An Online Symposium on Liability for Exercising Personal Belief Exemptions from Vaccination

Michigan Law Review

Parents Should Not be Legally Liable for Refusing to Vaccinate their Children

Parents Should Not be Legally Liable for Refusing to Vaccinate their Children

Jay Gordon 

* Fellow, American Academy of Pediatrics. † Suggested citation: Jay Gordon, Commentary, Parents Should Not Be Legally Liable for Refusing to Vaccinate Their Children, 107 Mich. L. Rev. First Impressions 95 (2009), http://www.michiganlawreview.org/firstimpressions/vol107/diekema.pdf.

Introduction  Should a parent who takes advantage of a personal belief exemption to avoid vaccinating a child be held liable if that child infects other people? No, because there are valid medical reasons for choosing this exemption and tracing direct transmission of these illnesses from an unvaccinated child to another person is virtually impossible.  I have been a pediatrician in private practice for nearly thirty years. I was conventionally trained, completed a residency in pediatrics at Children’s Hospital of Los Angeles and was the Senior Fellow in Pediatric Nutrition at Memorial Sloan-Kettering Institute in New York City. Over many years, seeing thousands of children, my point of view about childhood vaccines has changed. I believe that parents have the right to decide when and how their children receive vaccinations and also have the right to decline any or all vaccines. Like many medical interventions, vaccines have risks and benefits, and parents may elect nonvaccination as the better choice for an individual child. The societal ramifications are significant and should certainly be a part of any discussion.  When children or babies who have been in contact with other children (or adults) contract most illnesses, there is no feasible way to know from whom they got the disease. Whether one is talking about a routine winter viral illness, chickenpox, or whooping cough, the contagion could have come from a child with overt disease signs and symptoms, an asymptomatic carrier, or another, perhaps mutual, contact. Vaccines are not 100% effective, so that even a fully vaccinated child can contract an illness or carry that illness and give it to another child. Blaming a specific individual—let alone suing one—because your child gets sick has no credible medical basis.   I. Parents May Be Justified in Declining to Vaccinate Their Children There are many valid reasons to support vaccination, but they don’t support removing the right to refuse vaccinations. There are also situations—medical and personal—which justify waiving all or some childhood vaccines, but these are not good reasons to abandon vaccines altogether. Twenty states (including Michigan) allow parents to waive any or all vaccines for personal or philosophical reasons. These children may still attend school at all levels, but the school system reserves the right to exclude these children in the event of an outbreak. This is a firm commitment on the part of the government to protect the rights of parents to participate fully in this important healthcare decision. Parents who feel that the risks of vaccinating outweigh the benefits are entitled medically and legally to waive vaccines. Section 6051 of the California Code states that “[a] pupil with a permanent medical exemption or a personal beliefs exemption to immunization shall be admitted unconditionally.” Similar wording appears in most of the state laws allowing a personal belief exemption. These are not whimsical choices on the part of the legislators, the parents, or the doctors who support this right. Parents who vaccinate their children base their decisions on the advice they receive from their pediatricians and the other knowledge they have gathered. Parents who choose to waive vaccinations do so for similarly valid reasons. Adverse outcomes can occur from both vaccination and nonvaccination. Vaccines work very well at creating immunity to illnesses, so there are very few situations that would likely lead to transmission of an illness from an unvaccinated child to a vaccinated child. The obvious exceptions would be infants too young to have received a full complement of shots and immuno-compromised children. Parents must protect these two groups of children by keeping them away from too many other children. Period. Newborns and young babies are at risk any time they are in public. We can only vaccinate against a very small minority of contagious illnesses; it is unwise to bring your newborn into preschool when you pick up your toddler, and equally risky to attend older children’s birthday parties with this baby. Further, parents of children taking high dose steroids for asthma or receiving immunosuppressive medicine for other diseases are strongly cautioned by their doctors to avoid the potential dangers I have described. There are valid reasons for giving all the recommended vaccines, but parents’ ambivalence is supported not just by instinct or alleged self-interest but also by medical literature questioning the effectiveness of immunizations. The Centers for Disease Control and Prevention (“CDC”) funded a peer-reviewed article about flu shots published in the October 2008 issue of the highly respected Archives of Pediatric and Adolescent Medicine. It concluded: [S]ignificant influenza VE [vaccine effectiveness] could not be demonstrated for any season, age, or setting after adjusting for county, sex, insurance, chronic conditions recommended for influenza vaccination, and timing of influenza vaccination (VE estimates ranged from 7%–52% across settings and seasons for fully vaccinated 6- to 59-month-olds). . . . In 2 seasons with suboptimal antigenic match between vaccines and circulating strains, we could not demonstrate VE in preventing influenza-related inpatient/ED or outpatient visits in children younger than 5 years. Further study is needed during years with good vaccine match. We have known for years that flu shots do not work well in older adults; newer research questions their efficacy in children, too.  Another example involves chickenpox. The Varicella Zoster virus (“VZV”) causes chickenpox in children; the illness is virtually always benign and leaves the child with immunity to chickenpox. In adults, this virus also can cause “shingles,” an extremely painful illness. VZV can live in the nervous system for years and then reactivate in adults whose immune systems no longer suppress it.   Fortunately, continued occasional exposure to children with chickenpox usually keeps the antibody level against the virus high enough so that shingles is not terribly common. That is the state of medical care in most of Europe where governments and the medical establishment have refused to officially recommend universal vaccination against chickenpox. Among many studies supporting this refusal is a report in the prestigious medical journal Vaccine written by researchers at Britain’s Public Health Laboratory Service, who found that “eliminating chickenpox in a country the size of the United States would prevent 186 million cases of the disease and 5,000 deaths over 50 years. However . . . they said it could also result in 21 million more cases of shingles and 5,000 deaths.” Of course, we have been quite successful in reducing certain childhood diseases to almost insignificant numbers in the United States, Western Europe, and many other places. (Somalia experienced its first polio-free year in 2008.) And widespread vaccination directly led to this success.  In March 2005, Julie Gerberding, Director of the CDC, held a press conference to announce that “[t]he elimination of rubella in the United States is a tremendous step in protecting the health and well being of pregnant women and infants.” A viral illness feared by pregnant women “is no longer considered to be a major public health threat in the United States.”   Another success story involves measles. The United States averages about 60 cases of this viral illness each year. In 2008, the country is on course to have about 160 cases among 300 million Americans. However, the media have managed to turn these extra 100 cases into a cause célèbre for vilifying parents who question the currently recommended schedule of twenty-five or more separate injections over the first two years of life.   In 1960, if a parent were presented with a dilemma about the polio vaccine and hypothetical side effects, the decision would not have been too difficult given the prevalence of polio during that time period. In 2008 or 2009, the illness is rare worldwide: we are on target for about 1700 cases on the entire planet in 2008 with all but 100 of the cases being in India, Nigeria, Pakistan, Angola, or Afghanistan. The benefits, both personal and societal, of the polio vaccine were so clear thirty or forty years ago that parents and doctors easily agreed on universal vaccination. “Childhood vaccines save 33,000 lives each year in the United States.” This statement has been made so often that no one seems to question the absence of logical thinking behind it. The numbers are based on medical care in the early to mid-1900s. There is no way to estimate how many lives vaccines are saving, and a similar estimate of harm from vaccines is difficult to calculate. As a result, a parent’s decision not to vaccinate a child is being unfairly vilified.  II. Parents Should Not Be Liable for Placing Their Children’s Best Interests Above Universal Vaccination Policies   In the absence of facts, doctors and others are trying to frighten people into vaccinating or not vaccinating. That fear includes the notions that unvaccinated children pose a great threat to others and that parents of these children are not being responsible. In fact, these parents are choosing what they consider to be the safest course of action for their children and pose very little, if any, danger to other children and adults.  Some medical interventions are not controversial, and some prompt only mild controversy. For example, if a child has acute lymphocytic leukemia, the cure rate with conventional medical care approaches ninety percent, and very few doctors or parents will argue against the standard treatments offered in spite of their known complications and adverse reactions. But vaccines are presently controversial, and purported truths about safety and efficacy are challenged daily by lay people and physicians.  Very few medical actions are risk free. Prior to surgery or when medication is prescribed, your doctor explains the risks and benefits. For surgery, the consent form is often many pages long with dire warnings about what can go wrong. Childhood vaccines are shipped to my office with a long thin package insert detailing how the shots are manufactured, what they contain, and what can and has gone wrong. The last lines in many of these inserts sound ominous: “This vaccine has not been evaluated in animals for its carcinogenic or mutagenic potentials or for impairment of fertility.” I seriously doubt that vaccines are a large source of cancer, genetic mutation, or impaired fertility. However, any time I inject a vaccine into a child there is potential for adverse outcome. I respect parents’ questions and objections to our current vaccine schedule. Parents have the absolute right to participate in these medical discussions, and not giving them the information they need to make informed decisions is inadequate medical care. Not seeking out this information is an abrogation of parental responsibilities.  The list of side effects from adverse reactions to vaccines, in a Physicians’ Desk Reference “warning” section, given out of context, would probably frighten many parents out of vaccinating at all. There are thirty or more items on that list. Similarly, the list of symptoms and complications of the illnesses against which we vaccinate could scare parents into giving every shot available as soon as possible. Pediatricians and other physicians use the latter option on a daily basis. I share my colleagues’ disdain for scare tactics from the “antivaccine” camp, but I object equally to doctors using fear and misinformation to try to convince parents (and legislators) that vaccines are risk free. Both sides are distorting the truth for their own purposes. Childhood illnesses are part of the first decade of life; immunity is acquired, and the consequences are almost always minor.   Modern medical care has completely changed the morbidity and mortality rates associated with virtually every single infectious disease. Yet, the “33,000” number is used in the media as if we actually know how many children would succumb to these illnesses in the absence of vaccines in the twenty-first century. We do not really have any idea what this number would actually be with twenty-first century medications and care. And unvaccinable diseases are far, far more common and, realistically, a greater concern for parents: toddlers get eight to ten or more colds each year. To restate a very important point, even vaccinated children can carry diseases like pertussis and mumps. There are no completely reliable medical or laboratory tests showing who infected whom.  Conclusion  Vaccines work. They carry some risk but are a viable method of preventing contagious diseases. Parents who choose not to vaccinate their children accept responsibility for their actions, do not endanger others, and must retain this right. There is no medical basis for holding them liable.

N.Y. Sincerity Test

3 part video on a ‘sincerity test’ given to parents in NY by a school lawyer.

Part 1

Part 2

Part 3

keep in mind..no matter what he or the school decides, it can be over turned (if it is denied) by the NYS commissioner.

NY vaccine exemption article

NVIC Vaccine E-Newsletter

New Yorker’s Stand Up for Vaccine Exemptions

 by Barbara Loe Fisher

In the harbor of New York City stands the Statue of Liberty, a symbol of freedom that has welcomed millions of immigrants for 112 years, half of the time that the United States of America has been a nation. And on the base of the statue is an inscription that says in part “…..Give me your tired, your poor, your huddled masses yearning to breathe free….”

I remembered that phrase when we were driving from Washington, D.C. to New York City and our van got caught up in the Sunday afternoon Manhattan traffic that led us past the Empire State Building on our way to Long Island. Freedom was very much on my mind as we headed for Stony Brook University to participate in the December 15 Vaccine Education Roundtable sponsored by New York state Assemblymen Marc Alessi (D-1st Assembly District) and Richard Gottfried (D-75th Assembly District), who is Chair of the House Health Committee.

Americans have always cherished the freedom to breathe free; to speak, write and dissent without fear of retribution; to believe in God and worship freely without being persecuted; to vote for whom we want to represent us in government and know our vote counts; to follow our conscience and stand up for what is right. Although America is only 222 years old, which is very young compared to other countries that have existed for several thousands of years, during our short history there is no other nation that has defined and defended the freedom of citizens to live in a society based on the principle of equal rights and consent of the governed any better than the United States of America.

These are troubled times for parents in New York and New Jersey and other states. Every day parents are facing more hostility from pediatricians throwing them out of doctor’s offices for questioning vaccine safety and are being harassed by government officials determined to force their children to get dozens of doses of state mandated vaccines without voluntary, informed consent. New York currently mandates more than two dozen doses of 11 vaccines for school attendance while New Jersey leads the nation with nearly three dozen doses of 13 vaccines, including annual influenza shots.

Religious exemptions are being pulled by state officials after they throw parents into rooms and grill them for hours about the sincerity of their religious beliefs. Last year in Maryland, state officials threatened several thousand parents with jail time and stiff fines for failing to show proof their children had gotten hepatitis B and chickenpox vaccinations.

It is in this climate of fear and crisis of trust between parents, who want a more equal role in making vaccination decisions for their children, and pediatricians and public health officials, who are determined to strengthen their power to tell parents what to do, that Assemblymen Alessi assembled a panel representing both sides to discuss whether or not a philosophical exemption to vaccination should be added to New York’s vaccine laws. Currently New York only provides for a medical and religious exemption, even as 18 other states allow a personal, philosophical or conscientious belief exemption to vaccination.

After the Roundtable, Assemblyman Gottfried expressed strong support for First Amendment rights and told the audience of parents, doctors and legislative staff that he is sponsoring two bills to clarify rights defined under existing religious and medical exemptions so they cannot be violated by state officials. After the Roundtable concluded, he said “Important issues were raised. I look forward to seeing additional data from all sides, especially about the impact of the personal objection laws in other states. I will be reintroducing my bills to strengthen the religious and medical exemptions in the 2009 session. I urge parents to contact their local assembly members and state senators to urge them to co-sponsor.”

Assemblyman Alessi commented that “The discussion framed the fact that there is still a large debate on the issue. And although some people in the medical community are adamant that this debate is over, it has only just begun. The amount of conflicting evidence parents are presented with regarding the effects of certain vaccines is staggering. This forum opened the lines of communication between experts in the debate and provided concerned parents with the most recent information on the safety of vaccines. As a parent, I know how difficult it is to make the right decisions regarding our children’s health, but if we are to make good decisions, we need to be well informed and continue to have discussions like this roundtable.”

At the beginning of the Roundtable, I framed the vaccine safety and informed consent debate and outlined how the informed consent principle relates to philosophical/conscientious belief exemption. I reviewed the general health ranking of New York (25th) compared to the 18 states which have philosophical exemptions (six of the top 10 ranked states have philosophical exemption) and noted that the U.S. uses more vaccines than any nation in the world but ranks 39th in infant mortality. Click here to read my entire presentation with live links to references (see text below).

Other panelists supporting philosophical exemption to vaccination included New York pediatrician Lawrence Palevsky, M.D. , who called for an authentic dialogue that “moves past what appears to a growing number of citizens to be a one-sided, paternalistic, and patronizing set of policies and language with an unwillingness to engage in a real discussion about the science of vaccines.” He challenged many of the myths and misconceptions about the safety and effectiveness of vaccine policies.

New York’s John Gilmore, executive director of Autism United, who has a vaccine injured son with autism and said “without trust, the proponents of forced vaccination have nothing but authority and authority is an unacceptable basis for any public policy in a democratic society.” He pointed out operational flaws and conflicts of interest in vaccine safety regulation and policymaking. Louise Kuo Habakus, of the New Jersey Coalition for Vaccination Choice, who has two young sons recovering from vaccine injuries, presented slides summarizing vaccine risks and questioning whether vaccines can be credited with major infectious disease morbidity and mortality decreases in the 20th century. She recounted her impression of the day’s events at www.ageofautism.com. (In related events, New Jersey parents held several open houses this week to educate New Jersey legislators about the need to support pending conscientious belief exemption legislation in that state.)

Panelists defending current vaccine policies and opposing philosophical exemptions included New York pediatricians Paul Lee, M.D. , who agreed vaccine safety should be a high priority but disagreed that the amount of mercury and aluminum in vaccines posed a health risk; and longtime vaccine policymaker and American Academy of Pediatrics spokesperson Louis Z. Cooper, M.D. , who agreed trust between pediatricians and parents needs to be strengthened but defended the safety of existing vaccine policies; and Debra Blog, M.D. , medical director of the Immunization Program, New York State Department of Health, who showed slides of children with infectious diseases and strongly opposed adding philosophical exemption to New York state vaccine laws.

Following panelist presentations there was a spirited debate that lasted for more than two hours as panelists argued and defended their positions. NVIC’s videographer, Chris Fisher, will be making a video of the day’s events available on NVIC’s website.

By the end of the day, I thought about how long parents of vaccine injured children have been asking pediatricians to become partners with them in preventing vaccine injuries and deaths. After nearly three decades, parents and doctors inside and outside of government could not be further apart. The failure of pediatricians and public health officials to take seriously the many cases of regression into poor health after vaccination has become the Number One public health problem in the U.S. today.

There will be no resolution until every state has embraced the informed consent ethic and adopted conscientious or philosophical exemption to vaccination in state vaccine laws. At that point, Americans will be free to vote with their feet and the vaccines the public considers to be necessary, safe and effective will be used and those they do not consider to be necessary, safe and effective will be driven off the market. And then, a real time comparison of the long term health of highly vaccinated, less vaccinated and unvaccinated citizens will tell us a lot about the safety and effectiveness of vaccine policies in the last half of the 20th and first half of the 21st centuries.

Statement of Barbara Loe Fisher
Co-founder & President, National Vaccine Information Center
December 15, 2008 at New York Stony Brook University
Vaccine Education Roundtable

Assemblyman Alessi and NY State Legislators:

Thank you for holding this Vaccine Education Roundtable to discuss issues which impact on Assembly Bill 5468 to insert philosophical exemption in New York vaccine laws. I appreciate the invitation to be part of this panel on behalf of New York members of the National Vaccine Information Center, non-profit organization founded in 1982 to prevent vaccine injuries and deaths through public education and defend the informed consent ethic.

Vaccination is a medical intervention performed on a healthy person which carries an inherent risk of injury or death. The risk of harm can be greater for some than others and there is no guarantee that vaccination will, in fact, confer immunity. With very few predictors having been identified by medical science to give advance warning that harm or failure to confer immunity will occur, vaccination is a medical procedure that could reasonably be termed as experimental each time it is performed on a healthy individual.

Further, the FDA, CDC and vaccine makers openly state that often the numbers of human subjects used in pre-licensing studies are too small to detect all adverse events caused by a new vaccine. This makes government recommended use of newly licensed vaccines by millions of children a de facto uncontrolled national scientific experiment. In this regard, the ethical principle of informed consent to vaccination attains even greater significance.

Informed consent means that a patient or guardian has the right to be fully informed about the benefits and risks of a medical procedure and be allowed to make an informed, voluntary decision about whether or not to take the risk. Informed consent is an important check and balance for the relationship between physicians and patients that encourages physicians to obey the Hippocratic oath to “first, do no harm.”

The affirmation of the informed consent ethic in the practice of modern medicine is rooted in a rejection of the traditional paternalistic medical model, which places the patient or guardian in an unequal, powerless position with a physician and facilitates uninformed, involuntary risk taking. The human right for individuals to exercise informed consent to participating in scientific experiments was officially acknowledged by the judges of the Nuremberg Tribunal after World War II. Their ringing endorsement of individual inviolability and the right to self determination when taking medical risks has became an internationally accepted moral guidepost for the ethical practice of modern medicine. The first principle of the Nuremberg Code begins with:

“The voluntary consent of the human subject is absolutely essential. This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision.”

In America, the closest we come to upholding the informed consent principle with regard to vaccination is in the 18 states which allow personal, philosophical or conscientious belief exemption to vaccination. In the 2008 edition of America’s Health Rankings, Vermont is ranked the number one healthiest state. Vermont allows philosophical exemption to vaccination. In fact, out of the top ten ranked healthiest states, six of them allow philosophical exemption (Vermont, Minnesota, Utah, Idaho, Maine, Washington).

New York ranks 25th in health behind the nation’s most populous state, California. The state of California has twice as many residents as New York, as well as more foreign born residents and those who speak English as a second language. However, in almost all other demographics, California is nearly identical to New York in ethnic diversity; numbers of children under age 18; median household income and persons living below poverty.

California allows philosophical exemption to vaccination.

What is interesting is that in the top 10 healthiest states, four had among the lowest vaccination rates for children ages 19 to 35 months: Utah (37th) , Idaho (45th), Maine (40th) and Washington (48th). California which is ahead of New York in overall health ranking, is 31st in vaccination coverage of 19 to 35 month olds while New York is number 9. The healthiest state, Vermont, is 29th in vaccination coverage.

In fact, health is not primarily measured by high vaccination rates or an absence of infectious disease. High vaccination rates are not the most important measure of the overall health of citizens. The 18 states allowing philosophical exemption to vaccination have not compromised individual or public health when compared to other states.

This past September, the CDC announced that national childhood vaccination rates are at near record levels, with at least 90 percent of young children receiving all but one CDC recommended vaccine. Less than 1 percent of children aged 19 to 35 months remain completely unvaccinated.

Today, the U.S. government recommends the use of more vaccines than any other country in the world: 69 doses of 16 vaccines for girls; 66 doses of 15 vaccines for boys given between the day of birth and age 18. That is triple the numbers of vaccinations recommended by public health officials and physician organizations a quarter century ago, when 23 doses of seven vaccines (DPT, MMR, OPV) were routinely given.

But in comparison to other nations, the overall health of Americans has not improved since 2004 and there are 27 countries that exceed the US in healthy life expectancy while the U.S. ranks 39th in infant mortality.

Today, 1 in every 143 babies born in America dies; 1 child in 450 becomes diabetic; 1 in 150 develops autism;1 in 9 suffers with asthma; and 1 in every 6 child is learning disabled.

The chronic disease and disability epidemic that has developed in the last quarter century is killing and injuring more children than any infectious disease epidemic in the history of our nation, including smallpox and polio. The social, economic, and human costs are enormous: nearly two billion dollars has been paid to vaccine victims by the federal government in the Vaccine Injury Compensation Program while three-quarters of the more than $2 trillion dollar annual price tag for health care is spent to care for the chronically ill and disabled.

The big question vaccine educated parents are asking is: why are so many of the most highly vaccinated children in the world so sick, suffering with all kinds of chronic brain and immune system dysfunction? Why are babies born in the richest country in the world dying more often than babies born in poorer countries, who do not get vaccinated at all or who get far fewer vaccines?

It is a question that has not been answered by any scientific study conducted to date because there has never been a large, prospective study comparing the long term health of highly vaccinated children to unvaccinated children. In the absence of definitive answers, the right to freely exercise medical, religious and philosophical exemption to vaccination is a human right that may well determine the biological integrity of this and future generations in America.

Because vaccines are pharmaceutical products that carry significant risks greater for some than others; because doctors and public health officials are not infallible; because what is considered scientific truth today can be proven false tomorrow; because philosophical exemption to vaccination does not negatively impact on the health of individuals or states; and because informed consent to medical risk taking is a human right, the National Vaccine Information Center urges legislators to affirm the freedom of all New Yorkers to make informed, voluntary vaccination decisions for themselves and their children by supporting philosophical exemption to vaccination.

Georgia State Law (Daycare)

WHAT THE LAW SAYS

Local health officials often tell day care operators their centers are complying with the law as long as 90 percent of their children have proof of vaccinations, a temporary waiver or medical or religious exemption.

But the law says:

“No child shall be admitted to or attend any school or facility in this state unless the child shall first have submitted a certificate of immunization to the responsible official of the school or facility. …”

“Any responsible official permitting any child to remain in a school or facility in violation of this Code section, and any parent or guardian who intentionally does not comply with this Code section, shall be guilty of a misdemeanor and, upon conviction thereof, shall be punished by a fine of not more than $100.00 or by imprisonment for not more than 12 months.”

To read the full text of the law, O.C.G.A. 20-2-771, go here

To attend day care, depending on the child’s age, Georgia law may require vaccination against measles, mumps, rubella, polio, whooping cough, chickenpox, diphtheria, tetanus, hepatitis A and B, pneumococcal disease, and Haemophilus influenzae type B (Hib). Exemptions are allowed for medical and religious reasons.

Vaccine Information Sheet (VIS)

Vaccine Information Sheet (VIS)

 Vaccine information sheets are produced by the CDC.  In the US, it is a federal law that the VIS sheet be signed prior to any vaccine administration. It became a requirement with the passing of the National Childhood Vaccine Injury Act of 1986. The VIS sheets purpose is to describe a brief overview of the vaccine, the benefits, and the risks.

 

  It is NOT an informed consent sheet. A parent signs the sheet simply as an acknowledgment that they were informed of the benefits and risks.

 

There is no Federal requirement for informed consent. VISs are written to fulfill the information requirements of the NCVIA. But because they cover both benefits and risks associated with vaccinations, they provide enough information that anyone reading them should be adequately informed. Some states have informed consent laws, covering either procedural requirements (e.g., whether consent may be oral or must be written) or substantive requirements (e.g., types of information required). Check your state medical consent law to determine if there are any specific informed consent requirements relating to immunization. VISs can be used for informed consent as long as they conform to the appropriate state laws. (bolding mine)

 

According to an AAP survey regarding consent and immunizations: (bolding mine)

 

• The majority of pediatricians distribute written information on these vaccines the first time they are administered: 73.0% always distribute written information on the DTP vaccine; 63.8% always do so for MMR; 60.6% always do so for HIB; and 65.4% always do so for OPV.
• The majority of pediatricians also document provision of information in the patient’s record the first time a vaccine is administered. for the DTP vaccine, 61.3% of pediatricians said they always document provision of benefit/risk information, 56% reported always documenting information on the MMR, 53.8% always do so for the HIB vaccine, and for the OPV, 59.1% always do so.
• Two-thirds of the pediatricians reported they never record a parent’s specific verbal consent in the patient’s record the first time a vaccine is administered. For the DTP vaccine, 19.1% of the pediatricians said they always record parent’s specific verbal consent and 15.6% said they sometimes do so. For MMR, 17.1% said they always do and 13.3%, sometimes. For the HIB vaccine, 16.4% said they always record the parent’s verbal consent in the record and 13.8% said they sometimes do so; for OPV, 18.9% always and 13.0% sometimes do so.

One-half of the pediatricians always obtain the parent’s signature as evidence of consent the first time a DTP, MMR, or OPV vaccine is administered; 47.5% do so for the HIB vaccine. Most of the balance of pediatricians said they never do so (39.8% DTP, 43.0% MMR, 46.3% HIB, and 42.9% OPV).

 

Another AAP survey:

 Vaccine administration practices vary as a function of practice setting, practice area and region of the country. For example, pediatricians in group practices (45%) are less likely than pediatricians in hospital/clinic practices (59%) or solo practices (51%) to say they discuss vaccine risks/benefits with every dose of at least six of the seven vaccines (p<.01). Pediatricians practicing in rural areas and those in the Midwest and South are more likely to distribute VIS at every dose than are pediatricians practicing in other areas (70% rural vs. 55% inner city vs. 64% other urban vs. 59% suburban, p<.05) or regions of the country (72% Midwest vs. 68% South vs. 54% West vs. 49% Northeast, p<.001). practitioners in rural areas (65%) also are more likely to document provision of VIS with every dose of each vaccine than are practitioners in urban inner cities (43%), other urban areas (58%) or suburban areas (54%) (p<.01).

Doctors “firing’ Patients

 

Refuse to get your child a vaccine and get ‘fired’ by your Pediatrician. Who would of thunk?

 Refuse Vaccine, Get ‘Fired’ by Pediatrician?

 Well over a third of pediatricians — 39% — say they would “dismiss” families that refuse all vaccinations, a new study suggests. That’s surprising, says study leader Erin A. Flanagan-Klygis, MD, assistant professor of pediatrics at Chicago’s Rush Medical College.

But another finding surprises Flanagan-Klygis even more. More than one in four pediatricians — 28% — say they would fire families that agreed to some vaccinations but refused one or more other vaccinations.

This study is based on questionnaires filled out by 302 randomly selected members of the American Academy of Pediatrics who give recommended childhood vaccinations. Ref: October issue of Archives of Pediatrics and Adolescent Medicine.

 

Dismissing the Family Who Refuses Vaccines

A Study of Pediatrician Attitudes

Results Fifty-four percent faced total vaccine refusal during a 12-month period. Pediatricians cited safety concerns as a top reason for parent refusal. Thirty-nine percent said they would dismiss a family for refusing all vaccinations. Twenty-eight percent said they would dismiss a family for refusing select vaccines. Pediatrician dismissers were not significantly different from nondismissers with respect to age, sex, and number of years in practice. Pediatrician dismissers were more likely than nondismissers to view traditional vaccines (diphtheria and tetanus toxoids and acellular pertussis; inactivated poliovirus; Haemophilus influenzae type b; measles, mumps, and rubella) as “extremely important,” but they were no more likely to view newer vaccines (7-valent pneumococcal conjugate, varicella-zoster virus, hepatitis B) as “extremely important.”

Conclusions Pediatricians commonly face vaccine refusal that they perceive to be due to parent safety concerns. In response, many pediatricians say they would discontinue care for families refusing some or all vaccines. This willingness to dismiss refusing families is inconsistent with an apparent ambivalence about newer, yet recommended, vaccines. The practice of family dismissal needs further study to examine its actual impact on vaccination rates, access to care, and doctor-patient relations.

 

Logically though, how can you as a parent or your child be ‘fired’?  They provide a service to YOU. You don’t work for THEM. Without YOU, who would THEY WORK FOR? Would you honestly want a physician that didn’t TRUST and RESPECT YOU to KNOW what is best for YOUR child?  Would you really want a physician that didn’t RESPECT your RIGHT to choose what you believe to be in the best interest of your child? Patients can fire their doctors. Doctors can only refuse to see you as a patient in the future. :)

 

 According to the American Medical Association, doctors have “an obligation to support continuity of care for their patients” and “should not neglect a patient.” But if a doctor must end the relationship, they have to provide enough notice so the patient can secure another health care provider.”

I’ve often found that doesn’t happen. Doctors simply tell patients to find a new doctor and in not so nice words. 

Take care when firing a patient

 A physician may legally and ethically decide not to continue treating a patient as long as the patient is not in need of immediate care and has been given a reasonable opportunity to find another doctor, which is consistent with the recommendations of the American Medical Association Council on Ethical and Judicial Affairs.

 

According to the AAP:

Responding to Parental Refusals of Immunization of Children

Douglas S. Diekema, MD, MPH and the Committee on Bioethics

 The American Academy of Pediatrics strongly endorses universal immunization. However, for childhood immunization programs to be successful, parents must comply with immunization recommendations. The problem of parental refusal of immunization for children is an important one for pediatricians. The goal of this report is to assist pediatricians in understanding the reasons parents may have for refusing to immunize their children, review the limited circumstances under which parental refusals should be referred to child protective services agencies or public health authorities, and provide practical guidance to assist the pediatrician faced with a parent who is reluctant to allow immunization of his or her child.

 

So much for the Hippocratic Oath. Or respecting a parents RIGHTS under the LAW. Perhaps they have even forgotten that vaccines are not mandatory. They are only mandated for school or daycare attendance, without an exemption.

 

Parents often feel they have to explain their reason for not vaccinating. Why? If a physician’s belief  is to vaccinate everyone under the sun, nothing you say will make a difference to them. If not vaccinating is your choice, own it. If you do not vaccinate for religious reasons, simply state it. You owe no further explanation and it is against the law for a physician to question your faith or religious beliefs further. If it is against your philosophical beliefs, much like religion, simply state it, and no further discussion needed. You don’t question their religious beliefs, so nothing gives them the right to question or discriminate against yours.

Bullying? Yes, I’ve heard this one too. Remember, only you allow a physician to bully you. If a physician is unethical and unprofessional enough to start it, calmly leave without comment. A physician has no right to bully, yell, discriminate, name call, harass or threaten you, ever. We would call those descriptions ‘abuse’ and that is exactly what they are doing, and they are not above the law.

 

Finding the Right Physician

1. Make a list of physician’s names and get references from friends or families who have similar views as yours.

2.  Call and ask the receptionist if non-vaccinating/selective/delay patients are accepted before making the first appointment.  If you are comfortable with the answers to your questions, book an appointment.

3. Direct any further questions directly to the physician at the appointment.

National Vaccine Registry

 

Vaccines are now recorded and registered with your state’s vaccination registry.

 

According to the CDC:

 

Immunization Information Systems are confidential, population-based, computerized information systems that attempt to collect vaccination data about all children within a geographic area. IIS are an important tool to increase and sustain high vaccination coverage by consolidating vaccination records of children from multiple providers, generating reminder and recall vaccination notices for each child, and providing official vaccination forms and vaccination coverage assessments. One of the national health objectives for 2010 is to increase to 95% the proportion of children aged <6 years who participate in fully operational population-based IIS.

 

If you look further down the page you will find this statement:

 

State law requires that information in the IIS be kept confidential. Only you, your doctor, or healthcare workers who can assist you have access to the information. The information will not be shared with any other people or any other agency. If you are not interested in having your child in the IIS, all you would need to do is contact your state IIS and request to “opt-out” of the registry.

 

Healthcare workers would include Department of Health, CDC, and other government monitoring agencies. Is your child’s school a healthcare agency? Last I knew they were in the education field, yet they have access to it as well. Even the WIC program has linkages. See also: WIC Policy for Immunization Screening and Referral

 

Is this “opt-out” provision true? Not entirely. New York State no longer allows an ‘opt-out’ provision. That means, all children regardless of whether they are vaccinated or not, are in the system. If this vaccine registry was solely for its stated purpose above, why would nonvaccinated children need to be in it? They don’t need reminder notices or updated vaccination forms, etc.

 

Will children with medical or religious exemptions need to be included in NYSIIS?

• These children will be entered in NYSIIS and their records noted with the appropriate exemption. NYSIIS is a valuable tool to identify and protect these children in the event of an outbreak of a vaccine preventable disease. (bolding mine)

 

Why not call it what it is: identify, track, control, and discriminate.

I have heard many stories over the last few years of parents who ‘opted out’ in other states, yet they have found their child in the vaccine registry. Wouldn’t that be a clear violation of the HIPPA law?  No, and here is why:

 

Shalala Will Decide Privacy Rights If Congress Does Not Meet Deadline

 HIPAA provided that, if Congress does not enact legislation to create standards to protect individually identifiable health information in medical records by August 21, 1999, then the Secretary of HHS is required to establish rules governing how much information the government and other third parties can get out of private medical records by February 21, 2000. Currently, there are four medical privacy bills in the House and Senate, including the Health Care Personal Information Nondisclosure Act of 1999 (S.578-Senators Jeffords/Dodd); the Medical Information Protection Act of 1999 (S.881-Senator Bob Bennett) and the Medical Information Privacy and Security Act (S.573/H.R. 1057-Leahy/Kennedy).

All of these medical “privacy” bills allow extensive exemptions for unrestricted access and use of personal medical information in an individual’s medical records by anyone who invokes a right to access and use this information in the name of the public health including government officials, researchers and law enforcement officers. Citizens can be enrolled without their informed consent as research subjects in medical experiments if researchers make the case that the study will contribute to the public health.

This means that, without the individual’s informed consent, researchers working with government, industry and private physicians will be allowed unrestricted access to personal medical records for the purpose of enrolling unsuspecting patients in medical research experiments. Scientific researchers of the future could experiment on citizens with new drugs and vaccines. The elderly will not know whether the nursing home doctor urging the use of a new antidepressant or the family pediatrician recommending to a mother that her infant get 15 vaccines in one day, is making that recommendation because it is in the best interest of the individual or because the doctor has enrolled his patients in a government-endorsed medical experiment.

 

 Often, when these parents have requested to opt-out, they have been given false information from the Department of Health or have had to jump through hoops to get their child’s name removed. I seriously question if their name is ever entirely removed.

 

 The AAP’s stance:

 
The American Academy of Pediatrics continues to support the development and implementation of immunization information systems, previously referred to as immunization registries, and other systems for the benefit of children, pediatricians, and their communities. Pediatricians and others must be aware of the value that immunization information systems have for society, the potential fiscal influences on their practice, the costs and benefits, and areas for future improvement.

 

Yes, the almighty dollar sign right in the first paragraph…cha-ching!

 

How did the National Vaccine registry come about? Who or where does it get its funding from?

 All Kids Count

 The All Kids Count II program, funded by The Robert Wood Johnson Foundation (RWJF) from 1998-2000, sought to make 16 immunization registry projects based in local, county, and state health departments fully operational by January 1, 2000. The program also sought to develop a long-term policy to ensure registries are implemented and sustained nationwide. The program built on progress made under All Kids Count Phase I, 1992-1997, an RWJF program to begin the development of registries.

The national program office was based at the Task Force for Child Survival and Development in Atlanta With guidance from the program’s National Advisory Committee, the national program office gave grants ranging from $300,000 to $700,000 to 16 projects.

RWJF’s Board of Trustees authorized up to $11.25 million for phase II beginning in 1997.

 

…In late 1997, public policy set the stage for All Kids Count projects and other state and community registries to take a giant step forward. President Bill Clinton issued a presidential directive to Secretary of Health and Human Services Secretary Donna Shalala “to start working with states on an integrated immunization registry system … we have to do it and do it right.”

 

As a result, an Initiative on Immunization Registries was undertaken by the National Vaccine Advisory Committee (NVAC), with support from the National Vaccine Program Office (NVPO) and the National Immunization Program of the CDC.

At the same time, more communities and states were developing or implementing registries. In 1998, when All Kids Count II began:

 

All 50 states had begun developing immunization registries.

Some 18 states had a law or rule authorizing immunization registries.

Ten states and several cities had mandated private provider reporting of immunizations to registries.

In 2001, 25 states had a law or rule authorizing immunization registries, and several states planned to introduce legislation or rules authorizing registries.

 …Educational Effort
All Kids Count began an intensive effort with immunization partners, especially the National Immunization Program, American Academy of Pediatrics and Every Child by Two (a non-profit organization that raises awareness of the importance of getting children fully immunized by the time they are two years old) to inform policymakers about the benefits, costs, and savings of registries, and the need to find a sustained source of funding if the promise of registries were to be realized.

 …The education effort culminated in a legislative briefing held May 1, 2000, in Washington, D.C. Hosted by former First Lady Rosalynn Carter and Mrs. Betty Bumpers, co-founders of Every Child by Two, the briefing had bi-partisan sponsorship from members of the Senate and House. Leading health organizations, health care professional organizations, and education organizations co-sponsored the briefing.

Carter and Bumpers urged legislators to find the political will and financial backing for development of immunization registries.

 New Federal Attention and Funding

…The education effort paid off. At the July 2000 National Immunization Conference, Secretary of Health and Human Services Donna Shalala promised support through the Medicaid program.

In Fall 2000, Medicaid announced its commitment to fund development and implementation of immunization registries at an enhanced rate of up to 90 percent matching funds for registry costs associated with Medicaid-eligible children (approximately 26 percent of children under age 7).

 

In June 2000, the Institute of Medicine issued Calling the Shots: Immunization Finance Police and Practices, a report on the future of the nation’s immunization system. It noted that community immunization information systems are an important tool to help keep children from but that a commitment must be made to ensure their success.

 

The report, approved by NVAC in January 2001, recommended:

 Continued and increased support for registries through the federal immunization grant program.

Wide promotion of use of Medicaid funds for registries.

Seeking approval to use the CDC’s Vaccines for Children operational funds for registries.

Discussions with insurers/health plans urging them to provide support for registries.

Development of a five-year, $60-million a year grant program to support further development and initial operation of registries.

 

…As All Kids Count II closed in 2001, The Robert Wood Johnson Foundation funded All Kids Count for three years to develop a vision for information systems that will integrate data about multiple health services.

 

 Immunization Registry Strategic Plan 2002-2007

Medicare and Medicaid funding

Federal Direct Assistance Grant Funds

Research Grants

Gardasil Mandated For New U.S. Citizens

Gardasil Mandated For New U.S. Citizens

If at first you don’t succeed, try, try, again. That’s exactly what the giant drug company Merck has done; it changed its lobbying target and now has the federal government mandating injections of its vaccine for legal immigrants, ensuring a continuous return on its product development investment.

Continued

Present and Past U.S. Vaccine Schedules

 1980:

1983-2007:

 1990:

HepB- Birth, 2 months, 6 months

DTP- 2mon, 4 mon, 6 mon, 15-18mon, 4-6 years

HIb- all doses between 2-18months

Polio- 4mon, 6mon, 15-18mon, 4-6years

MMR-15 mon, 4years

Td- 14-16 years

 

 

1996:

 1997:

1998:

 

1999:

 

2000:

 

2002:

2004:

 

 

2005:

2007:

 

2008:

1960’s and 1970’s:

DPT

Individual doses of Measles, Mumps, Rubella OR MMR

OPV

Smallpox (before 1972)

 

AMERICAN HOME PRODUCTS CORP. et al. v. FERRARI et al

Supreme Court of Georgia

Decided: October 6, 2008

AMERICAN HOME PRODUCTS CORP. et al. v. FERRARI et al

 

Summary

AMERICAN HOME PRODUCTS CORP. ET AL. V. FERRARI ET AL. (S07G1708)

 

 

Attorneys for Appellants (Manufacturers): Lowell Fine, Leslie Suson, Robert Hays, Matthew Harman

Attorney for Appellees (Ferraris): Lanny Bridgers

 

The state Supreme Court has upheld a decision by the Georgia Court of Appeals and ruled in favor of a Fulton County couple who sued several vaccine manufacturers for damage done to their toddler by childhood vaccinations. In today‟s landmark decision, written by Justice George Carley , the high court has unanimously affirmed the Court of Appeals judgment, which was the first appeals court in the nation to decide that the 1986 National Childhood Vaccine Injury Compensation Act does not preempt state law permitting such lawsuits. At issue is the language of the federal law, which states that vaccine manufacturers cannot be held liable for vaccine-related injuries or deaths “if the injury or death resulted from side effects that were unavoidable even though the vaccine was properly prepared and was accompanied by proper directions and warnings.” The case was brought by Marcelo and Carolyn Ferrari, after they took their son Stefan, born in 1998, to get his early childhood vaccinations. Prior to being vaccinated, his parents claim, Stefan was a healthy verbal toddler. Subsequently, he stopped speaking and has not spoken since. The Ferraris sued several vaccine manufacturers, including American Home Products Corp., alleging that their son suffered neurological damage caused by vaccines containing thimerosal, a mercury-based preservative. The trial court ruled in favor of the vaccine manufacturers, ruling that the Ferraris‟ design defect claims were preempted by the national Vaccine Act. The Court of Appeals, however, reversed the decision and ruled in the Ferraris‟ favor, calling the federal law unclear and capable of being read two different ways. 2 In reaching today‟s decision, the Supreme Court has carefully reviewed the law and congressional intent in determining that the Vaccine Act “clearly does not preempt all design defect claims against vaccine manufacturers.” Rather the law only protects the manufacturers from liability if it is determined, on a case by case basis, that the vaccine‟s side effects were unavoidable. In this case, the Ferraris argued that their son‟s injuries could have been avoided if the manufacturers had not used thimerosol in their vaccines. Even if the language of the federal law is ambiguous, today‟s 19-page opinion says, “the legislative history hardly shows a „clear and manifest‟ congressional purpose to supplant state tort law with respect to claims of defective design.”

Attorneys for Appellants (Manufacturers): Lowell Fine, Leslie Suson, Robert Hays, Matthew Harman

Attorney for Appellees (Ferraris): Lanny Bridgers

 

 

 

 

 

Mandating Homeschooled Children get vaccines..

The New Way Parents Avoid Vaccination (whole article in link)

Parents choose to home-school their children for economic reasons or to provide what they feel is a better education — but a growing number of moms and dads are choosing to teach their kids at home to avoid forced immunizations.

While some states allow kids to obtain medical or religious exemptions from the immunizations, most states don’t require home-schooled children to be vaccinated at all.

But with recent outbreaks of measles being tied to unvaccinated, home-schooled children, health officials want to change the rules.

In fact, according to the Centers for Disease Control, exemptions from immunizations should be harder to get and home-schooled children should be required to get them as well….

*****************

I am not at all surprised by this and expected it to come about as more parents are choosing to homeschool their kids. More and more parents are choosing to homeschool, not because of the vaccine issue, but because they are fed up with the public schools educational system, crumbling schools, and what have you. For the CDC to stick their nose in-what gives them the right when vaccines for many parents is still at the bottom of the list in terms of their decision. This is simply another attempt to further ‘control the herd’.

Flash of Hope – Why the Georgia Supreme Court Case is Important.

Flash of Hope – Why the Georgia Supreme Court Case is Important. (American Home Products Corp. v. Ferrari)

The pharmaceutical companies and government health authorities don’t want the “vaccine-autism” theory in civil courts.

It is so important you understand this idea, I’ll say it again.

The pharmaceutical companies and government health authorities don’t want the “vaccine-autism” theory in civil courts.

That’s why the recent unanimous Georgia Supreme Court decision allowing plaintiffs to sue for vaccine injuries in civil court if the damage is due to a “design-defect” is so important.

More

Vaccine Injury Court Rulings

“The Supreme Court of Georgia on Monday upheld a state appeals court ruling that could open the door to product liability claims against vaccine manufacturers by the parents of autistic children. Justice George H. Carley wrote for a unanimous court that a Fulton County suit against manufacturers filed by the parents of an autistic child may to go to trial. The justices rejected what Carley described as a “far-reaching interpretation” of a federal vaccine statute that defendant vaccine manufacturers argued gave them sweeping immunity from liability….. Carley specifically focused on Congress’ intent. He wrote that a reading of the federal vaccine act “and the congressional intent behind it show that the Vaccine Act does not pre-empt all design defect claims.” Instead, Carley noted, the federal vaccine law “provides that a vaccine manufacturer cannot be held liable for defective design if it is determined, on a case-by-case basis, that the injurious side effects of the particular vaccine were unavoidable.” But, the judge added, “The conditional nature of this clause contemplates the occurrence of side effects which are avoidable, and for which a vaccine manufacturer may be civilly liable. In order to bar all liability for defective design and to permit liability only for manufacturing and warning defects, Congress could easily have ….. made the bar to civil liability conditional on proper preparations and warnings.” “As the statute is actually written, however,” Carley continued, “it is best understood as barring liability only for those side effects which were unavoidable by means other than proper manufacturing and packaging. Conversely, if such effects were avoidable by a feasible, alternative design, liability is not completely barred.” Neither can federal law nor, by extension, Congress unilaterally pre-empt state causes of actions, Carley said. Instead, the justice noted that the question of whether a particular vaccine is unavoidably unsafe — and therefore subject to immunity from liability — is a question of fact for a jury to decide.” – R. Robin MacDonald, Law.com (October 7, 2008) http://www.law.com/jsp/article.jsp?id=1202425070398

“A Missouri appeals court Tuesday upheld an $8.5 million judgment for a St. Louis man who contracted polio after receiving an oral vaccine as a child. A three-judge panel of the Court of Appeals’ Eastern District also ruled that the vaccine’s manufacturer owed about $2.8 million for prejudgment interest on top of the award because it refused to accept a pretrial settlement offer that was less than the amount awarded by a jury. Cortez Strong contracted polio in June 1987, shortly after receiving a second dose of the vaccine Orimune, which was made by American Cyanamid Co…..Strong sued American Cyanamid and the pediatrician who administered the vaccine. In 2005, a St. Louis jury cleared the doctor of liability but ordered American Cyanamid to pay Strong $1.5 million for pain and suffering, $2 million for future lost earnings and $5 million for future pain and suffering. The company appealed, contending there was insufficient evidence that it was legally liable for Strong’s injuries. The company also sought to have the judgment reduced or set aside or that a new trial be ordered. Strong also appealed, seeking to be allowed to introduce rebuttal evidence against the physician and to have American Cyanamid be ordered to pay interest on the award. The appeals court rejected each request except Strong’s appeal for prejudgment interest. “ – Chris Blank, Associated Press (October 8, 2008)
http://biz.yahoo.com/ap/081008/mo_polio_award.html?.v=1

state laws forcing autism coverage

A look at state laws forcing autism coverage

October 19, 2008

In 2006, Indiana’s insurance commissioner ruled that a law adopted earlier required private health insurers to cover applied behavior analysis, a specific and costly type of autism therapy. In the past two years, other states have adopted their own laws ordering insurance coverage for this treatment.Arizona: Effective June 30, 2009. Covers therapy costing as much as $50,000 per year up to age 9, $25,000 per year up to age 16.

Florida: Effective April 2009. Covers $36,000 per year, $200,000 lifetime up to age 18.

Louisiana: Effective Jan. 1, 2009. Covers $36,000 per year up to age 17.

 

Pennsylvania: Effective July 1, 2009. Covers $36,000 per year up to age 21, no lifetime cap.South Carolina: Effective July 1, 2008. Covers $50,000 per year up to age 16.

Texas: Took effect Jan. 1, 2008. Covers children over age 2, up to age 6.

 

 

Source: Autism Speaks and state insurance commissioners

 

Court Cases and School Mandates

Court Cases and School Mandates

 

How do exemptions to mandated vaccines apply? Some people will have medical conditions that increase the risk for adverse effect and should not receive vaccines. Therefore, all state vaccination laws have exemptions for children with medical conditions. Others have religious beliefs that are in opposition to vaccination, while some may oppose vaccination on philosophical or personal grounds. Not all vaccines may be opposed, but rather, may oppose the concept of mandatory vaccination or being given specific vaccines. So what then is a parent’s constitutional right to a religious exemption from mandated vaccination?  Challenges to mandated vaccination laws which are based on religious or philosophical beliefs have led many courts to state that no constitutional right exists to religious or philosophical exemptions.

 

In 1879 the Supreme Court ruled that freedom of belief is absolute, freedom of action is not. Acts or conduct of our citizens must conform to all reasonable regulations adopted by governmental agencies acting within the scope of their authority. In other words, religious followers have a right to their beliefs but have no right to endanger others by practice of their beliefs as scientists see it.

Further authority to force vaccination of children comes under the doctrine of parens patriae in which the state asserts authority over child welfare. In the 1944 case of Prince v. Massachusetts, which involved child labor under an asserted right of religious freedom, the U.S. Supreme Court summarized the doctrine, noting that:

Neither rights of religion nor rights of parenthood are beyond limitation. Acting to guard the general interest in youth’s well being, the state as parens patriae may restrict the parent’s control by requiring school attendance, regulating or prohibiting the child’s labor, and in many other ways. Its authority is not nullified merely because the parent grounds his claim to control the child’s course of conduct on religion or conscience. Thus, he cannot claim freedom from compulsory vaccination for the child more than for himself on religious grounds. The right to practice religion freely does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.  (321 U.S. at 166-7, 64 S.Ct. at 442)

Religious refusal of medical treatment may be penalized by the state under this clause. There was a leading case in 1903 in N.Y. that stated ‘the proposition that the right to practice religion freely does not include liberty to expose the community of a child to communicable disease, nor to expose the child himself to ill-health and death.’

 

When the exercise of the right to religious liberty comes into conflict with public health laws, medical practice acts, parental obligations to provide medical care to minors, courts were upholding the validity of public health laws.

 

Jacobson was essentially a public health law case. In 1905, the U.S. Supreme Court issued a landmark ruling in Jacobson v. Massachusetts, which upheld the right of states to force vaccination. The Court declared that smallpox vaccination, under health regulations, was reasonable and that it did not violate the liberty rights under the Fourteenth Amendment to the U.S. Constitution. Police power could be used because it is the authority reserved to the states by the Constitution and embraces “such reasonable regulations established directly by legislative enactment as will protect the public health and the public safety” (197 U.S. at 25, 25 S.Ct. at 361).

In Jacobson, the Commonwealth of Massachusetts had enacted a statute that authorized local boards of health to require vaccination. Jacobson challenged his conviction for refusal to be vaccinated against smallpox as required by regulations of the Cambridge Board of Health. While acknowledging the potential for vaccines to cause adverse events and the inability to determine with absolute certainty whether a particular person can be safely vaccinated, the Court specifically rejected the idea of an exemption based on personal choice. To do otherwise “would practically strip the legislative department of its function to [in its considered judgment] care for the public health and the public safety when endangered by epidemics of disease” (197 U.S. at 37, 25 S.Ct. at 366). The Court elaborated on the tension between personal freedom and public health inherent in liberty: “The liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good. On any other basis organized society could not exist with safety to its members” (197 U.S. at 26, 25 S.Ct. at 361).

 

The beginning of the Lochner Era in constitutional law began in 1905-1937. Lochner Era represented an unwarranted judicial interference with democratic control over the economy to safeguard public health and the environment. Lochner was a form of judicial activism that was unreceptive to protective and redistributive regulation. Lochner vs. N.Y.

 

In 1922, the Supreme Court addressed the constitutionality of childhood vaccination mandates in Zucht v. King. The Court denied a due process Fourteenth Amendment challenge to the constitutionality of city ordinances that excluded children from school attendance for failure to present a certificate of vaccination holding that “these ordinances confer not arbitrary power, but only that broad discretion required for the protection of the public health”. (260 U.S. at 177, 43 S.Ct. at 25).

 

The Numberg Code was initiated in 1947.

 

“This judgment established a new standard of ethical medical behavior for the post World War II human rights era. Amongst other requirements, this document enunciates the requirement of voluntary informed consent of the human subject. The principle of voluntary informed consent protects the right of the individual to control his own body.

“This code also recognizes that the risk must be weighed against the expected benefit, and that unnecessary pain and suffering must be avoided.

This code recognizes that doctors should avoid actions that injure human patients.

The principles established by this code for medical practice now have been extended into general codes of medical ethics.

 

Forward to 1951, there was a conviction for violation of the Georgia statue which required vaccines as a prerequisite for school attendance, which was appealed on the grounds that it violated freedom of religion. It was also a N.Y. decision in 1944.

 

The civil rights movement also changed the social structure which began with Brown vs. Board of Education in 1951.

 

The 1971 U.S. Supreme Court in Lemon v. Kurtzman (Lemon v. Kurtzman, 403 U.S. 602, 91 S.Ct. 2105) was a case involving state supplementation of parochial school salaries, and defined a three-pronged test for determining whether a state religious accommodation complies with the Establishment Clause: “First, the statute must have a secular legislative purpose; second, its principal or primary effect must be one that neither advances nor inhibits religion; finally, the statute must not foster ‘an excessive government entanglement with religion’ ” (403 U.S. at 612-3, 91 S.Ct. at 2111 [citation omitted] [quoting Walz v. Tax Commission, 397 U.S. 664, 674, 90 S.Ct. 1409, 1414 (1970)]).

 

The 1972 Wisconsin vs. Yoder case (Wisconsin v. Yoder, 406 U.S. 205, 92 S. Ct. 1526) wasn’t about vaccine mandates but still centered on the right to practice ones religion. Members of the Amish religion were convicted of violating Wisconsin’s compulsory school-attendance law by declining to send their children to public or private school after they had graduated from the eighth grade. Amish objection to formal education beyond the eighth grade is firmly grounded in their central religious concepts.  “Although the trial court in its careful findings determined that the Wisconsin compulsory school-attendance law “does interfere with the freedom of the Defendants to act in accordance with their sincere religious belief” it also concluded that the requirement of high school attendance until age 16 was a “reasonable and constitutional” exercise of governmental power, and therefore denied the motion to dismiss the charges. The Wisconsin Circuit Court affirmed the convictions. The Wisconsin Supreme Court, however, sustained respondents’ claim under the Free Exercise Clause of the First Amendment and reversed the convictions. A majority of the court was of the opinion that the State had failed to make an adequate showing that its interest in “establishing and maintaining an educational system overrides the defendants’ right to the free exercise of their religion.” (49 Wis. 2d 430, 447, 182 N. W. 2d 539, 547 1971).

Court claims of religious freedom under the Free Exercise Clause do prevail, such as the case of Wisconsin v. Yoder in 1972. “[W]here fundamental claims of religious freedom are at stake,” the Court will not accept a state’s “sweeping claim” that its interest in compulsory education is compelling; “despite its admitted validity in the generality of cases, we must searchingly examine the interests that the State seeks to promote . . . and the impediment to those objectives that would flow from recognizing the claimed Amish exemption” (406 U.S. at 221, 92 S.Ct. at 1536).

 

The Frazee vs. Illinois case in 1989 centered on the refusal of a temporary retail position because the job would have required him to work on Sunday in violation of his personal religious beliefs, and was thus denied unemployment compensation benefits.

“Held: The denial of unemployment compensation benefits to appellant on the ground that his refusal to work was not based on tenets or dogma of an established religious sect violated the Free Exercise Clause of the First Amendment as applied to the States through the Fourteenth Amendment. Sherbert v. Verner, 374 U. S. 398, Thomas v. Review Bd. of Indiana Employment Security Div., 450 U. S. 707, and Hobbie v. Unemployment Appeals Comm’n of Florida, 480 U. S. 136, rested on the fact that each of the claimants had a sincere belief that religion required him or her to refrain from the work in question, not on the consideration that each of them was a member of a particular religious sect or on any tenet of the sect forbidding such work. While membership in a sect would simplify the problem of identifying sincerely held beliefs, the notion that one must be responding to the commands of a particular religious organization to claim the protection of the Free Exercise Clause is rejected. The sincerity or religious nature of appellant’s belief was not questioned by the courts below, and was conceded by the State, which offered no justification for the burden that the denial of benefits placed on appellant’s right to exercise his religion. The fact that Sunday work has become a way of life does not constitute a state interest sufficiently compelling to override a legitimate free-exercise claim, since there is no evidence that there will be a mass movement away from Sunday employment if appellant succeeds on his claim.” Pp. 489 U. S. 832-835.

 

In the 2001 Wyoming Hepatitis B case, the Pages successfully sued the Wyoming State Department of Health for denying the Pages’ request for a religious exemption from the Hepatitis B vaccine. The Wyoming Supreme Court held that the Health Department had to grant the exemption request and had no right or ability to consider the sincerity or credibility of those requesting exemptions.

 

An Arizona Court of Appeals rejected the argument that an individual’s right to education would trump the state’s need to protect against the spread of infectious diseases short of confirmed cases of measles in the particular school. The court in Maricopa County Health Department v. Harmon took action by excluding unvaccinated children from school when there is a reasonably perceived, but unconfirmed, risk for the spread of measles (156 Ariz. at 166, 750 P.2d at 1369). The court in Maricopa specifically noted that Jacobson did not require that epidemic conditions exist to force vaccination. (156 Ariz. at 166, 750 P.2d at 1369)

 

Arkansas had introduced a religious exemption in 1967. The exemption then stated that vaccines could be exempted if it conflicts with the religious tenets and practices, but you had to be a member of a recognized church, along with statements from the church, etc. In the 2002, McCarthy vs. Boozeman and Boone vs. Boozeman case, the state’s religious exemption was challenged based on the establishment and free exercise clauses of the first amendment, and equal protection clauses of the 14^th Amendment. The court agreed and found that the exemption provision was unconstitutional under the test in Lemon vs. Kurtzman, which violates the establishment clause. However, it upheld the mandated vaccine laws. In 2003, the Arkansas General Assembly rewrote the religious exemption provision and added a philosophical exemption.

 

The First Amendment

 

Religious freedom, or the right to believe in your religion, is considered absolute under the First Amendment. However, the freedom to act in accordance with one’s religious beliefs “remains subject to regulation for the protection of society.” This was stated in the U.S. Supreme Court case of   Sherbert v. Verner in 1963.  This established a balancing test for determining whether a regulation violated a person’s First Amendment right to free exercise of religion. The test, which prevailed until 1990, required the government to justify any substantial burden on religiously motivated conduct by a compelling government interest and by means narrowly tailored to achieve that interest (374 U.S. at 406-8, 83 S.Ct. at 1795-6).

 

Forty-eight states do provide religious exemption laws today. However, due to the earlier court rulings, both parens patriae and police power grounds apply and the U.S. Supreme Court upholds state interest in mandating vaccination of children by sighting these reasons; a health threat to the community and to the children themselves, disease risks, and mandatory vaccination should also meet the  criterion of Sherbert.

 

In another court case, before Yoder, the Wright v. DeWitt School District, (Wright v. DeWitt School District, 238 Ark. 906, 385 S.W.2d 644 Ark. 1965),  a decision and enactment of a statutory religious exemption by the Arkansas Supreme Court held that no First Amendment right existed to a religious exemption given the state’s compelling interest in mandating vaccination under its police power to protect the public health. (238 Ark. at 913, 385 S.W.2d at 648).

 

The compelling interest test is moot now due to a U.S. Supreme Court ruling that significantly lowered the bar for states to prevail. In 1990, a decision in Employment Div., Dept. of Human Resources of Oregon v. Smith, (Employment Div., Dept. of Human Resources of Oregon v. Smith, 494 U.S. 872, 110 S.Ct. 1595 (1990) the Supreme Court rejected the compelling interest test and established a new standard that states: “the right of free exercise does not relieve an individual of the obligation to comply with a ‘valid and neutral law of general applicability on the ground that the law proscribes (or prescribes) conduct that his religion prescribes (or proscribes)” (494 U.S. at 879, 110 S.Ct. at 1600 [quoting United States v. Lee, 455 U.S. 252, 263, n. 3, 102 S.Ct. 1051, 1058, n. 3 (1982)]).

In 1993, Congress attempted to legislatively override the ruling in Smith by enacting the Religious Freedom Restoration Act of 1993 (RFRA). This would bring back the compelling interest test as the standard for considering the constitutionality of free exercise claims.  In 1997, the U.S. Supreme Court in the case of City of Boerne v. Flores (City of Boerne v. Flores, 521 U.S. 507, 117 S.Ct. 2157 refused to allow the Religious Freedom Restoration Act. They stated that Congress had exceeded its constitutional authority in implementing the statute (521 U.S. at 510-37, 117 S.Ct. at 2160-72). Therefore, the Smith standard is the current law.

 

The Establishment Clause of the First Amendment establishes a constitutional limit within which a state which may accommodate a religious exemption based on a law of general application. This includes whether an exemption is allowed and how detailed the exemption must be defined.

In Brown v. Stone in 1979, the Mississippi Supreme Court vetoed the religious exemption that appeared in the Mississippi school vaccination statute. They held that the statutory religious exemption violated the Equal Protection Clause of the Fourteenth Amendment because it would “require the great body of school children to be vaccinated and at the same time expose them to the hazard of associating in school with children exempted under the religious exemption who had not been immunized.” (378 So.2d at 223).

 

In Sherr v. Northport-East Northport Union Free School District in 1987, the plaintiffs were denied a religious exemption under the state’s religious exemption statute by the school district because they were not “bona fide members of a recognized religious organization” whose teachings oppose vaccination, as required by New York law (672 F.Supp. at 84 [quoting subsection 9 of N.Y. Pub. Health L. § 2164]). The U.S. District Court for the Eastern District of New York stated that New York’s limitation of the religious exemption violated the Establishment and Free Exercise clauses of the First Amendment.  This limitation violated the Establishment Clause by going against two prongs of the Lemon test. The first by inhibiting the religious practices of individuals who oppose vaccination of their children on religious grounds but are not members of a religious organization recognized by the state and two by restricting the exemption to “recognized religious organizations” requires that the government involve itself in religious matters to an inordinate degree through such government approval (672 F.Supp. at 89-90. The court also stated that the limited language violated the Free Exercise Clause because no compelling societal interest existed to justify the burden placed on the free religious exercise of “certain individuals while other persons remain free to avoid subjecting their children to a religiously objectionable medical technique because they may belong to a particular religious organization to which the state has given a stamp of approval” (672 F.Supp. at 90-1). There “surely exist less restrictive alternative means of achieving the state’s aims than the blatantly discriminatory restriction . . . the state has devised” (672 F.Supp. at 91). By striking down New York’s limitation, the court stated that “sincerely held religious beliefs” in opposition to vaccination, whether or not as part of a recognized religion, should suffice (672 F.Supp. at 98).

The 1^st Amendment to the Constitution of 1791 declares: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof…” These provisions are limitations only in federal government. There is no language requiring states to guarantee religious liberty.

 

The Free Exercise and Establishment Clauses have been held applicable to the States through the Due Process Clause of the Fourteenth Amendment. (Cantwell v. Connecticut, 310 U.S. 296, 303-4, 60 S.Ct. 900, 903 (1940).

Also:

 

Cude v. State: Court Rejects Religious Objection to Child’s Vaccination. (237 Ark. 927, 377 S.W.2d 816 1964)  “Appellants, Archie Cude and his wife, Mary Frances, are the parents of eight children, three of whom are between the ages of 7 and 15… The children are not in school for the reason that the school authorities will not permit them to attend school because they have not been vaccinated against smallpox. The Cudes will not permit such vaccinations; they contend that it is contrary to their religion.”  The court thus appointed Miss Ruth Johnston, Director of the Child Welfare Division of the State Welfare Department, as guardian of the children.

 “Article 2, Sec. 24 of the Constitution of Arkansas provides: “All men have a natural and indefeasible right to worship Almighty God according to the dictates of their own consciences; no man can, of right, be compelled to attend, elect or support any place of worship; or to maintain any ministry against his consent. No human authority can, in any case or manner whatsoever, control or interfere with the right of conscience; and no preference shall ever be given, by law, to any religious, establishment, denomination or mode of worship above any other.”, The foregoing provision of the Constitution means that anyone has the, right to worship God in the manner of his own choice, but it does not mean, that he can engage in religious practices inconsistent with, the peace, safety and health of the inhabitants of the, State, and it does not mean that parents, on religious grounds, have the right to deny their children an education.”

 

In Davis v. State, (294 Md. 379, 451 A.2d 107 Md. 1982) this held that “limiting religious exemption to children whose parents were “members” or “adherents” of a “recognized church or religious denomination” opposing vaccination violated the Establishment Clause. On the basis of rules of statutory construction in Maryland, the court severed the offending religious exemption from the statute and upheld the conviction of Davis under the remaining statute that compelled vaccination (294 Md. at 382-5, 451 A.2d at 114-5). Rules of statutory construction vary so that in the Sherr case the court vetoed the limiting “bona fide members of a recognized religious organization” language but upheld the religious exemption. In addition, the court enjoined enforcement of the “bona fide” language as to one of the two sets of plaintiffs, who otherwise qualified, and further enjoined the state from enforcing the offending language in the future (672 F.Supp. at 97-9).

 

Individual rights were described in broad terms when it came to the Bill of Rights. In democracy, with no official ideology or religion, any interpretation of such abstract concepts could be attacked by the justices own personal philosophy. During the second half of the 20^th century, the U.S. Supreme Court recognized that liberty can be protected by the 14^th Amendment including most of the rights guaranteed by the Bill of Rights.

 

1868: “No state shall make or enforce any law which shall abridge the privileges and immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny any person within its jurisdiction the equal protection of the laws.”

 

Religious freedom concept was written into the Federal and State Constitutions. Article VI of the Federal Constitution in 1789 states: “No religious test shall ever be required as a qualification to any office or public trust under the United States…”

 

 Under the U.S. Constitution, most power to protect the public’s health and safety or police powers is reserved for the states. Each state passes its own laws mandating vaccines for school and permits various exemptions. What is police power? It is power inherent in the state to enact and enforce laws to protect and promote the health, safety, morals, order, peace, comfort, and welfare of the people. Power was possessed by the states before the federal constitution was adopted in 1789, and was not surrendered to the national government at that time. Public health is primarily the responsibility of the states and they delegate this duty to political subdivisions and agencies such as school boards, counties, and the Board of Heatth.

 

What about Philosophical opposition? Should it also be included as religious? Two conscientious or philosophical objector cases and decisions by the U.S. Supreme Court points out that some philosophical opposition to vaccination may be religious and incorporated into a religious exemption, regardless of whether a state law details or provides for a philosophic exemption.

 

In 1965 United States v. Seeger, (United States v. Seeger, 380 U.S. 163, 85 S.Ct. 850)  and 1970 Welsh v. United States, (Walsh v. United States, 398 U.S. 333, 90 S.Ct. 1792) the Court interpreted “religious,” as it appeared in a federal statutory religious-based conscientious objector exemption from military conscription, very expansively to extend beyond traditional religious beliefs. Seeger defined the test as “[a] sincere and meaningful belief which occupies in the life of its possessor a place parallel to that filled by the God of those admittedly qualifying for the exemption” (380 U.S. at 176, 85 S.Ct. at 859). The Court elaborated in Welsh: “to be ‘religious’ . . . this opposition . . . [must] stem from . . . moral, ethical, or religious beliefs about what is right and wrong and that these beliefs be held with the strength of traditional religious convictions” (398 U.S. at 340, 90 S.Ct. at 1796). The Welsh Court, however, clarified that “moral, ethical, or religious principles” do not incorporate “considerations of policy, pragmatism, or expediency” (398 U.S. at 342-3, 90 S.Ct. at 1798).

 

In the 1988 court case of Mason v. General Brown Central School District, (Mason v. General Brown Central School District, 851 F.2d 47 (2d Cir. 1988) they rejected fear of the possible side effects from vaccination, although it was based on strong convictions, near the level of religious beliefs because of evidence that the plaintiff’s beliefs were “simply an embodiment of secular chiropractic ethics.”(851 F.2d at 51-2).

 

Vaccination laws and mandates were first enacted to control epidemic diseases. Today, they are also used to increase vaccine coverage to protect the public’s health even in the absence of epidemics. Their constitutional basis rests in the police power of the state and in parens patriae doctrine. Although most states allow religious exemptions and some allow philosophical, no constitutional right exists. Courts, however, have generally upheld these exemptions. The current laws can be expected to be upheld by the courts as long as the balance of protecting the public health or the ‘herd’ is achieved.

 

The Jacobson case in 1905 was based on public health and safety issues. The Hepatitis B and HPV vaccines, along with others coming up the pipeline, don’t meet this basis as they are not medically essential in preventing the spread of disease. The concern in the 20^th century was government power itself. Today, it is the medical unnecessary exercise of power because many of the vaccines being mandated today are not medically necessary to prevent disease from spreading, or to protect public health.

 

 Model State Emergency Power Act was a law designed to provide responsible state officials with powers needed to detect and contain a potentially catastrophic disease outbreak and protect individual rights and freedoms. Many states have passed some version of this law.

Vaccine State Mandates

How School Vaccine Mandates Came About

 

In 1809, the first state law mandating vaccination was enacted in Massachusetts. By 1855, Massachusetts became the first state to enact a school vaccination requirement for Smallpox. By the twentieth century, roughly half of the states had enacted vaccine mandates for children before they could enter school; however, they were not strictly enforced. The Diphtheria vaccine was introduced in the 1920’s, but only a few states made the Diphtheria vaccine compulsory for two decades. By the early 1950’s, with the licensure of the Diphtheria and Tetanus vaccines, state and local health departments began more aggressive vaccination programs. When the Salk Polio vaccine was licensed in 1955, only a few states passed laws that mandated it for school entry. The polio vaccine also led to federal funding of state and local vaccine programs. In 1962, the Vaccination Assistance Act established a federally coordinated program that would supply funds for the purchase and administration of childhood vaccines.  By 1963, several vaccines were mandated, but there was no enforcement by all states. The New York City health commissioner opposed making the Polio vaccine mandatory in 1965.

 

Compulsory vaccination made some radical changes by the late 1960’s and 1970’s. In 1970 a nationwide rubella vaccine campaign was launched. It was recommended by the Department of Health for all 11-13 year old girls. Then the CDC moved on and began leading a nationwide effort to eradicate Measles. In 1968, only a half the states required one or more vaccines for school entry. By the early 1970’s, the Measles Initiative program was started. By 1976-77, health officials strictly enforced the vaccine mandate for Measles under the Childhood immunization Initiative. Its purpose was to raise vaccination coverage in children to 90% by 1979.  The largest component of this initiative was to enact and enforce school vaccination mandates.

By 1981, all fifty states mandated Measles vaccine along with all others for school entry. Nearly all states had school vaccination mandates covering Kindergarten through 12th grade levels, and mandates for licensed preschools.  State mandated vaccine laws specified which vaccines would be required and the number of doses. Some states authorized the public health boards to designate which vaccines and doses would be required. States were not uniform in what vaccines they require, or how many doses. This still holds true today. In 1980, the state of Wisconsin passed the No-immunization-No School law and was enforced by March 1981. Other states soon followed.

In 1998–1999, all but four states (Louisiana, Michigan, South Carolina, and West Virginia) enacted mandates which covered Kindergarten through 12th grade. In 48 states, with the exception of Iowa and West Virginia, daycare mandates and Head Start program mandates were enacted. Thirty states mandated some requirements for college entrance. School vaccine mandates included:

All 50 states required: Diphtheria toxoid, Polio, Measles and Rubella vaccines

49 states required: Tetanus toxoid

46 states required: Mumps

44 states required: Pertussis

28 states required: Hepatitis B

 

During the late 1980’s and early 1990’s, state vaccine laws were tightened to make religious and philosophical exemptions harder to obtain. By the end of the 1990’s, the trend was reversed. Religious and Philosophical exemptions were made less restrictive through rewriting exemption clauses.

 

The Task Force on Community Preventive Services is an independent body carrying out evidence-based reviews of the literature to assess the claims that preventive interventions directed to populations are effective. One of the 17 interventions reviewed for vaccine-preventable diseases was mandatory vaccination requirements. The Task Force found that sufficient evidence existed to demonstrate the effectiveness of these requirements in increasing vaccine coverage, thereby reducing disease incidence, and so recommended their use.

U.S. Congress passed the National Childhood Vaccine Injury Act in 1986 and the Vaccine Compensation Amendments in 1987 and 1995. The NCVIA establishes a compensation system for people who may be injured by routine vaccinations. The National Childhood Vaccine Injury Act of 1986, Public Law 99-660, was signed by President Reagan in November 1986, however, it did not contain a funding mechanism to enable the compensation system to operate.  In 1987, Congress passed amendments to the law and developed a plan to fund the system, which comes from a surcharge on each mandatory vaccine.  The main purpose of the law was to create safety provisions for the administration of vaccines to help prevent future vaccine injuries, to promote the improvement of existing vaccines and develop safer vaccines.  Another element was to create a no-fault compensation system alternative to suing vaccine manufacturers and physicians on behalf of injured or deceased people from reactions to mandated vaccines.  Children and/or adults injured or killed from these vaccines are divided into two categories; those who were damaged or killed before October 1, 1988 and those who were damaged or killed after that date. In 1990, the FDA and the CDC developed the Vaccine Adverse Event Reporting System (VAERS), which allows public and private physicians to use one standard reporting form to report reactions. 

 

Next, we’ll take a look at some of the court cases that further fueled the school vaccine mandates.

 

Local, State and Federal Mercury Legislation Laws

Status of Local, State and Federal Mercury Product Legislation and Laws

2007-2008 Legislative Sessions

June 11 – 21, 2007

 

Arkansas

 

SB 911 is a bill to Prohibit or reduce the amount of mercury in childhood vaccines. Introduced on March 5, 2007 and  referred to the Committee on Public Health, Welfare and Labor. Three amendments have been offered, it has been engrossed and re-referred to the Committee on Public Health, Welfare and Labor.

http://www.arkleg.state.ar.us/2007/scripts/ablr/bills/bills.asp?billno=SB911

 

California- *nothing new relating to vaccines

Article 9. Mercury-containing Vaccines 124172. (a) Except for an influenza vaccine described in

subdivision (b), on and after July 1, 2006, a person who is knowingly pregnant or who is under three years of age shall not be vaccinated with a mercury-containing vaccine or injected with a mercury-containing

product that contains more than 0.5 micrograms of mercury per 0.5 milliliter dose.

(b) On and after July 1, 2006, a person who is knowingly pregnant or who is under three years of age shall not be vaccinated with a mercury-containing influenza vaccine that contains more than 1.0 microgram of mercury per 0.5 milliliter dose.

 

 

Connecticut

 

HB 6895 would require dental plans to provide equivalent or greater coverage for nonmercury or composite dental fillings. Introduced January 22, 2007 and referred to the Joint Committee on Insurance and Real Estate.

http://www.cga.ct.gov/asp/cgabillstatus/cgabillstatus.asp?selBillType=Bill&bill_num=6895&which_year=2007

http://www.cga.ct.gov/asp/menu/Search.asp

 

Delaware

 

HB 194 allows the use of mercury-containing vaccines for children less than 8 years of age or to pregnant women when an emergency occurs as declared by the Director of the Division of Public Health, or when there is no mercury-free vaccine manufactured or available for a specific disease. Introduced on June 12, 2007, it was referred to the Health and Human Development Committee, which reported it out favorably.  Substitute amendment HS 1 was offered on June 20, 2007 and it was re-referred to this committee.

http://www.legis.state.de.us/LIS/lis144.nsf/vwLegislation/HS+1+for+HB+194/$file/legis.html?open

http://www.legis.state.de.us/LEGISLATURE.NSF?open

 

Current-Except for vaccines for influenza, no vaccine containing more than a trace amount of mercury shall be made available to a medical provider in this State for administration to children under eight years of age or to pregnant women.

This section shall not apply to vaccines administered during declared states of emergency or epidemics.”

Section 1. of this Act shall become effective on January 1, 2006.

 This section shall not apply to vaccines administered during declared states of emergency or epidemics.”

shall become effective on January 1, 2007.

No vaccine containing mercury shall be made available to a medical provider in this State for administration to children under eight years of age or to pregnant women. 

No vaccine containing mercury shall be administered by a medical provider in this State to a child who is under eight years of age or to a pregnant woman, notwithstanding the expiration date thereof. 

This section shall not apply to vaccines administered during declared states of emergency or epidemics.” become effective on January 1, 2008.

 

Florida

SB 222 is an act relating to immunizations; prohibiting  vaccinating a woman who is knowingly pregnant or a child who is younger than a specified age with a vaccine that contains any mercury or injecting such a woman or child with a product that contains more than a specified amount of mercury; prohibiting vaccinating a woman who is  knowingly pregnant or a child under a specified age with an influenza vaccine that contains more than a specified amount of mercury; providing the effective date of such prohibitions; providing for the State Health Officer to authorize the use of vaccines that contain a greater amount of mercury than is otherwise allowed if the Secretary of Health declares a public health emergency and makes certain findings; providing exceptions to the prohibition following disclosure regarding certain risks and benefits; providing an effective date. Introduced December 14, 2006, referred to the Committee on Health Regulation. Withdrawn on January 23, 2007.

http://www.flsenate.gov/Session/index.cfm?Mode=Bills&SubMenu=1&BI_Mode=ViewBillInfo&BillNum=0222 

 

Hawaii- The Hawaii legislature is now adjourned and did not adopt any of the following legislation.

HB 1816.  From July 1, 2007, prohibits persons known to be pregnant or under age 5 from being vaccinated with (1) a mercury-containing vaccine containing more than 0.5 micrograms of mercury per 0.5 milliliter dose; and (2) influenza vaccine containing more than 1.0 microgram of mercury per 0.5 milliliter dose  Allows certain exemptions. Introduced on January 24, 2007 and referred to the Committee on Health, and the Committee on Judiciary.

http://www.capitol.hawaii.gov/sessioncurrent/Bills/HB1816_.htm

http://www.capitol.hawaii.gov/site1/docs/getstatus2.asp?billno=HB1816

 

Illinois

SB 133 amends the state’s mercury free vaccine act and provides that the Department of Public Health shall implement a policy to distribute, preferentially, influenza vaccines that are thimerosal-free or contain only trace amounts of thimerosal for the immunization of children under the age of 3 who are participating in the Vaccines for Children program, provided that the supply of influenza vaccines to health care providers is not impeded by the exercise of this preference. Provides that the Department shall annually communicate this policy to the General Assembly and health care providers. Provides that upon issuing an exemption from the Act, the Department shall remind health care providers to distribute, preferentially, influenza vaccines that are thimerosal-free or contain only trace amounts of thimerosal for the immunization of children under the age of 3, provided that the supply of influenza vaccines to health care providers is not impeded by the exercise of this preference. Provides that the Department shall annually notify health care providers about the requirements of the Act and encourage health care providers to increase immunization rates among persons who are recommended to receive influenza immunization, using all licensed vaccines, with preference given to influenza vaccines that are thimerosal-free or contain only trace amounts of thimerosal. Provides that the Department shall include this annual notification on its Internet web site. Provides that the Department shall annually report to the General Assembly, on or before December 31, on its efforts to inform health care providers about thimerosal-free vaccines. Provides that the Department of Public Health shall notify health care providers about the availability of influenza vaccines and the most effective time for persons to be vaccinated. Adopted by both houses, as of May 30, 2007.

http://www.ilga.gov/legislation/BillStatus.asp?DocNum=0133&GAID=9&DocTypeID=SB&LegID=27356&SessionID=51&GA=95

 

Current- Mercury Ban not in effect until 2008 however on Mar 04, 2006- the Illinois Department of Public Health has declared 4 vaccines with high levels of mercury exempt from the law.

Illinois passed landmark legislation that limits mercury levels in vaccines to 1.25 micrograms per dose by the first of this year and eliminates mercury all together by January 1st 2008, the Illinois Department of Public Health has issued a declaration of exemption which allows four vaccines to exceed the limit. In addition to the flu vaccine, the diphtheria-tetanus, Japanese encephalitis and meningitis vaccines are also exempted from the law.

The Illinois Department of Public Health claims the mercury-free versions of these vaccines are either too expensive, in short supply or non-existent, hence they have allowed thimerosal, the mercury-laden preservative in these vaccines to persist.

 

Indiana

 

HB 1361 requires that before a person administers a vaccine that contains more than a trace amount of mercury, the person must inform the person who will be vaccinated that there are alternatives to mercury preserved vaccines. Allows the state department of health to suspend this requirement during a public health emergency or an epidemic. Provides that a health care practitioner may be subject to disciplinary sanctions for failing to comply with these requirements. Introduced on January 16, 2007, and referred to Committee on Public Health.

http://www.in.gov/legislative/bills/2007/IN/IN1361.1.html

http://www.in.gov/apps/lsa/session/billwatch/billinfo?year=2007&session=1&request=getBill&docno=1361

 

Iowa

 

The Iowa Legislature is now adjourned and did not adopt either of the two mercury product bills that were introduced.

 

HF 515 would require testing of vaccines to determine the amount of mercury that they contain, and that beginning July 1, 2008, a drug or vaccine administered in this state shall not contain more than trace amounts of mercury, and beginning July 1, 2010, a drug or vaccine administered  in this state shall not contain any amount of mercury.  Introduced on February 23, 2007, and referred to Human Resources Committee.

http://www.legis.state.ia.us/

 

Current-Beginning January 1, 2006, immunizations administered in this state shall not contain  more than trace amounts of mercury. The prohibition under this section shall not apply to  early childhood immunizations for influenza or in times of  emergency or epidemic as determined by the director of public  health. 

 

 

Kansas

 

SB 1 says that no person who is eight years of age or younger or who is knowingly pregnant shall be vaccinated in this state with a vaccine containing more than 0.5 micrograms of mercury per 0.5 milliliter dose.  Introduced January 8, 2007, it is now in the Public Health and Welfare Committee; a hearing was scheduled for March 22, 2007. However, according to the schedule for legislation, this bill is now dead.

http://www.kslegislature.org/bills/2008/1.pdf

http://www.kslegislature.org/legsrv-billtrack/index.do

 

Maine

The Maine Legislature has adjourned and adopted three mercury product bills into law.

LD 637 requires the elimination of mercury in dental offices over a 3-year period, and requires dental schools to include in their curricula by January 2008 the risks of exposure to mercury. Dental offices are to post in the office the disclosure statement published by the Department of Health and Human Services, Bureau of Health on the risks of having mercury fillings. Introduced on February 28, 2007, it is listed as being dead.

http://janus.state.me.us/legis/LawMakerWeb/summary.asp?LD=637

 

LD 1446. Beginning January 1, 2008, this bill prohibits the use of more than trace amounts of mercury or thimerosal in any immunizing agent for administration to children under 8 years of age and to pregnant women. It imposes requirements for labeling and written information packaged with the immunizing agent. It provides for an exemption if the Commissioner of Health and Human Services determines that an immunizing agent containing more than a trace amount is necessary due to an actual or potential bioterrorist incident or public health emergency. The bill also directs the department to develop a plan to ensure that all immunizing agents are mercury-free and thimerosal-free, including considering the requirement of the use of single-dose immunizing agents.  Introduced on March 15, 2007 and referred to the Committee on Health and Human Services by both houses. It is listed as being dead.

http://janus.state.me.us/legis/LawMakerWeb/summary.asp?LD=1446

LD 1523. Beginning January 1, 2008, this bill prohibits the use of more than trace amounts of a heavy metal, including mercury or thimerosal, in any immunizing agent for administration to a person in this State. It imposes requirements for labeling and written information packaged with the immunizing agent. It provides for an exemption if the Commissioner of Health and Human Services determines that an immunizing agent containing more than a trace amount is necessary due to an actual or potential bioterrorist incident or public health emergency. The bill also directs the Department of Health and Human Services to develop a plan to ensure that all immunizing agents are free of heavy metals, including mercury and thimerosal, including considering the requirement of the use of single-dose immunizing agents. Introduced on March 20, 2007 and referred to the Committee on Health and Human Services by both houses. Listed as dead.

http://janus.state.me.us/legis/LawMakerWeb/summary.asp?LD=1523

 

Maryland

SB 902 requires an individual to be vaccinated with a vaccine containing less than a specified amount of mercury per dose on or after January 1, 2009, unless vaccines that meet the requirement are not readily available or appropriate.. Introduced February 22, 2007 and referred to the Rules Committee.

http://mlis.state.md.us/2007rs/billfile/sb0902.htm

 

 

 

Massachusetts

Petition 2115  relates to prohibiting the use of certain vaccines and serums containing mercury and is scheduled to have a hearing on June 13, 2007.

http://www.mass.gov/legis/185history/h02115.htm

 

 

Michigan

SB 412 says that state agencies shall, to the extent possible, avoid the purchase of products with mercury in them if non-mercury alternatives exist.  Introduced on April 18, 2007; adopted unanimously by the Senate on May 15, 2007 and sent to the House, where it was referred to the Committee on Great Lakes and the Environment.

http://www.legislature.mi.gov/(S(dvqpoimxxowgof45mq3pnz45))/mileg.aspx?page=getObject&objectName=2007-SB-0412

 

 

Minnesota

HF 0470 is a companion to SF 0746 and would require patient notification when a vaccine contains more than a
trace amount of mercury. Introduced on February 1, 2007 and referred to the Health and Human Services Committee.

http://www.revisor.leg.state.mn.us/revisor/pages/search_status/status_detail.php?b=House&f=HF0470&ssn=0&y=2007

 

 

HF 1917 is a companion to SF 1780, providing a preference for a mercury-free vaccines preference established. Introduced on March 12, 2007 and referred to the Committee on Health and Human Services.

http://www.revisor.leg.state.mn.us/revisor/pages/search_status/status_detail.php?b=House&f=HF1917&ssn=0&y=2007

 

HF 2350 would prohibit the use of mercury in certain vaccines. Introduced on March 24, 2007 and referred to the Committee on Health and Human Services.

http://www.revisor.leg.state.mn.us/revisor/pages/search_status/status_detail.php?b=House&f=HF2350&ssn=0&y=2007

 

 

SF 0746 is an act requiring medical providers administering vaccines to school children to notify
parents and guardians of certain mercury (thimerosal) content in vaccines was introduced on February 12, 2007 and referred to the Committee on Health, Housing and Family Security. Companion is HF 0470.

http://www.revisor.leg.state.mn.us/revisor/pages/search_status/status_detail.php?b=Senate&f=SF0746&ssn=0&y=2007

 

SF 1780 is a companion to HF 1917 and is a bill for establishing a preference for mercury free vaccines in the state; authorizing the use of vaccines containing a trace amount of mercury under certain conditions; specifying certain patient informed consent requirements prior to administering the vaccine; specifying certain disclosure requirements for immunization providers; requiring the commissioner of health to provide and maintain vaccine information on the department Web site.  Introduced on March 12, 2007 and referred to the Committee on Health, Housing and Family Security.

http://www.revisor.leg.state.mn.us/revisor/pages/search_status/status_detail.php?b=Senate&f=SF1780&ssn=0&y=2007

 

Mississippi

 

*nothing relating to vaccines

 

Missouri-*nothing new in relation to vaccines

Current-Prohibits immunizations administered to children less than eight years old from containing mercury after January 1, 2007.PASSED IN MAY 2005. Under the act, after April 1, 2007, any immunizations administered to knowingly pregnant women or children under three years of age shall not contain more than 1 microgram of mercury per 0.5-milliliter dose.

 

Montana

The Montana Legislature adjourned on Friday, April 27, 2007 and none of the following mercury product bills was adopted into law.

SB 0236 is an act requiring mercury-free childhood vaccines; and establishing an interim preference for dispensing mercury-free influenza vaccines. Introduced on January 10, 2007, it was referred to the Committee on Public Health, Safety and Welfare. It was recommended for adopted and passed the Senate on February 5, 2007. It has been sent to the House, where it is in the Committee on Human Services, which had a hearing on March 16, 2007. It died in committee on April 27, 2007.

http://data.opi.mt.gov/bills/2007/billhtml/SB0236.htm

 

Nebraska

 

The Nebraska Legislature has adjourned, without adopting the following bill.

 

LB 49 states that on and after July 1, 2007, no vaccine or other drug administered in the State of Nebraska shall contain more than a trace amount of mercury; and on and after July 1, 2009, no vaccine or other drug administered in the State of Nebraska shall contain any amount of mercury. Introduced on January 4, 2007 and referred to Health and Human Services. Indefinitely postponed on February 26, 2007.

http://uniweb.legislature.ne.gov/Apps/BillFinder/finder.php

 

New Hampshire

 

*nothing relating to vaccines

 

New Jersey-

The New Jersey Legislature is unusual in that it starts in the even year and carries its bills over into the odd-numbered year.

 

A1324 is the same as A4433 from the 2004-2005 session and would phase out the use of mercury in vaccinations over a period of three years. Introduced January 10, 2006, referred to Assembly Health and Senior Services Committee. It was reported out of committee on May 11, 2006, with amendments.

http://www.njleg.state.nj.us/2006/Bills/A1500/1324_I1.HTM

http://www.njleg.state.nj.us/Default.asp

S618 is the same as A1324 and would phase  out the use of mercury in vaccinations over a period of three years. Introduced on January 10, 2006 and referred to Senate Health, Human Services and Senior Citizens Committee.

http://www.njleg.state.nj.us/2006/Bills/S1000/618_I1.HTM

http://www.njleg.state.nj.us/Default.asp

 

New Mexico-

New Mexico adopted a resolution and is now adjourned.

 

SJM 25 is a joint memorial resolution that encourages the use of vaccines with no more than a trace of mercury in them. Adopted and signed.

http://legis.state.nm.us/Sessions/07%20Regular/memorials/senate/SJM025.html

http://legis.state.nm.us:8080/lcsbillsearch/session.jsp?year=2007R&type=JM&chamber=S&number=25

 

New York

*nothing new relating to vaccines

Current: Mercury Ban does not take effect until 2008. Prohibits the administration to any person under the age of three years and to women who know they are pregnant of any vaccine containing more than 0.5micrograms of mercury per 0.5 milliliter dose, except that, for children under3 years, an influenza vaccine may contain not more than 0.625 micrograms ofmercury per 0.25 milliliter dose, and for pregnant women, an influenza vaccinemay contain not more than 1.25 micrograms of mercury per 0.50 milliliter dose;authorizes the commissioner of health to grant exemptions in cases of diseaseoutbreaks and vaccine shortages, and exempts influenza vaccines for pregnantwomen if there is in any year an insufficient supply of such vaccine which complies with the provisions of this act.

 

 

North Carolina

 

HB 431 would require that vaccines, containing the preservative thimerosal, administered to children under the age of eight years shall not contain more than 0.5 micrograms of mercury per 0.5 milliliter dose. Influenza vaccines administered to children 6‑35 months of age and pregnant women shall not contain the preservative thimerosal, except:  (1) vaccines with a trace amount (<0.5ug/0/5ml dose) of mercury are permissible only if there are no alternative vaccines available; and(2) in times of emergency or epidemic as determined by the State Health Director. If an emergency or epidemic is determined to exist, the State Health Director shall notify the Commission for Health Services, the Governor, and the Joint Legislative Commission on Governmental Operations, and the general public. The Department of Health and Human Services, Division of Public Health, shall develop and produce a brochure that explains the use of thimerosal and other preservatives in vaccines. The brochure shall describe what alternatives are available and what potential advantages and disadvantages are posed by the use of thimerosal and the alternatives. Introduced February 28, 2007, referred to the Committee on Health. A substitute was favorably reported on April 26, 2007 and it was referred to the Committee on Appropriations.

http://www.ncleg.net/gascripts/BillLookUp/BillLookUp.pl?Session=2007&BillID=H431

 

 

Oregon

*nothing new relating to vaccines

Current-Restricts use of vaccines containing mercury by pregnant women and children under three years of age.  Takes effect January 1, 2007. A woman who is known to be pregnant or a child under three years of age may not be vaccinated with a vaccine containing mercury or injected with a product that contains more than 0.5 micrograms of mercury per 0.5 milliliter dose.

(b) Notwithstanding paragraph (a) of this subsection, a woman who is known to be pregnant or a child under three years of age may be vaccinated with an influenza vaccine that contains 1.0 microgram of mercury or less per 0.5 milliliter dose.

 

 

Pennsylvania

HB 790 prohibits certain persons from being vaccinated with vaccines containing mercury or injected with any mercury-containing product. Referred to Health and Human Services, March 19, 2007.

http://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?&syear=2007&sind=0&body=H&type=B&bn=0790

 

HB 1001 amends existing law, known as the Childhood Immunization Insurance Act, further providing for definitions; and providing for mercury-free vaccines. Referred to Health and Human Services, April 2, 2007.

http://www.legis.state.pa.us/cfdocs/billinfo/billinfo.cfm?&syear=2007&sind=0&body=H&type=B&bn=1001

 

Rhode Island

 

H 5282  would require, prior to any vaccination of a minor child, a physician shall provide notice to a parent or guardian if the vaccination contains mercury. A standardized consent form stating that mercury is a dangerous toxin, and that  exposure to even low levels may permanently damage the brain and nervous system and cause  behavior changes, shall be developed and provided by the department of health. This form shall  be signed and dated by a minor child’s parent or guardian prior to vaccination and kept with the  minor child’s permanent record. Introduced on  February 01, 2007, and referred to the House Health, Education & Welfare Committee.

http://www.rilin.state.ri.us/billtext07/housetext07/h5282.htm

 

H 5863  would require, except for an influenza vaccine, on and after July 1, 2008, a person who is knowingly pregnant or who is under 3 years of age shall not be vaccinated with a mercury containing vaccine or  injected with a mercury containing product that contains more than 0.5 micrograms of mercury per five tenths 0.5 milliliter dose. On and after July 1, 2008, a person who is knowingly pregnant or who is under three  years of age shall not be vaccinated with a mercury containing influenza vaccine that contains more than one  microgram of mercury per 0.5 milliliter dose. The director of the department of health may exempt the use of a vaccine from this  section if the director finds, and the governor concurs, that an actual or potential bioterrorist incident or other actual or potential public health emergency, including a pandemic, an epidemic or shortage of supply of a vaccine that would prevent persons from receiving the needed vaccine, makes necessary the administration of a vaccine containing more mercury than the maximum level set forth herein. Date Introduced March 01, 2007 and referred to the House Health, Education & Welfare Committee.

http://www.rilin.state.ri.us/billtext07/housetext07/h5863.htm

 

South Carolina

 

*None relating to vaccines

 

Tennessee-*nothing new

Current-All immunizations administered to any person, including pregnant women, in the State of TN shall not contain mercury, trace amounts of mercury or preservatives containing mercury.

 

Vermont

 

H.0114 proposes to prohibit the use of mercury‑containing vaccines for children and pregnant women. Introduced January 23, 2007 and referred to the Human Services Committee.

http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/H-114.HTM

http://www.leg.state.vt.us/database/status/summary.cfm?Bill=H%2E0114&Session=2008

 

H.0121 proposes to limit the presence of mercury in the air and waters of the state by prohibiting the installation of  mercury-containing dental amalgam, except in back molars, effective January 1, 2011.  It establishes reporting requirements regarding amounts of mercury supplied to the dentists of the state.  It also proposes to establish a comprehensive program by which manufacturers of mercury-added thermostats will collect mercury-added thermostats facing disposal. Introduced January 23, 2007 and referred to the Human Services Committee. Reported out favorably with amendment and referred to the Human Services Committee on March 14, 2007.

http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/H-121.HTM

http://www.leg.state.vt.us/database/status/summary.cfm?Bill=H%2E0121&Session=2008

S.0081 would require that dental patients are notified of alternatives to mercury amalgam dental fillings, using brochures and posters the department of health must produce; phase out the use of mercury amalgam fillings, beginning with a ban on the use of mercury amalgam fillings for pregnant women and children commencing in 2008 and then applying it to the rest of the general public by 2011; and prohibit the use of mercury in flu vaccines except in the case of a shortage or public health emergency. Introduced February 9, 2007 and referred to the Health and Welfare Committee.

http://www.leg.state.vt.us/database/status/summary.cfm?Bill=S%2E0081&Session=2008

http://www.leg.state.vt.us/docs/legdoc.cfm?URL=/docs/2008/bills/intro/S-081.HTM

 

Washington

 

The Legislature of the State of Washington has adjourned and adopted the following bill.

 

HB 1098 modifies the state statutes limiting the amount of mercury in vaccinations to provide an exemption for the use of mercury-containing vaccinations in times of an outbreak of a vaccine-preventable disease. Introduced January 10, 2007, a substitute was adopted with amendment and sent to the Governor on  April 22, 2007, who signed it into law on May 2, 2007. http://search.leg.wa.gov/pub/textsearch/default.asp##

 

West Virginia

 

The Legislature adjourned in March 2007, and the following two bills were not adopted.

HCR 57 Requests that  the Joint Committee on Government and Finance conduct a study on the need to eliminate mercury and mercury preservatives (thimerosal) in vaccines. Introduced February 26, 2007, adopted by the House on March 7 and sent to the Senate, where it has been referred to the Committee on Health and Human Resources.

http://www.legis.state.wv.us/Bill_Text_HTML/2007_SESSIONS/RS/Bills/hcr57%20intr.htm

http://www.legis.state.wv.us/bill_status/Resolution_History.cfm?year=2007&sessiontype=rs&btype=res

 

HB 2152 provides that, effective the first day of July, two thousand seven, vaccines administered in this state shall not contain any mercury or mercury compounds, including but not limited to thimerosal, unless a vaccine containing no mercury is not manufactured; or the provider finds that the mercury-free vaccine is not obtainable by utilizing best efforts, because the vaccine is not on the market for sale. If a mercury-free vaccine is not available according to subsection (a), then a vaccine containing a trace amount of mercury as defined by the United States Food and Drug Administration may be administered. If neither a mercury-free vaccine nor a vaccine containing a trace amount of mercury is available, then the vaccine containing the least amount of mercury may be administered. Introduced January 16, 2007; referred to the Committee on Health and Human Resources, then the Judiciary.

http://www.legis.state.wv.us/Bill_Text_HTML/2007_SESSIONS/RS/Bills/hb2152%20intr.htm

http://www.legis.state.wv.us/bill_status/Bill_Status.cfm

 

Federal

 

HR 881 amends the Federal Food, Drug, and Cosmetic Act to deem a banned mercury-containing vaccine to be adulterated. Amends the Public Health Service Act to provide that a vaccine is a banned mercury-containing vaccine if one dose of the vaccine contains one or more micrograms of mercury in any form. It authorizes the Secretary of Health and Human Services to declare that an actual or potential bioterrorist incident or other public health emergency makes the administration of such vaccines advisable for a specified period. The bill requires the Secretary to prohibit the distribution of banned mercury-containing influenza vaccines that are approved as biological products to: (1) any child under the age of three years old (effective July 1, 2007); (2) pregnant women if the vaccine contains thimerosal (effective July 1, 2007); and (3) any child under the age of six (effective July 1, 2008). It also requires the Secretary to revise the vaccine information included with mercury-containing vaccines to include: (1) a statement that indicates the presence of mercury in the vaccine; (2) information on the availability of any mercury-free or mercury-reduced alternative vaccine and instructions on how to obtain such an alternative vaccine; and (3) a recommendation against administration of any mercury-containing vaccine to a pregnant woman. In addition, the bill expresses the sense of Congress that the Centers for Disease Control and Prevention (CDC) should disseminate, with any vaccine-related information, a recommendation against administration of any thimerosal-containing vaccine to a pregnant woman. Introduced on February 7, 2007, it has 17 sponsors and co-sponsors, and has been referred to the Committee on Energy and Commerce.

http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.00881:

 

HR 2101 would prohibit after 2008 the introduction into interstate commerce of mercury intended for use in a dental filling, and for other purposes. Introduced on May 1, 2007, it has two sponsors and co-sponsors and has been referred to the Committee on Energy and Commerce.

http://thomas.loc.gov/cgi-bin/bdquery/z?d110:h.r.02101:

 

 

PDF version

Canada

Canadian vaccines

 Why do Canadian parents repeatedly say their vaccines are mercury free and they say it with absolute. 
So where do they get this from?  

According to Health Canada: 
 
Currently, the only thimerosal-containing vaccine in routine use in the infant immunization schedules of some Canadian jurisdictions is the hepatitis B vaccine.

 This does not mean that all thimerosal-containing vaccines have been eliminated in Canada. A number of other thimerosal-containing vaccines are licensed that are used in special circumstances, that could continue to expose infants < 6 months of age to ethylmercury.  
 
These include some single antigen acellular pertussis and conjugate H. influenzae vaccines, diphtheria-tetanus, and diphtheria- tetanus-acellular pertussis combination vaccines, all of which contain thimerosal in a concentration of 0.01%, and represent an exposure of 25 µg ethylmercury per 0.5 mL dose(11).  
 
Thimerosal- containing hepatitis B vaccine continues to be used in some Canadian jurisdictions to protect high risk infants born to chronic hepatitis B infected mothers. Influenza vaccines that are licensed in Canada also contain 0.01% thimerosal but are not recommended or used in infants < 6 months of age because of lack of effectiveness early in life.

 Here are the thimerosal concentrations in the Hep B vaxes licensed for use in Canada: 
 
Engerix BTM [Glaxo Smithkline] and Recombivax BTM [Merck Frosst Canada]) have been available in Canada since these programs were initiated, containing thimerosal at a concentration of 0.005% or 50 µg/mL.  
 
A regular infant dose of 0.5 mL Engerix BTM contains 12.5 µg of ethylmercury, while a regular infant dose of 0.25 mL of Recombivax BTM contains 6.25 µg.  
 
 
Health Canada also states: 
 
There is no legitimate safety reason to avoid the use of thimerosal-containing products for children or older individuals, including pregnant women.

 Vax schedule in Canada (Alberta)

Link:  
 
2 months  
• DTaP-IPV-Hib1 
• Pneumococcal conjugate 
• Meningococcal conjugate 
 
4 months  
• DTaP-IPV-Hib 
• Pneumococcal conjugate 
• Meningococcal conjugate 
 
6 months  
• DTaP-IPV-Hib 
• Pneumococcal conjugate 
• Meningococcal conjugate 
 
6-23 months  
• Influenza 
 
12 months  
• MMR2 
• Varicella (Chickenpox) 
 
18 months  
• DTaP-IPV-Hib 
• Pneumococcal conjugate 
 
4 – 6 years  
• DTaP-IPV3 
• MMR 
 
Grade 5  
• Hepatitis B (3 doses) 
• Varicella4 (Chickenpox) 
 
14 – 16 years  
• dTap5 
 
Note: each bullet represents one vaccine/injection 
 
* 1 Diphtheria, tetanus, acellular pertussis, polio, haemophilus influenza type b 
* 2 Measles, mumps, rubella 
* 3 Diphtheria, tetanus, acellular pertussis, polio 
* 4 If no history of disease or not previously immunized 
* 5 Diphtheria, tetanus, acellular pertussis

State Mercury Laws

What do some of the Mercury (Thimerosal) Bans REALLY mean?

 

Mercury free does NOT mean a total ban for most states so read the state law to be sure of what it says. For all states, they can be viewed here:

 

 

`Mercury-Free Vaccines Act of 2005’

 

 

Some Examples:

 

California-The state data do not include children under the age of 3. About 90 percent of all autistic children are entered into the system before the age of 6. According to the state data, 2002 was a record year for new autism diagnoses, with 3,259 cases. In 2003, the number of new cases slipped to 3,125. In 2004, the number was 3,074. For the first half of 2005, there were 1,470 new cases, compared to 1,518 in the same period in 2004. (Source:AP-California)

California- Article 9. Mercury-containing Vaccines

124172. (a) Except for an influenza vaccine described in subdivision (b), on and after July 1, 2006, a person who is knowingly

pregnant or who is under three years of age shall not be vaccinated with a mercury-containing vaccine or injected with a mercury-containing product that contains more than 0.5 micrograms of mercury per 0.5 milliliter dose.

(b) On and after July 1, 2006, a person who is knowingly pregnant or who is under three years of age shall not be vaccinated with a mercury-containing influenza vaccine that contains more than 1.0 microgram of mercury per 0.5 milliliter dose.

 

 

Iowa- Beginning January 1, 2006, immunizations administered in this state shall not contain more than trace amounts of mercury. The prohibition under this section shall not apply to   early childhood immunizations for influenza or in times of  emergency or epidemic as determined by the director of public  health.

 

 

New York-ban does not take effect until 2008. Prohibits the administration to any person under the age of three years and to women who know they are pregnant of any vaccine containing more than 0.5micrograms of mercury per 0.5 milliliter dose, except that, for children under 3 years, an influenza vaccine may contain not more than 0.625 micrograms of mercury per 0.25 milliliter dose, and for pregnant women, an influenza vaccine may contain not more than 1.25 micrograms of mercury per 0.50 milliliter dose; authorizes the commissioner of health to grant exemptions in cases of disease outbreaks and vaccine shortages, and exempts influenza vaccines for pregnant women if there is in any year an insufficient supply of such vaccine which complies with the provisions of this act.

 

 

Missouri– Prohibits immunizations administered to children less than eight years old from containing mercury after January 1, 2007. PASSED IN MAY 2005. Under the act, after April 1, 2007, any immunizations administered to knowingly pregnant women or children under three years of age shall not contain more than 1 microgram of mercury per 0.5-milliliter dose.

 

 

Illinois-ban not in effect until 2008 however on Mar 04, 2006- the Illinois Department of Public Health has declared 4 vaccines with high levels of mercury exempt from the law. Illinois passed landmark legislation that limits mercury levels in vaccines to 1.25 micrograms per dose by the first of this year and eliminates mercury all together by January 1st 2008, the Illinois Department of Public Health has issued a declaration of exemption which allows four vaccines to exceed the limit. In addition to the flu vaccine, the diphtheria-tetanus, Japanese encephalitis and meningitis vaccines are also exempted from the law. The Illinois Department of Public Health claims the mercury-free versions of these vaccines are either too expensive, in short supply or non-existent, hence they have allowed thimerosal, the mercury-laden preservative in these vaccines to persist.

 

 

Oregon-Restricts use of vaccines containing mercury by pregnant women and children under three years of age.  Takes effect January 1, 2007. A woman who is known to be pregnant or a child under three years of age may not be vaccinated with a vaccine containing mercury or injected with a product that contains more than 0.5 micrograms of mercury per 0.5 milliliter dose.

(b) Notwithstanding paragraph (a) of this subsection, a woman who is known to be

pregnant or a child under three years of age may be vaccinated with an influenza vaccine

that contains 1.0 microgram of mercury or less per 0.5 milliliter dose.

 

Tennessee- All immunizations administered to any person, including pregnant women, in the State of TN shall not contain mercury, trace amounts of mercury or preservatives containing mercury. :)

 

 

Delaware- Except for vaccines for influenza, no vaccine containing more than a trace amount of mercury shall be made available to a medical provider in this State for administration to children under eight years of age or to pregnant women.  This section shall not apply to vaccines administered during declared states of emergency or epidemics.” Section 1. of this Act shall become effective on January 1, 2006. No vaccine containing more than a trace amount of mercury shall be made available to a medical provider in this State for administration to children under eight years of age or to pregnant women.  This section shall not apply to vaccines administered during declared states of emergency or epidemics.” shall become effective on January 1, 2007. No vaccine containing mercury shall be made available to a medical provider in this State for administration to children under eight years of age or to pregnant women.  No vaccine containing mercury shall be administered by a medical provider in this State to a child who is under eight years of age or to a pregnant woman, notwithstanding the expiration date thereof.  This section shall not apply to vaccines administered during declared states of emergency or epidemics.” become effective on January 1, 2008.