Thursday, July 30, 2009

Wendy Jones and school-age immunizations: a post I wish I did not have to write

Caught in the tender clutches of United Airlines returning from Colorado I did not see the following comment at Delawareliberal by Libertarian 19th District State Senate candidate Wendy Jones until late last night--too late to make any reasoned response before falling asleep.

Here is the part that Wendy wrote which is most problematic for me:

“polio” – can you be sure it’s just polio if it’s the State that mandates it? Should it perhaps be a better idea that educating on the pros & cons rather than sticking a needle willy-nilly into your child filled with whatever they decide to tell you is in it? What if, through viral gene replacement technology, for instance, thought patterns & personalities could (& even might be) changed to eliminate “undesirables”, for instance, & ensure a dull, compliant populace? Mandated by the State?

These statements are troubling for a variety of reasons. For the sake of intellectual consistency I need to parse them out, despite the fact [perhaps especially because of the fact] that Wendy is running as the Libertarian candidate in this election.

1) The level of paranoia approaches birther/9-11 truther saturation. You can have abstract arguments over the government's role in mandating public health measures like vaccinations or the wisdom of particular vaccines ala anthrax [as I will discuss in point two], but the idea that can you be sure it's just polio if it's the State that mandates it? Not sure about Wendy, but while the State mandates these immunizations, the vaccines themselves are produced by private companies and in general administered by your own pediatrician's office. Having worked for a military unit that was responsible for administering vaccinations to soldiers, I have been personally responsible for quality control and batch testing for vaccines. When dealing with conspiracies, you always need to ask yourself, What would I have to believe in order for this to be true?

In this case I would have to believe that to inject my children with chemicals through viral gene replacement technology, for instance, thought patterns & personalities could (& even might be) changed to eliminate “undesirables”, for instance, & ensure a dull, compliant populace? that virtually every pediatrician and public health care worker in America had been either duped or co-opted into the conspiracy, and that the government has so penetrated virtually all pharmaceutical companies to the point where it can not only require them to produce something other than polio vaccine labeled as polio vaccine, but also has managed to completely suppress any whistle-blowers from talking about it for decades.

Is the State capable doing dire medical things to people? Of course it is. The Tuskegee Syphillis experiment and the US Army LSD experiments in the early 1960s are prime examples. But those examples are also instructive: small groups of people working in secrecy against the larger policies of the government, and whose misdeeds were found out pretty quickly because of their ineptitude. The Army officers conducting the LSD experiments, for example, actually took movies of the troops they had unwittingly dosed with hallucinogens and showed them openly at a variety of training occasions. The perpetrators of the Tuskegee experiment actually submitted their results to refereed journals.

The common threads in these conspiracies are small scale and incompetence. For a Libertarian, who generally holds government actions to be awkward and incompetent unless otherwise proven, suspecting the government of such a massive intricate conspiracy to inject public school students with gene therapies as yet unknown to mainstream science is--I am sorry to say--simply loonie tunes.

2) Should the government have the authority to mandate vaccinations as a public health matter? Here I follow Libertarian philosopher Tal Scriven, who proposes a four-point checklist for whether or not the State should have the power to prohibit or mandate any particular actions, such as universal vaccination of school children. [Note: what you will read below is my plain-English paraphrase of Scriven's rather more difficult academic writing; you can read the original here]:

1. The law must be clearly and unambiguously written.

2. The law must be universally publicized.

3. The law must prohibit an action (or an inaction) that can be demonstrated to pose serious harm to individuals.

4. The law may not be enacted if either (a) the pleasure (or good) associated with the action/inaction outweighs the harm; or (b) if prohibiting such actions/inactions creates a greater harm than leaving it alone.

Scriven describe harm in a pretty narrow fashion, as Harm should include not only physical pain but also death and severe psychological suffering.

Let's think about vaccinations then:

1. You can't go to public schools without being vaccinated against common, massively infectious diseases.

2. Yeah, it's universally publicized.

3. The failure to vaccinate has a well-documented consequence of public health risks not just to individuals but to whole populations.

4. Does the good associated with this law outweight the harm it could potentially cause?

Ah, number four--there's the potential rub, leading to number three:

3) What are the public health implications [positive and negative] of universal vaccinations? Positive: prevention or limitation of widespread infectious diseases like the polio epidemics of the 1940s and 1950s. Negative: some tiny percentage of those vaccinated will have moderate to serious to life-threatening reactions even to modern vaccines, and large numbers of people believe [erroneously, the experts tell us] that large-scale vaccination is causally linked to autism. Urban legends aside, the science on the autism/vaccination non-linkage is pretty clear and unambiguous (and shared by medical authorities in other countries who have no association with our government).

But what about the .0001% of people who will have a severe enough reaction to be life-threatening? Can a Libertarian justify a government mandate that places a person at any level of risk they would not, as individuals, choose to accept for themselves? The answer, for me, lies in Scriven's fourth requirement, about the relationship between harm and inaction.

Here's the rub: in a society in which there are no universal immunizations my children have a much MUCH higher risk of death or life-threatening harm from mass infectious diseases than they do from the tiny percentage chance that they will react badly to a vaccine. Moreover, the government in taking the universal action of requiring immunizations of all children is not transferring wealth or selectively benefitting any population; instead, in an originalist Constitutional sense, the government is promoting the general welfare.

As a Libertarian and Constitutionalist, I think therefore that immunizations for major infectious diseases as a prerequisite for entering the school system represents a legitimate State power. That does not mean the State should get to vaccinate you against anything, or that people shouldn't be skeptical until a scientific consensus emerges, but that limited public health measures are consistent with Libertarian thought.

Which is going to subject me to shitloads of criticism from a number of my anarcho-capitalist and severely minarchist friends.... But it will not be the first time for that.

So all of this comes back to Wendy Jones and Delaware's 19th State Senate race. Her position on vaccinations is--as I have said above--unfortunately, loonie tunes from my perspective. I cannot credit it as a serious policy position, and it raises disquieting questions about her understanding of science and the Libertarian perspective of public policy.

On the other hand, all of us (including Polly ADAMSADAMSADAMS Mervine's husband) have our own individual weird beliefs, such as the idea that the 19th District's Senator should vote based on Mennonite theological concerns about sexuality. [It sort of tells me that the talent pool in the district is shallow enough to be safe for non-swimmers.] Like Redwaterlilly I am beginning to feel like the district has a race between four social conservatives [even though I do think RWL does a disservice to Wendy's positions on LGBT questions.]

Fortunately, no Delaware State Senator is going to have the ability to vote upon or eliminate immunization programs for school children. [And, no, Dana, before you ask, I do not equate cold-blooded public health decisions with paternalism.]

And I really do believe that yet another nepotist Democrat or socially conservative GOPer [even if running as an IPoD] is not healthy for Delaware's economic future, so that Wendy sitting in Dover voting No, no, no is probably preferrable [Ron Paul has made a fortune as "Dr. No"] to the alternatives, I have to pull back from any unequivocal endorsement of my own party's candidate, not that my endorsement or lack of it matters one whit in a district in which I do not live and cannot vote...

But if I expect Dems and GOPers to confront strange behavior in their own parties, I have to be honest enough to do so within my own movement.


Anonymous said...

I think touting membership in the "Pink Pistols" as a qualification for serving as a legislator was kind of a clue early on.

Joining a club that combines celebration of guns with one's sexual preferences pretty much ruled her out.

Mind you, I would have felt the exactly same about somebody joining a similar club for heterosexuals, like, say, the "Straight Shooters."

Either way, it just doesn't work as a qualification for high office.


Anonymous said...

God Steve, Thank you for calling her out on something I did not have the energy to do. She wants to rail against HPV vaccines fine, but public policy of well known devestating scurges is another thing.

tom said...

"Joining a club that combines celebration of guns with one's sexual preferences pretty much ruled her out."

I'm guessing that not living in Delaware's 19th Senatorial District is the primary reason you won't be voting for her, and everything else is just talk.

tom said...

While I agree that the excerpted statement is "loonie tunes", the point she was trying to make is far less crazy than many of the things you see on Delawareliberal on a daily basis.

I know you are somewhat myopic about your own health, and even more so about your family.

But Polio, really?

Calling Polio a "common, massively infectious disease" is, let's just say, stretching things a bit. Polio is believed to have been eradicated everywhere except Nigeria, India, Pakistan, and Afghanistan.

In the U.S., or even most 3rd world countries, your chance of contracting polio from the Oral Polio Vaccine is thousands of times greater than that of getting it from an infected person, animal, or insect. So unless you are planning a career in the military or as a missionary, it is probably not much of a risk to to anyone if you skip the Polio Vaccine.

tom said...

As I pointed out in my previous comment, Polio Vaccination clearly fails your "Tal Scriven Test", badly.

But what about mandatory vaccination for diseases that are actually endemic in the U.S.?

The issue is far more complex than you make it out to be in your rather simplistic and biased analysis above.

Contrary to popular belief ;-) not all libertarians, including me, have read or even heard of Tal Scriven, but since you laid out your argument according to his principles i'll try to follow it.

"1. The law must be clearly and unambiguously written."

We are talking about a decades old, pre-existing law here, which may have been passed due to valid public policy concerns but more likely was the result of lobbyists whose companies realized they could sell a lot more vaccines if they were mandatory. Or as somebody said in an argument about seat belts & helmets, "Because the State, in this case, is not a paternalistic, disinterested guardian of the public safety, it is a political process for making deals with special interest groups".

These laws are never reviewed, except to add more vaccines to the list. And as you know, getting rid of laws tends to be much harder than passing them was.

There is also a very large difference between a law mandating that children must be immunized against certain diseases, where there are several competing vaccinations for each, and having had a disease that confers lasting immunity to itself counts as immunization; and one which consists of a list of specific vaccines that are required.

"2. The law must be universally publicized."

This is pretty much a given.

"3. The law must prohibit an action (or an inaction) that can be demonstrated to pose serious harm to individuals."

This is where your argument starts to fall apart. "The failure to vaccinate has a well-documented consequence of public health risks not just to individuals but to whole populations." This is simply not the case. Assuming the vaccinations are as effective as claimed, vaccinated individuals will not be at risk whether or not there is an outbreak. Non-vaccinated individuals are only at risk if actually exposed.

School districts could "strongly recommend" vaccination programs and offer them for free to non-vaccinated low income children for less than the cost of documenting that every child was fully vaccinated. Unless they went completely overboard with the recommendations, they would probably get at least 90% voluntary compliance which is more than enough to prevent epidemics.

I like you Steve. You probably have really great kids. But they do not count as an argument for universal mandatory vaccination. If you think it is a good idea, get your own kids vaccinated, then other people's bad decisions won't put them at risk.

"4. Does the good associated with this law outweigh the harm it could potentially cause?"

Paranoia and conspiracy theories aside, vaccinations are not all perfectly safe and effective. Some only slightly reduce your chances of getting the disease. Some can give you the disease they were supposed to protect against. Some contain Mercury or other toxic compounds. Many have extremely unpleasant, but not life-threatening side effects. There is a growing body of studies linking certain vaccines with Alzheimer's disease. Some cause severe reactions in a few people.

You didn't say where the 0.0001% figure for life threatening reactions came from, but it sure as hell wasn't double-blind clinical trials. Regardless of whether it came from the fine print on some vaccine company's marketing info or you pulled it out of your ass, let's use it: that 1 in a million means that if universally administered, it would kill about 300 people in the U.S. If that were a vitamin supplement, the FDA would leap at the opportunity to ban it. Where is that zeal when it comes to vaccines?

[apparently this comment is too long. continued in my next one...]

tom said...

[continued from above]

Another problem is that vaccines are constantly being reformulated, but as long as they are "substantially similar" to an approved version, they are fast tracked through the approval process, and as a result, many of the vaccines in use today have not had extensive human trials.

Then there are the accidents. In order to avoid straying too close to the realm of conspiracy theory, one is forced to believe that Baxter International is the most inept pharmaceutical company in the world. In less than five years they have nearly triggered an avian flu epidemic by releasing contaminated vaccines twice.

Even if they are completely innocent of malicious intent, do you really want a flu shot from a company this negligent? Do you want the state mandating it?

Steve Newton said...

I will spot you that I should not have personalized with "my" children and that polio was perhaps not the best choice of disease (I just sort of continued Wendy's example there).

However, as you are critiquing me for not sourcing the percentage of people with serious adverse reactions, your entire comment is filled with unsupported suppositions and assertions.

Your suggestion that partial or voluntary vaccination programs are essentially as effective on a population-wide basis because vaccinated individuals will not get the disease anyway sounds good, sounds logical, but doesn't match up to the conclusions of most serious public health studies. I will try to find you some citations for that.

Your segment on the dangers of vaccinations is also filled with an interesting mix of urban legend, factoid and fact. The overwhelming majority of vaccinations given in the US today, for example, are neither live virus nor attenuated virus vaccines, but DNA snippets that do not actually contain the disease in question and so cannot give you the disease. There is a very tiny minority of vaccines still in use that are attenuated virus vaccines, so in a technical sense your use of the word "some" is correct but it is highly misleading.

The Alzheimer's connection, despite some early interest in the literature, is proving to be about as real as the autism connection: to wit, there is no solid causal linkage or even strong sets of correlational data supporting that thesis.

Your suggestion that 90% compliance is more than enough to prevent epidemics is true in many--perhaps even most--cases, but not with rapidly mutating strains.

Delaware Watch said...

So basically you have given us a nutcase alert. It must be embarrassing for Libertarians that she is one of them.

David said...

I have to disagree with you. Her statement seemed unartful, but not loony. A lot of people would rather have education than mandates. I know some very educated people who even have degrees in the health profession who would agree with her. She may be wrong, but not loony. As far as I know Polio is not even given as a vaccine in this country any longer.

What is more relevant is the fact that government thinks that it can force consent upon us for any vaccine that it wants. The new swine flu vaccine has not even been tested. The last one they did in the 70's was worse than the disease. She would have been better off saying mandates should only come in a real emergency or after there is a near consensus about the safety and effectiveness of the vaccine in medical circles.

Steve Newton said...

She suggested that the government is or will use vaccinations for mind control and eugenic purposes.

Exactly where is the line between inartful and loonie tunes for you?

tom said...

I still think Wendy's comment sounded nuts, and I hope it was just a case of typing before thinking, but, as you noted:

Rogue elements within our government have done similar things.

In fact there's quite a history of it, starting w/ the smallpox blankets.

The X Files story arc where there was a massive shadow government program doing exactly what Wendy suggested was quite chilling precisely because it's not all that hard to suspend your disbelief and imagine that maybe all those isolated incidents could actually be a conspiracy.

And in that nightmare world of Obama's second term when the government completely takes over health care, what is left to stop her scenario?

David said...

Steve consider that one of President Obama's czar's basically proposed using the drinking water as a distribution source for birth control, I can't call it loony.

I just don't read it that way. The way I read her comments is that she thinks that the forced consent with a lack of information is mind control not the vaccinations.
It was inartful to say that they are as opposed to that we should have better information. I don't buy it, but it isn't like she said the government is killing us.

I do have legitimate concerns about the move to give my children lightly tested vaccinations. I am not willing to toss someone under the bus because she goes a bit further. I think you can have an outlier position or two and be ok.

It is when someojavascript:void(0)ne is consistently wacky that I say I am drawing the line.

Suzanne said...

I know I am late, but this is cracking me up.

"It sort of tells me that the talent pool in the district is shallow enough to be safe for non-swimmers.]"

Yep, it sure is. For 19th District voters that really care about seeing something different for this district, it will be a difficult election. Quite frankly, I would not be surprised if we had the lowest voter turn out ever. It will be low anyway - special elections often are - but the choices for voters aren't the "cream of the crop".

The immunization post by Wendy Jones really bothered me as I am born and raised in Germany and there we are given immunizations in school - all lining up - so that as many kids as possible are covered. HOWEVER< parents do have to sign an authorization form. We received smallpox, polio, MMR, German Measles and all other vaccinations that way. Very cost effective and a good way to eradicate some childhood illnesses that can turn into epidemics of sorts or cause complications later on (such as German Measles in pregnant women) .
And - I don't think they used us as "test hamsters".

tom said...

And for a very belated note: Merck's version of the Polio Vaccine was also found to cause cancer in humans. (Lancet. 2002 Mar 9;359(9309):817-23.

And yes I am aware that the NCIJ published a study purporting to refute this link in 2004, but it can probably be discounted in light of the fact that Dr. Maurice Hilleman, Chief of the Merck Pharmaceutical Company’s vaccine division confirms the connection in an interview. (