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Vaccination Choices
What are vaccination choices?
Recommended vs. mandated
State-level exemptions to vaccination the in United States
Why do they matter?
Scientific truth is a moving target
All Americans are entitled to informed consent
It's a moral slippery slope
The high price of mandatory government intrusion
Vaccine court and legal recourse - who will foot the bill?

Vaccination Choices - Why Do They Matter?

By Louise Kuo Habakus

It takes a simple willingness to start challenging sacred assumptions:

  • Vaccines save lives. All children must get all shots on schedule.
  • To go against expert opinion puts your children and our entire society at risk.
  • Every licensed vaccine should be given.

It takes a simple willingness to start asking basic questions and connecting the dots:

  • Are vaccines safe? What's in a vaccine? What studies have been done?
  • How many shots do kids get today? What do we know about all these sick kids?
  • Why do we vaccinate more than other First World countries?

I am not anti-vaccine, just as I would not be anti-plane if I were speaking out about aviation safety. It is a predictable tactic, to be labeled a term that brings certain calculated qualities to mind: fringe, angry, irresponsible. It is also unprofessional and abrogates the contract between government and citizen, legislator and voter, physician and patient. Parents have legitimate concerns. Rather than approaching us with respect, actively engaging in the dialogue, and answering the questions squarely, our government, industry and medical officials undermine the people asking the questions. They take away our choices to force our hand. They marginalize us for challenging their policies, in an attempt to make the debate go away. This debate is most assuredly not going away. Their actions are merely serving to widen the trust gap and will bring about the very thing they most dread: a steady, irrevocable erosion of public confidence in the national childhood vaccine program. Above all, parents want to protect their children. Backed into a corner, we are told that it is all or none. In the absence of solid answers to their questions, more parents will choose none.

what are vaccination choices?

In our country, we have some choices when it comes to vaccines. Although we are not routinely told about our choices, we deserve to know what they are and why they matter.

Recommended vs Mandated

The vaccines recommended by our federal government are just that; they are optional. Vaccines are mandated at the state level for daycare and school admission. But if you do not plan to put your children in daycare or school, then you are free to determine your child’s vaccination schedule with a philosophically-aligned physician. We forget that we have the right to fire our doctors. If yours pressures you to vaccinate or fails to address your concerns, get a new provider. Today, doctors are more willing to consider alternative schedules. Find one who will work with you.

State-Level Exemptions to Vaccination in the United States

There are three primary types of legal exemptions to mandatory exemptions for daycare and school attendance.


Click on this map to find out which exemptions are permitted in your state.

I am pro-vaccination choice and support the right of Americans to get all, some or no vaccines. The choice to be fully vaccinated is not a problem in this country. In fact, chances are that your shots are covered by private insurance or a government entitlement program. America loves its vaccines. We recommend and mandate more shots than any other country in the world. A sizable subset of them is mandated for daycare and school admission. When I talk about choices, I am also talking about the right to selectively vaccinate or not vaccinate at all.

Why do vaccination choices matter?

There are five main reasons that the personal and religious beliefs of every citizen must be considered legitimate grounds to receive an exemption from some or all vaccines:

  1. "Scientific truth" is a moving target. And with vaccination, we aren't getting the fully story.

  2. The absence of vaccination choices violates every American's right to informed consent.

  3. The absence of choice creates a moral slippery slope with dangerous societal implications.

  4. Mandatory government intrusion into our lives results in the loss of sacred basic freedoms.

  5. If you harm someone, you must pay damages. But no one wants to foot this bill.

"Scientific Truth" Is A Moving Target

Our government often takes a long time to do the right thing. Typically, many people are harmed or killed first. It took decades to admit that cigarettes cause lung cancer and to stop using hormone replacement therapy to treat the symptoms of menopause. Five long years passed before we removed both thalidomide and Vioxx from the market. “Safe” changes over time. In the first five decades of the Nuclear Age, the international recommendations for acceptable levels of worker exposure to radiation were significantly revised downward multiple times [5]. Human beings make mistakes. Because these mistakes can be deadly, we must give people choice.

Vaccines are no exception. Some previously licensed vaccines, once deemed “safe,” were quietly removed from the market. These include the whole cell pertussis vaccine, the first rotavirus vaccine, the Sabin polio vaccine and ProQuad (MMRV). Vaccine formulations and protocols have changed over time, including the presence of certain ingredients, the size and number of doses, and the ages at which they are given. We know all too well, “that which is known” changes.

When it comes to vaccines, our public health officials tell us:

Vaccines are the cornerstone of sound public policy and a miracle of modern medicine.
Unvaccinated children run an unacceptably high risk of death and irreversible harm.

Unvaccinated children put society at risk because deadly diseases will return.

But how many of us know:

  • Vaccines are given more credit than they deserve?

Deaths from infectious diseases declined by over 90% during the first half of the 1900s, well before vaccines were widely implemented. In Figure 1 of this footnote, view the dramatic downward trajectories for six diseases including typhoid and scarlet fevers, for which there were no shots commonly (or ever) administered. At the time, this was correctly attributed to improved sanitation and hygiene. Modern school vaccination programs did not begin until the 1960s and 1970s.

  • Herd immunity is assumed by has never been proven?

This is the belief that a very high percentage of people must be vaccinated or deadly diseases will return. if non-compliance truly resulted in disease outbreaks, we should have rampant disease amongst adult segments of the populations today. Similarly, we also would have had extensive outbreaks when you and I were children. But we did not.

  • Outbreaks regularly occur among the vaccinated?

This includes school populations in which 99%+ vaccination rates are documented. In the January 2008 confirmed New Jersey pertussis outbreak, all 30+ children were vaccinated. The reason given? Some were in the 7 to 9 age group, for which there is no licensed vaccine. If the six pertussis shots mandated by age eleven aren't enough, is the answer a seventh shot? Or should we ask if the vaccines are working as we originally hoped? The fact is that we don't fully understand how, when and why outbreaks occur as they do, in both vaccinated and unvaccinated communities. Some diseases, such as pertussis, are cyclical and occur irrespective of vaccination. Our officials recommend high immunization coverage because they have no other solutions. [If you want to read about the cyclical nature of pertussis, google "Generic protocol for estimating the burden of pertussis in young children, WHO."]

Parents are not told the risks of vaccination:

  • The government vaccine injury compensation table provides eligibility guidelines for the children who are harmed and die from their vaccines. Nearly two billion dollars have been paid out to thousands of affected families. Vaccine package inserts disclose a shocking list of injuries and deaths which occur in temporal association with vaccination.

  • Vaccine ingredients are toxic by design, to help provoke the body's immune system into creating antibodies against the pathogens in the vaccine. However, these substances have never been adequately safety tested, neither individually nor cumulatively, let alone for injection into newborns and young children. They include mercury and aluminum which are neurotoxic and extremely difficult to remove from our bodies.

  • Our vaccine experts know less about vaccines than we assume:

    • There have never been any double-blind, placebo-controlled longitudinal studies performed comparing total health outcomes of the vaccinated to the unvaccinated.

    • "Fourteen studies have been conducted (which prove that) there is no association between autism and vaccines." Go to www.14studies.org and learn about the various ways these studies have been misrepresented by public health officials.

    • The risks of simultaneous injection on the first set of multiple vaccines (i.e., MMR, polio, DPT) were never studied before adding dozens of new shots to the schedule.

    • Existing and emerging scientific research studies link vaccination to autism, autoimmune and chronic disease including asthma, diabetes and anaphylaxis, among others.

    • Americans are not permitted to sue for injury and death from a government-recommended vaccine. Does liability protection of manufacturers motivate them to invent safer shots?

Parents are worried. New vaccines continue to be added to the schedule. Many children are sicker than ever. And our doctors and government won’t engage in an open dialogue with us.

  • We vaccinate more than ever before. The CDC recommends American boys get 66 vaccines by age 17. Girls get 69. That's three time more than we gave children in 1983.

  • We vaccinate earlier than ever before; 33 of those 66 shots are given to American babies by 15 months of age. We started vaccinating newborns for Hepatitis B in the early 1990s. (Newborns have virtually no risk of Hepatitis B exposure. Maternal infection can be tested.)
  • We vaccinate more than other developed countries. Many including Japan, the UK, Canada and New Zealand do not mandate vaccines. Japanese babies receive 15 shots by age two.
  • Most damning of all, our children are not well. One in 91 has autism (up from 1 in 150 released by the CDC in 2007), 1 in 450 is diabetic, 1 in 9 asthmatic, 1 in 6 learning disabled, 1 in 3 with chronic, neurological or immune disorder. There are peanut-free zones in every school. The numbers of ill children increased as we ramped up the number of shots. This is the public health crisis of the day. Doctors and public health officials have no credible explanation for this level of chronic illness facing an entire nation of children, irrespective of geography, ethnic background and socioeconomic status. How can we say vaccines are safe when vaccine safety research has been "done on the cheap" and is "seriously deficient?"
  • Doctors are kicking non-vaccinating parents out of their practices. Do you want a doctor who won't take the time to address your concerns? The American Academy of Pediatrics (AAP) featured a patient letter in its May 2008 newsletter AAP News, drafted by a member pediatric practice. This letter, touted as a timesaver, is posted in their waiting room. "Finally, if you should absolutely refuse to vaccinate your child despite all our efforts, we will ask you to find another health care provider who shares your views. We do not keep a list of such providers nor woudl we recommend any such physician." Have a nice day.

The vaccines do not seem to be working as we had hoped and intended. Someone needs to address these concerns and hold our experts accountable for the answers. Who should it be? The CDC, responsible for both vaccine promotion and safety? The beleaguered FDA, mired in failure and controversy? The pharmaceutical industry, fat and influential, loudly proclaiming that causation has not been established? The fifty state health departments, all CDC-funded, understaffed and busy enforcing state statutes mandating shots? Our nation’s pediatricians, inculcated that vaccines are safe, more reliant than ever upon well visits and the requisite vaccines to earn a living? Thus far, not a knight in shining armor among them. Parents are looking for real leadership which is all too rare a commodity today.

All Americans Are Entitled To Informed Consent

Informed consent is considered the highest standard in the ethical practice of modern medicine. It represents a legal condition in which an individual is presented with full disclosure of the risks and benefits of a medical intervention, personally weighs the tradeoffs and then makes the decision whether to proceed. The doctrine of informed consent is a critical aspect of the duty of care owed to the patient by the health practitioner.

Health care freedom is a fundamental human right. It was reasserted by the judges of the Nuremberg Tribunal after World War II. The first principle of the Nuremberg Code states: “The voluntary consent of the human subject is absolutely essential. This means the person involved should have the legal capacity to give consent; should be so situated as to be able to exercise free power of choice…”

Many Americans are unable to exercise “free power of [vaccination] choice” because thirty-two U.S. states do not offer a philosophical exemption to mandatory immunization. Vaccination is the only medical intervention forced upon us by our government. It is the only medical intervention for which there is no federal law requiring informed consent. We live in a country where our government compels many of us to do something that has the possibility to cause harm.

It's A Moral Slippery Slope

Government and industry admit that vaccines harm and kill a subset of the population. They say the numbers are small but it is becoming clear that this is neither confirmed nor true. Parents are witnessing the damage first-hand. And this raises an acute moral dilemma. Will we intentionally sacrifice a segment of our population for an unproven “greater good?” In other words, is it ok to kill and permanently harm some children because we think that vaccines are preventing disease?

There are many more difficult questions with no easy answers. Here are some of them:

  • Should you be forced to inject your child with something that could kill or maim?

    • Let's say vaccines prevent measles but cause autism. Measles versus autism. Who gets to decide which risks are taken with your children? Who bears the consequences?

    • Should government mandate vaccines with serious side effects for diseases which are not deadly, such as chicken pox? How about for sexually-transmitted diseases? HPV is not contracted by sitting next to someone in school who is infected.

    • Should we require vaccines for diseases which don't threaten children? Children are given the flu shot to protect the elderly. Only two kids died of the flu in New Jersey in four years, yet the state saw fit to mandate the shot for daycare and preschool. And all newborns are vaccinated for Hepatitis B, a sexually-transmitted disease they will most likely never get, because we are unable to reach the high-risk adult populations.

    • Who's getting protected and who's bearing the risk? As guardians of their young children, parents are major stakeholders in this debate. Don't parents deserve the right to choose?

  • How many children should be sacrificed? Who decides on the acceptable limits?

    • Are ten tolerable? How about 1,000? 500,000? 500,001?

    • When so many children are chronically ill, should we err on the side of caution?

    • Why are we continuing to mandate more shots?
  • With hundreds of vaccines in various stages of development, what's your personal limit?

    • Do you want someone to decide for you?

    • Do you want your child to be vaccinated at school without your permission?

  • Should we attempt to identify those who are vulnerable to injury so we can "save" them?

    • How do we define "vulnerable?" Do we limit it to the most severe injuries, such as brain damage and autism? Or do we include eczema, food allergies and ADHD?

    • Do we let these children get fewer shots?

    • If your child isn't deemed vulnerable, can you still get the kinder, gentler schedule?

    • What if the government says no and your child dies?
  • How do you feel if our doctors and government fail to disclose the risks of vaccination because they are worried that large numbers of parents will lose confidence in vaccines and stop immunizing their children?

  • Should pharmaceutical firms be entitled to billions in profits from government-mandated vaccines?

    • Should vaccine makers be allowed to spend huge amounts of money on lobbyists to convince politicians to pass industry-friendly laws?

    • Should the government protect manufacturers from injury lawsuits?

It’s no wonder that this subject is so tightly and carefully managed. What politician, appointed health official, doctor or CEO wants to answer these questions?

The High Price of Mandatory Government Intrusion

Benjamin Franklin warned us: Those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety." Freedom is an academic concept to most Americans today, many of whom came of age during a peod of unprecedented privilege and prosperity. We regard our political system with a mixture of strident disdain and sheepish apathy. How removed we have become from the true American spirit of self-determination! Our ancestors did not look to our government to protect them. They made their own way. They fought hard and were willing to die for basic rights which were codified in the Constitution, including religious freedom, due process and the limits of government to make laws which abridge the privileges of citizens and deprive people of life, liberty or property.

During Bush’s two terms, government grew bigger than ever before. Obama plans to outspend Bush substantially. Let’s be clear. Big government meddles. Even with the best of intentions, human beings (and this includes politicians) still make mistakes. With poor execution, good ideas can fail miserably. In politics, the end result often bears no resemblance to the original objective. When we allow government to intrude in our lives, we must be prepared for the consequences. Do you want a politician in Washington, or your state capital, making medical decisions for your family, without a medical degree and without knowledge of your medical history?

There is a role for government involvement. Free market forces can create problems requiring overarching solutions that transcend existing infrastructure and/or industries. All of us would agree that clean air is a desirable public good. In this case, government intervention is needed because industries would not naturally set and restrict themselves to costly and onerous pollution standards. The promise of a disease-free society is also a compelling public good. But vaccines differ from pollution standards. Vaccines are not a panacea. They don’t always work. They have risks. And there are powerful interests which benefit from their widespread adoption. Today, we are seeing the need for government that is both intelligent and moral. It is easy to shake our heads while pointing at crooked and greedy officials. But we are all complicit. Through our passivity or our advocacy, we participate in the creation of our society. Corrupt politicians can be voted out of office, corrupt laws can be overturned, and corrupt companies can be challenged, boycotted and brought down when people care enough to learn the truth and become involved. Most people never give vaccines a moment’s thought. Will you?

Vaccine Court and Legal Recourse - Who Will Foot the Bill?

There are advantages to a free market system. Companies want to make money so they strive to sell intelligent, value-added products that people will buy. Ill-conceived duds are quickly canned. And when products harm and kill consumers, the manufacturer is on the hook. Period. This is one of the most important of our checks and balances: plaintiffs can sue. And when their claims are legitimate, businesses are compelled to pay damages. In this very straightforward fashion, the market self-regulates. This was the environment in which vaccine manufacturers operated during the early years of our modern childhood vaccination programs in the 1960s and 1970s. Some children were injured and their parents sued. Most cases were quietly settled on the courthouse steps; many families were contractually forbidden to disclose the details and terms of their cases.

Increasingly concerned about negative publicity and the financial impact of these injury lawsuits, however, vaccine makers approached Congress and made the case that they should receive protection. Congress complied and passed the National Childhood Vaccine Injury Act of 1986. Pharmaceutical firms and doctors were no longer liable for injury and death caused by government-recommended vaccines. In one fell swoop, we removed the most important inducement the vaccine industry had to create safer vaccines with safer protocols. Congress removed the natural market forces protecting consumers and set the stage for the dramatic increase in the number of vaccines licensed and mandated in this country in the 1990s. Some will argue that the Vaccine Injury Compensation Program (VICP) provides accelerated recourse to injured families. Ask the families. It doesn’t even come close. This alternative to the tort system has proven to be neither expedited nor just. It is a failed experiment and should be abolished.

In two decades, 2260 families who filed petitions in federal “Vaccine Court" have been paid almost two billion dollars. Thousands had their claims denied. Today, some five thousand families in the Omnibus Autism Proceedings allege that vaccines caused their children’s autism. Many thousands more were shut out of the system because recognition of the injuries did not occur within the three-year statute of limitations. (Doctors typically don’t know how to diagnose vaccine injuries.)

In 2008, Vaccine Court awarded compensation to Hannah Poling for her vaccine-induced autism. One case. One little girl. A highly inconvenient ruling for the CDC, the AAP, our nation’s doctors, drug companies and the millions of parents who were offered the most sincere assurances that vaccines are both safe and effective. In the following days, CBS revealed that the parents of Madison Hiatt, a young girl with autism, were paid by the VICP in 2002. CBS also discovered eight more families of children with autism who had been quietly paid by the fund.

In February 2009, Vaccine Court ruled against parents in three highly followed “test cases” involving autism and the MMR vaccine. Just weeks later, the public learned of yet another child who was awarded a lump sum and ongoing care valued in excess of $1 million in 2007 because it was determined that the MMR vaccine had caused acute brain damage that led to his autism.

Vaccines are safe. Vaccines do not cause autism.

What’s going on here? Have we failed to ask the right questions? A vaccine injury ruling is made by linking medically-diagnosed conditions to the administration of one or several vaccines. An autism diagnosis is based solely upon the degree of behavioral, social and communication impairments. By definition, the circles never intersect. How will we uncover the relationship between vaccines and autism if we aren’t studying the populations who became ill after vaccination? If many vaccine-injured children also have an autism diagnosis, it may follow that many autistic children have symptoms of vaccine injury. Let’s find out.

To again quote Benjamin Franklin: “I think opinions should be judged by their influences and effects; and if a man holds none that tend to make him less virtuous or more vicious, it may be concluded that he holds none that are dangerous, which I hope is the case with me."

Make no mistake about what’s happening. There is overwhelming institutional inertia for the preservation of profits, credibility, livelihoods and credentials of extremely powerful organizations. We are confronted with a curious and awkward truth about Vaccine Court. The government effectively is putting the government on trial. The government is defended by the government, to protect a multi-billion dollar fund from the public. Government ruled in favor of itself. What a surprise. Government won. Let’s speak very plainly. Government cannot rule that vaccines cause autism. If vaccines cause autism, there is not remotely enough money in the VICP to appropriately compensate our country’s affected families. And there is simply no safety net in place to deal with the institutional fallout, should the American public simultaneously lose confidence in our doctors, our vaccines, our industry and our government.

The stakes could not be higher, for all involved parties. Industry remains wary and guarded; desperately aware of the precarious privilege they should never have been granted. Some courageous doctors and scientists put their careers and reputations on the line to speak out. Our government fiercely maintains that vaccines are safe. No one wants to foot the bill for these injuries and deaths. Parents are furious and asking very tough questions. It is a recipe for disaster.

I come full circle, back to the subject of vaccination choice. For the reasons stated above, choice is the only policy that a moral, civilized, rational society can adopt. Government is attempting to legislate the impossible and we are experiencing the unintended consequences. People will always have legitimate reasons to vaccinate selectively or not at all. It is for these reasons and many others that I believe that all Americans must have vaccination choice.


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