vaccines at the intersection of religious liberty and public health


MrShorty
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I saw this article from the AP today in various news outlets https://www.usnews.com/news/health-news/articles/2019-06-13/new-york-set-to-cut-religious-exemption-to-vaccine-mandates If this link fails or you find it behind a paywall or something, the article is attributed to David Klepper of the Associated Press with a headline about New York state eliminating or ending the religious exemption to vaccine mandates and you should be able to find a copy of the article searching for those parameters.

Since religious liberty has been kind of a hot button topic lately -- especially as it intersects other issues -- I found this piece interesting. I am certainly pro-vaccine and do not understand how so many accept the anti-vaccine pseudo-science. But I also feel some of the concern that the Church feels about eroding religious liberties. A few statements that stood out to me:

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"I'm not aware of anything in the Torah, the Bible, the Koran or anything else that suggests you should not get vaccinated," said Bronx Democrat Jeffrey Dinowitz, the bill's Assembly sponsor. "If you choose to not vaccinate your child, therefore potentially endangering other children ... then you're the one choosing not to send your children to school."

Supporters also suggest some parents may be claiming the religious exemption for their children even though their opposition is actually based on scientifically discredited claims about the dangers of vaccines.

Is it the job of the state to decide what is a legitimate or valid or honestly held religious belief and what is not?

It is also pointed out that the choice is about sending kids to school. I get the impression that you are only required to get vaccinations if you want your child to attend school. Anyone can homeschool their unvaccinated child (within the limits the law imposes on homeschooling, which I don't know what NY allows as far as homeschooling).

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"I understand freedom of religion," he said. "I have heard the anti-vaxxers' theory, but I believe both are overwhelmed by the public health risk."

This might be the biggest statement. Even if I agree that public health overrides religious liberty in this case, what are the criteria that we use to decide when a public _______ issue overrides religious liberties? It kind of seems like it is up to case by case voting, but do I/we trust legislators (and even the voters in general) to do this well?

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Guest MormonGator

Your right to religious liberty (and liberty in general) stops when there a valid public health concern. The anti-vaxxers put all of us at risk. 

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@NeuroTypical Again, I would tend to agree, but it is easy for me to agree because I believe that vaccines are safe and effective and my religion does not require me to avoid vaccines. My goal is not necessarily to get too bogged down in the anti-vax junk (not that I have any control over the direction this thread takes), but to explore the intersection of government and religious liberty.

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Guest MormonGator
9 minutes ago, MrShorty said:

@MormonGator I think I will agree -- but (you knew there would be a "but") -- who gets to decide and how should they decide what is a valid public health concern?

 Public health authorities. I'm as libertarian as they come, but in the end, I want to live. I want my niece and nephew to live. I want my Grandmother to live. A line has to be drawn and eventually you have to trust medical and yes, government authorities. 

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I agree that it’s not for government to determine what “real” Christianity or Buddhism or Judaism or Shinto entails, for the purposes of deciding whether an objector to a particular government policy is acting in accordance with a bona fide religious belief.  

I am also deeply, deeply concerned at the idea that merely existing in a natural state, makes one either a creditor or a debtor to the rest of society (even in matters of public health); and oppose mandatory vaccination on that principle.  (I am fine, though, with civil litigation against fraudulent purveyors of bad science whose misinformation leads to affirmative harm.  And if someone’s actually sick—sure, quarantine their house or whatever.  But if we are going to say that someone’s mere existence poses a threat to society and that therefore we must infringe on their rights to life, liberty, property, religious or ideological freedom, etc—that leads us down some very dark roads very quickly.)

On the other hand, any institution offering a service has the innate right to set terms and conditions for would-be users of that service.  If I want my kid educated at a public school, and the public school wants all the kids on its campus to be vaccinated—that’s legit; provided that government is reasonably flexible in allowing me to make alternate arrangements for the education of my kids.

Edited by Just_A_Guy
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Guest Mores
44 minutes ago, MormonGator said:

 Public health authorities. I'm as libertarian as they come, but in the end, I want to live. I want my niece and nephew to live. I want my Grandmother to live. A line has to be drawn and eventually you have to trust medical and yes, government authorities. 

This is a difficult pill to swallow.  I'd like to trust most authorities in this vein to do what is reasonable.  But they often don't.  I see having to vaccinate for things like MMR or DPT.  But I'm not sure why they would mandate HPV shots.

Now, the flu shot is something that makes me wonder.  Yes, I've seen the news lately about how many critically ill and even some deaths due to the flu.  But I had been under the impression that average healthy individuals aren't really in danger of serious conditions/death.  Yet, when I've gotten my flu shots (it's hit or miss each year) I ended up getting the flu fairly seriously for a couple weeks.  Other years, I just don't make it a priority.  And I either don't get it, or I get it very mildly.

Most places simply say "shots are available" either free or for a very cheap price.  But some localities I've lived in, the announcement was made that it was mandatory.  Funny thing is that if you didn't get it, no one came a knockin' at the door or anything.  They just announced it.

Here's what I got from the all-knowing internet:

Quote

People at higher risk of developing flu complications include:

  • Young children under age 5, and especially those under 2 years
  • Adults older than age 65
  • Residents of nursing homes and other long-term care facilities
  • Pregnant women and women up to two weeks postpartum
  • People with weakened immune systems
  • People who have chronic illnesses, such as asthma, heart disease, kidney disease, liver disease and diabetes
  • People who are very obese, with a body mass index (BMI) of 40 or higher

I suppose I could see it as a service to these high risk people for me to get my shots.  But dang!  It is unpleasant to do every single year.  And I get sick every time I get a shot -- like REALLY sick.

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Guest MormonGator
9 minutes ago, Mores said:

This is a difficult pill to swallow.

It is....and it isn't. The simple truth is that vaccines work and that anti vaxxers put all of at risk. That part is black and white. 

It gets slightly murky when you bring in government force, I accept and understand that. However, in the long run yes, government force should be used to protect my and my loved ones health. 

Edited by MormonGator
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Guest Mores
13 minutes ago, MormonGator said:

It is....and it isn't. The simple truth is that vaccines work and that anti vaxxers put all of at risk. That part is black and white. 

It gets slightly murky when you bring in government force, I accept and understand that. However, in the long run yes, government force should be used to protect my and my loved ones health. 

I get your point.  But what would you say about a person in my predicament? 

I'm not actually in a case where it's contraindicated.  But I can tell you from personal experience that the shots get me sicker than the disease -- every single time. I don't fit into a pigeon hole.  Such a govt mandate would make me sicker. 

If I just "catch the flu" I'm only sick for a couple of days -- usually very mildly.  I can still go to work.  I'm in a private office so I can do things without contaminating anyone. 

But those years I get the shot, I'm sick so bad that I'm out of commission for a couple of weeks.  That's lost time at work.  That's a lot of money gone down the toilet (I don't get paid sick time).  And my work itself suffers from my absence.

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Guest MormonGator
1 minute ago, Mores said:

I get your point.  But what would you say about a person in my predicament? 

I'm not actually in a case where it's contraindicated.  But I can tell you from personal experience that the shots get me sicker than the disease -- every single time. I don't fit into a pigeon hole.  Such a govt mandate would make me sicker. 

If I just "catch the flu" I'm only sick for a couple of days -- usually very mildly.  I can still go to work.  I'm in a private office so I can do things without contaminating anyone. 

But those years I get the shot, I'm sick so bad that I'm out of commission for a couple of weeks.  That's lost time at work.  That's a lot of money gone down the toilet (I don't get paid sick time).  And my work itself suffers from my absence.

You have to make that choice for yourself of course, as of right now. And if you don't get the flu shot, catch the flu, and your 85 year old grandmother dies of the flu, that'll be on you for the rest of your life. Same with your 3 day old niece. And your brother who has a weakened immune system due to HIV. 

Honestly, anti-vaxxers blow my mind. For thousands of years people died of Yellow Fever, Measles, Diphtheria, Polio-and now, thanks to whack job conspiracy theories and people who don't understand science, these diseases are roaring back. I don't understand it. I don't understand it. 

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Guest Mores
2 hours ago, MormonGator said:

You have to make that choice for yourself of course, as of right now. And if you don't get the flu shot, catch the flu, and your 85 year old grandmother dies of the flu, that'll be on you for the rest of your life. Same with your 3 day old niece. And your brother who has a weakened immune system due to HIV. 

Honestly, anti-vaxxers blow my mind. For thousands of years people died of Yellow Fever, Measles, Diphtheria, Polio-and now, thanks to whack job conspiracy theories and people who don't understand science, these diseases are roaring back. I don't understand it. I don't understand it. 

I don't really have any of those categories in my life. 

And as for anti-vax, I'm talking about only those vaccines that seem to not make sense.  It's like environmental laws.  Some of them make all the sense in the world.  Others only seem to cause trouble with little to no actual benefits.

You don't trust politicians to make those decisions.  Why do you trust them to make these decisions?

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45 minutes ago, MormonGator said:

Do you go to church? 

Let’s continue the thought experiment:

Scenario 1:  @Mores refuses to get vaccinated.  Flying in the face of all his experience, he comes down with a very heavy case with the flu and infects his 85-year-old relief society president, who duly dies.  Let us assume arguendo that @Mores is morally culpable in spite of any attempts he may have made to avoid physical contact, wash his hands, wear a surgical mask, etc; and that he should be legally liable (if not criminally culpable) for the death as well.

As I understand it, the flu vaccine is actually a mixture of vaccines against quite a few individual strains of flu; and precisely which strains are included in the overall vaccine varies year to year according to what is basically an educated guess as to which strains are most likely to gain traction in any given season.

So let us imagine Scenario 2:  @Mores gets the vaccine, but winds up getting a strain of flu that wasn’t included in the vaccine because some lab flunkie decided it wasn’t a threat that particular year; and so @Mores infects the RS President who, again, dies—should the lab flunkie be held liable/culpable for the RS President’s death?

If not, aren’t we granting legal immunity to Scenario 2’s PhD-wielding lab flunkie for taking the same sort of losing gamble for which we’d happily imprison the non-PhD-wielding reluctant vaccer in Scenario 1?  Weren’t the consequences of the lab flunkie’s inaction at least as foreseeable as the consequences of Mores’s inaction?

Do we want that sort of elitism, either in our criminal code or in our cultural mores?

Edited by Just_A_Guy
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8 hours ago, MrShorty said:

"I'm not aware of anything in the Torah, the Bible, the Koran or anything else that suggests you should not get vaccinated," said Bronx Democrat Jeffrey Dinowitz, the bill's Assembly sponsor.

- This guy obviously doesn't know about/understand *personal revelation*. I know of people who had their older kid/s vaccinated and saw the result so then prayed about whether or not to vaccinate their younger kid/s and got the answer not to.

- If people decide that anyone living in a house with a gun is a danger to society and if you have one (or more), you have to turn it in before your kid/s can go to school, what would you say about that? (don't have to answer, just putting it out there)

- How important is liberty? "Now they never had fought, yet they did not fear death; and they did think more upon the liberty of their fathers than they did upon their lives" Alma 56:47
 



 

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As a medical professional I can tell you that I am weary of the nanny state requiring immunizations. And I do question their safety and effectiveness.

http://www.marinhealthcare.org/upload/public-meetings/2018-06-19-600-pm-mhd-community-health-seminar-vaccination/BRANCO_06192018_MGH Vaccine Presentation.pdf

Look how required vaccinations have changed over the years.  In 2050 there will likely be 50 - 100 vaccinations required...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027411/#!po=0.526316

NIH’s internal study explaining why the flu vaccine is horribly in-effective.  

https://www.google.com/amp/s/amp.cnn.com/cnn/2019/02/14/health/flu-vaccine-effectiveness-cdc/index.html

This year’s flu vaccine was only 24% effective for those over age of 50 (raises hand)!

https://physiciansforinformedconsent.org/measles/dis/

Information about the Measles.  Although there is a current hysteria about this disease.  Contrary to public indoctrination it is not very communicable (compared to the common cold).  Its mortality (Death Rate) in the USA is near Zero.  Since the year 2000 there have been a grand total of 11 deaths in the USA caused by the measles.

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Edited by mikbone
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14 hours ago, Mores said:

But I'm not sure why they would mandate HPV shots.

The HPV vaccines protects against strains of HPV that cause over 70% of cervical cancers.  Is has been estimated that widespread vaccination could reduce the number of cervical cancer deaths by as much as 2,000 per year (only about half of cervical cancers are detected in early stages, which have a 92% 5-year survival; advanced stages top out at 50% survival; and then there's the fact that not undergoing cancer treatments at all is generally better than having to undergo them)

source: https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet
https://seer.cancer.gov/statfacts/html/cervix.html

What's great is that the 70% thing mentioned above is true for the bi-valent vaccine, which only protects against two strains of HPV (out of about 140).  Some critics have complained that the HPV vaccine is pointless because it protects against so few strains, but the target is not HPV--the target is cervical cancer.  And even vaccinating against those two strains alone is making a huge dent.  Since the original bi-valent came out, there have been quad-valent and oct-valent versions introduced. New to me even is a vaccine that protects against 9 strains, which account for more than 70% of cervical cancers and more than 90% of genital warts. 

Anyway, I'll stop now. But the reason HPV shots (and I stress, for both males and females) are being pushed is to cut down on cervical cancer.  I don't recall them being mandated anywhere, but strongly encouraged. (It's been a few years since I worked in Women's Health, so I may not be fully up to date)

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Guest Mores
3 minutes ago, MarginOfError said:

The HPV vaccines protects against strains of HPV that cause over 70% of cervical cancers. 

I know what it is.  My point is that it is 100% preventable by living a chaste life.  So, there is a VERY easy way to avoid it without medical intervention.

As far as mandating it, I am also unaware of it being a reality -- today. 

There have been discussions about it on various talk shows and such -- even among public officials and politicians.  It is automatically assumed that everyone will participate in casual sex throughout their lives (among the people discussing it).  But so far, I have not heard of any actual policies being formally proposed.  It's just in the early stages.

Edited by Mores
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10 minutes ago, Mores said:

I know what it is.  My point is that it is 100% preventable by living a chaste life. 

This probably isn't true anymore.  It is estimated that somewhere between 65 and 70% of adults have some form of HPV. Remember, many of them are asymptomatic.

Note also that, at least in the U.S., more than 95% of people will have penetrative sex before they are married. 50% will have had sex before the age of 17.  The mean number of sexual partners for Americans is 7.2.  

While I appreciate the point you are trying to make, public health decisions need to operate in the world in which we live, not the world in which we wish to live.

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7 hours ago, mikbone said:

Information about the Measles.  Although there is a current hysteria about this disease.  Contrary to public indoctrination it is not very communicable (compared to the common cold).  Its mortality (Death Rate) in the USA is near Zero.  Since the year 2000 there have been a grand total of 11 deaths in the USA caused by the measles.

Um, 11 deaths out of 2,671 cases.  Or about 4.1 deaths per 1,000 cases.  Now consider that by 1962 (before the measles vaccine was developed), the mortality rate was about 1 per 10,000 cases.  Let me put those in the same units

1959 - 1962: 1 per 10,000 cases
2000 - 2019: 41 per 10,000 cases

And mind you, this is a disease that was declared eliminated in 2000--and we are worse off now than we were sixty years ago!

The major difference is that we are looking at 2,671 cases in the modern era compared to 4 million cases in the 1959-1962 era. Largely due to vaccination.  Perhaps a little hysteria is warranted.

https://physiciansforinformedconsent.org/measles/dis

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17 minutes ago, MarginOfError said:

Um, 11 deaths out of 2,671 cases.  Or about 4.1 deaths per 1,000 cases.  Now consider that by 1962 (before the measles vaccine was developed), the mortality rate was about 1 per 10,000 cases.  Let me put those in the same units

1959 - 1962: 1 per 10,000 cases
2000 - 2019: 41 per 10,000 cases

And mind you, this is a disease that was declared eliminated in 2000--and we are worse off now than we were sixty years ago!

The major difference is that we are looking at 2,671 cases in the modern era compared to 4 million cases in the 1959-1962 era. Largely due to vaccination.  Perhaps a little hysteria is warranted.

https://physiciansforinformedconsent.org/measles/dis

https://www.cdc.gov/heartdisease/docs/ConsumerEd_HeartDisease.pdf

Heart Disease causes about 600,000 deaths a year.  It is largely preventable by not smoking, diet, and exercise.  And I don’t see any hysteria about stopping smoking, obesity, or high blood pressure...

11 vs. 600,000 cases 

do the math

 

Or how about 40,000 auto accident deaths a year?   I don’t see anyone getting all excited about taking away our cars...

Edited by mikbone
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Lastly, I am a statistician (Master's degree in Biostatistics, to be precise), and as someone who grew up very skeptical of vaccines, I poured a lot of hours into reading the peer reviewed research on this topic before choosing to vaccinate my children. The research is sound. The ethics are sound.  The statistics are sound.

Are there individuals who suffer from vaccination? Without question.  But you also have to recognize vaccines are developed, tested, and validated on a sample numbering in the thousands. For a really big trial, it may go as far as tens of thousands.  And then we scale those results by expanding their use into a population numbering in the hundreds of millions. We're going to find some outliers. And yes, some people will be injured. It's tragic, and unfortunate. But it is not a reason to suspend vaccination.  In fact, the only hope we have of learning how to identify those that are susceptible to injury is to continue the program.

I get that this sounds heartless, but consider this (true) case study.  There have been two girls in the United States that have died after receiving the HPV vaccine. Anti-HPV vaccine proponents have declared this as sufficient cause to terminate HPV vaccinations, because even one death is too many.  That's a lovely sentiment, and I agree that one death is too many.  But let's also consider that literally millions of girls have received the HPV vaccine.  So the probability that any one girl will be killed by it is less than one in a million.  What's more, if the estimates hold that the HPV vaccine will prevent 2,000 cervical cancer deaths per year, then in the past ten years, we will have prevented 20,000 cervical cancer deaths.  That puts us in this great bind place of "one death is too many," but apparently we're okay losing the other 20,000?

Most often, when people rail against these kinds of health policy ideas, it comes down to "fear of the new thing" and "fear of it happening to me or someone I know."  You have my empathy. You really truly do. I have those same fears. yet I will continue to advocate that health policy is best debated and discussed as a matter of cold-hearted statistics where the chosen policy should reflect what is best for the population, not the individual.

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