However, since that time an anti-vaccine movement has sprung up internationally, which has lowered the percentage of children vaccinated at levels that are alarming the medical community.Earlier this year, there was a surge of measles cases in Washington State. The vaccination rate across Clark County, Wash. was 78%, but some schools in the area have had rates under 40%, according to the Clark County Public Health website. Washington State legislators introduced bills to deny parents refusing to vaccinate their children for personal and philosophical reasons. Washington was one of only 17 states that allowed for that exemption. The bills, supporters explained, was to prevent a full-blown epidemic in the Pacific Northwest. After a contentious debate and hearings, the bills were passed and signed into law by Governor Jay Inslee. What follows are the views of two Physicians who have been personally touched by the vaccine debate in Washington State.

Dr. Gary Goldbaum, M.D.

Gary Goldbaum, M.D., and his brother are polio survivors. Before vaccines were available, Dr. Goldbaum and his brother contracted poliomyelitis. “I have a photo of my brother in a wheelchair and braces while he endured months of physical and occupational therapy to support his recovery,” Dr. Goldbaum said. “The days of iron lungs to treat polio are now behind us—thanks to vaccines.”

Dr. Goldbaum represented the Washington State Medical Association (WSMA) in Olympia testifying before the Senate Health & Long Term Care Committee giving his firsthand account of the life-threatening dangers that diseases, once considered nearly eliminated, can pose to a whole new generation of children. “Before vaccines were available, infectious diseases including measles killed thousands and hospitalized tens of thousands nationwide. We must do all we can to keep that Pandora’s box from opening again in our state,” he said.

Goldbaum, a former health officer and director of the Snohomish Health District, remembers the pertussis (whooping cough) outbreak and the H1N1 influenza pandemic, when unvaccinated Snohomish County residents fell victim to these dangerous diseases, and some died. “I do not wish to see such events like this occur again in our state,” he said.

Goldbaum echoed WSMA, together with the Washington Chapter of the American Academy of Pediatrics (WCAAP), in support of the elimination of personal and philosophical vaccine exemptions for school, childcare and preschool immunization requirements to strengthen Washington State’s immunization policy and protect its communities. Goldbaum made the case that vaccines are safe and they are rigorously tested for safety before being approved for use.

Testimony from Goldbaum and other vaccine advocates maintain that vaccinations are very important in protecting most vulnerable citizens—newborns and those with compromised immune systems, such as persons undergoing cancer treatment—who cannot be vaccinated. In order to protect them, it’s critical that more than 95% of the population is vaccinated. This is often referred to as “herd immunity.” Unfortunately, Washington state has previously failed to reach this level of vaccination of its population, and one of the primary reasons is parents exempting their children for personal and philosophical reasons. Washington is one of only 17 states in the nation that allow for a personal/philosophical exemption.

“We know that if these personal/philosophical exemptions are eliminated we will see vaccination rates rise, because states that have eliminated this exemption have proven it,” said Tom Schaaf, M.D., president of the WSMA. “And when vaccine rates rise, not only are vaccinated people protected, but so are others in the community who cannot be vaccinated, because their potential for exposure to dangerous diseases drops as the number of vaccinated people increase in their community.”

Dr. Kelly Larson, M.D.

“The latest measles outbreak in Washington state brings back memories of a place and time where I witnessed firsthand how deadly that disease can be.

In 2012, I was an active-duty navy Physician deployed on a medical mission in Nigeria. I was discussing the day’s events with the local public health nurse; in particular, a case of measles in an infant who had almost no hope of surviving.

The nurse asked me ‘Is it true that in America, anyone who wants a measles vaccine can get it for free, but some people refuse because they think it causes autism?’ I answered in the affirmative, but for her and her associates, it was impossible to imagine that people who had access to a vaccine would choose not to take advantage of it.

Later that day, I went to use the restroom. When I opened the door, a goat standing on top of the commode greeted me with a bleat. Startled, I audibly overreacted. But in that moment, it occurred to me that even here in this place with a tin roof, a dirt floor and a goat in the john, they understood that vaccines are safe and necessary to save lives. I realized then that we’ve lost sight of just how deadly this 100% preventable disease can be.

And that’s why I took time away from my family Medicine practice at Olympia Medical Center to testify in support of House Bill 1638 in front of the House Health Care & Wellness Committee. Lawmakers were to receive public testimony on a bill that would remove the personal or philosophical exemption from the MMR (measles, mumps and rubella) vaccine. If this bill passes, children in Washington state’s public schools can only opt out of MMR vaccine with medical consent from their Physician.

I arrived an hour early, confident I would arrive in plenty of time to register to give public testimony. I thought only a dedicated few people would stand in line for an hour in 30-degree temperatures. I was right about the ‘dedicated’ part, but wrong about the ‘few.’

By 7 a.m., hundreds of people were in line, and they were nearly all anti-vaccine advocates, many brought in by coach buses from Seattle and Spokane. I was in the middle of an anti-vaccine rally—a grassroots campaign effectively organized on social media. I had to display my Kaiser Permanente Physician badge to prevent participants from handing me propaganda. I overheard conversations about ‘being in this fight together’ and ‘my child, my choice.’

The committee decided to forgo public testimony, electing instead to hear testimony from Physicians, Physician scientists and ‘vaccine injury experts’ who were invited by the committee to speak. The supporting testimonies were by pediatricians and public health Physicians who live and work in Washington state. The opposition testimonies were by a Physician, biochemist and ethics professor who were from Illinois, California and New York. Even Robert F. Kennedy Jr. spoke against the bill, adding to the media and political buzz.

His comments reflected much of what I heard all morning:

• Measles is not that serious of a disease. Reports on morbidity and mortality of measles are overreported, or even fraudulent. Nobody died of measles when he was a kid; it wasn’t until after they started mandating MMR vaccine that there were death reports from measles infections.

• Pharmaceutical companies are knowingly poisoning people because they don’t care, and vaccines are so profitable.

• Vaccinations cause irreparable harm and are the cause for countless morbid diseases (autism, multiple sclerosis, rheumatoid arthritis, fibromyalgia, etc.), all of which have skyrocketed since the introduction of vaccinations.

His remarks received enthusiastic support from the crowd. The woman next to me wept, saying, ‘Finally, someone is publicly stating what we all know to be true.’ I heard comments about ‘sheeple’ and that people who vaccinate need to ‘think for themselves.’ When testimony was given on the danger of measles, the crowd jeered, ‘No more lies!’

The reason I’m writing in this detail is because I was naïve. I had no idea about the extent of the opposition, so I’m presuming you don’t either. This movement is loud, passionate and organized.

I saw HB 1638 potentially as progress, but now it feels like a hopeless cause. Even if legislators can ignore the pseudo-science and the junk science, it will be hard for them to ignore the vast numbers of constituents that demand to be heard.

When the anti-vaccine advocates called vaccine supporters ‘sheeple’ and when the Physician testimonies were met with a bleat, I thought of that goat in the john. Sometimes your purpose in life is to serve as a warning to others. We are Physicians. Let’s speak up.” 

This opinion piece comes courtesy of WSMA member Dr. Kelly Larson, M.D., a family Medicine Physician at Kaiser Permanente’s Olympia Medical Center in Olympia. Reprinted with permission from “Take it from me, childhood diseases are dangerous” and “Dr. Kelly Larson: Why I testified” by the Washington State Medical Association, www.wsma.org. © 2019 WSMA. Dr. Goldbaum’s story is courtesy of WSMA.

Philippines Battle Back Against Polio

Those of us who are old enough to remember the introduction of the polio vaccine also remember the fear of contracting this deadly and crippling disease. When stories spread about a U.S. president, Franklin Roosevelt who contracted polio as a young man after sitting around in wet bathing suit, summer was viewed with dread and referred to as “polio season.” It was not unusual for communities to close their municipal pools in response to public fears. It was understandable. Polio is an infectious disease, which spreads rapidly. It can cause paralysis and can be fatal. There is no cure for polio—it can only be prevented with multiple doses of polio vaccines that have long been proven safe and effective. In 1952, close to 60,000 children contracted polio—in one single year. More than 3,000 children died, and many were confined to an iron lung.

Eradicating polio became one of the great scientific achievements of the 20th century. The idea polio could return as a global health threat is almost unimaginable, but it has. In September of this year, the Philippine government issued the grim confirmation that polio is re-emerging in the Philippines, 19 years after the country was declared polio-free by the World Health Organization (WHO) in 2000.

One polio case was confirmed in a 3-year-old girl from Lanao del Sur. Aside from the confirmed case, a suspected case of acute flaccid paralysis is awaiting confirmation. In addition, the poliovirus has been detected in samples taken from sewage in Manila and waterways in Davao as part of the regular environmental surveillance. The samples were tested by the Research Institute for Tropical Medicine and verified by the Japan National Institute for Infectious Diseases and the United States Centers for Disease Control and Prevention.

The Philippine government and WHO took this case very seriously. They began an immunization campaign in mid-October to cover about 1.8 million children under 5 years old. For the Philippines it was a wakeup call. The fact is that in 2018 only 66% of children in this country completed their oral polio vaccine (drops) doses, and 45% received their inactivated polio vaccine (injection) dose.

“We strongly urge parents, health workers and local governments to fully participate in the synchronized polio vaccination,” Health Secretary Francisco Duque III said, adding that “It is the only way to stop the polio outbreak and to protect your child against this paralyzing disease.”

“Aside from immunization, we remind the public to practice good personal hygiene, wash their hands regularly, use toilets, drink safe water and cook food thoroughly,” the Health Chief concluded.