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US county bars unvaccinated children from public spaces amid measles emergency

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l1481 (Published 28 March 2019) Cite this as: BMJ 2019;364:l1481

Linked opinion

Measles in America—what’s playing out in New York State is nightmarish

Re: US county bars unvaccinated children from public spaces amid measles emergency

Response to John Stone & Elizabeth M. Hart

Stone says we should call the diseases in question (e.g., measles) “vaccine discourageable” rather than “vaccine preventable.” I guess he either doesn’t know the history of smallpox and polio or doesn’t believe it. Smallpox killed around 200 million in the 20th Century. A less dangerous strain was circulating in the U.S.; but 100s of Americans still died from the dangerous strain imported from abroad; but without mass vaccinations, it would have been higher and there was no guarantee that the milder strain, which also killed, could not have been replaced once again by the more dangerous strain. And if one follows the WHO polio campaign, nothing else can explain polios disappearance from countries where it was endemic. However, only infectious diseases with humans as their only reservoir can be completely eliminated. Measles, actually is one of them. And neither the smallpox nor the polio nor the measles vaccines need be 100% effective, something Stone doesn’t understand. Measles was considered eliminated in the U.S. by 2000; but as more and more people refuse to vaccinate their kids, it has arisen again because of visits by unvaccinated from abroad or returning unvaccinated American travelers. Stone also ignores what I wrote about those who can’t be vaccinated.

I just threw Ebola out as an example that quarantine has been implemented for diseases not listed and Stone ignored what I wrote about a local outbreak of Hepatitis A among homeless. What I failed to explain is that Stone doesn’t understand the U.S. Constitution. States have quite a bit of sovereignty and our Supreme Court has ruled on this, especially when it comes to infectious diseases.

As for “making vaccination compulsory for every disease . . . where does it end?” Hopefully, a reduction in human suffering.

Hart writes her understanding is that measles vaccine isn’t given before 1 year of age because the child is protected by mother’s antibodies. This protection begins to wane as early as 3 months of age, so the infant is vulnerable. However, their immune system is still developing & remaining mother’s antibodies make the MMR less effective; but in emergency, earlier vaccination still confers some protection. My previous RR addressed the risks from the natural diseases. And, with mumps, not measles, the science says that, besides the childhood schedule, one additional booster needed early adulthood; but one should get the flu vaccine every year, I do. Yep, having seen polio victims, parents & grandparents suffering from shingles, kids blinded by measles, etc. I prefer a few jabs.

I have exchanged comments with Stone in the past. I asked him if he had ever studied or even read a book on immunology, microbiology, infectious diseases, epidemiology, biostatistics, the history of any of the vaccine-preventable infectious diseases, or monitored the current status of these diseases in the world (just a plane flight away from us). His answer was that he bases his understanding on years of careful reading and experience. I consider myself reasonably intelligent; but if someone gave me several detailed plans for building a bridge over a river, no matter how carefully I read them I don’t have training/education in structural engineering. I’m sure there are antivaccinationists far more intelligent than me; but not even understanding the basic concepts of the sciences underlying vaccines can’t be compensated for by just intelligence, otherwise, why not scrap university degrees, just give people IQ tests, and hire them. Let’s have the John Stones of the world design our bridges, etc.

Stone writes: “We should also ask, if we are arriving at the point where no one may criticise vaccine science, how can we have good science?” Stone and his ilk have been criticizing and responded to; yet, they ignore what doesn’t conform to their rigid ideology and research is criticized all the time by those who actually understand it. I have written several articles showing just how illogical, unscientific Stone is. The FDA approval process for vaccines and CDC post-marketing surveillance, including the Vaccine Safety Datalink, which provides “real-time” data on every vaccine given to a large number of kids, their co-morbidities, and any adverse events, is higher by far than for any other drug or our foods.

Stone claims he is not an antivaccinationist; but his view of himself as standing “against the vaccine lobby,” and his continued denial that vaccine safety has been studied many times and continues to be studied, and the nature of the blog he writes for, Age of Autism, counter that. If one follows the logic of antivaccinationists, since a few people have been harmed by seatbelts, we should outlaw them, or at least remove laws making them mandatory. If we eliminated seatbelts, we could save a few lives and injuries, while sacrificing 10s of thousands. While seatbelts only save the individual, mass vaccinations save those who can’t be vaccinated or whose immune systems didn’t respond to the vaccine. As for vaccine safety, no one denies that there are some risks, albeit the serious ones are quite rare, not Autism, and one can find ALL of them on the CDC website as well as other websites.

What Stone and other antivaccinationists call a lobby, I call people like myself who chose our professions, who put in years of study, because we wanted to contribute to people’s health, people working for the CDC, FDA, NIH, State Public Health Agencies, Medical Schools, etc. as, based on our actual understanding of the research and dangers of various infectious diseases, supporting vaccines because we care.

As for Stone’s submission to the House of Commons, while I don’t know British law, my guess is they are required to publish such submissions and take them as seriously as the U.S. National Aeronautic and Space Administration would a submission by the Flat Earth Society. The only ones who probably take Stone’s submissions seriously are the echo chamber blog, Age of Autism.

References:

Harrison JA (2015 Dec 5). Debunking Antivaccinationist John Stone & the CDC “Whistleblower”: A Review of John Stone’s “DeStefano Rids Again: GSK Rotarvirus Vaccine Study Loses 805 Of Cases and 18 Deaths”. Every Child By Two archived at: https://web.archive.org/web/20160505150756/http://www.ecbt.org/images/ar...

Harrison JA (2017 Feb 23). John Stone and the “Best of Age of Autism”: Just Plain Wrong About Everything. Expert Commentary Series, Every Child By Two archived at: https://web.archive.org/web/20170311163007/http://www.ecbt.org/images/ar...

Reiss DR (2019 Mar 30). New York county’s one on vaccinations was bold, necessary and perfectly legal. CNN. at: https://www.cnn.com/2019/03/30/opinions/vaccinations-new-york-ban-reiss/...

BMJ News (2019 Mar 28). US county bars unvaccinated children from public spaces amid measles emergency at: https://www.bmj.com/content/364/bmj.l1481/rapid-responses

Competing interests: No competing interests

07 May 2019
Joel A. Harrison
Long-Retired Epidemiologist
None
I have NEVER worked for the FDA, NIH, CDC, any pharmaceutical company, nor ever purchased pharmaceutical stocks