‘Boiled Frog’ Game Continues as New Yorkers Face Jail Time for Skipping Measles Vaccine
- April 23, 2019
Story at-a-glance
- April 8, 2019, New York City health officials ordered Orthodox Jewish schools and day care programs in Williamsburg, New York, to bar unvaccinated students from attending classes for the remainder of the measles outbreak, or face closure
- April 9, health officials ordered residents in four Williamsburg, New York, zip codes — 11205, 11206, 11211, 11249 — to get vaccinated for measles within 48 hours or face a $1,000 fine or six months in jail. The order applies to any individual who lives, works or goes to school in these zip codes
- Williamsburg is a predominantly orthodox Jewish neighborhood in Brooklyn, where many families object to vaccination on the grounds of their religious beliefs. A civil rights lawsuit against the city has been filed by some affected Williamsburg residents
- Donna Lieberman, executive director of the New York Civil Liberties Union, called the measure “extreme,” saying it “raises civil liberties concerns about forced medical treatment”
- According to World Health Organization data, measles killed 110,000 people globally in 2017. In the U.S., measles rarely leads to death. The last recorded measles-associated death in the U.S. occurred in 2015
The following referenced information contains opinion and perspective
on a health topic related to vaccine science, policy, law or ethics
that is being discussed in public forums, including in medical, law and
other professional journals; newspapers, magazines and other print;
broadcast and online media outlets; state legislatures and the U.S.
Congress.
Readers are encouraged to go to the websites of the U.S. Department of Health and Human Services (DHHS) for the perspective of federal agencies responsible for vaccine research, development, regulation and policymaking, including the U.S. Centers for Disease Control (CDC) for information on vaccine policymaking; to the U.S. Food and Drug Administration (FDA) for information on regulating vaccines for safety and effectiveness; and to National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) for information on research and the development of new vaccines.
The World Health Organization has stated that “vaccine hesitancy” is one of the top 10 global public health threats.
On March 26, 2019, Rockland County, New
York, executive Ed Day issued a state of emergency, barring children
under the age of 18 who had not gotten a measles-containing MMR shot
from entering public places, including schools, restaurants, churches,
synagogues and public transportation.1,2,3Readers are encouraged to go to the websites of the U.S. Department of Health and Human Services (DHHS) for the perspective of federal agencies responsible for vaccine research, development, regulation and policymaking, including the U.S. Centers for Disease Control (CDC) for information on vaccine policymaking; to the U.S. Food and Drug Administration (FDA) for information on regulating vaccines for safety and effectiveness; and to National Institutes of Health’s National Institute of Allergy and Infectious Diseases (NIAID) for information on research and the development of new vaccines.
The World Health Organization has stated that “vaccine hesitancy” is one of the top 10 global public health threats.
The ban was initially set to expire once the state of emergency was lifted in 30 days, but was cut short when an acting New York State Supreme Court judge issued an injunction lifting the state of emergency on April 5, saying the number of measles cases did not meet the legal definition of an epidemic required for an emergency order declaration.4
A few days later, on April 8, 2019, New York City health officials ordered Orthodox Jewish schools and day care programs in the Williamsburg neighborhood of Brooklyn to bar unvaccinated students from attending classes for the remainder of the measles outbreak, or face closure.
The next day, April 9, public health officials ordered residents in four Williamsburg, New York zip codes — 11205, 11206, 11211, 112495 — to get vaccinated within 48 hours or face a $1,000 fine or six months in jail.
The order applied to any individual who lives, works or goes to school in these Brooklyn zip codes and has not gotten an MMR shot and/or cannot show proof of natural immunity or does not have an approved medical vaccine exemption. According to the Daily Mail,6 city officials plan to “track unvaccinated people by tracing anyone who may have come into contact with people who have measles.”
In a follow-up move on April 15, 2019, on behalf of five Brooklyn mothers identified only by their initials, lawyers Robert Krakow, Robert F. Kennedy (of the litigation advocacy group Children’s Health Defense) and Patricia Finn filed a legal challenge in the New York State Trial Court,7,8 asking for a temporary restraining order against the New York City Department of Health and Human Hygiene and its commissioner as respondents for issuing the Williamsburg neighborhood MMR vaccination mandate.
Although New York Justice Lawrence Knipel initially denied a temporary restraining order, the preliminary injunction issue is expected to be argued in court.9
But not to be undone, in a game of moves and countermoves, the very next day, April 16, 2019, Rockland executive Day announced a new order that he and local health officials are now imposing: Get vaccinated or face a $2,000-per-violation, per day, fine.
“The new order would keep unvaccinated students who don’t have medical or religious exemptions in the most affected areas from going to school, and those who have measles or have been exposed to it and are not vaccinated from going to public places, both indoor and outdoor,” CBS2 New York reported.10Rockland County leaders told CBS2 New York that they believe the new order will “stand up to legal challenges” because it also orders people to cooperate with investigators from the Board of Health. Beyond that, Day added, “We will restrategize at every opportunity regardless of what’s thrown in front of us. That’s just what we’re going to do.”
Vaccination Order in Williamsburg Raises Concerns About Forced Medical Treatments
As in Rockland County, the Williamsburg section of Brooklyn is home to thousands of predominantly orthodox Jewish families, many of whom object to vaccination on the grounds of their religious beliefs. According to the Chicago Tribune:11“News of the order got a mixed reaction among Orthodox Jews in Williamsburg, the Brooklyn neighborhood affected by the order. Some residents — even those who support vaccination — said they felt uncomfortable about the city pushing inoculations on people who don't want them.
Others remain convinced, against expert assurances, that vaccines are unsafe. ‘It's true that a lot of people have measles, and measles are not a very good thing,’ said resident Aron Braver, but he thinks the vaccine is ‘also not a very good thing.’ ‘And it's everybody's option to do what he wants. What he decides,’ Braver added.”Donna Lieberman, executive director of the New York Civil Liberties Union, called the measure “extreme,” saying it “raises civil liberties concerns about forced medical treatment.”12
Indeed, if the government can threaten and force people to get MMR shots, what’s to stop forced vaccinations for influenza, or HIV infection, or any of the other hundreds of experimental vaccines currently being developed by the pharmaceutical industry and the federal government?
After that, what’s to stop forced use of prescription drugs when you’re diagnosed with an illness and government approved “standard of care” policy dictates that doctors prescribe you a particular drug for a particular health condition?
It’s a slippery slope. The irony is that vaccines are not without risk just like prescription drugs are not without risk. The difference between prescription drugs and vaccines is that drugs are given to sick people to theoretically make them well and vaccines are given to healthy people (at least most of the time) to theoretically keep them well if in the future they come in contact with a microbe that could make them sick.
Either way, there’s always going to be risk involved. Shouldn’t everyone have the right to decide which risk they’re most comfortable taking?
Why is it that government is so eager to protect you from the possibility you might get sick or die from natural causes, but appears unwilling to lift a finger to protect you from the harms of medical treatments?
Is Measles Really a Public Emergency Warranting Draconian Measures?
I, for one, can think of a whole host of issues that might warrant declaring a state of emergency, but measles is not one of them. According to World Health Organization (WHO) data,14 measles killed 110,000 people in 2017, and that’s the global number. In the U.S. and other developed countries measles rarely leads to death. In fact, the last recorded measles-associated death in the U.S. occurred in 2015.15
Just how does an illness that hasn’t killed a single American in four years, and prior to measles vaccine being introduced in the early 1960s resulted in an average of between 450 to 50016 deaths annually, qualify as an emergency warranting the violation of First Amendment and other constitutional rights that protect us from government overreach?
If you’re old enough, you probably recall the days when no one batted an eye at the mention of measles because it was a common infection that most everyone experienced before age 10. If you’re not, the video above includes several clips from popular TV shows in the 1960s, illustrating people’s attitudes toward measles at the time. Similarly, a 1963 article in the Minneapolis Tribune (image below), which quotes Dr. Karl Lundeberg, the chief health officer for the city, notes:
“Children’s diseases, particularly red measles, seem to come in cycles of two or three years, said Lundeberg. The cycle pattern occurs because the disease is so highly contagious. ‘Everybody gets the measles during the epidemic, so they become immune,’ said Lundeberg. It usually takes two to three years before enough susceptible persons are born to transmit the disease.”This 1963 article mentions the outbreak involved 2,325 reported cases of measles. The primary concern of parents and doctors at the time? How to keep the young patients’ boredom at bay. In this article, the advice given was to stock up on board games. Fast-forward some 55 years, and a couple of hundred cases are now spawning calls for forced vaccinations and the removal of civil rights.
The disease itself remains one of the more benign — unless you get it when you’re older, are vitamin A deficient or live in an underdeveloped country where there is a lack of basic health care and sanitation. A 1964 paper17 describing the frequency of measles complications includes comments by authors on the announcement of a measles vaccine, stating:
“One of the major sources of doubt about the need for immunization stems from the belief among many parents and doctors that measles is a mild disease in which serious complications are rare and almost never fatal in normal children.
Deaths have indeed declined rapidly in recent years to about 2 per 10,000 notifications, and a recent study has shown that about half of the deaths occur in persons with serious chronic disease or disability.”You can learn more about the history of measles in the U.S. and other countries on the National Vaccine Information Center’s website.18
Measles Cannot Be Compared to Smallpox
Now, Day and others are trying to force the measles containing MMR vaccine on everyone, in some cases justifying forced use of MMR vaccine by comparing it to mandates issued for smallpox vaccination back in 1902.19 Mandatory use of the smallpox vaccine became common in the 19th century because smallpox had a complication and mortality rate of 30 percent.20In 1905, the U.S. Supreme Court upheld Massachusetts’ decision to mandate smallpox vaccination and revaccination during smallpox epidemics, which included a fine of $5 for those who refused.21
Rev. Henning Jacobson had sued the state, saying he and his son had experienced allergic reactions to the vaccine when they received it the first time, and therefore feared getting revaccinated might jeopardize their health. The judge in the case ruled their personal health concerns of a minority did not outweigh the greater good of the majority of society.
However, the 1905 Supreme Court justices also warned that mandatory vaccination laws should not be so inflexible that they become “cruel and inhuman to the last degree.” They commented, “All laws, this court has said, should receive sensible construction.”22
Measles is nowhere near as deadly as smallpox. In 1962, a year before the measles vaccine was licensed in the U.S., the measles death rate was reported to be 1 in 1,000 cases.23 However, chances are the death rate was much lower than that, as the case fatality figures are based on reported cases and most measles cases were benign and went unreported.24
Parents were not particularly worried about measles before the vaccine was widely used because, like chickenpox, it was accepted as a childhood rite of passage and complications were rare. However, measles does have more serious complications for older children and adults, which is why parents in the past wanted their children to get the disease when they were young.
Authors of a recent study25 in The Lancet Infectious Diseases reported that when measles infection is delayed, negative outcomes are 4.5 times worse “than would be expected in a prevaccine era in which the average age at infection would have been lower.”
Studies have also shown vitamin A deficiency tends to make measles deadlier, and this deficiency primarily affects developing countries, Africa and South-East Asia in particular.26 This is also where most of the measles deaths occur. Research has shown vitamin A therapy prevents pneumonia and measles-associated mortality,27,28 and the WHO recommends administering vitamin A at the time a diagnosis of measles is given.29
Illness Prevalence Versus Mortality
For some reason, when it comes to measles, public health officials and the media make it seem as though being sick is, in and of itself, a cause for hysteria, even though the absolute risk for death from that illness is minuscule. It is, in short, nonsensical. You cannot eradicate all infections, and if such an effort is undertaken, it would be wise to focus on diseases that have the highest mortality rates.Naturally, any death, for any reason, is tragic, but you cannot avoid all causes of illness and death, and it certainly seems reasonable to ask whether it makes sense to mandate that children receive vaccines for diseases with low mortality when there are many other causes of death that are not only easier to prevent but would save far more lives.
According to a special report30,31 on child mortality published in 2018 in The New England Journal of Medicine, the two top causes of death among children aged 1 to 19 in 2016 were motor vehicle crashes (20% of total deaths; 4,074 children) and firearm-related injuries (15% of total deaths; 3,143 children).
In terms of disease, cancer was the primary cause of death (1,853 deaths), followed by suffocation (1,430 deaths) and drowning (995 deaths). A total of 982 children died from drug overdoses. Heart disease killed 599 children and chronic lower respiratory disease took the lives of 274.
So, where is the evidence that measles is a catastrophic public health concern comparable to smallpox that warrants forcing all children to get vaccinated or be banned from going out in public?
What’s more, let’s not forget that going through and recovering from measles confers natural lifelong immunity. The same cannot be said for the vaccine, which only provides an artificial immunity that can be temporary as health authorities found out in the early 1990s that one dose of MMR was not enough and now two doses of MMR are given. Measles outbreaks often occur even in highly vaccinated populations,32,33,34,35,36,37 so vaccination even with two doses is no guarantee the disease won’t spread.
Plus, because MMR vaccine is a live virus vaccine, people who get it can develop vaccine strain measles infection with symptoms like fever and a red rash that looks a lot like wild type measles. In fact, a study published in 2017 revealed that when samples of blood from “confirmed” measles cases in 2015 in the U.S. were lab tested, 37.63% (73 of 194 cases) turned out to be vaccine strain measles, not wild-type measles.38
Measles Outbreaks Have Repeatedly Occurred in Vaccinated Populations
By the early 1980s, about 95 percent of children entering kindergarten in the U.S. had received a dose of measles-containing vaccine but, in 1989-1990, there were outbreaks of measles among school-age children and college students.Public health officials responded by recommending a second dose of MMR vaccine for all children. In an article published in Clinical Microbiology Reviews in 1995, researchers stated:39
“Measles, which was targeted for elimination from the United States in 1979, persisted at low incidence until 1989, when an epidemic swept the country. Cases occurred among appropriately vaccinated school-age populations and among unimmunized, inner-city preschool children.
In response to the epidemic, measles immunization recommendations have been modified. To prevent spread among school-age populations, a second dose of MMR vaccine is recommended at 5 to 6 or 11 to 12 years of age.”Today, measles outbreaks are occurring even in populations that have received two or more doses of measles vaccine, and/or where vaccination rates are above the “herd immunity” threshold. For example:
• A 2017 measles outbreak in a highly
vaccinated military population in Israel, ranging in age from 19 to 37.
The first two patients identified had both received two doses of
measles vaccine. Patient zero, a 21-year-old soldier, had documentation
of having received three doses.40
• A 2014 study41 conducted in the Zhejiang province in China found populations that have achieved a measles vaccination rate of 99 percent through mandatory vaccination programs still experience outbreaks far beyond what the World Health Organization expects.
What’s more, 93.6 percent of the 1,015 participants in this study tested seropositive for measles antibodies, which theoretically means they should have been protected against the disease.
• A 1994 study42 looking at measles incidence in Cape Town, Africa, indicated that as vaccination rates increased, measles became a disease in populations where the majority of children had been vaccinated. The immunization coverage was 91 percent and vaccine efficacy was estimated to be 79 percent. According to the authors:
The herd immunity threshold for vaccine-acquired artificial immunity is thought to be between 80 and 95 percent,43
depending on the disease in question. For measles, it’s between 90 and
95 percent. According to the CDC, over 94 percent of kindergarten
children nationwide have received two doses of measles-containing MMR
vaccine and only about 2 percent of children attend school with vaccine
exemptions.44• A 2014 study41 conducted in the Zhejiang province in China found populations that have achieved a measles vaccination rate of 99 percent through mandatory vaccination programs still experience outbreaks far beyond what the World Health Organization expects.
What’s more, 93.6 percent of the 1,015 participants in this study tested seropositive for measles antibodies, which theoretically means they should have been protected against the disease.
• A 1994 study42 looking at measles incidence in Cape Town, Africa, indicated that as vaccination rates increased, measles became a disease in populations where the majority of children had been vaccinated. The immunization coverage was 91 percent and vaccine efficacy was estimated to be 79 percent. According to the authors:
“The epidemiology of measles in Cape Town has thus changed as evinced in this epidemic, with an increase in the number of cases occurring in older, previously vaccinated children. The possible reasons for this include both primary and secondary vaccine failure.”
Despite the high vaccination rate in the U.S., it’s not enough to thwart outbreaks, and evidence suggest outbreaks would probably continue to occur even if vaccine coverage was at 100 percent.
Lawsuit Is Being Mounted Against New York City
In response to the latest attempt to force vaccinate individuals in New York, civil rights lawyer Michael Sussman is mounting a lawsuit on behalf of families who feel the order unlawfully targets the Jewish community.According to the Daily Mail,45 “Public health law experts say the case could swing either way; it will all rest on how deadly a judge believes measles to be.” If that’s truly the case, the outcome should be clear, seeing how no measles-associated deaths have been reported in the U.S. since 2015, and even before the measles vaccine became available, the death rate from measles was low.
Update: Vaccine Refusers in Arizona Battle Department of Child Services
In a related update, on April 9 I wrote about a case in Arizona where a SWAT team used a battering-ram to break down the door to the home of a family whose 2-year-old son had a fever. Their doctor reported them to state authorities for failing to take the child to a hospital — a decision the parents say they made because the boy’s fever was already coming down. They also said they feared “possible repercussions” for not having vaccinated the child.46The Department of Child Services (DCS) removed all three of the couple’s children. Arizona state Rep. Kelly Townsend, R-Mesa, has spoken out in defense of the parents, calling on the DCS to release the children back into the parents’ custody.
On April 11, AZ Central reported47 that Maricopa County Juvenile Court judge Timothy J. Ryan barred Townsend from attending the April 10 pretrial hearing. Townsend said she’s following the case to make sure the couple’s legal and constitutional rights are not violated by DCS or the court. She told AZ Central she was “stunned” by the judge’s behavior. The article goes on to state:
“Townsend had previously said she worried the parents … were unfairly targeted because they had not vaccinated their children. In Arizona, a parent may decline vaccinations for their child based on personal, religious or medical exemptions.
She called on DCS to ‘immediately return the children who are also being traumatized’ and said the case was ‘a complete miscarriage of justice and a shame to the state of Arizona.’
Townsend said state lawmakers have required a presumption of open child-welfare court hearings ‘to protect everyone — children, parents, the entire process.’ Barring lawmakers from a courtroom doesn’t serve the public’s interest, she said …
Michael Ramey, executive director of the Parental Rights Foundation, said the case has drawn national attention from families worried about their right to parent. ‘Far too often, family courts are closed to the public, not to protect the families but to protect the secret, underhanded goings-on of the family court system,’ he said.”
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