs over $2,000 now,” Smith said, not including the cost for office visits. (In India the cost until recently was $2.00, reflecting more reasonable pricing and fewer newer vaccines whose effects on disease ecology are uncertain:  they may be net bad or good, like Prevnar, which contributed to increased multidrug resistance in some areas... see my earlier blog post)

Set to take effect Jan. 1, 2012, the program will purchase vaccines at a lower bulk rate with funds collected through an assessment on health insurers and other entities, according to Peter Gore, chairman of the Maine Vaccine Board. The vaccines will be distributed to health care providers at no cost, but parents may have to pay an administrative fee, he said.

“The program’s goal is to promote better access to vaccines for all Maine children,” Gore said. “It does not mandate vaccines for children.”

The budget for the program will total roughly $10 million in its first year, according to Smith.

The number of shots is also giving some parents pause. By the time most children are 6, they will have been stuck with a needle about two dozen times, with many of those shots given in infancy. The cumulative effect of all those shots has not been studied enough, some parents say.

But few serious problems have turned up over years of vaccinations and several studies have shown no link with autism, a theory from the 1990s that has been widely discredited. (And equally credited by others--Nass)

To be sure, childhood vaccination rates remain high overall, at 90 percent or better for several vaccines, including those for polio, measles, hepatitis B and even chickenpox. In many states, exemptions are filed for fewer than 1 percent of children entering school for the first time.

Health officials have not identified an exemption threshold that would likely lead to outbreaks. But as they push for 100 percent immunization, they worry when some states have exemption rates climbing over 5 percent. The average state exemption rate has been estimated at less than half that. (Plenty high enough to prevent diseases spreading through our population--unless the vaccines fail, which they do in at least 3 cases.--Nass)

Maine’s exemption rate for the 2009-10 academic year was 3.56 percent, with the majority of parents citing religious and philosophical objections to vaccinations. The rate inched up from 3.33 percent the previous year but remained lower than a peak rate of more than 4 percent in 2007-08.

Even more troubling are pockets in some states where exemption rates much higher. In some rural counties in northeast Washington, for example, vaccination exemption rates in recent years have been above 20 percent and even as high as 50 percent.

“Vaccine refusers tend to cluster,” said Saad Omer, an Emory University epidemiologist who has done extensive research on the issue.

While parents may think it does no harm to others if their kids skip some vaccines, they are in fact putting others at risk, health officials say. No vaccine is completely effective. If an outbreak begins in an unvaccinated group of children, a vaccinated child may still be at some risk of getting sick.

Studies have found communities with higher exemption rates sometimes are places where measles have suddenly re-emerged in outbreaks. Vaccinated kids are sometimes among the cases, or children too young to be vaccinated. Last year, California had more than 2,100 whooping cough cases, and 10 infants died. Only one had received a first dose of vaccine.

Earlier this month, the Maine CDC issued an advisory about a rising rate of pertussis, or whooping cough, centered in Penobscot County. As of Nov. 10, the state had recorded 163 cases of the disease, which primarily affects school-age children, compared to 53 in all of 2010.

“Your child’s risk of getting disease depends on what your neighbors do,” said Omer.  (That's right: scare those parents and set neighbor against neighbor.--Nass)

And while it seems unlikely that diseases like polio and diphtheria could ever make a comeback to the U.S., immunization expert Dr. Lance Rodewald with the federal Centers for Disease Control and Prevention says it could happen.

“Polio can come back. China was polio free for two decades, and just this year, they were infected from Pakistan, and there is a big outbreak of polio in China now. The same could happen here,” Rodewald said in an email.  (In the US, all recent cases of polio were vaccine strain, vaccine-induced.  That is why the live oral polio vaccine was stopped here in 2000.--Nass.
According to CDC:

From 1980 through 1999, a total of 152 confirmed cases
of paralytic poliomyelitis were reported, an average of 8
cases per year. Six cases were acquired outside the United
States and imported. The last imported case was reported
in 1993. Two cases were classified as indeterminant (no
poliovirus isolated from samples obtained from the patients,
and patients had no history of recent vaccination or direct
contact with a vaccine recipient). The remaining 144 (95%)
cases were vaccine-associated paralytic polio (VAPP) caused
by live oral polio vaccine. 

He cited outbreaks of Hib, a disease that can lead to meningitis, among the Amish who don’t consistently vaccinate their children. Russia had a huge diphtheria outbreak in the early- to mid-1990s, he said, because vaccine coverage declined.

“Measles is just visible, but it isn’t the only concern,” Rodewald said.

For its review, the AP asked state health departments for kindergarten exemption rates for 2006-07 and 2010-11. The AP also looked at data states had previously reported to the federal government. (Most states don’t have data for the current 2011-12 school year.)

Alaska had the highest exemption rate in 2010-11, at nearly 9 percent. Colorado’s rate was 7 percent, Minnesota 6.5 percent, Vermont and Washington 6 percent, and Oregon, Michigan and Illinois were close behind.

These exemption rates are double that of Maine, yet we are trying to spread fear about the consequences here--Nass

Mississippi was lowest, at essentially 0 percent.

The AP found that vaccine exemptions rose in more than half of states, and 10 had increases over the five years of about 1.5 percent or more, a range health officials say is troubling.

Those states, too, were in the West and Midwest — Alaska, Kansas, Hawaii, Illinois, Michigan, Montana, Oregon, Vermont, Washington and Wisconsin. Arizona saw an increase that put that state in the same ballpark.

Exemption seekers are often middle-class, college-educated white people, but there are often a mix of views and philosophies. Exemption hot spots like Sedona, Ariz., and rural northeast Washington have concentrations of both alternative medicine-preferring as well as government-fearing libertarians.

Opposition to vaccines “is putting people together that normally would not be together,” observed Elizabeth Jacobs, a University of Arizona epidemiologist looking at that state’s rising exemption rates.

What many of exemption-seeking parents share, however, is a mental calculation that the dangers to their children of vaccine-preventable diseases are less important than the possible harms from vaccine. Or they just don’t believe health officials, putting more stock in alternative sources — often discovered through Internet searches.

“We are being told this by every government official, teacher, doctor that we need vaccines to keep us safe from these diseases. I simply don’t believe that to be true. I believe all the diseases in question were up to 90 percent in decline before mass vaccines ever were given. I don’t think vaccines are what saved the world from disease. I think effective sewer systems, nutrition, and hand-washing (are the reasons),” said Sabrina Paulick, of Ashland, Ore. She works part-time as a caregiver for elderly people in their homes and is a mother of a 4-year-old daughter.

Parents say they’d like to reserve the right to decide what vaccinations their children should get and when. Health officials reply that vaccinations are recommended at an early age to protect children before they encounter a dangerous infection. “If you delay, you’re putting a child at risk,” said Gerri Yett, a nurse who manages Alaska’s immunization program.

Analyzing vaccination exemptions is difficult. States collect data differently; some base their exemption rates on just a small sample of schools — Alaska, for example — while others rely on more comprehensive numbers. So the AP worked with researchers at CDC, which statistically adjusted some states’ 2010-11 data for a better comparison.

It’s also not clear when an exemption was invoked against all vaccines and when it was used to excuse just one or two shots. CDC officials think the second scenario is more common.

Also, states differ on some of the vaccines required and what’s needed to get an exemption: Sometimes only a box on a form needs to be checked, while some states want letters or even signed statements from doctors.

Meanwhile, some parent groups and others have pushed legislators to make exemptions easier or do away with vaccination requirements altogether. The number of states allowing philosophical exemptions grew from 15 to 20 in the last decade.

Some in public health are exasperated by the trend.

“Every time we give them evidence (that vaccines are safe), they come back with a new hypothesis” for why vaccines could be dangerous, said Kacey Ernst, another University of Arizona researcher.

The exemption increases have come during a time when the government has been raising its estimates of how many children have autism and related disorders. Some experts suggest that parents have listened intently to that message, with some believing the growing roster of recommended shots must somehow be related.

“I don’t understand how other people don’t see that these two things are related,” said Stacy Allan, a Summit, N.J., mother who filed religious exemptions and stopped vaccinating her three children.

Several parents said that while they believe many health officials mean well, their distrust of the vaccine-making pharmaceutical industry only continues to grow.

“I wouldn’t be one to say I am absolutely certain these things are hurting our children,” said Michele Pereira, an Ashland mother of two young girls. She is a registered nurse and married to an anesthesiologist. While her daughters have had some vaccinations, they have not had the full recommended schedule.

“I feel like there are enough questions out there that I don’t want to take the chance,” she said.

BDN health editor Jackie Farwell and Associated Press writer Jeff Barnard in Grants Pass, Ore., contributed to this report.

http://bangordailynews.com/2011/11/29/health/maine-adds-program-to-boost-child-vaccination-rates/ printed on July 31, 2013

5th Anniversary of Bruce Ivins' Death is Today, July 29/ Frederick News-Post

The paper representing Maryland's second largest city is featuring two articles (here and here) skeptical of Ivins' role in the anthrax letters.

It also created a site for readers to vote whether they believe Ivins was responsible for the anthrax attacks, or not.  Right now, only 27% think Ivins was the perpetrator.

And now that we know a lot more about the extent of government surveillance on "ordinary American citizens", it seems we can safely assume Ivins was under pretty complete 24/7 surveillance.  And that his phone calls and emails were probably all scooped up from even before 9/11/01.

The fact that after the FBI's most expensive and detailed investigation in history, burnished by all the intel the NSA could provide, there was still no real evidence linking Ivins to the crime -- well, that is probably a very good reason to exonerate him.

FBI bars Fla. from releasing Todashev autopsy/ Boston Globe

The Boston bombing case was horrific and unexplainable, unpardonable.  Yet the public lacks much evidence about it and no trial has taken place.

Where is the evidence the brothers made the bombs?  What is Dzhokhar's side of the story?  Have you heard it?  One brother is dead and the other has been under wraps since he was captured... with or without a weapon? After how many shots were fired at the boat he was in?  Was Tamerlan alive when captured?  I have no opinion about these matters, but the press has presented multiple contradictory stories at different times.

Then there is Todashev.  The Globe tells us that this young man, here on asylum, had generally cooperated with the FBI, but was fatally shot in his apartment by FBI agents.  His apartment mate, who may have witnessed the events, was arrested and remains in prison, unable to speak with reporters about what she saw.  And now, with an autopsy completed, the FBI has ordered the medical examiner's office not to release the report, "because of the federal agency's active internal investigation into his death."  This explanation makes no sense.

Meanwhile, a Rolling Stone magazine cover of accused Boston bomber Dzhokhar Tsarnaev has led chain stores like CVS to pull the magazine off its shelves.  (Also Stop and Shop, Tedeschi's, 7-11, Walgreens and Rite-Aid refuse to carry the magazine.) Why?  No one is forcing anyone to buy it.  Why is a cover story-- of an alleged bomber who has pleaded not guilty and has yet to have his day in court--being censored?  Is this the Soviet Gulag or the USA?

I am glad the NY Times took up this latest example of perverted patriotism, pointing out that Hitler's face peppered many magazine covers, as did Charles Manson's and Osama Bin Laden's.  Censorship benefits no one.

David Kelly, ten years on: A spectacular failure of accountability / New Statesman

I have reprinted in full a piece from today's New Statesman about the death of David Kelly and the surprising calls from prominent liberal members of the media to "let it be"--denying the many questions regarding cause of death and how Kelly's death related to the (false) justification for the Iraq war.  The ten year anniversary of Kelly's death is today.

Ironically, those calling for an inquest into David Kelly’s death - ten years on today – base their arguments on precisely the values held so dear by professional journalists: the need for a full, impartial appraisal of the facts without fear or favour.By Justin Schlosberg  

Ironically, those calling for an inquest into David Kelly’s death - ten years on today – base their arguments on precisely the values held so dear by professional journalists: the need for a full, impartial appraisal of the facts without fear or favour. 

Dr David Kelly arriving at the House of Commons on 15 July 2003. Photograph: Getty
Ten years after the death of intelligence analyst David Kelly, the campaign for a formal inquest wages on. Shortly before his unnatural death in 2003, Kelly was outed as the BBC news source for a controversial report suggesting the government had lied in building its case for war with Iraq earlier that year. The fact that key questions remain unasked about an official investigation into a controversial death is nothing unheard of in British politics. But the Kelly case is unique because the most vociferous opponents of due process are not officials or politicians, but journalists. 

This is even more odd because the journalists who are most outspoken against campaigners hail not from the predominantly conservative red tops, but from the so-called "liberal" media comprised of the broadsheets and broadcast newsrooms. It is respected columnists and opinion editorialists – not government spokespeople – who are routinely called on to make the case against campaigners. These are not journalists who tend to shy away from attacking the government or challenging established viewpoints. Indeed, they are journalists who predicate their life’s work on the unfettered scrutiny of power; who place the utmost professional value on evidence, impartiality and accuracy. 

Yet in relation to the cause of Kelly’s death, even the evidence presented at the widely discredited Hutton Inquiry was, by the most conservative measure, conflicting. According to the official verdict, Kelly bled to death after cutting the ulnar artery in his left wrist. Yet paramedic Vanessa Hunt, the first medically trained professional to examine his body, told [2] Hutton that: 

the amount of blood that was around the scene seemed relatively minimal and there was a small patch on his right knee, but no obvious arterial bleeding. There was no spraying of blood or huge blood loss or any obvious loss on the clothing [...] His jacket was pulled to sort of mid forearm area and from that area down towards the hand there was dried blood, but no obvious sign of a wound or anything, it was just dried blood. 

A secondary cause of death, according to the official verdict, was that Kelly had died from a lethal overdose of painkillers. But the toxicology report showed that the level of coproximal in Kelly’s blood was less than a third of what would normally be considered fatal and less than one pill was actually found in his stomach contents. Yet this kind of evidence remains elusive to journalists who continue to circulate assumptions disguised as facts [3]: namely that Kelly swallowed 29 tablets based solely on a blister pack of 30 found on his person with only one tablet left (and incidentally, none of Kelly’s fingerprints). 

What about Kelly’s state of mind? At the Hutton Inquiry, we heard expert witness testimony that he was acutely depressed over a supposed life’s work in ruins and ravaged by the shame of having breached the civil service code. But that testimony was provided by a consultant psychiatrist who had never actually met Kelly, let alone interacted with him during his final days and hours. It was based in large part on that of other witnesses, including Kelly’s close family. While they had spoken of him as "withdrawn" and "subdued", this was primarily in the context of the period leading up to his appearance before the Foreign Affairs Select Committee on 14 July 2003. Following that, Kelly’s daughter and son-in-law, with whom he was staying at the time, described his demeanour repeatedly as "normal", "calm", "relaxed", "relieved", and eating and sleeping "very well" right up to the day of his disappearance. According to his sister [4] (pdf), Sarah Pape, who spoke to Kelly by telephone two days before his death: 

In my line of work I do deal with people who may have suicidal thoughts and I ought to be able to spot those, even on a telephone conversation. But I have gone over and over in my mind the two conversations we had and he certainly did not betray to me any impression that he was anything other than tired. He certainly did not convey to me that he was feeling depressed; and absolutely nothing that would have alerted me to the fact that he might have been considering suicide. 

Of course, such testimony does not prove that Kelly did not commit suicide, any more than conflicting testimony proves that he did. But in the week following Hutton’s report, BBC and ITN journalists cited evidence [5] that Kelly was suicidal no less than seven times in news reports without any qualification or caveat and without once mentioning evidence to the contrary. 

For any journalist genuinely concerned with ‘the facts’, it would have been clear from the outset that the only thing we know in relation to this case is that we don’t know how Kelly died. It is possible that he did die in the way Hutton said he died (albeit extremely unlikely according to mainstream medical opinion), and that conflicting evidence was the result of random anomalies; just as it is possible that Kelly was murdered, with or without the connivance of elements within the British state. The point is that no cause of death has been established on the basis of likely probability, let alone beyond reasonable doubt. 

But there is something else we know which is that there has been unprecedented misinformation, obstruction of justice and on-going suppression of information in relation to this case. Only around a quarter of the police documents submitted to Hutton have been published and much of the remaining evidence has been sealed under an extraordinarily high level of classification for 70 years. It includes medical reports, photographs of the body and supplementary witness statements. The justification for this enduring secrecy is to prevent undue distress to the bereaved. But David Kelly was a public servant who suffered an unnatural death in extremely controversial circumstances. In far less controversial cases, the interests of the bereaved never outweigh that of the public interest in having a formal coroner’s inquest into an unnatural death. 

With occasional and notable exceptions, journalists’ persistent refusal to engage with the substance of this controversy reveals a blind spot in our system of democratic accountability, encapsulated by the label of "conspiracy theory". This taboo, which operates within journalist and academic circles alike, has some sound basis. It discriminates against conjecture often associated with tabloid sensationalism or internet subcultures that respond to secrecy or uncertainty with unfounded reasoning. This kind of theorising has also provided the foundation for racist and extremist ideology upon which acts of terror, genocide and ethnic cleansing have been predicated. 

Such a cautionary approach, however, has led to an outright rejection of the idea that particular groups of powerful people might make, in the words of terrorism expert Jeffrey Bale, “a concerted effort to keep an illegal or unethical act or situation from being made public”. [6] Yet both historical precedent and contemporary events suggest that such instances are a regular feature of real-world politics. The Chilcott Inquiry into the Iraq War, for instance, has surfaced considerable evidence that the decision to invade Iraq was taken in secret and long before it was publicly announced and justified on what turned out to be false intelligence. The problem amounts to an “intellectual resistance” with the result that “an entire dimension of political history and contemporary politics has been consistently neglected” (Bale 1995).
 
Ironically, those calling for an inquest into David Kelly’s death - ten years on today – base their arguments on precisely the values held so dear by professional journalists: the need for a full, impartial appraisal of the facts without fear or favour. The baseless conjecture associated with conspiracy theory, on the other hand, characterises precisely the way in which most journalists have approached this case. Above all, it is the enduring silence of newsrooms which has shielded successive governments from pressure for an inquest or from challenge to their persistent refusals to hold one. 

The fires of injustice rage unabated. It took a lot longer than ten years for the relatives of Stephen Lawrence, Bloody Sunday and Hillsborough victims to get some semblance of accountability from the state. For the relatives of Daniel Morgan, the victims of the Iraq War, Lockerbie, secret rendition and torture, the struggle continues. If nothing else, campaigners for an inquest into David Kelly’s death have succeeded in drawing some attention to yet another spectacular failure of British justice.  

Justin Schlosberg is a media activist, researcher and lecturer at Birkbeck, University of London. He is the author of Power Beyond Scrutiny: Media, Justice and Accountability [7]