https://www.washingtonpost.com/national/health-science/anti-vaxxers-face-backlash-as-measles-cases-surge/2019/02/25/e2e986c6-391c-11e9-a06c-3ec8ed509d15_story.html
Anti-vaxxers face backlash as measles cases surge
By Lena H. Sun <https://www.washingtonpost.com/people/lena-h-sun/>
February 25 at 7:31 PM

The resurgence of measles
<https://www.washingtonpost.com/national/health-science/it-will-take-off-like-a-wildfire-the-unique-dangers-of-the-washington-state-measles-outbreak/2019/02/06/cfd5088a-28fa-11e9-b011-d8500644dc98_story.html?utm_term=.05f616665420>
across the United States is spurring a backlash against vaccine critics,
from congressional hearings
<https://energycommerce.house.gov/committee-activity/hearings/hearing-on-confronting-a-growing-public-health-threat-measles-outbreaks>
probing the spread of vaccine misinformation to state measures that would
make it harder for parents to opt out
<https://www.washingtonpost.com/health/2019/02/08/washington-measles-outbreak-draws-crowd-hearing-vaccine-law/?utm_term=.0a5a1f7396f0>
of immunizing their children.

In Washington state, where the worst measles outbreak in more than two
decades has sickened nearly 70 people
<https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Measles/MeaslesOutbreak>and
cost over $1 million, two measures are advancing through the state
legislature that would bar parents from using personal or philosophical
exemptions <https://app.leg.wa.gov/billsummary?BillNumber=5841&Year=2017>
to avoid immunizing their school-age children. Both have bipartisan support
despite strong anti-vaccination sentiment in parts of the state.

In Arizona, Iowa and Minnesota, lawmakers have for the first time
introduced similar measures. The efforts have sparked an emotional,
sometimes ugly response from those protesting what they see as efforts to
trample on their rights. Opponents of the Arizona bill
<https://apps.azleg.gov/BillStatus/BillOverview/71262?SessionId=121>, which
died quickly, have described the toll of stricter vaccine requirements as a
Holocaust
<http://azleg.granicus.com/MediaPlayer.php?clip_id=22184&autostart=0&meta_id=542474>
and likened the bill’s sponsor, who is Jewish, to a Nazi.

In Vermont, legislators are trying to do away with the state’s religious
exemption four years after eliminating the philosophical exemption. In New
Jersey, where lawmakers have sought unsuccessfully to tighten religious
exemptions, a bill to repeal it entirely was recently amended on the
General Assembly floor.

While it’s too early in the legislative season to say how many of the state
efforts to tighten vaccine exemptions will be signed into law, some public
health advocates say the rash of vaccine-preventable illnesses is creating
a shift in public thinking.

“The wave is starting to turn back,” said Michelle Mello, a professor of
law and health research and policy at Stanford University.

Diane Peterson of the Immunization Action Coalition, a Minnesota nonprofit
group, said that “there is a growing consensus for state authorities to
make the bold move to require all children to be vaccinated, with the only
exception being those who cannot be given the vaccine for medical reasons.”

Amid mounting public pressure, websites that have been a platform for the
anti-vaccination movement’s misleading claims are also making changes.
Pinterest
<https://www.washingtonpost.com/business/2019/02/21/pinterest-is-blocking-all-vaccine-related-searches-all-or-nothing-approach-policing-health-misinformation/?utm_term=.7eef438809d5>
has blocked all searches on vaccinations to stop the spread of
misinformation, while Facebook is considering removing anti-vaccination
content
<https://www.washingtonpost.com/business/2019/02/15/facebook-will-consider-removing-or-demoting-anti-vaccination-recommendations-amid-backlash/?utm_term=.0d632029d639>
from its recommendations. YouTube said it is also pulling ads from
anti-vaccine videos, claiming they violate its policies against “harmful or
dangerous” acts.

The U.S. House and Senate have scheduled rare bipartisan hearings this week
and next to investigate the reasons behind recent outbreaks.

“If vaccine hesitancy persists — or even expands — it could seriously
undermine these important advances,” Sens. Lamar Alexander (R-Tenn.) and
Patty Murray (D-Wash.) — the Senate Health, Education, Labor and Pensions
Committee’s chairman and ranking Democrat — wrote to federal health
officials.

All those actions are happening against a backdrop of rising global concern
<https://www.washingtonpost.com/world/2019/02/08/global-wave-measles-cases-fed-by-conspiracies-misinformation-has-health-officials-worried/?utm_term=.9806b5b4412e>
about vaccine hesitancy as cases of measles have surged because of gaps in
vaccination coverage. For the first time, the World Health Organization
listed vaccine hesitancy as one of the top 10 global threats of 2019.

Jessica Castro, holding her 2-month-old infant, protests a state measure to
tighten vaccine exemptions last week in Olympia, Wash. (Lindsey
Wasson/Reuters)

No measles deaths have been reported in the United States since Jan. 1, but
the virus can be deadly, especially for children. Nearly 1,000 people,
mostly children, have died of the illness in Madagascar this year,
according to the WHO, offering a window into how rapidly the disease can
devastate a country with low vaccination rates.

In Europe, measles cases are at a 20-year high, with 60,000 cases and 72
deaths. A quarter of those are in Italy, where anti-vaccine groups allied
with populist politicians won passage last year of a law to end compulsory
vaccines — a law repealed a short time later because of soaring measles
cases.

Such fears are not going away soon.

The introduction of competing anti-vaccine bills in state legislatures
reflects continuing alarm about vaccine safety, said Barbara Loe Fisher,
who heads one of the oldest and most well-established anti-vaccine groups,
the National Vaccine Information Center.

“You cannot bring down the hammer on people and force them to obey
one-size-fits-all when the risk is not being shared equally,” she said,
adding that individuals have different genetic risks.

She argues that parents should have the right to make voluntary decisions
without their children being denied a school education. “We consider this
to be parental rights, a human rights issue,” Fisher said.

While 11 states are considering bills to restrict or eliminate vaccine
exemptions, her group supports 61 out of 140 vaccine-related state
measures, “which is the most bills we have supported in a legislative
session,” she said.

Groups such as Fisher’s frame their message in terms of individual rights,
insisting that parents, not the government, should decide whether to
vaccinate their children — an argument championed by affluent,
well-educated parents that resonates with liberals and conservatives.

Those responsible for protecting public health counter that immunizations
are designed to protect whole communities, not just individuals —
especially those community members who cannot get certain shots, such as
young children, and those with compromised immune systems. When
immunization rates fall below a certain level — between 93 percent and
95 percent for measles — the vulnerable are at much higher risk. It is a
rationale that has repeatedly persuaded judges to uphold mandatory
vaccination programs.

And the enforcement of such mandates resulted in the elimination of measles
from the United States in 2000.

As public memory of the terror of measles epidemics has faded, however,
doubts about vaccines have grown — often stoked by debunked assertions
linking the shots to autism. Between 2009 and 2013, the use of nonmedical
exemptions for kindergartners increased by 19 percent nationwide, according
to a 2014 study <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202987/>.

That created pockets
<https://www.washingtonpost.com/news/to-your-health/wp/2018/06/12/kids-in-these-u-s-hotspots-at-higher-risk-because-parents-opt-out-of-vaccinations/?utm_term=.11932f649200>
such as the one in Clark County, the epicenter of Washington state’s
outbreak, where rates fell far below the threshold needed to create
community immunity.

Since this year began, there have been 159 measles cases reported in the
United States — more than the total reported for all of 2017, according to data
from the Centers of Disease Control and Prevention
<https://www.cdc.gov/measles/cases-outbreaks.html>. All are linked to
travelers who brought measles back from other countries, such as Israel and
Ukraine.

New York has been scrambling to contain its largest measles outbreak in
decades, with more than 200 people sickened since its start in October.
Texas is grappling with an outbreak that has infected nine people,
including four in Harris County, which includes Houston.

After the measles outbreak prompted Gov. Jay Inslee (D) to declare a state
of emergency in Washington state, the Portland, Ore., school where Rachel
Hall’s son is a kindergartner told students, staff members and parents
without immunity to measles that they would probably be required to stay
home for two to three weeks if a measles case were confirmed there. The
school has a high number of unvaccinated children.

Hall had hesitated to give her first child the shots. “I was attempting to
do the natural-birth, hippie-dippie thing,” she said. But she has since
immunized both her children.

Still, measures to impose stricter vaccine requirements draw fierce
opposition. In Washington, nearly 1,000 people turned out for the public
hearing last week on a state Senate bill that would eliminate all personal
exemptions for all vaccines. Most were opposed to the bill.

Jill Collier, a registered nurse, told lawmakers she was against the bill
because she believed it would harm the doctor-patient relationship. “We
cannot blanket-mandate an injection for a child and hold their education
hostage for noncompliance,” she said.

The bill’s sponsor, state Sen. Annette Cleveland, a Democrat whose district
is at the epicenter of the outbreak, said the measure would reduce the
threat of exposure by 75 percent. “I don’t know how we’ve come to a point
today where we no longer continue to embrace the miracle that vaccines
continue to be in eradicating disease,” she said in an interview.

Anti-vaccine narratives do particularly well on social media because
personal anecdotes and sensational content play better than the dry
recitation of scientific facts, according to a study
<https://nautilus.org/napsnet/napsnet-special-reports/of-virality-and-viruses-the-anti-vaccine-movement-and-social-media/>
last year. Although anti-vaccine proponents are a small minority, on social
media they may appear to be the majority.

And anti-vaccine activists are learning to leverage their strength in the
public square as well. Increasing numbers have appeared at public meetings
of a national vaccine advisory group, the Advisory Committee on
Immunization Practices
<https://www.cdc.gov/vaccines/acip/meetings/index.html>, which makes
recommendations to the CDC and meets three times a year in Atlanta.

The Facebook page of a recently formed group, Inundate the CDC ACIP, posted
a photo of nearly two dozen people at the October meeting above the caption
“Vaccine Truth Warriors descend on the CDC ACIP meeting.”

Lynette Marie Barron, who manages the Facebook page, said she started it as
a way to give voice to parents like herself who claim their children have
been injured by vaccines. “We want to bring them the stories and the
science they refuse to look at,” said Barron, 38, of Pell City, Ala.

More than 400 people have registered to attend the immunization panel’s
next meeting, on Wednesday.