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Dorit Reiss
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"Byington et al. disagreed. They point out that diseases with low R0 (defined as the average number of secondary cases produced by a typical infected person in a fully susceptible population) – less infectious than measles – can cause extensive harm and be harmful, even deadly.

Such diseases did, in fact, causes thousands of deaths (and led to hundreds of thousands of cases). While the required rates to prevent measles are high, herd immunity thresholds for other diseases are hardly low, ranging in the area of about 85-94%. Since school immunization requirements are extremely effective at preventing disease, the authors imply we should use them to the extent possible – without non-medical exemptions – to prevent these other dangerous diseases. The authors don’t say it in those words, but I think it’s a fair reading of their argument, and I agree with them.

On the other hand, there is a potential argument that the proposal does not immediately mean return of preventable diseases. Most people vaccinate even in states that have easy to get exemptions, though the rate of exemption is higher in those states than in those with hard to get exemptions. The need to get at least one vaccine would remove exemptions of convenience, keeping rates high.

I think this argument is a little tricky, since the rates of people who vaccinate selectively or on a delayed schedule are higher than of those who are completely non-vaccinated. Limiting removal of non-medical exemptions to measles vaccines would not necessarily assure rates of other vaccines remain high. The concern that this will lead to a drop in immunization rates for other diseases – a concern the authors themselves acknowledge – is very real.

While it’s hard to disagree that measles is unusually contagious, I do not think the natural conclusion is that it is more important to prevent it than other preventable  diseases, to the tune of removing non-medical exemptions for measles vaccines only. As Opel et al themselves highlight, some of the other diseases are more deadly or harmful than measles.

The combination of measles’ contagiousness and the effectiveness of the vaccine not only creates a strong argument for maximizing rates to prevent it – and I agree with the authors on that – but make it a good canary in the coal mine. Return of measles can be a warning sign – rates are dropping to a degree where the population starts to be vulnerable to outbreaks. This allows action before other diseases with higher rates of fatalities and harms (and as the authors mentioned, measles is bad enough) return.

Limiting the removal of non medical exemptions to measles may not only provide sub-optimal protection against other diseases, but remove that effect. We don’t want outbreaks of measles. But neither do we want outbreaks of diphtheria, polio or hib because we didn’t react early enough to dropping rates by tightening policy."

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Check out this video on YouTube:

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"Given the vaccine-related work that occupies most of my day, I value the modern medicine that gives me a safe, effective way to protect my baby from so many previously dangerous diseases. Some scourges of the past I can be confident my child will be safe from relatively early, as we follow the recommended schedule. Others diseases, I know his vulnerability will be temporary. While there’s always a tiny risk of vaccine side effects, I know that my son is much more safe getting vaccinated than being in my car, hanging around the house (yes, accidents happen at home), or starting to eat solids. To paraphrase The Princess Bride, life is risk. Anyone who tells you differently is selling something. But vaccines are one of the least risky things my son will face – and one of the ways to reduce the risks this big world imposes on him.

My husband and I are lucky, and privileged, to have the option to do that." 

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No, it's not a violation of constitutional rights to pass SB277. "A vocal group of parents fighting the bill insists the vaccination mandate would deprive their kids of their constitutional right to an education, and that argument has suddenly become a threat to the legislation. But legal experts -- including a lawyer who participated in a landmark education rights case -- say both state and federal law allow government to protect the health of the community, first and foremost." http://www.mercurynews.com/health/ci_27941931/california-vaccine-legislation-spurs-legal-debate-over-right?source=infinite

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"The majority of people support vaccines. The vocal anti-vaccine minority is exactly that: a minority. But because the benefits of vaccination are so obvious, many people don’t see a need to speak up, leaving the stage to a vocal, misinformed minority – possibly creating an impression the minority has more support than it does. What people need to do is speak up.

Don’t let a tiny extreme group continue to impose a risk you have not chosen on your children and yourself.

How can you make a difference? "

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