NERMEEN SHAIKH: The federal government has confirmed over a hundred people across 14 states have now developed measles. Public health officials suspect the outbreak, which is concentrated in California, began when an infected person visited Disneyland in Anaheim in December. On Wednesday, Dr. Jeffrey Gunzenhauser, Los Angeles County’s interim health officer, updated reporters on the outbreak.

DR. JEFFREY GUNZENHAUSER: The outbreak of measles that we’re currently experiencing is the largest that we’ve had in this county and in this state in 15 years. Public Health is doing all we can to identify cases and to isolate contact so as to prevent spread; however, to end this outbreak, we need to do more, and we need help. I encourage everyone to review their vaccination status and, if needed, to get the vaccine now.

NERMEEN SHAIKH: Fifteen years ago, the Centers for Disease Control and Prevention proclaimed victory over measles, but in recent years there’s been an increase in outbreaks as a growing number of parents have opted not to have their children vaccinated, claiming a link between vaccines and autism. The prestigious medical journal Lancet published a study in 1998 showing such a link, but the study was later retracted and has been widely discredited. According to the CDC, one in 12 children born in the United States is not being vaccinated as recommended.

On Wednesday, two California lawmakers announced a bill to eliminate, quote, “personal belief exemptions” that allow parents to refuse to vaccinate their children. The state has allowed such exemptions since 1961, when it first required all public school teachers and students to be inoculated against polio. But since 2000, the rate of parents seeking exemptions has tripled to about one in every 40 children. Meanwhile, Senators Dianne Feinstein and Barbara Boxer asked state health officials to go further and eliminate, quote, “religious exemptions.”

AMY GOODMAN: Several potential Republican presidential candidates have also weighed in on the debate. On Monday, Kentucky Senator Rand Paul, an ophthalmologist, said he had heard of instances where vaccines caused “mental disorders.”

SEN. RAND PAUL: The hepatitis B vaccine is now given to newborns. We sometimes give five and six vaccines all at one time. I chose to have mine delayed. I don’t the government telling me that I have to give my newborn hepatitis B vaccine, which is—

KELLY EVANS: Understood.

SEN. RAND PAUL: —which is transmitted by sexually transmitted disease and/or blood transfusions. Do I think it’s ultimately a good idea? Yeah. And so I had mine staggered over several months. I’ve heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines. I’m not arguing vaccines are a bad idea; I think they’re a good thing. But I think the parents should have some input.

KELLY EVANS: OK.

SEN. RAND PAUL: The state doesn’t own your children. Parents own the children. And it is an issue of freedom.

AMY GOODMAN: That’s Senator Rand Paul on Monday. Since then, he has backtracked on his comments. On Tuesday, he was photographed receiving a hepatitis A booster shot at the Capitol to show his support for vaccinations. But Senator Paul has deep ties to vaccine skeptics. For 20 years, he was a member of the Association of American Physicians and Surgeons, which has backed a moratorium on vaccine mandates.

Meanwhile, another possible Republican presidential candidate, New Jersey Governor Chris Christie, was questioned about vaccines during his trip to England.

REPORTER: Do you think Americans should vaccinate their kids? Is the measles vaccine safe?

GOV. CHRIS CHRISTIE: Well, all I can say is that we vaccinate ours. And so, you know, that’s the best expression I can give you of my opinion. You know, it’s much more important, I think, what you think as a parent than what you think as a public official. … What I said was that there has to be a balance, and it depends on what the vaccine is, what the disease type is and all the rest. And so, I didn’t say I’m leaving people the option. What I’m saying is that you have to have that balance in considering parental concerns.

AMY GOODMAN: New Jersey Governor Chris Christie’s spokesman later said the governor believed kids should be vaccinated against measles.

Well, for more, we’re joined by several guests today. Later in the broadcast, we’ll speak with Mary Holland, the mother of a child with regressive autism who, she believes, was injured by the measles, mumps, rubella vaccination, known as the MMR vaccine. And we’ll speak with Dr. Paul Offit, professor in the Division of Infectious Diseases and the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia.

NERMEEN SHAIKH: But first we’re joined now from San Francisco by Dorit Reiss, professor of law at UC Hastings College of the Law. She specializes in legal issues related to vaccines, including exemption laws. She co-authored a report last year about, quote, “Funding the Costs of Disease Outbreaks Caused by Non-Vaccination.”

Professor Reiss, welcome to Democracy Now! So could you lay out for us what you think the key issues are regarding exemptions on children getting vaccinated?

DORIT RUBINSTEIN REISS: Of course. So, first, thanks for having me. The starting point is that we have a tension between three important values. The first is parental rights. Parents have rights. We care about their ability to take care of their children, guide their children. The second is the public health. We want to make sure that the public is protected against infectious diseases and other problems. And remember, the public includes other people. Other parents and other children have rights to be protected against diseases, as well. And the third is the right of a child. Given the incredible imbalance between the risks of vaccines and the risks of not vaccinating, with the risks of vaccines very small and the risks of not vaccinating much larger, there’s a strong argument that the right of health—right to health of a child means that the child should be vaccinated.

The combination of that is part of what supports the state’s right to impose school immunization requirements. School immunization requirements have been in the states since the 19th century, at least. And in the first years, we didn’t have exemptions. Exemptions are relatively new, during the 20th century. And in terms of exemption, as you probably know, we have three types. We have medical exemptions, which all states have. We have religious exemptions, or personal belief exemptions, also known as philosophical exemptions. And 48 states, every state except as West Virginia and Mississippi, have either a personal belief exemption or a religious exemption or both. The issues that come up is how much—how broad should the exemption be? And states vary dramatically on that. California, for example, is right now one of the broadest. And that’s part of the reason behind the change.

AMY GOODMAN: So, this issue, for example, of Mississippi, even though something like two dozen lawmakers wanted to support this exemption based on conscientious beliefs, they are in the vast minority here of states—48 states, as you said, allow for a conscientious objection—saying no public or private school student can go without a vaccine.

DORIT RUBINSTEIN REISS: That’s correct. Most states allow either personal belief or religious exemption, and that has been—started around the '60s, as well. Mostly, my best reading, it's because of the high value we place on personal freedom and on religious values. And I would expect that most states that adopted religious exemption expected them to be very limited, mostly to Christian Scientists and other small sects. That’s not what happened. In many states, religious exemptions are used much more broadly than by the very small sects that have strong views against vaccination. And our jurisprudence makes it very hard to limit religious exemptions only to those religions that really object to vaccination.

NERMEEN SHAIKH: But do you believe, Professor Reiss, that with the latest outbreak, now states will reconsider the extent and range of these exemptions?

DORIT RUBINSTEIN REISS: Yes, I think we are already seeing that. We’re seeing several states consider following the Western states—California, Oregon and Washington—and adopting an educational requirement, in addition to the personal belief exemption. We’re seeing this discussed in Maine, in Minnesota and in other states. And as you’ve seen, California has recently been reconsidering its own exemption law. So I would expect a move to more restrictive exemptions. And given what we’re seeing, the rise of outbreaks, that’s all for the good.

AMY GOODMAN: Well, explain why that is so important, why parents shouldn’t be able to opt out. In a moment, we’re going to hear from a parent who feels very differently from you.

DORIT RUBINSTEIN REISS: So, remember what we’re talking about. We’re not talking about telling parents, “Whether you wish to or not, we’re going to tie your child down and vaccinate them.” That’s something that, if done, is done in only extreme circumstances. We’re talking about the question whether a parent can send a child to a school, a public or private, unvaccinated. If a child is sent to school unvaccinated, first of all, the child herself is at risk. But in the atmosphere of the school, this child also puts others at risk. First, directly, if the child who is unvaccinated and higher risk of disease contracts the disease, they may infect someone else. And second, by reducing the level of immunity at the school by undermining herd immunity, the school is more vulnerable to an outbreak. And then—

AMY GOODMAN: When you say that—just for people who are not familiar with this debate, Professor Reiss, when you say “herd immunity,” explain what you mean.

DORIT RUBINSTEIN REISS: I hope Dr. Offit will talk about this more in detail, but basically the idea is that if we have a certain number of people immunized in the school, those people form kind of a ring around the few that aren’t immunized and prevent the disease from reaching them. That’s the idea of herd immunity. If you have enough people immunized, even if one person who is infected comes into the school, the disease won’t spread.

NERMEEN SHAIKH: You’ve also suggested, Professor Reiss, that parents who choose not to have their children vaccinated are almost always negligent under the law. So do you think that there should be legal consequences for parents who choose not to have their children vaccinated?

DORIT RUBINSTEIN REISS: Yes, I do. And my point of view is less focused on the parent that doesn’t vaccinate—we need the behavior to be negligent to impose consequences—but more on those harmed by the decision. If one parent chooses to reject expert opinion, to choose for their own child the bigger risk, the risk of not vaccinating, over the smaller risk of vaccinating, and something happened that harms another family, I think it’s unfair to make the other family pay for the costs of the first family’s decision. Again, think about the situation. A child is left unvaccinated, contracts measles, passes it to an immunocompromised child that suffers serious complication. The family of that child has emotional costs. The child that suffers pays a physical price. And they have financial costs. Why should they have to pay for someone else’s choice?

NERMEEN SHAIKH: Is there any kind of legal precedent for that, though?

DORIT RUBINSTEIN REISS: Not at this point. The case has simply, to my knowledge, not come up. We have other cases of a liability for infectious disease. We have a case of a liability when someone went into a boarding house that has—produces whooping cough and wasn’t told that there was whooping cough, and his children caught whooping cough. We have liability for sexual-transmitted diseases, if there was negligent nondisclosure. So we have a history of liability for infectious disease, but this context hasn’t come up yet.

AMY GOODMAN: Are you saying that parents—what should happen? What should be the consequence for a parent who doesn’t immunize their child, vaccinate their child? Are you saying they should be jailed?

DORIT RUBINSTEIN REISS: No, I’m not. There’s a whole range of possible consequences. I’ve heard the idea of jailing parents in that situation, and I think that’s going substantially too far. A parent making the decision is making the decision on their best judgment. There’s a lot of misinformation out there. And it’s natural for the parents to make their own decision for their child. And it’s a decision that puts their own child, first and foremost, at risk. I don’t think the level of culpability is high enough to justify criminal law.

But I think it’s fair to tell the parents, “You made the decision, you internalize the consequences. Take personal responsibility. Nobody else should have to pay for that. You’re going against expert opinions. You’re going against the science. You’re going against the credible data. Why should others carry the cost?” And that’s true for another family, if they’re infected, or the public health. These outbreaks cost a lot of money to contain. And that money comes from somewhere. Public health departments are cutting other budget and not doing other things in order to track down and contain measles. Why should the public pay, rather than those that made the decision that led to the outbreak?

AMY GOODMAN: Dorit Reiss, we want to thank you for being with us, professor of law at UC Hastings College of Law, specializing in legal issues related to vaccines, including exemption laws. We’ll link to your piece, “Funding the Costs of Disease Outbreaks Caused by Non-Vaccination.” When we come back, a very different view. We’ll be joined by another lawyer, by Mary Holland, a research scholar at NYU School of Law, adviser to Health Choice. This is Democracy Now!, democracynow.org, The War and Peace Report. Back in a minute.

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AMY GOODMAN: This is Democracy Now!, democracynow.org, The War and Peace Report. I’m Amy Goodman, with Nermeen Shaikh.

NERMEEN SHAIKH: As a growing number of parents raise concerns about vaccinations, we speak now with Mary Holland. She’s the mother of a child with regressive autism who, she believes, was injured by the MMR vaccination. Holland is a research scholar at NYU School of Law and adviser to Health Choice. She’s also a contributor to the blog, “Age of Autism,” and the co-editor of the book, Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children.

Mary Holland, welcome to Democracy Now! Could you talk about your position on vaccinations?

MARY HOLLAND: Yes, absolutely. So, all vaccines, like prescription drugs, are considered unavoidably unsafe. They carry known risks and unknown risks. There’s no question—and I don’t believe Professor Reiss or Dr. Offit would disagree—that death is caused by some vaccines to some children, and severe injury, brain damage in particular. That’s indisputable. And for that reason, industry and the medical profession were given by Congress virtually blanket liability protection. So we have now an industry with high profits and exceedingly low litigation risks. I think that should set off some alarm bells for us, as it is. I also think that the global standard for ethical medicine today is prior, free and informed consent. And what Dr. Offit and Professor Reiss are suggesting is that there should be no free consent for vaccination. I think that’s a very serious departure from medical ethics, and we have to look at it for what it is. This is not just about tort liability. It’s about informed consent.

AMY GOODMAN: What about the issue of when a child goes to school, who might be infected because they have not had a vaccine, that they then will infect other kids?

MARY HOLLAND: Yeah. I think infectious disease is real, Amy. Infectious disease is a serious problem. I think what you do when a kid is sick is the kid stays home from school. You make sure that you have medical leave for parents. You make sure that there’s healthcare for children. And I believe in quarantine. I have no problem with the government, in certain circumstances that warrant it, saying people must stay home, or they even must go to other places. But I absolutely have a problem with the idea that the state can force, through criminal and civil sanctions, that—or failure to educate children, that they have to take compulsory medical interventions.

AMY GOODMAN: Talk about your own personal story, Mary Holland.

MARY HOLLAND: Oh, just very briefly, my interest in this, as a lawyer and as an advocate, stems from my personal experience. I watched a child reverse in their development. That’s one of the most horrible things any adult or parent can see. You don’t want to see, and it is not normal to see, a child lose all speech, lose all sleep, lose all bowel function, lose all eating function. And that’s what I lived through.

AMY GOODMAN: With your child.

MARY HOLLAND: With my own son. I’m very fortunate that my son has substantially recovered over the years, but through painful efforts, great expense. And his injury is not categorized anywhere. Doctors don’t generally perceive things as vaccine injury. But there is no other plausible explanation for what happened to my child.

AMY GOODMAN: What happened?

MARY HOLLAND: So there was a temporal association. He had received his standard vaccines, all of which—most of which contain thimerosal, so that’s mercury, ethylmercury. There’s no question that that can compromise the immune system. And then he received the MMR vaccine, which is three live viruses simultaneously. And he, within a very short period, regressed precipitously. Precipitous regression.

AMY GOODMAN: At the age of?

MARY HOLLAND: Two-and-a-half. He got his vaccine slightly before that juncture. It’s the only plausible explanation for what happened to him. He had EEGs that were abnormal. He had epileptiform brain waves. This was all in very close temporal association. So, then, when I studied what do—what does brain injury look like? And I studied the federally funded Vaccine Injury Compensation Program. Lo and behold, encephalopathy, brain swelling, brain damage is a common side effect among side effects from vaccines, as is autism. That is covered up. The federal government doesn’t track it. They would say that there’s no association. If you look at compensated cases of brain injury in the Vaccine Injury Compensation Program, you will see autism left, right and center. So, I think what happened to my son is what I’ve heard happened to thousands of parents. I work in this area. It’s not an atypical story. One story is an anecdote. What then should happen is there should be rigorous science. That science hasn’t been done.

NERMEEN SHAIKH: Why do you think that science hasn’t been done?

MARY HOLLAND: I think that’s a great question. I think that’s a question I’d love to hear you put to Dr. Offit. He would say that that science has been done. One of the key scientists in the autism-vaccine science is Poul Thorsen. He’s an indicted felon. He’s in Denmark. The Department of Justice has done nothing to bring that man back. Another key question about the corruption is Dr. William Thompson, in the CDC, has come forward and said that he colluded with other key scientists to mask a signal that vaccines and autism are linked in African-American boys who got the MMR before age three—before age five. He has now been granted, according to one report, immunity and can testify in Congress. I hope to God we have that hearing. This is critical. One in 68 kids has autism. There’s plausible science that there’s a link. It needs to be followed up, not suppressed.

AMY GOODMAN: What is the most convincing scientific study, to you, that makes a link?

MARY HOLLAND: Ah, there’s many. There’s many in my book. We include 20 scientific abstracts. One is Ray Palmer’s work showing environmental mercury. The closer somebody lives to the environmental source, the higher the rates of autism. Another is related to special education reports. Boys, neonates, who received the Hep B vaccine were nine times more likely to end up in special education, three times more likely to have an autism diagnosis. There are many pieces of science that suggest to us that there is a link. We need to look at the children who regressed. We need to look at the crash reports, the people in the Vaccine Injury Compensation Program. Just last year, in 2014, a child was compensated $500,000 because she died after getting the MMR. This is not controversial.

AMY GOODMAN: So what should happen with the crisis of measles outbreak right now in this country? Are you opposed to children getting the MMR vaccine?

MARY HOLLAND: No, I’m not. I’m pro-choice, Amy. I’m not anti-vaccine. That label is thrown around as a way to marginalize people like me. I’m not anti-vaccine in the slightest. I’m pro-choice. I think parents have to make informed choices. That’s the standard of ethical medicine.

So what should happen right now? Yeah, look at your titers. See if you need a measles vaccine, if you think you should. I think the industry should make measles, mumps and rubella available separately. If somebody has a low titer for measles, why should they go get an MMR? They should get what they precisely need. I think people with young children, who are too young to be vaccinated because the risks of injury are so great, they probably should go to places like Disneyland, where there will be people from foreign countries where measles is endemic. We don’t have herd immunity for measles. We don’t have herd immunity for any of these childhood diseases.

AMY GOODMAN: And again, explain what you mean by “herd immunity.”

MARY HOLLAND: What I mean by that, herd immunity means that everybody is—that because most people vaccinated, it’s not possible that people—that the disease will spread. That’s just not possible when something like measles is in the Philippines, it’s in Germany, it’s in France. People come and go. Unless you’re going to seal the borders, we don’t have herd immunity. And no vaccine is perfectly effective. There may be 85 to 95 percent effective. They wear off over time. That’s why there’s a mandated MMR booster. We don’t have herd immunity. We have herd effect. So people have to make up their own minds. And voluntary choices, like in Australia, like in the U.K., like in Japan, like in Sweden, like in France, like in Germany, they achieve the same results as we have. We would be so much better—

NERMEEN SHAIKH: So, in all those countries—

MARY HOLLAND: There is not mandates for school. In none of those countries are there mandates. In most of those countries, there are blanket rights of conscientious objection. We should have the same thing. There should be a right of exemption that is federal in this country.

AMY GOODMAN: So this has entered into the presidential debate.

MARY HOLLAND: Yes.

AMY GOODMAN: Possible presidential candidates.

MARY HOLLAND: Yes. Yes, it has.

AMY GOODMAN: Chris Christie—

MARY HOLLAND: Yes.

AMY GOODMAN: —ironically, the governor of New Jersey, who said that the medical professional who came back from Africa, who was Ebola-free, should be quarantined, then said he—well, he’s had to walk back these comments about parents having choice around vaccine. Then you have Kentucky senator and doctor Rand Paul making the point you do. He says that kids who have had vaccines have then had mental disorders.

MARY HOLLAND: Well, I didn’t use the term “mental disorder.” He did. But this is not my opinion, Amy. If you look at the Vaccine Injury Compensation Program, people have been compensated by Health and Human Services, with their counsel Department of Justice, for brain damage, for encephalopathy. Encephalopathy is cognitive impairment usually associated with behavioral disorders, OK? So, I think it’s great that this is a 2016 presidential issue. I think that childhood health is critical. I think the role of vaccines is grossly understudied, and we must look at this. Chronic health disorders are about 50 percent of American kids today. Is there a relationship with vaccines? I don’t think we know the answer to that. We don’t even have a decent study of vaccinated versus unvaccinated health outcomes in children.

AMY GOODMAN: What do you mean?

MARY HOLLAND: Rudimentary science. We have not looked, either retrospectively or prospectively, at what is the health of children who have gotten the CDC-recommended schedule, what is the health of children who have gotten a state mandate, and what is the status of children who are unvaccinated. That’s a totally doable study, and that’s never been done.

AMY GOODMAN: Your response to those who call you and the people, the organizations you’re a part of, “anti-vaxxers”—

MARY HOLLAND: Mm-hmm, yeah.

AMY GOODMAN: —sort of see you as kind of climate change deniers, that the overwhelming scientific body of evidence goes in the other direction, and that the time when a child is getting these vaccines is also the time if they might develop autism, and so the fact that these are, you know, contemporaneous—

MARY HOLLAND: Right.

AMY GOODMAN: —does not mean that one causes the other?

MARY HOLLAND: Amy, I agree that, you know, correlation is not causation. We have to study this. I couldn’t agree more. But in the 1980s—that’s a mere 30-plus years ago—the rate of autism was one in 10,000. It’s now, according to the CDC, one in 68. And that’s looking at eight-year-olds, you know, and it’s four years to do the study. We don’t even know what the rate is among two-year-olds today. To say out of hand that vaccines could be playing no role, in my view, is reckless and irresponsible, and it’s not looking at the existing science. In our book, we include 20 abstracts. There’s far more. There’s good science that shows how plausible a connection is. But it needs more rigorous study.

NERMEEN SHAIKH: Could you talk about—you’ve mentioned this—the importance of the schedule of vaccines? So it’s not so much that certain vaccines necessarily not be given at all, but that they be spaced differently.

MARY HOLLAND: Well, yeah. I mean, there’s not a lot of rigorous science showing why the schedule is what it is. The way that vaccines are tested, before they’re recommended and then mandated, is they’re tested individually. They’re not tested as part of a schedule. As Senator Rand Paul said, he criticized the recommendation, and the mandate in most states, for a hepatitis B shot for infants, you know, one and two days old. Hepatitis B is sexually transmitted. What is the rationality for giving a baby a vaccine that will wear off by the time they’re sexually active?

AMY GOODMAN: What do you mean by the single doses rather than MMR, M then M then R?

MARY HOLLAND: Well, MMR is measles, mumps, rubella. But at the day of—while a baby is in the hospital, the federal recommendation is that they receive a hepatitis B vaccine. That, to me, is irrational. And that’s one example of what’s wrong with our vaccine schedule. Again, many other developed countries have no mandates for hepatitis B. It’s something you give to somebody whose mother is Hep B-positive or somebody who’s engaging in very risky behaviors where there might be transmission.

AMY GOODMAN: I want to get your comment on President Obama—

MARY HOLLAND: Sure.

AMY GOODMAN: —who talked about—has said his message to parents was, quote, “get your kids vaccinated.”

PRESIDENT BARACK OBAMA: Measles is preventable. I understand that there are families that, in some cases, are concerned about the effect of vaccinations. The science is, you know, pretty indisputable. We’ve looked at this again and again. There is every reason to get vaccinated. There aren’t reasons to not get vaccinated.

SAVANNAH GUTHRIE: Are you telling parents, “You should get your kids vaccinated”?

PRESIDENT BARACK OBAMA: You should get your kids vaccinated. It’s good for them. But we should be able to get back to the point where measles, effectively, is not existing in this country.

AMY GOODMAN: Mary Holland, what’s your response to President Obama?

MARY HOLLAND: I think it’s extraordinary that we need the president to tell parents to get their children vaccinated. I think that if you look at it in isolation, yes, the vaccine usually works against measles. Are there risks with the vaccine? Yes, there are. And should we look at that in isolation? No.

AMY GOODMAN: Are you getting your kid vaccinated?

MARY HOLLAND: My child has been vaccinated with the MMR, obviously. He suffered—he suffered developmental regression shortly thereafter.

AMY GOODMAN: But for other parents, would you say do or don’t?

MARY HOLLAND: I would say it’s up to them and their doctors and their healthcare practitioners. I think it’s an individual choice.

AMY GOODMAN: Mary Holland, we want to thank you for being with us, research scholar at NYU School of Law, adviser to Health Choice, a contributor to the blog, “Age of Autism.” She’s co-editor of the book, Vaccine Epidemic: How Corporate Greed, Biased Science, and Coercive Government Threaten Our Human Rights, Our Health, and Our Children. And she is the mother of a child with autism who, she believes, was injured by the MMR vaccine. This is Democracy Now!, democracynow.org, The War and Peace Report. When we come back, we’ll be joined by Dr. Paul Offit, professor at University of Pennsylvania, author of, among other books, Deadly Choices: How the Anti-Vaccine Movement Threatens Us All. Stay with us.

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AMY GOODMAN: We go to Philadelphia, where we’re joined by Dr. Paul Offit, professor in the Division of Infectious Diseases and the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. Dr. Offit is also professor of vaccinology and a professor of pediatrics at the University of Pennsylvania School of Medicine, also the co-inventor of the rotavirus vaccine, RotaTeq, recommended for universal use in infants by the CDC, author of numerous books, including Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure and Deadly Choices: How the Anti-Vaccine Movement Threatens Us All.

Well, Dr. Offit, you have heard our show today. Can you talk about why you feel vaccines are so important?

DR. PAUL OFFIT: Well, because they’ve saved our lives. If you look at how long we lived, say, a hundred years ago, we lived 30 years less long—less long then than we do today. So, the reason—the main reason for that is vaccines. We no longer have to see 50,000 children hospitalized and 500 die from measles every year as we did before the vaccine. We no longer have to see diphtheria as a common killer of teenagers. We no longer have to see 20,000 children suffer severe and permanent defects caused by rubella virus, so-called German measles virus. We no longer have to see children die or suffer permanent disability from bacterial meningitis from diseases like meningococcus, pneumococcus, Haemophilus influenzae type B. Vaccines, I think, were the single best preventive measure that we’ve ever had. The problem, as clearly reflected by your previous caller, is that we don’t appreciate them. I think vaccines are a victim of their success, and they’re obviously being blamed for things that they don’t cause.

AMY GOODMAN: Well, what about the issue of the connection between MMR and problems in children? Our last guest, Mary Holland, talked about her own son who ended up with autism, and she feels there was a direct connection between MMR and autism.

DR. PAUL OFFIT: I think it’s perfectly reasonable for a parent to ask the question: “My child was fine, they got a vaccine, then they weren’t fine anymore. Could the vaccine have done it?” As Ms. Holland has argued, it is a temporal connection. But it’s not a causal connection. I mean, there have now been 14 studies done, looking at hundreds of thousands of children either who did or did not receive the MMR vaccine, and the results have been clear and consistent and reproducible: MMR vaccine does not increase your risk of autism. All you do by choosing not to get an MMR vaccine is increase your risk of getting measles, mumps or rubella.

You know, what is upsetting to me about this—and I honestly think the last 10 minutes of your program set a new record for consecutive statements that were incorrect—is that when you do the science, when you do these excellent, retrospective, huge studies that answer the question, that people don’t believe them. And the reason Ms. Holland doesn’t believe them is she’s a conspiracy theorist. I mean, listen to what she says. There’s this guy who was a fraud, and then there’s this whistleblower at the CDC. I mean, there are 14 studies on three continents involving hundreds of thousands of children. Is she claiming that there is a massive international conspiracy to hide the truth? I think she is. And that’s what makes her, to me, a classic anti-vaccine person.

AMY GOODMAN: Well, what about the issue, for example, of the combined vaccine, the MMR—measles, mumps, rubella—the argument for separating them? And what was the—why were they put together? Talk about how vaccines came to be what they are and why they are mandated or not mandated in this country.

DR. PAUL OFFIT: Right, so, the measles vaccine was developed in 1963, the mumps vaccine in '67. There was a second measles vaccine, the last, best vaccine, in ’68. And then we had the rubella vaccine in ’69. In 1971, those three vaccines were put together because you could, because you could do it safely, as was proven, that when you combine those vaccines, that you didn't interfere with or change the safety profile or immunogenicity profile of those vaccines when they were given separately. So now you had to give one shot instead of three. Now we have a two-dose vaccine, so that means you give two doses instead of six. There’s no reason to separate those vaccines out, because all you do by separating them out is increase the number of shots without in any way changing the safety profile.

In terms of mandates, your question about mandates, I think you’re starting to see why it is that mandates are so important. There is no good reason to choose not to get a vaccine. If you’re choosing not to get a vaccine, then you’re basing it on a misperception or a series of false beliefs, as Ms. Holland has, about vaccines. She says, for example, that vaccines are never tested together. Of course they’re tested together. You cannot put a new vaccine on the schedule without proving that your vaccine doesn’t interfere with the safety and immunogenicity profile of existing vaccines, and vice versa. Those are called concomitant use studies. Ms. Holland says that there have been no studies looking at sort of relatively vaccinated or unvaccinated children. That’s not true. There are several studies that have looked at that, including that of Peter Aaby, which suggests that the highly vaccinated child has better health than the child who is less vaccinated.

I mean, Ms. Holland says that the hepatitis B virus is only transmitted by sexual contact. That’s not true. Children less than 10 years of age in this country, before the hepatitis B vaccine, 18,000 would suffer hepatitis B. Half got it by traveling through a birth canal that was infected with hepatitis B, but the other half got it from relatively sexual contact—relatively casual contact. You know, those children who were less than 10 weren’t getting it from getting tattoos or using intravenous blood, intravenous blood transfusions or intravenous drugs, and they certainly weren’t getting it from sexual contact. They were getting it from Uncle Bob, who had hepatitis B but didn’t know it, who gives them a little kiss. That’s how they were getting hepatitis B.

So there’s so much misinformation out there that causes people like Mary Holland to make bad decisions for her children. If vaccines were unsafe, I think this would be an interesting and reasonable discussion. But vaccines are remarkably safe and remarkably effective. And when you watch herd immunity erode, as it clearly is in this country—we eliminated measles by the year 2000, and now, because parents are choosing not to give vaccines based on their false, or at least ill-founded, concerns, other people are suffering. I think Professor Reiss, who was just spot on, on what she said earlier, I think, said it best. Is it your right to catch and transmit a potentially fatal infection? I think the answer is no.

NERMEEN SHAIKH: But, Dr. Offit, can you explain how it is that so many parents came to make an association between vaccines and autism, given all of the scientific research and the studies that you cite? Is it because such a large number of children were suffering after having received vaccines? Or what do you attribute this to?

DR. PAUL OFFIT: I think it’s—the analogy could be made for diabetes in the 1800s. In the 1800s, people suffered diabetes, and nobody knew why. And many things were blamed, including vaccines, right? “I got a vaccine. Now, you know, within six months, my child has type 1 diabetes. I think the vaccine did it.” And at the time, it was a smallpox vaccine or the rabies vaccine, which was introduced in the late 1800s. Vaccines are always sort of the universal scapegoat. Then, in 1920, Banting and Best isolated insulin, and all that nonsense went away.

I think maybe this nonsense doesn’t go away until we clearly have a cause or causes for autism or, I think much more difficult, a cure for autism. Then it will all go away. I mean, clearly, if you look at the science of autism, it’s clearly at least genetic. I mean, we know that it appears to be an in utero event. So, I don’t think there’s any evidence that an environmental influence, especially vaccines, have ever been shown to increase the rate of autism.

But, you know—and I think the answer to the question, “Why is it that people aren’t convinced?” I think the media is perfectly willing to put the sort of, you know, man-bites-dog story out there, which is Mary Holland’s rant that vaccines cause autism, and she knows it because that’s what she saw. You know, I’ll give you a story. My wife is a private-practicing pediatrician. She goes into the office one day, and she’s helping the nurse give vaccines. There’s a mother who has a four-month-old that’s sitting on her lap along the side wall. While my wife was drawing the vaccine up into the syringe, the four-month-old had a seizure, went on to have a permanent seizure disorder, epilepsy. If my wife had given that vaccine five minutes earlier, I don’t think there are any amount of statistical data that would have convinced that mother of anything other than what she believed to be true. “What do you think? I’m stupid? My child was fine. They came in here, they got a vaccine, now they have epilepsy. I know what I saw”—even though it was a temporal association.

AMY GOODMAN: I mean, to be fair, we wanted to have both of you on together to have a conversation, because there are many in this country, and a growing movement of parents, who are deeply concerned. But you wanted to have this conversation separately, Mary Holland and you separately. So, it’s important to, I think, have this kind of dialogue on all of these issues. Dr. Offit, on this issue of vaccines now being—

DR. PAUL OFFIT: I’ll tell you—can I just address that?

AMY GOODMAN: Yes, sure.

DR. PAUL OFFIT: Can I address that for one second? I think that it is not important to have a debate about the science with someone who clearly doesn’t know the science. I’m sorry, Ms. Holland misrepresented the science again and again and again. I don’t think that in any way helps your viewer. I don’t think it’s fair to have a debate where two sides are presented, when only one side is really supported by the science. I think—I’d like to think we’re beyond that.

AMY GOODMAN: But I think what’s—

DR. PAUL OFFIT: If you ask the question, why is it that—go ahead.

AMY GOODMAN: Dr. Offit, what I think is important, it’s not only about science. We’re talking about science. We’re talking about the practice of medicine in this country. We’re talking about public policy. I mean, after all, this has now become a presidential campaign issue, with possible presidential candidates taking on the issues. And I want your comment on that. But you’re combining all of this, and it’s important to bring all the various expertises of parents, of lawyers, of doctors together in a conversation on these issues.

DR. PAUL OFFIT: Right, but what Ms. Holland does is she presumes to represent the science. I actually agree with you. I think we’re at a tipping point. And I think the critical discussion now is the one that was brought up by Professor Reiss, which is: How far do we go here?

I mean, I happen to have survived the 1991 Philadelphia measles epidemic. I was a doctor at Children’s Hospital of Philadelphia. During a four-month period in Philadelphia in 1991, we had 1,400 cases of measles and nine deaths. And it centered on two fundamentalist churches that chose not to vaccinate their children. We got to the point of compulsory vaccination. And believe me, no one in Philadelphia had a problem with that. It was—people were so scared of that disease, because it was so common and so fatal, that we got to compulsory vaccination. By that, I mean those children in that school who were unvaccinated were made wards of the state, vaccinated, and then given back to the parents. And the American Civil Liberties Union, who is perfectly comfortable representing pretty unpopular causes, never stepped in. They were asked to step in by Charles Reinert, who was the pastor of one of those churches. And remember, there was a religious exemption to vaccination on the books for 10 years at the time this happened. And the American Civil Liberties Union said, “While we believe it is your right to martyr yourself to your religion, we don’t believe it is your right to martyr your child to your religion.” And I give the ACLU credit for that, at the time. But you had to be here. I’m not sure they would feel the same way.

How bad does it have to get before you say, you know, it is your right to swing your fist wildly, but that right ends at the tip of my nose? And I think that’s what’s true here. We were offended when that man got on a plane with tuberculosis and was coughing and had, you know, so-called multidrug-resistant tuberculosis. We thought he had done something that was awful. And I think this is no different. I don’t think it is your right to expose your child needlessly to infection and to expose those with whom they come in contact needlessly with infection. And if vaccines were a safety issue, I would get it. But it’s not. They’re remarkably safe.

AMY GOODMAN: What about the vaccine compensation board? Talk about what that is all about, how families get compensated.

DR. PAUL OFFIT: Yes, so, in early—in the early 1980s, there was born the notion, which was since refuted by scientific study, that the whole-cell pertussis, or whooping cough vaccine, caused permanent brain damage. It was a documentary that was made by Lea Thompson, a veteran newsmaker from NBC, called DPT: Vaccine Roulette. And it showed a series of children who supposedly were permanently brain-damaged by pertussis vaccine. Now that was wrong. Study after study showed it was wrong, but it was a vivid image, and it brought a ton of litigation against pharmaceutical companies that made vaccines, to the point that they were out. I mean, they weren’t going to make vaccines for American children anymore, because they didn’t want to have to fight all this in civil court based on a false notion, that was vaccines were causing permanent harm. And, you know, juries were perfectly willing to side against the pharmaceutical companies. And so, what was put in place was the National Childhood Vaccine Injury Act in ’86, which became the Vaccine Injury Compensation Program in 1988, to basically give people who may have suffered a permanent harm from a vaccine compensation. Fair enough. But that is not the place to determine scientific truths.

I mean, the—so, for example, there was a rotavirus vaccine that was introduced in this country in 1998. It was on the market for a year. It was found to be a rare but real cause of intestinal blockage, something called intussusception. I think parents were fairly compensated for that, because I think if we’re asking our citizens to get vaccines, there should be this sort of compensation system. But believe me, there are many compensations in that program that are wrong. I mean, they have compensated people for multiple sclerosis caused by hepatitis B vaccine, when it clearly doesn’t do that, and two New England Journal of Medicine studies show it don’t, which is to say that the courts are not a place to determine scientific truths. Scientific studies are the place to determine scientific truths. The courts are simply a place to settle disputes. A lawyer shouldn’t be making a decision about whether or not one thing causes another. I think that’s the province of scientists and academicians.

AMY GOODMAN: We have 10 seconds.

NERMEEN SHAIKH: Dr. Offit, yeah, just very quickly before we conclude, do you think that there should be compulsory vaccination across the U.S. now?

DR. PAUL OFFIT: I agree with—I agree with Professor Reiss. I think we should certainly, as a first up, make it much more difficult to get a philosophical or religious exemption, both of which, as far as I’m concerned, are misnamed. I mean, philo, love, sophos, wisdom—

AMY GOODMAN: We have five seconds.

DR. PAUL OFFIT: Where’s the wisdom that says—sorry. And, you know, it’s an unreligious act to get—to not get a vaccine. But I think we should make that harder. And yes, I think, eventually, we should make it so that you pay some sort of price for doing something that puts your child and other people at risk.

AMY GOODMAN: Dr. Paul Offit, we thank you for being with us, of the University of Pennsylvania.