SB 277 And The Vaccine Debate

Pertussis was terrifying, because people were dying — specifically, tiny baby people. There are few things as terrifying as children dying from anything. And then there was a measles outbreak, which started at Disneyland, ostensibly the Happiest Place On Earth (until you contract measles, anyway). 

California Governor Jerry Brown signed into law yesterday SB 277; legislation which will require California children be fully vaccinated to be allowed to attend public school.

Excerpts from the bill:

Existing law prohibits the governing authority of a school or other institution from unconditionally admitting any person as a pupil of any public or private elementary or secondary school, child care center, day nursery, nursery school, family day care home, or development center, unless prior to his or her admission to that institution he or she has been fully immunized against various diseases, including measles, mumps, and pertussis, subject to any specific age criteria. Existing law authorizes an exemption from those provisions for medical reasons or because of personal beliefs, if specified forms are submitted to the governing authority.

This bill would eliminate the exemption from existing specified immunization requirements based upon personal beliefs, but would allow exemption from future immunization requirements deemed appropriate by the State Department of Public Health for either medical reasons or personal beliefs. The bill would exempt pupils in a home-based private school and students enrolled in an independent study program and who do not receive classroom-based instruction, pursuant to specified law from the prohibition described above.

Do you have a headache? I have a headache.

This is, without a doubt, the most widely discussed (read: debated) issue in my social media timeline this week — and for the last several months, really. I’d prefer to just write this up as an Oatmeal-style satire piece — fun! Because regardless of the “side” I take, I’m taking on half of my friends, my village, the women I love. (Also, I’ve gotten no fewer than 75 hate e-mails this week already.)

Despite the outrage, the bill is passed. Which means it’s not a bill any longer. It’s enacted, and going forward the language is clear: to attend public school, vaccines will be required (medical exemptions are still allowed). But I’m not seeing much from the “YAY SB 277 BILL PASSED!” camp today. I suspect this is because they know they are essentially sealing their fate by saying anything that would sound even remotely like support of government-mandated anything. In the circles I run in, those opposing the bill are the loudest. They feel angry, violated. I get that. I don't condemn them. 

In matters such as these you can't stand on the center line. It's either yes or no, in or out. And even before the state legislature pushed this into a black-or-white issue for parents, my husband and I agreed we would vaccinate the children, albeit it on a delayed schedule. It wasn’t an easy decision or an easy deliberation. We started out miles apart. But at the end of the day, we came together on the side of vaccination. 

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I have kids on both ends of the vaccine spectrum, so to speak. When my older children were babies (in the mid-'90s), some of the currently-required vaccines weren’t even on the radar. Varicella was newly developed and without proven long-term efficacy. Hep B and Hib were in development, but certainly not in rotation. My pediatrician was as hippie-skeptic as they came back then, so all of this was coming up at every well visit. We discussed vaccines and their safety — just as we discussed everything from circumcision to antibiotics — and ultimately decided to forgo Varicella in light of the somewhat unclear data.

Those kids grew up from little people to big people. Vaccines didn’t kill or maim them. Polio didn’t cripple them. We didn’t have to worry about whooping cough or measles, they weren’t even a blip on the radar. They didn’t get autism or become paralyzed — nothing remarkable at all happened really. They just grew up.

Fast forward. In addition to my 15, 17, and 19-year-old children, I’ve added two more — who are now 3 and 4.

I’d consider myself a credible hippie. I scrub my sink with baking soda — until it’s stained; then I pull out the big bleach guns. I went no-poo for some time — sort of gross, honestly. I stopped shaving my armpits and wearing deodorant — sort of liberating. I had a baby in my kitchen — sort of messy, but how many people can say that?

During my second-wave parenting, research was easier to come by, via the Internet (which was previously only an imagined possibility), and I found myself immersed in a culture of women who simply weren't vaccinating their babies. They had important things to say, with research to support their decision, and while I wasn’t holding any firm footing in the “con” camp, my husband and I opted to do a very delayed schedule of immunizations (which mostly just amounted to me never taking them to the pediatrician) — and further, to opt out of some entirely. 

We weren’t incredibly unique. Between 2007-2014 the vaccine “opt out” rate doubled in California (from 1.56% to 3.15%). Interestingly, Marin Country has the highest rate at 7.57%, and also had 177 cases of pertussis out of the 2014 state total of 180.

Pertussis is terrifying, because people die — specifically, tiny baby people. There are few things as terrifying as children dying from anything, even if it is only a small number of them. And then there was a measles outbreak, which started at Disneyland, ostensibly the Happiest Place On Earth (until you contract measles, anyway). Is measles deadly? Well, not usually, but nonetheless, 145,700 people died globally in 2013 — most of them children under 5. Can the measles vaccine also cause death? Yes, in approximately 1/1,000,000 cases.  And then research started to show that, despite pertussis being a cyclical disease (meaning lack of a vaccine was not likely to be the only factor in its resurgence, though the Marin county outbreak convincingly suggests otherwise), we were losing herd immunity overall. In all regards. 

Along the way, with further research and more data, we, as parents, started to feel a bit dispassionate about the cause. Big Pharma greed was lolling around in the back of my mind. But so was science. And a desire to see my kids healthy. And and and.

We put them on the schedule and started giving them vaccines at spaced intervals. Did I lose my hippie cred? Maybe. Probably.

My children are strong and healthy. I don’t expect any of them to contract measles or pertussis and die. But I also recognize that not all children are healthy and that herd immunity is only as good as the herd itself. My sick children can pose a real threat to children who have a reduced immunity and to little tiny babies. I'm vaccinating my herd, at least against the things that pose a risk to the community at large.

These decisions are hard. Parenting is hard. There is almost always an enormous amount of what claims to be undeniable evidence on both sides of every debate. Without these juxtapositions, we’d only have to argue about the weather, or some other trivial thing. It’s 108 degrees here today. That’s hot. There’s really not much to discuss. Hot. Too hot. 

Presenting a laundry list of scientific data here for debate isn’t really helpful for a couple of reasons: 

1. If you’re here, it’s likely you have already developed an opinion and aren’t changing it.

2. It would be impossible to sift through the available data without causing all of us a considerable amount of grief (mostly me). 

Scientists, doctors, and lawmakers got together (presumably in Sacramento, over coffee and cronuts) and deduced that, in the court of public opinion, the anti-vaccine experiment (self-imposed by the people) was a failure. They further decided that, given its failure, and the overwhelming evidence of vaccine efficacy, the enactment of law was required for the safety of the herd at large. Research shows that vaccines do more good than harm, by an incredibly large margin. Thus the law was made, and passed. 

And just like that: your kids are either vaccinated or homeschooled (private-based homeschools and independent study are exempt). Which translates to: if you want access to the goods (school in this case) you have to be willing to participate in whatever the government/science/etc. deems necessary to protect the folks around you. Don't want to play? Homeschool it is. The benefit of public schooling is simply not a foregone conclusion. Case closed. The end. 

The bill is passed. And you may be angry about that. Enraged, even. You probably object to the government telling you what you can and cannot do with your child (and their body). And that’s valid. It is your child. Critical examination, however, demonstrates the already heavy hand of the government, dictating your behavior as a parent. It’s actually sort of a feature of the government, telling people what they can and can't do. They are in your car, making you secure your children in carseats. They are in your house, telling you that you can only spank with an open hand, and only on the bottom, and only over clothing. And there are certainly people to whom, either of those particular mandates look like tyranny. On both sides. How dare you tell me I can’t spank my child! How dare you let someone drive without their child properly restrained! You can see how this gets problematic.

Who gets to decide the best course for society as a whole, when society can't seem to decide for themselves? 

If the government can force us to vaccinate, what else can they force us to do? Well, that is a legitimately frightening thought. But rationally speaking, at present, vaccines are sort of a societal imperative. If we do end up in a sociological situation where sterilization or mandatory communal living is legislated, then we have probably arrived in some sort of Huxley/Orwell dystopian society, wherein we have much larger hills to die on than government mandate — in which case I’m calling Katniss.  

We’ve survived two Bush presidencies. We’ll get through this.

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