The Anti-Vaccine Crowd Shows They Are Anti-Informed Consent

"We want people to have informed choice when it comes to vaccines." These words, or at least something along these lines, are uttered by many anti-vaccine activists, like Barbara Loe Arthur (aka Barbara Loe Fisher) of the misnamed National Vaccine Information Center or the authors at Age of Autism. To hear them speak, you would imagine that they would be completely in favor of any efforts which strive to provide accurate, complete information to parents who are deciding whether or not to have their children vaccinated. Such efforts should be whole-heartedly embraced by these "pro-informed consent" warriors.

Just such an opportunity has arisen in California, with AB 2109. As I recently wrote, this bill would expand on California's philosophical exemptions regulations regarding immunization requirements for day care and school enrollment. If passed, parents seeking a philosophical exemption would need to obtain from a physician or other health care provider a signed statement that the doctor provided them with information on the benefits and risks of vaccines. Physicians are already required by Federal law to provide this information before administering a vaccine. This provision would provide an added opportunity for parents to receive sound information and advice regarding their children's vaccines.

Sounds like something Fisher and company would support, no? Surprisingly, no.

Well, I guess it isn't all that surprising. You see, Fisher and her organization, NVIC (who are described in her failed libel complaint [PDF] against Dr. Paul Offit, journalist Amy Wallace and publisher Condé Nast as advocating for "fully informed consent"), are vehemently opposed to the legislation. The NVIC, which is headquartered in Virginia, is urging its supporters to contact Assemblymembers to voice their opposition. They claim that parents' rights to "informed independent vaccination choices" are under attack with this legislation (which, remember, would be providing information to parents).

Some of the issues that Fisher finds objectionable I've already addressed in my previous post. For example, she claims that the bill forces parents to pay for "an expensive appointment at a medical doctor’s office". The bill requires no such thing. It merely states that parents need to submit with their request for exemption a signed statement from the physician that they provided the parents with information on the risks and benefits of vaccines. It does not specify how that information need be provided. The information could be provided over the phone and the signed form mailed. Hardly a costly burden. The bottom line, though, is that this claim is untrue. It is false. Go read the legislation yourself if you do not believe me.

She also suggests that it makes parents "jump through the bureaucratic hoops of obtaining yet additional new forms". Since the legislation has not yet been enacted, let alone passed the state Assembly, and we do not know precisely in what manner the forms will be provided, this objection seems rather premature. If the necessary forms are provided along with the exemption form, then there would not be any "hoops" to go through in acquiring it. Again, a groundless objection.

Her third objection is that parents would need to "find a health care provider actually willing to take the appointment and then sign the new forms within 6th [sic] months of starting school for the exemption to be valid". There is no reason to believe that physicians would not sign the form. "What will stop doctors from using this law to deny access to philosophical exemptions?" asks Fisher. I might similarly ask, what would stop physicians from using the medical exemption law to deny access to medical exemptions? Probably the fact that physicians want what is best for their patients and are not the vindictive, petty jerks that Fisher seems to think they are. If assuming that doctors are generally decent human beings is not enough, then there's always the threat of legal action, I suppose.

Ms. Fisher then provides a suggested course of action, with talking points including the previously mentioned untruth about forcing parents to make appointments with physicians. Here is where we really begin to see what she means by "informed consent". It appears that by "informed consent" what she really means is "informed with the information NVIC provides", which other writers have shown on numerous occasions omits important information and that the information they do provide is frequently presented in such a way as to exaggerate the risks of vaccines while downplaying their benefits and the risks of diseases.

There are plenty of examples of this in their call to arms, for example this:

Bill supporters claim that vaccines are safe. The reality is there is real risk. The Vaccine Injury Compensation Program was established by Congress in 1986 to protect vaccine manufacturers and doctors from liability for vaccine injuries and death. As of Jan. 3, 2012, there have been 14,073 claims filed for vaccine injury and 1077 death claims. The total dollar amount of vaccine injury and death awards granted and paid to families of vaccine victims by our government is $2,366,649,931.96.

Yes, vaccines are safe (insofar as anything in life can be said to be safe). Yes, there are risks, but the risks from vaccines are much smaller and less likely than complications from the diseases they prevent. Regarding the VICP, Ms. Fisher leaves out quite a lot of additional information. For example, she helped to establish it. It was also established to make it easier for those injured by vaccines to be compensated for it by paying for legal costs regardless of the outcome of the claim, eliminating the Daubert Standard for scientific validity, and doing away with the need for claimants to prove that the manufacturer was negligent, among other legal obstacles present in the tort system. She also fails to specify just how many of those claims have actually been causally connected and which were coincidental. Not all claims made are for injuries that actually stem from a vaccine. Fisher's statements are similar to those who cite VAERS figures, neglecting to mention that those figures also include claims like this:

VAERS ID 209245-1: "This subject is a three month old female, who suffered a fatal head injury while enrolled in a comparative post marketing safety study of Daptacel (diptheria and tetanus toxoids and acellular pertussis vaccine absorbed) administered with other recommended vaccines according to the US standard of care. The subject received one dose of study vaccine: the last dose prior to the event was given on 01/14/2003. The subject ""expired instantly due to blunt head injuries in motor vehicle accident described as ""auto vs. fixed object, ejected,"" 18 days post immunization and expired the same day. No other information was reported. Death Certificate has been received. Autopsy has been performed but report not yet received. The event of fatal head injury was reported by the investigator as unrelated to the study product. The autopsy report states accident automobile, death. Follow up on 09/30/2003: ""Autopsy Report received by medical affairs on 09/16/2003. This three-month-old female is a victim of an apparent accidental death. ""Auto (passenger) vs. F/O, rollover, ejected"". The base portion of the car seat strapped in the center of the back seat. The car seat carrier was facing rear, however it was behind the passengers seat of the vehicle (not locked in the base) with the seat belts in use. The car seat canopy was found with the descedent. She was about 100 feet north of the vehicle, face down with her head against a rock. There was a blanket covering her. Death is probably instant and is clearly from crushing blunt injuries to the head. Other injuries also listed in the autopsy report include a crushed head and multiple severe abrasions and probable compressed chest event due to collapsed lungs and areas of hemorrhagic discoloration on lungs. This can happen in infants without fractures of the ribs, etc. Other injuries included fracture of the left femur as well as crushed and avulsed toes of the right foot. There was no signs of internal torso injuries except for the lungs. No further information is anticipate"

The final bit of misleading is in the numbers she cites. Checking the link she provides (http://www.hrsa.gov/vaccinecompensation/statisticsreports.html#Claims), we find that of the ~14,000 claims that were filed, ~8,500 were dismissed, meaning that the claimants failed to show, even by the lowers standards of the vaccine court, that a vaccine was responsible for the injury. Out of the millions of doses of vaccines that have been administered since the Vaccine Injury Compensation Program began in 1988, less than 3,000 claims have been filed and compensated. From 1953-1963 (before the MMR vaccine was approved), the U.S. saw an average of 450 deaths from measles alone each year, or roughly 4,500 deaths from a single disease in a single decade. That does not include other complications, like hospitalization, blindness, deafness, brain damage and so forth. Compare that to the around 3,000 injury claims (which includes all injuries) over just shy of a quarter century. Is there room to make vaccines safer? Yes. Should manufacturers be working toward that? Yes. But Fisher and her ilk do not reasonably argue for improved safety, instead opting to exaggerate and spin.

The objections to AB 2109 of Barbara Loe Fisher, NVIC and other anti-vaccine activists give the lie to their claims that they are pro-informed consent. Unfortunately, there are quite a few parents who may believe the propaganda produced by these organizations. Please stand up for public health and true informed consent. If you are in California, contact your Assemblymembers to voice your support for the bill.