Why the Massachusetts Vaccine Bill Could Be Bad for the Immunocompromised
By Meryl Nass
The immunocompromised children whom the mandate bills are allegedly protecting will themselves be forced to be vaccinated, if CDC guidelines are used to determine medical exemptions
Here is the evidence that children who are currently exempt from vaccinations due to a medical exemption, such as previous treatment for cancer, bone marrow transplant, immune deficiency, or an autoimmune or rheumatologic disease such as systemic lupus erythematosus could, under the new rules, be forced to be vaccinated to attend school. See newest version of CDC recommendations in Table 4-1 and Table 4-2 "Conditions incorrectly perceived as contraindications or precautions to vaccination (i.e., vaccines may be given under these conditions)” of ACIP General Best Guidance for Immunization: Contraindications and Precautions
Children with immunodeficiencies (unless severe), autoimmune and rheumatologic diseases are now recommended for vaccinations. Most medical waivers are to be considered temporary. For children who have had severe reactions to previous vaccines (such as a seizure or 'collapse or shock-like state' after DTaP vaccination), they must now receive additional doses of the vaccines to which they reacted, because these adverse reactions were insufficiently severe. (See 2nd item in Table 4-2.) Children with autoimmune and rheumatologic diseases are supposed to receive vaccines, as are immune deficient children, unless their deficiency is rated severe.
While S2359 language is not specific about the medical criteria for exemptions, CDC guidelines for exemptions to vaccination are rapidly evolving and narrowing. Most Vaccine Information Statements (VIS’s) that are required to be given to parents before vaccinating their children, were changed on Aug 15, 2019 and October 30, 2019 and are still listed as “interim”.
S2359 Language:
(h) The department may add additional elements to the exemption application forms described in subsections (f) and (g).
(j) The department shall have the exclusive authority to approve or deny exemption applications… For medical exemption applications, the department shall approve all validly and accurately completed medical exemption applications; provided, however, that a generally accepted contraindication is the medical condition justifying the exemption. If another medical condition or set of conditions is provided as justification for the exemption, the department may approve or deny the exemption application based on a review by an expert licensed provider of the stated justification, or request more information about the participant’s medical history in order to make its determination.
- Note that an “expert licensed provider” (a nurse practitioner or PA, perhaps, whose scope of practice requires them to follow guidelines) being paid by the state, and who is not the child’s medical provider, probably won’t have discretion regarding exemptions and will likely use the CDC guidelines.
- Look at how few “generally accepted contraindications” CDC allows. See the language below in Chapter 4 of CDC’s recommendations to health care providers regarding medical exemptions, particularly
Table 4-2:
Contraindications and Precautions:
Updates Major changes to the best practice guidance in this section include 1) enhancement of the definition of a “precaution” to include any condition that might confuse diagnostic accuracy and 2) recommendation to vaccinate during a hospitalization if a patient is not acutely moderately or severely ill.
General Principles Contraindications (conditions in a recipient that increases the risk for a serious adverse reaction) and precautions to vaccination are conditions under which vaccines should not be administered. Because the majority of contraindications and precautions are temporary, vaccinations often can be administered later when the condition leading to a contraindication or precaution no longer exists. A vaccine should not be administered when a contraindication is present; for example, MMR vaccine should not be administered to severely immunocompromised persons (1). However, certain conditions are commonly misperceived as contraindications (i.e., are not valid reasons to defer vaccination).
Severely immunocompromised persons generally should not receive live vaccines (3). Because of the theoretical risk to the fetus, women known to be pregnant generally should not receive live, attenuated virus vaccines (4). Persons who experienced encephalopathy within 7 days after administration of a previous dose of pertussis-containing vaccine not attributable to another identifiable cause should not receive additional doses of a vaccine that contains pertussis (4,5). Severe Combined Immunodeficiency (SCID) disease and a history of intussusception are both contraindications to the receipt of rotavirus vaccines (6)…
Hospitalization should be used as an opportunity to provide recommended vaccinations.
For patients who are deemed moderately or severely ill throughout the hospitalization, vaccination should occur at the earliest opportunity (i.e., during immediate post-hospitalization follow-up care, including home or office visits) when patients’ clinical symptoms have improved. A personal or family history of seizures is a precaution for MMRV vaccination; this is because a recent study found an increased risk for febrile seizures in children 12-23 months who receive MMRV compared with MMR and varicella vaccine (36)…
Clinicians or other health-care providers might misperceive certain conditions or circumstances as valid contraindications or precautions to vaccination when they actually do not preclude vaccination (2) (Table 4-2). These misperceptions result in missed opportunities to administer recommended vaccines (37).
IMPLICATIONS:
- The proposed policy for exemptions can be restricted or changed at any time and is likely to follow CDC guidance.
- The Department will supersede all treating physicians in the granting of medical exemptions.
- Most contraindications and precautions are now deemed temporary. So, for example, a child with a bone marrow transplant receives intense immune-destroying treatment immediately before and after the procedure, but subsequently, after a period of months, usually requires less immunosuppression. Probably then vaccinations will be advised.
- Children are to vaccinated during hospitalizations. This has been the case for adults with flu and pneumococcal vaccines for about 10 years. The process involves a “standing order” signed by one physician in the hospital. Then, children can be vaccinated by nurses IN THE ABSENCE OF AN ORDER FROM THE TREATING PHYSICIAN, AND USUALLY WITHOUT THE PHYSICIAN BEING AWARE OR APPROVING.
- Severely immunocompromised persons can now received “killed” vaccines.
- Just one example: For DTaP (children receive 5 doses by age 5) even when seizures have occurred after a prior dose, when the child has a chronic seizure disorder or has a severe neurologic condition — these are no longer considered contraindications to vaccinations, as long as the neurologic condition has ‘stabilized'. See 4-2 chart listing contraindications:
https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.pdf#page=5
- "Severely immunocompromised persons generally should not receive live vaccines”. This suggests that unless severely immunocompromised, immune compromised children can receive all vaccines. It further implies that severely immunocompromised children can receive all “killed” vaccines, avoiding only those that are live. This will surprise parents of these children.
- Pregnant women may receive all “killed” vaccines except polio, which include influenza and TdaP, despite the fact that these vaccines have never been approved by FDA for use in pregnancy, and there is reasonable evidence that they are not safe.
- Most immune compromised children do not receive a diagnosis until after they have had multiple infectious disease episodes; by this time they will already have received the bulk of their required vaccinations. This is why treating physician discretion is so important in determining fitness for vaccination in “sickly” babies and young children who have not gotten their diagnosis yet.
- IMO this is not a problem that can be solved by altering the language in the Massachusetts bills. Even if wide medical exemption criteria are specifically allowed this year, there is nothing to stop a narrowing of medical exemptions in future. That is exactly what happened in California. Broad medical exemptions were retained in 2015’s vaccine mandate bill. They were significantly narrowed in 2019.
You are wrong about what an autoimmune disease is. It is the opposite of immune deficiency. Sometimes the medications do that to suppress flare ups, but the core problem is an over-active immune system. The immune system over-reacts to illness, why people with autoimmune diseases like Lupus can have organ failure from infections. If your daughter can breeze through any virus fast, that is wonderful and feel lucky about that. However, that means this statement can’t be true. “our immune systems are strong and capable, just have been tricked into too enthusiastic a reaction.” For people that really have an “too enthusiastic” immune system like Lupus, for example, a simple cold usually means higher fevers, rashes and probably a painful flare that can go on for weeks. It is really obvious when you have an over-active immune system. I have watched this in family. My kids don’t have this, just autism. Their immune systems are normal after vaccines. It is others in our family, so I see it all. The information linked here is just clarification and looks to me to be good advice for people with various types of immune issues. Hope this helps to understand other points of views.
Posted by: Concerned | December 18, 2019 at 06:19 PM
Concerned,
While some who have autoimmune diseases also have immune deficiency, in most cases we don't, and our immune systems are strong and capable, just have been tricked into too enthusiastic a reaction by triggers such as vaccines. My daughter with autism has always been as healthy as a horse, went through many viruses with fever and other symptoms for a few days, and then recovered, as have I. It's important not to confuse the two conditions: one is too weak an immune system while the other is too alert and active a one, and they do not lead to the same results.
Posted by: Cia | December 18, 2019 at 05:17 PM
I looked at the links and coming from a family with history of both autoimmune diseases and autism, this just looks like clarification to me that I found helpful. It’s basically what we do anyway to stay healthy. I think you are confused about autoimmune diseases.
*Any* virus/disease for someone with a real autoimmune disease can be deadly and fast. If you have Lupus, it is really important to get the flu shot, because the flu can kill you. A worst, the flu shot might make you feel a little achy and hot for a few days but that goes away. And then you get less flu and that is a blessing for anyone with an autoimmune disorder.
I would pause and think hard before yelling “evil”, when some of us who have seen first-hand what disease does to someone with an autoimmune disease. And maybe people with autism also deserve protection from risk of death or regression from disease. Have any of your kids had strep? Mine had and it was often, and it was scary in kids who already had autism. Yep, ER visits, high fevers, not eating or drinking, probably Pandas for a while on top of autism equals regression. Over use of antibiotics, and bad reactions to one of them. They are fine now, but now there is a vaccine for strep...
My family seems to have a long history of Lupus, autism and other neurological differences like dyslexia, like pre-1900 long history. Thank goodness, diagnosis is available so help is here now. You want to talk about “denial”? If only you had known anyone with Lupus in the last century, you would know how they were dismissed and what people called them. Same for autism then. This is 2019, not 1950. Try spending a week in an ER room watching a loved one with Lupus slowly die when the antibiotics stop working, and you may pause first before yelling “facism” and “abuse” at people who maybe are trying to protect children with an autoimmune disease. In my family the problems are better each generation, so I am not seeing some big world wide evil conspiracy. I see better diagnosis, acceptance and finally some help.
There have to be a more productive way for you to advocate against mandates that doesn't include misinformation and conspiracy theories.
Posted by: Concerned | December 18, 2019 at 02:18 PM
ALso above in the example of the parent whose child got molested and who won't accept it: They also don't want to give up the relationship to the abuser's family that telling the truth will entail. They sacrifice their child for the social connection.
Posted by: Debbie DeNile | December 18, 2019 at 02:26 AM
I think what is happening is literal insanity. And denial.
On the part of GOVT
It's the type of insanity that happens when an incarcerated person has been proven innocent (by confession and DNA) but the authorities will not let them go anyhow. The rationale is a deep fear that any challenge to the system will cause the system to tumble. The reality is that addressing challenges to the system can make the system more robust.
On the part of parents who won't accept this about their own child
It's the type of insanity that happens when someone's cousin molests her, but her mother cannot face telling the child's parents, so prefers to believe her own child lied or was confused. The rationale is that the terror of facing the fact that this terrifying crime has happened, that it happened on the parents' watch. The terror of facing the true loss to one's child, and the wish to pretend it had never occurred.
On the part of our fellow citizens
It's the type of insanity that happens when people are literally being sent away to "camps" to be gassed, but it's so painful and impossible to believe that the unaffected populace chooses to believe they are work camps, not death camps. It's easier. It's less painful. It's less terrifying.
Posted by: Debbie DeNile | December 18, 2019 at 02:24 AM
This is insanity.
Posted by: Leah | December 17, 2019 at 08:27 PM
First, the obvious:
Immune-compromised children are likely immune-compromised because of the vaccinations they have received, and/or because of the vaccinations their parents have received. Further vaccination will cause further harm, or death.
Second, legislators have no business mandating medical procedures. Their sole job is to protect our rights, not eliminate them.
Mandated medicine cannot exist in a free and ethical country.
Medicine cannot be practiced ethically in the presence of medical mandates.
The fundamental human right to bodily integrity and self autonomy cannot exist in the presence of medical mandates.
Parental rights cannot exist in the presence of medical mandates for children.
Religious freedom cannot exist in the presence of medical mandates.
The U.S. Constitution cannot be upheld in the presence of medical mandates.
Informed consent cannot occur in the presence of medical mandates.
Human decency cannot exist in the presence of medical mandates.
Exemptions to medical mandates are not acceptable or ethical. They are evidence that rights and freedoms have already been eliminated.
Medical mandates are evidence of tyranny, medical fascism, and evil.
Posted by: Laura Hayes | December 17, 2019 at 05:08 PM
I don't think population control is the intent, but rather the desire to do away with any vestige of an unvaccinated group, comparison with which shows that, in general, unvaxxed children are much healthier than vaccinated ones.
Posted by: Cia | December 17, 2019 at 11:42 AM
The more I learn about this madness the more I believe it has nothing to do with protecting the "immuno-compromised" .. it is far more likely the true intent of this vaccine madness is POPULATION CONTROL. The earliest and sicker our children become …. the less likely parents will have additional children ..
In my admittedly cynical opinion … POPULATION CONTROL is the only reason for this madness to be occurring all over the world.
Posted by: Bob Moffit | December 17, 2019 at 07:49 AM
Thank you Meryl Nass. Once again the lie has been given to the contention that mandates are there to protect the immunocompromised, when the immunocompromised are themselves being targeted with the products - this is the story of a morally unhinged bureaucracy which is absolutely intent on indiscriminate mayhem. First Do Harm is the watchword.
Posted by: John Stone | December 17, 2019 at 07:29 AM