Distortion of Facts Used to Support S199

Vermont’s Department of Health Misrepresentations and Distortions of Facts to Dupe State Legislators into Unjustified and Unneeded Constrictions of Exemption Rules.

Reuters, December 7th, 2011
Vermont Keeps Title of Healthiest State, Report Shows
http://www.reuters.com/article/2011/…7B52DP20111206

“Vermont retained its ranking as the healthiest U.S. state, topping the
list for a fifth straight year thanks in part to a high rate of education
and low incidence of infectious disease.”

“The rankings, published online, have tracked the nation’s health for the
last two decades by evaluating 23 factors including smoking, binge
drinking, diabetes, high school graduation, immunization, prenatal care
and obesity.”

A trip to the Vermont Health website confirms that 98% plus of Vermont 7th
Graders meet vaccination requirements or have natural immunity due to
infection contraction (for Varicella / Chicken Pox), exceeding Health
Department 2020 goals. Kindergartners are starting school with a
documented 91% + compliance to requirements even with 10.4% of the group
having “Provisional” exemption status, which is granted when a student is
either catching up with missed doses or unable to provide proper
documentation at the time of enrollment.

These very high vaccination rates co-exist with a Philosophical and
Religious exemption which allows parents to opt out of any doses of any
vaccines they feel are not appropriate. This exemption rate increased from
1.5% to 2.5% in 2008 due to the adding of 2 new vaccine requirements.
Vermont added the Varicella vaccine for Chicken Pox, which is linked to
increases in the MMR seizure rate beyond what some parents feel is
acceptable to prevent an infection, Chicken Pox, that until recently was
considered a routine childhood illness. Some parents choose to either
delay the vaccine or opt out altogether. The other new vaccine is for
Hepatitis B, a blood borne illness with the same infective profile as HIV,
primarily unprotected sexual activity and unsanitary IV drug use.
Hepatitis B negative parents who do not engage in the risk factors, or
associate with people who do so can consider the near zero chance of
exposure in Kindergarten and Elementary school as a reasonable risk
benefit calculation. They can recommend that their children follow the
adult guidelines and consider the Hepatitis B vaccine if they become First
Responders or another profession where they will interact with populations
where the infection is endemic.

Vermont’s reportable infectious disease rates are zero in most categories.

Yet, somehow, just over a month after Vermont is appropriately named the
Healthiest State in the Country these articles begin appearing in Vermont
media:

Rutland Herald (VT) – Sunday, January 8, 2012

Officials consider vaccine rules – Lawmakers consider new vaccine rules

“Only a decade ago, Vermont boasted some of the highest immunization rates
in the country. Christine Finley, immunization program chief for the
Vermont Department of Health, has since watched those rates fall “to some
of the lowest in the nation”.

Sen. Kevin Mullin, a Rutland County Republican, has introduced Senate Bill
199 in an effort to reverse the downward trend in immunization rate”
…”Vermont is doing miserably (?) when compared to other states and we have
to do better,” Mullin said.”

Burlington Free Press (VT) – Jan. 16, 2012

Vermont Lawmakers try to Boost Vaccination Rates

http://www.burlingtonfreepress.com/a…yssey=nav|head

“Last year, Vermont Health Commissioner Dr. Harry Chen lamented the fact
that only 60 percent of Vermont’s young people have had full doses of all
14 recommended immunizations, compared with 70 percent nationally and 67
percent to 76 percent in neighboring states such as New York and
Massachusetts. Some lawmakers hope to increase Vermont’s immunization rate
with stricter laws.”

“Two lawmakers decided independently to propose repeal of the
philosophical exemption.”

Wasn’t Vermont was just named the Healthiest State, with both high
vaccination rates and low infectious disease incidence as key factors?
What empirical evidence is there of any needs to change the current
program?

Why is Christine Finley claiming Vermont’s vaccination rate to be the
lowest in the nation?

Why is Commissioner Chen’s statistic 30% lower than the Vermont Health
Department?

How can Philosophical Exemptions be a problem if 98% of kids are vaccinated?

Consider all of the critical issues facing Vermont. Unprecedented fiscal &
economic pressures. Coal fired power plants spewing toxins into the state.
A debate about natural gas fracking rules. Is it truly plausible that 2
legislators would “independently’ come up with the idea that philosophical
vaccine exemptions are important enough to spend taxpayer time and money
to change a law? For a statistically insignificant potential increase in
vaccination rates?

Can anyone legitimately argue that the need for this legislation is
self-evident?

The next question after the obvious lack of necessity of changing the
exemption rules is why are Vermont Department of Public Health employees
mis-characterizing the true compliance of Vermont students with the
Vermont school attendance required schedule?

If Finley and Chen are not referencing Vermont’s requires schedule, what
are they talking about? They are citing Vermont’s adherence to an
ever-increasing Federal CDC Recommended schedule, one that has ballooned
from 7 vaccines in 1985 to 16 today. They are citing what are called CDC
National Immunization Survey (NIS) statistics, which do not simply measure
vaccination rates. A CDC NIS will include criteria such as if the first
Hepatitis B shot was a “birth” dose (within 24 hours), and if a multi dose
series is completed by a milestone age, and if not downgrade or even
statistically “toss” a child out and call him “unvaccinated”. So even if a
child has all his vaccines by Kindergarten, he can get a lowered or even
zero score if some fell outside of the CDC parameters. So when Chen uses
that “60%” statistic, even that is misleading in context because the
implication, which he makes no effort to clarify, is that 40% of Vermont
children have abandoned vaccination completely.

By conflating and misapplying the statistics Finley and Chen are being
multiply deceitful. First, by confusing the Vermont Legislature, Press,
and Public that the compliance with required vaccines is low. Second,
blaming this non-existent low vaccination rates on Religious and
Philosophical exemptions, again untrue. Third, claiming that eliminating
the exemption will increase vaccination rates, which is again untrue as
they are already above 98%. Eliminating the exemption won’t even raise the
CDC NIS statistic Chen is citing, because those vaccines are not required,
therefore parents do not need an exemption to opt out of them. Changing
the exemption rule won’t effect vaccines that aren’t required.

Doesn’t Finley and Chen’s misrepresenting Vermont’s true vaccination
status cause harm?

How can we expect the legislature to make an informed decision about the
proposed legislation if they are being misled?

Aren’t Finley and Chen denigrating the excellent work that Vermont Public
Schools have done in achieving near 100% compliance with the actual
required schedule? A near 100% compliance achieved with the exemption in
place, respecting Vermont parents’ rights to be sovereign in the control
of the preventive healthcare treatments their children receive?

Is it appropriate that the Vermont DOH is attempting to create friction
between citizens by mis-characterizing parents who use exemptions as
dropping the entire schedule, when the majority are selectively using
exemptions to moderate the expanding schedule? Should the DOH imply
parents who use exemptions are lazy, unscientific, and irresponsible?
“Vaccine hesitant” parents are actually a subject of research for public
health organizations. Public Healths’ own internal studies show that
“vaccine hesitant” parents are typically older, more educated, more
successful, and more informed about vaccine safety then the general
public. Isn’t that more than a bit disingenuous to represent otherwise?

VT DOH is taking advantage of legislators’ unfamiliarity with the current
system and abusing that ignorance by using inapplicable statistics to
influence legislative outcomes in a direction they are dictating.

Legislators are unfamiliar with the current system because it is working
very well and has not needed attention.

Legislators’ lack of information was observed at a recent S199 committee
hearing, when Miller (?) asked for a current required vaccine schedule and
wondered out loud how is it we do exemptions now?

When confronted in committee by the fact that Vermont is actually very
highly vaccinated, Chen came back with a map that again used inapplicable
statistics. Chen’s map of the state had dots indicating areas of “10%”
exemption rates, and Chen re-emphasized that we must eliminate the
exemption to protect public health. What Chen did not clarify is that the
10% locations were not philosophical exemptions, but the “Provisional”
exemptions given to Kindergartners. Provisional exemptions are granted to
students who are either behind on the dose schedule or who didn’t have an
updated vaccination record at the time of enrollment. A Vermont child who
does not attend a state licensed day care or pre-school has no vaccine
requirements prior to kindergarten. Understandably some number of
kindergartners are in the process of catching up during the first year of
public school attendance. Chen is again demonstrating that the lack of
empirical evidence against the philosophical exemption requires the
substitution of another statistic to improperly influence the committee.

The so-called “compromise” recently offered, requiring an approved Health
Care Provider to “educate the parent about the risks and benefits of
vaccination” and then sign off to use a Religious or Philosophical
exemption, is no compromise. It effectively converts all exemptions into
medical exemptions, as a parent must get permission to exempt. The DOH
knows from internal studies that the clinical setting is a poor one for a
vaccine safety consultation. They know 20% of Pediatricians will “fire”
patients who do not follow vaccine protocols. This legislation is very
poorly crafted and unworkable. There is no insurance billing code for a
“vaccine safety consultation” so pediatricians will either have to give
them for free, or Vermont citizens will be paying out of pocket to
exercise their right to exempt. There is no recognition of CAM signers in
a state where many people use complementary and alternative medicine for
primary health care. There is no provision for out of state signers,
important for Vermont with its large border population. The plan really
seems designed to fail.

If this was really about education, the information the state considers
critical could be offered online, by DVD or computer CD, or in hard copy
form and parents could review it and then certify they have done so on the
exemption form.

If the DOH is concerned that it is too “easy” to use an exemption Vermont
could follow other states who have added the requirement that a parent
have his own signature notarized, (not a health care providers) on the
exemption form. This would weed out true “convenience” exemptions, of
which there is very little evidence anyway.

So we now have a compelling case that the DOH is misrepresenting factual
evidence and recommending unneeded, unworkable, and potentially
unconstitutional legislation that almost certainly did not originate in a
legislator’s office but was offered by a lobbyist of some kind.

In the committee members’ defense, if you have a Vermont State Employee
briefing you in an official capacity, don’t you have the expectation that
they would be truthful with you? That the hard facts would be accurate,
and the recommendations based on those facts are in the best interest of
the state?

Once you wrap your head around the reality of the fact that the Vermont
DOH is actively engaged in behavior that one would think is at least
unethical, pushing legislation by conflation and misrepresentation of
facts, legislation that doesn’t even do what they claim, the next question
is “why?”

Why the sudden urgency to restrict exemption rules? A need so dramatic
that it warrants deceiving the Vermont Legislature, Press and Public?

There is a national, un-elected medical bureaucracy, a vaccine lobby, who
has a stated and written objective that every US citizen be subjected to
the full CDC Vaccination schedule, children and adults alike. This lobby
believes that there should be no exemptions other than medical
contra-indications, which for these groups only include an in-office,
immediate, violent reaction. This lobby believes that anyone who does not
use every available, licensed and indicated vaccine is a non-scientific
near Luddite.

This lobby considers the recommendations to be so infallible that all
persons should submit to them without question. This lobby was very put
out that a small percentage of the general public began chafing at the
addition of the Chicken Pox and Hepatitis B vaccines and using state
granted exemptions, and immediately began working to “correct” this
situation. The Vermont initiative did not originate here, it was test run
in Washington state in 2011.

This lobby has been consistently grinding out position papers, with the
same academic integrity as Vermont DOH’s handling of vaccination rates,
claiming that Religious, Philosophical, and Personal Objections are a
threat to public health when all facts and conditions scream otherwise.
Making scientifically unsupportable claims to link outbreaks with “low”
vaccination rates, and doing epidemiological gymnastics to try to link
every infection to an “unvaccinated” person.

This lobby is currently abusing the school attendance vaccination
requirements. The rationale for school attendance vaccination is to
prevent the school from being an infection hub for easily, casually
communicated highly contagious infections that students could pass from
one to another in the normal interactions of a school day. This is a
reasonable objective.

So why is the Hepatitis B vaccine now a school attendance requirement?
There is virtually no conceivable infection pathway that does not involve
illegal behavior where a child could be exposed to Hepatitis B in the
normal school day. One has to imagine a bloody, mouth to mouth playground
collision between students, one of who is infected, and even that exposure
is not a guarantee of infection. HIV has the same infective profile as
Hepatitis B, and the authorities consider the at school transmission risk
of HIV to be so low that known HIV positive persons are permitted school
attendance by law. Yet a child not vaccinated against a disease
communicated the same way, without any active infection, can be denied
school entry? A disease that even if he were infected with is not a threat
to other students? Doesn’t this student deserve the public school
education his family’s taxes pay for?

Separate from the need or efficacy of this vaccine is that when the state
requires vaccines for school attendance for diseases that can’t be
contracted at school it is advancing an agenda other than preventing
school infection outbreaks.

Make no mistake about it, the vaccine lobby desires mandatory
administration of the entire current schedule for all children and adults,
and is already developing plans to add in the numerous vaccines now in
development.

This is the group driving the actions to constrict exemption laws. The
Vermont initiative did not originate in Vermont, it was test run in 2011
in Washington State. Restricting exemption serves several current
purposes, even if doesn’t raise the required vaccination rates, which are
already high.

First, it marginalizes exemptions by framing parents using them as lazy,
unscientific, uninformed and irresponsible.

Second, it is constructing a legal framework so that as additional
vaccines without obvious utility are added they are much more difficult to
avoid.

Third, it conditions the populace to simply accept the mandates.

Fourth, it is providing a logical foundation for expanding requirements
out of childhood into the adult world. “If this is a necessary and
accepted mandate to keep our schools safe, why is an adult workplace
different? We have collections of people in close physical proximity, with
virtually the same conditions as a school except the people are older, so
why are we letting adults run around as potential infection reservoirs?”

Unless and until citizens educate their elected officials to the actual
facts surrounding legislation we can expect to see the Washington /
Vermont play-book in action. Next up is Arizona, which has 98% plus
vaccination rates but the newly introduced bill has the Orwellian title, ”

First, Public Health will issue press releases, decrying the deplorably
low vaccination rates, conflating NIS statistics with actual coverage
rates. Ideally these releases will coincide with a local case of a vaccine
preventable disease, but that is not required. Any infection anywhere can
be used to justify the story.

Shortly after or concurrent with these stories will be legislation to end
the excessively liberal exemptions. This legislation will be lauded as
critical to protecting Public Health from the lazy, irresponsible,
unscientific exemption using parents.

All discussions will concentrate on preventing the dangerous, actually
infectious diseases and ignore the mandates for Hepatitis B and Chicken
Pox.

When the vaccine lobby is on its game anyone opposing the legislation is
pro-infection and pro-infant mortality.

The end game for the vaccine lobby is to create an environment where the
populace has no right to exempt from any vaccine that is considered by the
vaccine authority to be necessary.

I don’t think that is an attractive future to even the most ardent
supporter of vaccination.