Late in 2014, news outlets were abuzz with reports of a measles outbreak originating in California’s Disneyland theme park, with the disease ultimately infecting hundreds of people and spreading to several states. This rapid spread of measles was facilitated by lax policies on vaccinations, which enable parents to cite a “personal belief” as a state-sanctioned reason to opt out of vaccinating their children. California has a particularly high rate of exemptions. In some pockets of the state, including Orange County — home to Disneyland — more than 5% of public school kindergarteners do not receive vaccinations because of their parents’ “personal beliefs”.
Vaccination Bill SB 277, which institutes a moratorium on the use of “personal belief” exemptions, recently passed in California’s Senate. Governor Jerry Brown signed the bill into law this morning (June 30th, 2015). California is now one of only three states, including Mississippi and West Virginia, that only permit vaccination exemptions for medical reasons and not “personal beliefs.”
Dr. James Colgrove recently met with the Voices in Bioethics team to outline the nuances of vaccination ethics. Dr. Colgrove is a professor of Sociomedical Sciences at the Mailman School of Public Health at Columbia University, where he also serves as the Deputy Chair of the department’s master’s program. He has authored several books on ethical issues in public health administration, with a focus on the politics of persuasion and coercion. We began our conversation with a focus on the recent measles outbreak in California.
Sources cited in this interview include:
Paper on Autism and MMR Vaccine:
Jain, Anjali, Jaclyn Marshall, Ami Buikema, Tim Bancroft, Jonathan P. Kelly, Craig J. Newschaffer. “Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism.” Journal of the American Medical Association 313, No 15(2015):1534-1540. doi:10.1001/jama.2015.3077
Paper on Vaccine Exemption:
Wang, Eileen, Jessica Clymer, Cecilia Davis-Haynes, Alison Buttenheim. “Nonmedical Exemptions From School Immunization Requirements A Systematic Review.” American Journal of Public Health 104(2014):e62-e84. doi:10.2105/AJPH.2014.302190
Paper on emotional appeals:
Nyhan, Brendan, Jason Reifler, Sean Richey, and Gary L. Freedman. “Effective Messages in Vaccine Promotion: A Randomized Trial.” Pediatrics 133, No. 4 (2014):1-8. doi: 10.1542/peds.2013-2365