Illinois Vaccine Awareness Coalition - Board of Health Executive Summary of Chicken Pox Hearings

Excerpts from:
EXECUTIVE SUMMARY OF THE IMMUNIZATION HEARINGS
HELD BY THE ILLINOIS STATE BOARD OF HEALTH ON IMMUNIZATION
Prepared by: Dianne Rucinski, Ph.D

Health Policy Center at the Health Research and Policy Centers - University of Illinois at Chicago

Presented to the Illinois State Board of Health

"Based on my review of the testimony presented at the three hearings, five themes emerged from the discussions:
1. The seriousness of varicella as an illness
2. Short and long-term efficacy of the varicella vaccine
3. Locus of control for childhood immunizations
4. Exemptions
5. Safety issues and risks of vaccination in general and for the varicella vaccine in particular."

The seriousness of chickenpox as a disease
"Opponents argued that chickenpox was a mild, childhood illness, rarely leading to complications."

…"Proponents and opponent agreed that adults with chickenpox were much more likely to have complications than children"…."opponents argued that a mandatory vaccination would push the virus into the adult population resulting in complications.

Proponents succinctly posed the policy question of whether the severity of the chickenpox illness was a public health threat of sufficient import to suspend the rights of citizens to make health care choices for their children."

The short and long term efficacy of the varicella vaccine
…"Opponents argued that the efficacy of the varicella vaccination had not be(en) established through the convention of peer-reviewed published research, but through vaccine manufacturer-supported studies. In addition a number of opponents cited financial conflicts of interest among those studying the efficacy of the varicella vaccination and among of some members of the Immunization Advisory Committee. Opponents also cited individual instances of varicella immunized children having the disease."…

"Opponents asserted that there were no long-term efficacy studies. The vaccine has been available in Japan since the 1970's, but the very long-term efficacy of the varicella vaccine is not known. A booster may be necessary.
A key policy question is whether the state should wait until the long-term efficacy of the vaccine is known before adding the vaccine to mandated vaccinations. Another policy issue concerns the participation of those who accept financial renumeration or support from the entities who would benefit from a decision to mandate the varicella vaccine."

The Locus of Control for Immunizations
"Opponents of the mandatory varicella vaccination argued that it should be the right and responsibility of parents to determine whether and when their children should be immunization for they bore responsibility for handling the consequences of immunization decisions. Nearly every vaccine opponent mentioned the rights of the parents over the rights of the state in determining medical care. Some parents testifying viewed the decision not to vaccinate as a protecting the health of their children; to vaccinate would put their children at unacceptable risk. Other opponents objected to the use of fetal tissues in the creation of the varicella vaccine. To adhere to a mandatory vaccination would cause these parents to act in opposition to their ethical and moral principles."…
"One issue is whether varicella immunization is an instance where the state has a legitimate need to over ride individual freedom to protect the health of the public at large. Another key issue is whether parents who decline to have their own children immunized have the right to put other children at potential risk for illness in school and day care settings."

Exemptions
…"Opponents countered that in addition to the clinical judgement exemption an additional exemption should be included to address the philosophical objections that some parents may have. Opponents also argued that the process of getting a religious or a medical exemption granted was inconsistent, arduous and demeaning."

Safety issues and risks of vaccination
…"Opponents argued that the lack of reporting of adverse reactions by physicians made such estimates meaningless. Opponents argued that only the most severe reactions are actually reported and thus estimating the actual incidence of any adverse reaction and the percentage of those that are serious reactions (i.e., life-threatening or incapacitating) is impossible. Some opponents cited the estimate of 1 in 100 adverse reactions reported and extrapolated from the public VAERS data to argue that there were thousands of serious adverse reactions to the varicella vaccine.

One policy issue emerging from discussions about the risk of the varicella vaccination is what can be done to encourage standardized reporting of adverse reactions. Another issue concerns the need for closer monitoring of suspected adverse reaction cases."

Fundamental Positions
"Most opponents objected to making the varicella vaccination part of the mandatory immunization schedule. Some did not object to the immunization per se, but to the mandatory nature of the requirement. The positions of the opponents can be summarized as follows.
1. Some opponents claim that the threat of serious complications due to chickenpox is not sufficient to justify the government's intervention.
2. The short and long-term efficacy of the varicella vaccination has not been established by independent researchers.
3. Parents and legal guardians have the right and responsibility to make choices about vaccinations for their children and to attend to the consequences of those choices.
4. Opponents claim the existing exemptions are not consistently defined or enforced and the process by which exemptions are granted are arduous and demeaning.
5. The chickenpox vaccination creates risks for their children that are greater than the risks associated with contracting the disease itself.":

Recommendations
…"Specifically, the Board may wish to review the process by which incidents become part of the VAERS."…

…"the Board may wish to consider recent published literature on the impact of the magnitude of exemptions granted on children who have been and children have not been vaccinated. The Board may also wish to review longitudinal studies conducted outside the United States to assess the long term efficacy of the varicella vaccine."

…"The Board may wish to establish criteria to be used to base decisions when mandating a particular vaccine."