Monday 20 April 2015

Should measles vaccination become compulsory?

Measles is highly contagious. It is an airborne illness - meaning it is spread through the air. Measles, also known as “Rubeola,” is a leading cause of death of young children worldwide, despite the availability of an inexpensive and effective vaccine. Measles-related deaths most frequently occur in developing countries with poor health care systems. Prior to introduction of the measles vaccine in 1963, infection during childhood was nearly 100%, causing the measles virus to be named the most infectious microbial virus. There are 24 different strains of measles, at least 19 of which have been circulating around the world since 1990.

The measles virus grows in cells that line the back of the throat and lungs. It is spread through the lymphatic system (a system that controls circulating immune cells) throughout the body, causing a systemic viral infection, called “viremia.” A person’s antibodies attack the virus, which coincidentally also damages the walls of tiny blood vessels, which then brings about a red rash.  

Measles is a highly contagious infection spread through coughing and sneezing. The infection is contagious 4 days before and 4 days after appearance of the measles rash. The virus can live and remain infectious for up to 2 hours on contaminated surfaces, so hand hygiene is very important in prevention. It has been estimated that, in the absence of vaccination or prior infection, all people will get measles at some point in their lives.  This means that if someone has measles and is amongst the public, that person can affect a great many people. And they without knowing they have caught the virus and subsequently infect a far greater number of unsuspecting victims.    

Symptoms typically first appear about 10 to 12 days after virus exposure. A high fever that lasts 4 to 7 days is accompanied by a runny nose, cough, red, watery eyes, and small white spots inside the cheeks. Between 7 to 18 days after exposure, a rash will appear on the face and neck, spreading downward over a period of 3 days and lasting 5 to 6 days.                                

The prognosis for measles in healthy children is usually good. However, in developing countries, measles is associated with complications, especially in small children under 5 years who are malnourished and in adults over 20 years. These complications are more common among malnourished individuals however even in healthy individuals; it can on occasion include blindness, brain infections, and death. Complications of measles are relatively common and include ear infections (~10% infected children), pneumonia (~5%), and brain infections leading to blindness, deafness or mental retardation (0.1%). Risk for death is ~0.1% to 0.2% worldwide. About 0.2% of people with measles die, although many people do like to push the idea that measles isn't deadly in the age of modern medicine.  At least 5 people in Canada have died with measles since 2000 among only 1,326 cases (source: Statistics Canada which only went back to 2000)

Despite the fact that a fairly small number of people die after catching the measles virus, this is still a good reason why you should get vaccinated against the virus if you didn’t have measles already no matter how old you are.  

Believe it or not, there are a great many fools who refuse to be vaccinated or even permit their children to be vaccinated. Here are some of the myths:

Vaccinations causes autism

Individuals and autism organizations who are trying to keep the focus on a link between vaccines and autism are actually doing a great harm to autistic children, autistic adults, and their families.

The Autism Omnibus Proceedings helped to dismiss most of the autism claims in vaccine court. Dr. Jeffery S. Gerber and Dr. Paul A. Offit concluded that "Twenty epidemiologic studies have shown that neither thimerosal nor MMR vaccine causes autism. These studies have been performed in several countries by many different investigators who have employed a multitude of epidemiologic and statistical methods. The large size of the studied populations has afforded a level of statistical power sufficient to detect even rare associations. Over 100 studies have shown that there is no link between vaccines and autism. These studies, in concert with the biological implausibility that vaccines overwhelm a child's immune system, have effectively dismissed the notion that vaccines cause autism.

No one else is at risk if you don't vaccinate your kids or yourself

Unvaccinated children and adults are responsible for starting most of the outbreaks of measles that continue to exist today, that are costing millions of dollars to contain.

The Vaccine Doesn’t Work Because It Protects Against a Different Strain

It’s true that the vaccine protects against an “A” strain of the measles, while the strain going around in at least nine cases of this outbreak has been B3. The measles vaccine protects against all strains of measles,” says Andrea Berry, MD. She's an assistant professor at the University of Maryland’s Center for Vaccine Development, in Baltimore.

Most people who get sick with measles during outbreaks are already vaccinated.

Whenever there is an outbreak of measles, people often ask how many of cases have actually occurred  in people who had been previously vaccinated.  Although all the specifics are unknown as of yet, we do know that out of the New York cases seven were adults, nine were children and four patients had been hospitalized. CBS 2 reports that most of the pediatric cases had been in children too young to be immunized and that two cases have been in patients where their parents refused to have them immunized. In regards to the adults, the vaccination status is often unknown since adults rarely have documentation of measles vaccination that they may have received as a child.  However, this is a good reminder of the importance of adult vaccination.  And since the recommendation of the second dose didn’t come about until the early 1990’s, it’s probably that most adults are unknowingly undervaccinated. This is why all adults who don’t know if they were ever vaccinated against measles should get vaccinated.

I am now going to tell you about a case heard in the Superior Court in Ontario, Canada that dealt with one parent who refused to vaccinate her daughter against measles. 

The mother, and the father cohabited until April 2012.  The mother brought an application in the Superior Court on September 6, 2013.  In the Application she claimed, among other things, sole custody of the child. The mother claimed that although the father had acquiesced to the mother’s decision-making regarding the children in the past, he had begun to openly question the mother’s parenting methods and decisions, especially concerning the parties’ decision to raise the children within a naturopathic health regimen, which requires that the children not participate in the immunization process.  The mother claimed that the father had threatened to have the child immunized without first obtaining the mother’s consent.

The parents’ consent order gave joint custody to each parent.  The order included a term that the parents had agreed to not vaccinate their child before she reached 12 years of age.  They further agreed that at age 12, the child would make her own decision with respect to vaccinations. In addition, although the parents were to consult and inform each other on all major decision making relative to the child, the mother would have final decision making authority.

Let me say from the beginning that it was a mistake on the part of the father to agree to let the child make her own decisions re her health and a bigger mistake to leave the final decisions with the mother.

Despite the parties entering into a joint custody agreement, their separation has been characterized by acrimony and conflict.  They had attempted to set their conflicts aside, however, predictably, disagreements between them about joint decision making over medical decisions started to escalate.  Their inability to decide on whether or not their child should receive a measles vaccination came to a head when the mother told her ex that she wanted to take the child to Germany to visit their extended family.  The father agreed that the visit was in the best interest of the child; however, he said that he would only give his consent for the child to travel if she is vaccinated for certain diseases, including measles.

This matter came before Justice Flynn of family court on February 20, 2015.  Justice Flynn did not make an order or any finding relative to the issue of vaccinations.  He ordered that the mother be allowed to take the child to Germany.  However, on that same day the father brought a motion to change the joint custody order to give him sole decision making power relative to medical issues related to the child.  The mother opposed his motion and countered that she should be given sole decision making powers relative to medical issues.

This case brought to the forefront multiple issues that included: when is it appropriate to enter into a joint custody arrangement; if such arrangement is entered into, what impact should that agreement have on a court who subsequently is asked to make a decision the parties are unable to make; and what degree of input should a child have in medical decisions affecting him/her.  It also highlights the polar opposite positions of those who refuse to vaccinate their children under any circumstances with those who feel that vaccination is a necessary preventative measure in preventing a serious infectious disease being contracted by or spread by an unvaccinated child. 

The father asserted that he only agreed to the clause relative to not vaccinating their child in order to stop the litigation from going any further.  He suggested that recent worldwide developments that have been featured in the news highlight  concerns over diseases that were otherwise thought to be contained and relatively non-existent becoming a concern once again.  The recent outbreak of the measles disease was at the centre of the controversy before the Superior Court.

The father now contended that the child must be vaccinated before the trip to Germany and that the situation has changed materially changed since the parties entered into that agreement in 2007.  The mother strongly opposed the child being vaccinated.  She is an adherent to the homeopathic approach to health and treatment.  She submitted that the introduction of pathogens into her child by vaccination would be harmful to the child.  It was the mother’s submission that the vaccination is harmful and the benefits do not outweigh the harm.

Thw made an order on March 11, 2015 requesting the Office of the Children’s Lawyer to become involved to assist the court by acting for the child and ensuring that a complete evidentiary record be placed before the court and to make legal submissions that would provide for a better opportunity for a just determination of this issue since the parties didn’t bring a lawyer with them.

Before a court makes a variation order in respect of a custody order, the court must satisfy itself that there has been a change in the condition, means, needs or other circumstances of the child of the marriage occurring since the making of the custody order or the last variation order made in respect of that order, as the case may be, and, in making the variation order, the court shall take into consideration only the best interests of the child as determined by reference to that change.

In this particular case, the agreement of the parties was made part of a court order on the consent of the parties.  It is clear that there had been no adjudication on the issue of the clause in the agreement that dealt with the child being vaccinated. That was going to be left to the judge in the Superior court.

The suggestion that the best interests of the child may enable a court to override or disregard a provision in a separation agreement governing custody or access was also recognized in previous decision of the Ontario Superior Court of Justice. In that decision, the judge said in part;

“Where an agreement deals with custody or access, even if it is in proper form, the court is free to disregard those terms though on other matters it still prevails over the statute if the best interests of a child are, in the court’s opinion, not served by the contractual terms.”

This clearly means that even though you may sign away your rights, if in doing so, if those interests are related to your wellbeing and that of your child, what you signed away can be reversed.

With the rights and obligations of parents, there are duties on the parent that is charged with making decisions that impact on their child’s best interest to inform themselves fully and as objectively as possible in order to make the necessary decision.  As the child matures, such decisions will allow the child to share in the decision-making. As the level of input increases, it will reach the point of autonomy when the child is able to understand all of the issues and appreciate the consequences of his or her decision.

The judge in this case I am writing about said in part; “It is my view that this child is not in a position that would allow her to consider and understand all of the relevant information and appreciate the consequences of a decision to be vaccinated for measles, mumps, and rubella.  She is in a conflict of loyalty between the two parents she loves.  In such circumstances, she cannot decipher which information given by either parent has validity and should be accepted.  How is it possible for her to decide when her own parents cannot decide what data is valid and worthy of acceptance?  Even if that were possible, by making a choice she would be aligning with one parent and being disloyal to the other.  I will not place this child in such a position.  Whatever information I may obtain from interviewing the child would not be relevant and would most certainly be harmful to the child.” unquote

The mother testified that she had researched this vaccination issue for over 15 years.  She stated that she has a Bachelors and Master’s Degree in Human Biology and Nutritional Sciences. She also stated that she has worked in the health care industry for the last 5 years and she is well versed in research technique and analyzing medical studies.

She also said; “I have not found sufficient evidence that proves the safety of vaccines or that they are effective in actually preventing disease. What I have found is an enormous amount of evidence that supports the contrary, that vaccines are dangerous and ineffective. After objectively reviewing this evidence, one cannot but doubt why a child’s bloodstream should be injected with toxic, foreign substances. By vaccinating my children, not only am I subjecting them to a real risk of a severe reaction to the vaccine, but the children are still at risk of maybe catching the disease for which the vaccine is said to protect against.” unquote

There may be incidents where such vaccines have done more harm but compared to the good vaccines do, her reasoning in my opinion isn’t reasonable. Consider what the Salk vaccine did to eradicate polio and what the small pox vaccine did to eradicate small pox. If parents felt the same way that woman does, millions of victims would have suffered.

Then she said something really stupid. “Most diseases were resolved, and almost non-existent, before vaccines were introduced.” The Black Plague wiped out millions of people in Europe and Asia. In 1918, a flu virus spread around the world, leading to a pandemic. This pandemic has come to be known as the 1918 or the Spanish Flu. It is estimated that up to 40% of the world's population was infected with the virus and between 20 and 50 million people died. It is estimated that nearly 70,000 people died in the United States alone from the 1957-58 Asian Flu pandemic. Worldwide, an estimated 1 to 2 million people lost their lives to the Asian Flu. I got that particular flu in 1957 and when I arrived at an isolated Indian residential school as a senior supervisor, I unknowingly thinking that I only had a bad cold so over a period of several days, I infected the entire school, both children and staff with the virus.  Fortunately, none of us died but we were very sick.

She also said that vaccines are ineffective and diseases and epidemics continue to occur in highly vaccinated populations. She is wrong again. The Ebola hemorrhagic fever or Ebola virus, kills up to 90% of people who are infected. Now they have a vaccine that destroys infected cells thereby saving the lives of thousands of people who were suffering from that disease.

The judge said in part; “I find that the mother and her supporting witnesses are locked in a never ending spiral of blind acceptance of statements by individuals who claim to be experts in the field in which they are not.  The mother accepts many of their statements about the state of the research and like the alleged experts who filed evidence on her behalf; she passes these beliefs on as if they are legitimate studies that have received general acceptance.  Most of the supporting research offered by the mother and her supporters is not valid and does not consider objective facts, research and literature that are thorough and peer reviewed.  Counsel for the mother submitted that the present hysteria around measles and vaccinations is something that is a creation of the media and not grounded in fact and research.  I strongly disagree.” unquote

During this century alone, there has been a dramatic decrease in measles epidemics. Prior to the development of the measles vaccine between 5 and 7 million people died each year from measles. By 1995, measles deaths had fallen 95 percent worldwide and 99 percent in Latin America. In the United States, the incidence of measles hit an all-time low in 1998, with only 89 cases and no deaths reported.

Vaccinations against known infectious diseases are essential for the health of not only those that are prone to getting a disease (the young and very old) any anyone else who is near someone who is a carrier of the disease.

Vaccines work by stimulating our immune system to produce antibodies (substances produced by the body to fight disease) without actually infecting us with the diseases.  They trigger the immune system to produce its own antibodies, as though the body has been infected with a disease.  This is called “active immunity.”  If the vaccinated person then comes into contact with the disease itself, their immune system will recognize it and immediately produce the antibodies they need to fight it. Getting the Vaccine is a much safer way to make antibodies without the suffering of the disease itself and the risk of becoming disabled or dying.

There are no legitimate scientific studies that have shown vaccinations to be harmful. The control and eradication of certain infectious diseases throughout the world is simply beyond dispute. The rationalization by those who are against vaccinations that such phenomena would have developed without the use of vaccinations is indefensible and illogical.

Claims that herbal or naturopathic medicines are as effective as vaccines against the diseases named (such as measles, mumps and rubella) are simply not borne out by any scientific studies.  Side effects of vaccinations, when they occur are nothing more than a very temporary mild irritation around the location of the immunization or a low grade fever for one to two days. Vaccinations against common and potentially fatal infectious diseases has led to the decline or elimination of very serious illnesses. 

The public policy in the Province of Ontario (where this case was heard) has been expressed in its legislation that it is in favour of vaccinations of children.  The exemption allowance (such as for religious reasons) can be overridden by the medical officer of health if there are reasonable grounds that there is an immediate risk of an outbreak of a designated disease (including measles) at the location the unvaccinated child attends.  Even with the exemption, the emphasis is on prevention by vaccination of any disease outbreak.

The judge said in his ruling; “Public policy as expressed by the Ontario and Canadian governments supports vaccinations as essential to the health of children and the public in general.  The World Health Organization promotes vaccinations for the same purposes as a matter of public health and safety. For these reasons, vaccination of disease outbreak, I find the there is sufficient evidence on the balance of probabilities that the child in this case should be vaccinated as it is in her best interests.”  

The judge also said; “As a result of the above reasons, there shall be an order that the father shall have the decision making ability with respect to the child getting vaccinations.  Prior to the child being taken on the trip to Germany, she shall receive a vaccination for measles, mumps, and rubella or whatever vaccination combination for these diseases is recommended by the child’s family doctor. I further order that the mother is not to communicate with the child in a manner that would be negative to the child receiving the vaccinations.                                                                                    

If the mother violates any of those orders, she could permanently lose custody of the child. Quite frankly, I really believe that any parent who refuses to permit the vaccination of his or her child or children should lose custody of his or her child until that parent concedes.

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