For a change today, we bring you a vaccine story that's not about the coronavirus vaccines. A Republican-sponsored bill in the Pennsylvania legislature would undermine the Centers for Disease Control's recommended schedules for childhood immunizations, and the state's pediatricians are up in arms over it — little kids' skinny, measles-covered arms, if that helps you visualize the threat. Harrisburg public radio station WITF explains:

The "Immunization Freedom Act," sponsored by Republican state Rep. David Zimmerman of Lancaster, passed the House health committee last week with a party-line vote.

In part, the bill seeks to bar pediatricians from denying care to a child whose parent doesn't want to follow the Centers for Disease Control and Prevention immunization schedule.

Zimmerman claims his bill is "the first step in allowing the families and the physicians to work together" — if by "work together" you mean giving parents misled by online anti-vaxxer lies the option to ignore sound medical advice. Oddly, it turns out that pediatricians have this crazy idea that working together with parents shouldn't mean throwing out medical best practices or their professional ethics.

The bill is opposed by the Pennsylvania chapter of the American Academy for Pediatrics; WITF notes that the doctors interviewed for the story "say almost every sentence in the bill is based on misinformation." Even if the bill goes nowhere, they're worried about the precedent the bill sets, since it places online misinformation on the same level as medical knowledge. Dr. Gabriel Cisneros, a Pittsburgh pediatrician who co-chairs the nonprofit's advocacy committee, says that for parents who are "ambivalent or concerned, this bill gives credence to that false notion that it's okay to delay vaccines for their children."

Big surprise: All the research indicates that delaying vaccines puts kids at risk, with no identifiable health benefits.


One of the more pernicious arguments of the anti-vax movement is that the CDC's recommended vaccination schedule is just too many shots for an itty-bitty baby, so why not just stretch out the vaccines over a longer period of time? But there's no indication that children are somehow "overwhelmed" by vaccines, and plenty of evidence that delaying vaccinations leaves them vulnerable to infections that could cause serious harm or even death.

The bill would require doctors to go along with parents' decisions on when to schedule their kids' vaccines, as long as the child still receives one vaccine per year. That's vastly different from the CDC recommendations, to say the least, which call for quite a few vaccines in the first 15 months, with additional doses for some vaccines throughout childhood.

Spacing out those vaccines over a longer period of time might make intuitive sense to some parents, but it also means more trips to the doctor for each vaccine, increasing the risk of being infected by other kids in the waiting room, and potentially making kids more fearful of doctors. Nobody remembers a series of, say, five shots at 4 months of age. Space them out all through the toddler and preschool years, and you might have a very phobic little kid. And again, you're increasing the time the kids are vulnerable to infection.

The bill would also prohibit insurers from giving financial incentives for doctors to follow the CDC schedule, so the insurance industry is against the bill, too. Good on them. And pediatricians wouldn't be allowed to limit the hours when they see non-vaccinated kids, because while docs might think it's a good idea to protect their immunocompromised patients from the little disease vectors whose parents don't trust science, protecting kids with cancer or babies who are too young to be vaccinated is actually terribly discriminatory against Johnny Bucket O'Measles and his parents, whose feelings may be hurt.

Doctors who insist on following the CDC guidelines and established professional practice could be brought before a medical board and punished for "unprofessional conduct" if they disrespect parents who rely on fictitious medical advice from Dr. Facebook. Yes, really.

But that's only if the thing passes, which is not a sure thing, what with the opposition from Pennsylvania's medical and insurance community. Gov. Tom Wolf, a Democrat, hasn't outright said he'd veto the bill, but his office did say he "has concerns" about it, which seems to be putting it lightly.

Dr. Cisneros, the state American Academy for Pediatrics guy, said he has plenty of compassion for parents who have been misled by online misinformation about vaccines, but that the better way to help them is to talk to them about the importance of getting babies vaccinated on a timely schedule, not mandating that doctors follow ill-advised requests to vary from best practices.

Why yes, the bill does bar doctors from billing for the time they spend talking to parents about vaccines!

And instead of giving in to antivaxxer pressure, Cisneros said he'd like to see Pennsylvania join other states that have ended non-medical exemptions for childhood vaccines, like California, New York, Mississippi, and West Virginia.

"We swore an oath to do no harm and we see that by modifying the schedule in a way that's not evidence-based is basically providing substandard care and basically a violation of our oath," Cisneros said.

Another pediatrician WITF talked to, Dr. Todd Wolyn of Kids Plus Pediatrics in Pittsburgh, noted that a 2016 study in Pediatrics found that only about one percent of parents appeared to be hardcore adherents of anti-vaccine ideology, while many more, about 23 percent, were "vaccine hesitant," and probably more open to evidence that vaccines are safe and effective. (We'd venture a guess that, in the Trump era, the percentage of deeply committed anti-vaxxers has grown, but we'd love to be wrong about that.)

Wolyn also knows a thing or two about what happens when the online flying monkey brigade targets medical providers, because he's been there. In 2017, after his clinic ran Facebook messages encouraging parents to get their kids vaccinated against HPV, which causes cervical cancer, the clinic's social media accounts were flooded by anti-vaxxers in a coordinated campaign — with most of the messages coming from outside Pennsylvania, as the Washington Post reported. So hooray for Facebook yet again.

For his part, state Rep. David Zimmerman, the Republican who sponsored the bill, wouldn't talk to WITF, although he had previously told the Pennsylvania Capital-Star that the bill was necessary because he'd been contacted by more than a dozen families who said they'd been "kicked out" of pediatricians' offices for refusing to vaccinate their children. So clearly, the answer is to make doctors provide bad treatment in accordance with parents' wishes.

A spokesperson for Zimmerman told WITF that the representative

has also talked to doctors who are concerned about issues raised by the families. But she didn't respond to requests to speak with one of those doctors.

That's probably because the poor doctors are afraid of being harassed by science, or because they simply want to protect their right to be fictional.

[WITF / Scientific American / Pediatrics / WaPo / Pennsylvania Capital-Star]

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Doktor Zoom

Doktor Zoom's real name is Marty Kelley, and he lives in the wilds of Boise, Idaho. He is not a medical doctor, but does have a real PhD in Rhetoric. You should definitely donate some money to this little mommyblog where he has finally found acceptance and cat pictures. He is on maternity leave until 2033. Here is his Twitter, also. His quest to avoid prolixity is not going so great.

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