By David Gorski
Given the ongoing (and increasing) measles outbreak linked initially to Disneyland, it’s hard for me not to revisit the topic from time to time. This time around, there are two issues I wish to discuss, one political and one that is a combination of medical and political. After all, it was just one week ago when New Jersey Governor Chris Christie stepped in it by advocating parental choice in vaccines, as if parents don’t already have a choice. He rapidly had to walk it back, and his ill-considered remarks were almost certainly not evidence that he is antivaccine. They are, however, evidence that he doesn’t understand that we do not have “forced vaccination” in this country (we have school vaccine mandates). Parents already have choice in 48 states, given that only two states (Mississippi and West Virginia) do not allow belief-based non-medical exemptions, be they religious exemptions, personal belief-exemptions, or both, to school vaccine mandates. It also came out that in 2009 while running for Governor, Christie met with Louise Kuo Habakus (who is antivaccine) and the NJ Coalition for Vaccine Choice, a very vocal NJ antivaccine coalition whose member organization list reads like a who’s who of the national antivaccine movement and includes Life Health Choices, the antivaccine organization founded by Habakus. He even wrote a letter promising that as governor he would stand with them in “their fight for greater parental involvement in vaccination decisions that affect their children.”
It’s also evidence that vaccine mandates are becoming even more politicized. Indeed, Senator Rand Paul, on the very same day, provided more such evidence when he claimed on a conservative talk radio show that he’s seen children with severe neurological problems after vaccination, the implication being that he believed these children’s problems were linked to vaccination. Later, in a testy exchange with a CNBC reporter, who asked him whether he had really said that he thought vaccines should be voluntary, Paul sarcastically replied, “I guess being for freedom would be unusual.” Later in the exchange, after repeating the same antivaccine talking points that he had related earlier in the day, he said, “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” You get the idea. He, too, ultimately had to back off a bit, famously showing himself getting vaccinated for hepatitis A, but given that Paul has had a long history of making similar comments, this was almost certainly strategic.
What is happening is that refusal to vaccinate is being painted, instead of as a public health issue with potentially dire consequences, as an issue of “freedom.” Rand Paul’s statements are health freedom rhetoric packaged toxically with “parental rights” rhetoric in which children are viewed as the property of their parents and the parental choice always trumps the child’s right to good medical care. It’s the same sort of rhetoric I’ve decried before in the cases of children whose parents refuse chemotherapy, such as the two 11-year-old aboriginal girls in Canada (one of whom has already died) or Jann Bellamy and Harriet Hall have while discussing cases of faith healing and lack of parental accountability. No wonder the antivaccine crank blog Age of Autism loves Rand Paul.
Politicians will be politicians, of course. They go where they think there’s support and say whatever message they perceive to be advantageous to them politically. Also, Rand Paul has long been known for saying dumb things about vaccines, things no doctor should be saying. What was more disturbing was that a relatively moderate Republican as nationally prominent as Gov. Christie would think that pandering to the health freedom and antivaccine movements might be good for him politically. On the other hand, the rapidity with which these two were slapped down by the media and prominent Republican politicians rushed to support vaccines was reassuring to me that antivaccine beliefs haven’t become as prevalent as I had perhaps feared.
Of course, politicians spouting antivaccine nonsense can often be dealt with through public opinion and shame. It doesn’t always work (witness how long Dan Burton was in Congress), but they, at least, are public.
Less well known but even more pernicious are antivaccine doctors, such as pediatricians Dr. Jay Gordon and Dr. Bob Sears. If there’s one salutary effect of this outbreak, one silver lining in a dark cloud of measles suffering, it’s that the question of what to do about antivaccine physicians has come to the fore.
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