Who knew? My state’s vaccine personal belief exemption rate stinks! (Part 2: What to do.)


After yesterday’s post on the depressingly high (and increasing, apparently) rate of personal belief exemptions to vaccination requirements for entering school in the state of Michigan, I felt the need to pontificate a bit further. The reason is that MLive.com has posted some followup stories. Also, I didn’t have a lot of time last night to write because I had the pleasure of attending the CFI-Michigan Solstice dinner to hang out with fellow skeptics and heathens. Unfortunately, the topic of the high exemption levels in Michigan came up.

First up on the follow up story parade is one entitled Why some Michigan parents choose not to vaccinate their children. It’s depressingly familiar reading to anyone who’s been following the antivaccine movement as long as I have. Worse, it falls into the utterly aggravating lazy journalistic trope of “telling both sides” of a story that, scientifically at least, doesn’t have two sides. Antivaccine parents ignorant of basic biology are allowed to spew nonsense about “toxins,” dismissive comments about justifiable concerns that their failure to vaccinated their children endangers others, conspiracy theories about “big pharma,” and braggadocio about how they’ve “done their research.” If you want to know how bad it is, consider this: “Media Editor” and controller of the flying antivaccine monkeys who go into a dive bombing run flinging their poo at any pro-vaccine article she comes across likes this MLive.com article.

The article starts right off with a mother whose brain does what human brains are so good at. It confuses correlation with causation:

A registered nurse who once worked in the pharmaceutical industry, Gretchen Perry didn’t question the potential risk of vaccinations until she became a mother.

Her son was born 11 years ago, and was a sickly infant and toddler, she said. He had a series of gastrointestinal issues, didn’t sleep through the night until he was in kindergarten, and showed language delays and socialization problems consistent with autism, said Perry, who lives in Rochester.

Her daughter, who is now 10, had similar problems, although not as severe, she said.

Perry said she thinks her children were born with compromised immune systems and suspects vaccinations were aggravating their health problems.

She swore off vaccines a decade ago, and says her children’s health has improved considerably, thanks to their diet and health supplements that have “detoxified” their systems.

Or, as is so often the case, there’s likely something genetic going on, given that both of her daughters were born “sickly” to varying degrees and suffered from GI issues and socialization issues “consistent with autism.” Of course, I couldn’t help but notice that nowhere does it say whether either of her daughters actually has a diagnosis on the autism spectrum. In any case, her second daughter suffered from similar problems to those of her first daughter even though she apparently didn’t have any vaccines, given that her mother “swore off vaccines a decade ago.” Naturally, confirmation bias led Perry to see any improvements in her children’s health being due to the supplements and the “detoxification quackery” to which she appears to have subjected her children. (Yes, detoxification in the absence of an acute poisoning is quackery.)

In any case, in Michigan as in California and elsewhere, irresponsible non-vaccinating parents, who endanger not only their own children but every child with whom their children come in contact, tend to be clustered in affluent communities like Rochester. Similar gambits to the ones I’ve discussed time and time again come up in this article, all of them infused with distrust of pharmaceutical companies, the naturalistic fallacy, and pure pseudoscience. Indeed, every parent interviewed in this article mentioned vaccines being tested by pharmaceutical companies as a reason why they don’t trust the strong scientific consensus that childhood vaccines are safe and effective. Perry mentions how the Internet has made it easier for such vaccine-averse parents to gather online and trade misinformation and strategy. (Yes, I know she didn’t use the word “misinformation” but that’s what these parents are doing, just as the not-so-merry gang of “activists” and “journalists” at the antivaccine crank blog Age of Autism do):

We all talk about this, and we’re all on social media reading the information from the good nonprofits that educate us on the dangers of vaccination,” Perry said, adding her belief that the mainstream medical establishment “ignores the very real adverse events” associated with vaccinations.

Yep. The antivaccine nonprofits are “good” and the mainstream medical establishment is covering something up, conspiratorial thinking at its finest. Then, of course, there’s the Dunning-Kruger effect, in which parents think that a few hours on the Internet, coupled with a degree in something else, qualifies them to question the findings of scientists who have spent their entire lives studying vaccines, autism, and infectious disease and, because of their incompetence and lack of knowledge, are unable to acknowledge that they do not know what they are talking about. In other words, they think they know and understand far more than they, in fact, actually do know and understand:

Heather Stevens, the mother of a preschooler in Oakland County, doesn’t buy those assurances.

She has a master’s degree in environmental engineering and has helped conducting human health risk assessment for environmental pollutants. She says vaccine safety studies are typically conducted by pharmaceutical companies who have an interest in downplaying safety issues, and says there hasn’t been adequate research into the “cumulative and sometimes synergistic effect of chemicals on the human body,” especially over the long term.

“The media tends to stereotype us as this random, scared/fearful, mob-crew bunch of crunchy hippies,” Stevens said. “At least speaking for myself, and my parent friends that choose to selectively vaccinate or not vaccinate at all, we are all very well-educated prior to becoming a parent and have spent a significant amount of time researching vaccines for the most important people in our life.”

Stevens added that “so much of this is a gray area” and she recognizes the downsides of going unvaccinated.

That’s nice, except that it’s not a “gray area.” Stevens wants it to be a gray area. She believes it’s a gray area. But it’s not a gray area. Dunning-Kruger. Being an environmental engineer does not qualify you to evaluate vaccine safety studies. Being “highly educated” does not mean you aren’t a scared “mob-crew bunch of crunchy hippies.” Once again, researching vaccines does not mean perusing Mercola.com, Age of Autism, The Thinking Moms’ Revolution, and the numerous other antivaccine blogs and websites that peddle pseudoscience dressed up as science. I don’t blame Stevens for not being capable of properly evaluating the evidence, and I don’t doubt that she is well-intentioned and loves her children. It’s just that she’s wrong, and the arrogance of ignorance inherent in the Dunning-Kruger effect leads her to view her knowledge of vaccines as being on par with real experts and herself as someone whose knowledge qualifies her to reject the overwhelming evidence that the current vaccine schedule is safe and effective and thereby endanger her children and others, rather than what she is: A non-expert victim of the Dunning-Kruger who, despite her many hours at Google University, still doesn’t know what she’s talking about.

I do have to admit, there was one quote here that made me laugh out loud when I read it:

Marcel Lenz, a Traverse City resident with two young children, shares similar concerns.

“I thought vaccines were magical, but then I started looking into it,” said Lenz, who has a doctorate in horticulture and a big interest in homeopathic medicine.

Given that Lenz believes in homeopathy, which is basically sympathetic magic made into a system of medicine, apparently he was disappointed to find out that vaccines weren’t actually magic; so he rejected them. Of course, someone who believes in homeopathy is highly unlikely to be persuaded to change her antivaccine views; so Lenz is almost certainly a lost cause. After all, when last we met Lenz, he was peddling the antivaccine trope I’ve dubbed the “toxin gambit,” and this time around he repeats the same sort of misinformation. However, learning that he’s into homeopathy does explain a lot, as do his sources of information: Bob Sears and Neil Z. Miller.

We then have a variant of the “toxin gambit,” one that I like to call the appeal to yuckiness. (It’s a term I’ve applied to The Food Babe before.) Generally, the appeal to yuckiness is a scientific fallacy in which disgust at the yucky-sounding nature of an ingredient in medicines, food, or vaccines leads one to think that it must be bad. Here, we see Hollie Heikkinen repeating that gambit:

Hollie Heikkinen, of Howell, also says she carefully weighed the risks in deciding not to vaccinate her four children, ages 7 to 19.

She said the idea of injecting viruses into her children seems like “playing Russian roulette,” and thinks it’s far better to ward off disease by living an “extremely healthy lifestyle.”

She acknowledged that some parents are critical of her decision.

“There’s a couple of people who don’t want their children playing with mine, but if your child is vaccinated, why should you worry?” Heikkinen said.

Yes, killed viruses are yucky to Heikkinen; so she doesn’t like them and won’t inject vaccines into her children. Like so many other antivaccinationists, she also doesn’t understand that vaccines are never 100% effective. It’s a common misconception that feeds into the “Nirvana fallacy” about vaccines wherein if vaccines aren’t perfectly protective and perfectly safe antivaccinationists reject and demonize them. It’s a standard that, I bet, they apply to no other product, medicine, or intervention in their lives, but they apply it to vaccines. That seeming belief leads her not to understand why even parents of vaccinated children don’t want her children around, because, apparently, either Heikkinen thinks they’re perfectly protected against her disease vector offspring or she thinks that vaccine believers should have “faith” in vaccines. Personally, I’m with the parents who refuse to let Heikkinen’s kids play with theirs because her kids are unvaccinated. I’d do the same. It’s a reasonable precaution.

Finally, no antivaccine trope greatest hits would be complete without downplaying the seriousness of the diseases being vaccinated against. For instance, Sue Waltman, who runs the local antivaccine group intellectually dishonest “vaccines didn’t save us” gambit as a rationale for not vaccinating.

As I said, this is all depressingly familiar to anyone who’s covered the antivaccine movement for years. Clearly, people like Marcel Lenz (into homeopathy), Sue Waltman (an antivaccine political activist), and Gretchen Perry (heavily into “natural health” and “detoxification”) are not likely to be dissuaded from their antivaccination views. It’s not impossible, but it’s incredibly unlikely. So I’m glad that Michigan is apparently going to get it right where California tried to get it right but was sabotaged by Governor Jerry Brown’s signing statement on the bill implementing this requirement.

Starting January 1, vaccine waivers will be harder to get in Michigan:

The Michigan Department of Community Health is working to force parents to think twice before opting out of getting their children vaccinated.

Under new rules that will take effect Jan. 1, Michigan parents will still have the right to refuse the required shots for their children. But they will have to:

  • Be educated by a local health worker about vaccines and the diseases they are intended to prevent.
  • Sign the universal state form that includes a statement of acknowledgement that parents understand they may be putting their own children and others at risk by refusing the shots.

On Thursday morning, the Joint Committee on Administrative Rules approved the new requirements.

In making the changes, Michigan is following the example of other states, such as California, Vermont and Colorado, all of which recently have made it more difficult for parents to opt out of vaccination requirements.

When California passed AB 2109, which was designed to do the same thing, Governor Brown gutted the requirement by ordering health officials to add a line where the parent could just affirm that vaccination is against her religion and avoid even having to be counseled by a physician or other specific health care professional. Here, Michigan appears to be getting it right.

Some, including MLive.com despite its having succumbed to the darker side of medical reporting by giving antivaccine parents such an open forum to promote their pseudoscience, are arguing that Michigan should go even further, having set up a Change.org petition to Governor Rick Snyder and the legislature urging them to:

  • Remove the philosophical exemption. Allowing parents to opt out of vaccinating their children for any reason sends a strong and dangerous message that vaccines aren’t really necessary. Science tells us that vaccines are absolutely necessary if we wish to keep our communities free of these diseases. Eliminating this exemption would go a long way toward restoring herd immunity to our communities that are currently in danger.
  • Strengthen religious waivers. It’s almost certain that if the philosophical exemption is removed, a number of parents will claim certain religious beliefs. Therefore, it’s imperative that the rules be strengthened to discourage skirting of the law. Religious waivers should be signed by a representative of the parent’s religious organization, asserting vaccination is contrary to religious beliefs. They should also be signed by a medical professional verifying the parent has attended an educational session about vaccination. Signatures should be notarized, and waivers should be renewed annually.
  • Strengthen medical waivers. A tiny fraction of children can’t be vaccinated for medical reasons. Removing the philosophical exemption could prompt more parents to seek unwarranted medical waivers. Therefore, medical waivers should be signed by a medical doctor verifying the patient has a true medical condition preventing vaccination, and that a parent has attended an educational session about vaccination. Signatures should be notarized.
  • Make vaccination rates public. Schools should be required to publish their vaccination rates on their websites, and update them every year. Parents have a right to know which schools have high numbers of parents opting out and putting everyone at risk.

These are good ideas, but problematic. I fully support removing the philosophical exemption, which in practice amounts to letting parents refuse vaccinations for their children for any reason whatsoever. However, verifying what is and isn’t a “real religious exemption,” on the other hand, will be highly problematic in practice. Moreover, allowing a religious exemption while not allowing philosophic exemptions in essence discriminates in favor of the religious. You belong to a church that says vaccines are evil? (They’re rare, but apparently do exist.) Great! You don’t have to vaccinate! You’re an agnostic or atheist who doesn’t want to vaccinate because you think vaccines are full of evil toxins and believe in keeping your child’s body “pure”? Tough luck. Both reasons for not vaccinating are divorced from reality, but one would be accepted as a valid reason not to vaccinated because it’s a “religion,” and one would not.

That’s why, unfortunately, I’ve been reluctantly forced to conclude over the last couple of years that states need to treat philosophical and religious exemptions the same: Either allow both or ban both. To do otherwise, allowing religious exemptions but not philosophical exemptions privileges religion above non-religion. That’s why the proposal in the Change.org petition is a start, but it doesn’t go far enough. Neither philosophical nor religious exemptions should be permitted.

In the meantime, trying to educate parents who don’t want to vaccinated about what they are doing before letting them do it is a reasonable first step.