SB 277 clears another major legislative hurdle

I bet antivaccinationists would be annoyed if they knew what I was up to yesterday. This week, our department had a visiting professor for Grand Rounds, and that professor was a Nobel laureate. Of course, it’s not every day that we have a Nobel laureate visiting us (actually, it’s rare). This time around the Nobel laureat visiting us was Harald zur Hausen. He won a Nobel Prize in Physiology or Medicine in 2008 for a discovery he made decades ago, namely his discovery of the role of papilloma viruses in causing human cervical cancer. Yes, antivaxers, not only did I meet the man whose science gave the rationale for the later development of HPV vaccines like Gardasil and Cervarix, but I got to sit at the same table with him at the dinner in his honor last night.

As a result of that, I got home rather late and didn’t have the time to produce my usual epic Insolence last night, leading to a rushed composition of this before I went to work. However, I doubt any one will begrudge me that, and if anyone does, I don’t really care. In the meantime, by the time I got home I had had a long day in the OR, where the air conditioning was on the fritz, leading to rather uncomfortable working conditions. I was so beat that I didn’t notice until I got up earlier than usual this morning that something great had happened. A bill to eliminate nonmedical exemptions (SB 277, which has been discussed here multiple times before) that’s been wending its way through the California legislature, had cleared another hurdle blocking its way to passage:

California lawmakers on Tuesday approved a hotly contested bill that would impose one of the strictest vaccination laws in the country, after five hours of highly emotional testimony that brought hundreds of opponents to the Capitol.

SB277 is intended to boost vaccination rates after a measles outbreak at Disneyland that sickened more than 100 in the U.S. and Mexico. It has prompted the most contentious legislative debate of the year with thousands of opponents taking to social media and legislative hearings to protest the legislation.

The Assembly Health Committee approved the legislation 12-6 Tuesday evening with one lawmaker abstaining, sending it to the full Assembly for its final legislative hurdle.

If the bill becomes law, California would join Mississippi and West Virginia as the only states with such strict requirements.

To be honest, I was amazed in a good way. When SB 277 was first introduced into the California Senate by Senators Richard Pan and Ben Allen in the wake of the Disneyland measles outbreak, I thought it was a good thing, but I was pessimistic about its prospects of ultimately becoming law. The reason was simple. SB 277 would eliminate religious and philosophic exemptions to school vaccine mandates in a state with high concentrations of antivaccine belief and some of the most famous antivaccine pediatricians out there (e.g., Jay Gordon and Bob Sears, who are antivaccine although they swear otherwise), as well as a large Hollywood contingent of really dumb celebrity antivaccinationists like Rob Schneider. And, no doubt, the antivaccine contingent did fight tooth and nail against SB 277, as they had done unsuccessfully against AB 2109, which had only proposed to make it more difficult to obtain nonmedical exemptions (i.e., religious or philosophical exemptions) to school vaccine mandates. As I noted yesterday, they mobilized on Twitter and tried to co-opt libertarian/conservative rhetoric to make the issue about “health freedom” and “parental rights” rather than about protecting children, because it’s always all about them more than anything else, not their children.

When they failed to prevent SB 277 from passing the Senate three weeks ago, they lost it. Now the bill is in the Assembly, and they failed to prevent it from passing its major committee hurdle, the Assembly Health Committee, and not by a little. I and other observers had been concerned that the vote would be close and that SB 277 might not even make it out of committee, but the Assembly Health Committee provided the antivaccinationists a resounding rebuke, despite their bringing in protesters, and antivaccine luminaries like Dr. Jay Gordon, who, in a fit of derpitude, tried to argue that because the Disneyland measles outbreak didn’t occur in a school and SB 277 wouldn’t have prevented it then it’s not necessary. Not surprisingly, Barbara Loe Fisher testified as well. It also probably didn’t help the antivaccine cause that in the lead up to the committee hearing the American Medical Association weighed in at its annual meeting as supporting the elimination of nonmedical exemptions, producing stories like this appearing on the morning of the hearing:

The American Medical Association, the country’s largest association of physicians, is weighing in on the vaccination debate by supporting the end of personal vaccination exemptions on both the state and federal levels.

At the group’s annual meeting in Chicago on Monday, members voted to mobilize the organization in order to persuade state legislatures to eliminate nonmedical reasons for exemption, such as religion, which are used to dodge crucial immunizations against diseases such as measles and whooping cough.

“As evident from the recent measles outbreak at Disneyland, protecting community health in today’s mobile society requires that policymakers not permit individuals from opting out of immunization solely as a matter of personal preference or convenience,” said board member Dr. Patrice Harris, according to Forbes. “When people are immunized they also help prevent the spread of disease to others.”

Yes.

So what next? SB 277 will go in front of the full Assembly for debate and final vote. Look for the antivax Twittersphere and the antivaccine contingent to crank up the crazy to 11, even though arguably in a way they are their own worst enemies, examples being threats against legislators and using full blown conspiracy theories to justify their opposition, you know, normal behavior in the antivaccine movement. The question is: Will SB 277 pass? That, I don’t know, but it’s gotten further than I ever would have predicted, and its progress is starting to take on an air of inevitability, to the point where one of our favorite antivaccine Dunning-Kruger examples, Ginger Taylor, is declaring that SB 277 is a “victory” for the antivaccine cause.

If SB 277 passes, though, I do worry about some things. Most importantly, I worry that Governor Jerry Brown will betray California children and sabotage the new law, as he did when AB 2109 passed by adding a signing statement instructing the California Department of Public Health to allow a check box for a religious exemption on the form that needed to be signed, thus bypassing the requirement for consulting with a pediatrician or health care provider to learn the benefits and risks of vaccines. There was no provision for doing that in AB 2109, but that didn’t stop Brown from crippling the law. Given his deference to religion, I could easily see him doing that again. I could also see him putting pressure on the legislature not to eliminate religious exemptions, with the implicit threat of a veto. We shall see.

Depressingly, in the meantime, the very same magazine that published the excellent network analysis of the antivaccine Twittersphere that I discussed yesterday published a terrible bit of anti-SB 277 propaganda by senior editor Sarah Fallon that parroted lines straight from the antivaccine movement. For instance, there is this straw man:

Now, there are those who might say vaccines are perfectly safe, so what’s the harm in requiring them. Like a seatbelt, right? But vaccines are not quite like seatbelts. For one thing, if your seatbelt goes wrong, or isn’t really that safe, you can sue the car manufacturer, or you can stop buying its cars.

If there’s someone out there who says that vaccines are “perfectly safe,” I’ve never encountered him, and I’ve been looking for a decade. I mean, seriously. At the risk of never being asked to write an article for WIRED while Fallon is editor, I can’t help but say it. There’s just no other way to put it: This is major derpitude, and Fallon should be embarrassed for having written that paragraph. (Heck, she should be embarrassed for having written the whole article!) It’s an argument straight out of the antivaccine playbook that completely ignores the history of the National Childhood Vaccine Injury Act of 1986 that created the Vaccine Court funded by a surcharge on vaccines and required that vaccine injury cases first go through this court. At the time, bogus lawsuits were driving vaccine manufacturers out of the country, threatening the vaccine program. Trial lawyers and antivaccine activists would love to go back to those bad old days, even though obtaining compensation through the Vaccine Court is easier and more straightforward than regular courts and the Vaccine Court pays complainants’ legal fees, win or lose.

There’s so much else wrong with this article. Fallon touts high vaccination rates in California, but fails to note that the overall vaccination rate in California is not the problem. It’s the pockets of low vaccine uptake that compromise herd immunity that exist in abundance. She trots out anti-big pharma rhetoric (distrust of big pharma and/or anticorporatism being, most likely, her motivation for this piece). She cites the Cochrane Review that criticized the design of studies examining the safety of MMR but ignores the part where the review also concludes that exposure to the MMR vaccine was “unlikely to be associated with autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn’s disease, demyelinating diseases, bacterial or viral infections.” She cites the case of the “Merck whistleblower” with no nuance (and, apparently, not much understanding of what the case was about and what the findings meant).

Unfortunately, even as California appears to be marching forward with measures to protect its children from infectious disease, it could be people like Sarah Fallon, who in their desire to appear “reasonable” über alles in comparison to (apparently) us pro-vaccine advocates aid and abet the antivaccine movement.