Tuesday, April 21, 2015

Government Vaccine Committee Considers How to Build Vaccine Confidence

Scared little patient during injection…but verifying or improving the safety of vaccines is not on the list. Action Alert!

You may remember our article on the National Vaccine Advisory Committee’s (NVAC) plan to increase adult immunizations, which could eventually lead to adult mandates. Now, NVAC’s Vaccine Confidence Working Group has released a draft report that considers “how confidence in vaccines impacts the optimal use of recommended childhood vaccines in the United States.”

It is clear from the first lines of the draft report that, from the perspective of the Working Group and NVAC, parents who disagree with the government’s recommended vaccination schedule need to be steamrolled, not reassured. The very existence of such parents amazes the authors. The draft report states, “[There are] parents whose reluctance, hesitation, concerns, or lack of confidence has caused them to question or forego recommended vaccines.” Imagine!

The report goes on to say that the ultimate goal is to “achieve acceptance of all Advisory Group on Immunization Practices (AGIP) recommended vaccinations by parents and healthcare providers.” This recommended schedule is more or less the same as the CDC’s, which include about nineteen injections in the first six months of life.

This is a crucial point. While one could read this report and naively think that there is a good faith attempt on the part of government health officials to answer real questions about vaccine safety, the real intent seems to be to find the most effective propaganda techniques to convince everyone of the virtues of the CDC’s vaccine schedule without any review or modification whatsoever. A number of the recommendations made by the Working Group to achieve these ends are particularly troubling.

One such proposal is to ramp up already existing pay-for-performance initiatives, which are financial incentives or mandates for physicians to achieve both “an immunizing standard within a practice” as well as “continued improvement in immunization coverage rates within a provider’s practice.” This recommendation would also provide billing codes for vaccine counseling, so doctors can “gauge how they are performing when taking time to explain the risks and benefits of vaccination to parents or patients.” In fact, docs can just check a box and they will receive even more money from insurance companies, just for trying to convince parents to vaccinate their kids.

In other words, doctors get more money if they hit a certain vaccination standard, with a bonus for counseling their patients to vaccinate, or they get paid nothing if they fail to hit the required number of vaccinations. They have a double incentive to urge vaccination, which is actually a disincentive for physicians to provide balanced information. The fact that this sets up a glaring conflict of interest is surely blindingly clear to the health officials responsible for this report.

These incentives or mandates would never be disclosed to the patient. It will all be done in secret.

The Working Group also recommends that states “strengthen” their policies regarding personal belief and religious exemptions to vaccination, thus ensuring that exemptions “are only available after appropriate parent education and acknowledgement of the associated risks of not vaccinating, to their child and community.”

Among the more telling recommendations made by the Working Group to achieve full confidence in vaccinations is the following:

NVAC recommends [that] healthcare providers, immunization programs, and those involved in promoting recommended vaccinations actively reinforce that vaccination according to the ACIP recommended schedule is the social norm and not the exception. Misperceptions that vaccination in line with the ACIP recommended schedule is not the norm should be appropriately addressed [emphasis added].

In other words, why use rational discussion to address a parent’s concerns when shaming and school-yard-style peer pressure will do? Will this lead to putting parents in jail, as Maryland did briefly?

There’s a certain logic to the strategy of callously dismissing reasonable concerns about vaccine safety and labeling parents concerned about their children as irrational, uneducated “nuts”: when you marginalize the opposition, nothing need be done to improve vaccine safety—a topic that very few people in government and the scientific community (and none in the vaccine industry) seem to be concerned about.

Action Alert! Submit your comment to NVAC and tell them that they need to listen to parents and be willing to make changes in vaccine ingredients and schedule. Informed consent is the basis for a sensible policy on vaccination—not bullying and public humiliation. Please send your message immediately.

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