On Tuesday, California Governor Jerry Brown signed a law that makes California the third state to eliminate “personal belief” exemptions from vaccine requirements for children to attend schools, either public or private.
Starting with the 2016 school year (and with one important exception noted below), all children except those with medical circumstances that would render vaccination unsafe must be vaccinated against ten specific illnesses in order to enroll in a California school. Those who insist on not vaccinating must home-school or find other “independent study” methods of education. The requirement applies to public and private schools, child day care centers (including homes that provide family day care services), and nursery schools. According to the Los Angeles Times, “the new law could affect more than 80,000 California students who annually claim personal belief exemptions.”
Actor/comedian Jim Carrey isn’t happy about the new law, about which more in a moment. Note to Jim: Jenny McCarthy is married; you’re not going to be able to sleep with her again (though I don’t blame you for thinking about it). So please, stop pandering to Jenny’s insanity by buying into her claim, which is not just ignorant but extremely harmful, that vaccinating children is dangerous. (McCarthy believes that a vaccine caused her son’s autism, from which he has largely recovered. Some have questioned whether he was ever autistic, a suggestion the former Playboy Playmate of the Year aggressively rejects.)
Despite trying to revise her own history, McCarthy has — in part thanks to being promoted by Oprah Winfrey — for nearly a decade been the face (and body?) of the anti-vaccine movement. In 2007, she told CNN that “moms and pregnant women” were asking her advice on vaccinating children. Her response: “I don’t know what to tell them, because I am surely not going to tell anyone to vaccinate. But if I had another child, there’s no way in hell.”
The number of unvaccinated children has been rising rapidly in recent years, particularly among upper-middle class white suburbanites. Although several conservative religious communities avoid vaccines, bastions of liberalism such as Boulder, Colorado (the nearest city to my home), have some of the nation’s lowest vaccination rates. In fact, Colorado has the lowest kindergarten vaccine rate in the country (82 percent for MMR as compared to a 95 percent national average); Mississippi has the highest rate.
Liberals object to vaccinations on the basis of pseudo-science and distrust of corporations whereas conservatives are more likely to object out of religious conviction. One expert I spoke to noted — and she wasn’t joking — that one of the best predictors of a low vaccination rate in a given area is the presence of a Whole Foods supermarket.
One important exemption within California’s new law: Children whose parents object to immunization in writing before January 1, 2016 will be allowed to continue in school until entering the next “grade span,” meaning until transitioning from pre-school to kindergarten or from sixth grade to seventh grade. This means that an unvaccinated first grader will, if his parents so choose, be able to remain unvaccinated for six years of school, putting perhaps thousands of other children at risk.
California politicians drafted the bill after last year’s measles outbreak at Disneyland that ended up spreading to six states, Mexico, and Canada, sickening more than 300 people of whom more than half were in Quebec, where the disease was spread by children in a cluster of families who didn’t vaccinate for religious reasons and then spread it to other children at their elementary schools.
In 2000, the United States declared measles to have been eliminated in this country. (Although the number of cases was more than zero, it usually numbered just a few dozen in most years until 2012.) So far in 2015, thanks in large part to the child abusers who have refused to get their sons and daughters vaccinated, the CDC reports 178 cases of measles in 24 states and the District of Columbia. (Two thirds of these cases came from the Disneyland outbreak.) In 2014, there were over 600 cases of which 383 were among unvaccinated Amish people in central Ohio.
Jim Carrey (well known among conservatives for calling Second Amendment supporters “heartless mother%ckers” — for which he later apologized) took to Twitter to blast the new law: “California Gov says yes to poisoning more children with mercury and aluminum in manditory [sic] vaccines. This corporate fascist must be stopped.” Yes, Governor Moonbeam is now a “corporate fascist.” And, “The CDC can’t solve a problem they helped start. It’s too risky to admit they have been wrong about mercury/thimerasol. [sic] They are corrupt.” To be fair, Carrey says that his objection is specifically to thimerosal and other metal-containing preservatives and not to vaccines more broadly.
The CDC has explained the debate over thimerosal, the purpose of which is to ensure that vaccines are not contaminated by bacterial growth, and does not agree with those sounding an alarm about its risks. Thimerosal is commonly (but not universally) used in the important MMR (measles, mumps, rubella) vaccine, which all children are recommended to receive. The safety issue arises because thimerosal contains mercury, which people are aware of as a potential health hazard — pregnant women are particularly aware of it with dietary limitations on certain types of mercury-containing fish recommended during pregnancy.
The theory of the anti-vaccine crowd, including particularly Jenny McCarthy and amplified this week by a vociferous Jim Carrey, is that the mercury in the minuscule amount of thimerosal in certain vaccines (less than 0.01%) can cause autism or other harm to children. Perhaps if Carrey could correlate his strange facial expressions to his parents having vaccinated him, he’d have a stronger case. CDC references a 2004 study of multi-year multi-nation data which concluded that “this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only. Further, the committee stated that the benefits of vaccination are proven…”
The myth of a harmful MMR vaccine began in earnest with a paper published in 1998 in the British medical journal The Lancet by Dr. Andrew Wakefield. The paper, formally retracted by the journal in 2010, argued that the vaccine may have caused a range of health issues in eight children. It was found that Wakefield’s methods were unethical — including subjecting autistic children to unnecessary and painful tests, his data was bogus, he was being paid by attorneys aiming to sue vaccine companies, and he had filed to receive a patent for a vaccine to compete with the leading MMR vaccine. Oh, is that all? In 2010, British medical authorities revoked Wakefield’s medical license. This is the Pied Piper leading McCarthy, Carrey, and friends to support behavior that risks the health of hundreds, thousands, perhaps even millions of people.
I’d like to address a particular argument commonly made by anti-MMR agitators: They will find a school in which, for example, four kids got measles of whom two were vaccinated and two weren’t and conclude that there’s no point in getting the vaccine. This is a near-criminal abuse of statistics.
According to the CDC, “Measles is so contagious that if one person has it, 90% of the people close to that person who are not immune will also become infected.” Imagine that the school had 202 children of whom 200 were vaccinated. Imagine further that someone with measles visited the school and was in close proximity to most of the students. Two of the two hundred vaccinated children nevertheless got sick (vaccines are never 100 percent effective), as did both of the unvaccinated children. In other words, 1 percent of the vaccinated caught the disease while 100 percent of the unvaccinated did. That massive disparity, not the “two of each” framing of the outcome, is the right way to think about the importance of making sure kids get the vaccine.
For those with faith-based objections to vaccinations, the substance of the California bill is worthy of real debate: How do you balance deeply held religious conviction with public health? The relevance of the question is that much higher after an assault by courts and state governments on those who would refuse to participate in same-sex marriage ceremonies that they find immoral. Republican presidential candidates Rand Paul and Chris Christie each attracted strong criticism for their comments on vaccinations last year although the question of “who owns your — or your child’s —body?” is a reasonable one.
But even as a fierce opponent of the Nanny State, I believe that government has a higher level of responsibility to protect children than to protect adults. Not an “it takes a village” level of responsibility, not a co-parenting level of responsibility, but something more than allowing an adult to harm a child — whether his own or someone else’s. The latter is a key point: Having a single unvaccinated child in a school — even if a vast majority of the other students are vaccinated — is an epidemiological time bomb.
My view is that public schools should require universal vaccination but that private schools should be allowed to set their own policies. Most likely, parents will demand that they set the same universal standard and most private schools, partly out of fear of litigation, will accept that standard. If there is enough demand for a school for unvaccinated kids, someone will provide it (if their insurance costs would be manageable). Even this flexibility, and even for this libertarian columnist, is a close call because at a school with many unvaccinated kids, if any of them is exposed to the disease, many children will get it, as may some of their vaccinated friends from other schools whom they play with in the neighborhood park or swim with at the neighborhood pool.
The challenge of settling competing claims of rights is never an easy one. But when you’re talking about a highly contagious illness that can kill you — even though last year’s outbreak did not cause any fatalities — one needs to ask which freedom most deserves protection.
One thing, however, is certain: When it comes to the issue of vaccinating your children, Jim Carrey is a clown, and a dangerous one at that.