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Arizona works to make measles great again by shutting down an optional vaccine education program

Arizona piloted a vaccine education program to increase vaccination rates by decreasing personal belief exemptions to school vaccine mandates. It wasn’t even a mandatory program. Yet, antivaxers complained, and Arizona caved, shutting the program down. It looks as though Arizona is up to make measles great again.

If there’s one thing that antivaccine activists don’t like, it’s information that doesn’t conform to their world view that vaccines are ineffective, dangerous, and cause autism, autoimmune disease, sudden infant death syndrome, brain damage, diabetes, asthma, and all manner of ailments, both acute and chronic. We learned that in Michigan when, in response to increasing rates of personal belief exemptions (PBEs) and recent pertussis outbreaks, the Michigan Department of Health and Human Services (MDHHS) instituted a regulation that required parents seeking a PBE to the state school vaccine mandate to travel to their local county health office for an educational program about vaccines before such a PBE will be issued. Also, a PBE won’t be granted unless a state-sanctioned form is used to claim it in which the parents must acknowledge that know they could be exposing their children and others to potential harm from vaccine-preventable disease. It’s been an effective strategy, and vaccine exemption rates have fallen significantly in the three years or so since the rule was instituted. The new policy has not been without resistance, of course. Local antivaxers hate it, and antivaccine groups have tried to get it overthrown. Meanwhile antivaccine-sympathetic legislators have been doing their best to make measles great again in Michigan by passing a law that would reverse the MDHSS rule while introducing all manner of bills that, if passed into law, would be likely to decrease vaccination rates, whether they realize it or not, whether that is their intent or not.

Basically, in this area, Michigan is a model for the rest of the nation. While the optimal plan would be to do what California has done and to eliminate nonmedical exemptions to school vaccine mandates, we have to face political reality. In a lot of states (probably the vast majority at this point), an SB 277-like law that would get rid of nonmedical exemptions is politically impossible. The next best thing, then, is an approach similar to what Michigan has done: Add a step that requires parents to be confronted with the potential consequences of their choice. It won’t deter hardcore antivaxers, but it clealry does sway parents who are on the fence. It also eliminates a problem with the claiming of nonmedical exemptions in which parents who might not necessarily be antivaccine would claim them because it’s easier just to sign a form than to get their children vaccinated. Unfortunately, even that modest step can run into the buzzsaw of antivaccine resistance, as has recently happened in Arizona:

The state of Arizona has canceled a vaccine education program after receiving complaints from parents who don’t immunize their school-age children.

The pilot online course, modeled after programs in Oregon and Michigan, was created in response to the rising number of Arizona schoolchildren skipping school-required immunizations against diseases like measles, mumps and whooping cough because of their parents’ beliefs.

But some parents, who were worried the optional course was going to become mandatory, complained to the Governor’s Regulatory Review Council, which reviews regulations to ensure they are necessary and do not adversely affect the public. The six-member council is appointed by Gov. Doug Ducey, with an ex-officio general counsel.

Members of the council questioned the state health department about the course after receiving the public feedback about it, emails show. State health officials responded by canceling it.

Now there’s some backbone! The backlash must have been intense. How many thousands of parents from the state complained, I wonder? Thousands? Um, not quite:

The complaints that ended the pilot program came from about 120 individuals and families, including 20 parents who said that they don’t vaccinate their children, records show.

Also, most of the emails did not specify where the parents live or where their children went to school, making it look rather suspicious that this campaign was the result of complaints from parents who don’t even live in the state. It’s just antivaxers working to make measles great again, I guess.

As for the course, it was being piloted in three Maricopa County school districts:

Carter hosted meetings attended by physicians, nurses, school administrators, school nurses, naturopaths and public health officials that led to the creation of the 60- to 90-minute evidence-based vaccine education program.

It launched in 17 schools in three Maricopa County districts last academic year. The largest share of those schools was in the Paradise Valley Unified School District.

The education program was scheduled to expand to other Maricopa County schools this academic year, and to schools in Pima, Yavapai and Pinal counties during the 2019-20 school year.

State health officials said they have returned to the drawing board regarding the regulatory duty to provide vaccine education to Arizona parents seeking vaccine exemptions.

I totally commend the process—with one glaring exception. What the hell were naturopaths doing being involved in the process leading to the creation of an evidence-based vaccine education program. Naturopaths are overwhelmingly antivaccine themselves. However, it is Arizona, home of Andrew Weil; so naturopaths are licensed, common, and unfortunately influential. Hopefully, they didn’t influence the education program too much. It appears that they didn’t.

The genesis of this program was several years ago, when a group of local pediatricians became concerned about the need for vaccine education. Then, in 2015, the Arizona Medical Association passed a resolution calling for Arizona parents who want a PBE for their children to receive public health-approved counseling that provides them with “scientifically accurate information about the childhood diseases,” including potential adverse outcomes and the risks unimmunized children pose to children who cannot be vaccinated for medical reasons. The result was this course. Moreover:

Nearly every school that participated in the pilot education program wanted to participate again, and other schools were interested in trying it, Sunenshine said, adding that schools field a lot of questions from parents that the online course addressed in a uniform, scientific way.

Dr. Rebecca Sunenshine is the medical director for disease control for the Maricopa County Department of Public Health.

In any event, the Arizona Governor’s Regulatory Review Council is similar to a legislative council in Michigan made up of legislators that reviews and either approves or rejects proposed new rules and regulations proposed by various government agencies. Unlike the case in Michigan, the Arizona Governor’s Regulatory Review Council rejected this course. Also unlike the case in Michigan, this course wasn’t even mandatory or proposed to be mandatory:

Most of the parents and others who contacted the Governor’s Regulatory Review Council about the vaccine education program were under the impression that they would be forced to take the course in order to obtain a personal belief vaccine exemption form. Many admitted they had not seen the course, but opposed it on principle.

Because of course they did. Antivaxers don’t want to have their pseudoscience bubble punctured by reality. Also, over the last several years, leaders of the antivaccine movement have been unfortunately very successful in weaponizing anti-government, anti-regulation conservatism by linking their cause to “parental rights” and “freedom,” portraying any government intervention to try to increase vaccine uptake by tightening up the requirements for PBEs or requiring education as government overreach. Sometimes the rhetoric can become quite overheated. For example, a couple of years ago, Del Bigtree, producer of the antivaccine propaganda film VAXXED, waxed full Bluto Blutarsky by invoking the Founding Fathers, ranting about how vaccine requirements were an unacceptable infringement of freedom, and how antivaxers should be willing to die for freedom.

This strategy has totally flipped the dynamic with respect to antivaxers. Traditionally, the stereotype of antivaccine parents and activists is that they’re all granola crunching hippie-dippy left wingers. As I’ve discussed many times, that’s never been true, but it was the stereotype. In reality, antivaccine pseudoscience has always been the pseudoscience that transcends political boundaries, with roughly equal prevalence on the left and the right. That doesn’t mean the most harmful variety of antivaccine activism is equally distributed between the left and right. Sadly, in 2018, the loudest and most dangerous antivaccine voices are nearly all on the right. Sure, Robert F. Kennedy, Jr. is definitely left wing and he’s antivaccine, but he’s not in government and he’s outnumbered by rightwing antivaccine politicians, all too many of whom are actual officeholders now. Indeed, my very own state senator is antivaccine, and my state representative is, if not antivaccine, antivaccine-adjacent or antivaccine-pandering. A powerful Republican Senator, Rand Paul, is openly antivaccine, while the 2016 election featured a lot of pandering to antivaccine views on the Republican side and virtually none on the Democratic side. Indeed, President Donald Trump himself has a long, sordid history of spewing antivaccine nonsense and has even met with antivaccine “icon” Andrew Wakefield.

Whatever the politics involved, it should be noted that one of the supporters of the course in the legislature is a Republican, and that’s a very good thing. As I said before, antivaccine views are not the province of the left or the right, and neither is support for vaccination:

“I’m not sure why providing ‘information’ is seen as a negative thing,” said state Rep. Heather Carter, R-Cave Creek, who spent the last three legislative sessions as chairwoman of the House Health Committee and helped create the pilot program.

“Providing information doesn’t take away a parent’s choice to seek an exemption. … This is a major concern. Vaccines have saved lives for generations. We all want to live in safe and healthy communities.”

Carter is, of course, quite correct. Providing information is not a negative thing; that is, unless you are an antivaxer who doesn’t want his or her bubble of misinformation punctured. This particular education program was, in actuality, an even more modest step than what was done in Michigan. In Michigan, it flew (barely). In Arizona, it was shot down, even though it wasn’t mandatory (although it should have been). The complaints were also quite familiar to anyone paying attention to antivaccine arguments and tactics:

More than 200 pages of emails with public feedback about the vaccine education program were obtained by The Arizona Republic. Nearly all were critical of additional steps associated with getting exemptions to vaccine requirements.

“In my experience, parents who have a personal belief against vaccines have already performed countless hours of extensive research on the benefits and risks of vaccines,” one parent wrote on July 26. “A one-sided video is not going to change their minds and therefore it is a waste of government resources as well.”

It’s probably true that a ninety minute video is not going to change the mind of a committed antivaxer who’s “done her research” through the University of Google, searching for and finding numerous sources publishing misinformation, pseudoscience, and nonsense about vaccines, but parents who are on the fence or just scared by the sorts of misinformation, pseudoscience, and nonsense about vaccines being promulgated by antivaxers might be reachable. That is exactly what antivaxers don’t want.

Then, of course, there was the fear of government helping to make measles great again in Arizona:

The course appears to be an attempt to, “create an emotional response, creating fear and pressure in order to compel parents to vaccinate,” one set of parents wrote on July 25. “Do lawmakers think we’re stupid?”

Several parents sent the same letter that said requiring them to watch a video to exercise a personal belief exemption is “an inappropriate interference with parental rights as currently defined by statute.”

First, no, lawmakers don’t think antivaxers are stupid. They are, however, without a doubt badly misinformed. Second, the fact that several parents sent the same letter is a strong indication that this was an orchestrated campaign. Yet the Governor’s Regulatory Review Council shut down the education program. Why? Sadly:

“We’re so sorry we couldn’t make a go of this — strong forces against us,” Brenda Jones, immunization services manager at the Arizona Department of Health Services, wrote in an Aug. 6 email to a Glendale school official, along with a notification about the course’s cancellation.

In an email to two Health Department staff members on Aug. 14, Jones wrote that there had been “a lot of political and anti-vax” feedback.

Unfortunately, that antivaccine activism, even though it was only 120 parents, most of whom probably didn’t live in Arizona and some of whom clearly were sending cut-and-paste emails, led the Governor’s Regulatory Review Council to cave in a most ignominious fashion. Meanwhile, the rate of PBEs in Maricopa County have surged from 3.4% to 5.9% since 2011. Truly, Arizona is setting the stage to make measles great again.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

56 replies on “Arizona works to make measles great again by shutting down an optional vaccine education program”

C’mon Rich, you’re supposed to say “He wouldn’t be considered left-wing in Europe.” 🙂

He wouldn’t be considered left-wing by me, because he does not favour a major expansion in public ownership, nor a qualitatively higher tax rate on upper-middle class people.

Forget Europe – he is not left-wing by some pretty basic criteria. I’m not concerned with the meaning of a word here, but by what is being said about ‘left and right’.

So, when Orac says ‘roughly equal on left and right’, does he mean between Republicans and Democrats, or between right-wingers and left-wingers? The difference is important, because I am interested in whether anxivax sentiments genuinely are common among leftists, that is, people who want to expand public property massively. There’s a genuine difference and I’m interested. When you talk about Kennedy you do not give me information about whether there are lots of real-deal leftist parents not liking the jabs.

So, if you are going to continue to use the highly idiosyncratic definition of left/right from American media, can you add a bit discussing real-deal leftists? If you have this information, I’d like to know about it. If you don’t, I’d like to know that too.

The replies to Mr. Scopie suggest that there is some irritation at what he says, some kind of unspoken accusation of pedantry. I’m not going to attempt litigation of my political views here, but I’ll just say for America that 1) many grassroots Democrats are real-deal leftists, and keep getting their ideas shouted down by right-wing liberals, and 2) the use of ‘left’ for ‘being against debtor prisons’ has drained that word of any appeal, to the point where the American presidency could be taken by an obviously crooked idiot and space cadet, and 3) a ‘leftist’ presidency only marginally distinguishable from the Texan Monkey’s was the proximate cause of America’s far-right moment.

In short, by accepting American media’s ‘right’/’left’ division, you help propagate the current lack of imagination and despair that leads to harder-right government. I’m not going to insist or argue further, but I submit to you that this is a very reasonable view, undeserving of mockery even if incorrect.

As to Arizona’s backtrack, well clearly I’m sorry to see this. While correlations between antivax sentiments and political views seem to be weak (I’m taking Orac’s word for it here), it is the right-wing side that has the political rhetoric and selective hatred of public institutions that really can damage efforts at promoting vaccination (as noted by our esteemed host), A future less-weird Federal congress will need to consider adopting ‘national security’ rhetoric with regards to vaccination. Thanks to the efforts of our host, we can see that leaving this matter to the States is problematic.

A future less-weird Federal congress will need to consider adopting ‘national security’ rhetoric with regards to vaccination. Thanks to the efforts of our host, we can see that leaving this matter to the States is problematic.

So, apparently, is capitalization during rambling disquisitions.

The Left/Right distinction is so variable in US political discourse as to be meaningless. Orac’s use appears to follow a more binary definition, in which pretty much everyone falls along a line with a demarcation point somewhere in the middle. This is obviously a misrepresentation of a more complex reality, but one engaged in for convenience and brevity. You and I would no doubt quibble about what constitutes a “genuine leftist”, but I’d guess we’d agree that the “granola crunching hippie-dippy” folks in places like Sonoma County in NoCal, aren’t “left-wingers” as we would use the term. They are, after all, they’re generally well-off, haute bourgeois young professionals. They would consider themselves more liberal than conservative generally, and vote mostly for Democrats. I think it’s relatively clear that Orac is using ‘left’ in the sense that merely asserts such folks are ‘somewhere left of the mid-point’.

I understand what you’re saying about RFKJ, and the ultimate ideological distortion of using left/right labels in a binary way, but I think you may state it a bit too strongly. That is, I think most readers here understand that the way Orac uses left-right above is binary and simplistic, that he isn’t starting the left at, say, Bernie Sanders or DSA. Nevertheless, it’s true that for the Right, anyone who doesn’t hew to the Fox/Talk-Radio line is a dangerous pinko. Limbaugh always called Bill Cinton (!!) a “socialist”. To the extent Orac’s terminology plays into that, which only may be a little in the end, I’d agree some other terminology might be more appropriate.

Where Orac is simply wrong above is in saying “antivaccine pseudoscience has roughly equal prevalence on the left and the right”. That’s a gross false equivalence, as the rest of Orac’s post demonstrates. Sure, antivax isn’t exclusive to one political position or another. But it’s not balanced. Even if the numbers of non-vaxers were roughly equal left and right sides, the anti-vax zeal , force, and action is now overwhelmingly on the Right. That’s easy enough to see in the vote on SB277, the Congressfolk who takes meetings with antivaxers, etc. etc.

To your question: As a “real-deal leftist” I can only offer the anecdotal evidence that I never encountered any antivax sentiments in the personal circles of like-minded folks I’ve been familiar with (largely within academia, fwiw).

I’ve been following the anti-vaccine movement a long time over the years I’ve backed up my assertions on this score with evidence. You’re just FOS on this one, I’m afraid. All you have is anecdotal evidence, and we know how reliable that is. Also, I have pointed out that right now the loudest antivaccine voices are all on the right.

In Canada, antivaxers are found on the left and right. Examples: Christopher Shaw – left-wing activist, campaigned against the Winter Olympics in Vancouver. Lawrence Solomon – right-wing columnist, global warming denialist, loves Donald Trump.

I can really only echo what Mr (Ms?) RJ has to say here. There’s a massive difference between left-wing socialism and “not being as far right as the others”, which is certainly the impression of US politics I get over here.

I find non-Americans lecturing us about our definitions of left and right compared to Europe or wherever to be incredibly tedious and pedantic, to be honest. And it’s invariably done with such an air of smug superiority.

As noted, this pilot was rolled out in Paradise Valley, Arizona. PV is home of the vile anti-vaxxers The Drs. Wolfson. This probably was not the smartest choice. One of the Wolfson’s Facebook pages had a post asking parents to speak out against this module in August, linking to an Autism Action Network Action Alert about this ( https://bit.ly/2CCaOzd ). I wrote the folks at TAPI ( Arizona’s pro-vax statewide non-profit group ) and was told that this was an incorrect alert and not to worry about it –so I didn’t write in support of this. I suspect few if any other physicians were aware of this pilot as well given that it was flying under the radar.

Well, apparently, that Autism Action Alert was correct and was enough with a whopping 120 complaints to stop a reasonable step to decrease non-medical vaccine exemptions. Very sad.

I’m so tired of finding out about pro-vax initiatives in my state from the anti-vax social media pages.

I’m so tired of finding out about pro-vax initiatives in my state from the anti-vax social media pages.

That is a problem isn’t it? We are familiar with anti-vaxx activities, SOPs and MOs but most aren’t and take for granted the consensus pro-vaccine position. We need to do a better job of communication and activism.

You know what? If women seeking abortions can be forced to undergo state-mandated “counseling” including false information that abortions are linked to depression, infertility, and breast cancer–and in some cases, are forced to watch/listen to an ultrasound–then antivax parents can stand to watch a damn educational video before signing an exemption form.

It is rather amusing to see the hypocrisy of right wingers who are more than happy to use highly obtrusive government power to enforce religion-derived control of women’s reproduction but view relatively unobtrusive government vaccine education requirements as an unacceptable assault on their freedom.

” a group of local pediatricians became concerned about the need for vaccine education”

AND I think I might know one of them: Dr Chris?

At any rate, many of the right-leaning in Arizona are so terribly disturbed about the border, I’m surprised that no one has yet scared them about disease carrying migrants and frightened them into vaccinating / sarcasm/

But their children are kept in a safe hygenic environment and well-nourished so they are in no danger of any disease (isn’t it how their arguments go?).

This program was not scrapped because of anti-vaxxer complaints, but because it wasn’t effective.

https://azcapitoltimes.com/news/2018/10/23/arizona-health-department-looks-for-ways-to-boost-child-vaccination-rates/

“In a blog post Tuesday, Health Director Cara Christ said in the elementary schools where the video was shown to parents who did not want immunizations for their children, in half of those schools there actually was a slight increase in the number of exemptions requested. Conversely, in half of the schools where there was no video, there actually was a slight decrease in exemptions.
“Unfortunately, these weren’t the results we were hoping to see,” she said.”

Not exactly Beth, yes that appeared to be a factor but so did the anti-vaxx hysterics. Furthermore, there are a lot of factors not mentioned as to why or even if the programme actually failed. “Slight” doesn’t indicate statistically significant, nor were trends prior to the pilot programme factored in as well as demographics. In other words, we cannot tell if the increases/decreases in vaccine exemptions were going to happen anyway and if they were statistically significant.

Whether statistically significant changes or not (the article doesn’t specify), it’s clear enough that the assessment was the program did not work well enough to justify expanding it. I was surprised to hear that the people implementing it would have cancelled it due to a few complaints. It’s far more understandable that they would cancel it because it wasn’t effective.

Whether statistically significant changes or not (the article doesn’t specify), it’s clear enough that the assessment was the program did not work well enough to justify expanding it.

No it isn’t clear enough. You always go with whatever conforms to your bias. I suggest reading the article in the OP because it conflicts with what you posted:

The feedback was discussed at a council study session on July 31. Six days later the state Health Department discontinued the course.

And:

Nearly every school that participated in the pilot education program wanted to participate again, and other schools were interested in trying it, Sunenshine said, adding that schools field a lot of questions from parents that the online course addressed in a uniform, scientific way.

So at best we can say is that we don’t know exactly what lead to the programme’s cancellation and the anti-vaxx “feedback” was at least partly contributory.

Not sure why you think it’s a good thing if a few anti-vaxxers can get an educational program scrapped by complaining and a bad thing if officials scrapped a program because it wasn’t effective, but that does appear to be what happened despite a plethora of headlines to the contrary.

“Bower acknowledged, as previously reported, that the pilot program drew objections from parents who are opposed to vaccinations. He said, though, that the decision to pull the plug was based largely on the failure of the test to produce the desired results.” https://tucson.com/news/local/test-program-to-boost-vaccination-rates-for-arizona-kids-backfires/article_ff352fa6-62fb-5c74-86a7-b86ae4341d77.html

That’s the exact same report you linked to previously, just a different newspaper.

Not sure why you think it’s a good thing if a few anti-vaxxers can get an educational program scrapped by complaining and a bad thing if officials scrapped a program because it wasn’t effective, but that does appear to be what happened despite a plethora of headlines to the contrary.

Huh? That would be pretty much opposite. We have conflicting reports; if you want to keep trying to pound that square peg into a round hole, go right ahead.

Well maybe this is all wrong and the actual public health people will laugh at me, but I’d like to see a course where they cover basic statistics, Andrew Wakefield’s storied career, and review every single study on vaccines ever made. Also VAERS and adverse event reporting. I want them to see micrographs of polio and varicella and tell them apart. Then make them take a test. And pass it. And finally make them say–not just say “I agree”–“I understand that I am putting my child at risk for a preventable disease that may kill them. I understand that the statistics show that the vaccine is safe and effective. I understand that I am putting other children and other adults at risk. I understand that I may be sued. I understand that if I lose a suit, I may have to pay money. I understand that this could be millions of dollars, or even more.”

And so on and so forth. If they really care about this they should be willing to do it.

…review every single study on vaccines ever made.

Um, that number is in the tens of thousands. I agree with the rest, but that is not just impractical, but impracticable.

I wasn’t thinking of actually covering every single study, just mentioning something like there was a meta analysis of 12 retrospective cohort studies on MMR. Obviously we have to explain what a cohort study is, and how to interpret the data.

@ Christine Rose:
( I used to have to create/ purvey SB material for non-college people for NGOs on diverse health/ mental health issues)

Pardon my rant:
I despair.
AS you know, I survey anti-vax and am aware of how badly these well educated, affluent people ( as they constantly remind us), comprehend simple facts about how vaccines work, what herd immunity is, how serious VPDs can be, etc. and fall prey to every frigging, woo-drenched conspiracy theory promulgated by attention whores and snake oil salesmen WHICH THEY DON’T SEE COMING!

I don’t know how to get through to vaccine hesitant ( read woo-fraught) parents. I think that there is self-selection: they choose what they want to believe in advance and are resistant to education in this subject despite other achievements. We see partisans who have got through law school ( Heckenlively, Kennedy,et al) who dismiss evidence and research. Other well-known advocates have degrees and are lost ( ok , they may have business, liberal studies degrees BUT STILL…)

Woo-meisters/ anti-vax doctors tell them what they want to hear:
– to parents of kids with ASDs: SBM “ruined” your child; we’ll protect you
– to nature lovers who fear contamination in the future : nature will protect you and yours

It’s only those on the fence we MIGHT educate. AS I said, I despair.

The complaints that ended the pilot program came from about 120 individuals and families

Sorry, but the Government of Arizona isn’t going to reverse a policy in response to just 120 complaining antivaxers. There aren’t enough votes in antivax anymore for the GOP to kowtow to that. There has to be something else at work here, which I’m guessing has something to do with money. One possibility is that the State just wanted to cut budget to accommodate more tax cuts for rich people, and the “complaints from parents” was just a convenient excuse to ignore the public good. Another possibility is that some prized GOP donor(s) objected. It would only take one of those, not 120…

all it might take would be one or two powerful legislators making their objections known

My point being that a pol is unlikely to expend political capital on a personal pet issue that doesn’t help them somehow politically, in terms of pleasing a key constituency of numerous voters or the right deep pocket individuals. So if it’s not a case of just coming up with a convenient excuse for a healthcare budget cut, I’d be looking at the donor angle. For state legislators we’re not talking THAT much $$, and even some well-to-do chiropractors could have enough cash or connections to have some pull.

As for Beth’s contention “they pulled it because it wasn’t effective”, I’m skeptical. I don’t doubt the 90 minute video they generated may have been poor, but if you have an important task, and the first effort fails, you figure out why, create a better intervention, and keep trying.

If 120 complaints got it stopped then 240 complaints about it being stopped would get it started again. But it’s probably more than just the complaints. Cost-effectiveness and budget cuts probably figured in there somewhere.

Misplaced response here:
https://www.respectfulinsolence.com/2018/10/24/arizona-works-to-make-measles-great-again/#comment-401657

Additional information: My father retired from the US Army during my last year in high school, and moved us to Arizona after I graduated. My younger sister and step-sister spent their high school years in high school. My dad and step-mother drove me up to the state where I was going to attend university and left me with my mother’s cousin. They did visit their family here, and then went back to Arizona. I stayed here, I visit my now 91 year old dad every so often, along with my sister. My older brother is there now. He and his wife are house sitting for my dad, who is out hunting deer.

What Orac said at 6:39 PM:

I agree.
There’s been a drift towards the right by anti-vax.** They sounded very different in 2008. More Nature Loving.

I think that the Canary Party was a turning point in their rhetoric. It may reflect the politics of some of the principals: Blaxill perhaps, Handley, Ginger Taylor is far gone politically.
Jake Crosby is now far right AFAIK, he worked on Trump’s campaign- he used to just be an injured party, trying to injure others ( through bad science and workplace interference as some here know all too well)

** also woo in general post-great recession I swear some days NN and PRN sound like outlets of Fox and RT.

Denice:

I think one contributing factor to the stereotype of AVs as granola crunchy liberals is another false stereotype of the naturalistic fallacy as being a liberal thing. I know I always used to think of conservatives as scoffing at appeals to nature. Maybe that was and is still is true of the old-school country-club GOP. But now, I’ve come to realize that there’s a very strong correlation between magical thinking about nature and the far right. Iow, there’s nothing that odd about Mike Adams selling ‘Natural’ supplements and Trumpism together. I suspect most readers here avoid right-wing talk radio. You might be surprised how many magical ‘natural’ supplement remedies are advertised on those shows. Michael Savage is especially into ‘natural health’. The far right has been selling (literally) alternative realities for decades, so it all actually fits…

Which are infamous in Arizona. My step-sister moved to Missouri to be near her son and grandkids, plus she had not had a raise in eight years as a third grade teacher in Arizona.

The funny thing is I learned in discussion with my sister (only sibling left in Arizona), that Arizona extracts more taxes than my state. They have both an income tax and a sales tax, plus the property taxes of her two-bed condo were the same as my much larger four bedroom house. Yet their human/health services are cut to the bone. But their gas taxes are low. That is about it.

Also none of the governors of my state have been sent to prison:
https://www.phoenixnewtimes.com/news/arizonas-top-10-disgraced-politicians-8486446

I am so very glad that I worked hard not to go to four high schools like my brother (US Army brats move around). I worked it so I graduated a year early, so I only went to two high schools. If I had not, the third high school would have been in Arizona. Also since I got the freak out of high school (a terrible place) when I was still seventeen years old, I was able to pay resident tuition in the state where my dad was born and had entered the Army. Woot! And I am still here.

This was supposed to be a response to BillyJoe’s “Cost-effectiveness and budget cuts probably figured in there somewhere.”

Reposting this comment because I must have fat-fingered my email address and I’m not feeling patient:

Dang. Higher taxes than WA? That’s a feat. Gotta wonder where it’s all going; WA actually has some good programs in terms of health care and college aid and so on. (They approximately matched the Pell grant I got.)

You and I both went to college at 17, right? I actually just got my GED and took the SAT, on which I got stupid high scores. (Perfect on the verbal and pretty darn good on the math. It’s been so long since I’ve done higher math that I imagine it’s atrophied a lot, though.)

I really don’t get the draw to Arizona; last time I checked, it had one of the fastest growing populations in the country. I have a Twitter mutual who lives there and hates it, but she’s there because she’s from there, and she’s shortly moving to another state. We’ve definitely had some fun conversations about water use and water politics vis-a-vis California, though.

My mom’s best friend and her husband sold their house and moved down there about a year ago. (They’re both retired now.) I mean, the climate, yuck. But apparently Lorraine likes the heat, especially because there’s a pool where they live. And the main reason they made the move is because the climate there is much easier on Jim’s arthritis.

I don’t really get actually voluntarily living in the desert though, haha. I like trees and lakes and rivers and stuff too much.

I actually just got my GED and took the SAT

You didn’t have to take the GRE in the first place, or has it expired? My prep for the second round (the first one was perfunctory; the latter, which was was the first with “adaptive” plus electronic, was to provide moral support for a friend) was a few vodka tonics. Verbal went to the top, and the other two fell modestly.

Dang. Higher taxes than WA? That’s a feat. Gotta wonder where it’s all going; WA actually has some good programs in terms of health care and college aid and so on. (They approximately matched the Pell grant I got.)

You and I both went to college at 17, right? I actually just got my GED and took the SAT, on which I got stupid high scores. (Perfect on the verbal and pretty darn good on the math. It’s been so long since I’ve done higher math that I imagine it’s atrophied a lot, though.)

I really don’t get the draw to Arizona; last time I checked, it had one of the fastest growing populations in the country. I have a Twitter mutual who lives there and hates it, but she’s there because she’s from there, and she’s shortly moving to another state. We’ve definitely had some fun conversations about water use and water politics vis-a-vis California, though.

My mom’s best friend and her husband sold their house and moved down there about a year ago. (They’re both retired now.) I mean, the climate, yuck. But apparently Lorraine likes the heat, especially because there’s a pool where they live. And the main reason they made the move is because the climate there is much easier on Jim’s arthritis.

I don’t really get actually voluntarily living in the desert though, haha. I like trees and lakes and rivers and stuff too much.

No, the GED; the poor man’s high school diploma, so to speak. You just go take tests and they give it to you.

The GRE is different. I took that in the fall just before I applied to grad schools. Close to perfect on the verbal, and pretty good on the math. I mean, given that I was applying to Slavic departments, I didn’t figure they would care too much about the math part, but I studied up some anyway. The GRE math was actually easier in a way than the SAT math, I think.

I’d like to know more about the regulatory mandate to educate mentioned here. Depending on what it actually said, they may really have to try again.

Vaccine safety advocates endorse government sponsored vaccine education programs that do not place an “undue burden” on individuals seeking a PBE. A MANDATORY vaccine education requirement, to receive a PBE, may be considered a undue burden based on time and expense. Although, such an undue burden could be overcome through monetary compensation for their time and out-of-pocket expenses.

@ Orac,

Should individuals seeking a PBE be instantly compensated for attending required government sponsored education programs?

Q. How does medical science substantially reduce the number of granted PBE’s.

A. With acts of kindness.

@ JP:
What’s the draw of Arizona?

To be truthful, I’ve hardy ever been there and only in the NW corner and near the NV/ CA border ( Oatman).
BUT someone I know has a relative there who is FOREVER cheerleading for the Phoenix area: she sends brochures about gated communities, shopping areas, ball parks, golf et al It’s so FABULOUS! Move here!

I wonder if the appeal is inexpensive LARGE homes? ( see Zillow for particular locales)

Personally, the only reason I liked the desert was because of the landscape, vegetation and night sky in the Mojave Preserve. The heat and dryness were unbearable in late March: I was happy to finally see trees near Big Bear. .
I once had to spend 4 hours in Las Vegas in July: I didn’t leave the airport : even the plane’s jetway was unbelievably hot at 10pm.Endless drives in Nevada and Utah to see…. not very much. I had to drink liters of water and ice tea to survive.
Luckily, brilliant pilots enabled me to see the Grand Canyon, Bryce and Zion from the air as part of flights.
(Yosemite is gorgeous as well but not a desert)

When I was in college I once took a Greyhound bus from Olympia, WA to Middlebury, Vermont for the summer intensive Russian program there. (Four days’ ride. Took it home also. At the time it was hundreds of dollars cheaper than flying.)

Anyway, we went through Idaho on the first night, and got into Utah, the area around Salt Lake, right around sunrise. There was all this red rock, and these rock formations, and it was June so there was actually a little bit of greenery (I mean, I think sage brush and stuff mostly), and when the sunrise hit everything it was transcendentally pretty. So that was pretty neat.

I mean, yeah, there are some deserts that are kind of pretty in an austere way, but I still wouldn’t want to live there. Like you, I really don’t like the heat. My favorite weather is like in the 50s and maybe drizzly, so Olympia was pretty ideal in that sense, actually.

Thanks for taking the time to outline and explain how the anti-vaxxers pulled this off in AZ. I use your respectful insolence website as an important link for parents to understand the need for vaccination, and the diseases that their children may get by not vaccinating. I advocate for the HPV vaccine. Check out my website at HPVcancerresources.org. The link to your site is on the Combatting Vaccine Misinformation page.

Went to your website Stewart Lyman, and noticed your second (2) goal contradicts the medical disclaimer you provided:

Second goal – To educate parents about, and advocate for, the safe and effective HPV vaccine, which can prevent infection with the virus and thereby block the development of these cancers; and

Medical Disclaimer – The information contained in this website is NOT intended as a recommendation for the self management of health problems, medical conditions, or wellness.

Q. Why is there a discordance.

The only “discordance” is the one blocking signals to your brain’s logic center.

One can advocate for preventive medicine while not encouraging self-diagnosis/treatment. The typical Quack Miranda Warning accompanies promotion of an ineffective/untested product to cure/prevent a variety of ills, and is only a nudge nudge wink wink advisory – the company or quack wants you to go right ahead and self-treat.

Not so hard to understand.

Dangerous Bacon writes,

The typical Quack Miranda Warning accompanies promotion of an ineffective/untested product to cure/prevent a variety of ills, and is only a nudge nudge wink wink advisory.

MJD says,

I’m starting to understand. In parallel, the typical contraindication warnings for vaccines are only a nudge nudge wink wink advisory from medical science. You’re right DB when you say, “Not so hard to understand”.

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