Public comment by Barbara Loe Fisher Co-founder & President, at the Vaccine Education Roundtable in Stony Brook University, Long Island, NY
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, [1] a 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. [2] [3].[4] The risk of harm can be greater for some than others[5] 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.[6] 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 [7] 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.[8][9] In the 2008 edition of America’s Health Rankings, [10] 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,[11] 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 [12] 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. [13] 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. [14]
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. [15] ,[16] 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. [17]
Today, 1 in every 143 babies born in America dies; [18] 1 child in 450 becomes diabetic;[19] 1 in 150 develops autism;[20] [21] 1 in 9 suffers with asthma;[22] ,[23] [24] and 1 in every 6 child is learning disabled. [25]
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 [26]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. [27]
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.
References:
2 Coulter HL, Fisher BL. 1985. DPT: A Shot in the Dark. New York: Harcourt Brace Jovanovich. [Return]
3 Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, D.C. National Academy Press. www.nap.edu [Return]
4 Institute of Medicine. 1994. Adverse Effects Associated with Childhood Vaccines: Evidence Bearing on Causality. Washington, D.C.: National Academy Press. www.nap.edu [Return]
5 Institute of Medicine. 1994. DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis. Washington, D.C.: National Academy Press. www.nap.edu [Return]
6 Institute of Medicine. 1994. Research Strategies for Assessing Adverse Events Associated with Vaccines. Washington, D.C.: National Academy Press. www.nap.edu [Return]
7 Shuster E. 1997. Fifty Years Later: The Significance of the Nuremberg Code. NEJM 337 (20): 1436-1440. http://content.nejm.org/cgi/content/full/337/20/1436 [Return]
8 Centers for Disease Control. 2008. Childcare and School Vaccination Requirements 2007-2008. Page 26. http://www2a.cdc.gov/nip/schoolsurv/CombinedLaws2007.pdf[Return]
9 National Vaccine Information Center. /Vaccine-Laws/state-vaccine-requirements.aspx [Return]
10 United Health Foundation. 2008. America’s Health Rankings. http://www.americashealthrankings.org/2008/index.html [Return]
11 U.S. Census Bureau. 2000. California Quick Facts. http://quickfacts.census.gov/qfd/states/06000.html [Return]
12 U.S. Census Bureau. 2000. New York Quick Facts. http://quickfacts.census.gov/qfd/states/36000.html [Return]
13 J Fisher BL. 2008. Vaccines, Autism & Chronic Inflammation: The New Epidemic. PB Industries, Inc. [Return]
14 Centers for Disease Control. September 4, 2008. Most U.S. Parents Are Vaccinating According to New CDC Survey: Vaccine Coverage Rates for Children Remain High. http://www.cdc.gov/media/pressrel/2008/r080904.htm [Return]
15 Centers for Disease Control. 2008. Recommended Immunization Schedule for Persons Aged 0-6 Years – United States. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2008/08_0-6yrs_schedule_bw_pr.pdf [Return]
16 Centers for Disease Control. 2008. Recommended Immunization Schedule for Persons Aged 7-18 Years – United States. http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2008/08_7-18_years_schedule_bw_pr.pdf [Return]
17 Snited Health Foundation. 2008. America’s Health Rankings. http://www.americashealthrankings.org/2008/othernations.html [Return]
18 Ibid. [Return]
19 Centers for Disease Control. 2003. National Diabetes Fact Sheet, U.S. 2003. http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2003.pdf [Return]
20 Centers for Disease Control. February 9, 2007. Morbidity & Mortality Weekly Report: Prevalence of Autism Spectrum Disorders --- Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2002. http://www.cdc.gov/MMWR/preview/mmwrhtml/ss5601a2.htm [Return]
21 J Centers for Disease Control. February 9, 2007. Press Release: New Data on Autism Spectrum Disorders. http://www.cdc.gov/media/pressrel/2007/r070208.htm [Return]
22 Centers for Disease Control. December 12, 2006. Press Release: State of Childhood Asthma, U.S. 1980-2005. http://www.cdc.gov/nchs/pressroom/06facts/asthma1980-2005.htm Full Report: http://www.cdc.gov/nchs/data/ad/ad381.pdf [Return]
23 Bloom B, Dey AN et al. December 2006. Vital Health Statistics: Summary health statistics for U.S. children: National Health Interview Survey, 2005.
http://www.cdc.gov/nchs/data/series/sr_10/sr10_231.pdf [Return]
24 Centers for Disease Control. March 31, 2004. Press Release: Nine Million US Children Diagnosed with Asthma, New Report Finds. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2002. http://www.cdc.gov/nchs/pressroom/04news/childasthma.htm [Return]
25 Centers for Disease Control. November 4, 2005. Morbidity and Mortality Weekly Report:Percentage of Children Aged 5-17 Years Ever Having Diagnoses of ADHD or Learning Disability by Sex and Diagnosis – U.S., 2003. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5443a8.htm [Return]
26 U.S. Department of Health and Human Services, Health Resources and Services Administration. National Vaccine Injury Compensation Program Statistics Report: December 2008. http://www.hrsa.gov/Vaccinecompensation/statistics_report.htm [Return]
27 JPartnership to Fight Chronic Disease. 2008. Almanac of Chronic Disease, 2008 Edition. Page 7. http://www.fightchronicdisease.org/pdfs/PFCD_FINAL_PRINT.pdf [Return]
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