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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cb>Blazing New Paths to Better Study and Respond to Wildfires\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">Record-breaking, deadly wildfires are ripping through the West Coast, burning millions of acres, destroying thousands of structures and leading to the evacuation of half a million people in Oregon alone. In California, October is the month historically associated with the most destructive wildfires in the state. But this year, California wildfires have already burned more than 3 million acres, shattering the previous record set in 2018. According to Cal Fire, nearly 15,000 firefighters are currently battling 28 major blazes across the state that have claimed at least 12 lives and forced thousands of residents to flee their homes. But amid the destruction comes opportunity, guided by science. Last week, San José State University recently unveiled a new academic wildfire research center, the largest one of its kind in the nation. The scientists and professors there span a range of disciplines — from meteorology to ecology to social science — to pioneer new tools and techniques to better study, predict and adapt to living with wildfires made more intense by climate change. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Craig Clements, professor of meteorology and director, Wildfire Interdisciplinary Research Center, San José State University\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Amanda Stasiewicz, assistant professor of wildfire management, Wildfire Interdisciplinary Research Center, San José State University \u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003cb>The COVID-19 Vaccine Arms Race\u003cbr>\n\u003c/b>\u003cspan style=\"font-weight: 400\">There are roughly 170 COVID-19 vaccine candidates being developed around the world right now, according to the World Health Organization. This week, a Phase 3 clinical trial of a vaccine candidate being developed by AstraZeneca and Oxford University was halted temporarily to investigate whether the vaccine was responsible for one of the study participants falling ill. Earlier this month, the Centers for Disease Control and Prevention informed public health officials across the U.S. to prepare to distribute a vaccine as early as October or November. The Trump administration has already spent $10 billion to invest in the development of a coronavirus vaccine with the goal of distributing 300 million doses by January 2021. But concerns are mounting that the race to develop a vaccine is being politicized and rushed out to help President Trump win reelection in November. Access to a safe and effective vaccine may also be an issue, with priority being given to health care workers and first responders but not necessarily to communities who have been disproportionately impacted by the coronavirus. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\"> \u003c/span>\u003cb>Guests:\u003c/b>\u003c/p>\n\u003cul>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Yvonne Maldonado, professor of pediatrics and infectious disease epidemiologist, Stanford University\u003c/span>\u003c/li>\n\u003cli style=\"font-weight: 400\">\u003cspan style=\"font-weight: 400\">Dr. Peter Chin-Hong, professor of medicine and infectious disease specialist, UCSF\u003c/span>\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>A 2015 \u003ca href=\"https://www.kqed.org/stateofhealth/222927/californias-new-vaccine-law-expected-to-send-disease-rates-plummeting\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> that eliminated personal belief exemptions for childhood vaccines appears to be working, according to new research out Monday, which found a hike in vaccination rates among children statewide.\u003c/p>\n\u003cp>The UC San Francisco \u003ca href=\"https://www.ucsf.edu/news/2019/12/416271/barring-nonmedical-exemptions-increases-vaccination-rates-study-finds\" target=\"_blank\" rel=\"noopener noreferrer\">study,\u003c/a> published in the journal “PLOS Medicine,” concluded that the state’s stricter immunization requirements have resulted in more kids getting vaccinated.\u003c/p>\n\u003cp>Researchers estimated the number of children in California who would have received the vaccine for measles, mumps and rubella (MMR) without the law, and compared that to the number vaccinated after the legislation — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener noreferrer\">SB 277\u003c/a> — went into effect.\u003c/p>\n\u003cp>[aside tag=\"vaccines\" label=\"Related coverage\"]The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A 2015 \u003ca href=\"https://www.kqed.org/stateofhealth/222927/californias-new-vaccine-law-expected-to-send-disease-rates-plummeting\" target=\"_blank\" rel=\"noopener noreferrer\">California law\u003c/a> that eliminated personal belief exemptions for childhood vaccines appears to be working, according to new research out Monday, which found a hike in vaccination rates among children statewide.\u003c/p>\n\u003cp>The UC San Francisco \u003ca href=\"https://www.ucsf.edu/news/2019/12/416271/barring-nonmedical-exemptions-increases-vaccination-rates-study-finds\" target=\"_blank\" rel=\"noopener noreferrer\">study,\u003c/a> published in the journal “PLOS Medicine,” concluded that the state’s stricter immunization requirements have resulted in more kids getting vaccinated.\u003c/p>\n\u003cp>Researchers estimated the number of children in California who would have received the vaccine for measles, mumps and rubella (MMR) without the law, and compared that to the number vaccinated after the legislation — \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener noreferrer\">SB 277\u003c/a> — went into effect.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The \u003ca href=\"https://www.latimes.com/science/sciencenow/la-sci-sn-vaccine-medical-exemptions-20181029-story.html\" target=\"_blank\" rel=\"noopener noreferrer\">law requires\u003c/a> every child taught in school classrooms or enrolled in a child care facility — with the exemption of students who receive medical exemptions from doctors — to be fully immunized against 10 communicable diseases: diphtheria, hepatitis B, haemophilus influenzae Type B, measles, mumps, pertussis (whooping cough), poliomyelitis, rubella, tetanus and varicella (chickenpox).\u003c/p>\n\u003cp>Researchers also compared California’s vaccination rates with those of other states that still have personal belief exemptions, factoring in demographic variations.\u003c/p>\n\u003cp>Vaccination rates went up across California, particularly in counties like Sonoma and Santa Cruz, where rates have lingered below the statewide average. the report found. Non-medical exemptions decreased statewide by 2.4%, while medical exemptions increased 0.4%.\u003c/p>\n\u003cp>“When we look at those high-risk counties, we see the largest increases in vaccine coverage. 10-plus percent jumps in those areas,” said UCSF public health researcher Dr. Nathan Lo.\u003c/p>\n\u003cp>These changes brought the vaccination rate to 95% in almost all California counties, enough to provide “herd” immunity, or rates high enough that a contagious disease is less likely to spread.\u003c/p>\n\u003cp>It also means that a significant number of parents who previously received non-medical exemptions ended up complying with the law.\u003c/p>\n\u003cp>“So that nudge is enough to push the majority of these children to get properly vaccinated,” Lo said, adding that other states and countries would be wise to follow California’s lead.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>In case you missed it … California has a new vaccination law on the books.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, which Gov. Gavin Newsom signed into law last week, cracks down on doctors who inappropriately issue medical exemptions that allow kids to skip some or all vaccines that most schools require. It gives power over the exemption process to public health officials and will create a vaccination database of all children with medical exemptions.\u003c/p>\n\u003cp>Supporters of the law are pleased that doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. The more children who get vaccines, the safer schools will be for all kids, proponents of the legislation say.\u003c/p>\n\u003cp>Critics fear the law will effectively shut down access to waivers for kids who could be harmed by vaccines, which carry some risk, or who need them for other medical reasons. Doctors may fear the investigative provisions of the law, opponents say, and thousands of children could even be tossed out of school if they are not fully up-to-date on vaccines.\u003c/p>\n\u003cp>Here are five things to know about the law, which goes into effect Jan. 1.\u003c/p>\n\u003cp>[aside label=\"related stories\" tag=\"vaccines\"]\u003c/p>\n\u003ch3>\u003cstrong>1. What does the new law do?\u003c/strong>\u003c/h3>\n\u003cp>In California, children are required to be vaccinated, or have a medical exemption, to attend school. The new \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201920200SB276\">law\u003c/a> creates a review process that gives public health officials the final say on those waivers, with the authority to reject them. Reasons for medical exemptions must still follow strict guidelines, and doctors will now be barred from charging any fees for exams or forms related to them.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, the law’s author, said he was concerned when the number of medical waivers rose across the state after a previous law that he wrote eliminated personal-belief exemptions in 2016 but kept medical exemptions intact. Pan said his goal this year was to keep physicians from issuing waivers for payment or for reasons that are not allowed.\u003c/p>\n\u003cp>The law, signed by the governor last week, \u003ca href=\"https://www.chhs.ca.gov/blog/2019/09/09/senate-bill-276-and-senate-bill-714-vaccinations-and-medical-exemptions-questions-and-answers/\">requires\u003c/a> doctors to examine patients and submit their recommendations to the state Department of Public Health. State officials will then cross-check recommendations against guidelines from the Centers for Disease Control’s Advisory Committee on Immunization \u003ca href=\"https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html\">Practices\u003c/a> or the American Academy of Pediatrics.\u003c/p>\n\u003cp>Currently, the state is not involved in how students are granted medical exemptions. Parents get them from doctors and submit them to schools, and schools with kindergartens are required to submit aggregate data to the state each autumn. The state does not receive exemption forms or information about doctors writing exemptions, according to the Department of Public Health.\u003c/p>\n\u003cp>Starting next year, parents will continue to get waiver letters from doctors, as they do now, and submit them to schools. In 2021, the state is set to have a standardized form and a new submission process: Doctors will send exemptions\u003cstrong> \u003c/strong>directly to the state for review and dissemination to schools.\u003c/p>\n\u003cp>Once the law takes effect in January, state health officials will begin reviewing all medical exemptions at schools in which fewer than 95% of students are vaccinated. They will also review doctors who submit five or more exemptions in one year as well as schools that have not shared vaccination rates with the state.\u003c/p>\n\u003cp>If the state determines a physician is “contributing to a public health risk,” it will report the physician to California’s medical board. The state will cancel waivers written by doctors who are under investigation by the medical board.\u003c/p>\n\u003cp>“It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable” by local doctors selling inappropriate exemptions, Pan said in a written statement.\u003c/p>\n\u003cp>Kids with medical exemptions issued before next Jan. 1 may keep their exemptions until they move into the next grade span. The spans are defined as birth to preschool, kindergarten to sixth grade and seventh to 12th grades. After July 1, 2021, students with temporary exemptions will need to receive a new one each year, and no exemptions will carry over when a child enters a new grade span.\u003c/p>\n\u003ch3>\u003cstrong>2. How did we get here?\u003c/strong>\u003c/h3>\n\u003cp>Vaccinations have been a hot issue in California for several years, even though nearly 95% of kindergartners were fully vaccinated in the last school year. At the same time, the portion of kindergartners with medical exemptions \u003ca href=\"https://calmatters.org/health/2019/02/california-made-it-hard-to-avoid-vaccinating-kids-medical-waivers-have-tripled-now-what/\">has been rising\u003c/a> since personal-belief exemptions were eliminated. Last year, nearly 1% of kindergartners — 4,812 of them — had exemptions. In some places rates are higher: The legislation notes that 16 counties had kindergarten vaccination rates lower than 90% in the last school year.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/a5d34577-fae8-4b96-9afe-c8f002f888c1?src=embed\" title=\"Vaccination Rates in California\" width=\"550\" height=\"700\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pan’s latest proposal drew opposition groups to the capital for weeks of protest, at times all but shutting down meetings and regularly scheduled operations in the Capitol building. Advocates for Physicians’ Rights, Physicians for Informed Consent and parents from across the state testified against the bill in committee hearings, saying their children had been injured by vaccines and that they didn’t want to be required to obtain more immunizations. Some also said their children had autoimmune disorders or similar conditions and many feared the bill would dissuade doctors from providing new exemptions.\u003c/p>\n\u003cp>Anti-vaccination activists reacted similarly in 2015, when Pan first proposed elimination of personal-belief exemptions. At that time, he \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">agreed\u003c/a> that a medical exemption is absolutely up to a physician and \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">argued\u003c/a> that parents would be able to find a practitioner to sign a form.\u003c/p>\n\u003cp>And, to the surprise some of the bill’s supporters, Gov. Gavin Newsom also had reservations.\u003c/p>\n\u003cp>Initially, he expressed \u003ca href=\"https://www.sfchronicle.com/politics/article/Gavin-Newsom-signals-opposition-to-tightening-13916178.php\">concern\u003c/a> about state involvement in the doctor-patient relationship. But after negotiations with the author and some amendments, Newsom said he would support the proposal. But\u003cstrong> \u003c/strong>as the bill advanced through the Legislature, Newsom \u003ca href=\"https://twitter.com/CAgovernor/status/1169027421930184705\">signaled\u003c/a> he wanted more changes. Pan agreed again and put them in a companion \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB714\">bill\u003c/a>. Newsom signed both bills into law.\u003c/p>\n\u003cp>The changes Newsom asked for allow kids who have medical exemptions before the law goes into effect on Jan. 1 to keep them until they enter a new grade span. Doctors also gained some breathing room in the amended version: Initially, Pan’s proposal said they would sign exemptions under penalty of perjury, but that clause was removed.\u003c/p>\n\u003ch3>3. The vast majority of kids are vaccinated, so what’s the big deal?\u003c/h3>\n\u003cp>A state Department of Public Health’s \u003ca href=\"http://eziz.org/assets/docs/shotsforschool/2018-19CAKindergartenSummaryReport.pdf\">review\u003c/a> shows that California’s vaccination rates are high: 94.8% of kindergartners in the last school year were vaccinated, a slight decrease from the year before. Meanwhile, the slight increase in medical exemptions represents families who had previously sought personal-belief exemptions and switched to medical waivers, say parents who oppose the new law.\u003c/p>\n\u003cp>Supporters of the new law, including the California Medical Association and the American Academy of Pediatrics in California, say it will strengthen community immunity and that vaccines are safe and effective for keeping communities healthy. They also content that it will crack down on physicians “practicing outside the accepted standard of care,” said David Aizuss, president of the medical association, in a written statement.\u003c/p>\n\u003cp>Doctors who oppose the law say they are concerned about losing their right to say what’s best for their patients, and about the lack of liability for those injured by vaccines, explained Debra Schaefer, spokeswoman \u003ca href=\"https://www.physiciansrights.org/mission/\">for\u003c/a> Advocates for Physicians’ Rights, in an email.\u003c/p>\n\u003cp>“The CDC itself warns that there are risks involved with vaccinations, and where there is risk, there should at least be a discussion between a doctor and a patient, like with any other pharmaceutical,” she said. “This bill is nothing more than government overreach. … Doctors were scared to write (medical exemptions) before this bill; this is just creating an additional killing effect.”\u003c/p>\n\u003cp>Other opponents say the law tries to solve a problem that doesn’t exist. Instead, it may force thousands of children to leave school or quickly get caught up on vaccines even if they have legitimate medical exemptions, said Toby Rogers, an independent researcher and prominent critic of the law.\u003c/p>\n\u003cp>“If you are missing a single shot in this bloated schedule, you are considered noncompliant and kicked out of school,” said Rogers, referring to the \u003ca href=\"https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html\">CDC schedule\u003c/a> of vaccinations for children. In California, kids are required to receive 15-16 vaccine \u003ca href=\"https://www.shotsforschool.org/k-12/\">shots \u003c/a>to enter kindergarten. Some of the shots carry combined doses.\u003c/p>\n\u003cp>Rogers suggested the state focus instead on the larger percentage of children affected by such diseases and conditions as diabetes, asthma, autoimmune disorders and autism.\u003c/p>\n\u003ch3>4. Are vaccines dangerous, as some critics say?\u003c/h3>\n\u003cp>Critics of the new law argue that it does not properly acknowledge the risk that vaccines pose. The law states that “for all but a small number of individuals, immunizations are safe and effective,” but does not elaborate.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Other opponents say the new requirements ignore the real needs of children who have been injured by vaccines and could be further harmed if forced into more. For example, they could have allergic reactions to vaccine components or have other underlying health conditions.\u003c/p>\n\u003cp>Vaccinations also can have \u003ca href=\"https://www.cdc.gov/vaccines/vac-gen/side-effects.htm\">side effects\u003c/a>, ranging from fevers and seizures to very rare cases of death, according to the literature included with the medications and the Centers for Disease Control and Prevention. In 1986, the federal government \u003ca href=\"https://pediatrics.aappublications.org/content/98/6/1179\">created \u003c/a>the National Childhood Vaccine Injury \u003ca href=\"https://www.congress.gov/bill/99th-congress/house-bill/5546\">Act\u003c/a>. that freed pharmaceutical companies from liability in cases of such injury. Under that law, billions of government dollars have been paid to families with children harmed by vaccines.\u003c/p>\n\u003cp>The group Physicians for Informed Consent, which opposes California’s new law, \u003ca href=\"https://physiciansforinformedconsent.org/wp-content/uploads/2019/07/PIC-MBC-SB276-7-9-19.pdf\">says \u003c/a>it is partly based on misinformation. The organization argues that some of the vaccines required for school are for illnesses that are not contagious and therefore do not affect herd immunity or other children. Those include immunizations against tetanus and Hepatitis B, which is first administered to newborns for an illness \u003ca href=\"https://www.cdc.gov/hepatitis/hbv/bfaq.htm\">transmitted\u003c/a> through sex and intravenous drug use.\u003c/p>\n\u003cp>Opponents also point to the Vaccine Adverse Effects \u003ca href=\"https://vaers.hhs.gov/\">Registry\u003c/a> and the National Vaccine Injury Compensation \u003ca href=\"https://www.hrsa.gov/vaccine-compensation/index.html\">Program\u003c/a> as evidence that vaccination decisions should be left to physicians.\u003c/p>\n\u003ch3>\u003cstrong>5. So is this fight over now?\u003c/strong>\u003c/h3>\n\u003cp>Robert F. Kennedy Jr., a vocal opponent of the California law, said at a rally last week that his \u003ca href=\"https://childrenshealthdefense.org/news/americans-can-handle-an-open-discussion-on-vaccines-rfk-jr-responds-to-criticism-from-his-family/\">organization\u003c/a>, Children’s Health Defense, intends to sue the state to block the law. And a group of opponents this week began the process of trying to overturn the new law through a ballot measure that would go to voters next November.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "Doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. Opponents say physicians may now be afraid to provide waivers, even for kids who need them.\r\n",
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"title": "Five Things to Know About California’s New Vaccine Law | KQED",
"description": "Doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. Opponents say physicians may now be afraid to provide waivers, even for kids who need them.\r\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In case you missed it … California has a new vaccination law on the books.\u003c/p>\n\u003cp>\u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, which Gov. Gavin Newsom signed into law last week, cracks down on doctors who inappropriately issue medical exemptions that allow kids to skip some or all vaccines that most schools require. It gives power over the exemption process to public health officials and will create a vaccination database of all children with medical exemptions.\u003c/p>\n\u003cp>Supporters of the law are pleased that doctors will no longer be the final authority on medical exemptions and could be investigated if they write too many. The more children who get vaccines, the safer schools will be for all kids, proponents of the legislation say.\u003c/p>\n\u003cp>Critics fear the law will effectively shut down access to waivers for kids who could be harmed by vaccines, which carry some risk, or who need them for other medical reasons. Doctors may fear the investigative provisions of the law, opponents say, and thousands of children could even be tossed out of school if they are not fully up-to-date on vaccines.\u003c/p>\n\u003cp>Here are five things to know about the law, which goes into effect Jan. 1.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003ch3>\u003cstrong>1. What does the new law do?\u003c/strong>\u003c/h3>\n\u003cp>In California, children are required to be vaccinated, or have a medical exemption, to attend school. The new \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billCompareClient.xhtml?bill_id=201920200SB276\">law\u003c/a> creates a review process that gives public health officials the final say on those waivers, with the authority to reject them. Reasons for medical exemptions must still follow strict guidelines, and doctors will now be barred from charging any fees for exams or forms related to them.\u003c/p>\n\u003cp>Sen. Richard Pan, D-Sacramento, the law’s author, said he was concerned when the number of medical waivers rose across the state after a previous law that he wrote eliminated personal-belief exemptions in 2016 but kept medical exemptions intact. Pan said his goal this year was to keep physicians from issuing waivers for payment or for reasons that are not allowed.\u003c/p>\n\u003cp>The law, signed by the governor last week, \u003ca href=\"https://www.chhs.ca.gov/blog/2019/09/09/senate-bill-276-and-senate-bill-714-vaccinations-and-medical-exemptions-questions-and-answers/\">requires\u003c/a> doctors to examine patients and submit their recommendations to the state Department of Public Health. State officials will then cross-check recommendations against guidelines from the Centers for Disease Control’s Advisory Committee on Immunization \u003ca href=\"https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html\">Practices\u003c/a> or the American Academy of Pediatrics.\u003c/p>\n\u003cp>Currently, the state is not involved in how students are granted medical exemptions. Parents get them from doctors and submit them to schools, and schools with kindergartens are required to submit aggregate data to the state each autumn. The state does not receive exemption forms or information about doctors writing exemptions, according to the Department of Public Health.\u003c/p>\n\u003cp>Starting next year, parents will continue to get waiver letters from doctors, as they do now, and submit them to schools. In 2021, the state is set to have a standardized form and a new submission process: Doctors will send exemptions\u003cstrong> \u003c/strong>directly to the state for review and dissemination to schools.\u003c/p>\n\u003cp>Once the law takes effect in January, state health officials will begin reviewing all medical exemptions at schools in which fewer than 95% of students are vaccinated. They will also review doctors who submit five or more exemptions in one year as well as schools that have not shared vaccination rates with the state.\u003c/p>\n\u003cp>If the state determines a physician is “contributing to a public health risk,” it will report the physician to California’s medical board. The state will cancel waivers written by doctors who are under investigation by the medical board.\u003c/p>\n\u003cp>“It is my hope that parents whose vulnerable children could die from vaccine-preventable diseases will be reassured that we are protecting those communities that have been left vulnerable” by local doctors selling inappropriate exemptions, Pan said in a written statement.\u003c/p>\n\u003cp>Kids with medical exemptions issued before next Jan. 1 may keep their exemptions until they move into the next grade span. The spans are defined as birth to preschool, kindergarten to sixth grade and seventh to 12th grades. After July 1, 2021, students with temporary exemptions will need to receive a new one each year, and no exemptions will carry over when a child enters a new grade span.\u003c/p>\n\u003ch3>\u003cstrong>2. How did we get here?\u003c/strong>\u003c/h3>\n\u003cp>Vaccinations have been a hot issue in California for several years, even though nearly 95% of kindergartners were fully vaccinated in the last school year. At the same time, the portion of kindergartners with medical exemptions \u003ca href=\"https://calmatters.org/health/2019/02/california-made-it-hard-to-avoid-vaccinating-kids-medical-waivers-have-tripled-now-what/\">has been rising\u003c/a> since personal-belief exemptions were eliminated. Last year, nearly 1% of kindergartners — 4,812 of them — had exemptions. In some places rates are higher: The legislation notes that 16 counties had kindergarten vaccination rates lower than 90% in the last school year.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://e.infogram.com/a5d34577-fae8-4b96-9afe-c8f002f888c1?src=embed\" title=\"Vaccination Rates in California\" width=\"550\" height=\"700\" scrolling=\"no\" frameborder=\"0\" style=\"border:none;\" allowfullscreen=\"allowfullscreen\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Pan’s latest proposal drew opposition groups to the capital for weeks of protest, at times all but shutting down meetings and regularly scheduled operations in the Capitol building. Advocates for Physicians’ Rights, Physicians for Informed Consent and parents from across the state testified against the bill in committee hearings, saying their children had been injured by vaccines and that they didn’t want to be required to obtain more immunizations. Some also said their children had autoimmune disorders or similar conditions and many feared the bill would dissuade doctors from providing new exemptions.\u003c/p>\n\u003cp>Anti-vaccination activists reacted similarly in 2015, when Pan first proposed elimination of personal-belief exemptions. At that time, he \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">agreed\u003c/a> that a medical exemption is absolutely up to a physician and \u003ca href=\"https://www.youtube.com/watch?v=w95QW-kO_yo\">argued\u003c/a> that parents would be able to find a practitioner to sign a form.\u003c/p>\n\u003cp>And, to the surprise some of the bill’s supporters, Gov. Gavin Newsom also had reservations.\u003c/p>\n\u003cp>Initially, he expressed \u003ca href=\"https://www.sfchronicle.com/politics/article/Gavin-Newsom-signals-opposition-to-tightening-13916178.php\">concern\u003c/a> about state involvement in the doctor-patient relationship. But after negotiations with the author and some amendments, Newsom said he would support the proposal. But\u003cstrong> \u003c/strong>as the bill advanced through the Legislature, Newsom \u003ca href=\"https://twitter.com/CAgovernor/status/1169027421930184705\">signaled\u003c/a> he wanted more changes. Pan agreed again and put them in a companion \u003ca href=\"http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB714\">bill\u003c/a>. Newsom signed both bills into law.\u003c/p>\n\u003cp>The changes Newsom asked for allow kids who have medical exemptions before the law goes into effect on Jan. 1 to keep them until they enter a new grade span. Doctors also gained some breathing room in the amended version: Initially, Pan’s proposal said they would sign exemptions under penalty of perjury, but that clause was removed.\u003c/p>\n\u003ch3>3. The vast majority of kids are vaccinated, so what’s the big deal?\u003c/h3>\n\u003cp>A state Department of Public Health’s \u003ca href=\"http://eziz.org/assets/docs/shotsforschool/2018-19CAKindergartenSummaryReport.pdf\">review\u003c/a> shows that California’s vaccination rates are high: 94.8% of kindergartners in the last school year were vaccinated, a slight decrease from the year before. Meanwhile, the slight increase in medical exemptions represents families who had previously sought personal-belief exemptions and switched to medical waivers, say parents who oppose the new law.\u003c/p>\n\u003cp>Supporters of the new law, including the California Medical Association and the American Academy of Pediatrics in California, say it will strengthen community immunity and that vaccines are safe and effective for keeping communities healthy. They also content that it will crack down on physicians “practicing outside the accepted standard of care,” said David Aizuss, president of the medical association, in a written statement.\u003c/p>\n\u003cp>Doctors who oppose the law say they are concerned about losing their right to say what’s best for their patients, and about the lack of liability for those injured by vaccines, explained Debra Schaefer, spokeswoman \u003ca href=\"https://www.physiciansrights.org/mission/\">for\u003c/a> Advocates for Physicians’ Rights, in an email.\u003c/p>\n\u003cp>“The CDC itself warns that there are risks involved with vaccinations, and where there is risk, there should at least be a discussion between a doctor and a patient, like with any other pharmaceutical,” she said. “This bill is nothing more than government overreach. … Doctors were scared to write (medical exemptions) before this bill; this is just creating an additional killing effect.”\u003c/p>\n\u003cp>Other opponents say the law tries to solve a problem that doesn’t exist. Instead, it may force thousands of children to leave school or quickly get caught up on vaccines even if they have legitimate medical exemptions, said Toby Rogers, an independent researcher and prominent critic of the law.\u003c/p>\n\u003cp>“If you are missing a single shot in this bloated schedule, you are considered noncompliant and kicked out of school,” said Rogers, referring to the \u003ca href=\"https://www.cdc.gov/vaccines/schedules/hcp/imz/child-adolescent.html\">CDC schedule\u003c/a> of vaccinations for children. In California, kids are required to receive 15-16 vaccine \u003ca href=\"https://www.shotsforschool.org/k-12/\">shots \u003c/a>to enter kindergarten. Some of the shots carry combined doses.\u003c/p>\n\u003cp>Rogers suggested the state focus instead on the larger percentage of children affected by such diseases and conditions as diabetes, asthma, autoimmune disorders and autism.\u003c/p>\n\u003ch3>4. Are vaccines dangerous, as some critics say?\u003c/h3>\n\u003cp>Critics of the new law argue that it does not properly acknowledge the risk that vaccines pose. The law states that “for all but a small number of individuals, immunizations are safe and effective,” but does not elaborate.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Other opponents say the new requirements ignore the real needs of children who have been injured by vaccines and could be further harmed if forced into more. For example, they could have allergic reactions to vaccine components or have other underlying health conditions.\u003c/p>\n\u003cp>Vaccinations also can have \u003ca href=\"https://www.cdc.gov/vaccines/vac-gen/side-effects.htm\">side effects\u003c/a>, ranging from fevers and seizures to very rare cases of death, according to the literature included with the medications and the Centers for Disease Control and Prevention. In 1986, the federal government \u003ca href=\"https://pediatrics.aappublications.org/content/98/6/1179\">created \u003c/a>the National Childhood Vaccine Injury \u003ca href=\"https://www.congress.gov/bill/99th-congress/house-bill/5546\">Act\u003c/a>. that freed pharmaceutical companies from liability in cases of such injury. Under that law, billions of government dollars have been paid to families with children harmed by vaccines.\u003c/p>\n\u003cp>The group Physicians for Informed Consent, which opposes California’s new law, \u003ca href=\"https://physiciansforinformedconsent.org/wp-content/uploads/2019/07/PIC-MBC-SB276-7-9-19.pdf\">says \u003c/a>it is partly based on misinformation. The organization argues that some of the vaccines required for school are for illnesses that are not contagious and therefore do not affect herd immunity or other children. Those include immunizations against tetanus and Hepatitis B, which is first administered to newborns for an illness \u003ca href=\"https://www.cdc.gov/hepatitis/hbv/bfaq.htm\">transmitted\u003c/a> through sex and intravenous drug use.\u003c/p>\n\u003cp>Opponents also point to the Vaccine Adverse Effects \u003ca href=\"https://vaers.hhs.gov/\">Registry\u003c/a> and the National Vaccine Injury Compensation \u003ca href=\"https://www.hrsa.gov/vaccine-compensation/index.html\">Program\u003c/a> as evidence that vaccination decisions should be left to physicians.\u003c/p>\n\u003ch3>\u003cstrong>5. So is this fight over now?\u003c/strong>\u003c/h3>\n\u003cp>Robert F. Kennedy Jr., a vocal opponent of the California law, said at a rally last week that his \u003ca href=\"https://childrenshealthdefense.org/news/americans-can-handle-an-open-discussion-on-vaccines-rfk-jr-responds-to-criticism-from-his-family/\">organization\u003c/a>, Children’s Health Defense, intends to sue the state to block the law. And a group of opponents this week began the process of trying to overturn the new law through a ballot measure that would go to voters next November.\u003c/p>\n\u003cp>\u003cem>\u003ca href=\"http://calmatters.org/\">CalMatters.org\u003c/a> is a nonprofit, nonpartisan media venture explaining California policies and politics.\u003c/em>\u003c/p>\n\u003cp> \u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>The author of a \u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\" target=\"_blank\" rel=\"noopener\">hot-button state bill\u003c/a> limiting medical exemptions for vaccinations on Friday accepted Gov. Gavin Newsom’s last-minute demand for additional changes, setting up a final series of votes before lawmakers adjourn for the year next week.\u003c/p>\n\u003cp>Democratic state Sen. Richard Pan of Sacramento amended a companion bill to reflect the governor’s wishes, days after lawmakers sent Newsom a bill cracking down on doctors who sell fraudulent medical exemptions.\u003c/p>\n\u003cp>Pan said in a statement he appreciates Newsom’s commitment to sign the bill and the amendments, which he says will “ensure we maintain the community immunity needed to protect our kids.”\u003c/p>\n\u003cp>The amendments would give school children grace periods that could last several years on existing medical exemptions. For instance, a kindergartener with an exemption could retain it through 6th grade, while a 7th grader could be exempted through high school.\u003c/p>\n\u003cp>[aside postID=\"news_11743713\" label=\"History of Anti-Vax\"]\u003c/p>\n\u003cp>That is similar to the phase-out period allowed when California eliminated personal belief vaccine exemptions in 2015, officials said.\u003c/p>\n\u003cp>Another new provision could revoke any medical exemptions written by Robert Sears, a Southern California doctor who has been disciplined by the Medical Board of California for writing an improper vaccine exemption.\u003c/p>\n\u003cp>The provision would apply to exemptions written by any doctor who has faced disciplinary action, but at this time Sears is the only California doctor to be disciplined regarding vaccine exemptions, said Carlos Villatoro, a medical board spokesman.\u003c/p>\n\u003cp>Sears told The Los Angeles Times it would result in hundreds of his patients losing their exemptions.\u003c/p>\n\u003cp>“This seems like a broad overreach from a government that is supposed to protect its medically fragile children,” he said.\u003c/p>\n\u003cp>Other changes would make it clear that enforcement will start next year, meaning doctors who previously granted a high number of medical exemptions won’t face scrutiny.\u003c/p>\n\u003cp>They also would remove a requirement that doctors swear under penalty of perjury that they are not charging fees to fill out medical exemption forms. And one change would ensure that an expert panel reviewing appeals of exemption denials could consider additional information from the doctor beyond the exemption form.\u003c/p>\n\u003cp>Newsom spokesman Nathan Click said the governor would sign the bill once the new amendments have also won legislative approval.\u003c/p>\n\u003cp>“These amendments clarify legal and administrative processes in SB276 in order to ensure medical providers, parents, school administrators and public health officials know the rules of the road once it takes effect,” Click said in a statement, referencing the bill number.\u003c/p>\n\u003cp>Newsom’s 11th-hour demands had roiled the Legislature and frustrated the bill’s supporters, all of whom were caught by surprise when he announced them in a tweet this week.\u003c/p>\n\u003cp>https://twitter.com/CAgovernor/status/1169027421930184705\u003c/p>\n\u003cp>It prompted several newspapers across California to editorially question the freshman governor’s commitment to limiting vaccine exemptions during a year of record measles outbreaks.\u003c/p>\n\u003cp>Senate President Pro Tem Toni Atkins, a fellow Democrat from San Diego, said both chambers plan to vote on the companion bill on Monday, with the understanding that Newsom would then sign the original measure.\u003c/p>\n\u003cp>[aside tag=\"childhood-vaccinations\" label=\"Related Stories\"]\u003c/p>\n\u003cp>Signing the bill would also counter opponents who have threatened and harassed Pan and other lawmakers over the pending legislation, she said: “It is important that we send the message that loud and violent will not drown out reason and science in how we govern California.”\u003c/p>\n\u003cp>The last-minute amendments are unlikely to mollify opponents who have swarmed the Capitol and had hoped Newsom might veto the bill, given his insistence on significant changes in June and again this week.\u003c/p>\n\u003cp>But the compromise pleased the bill’s supporters.\u003c/p>\n\u003cp>American Academy of Pediatrics, California, chief executive Kris Calvin and Vaccinate California executive director Leah Russin both praised Newsom and Pan for working out their differences.\u003c/p>\n\u003cp>Russin called the agreement “a victory for science over fear and for sound public health policy over conspiracy and misinformation,” while also urging Newsom to immediately sign the bill already on his desk.\u003c/p>\n\u003cp>Calvin said her group supports the amendments if it means both bills become law.\u003c/p>\n\u003cp>“We are perfectly satisfied that this bill will satisfy its objective of making sure that bogus medical exemptions are uncovered … while protecting valid medical exemptions,” Calvin said.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The author of a \u003ca href=\"https://www.kqed.org/news/11772219/vaccine-bill-passes-legislature-unclear-if-newsom-will-sign\" target=\"_blank\" rel=\"noopener\">hot-button state bill\u003c/a> limiting medical exemptions for vaccinations on Friday accepted Gov. Gavin Newsom’s last-minute demand for additional changes, setting up a final series of votes before lawmakers adjourn for the year next week.\u003c/p>\n\u003cp>Democratic state Sen. Richard Pan of Sacramento amended a companion bill to reflect the governor’s wishes, days after lawmakers sent Newsom a bill cracking down on doctors who sell fraudulent medical exemptions.\u003c/p>\n\u003cp>Pan said in a statement he appreciates Newsom’s commitment to sign the bill and the amendments, which he says will “ensure we maintain the community immunity needed to protect our kids.”\u003c/p>\n\u003cp>The amendments would give school children grace periods that could last several years on existing medical exemptions. For instance, a kindergartener with an exemption could retain it through 6th grade, while a 7th grader could be exempted through high school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>That is similar to the phase-out period allowed when California eliminated personal belief vaccine exemptions in 2015, officials said.\u003c/p>\n\u003cp>Another new provision could revoke any medical exemptions written by Robert Sears, a Southern California doctor who has been disciplined by the Medical Board of California for writing an improper vaccine exemption.\u003c/p>\n\u003cp>The provision would apply to exemptions written by any doctor who has faced disciplinary action, but at this time Sears is the only California doctor to be disciplined regarding vaccine exemptions, said Carlos Villatoro, a medical board spokesman.\u003c/p>\n\u003cp>Sears told The Los Angeles Times it would result in hundreds of his patients losing their exemptions.\u003c/p>\n\u003cp>“This seems like a broad overreach from a government that is supposed to protect its medically fragile children,” he said.\u003c/p>\n\u003cp>Other changes would make it clear that enforcement will start next year, meaning doctors who previously granted a high number of medical exemptions won’t face scrutiny.\u003c/p>\n\u003cp>They also would remove a requirement that doctors swear under penalty of perjury that they are not charging fees to fill out medical exemption forms. And one change would ensure that an expert panel reviewing appeals of exemption denials could consider additional information from the doctor beyond the exemption form.\u003c/p>\n\u003cp>Newsom spokesman Nathan Click said the governor would sign the bill once the new amendments have also won legislative approval.\u003c/p>\n\u003cp>“These amendments clarify legal and administrative processes in SB276 in order to ensure medical providers, parents, school administrators and public health officials know the rules of the road once it takes effect,” Click said in a statement, referencing the bill number.\u003c/p>\n\u003cp>Newsom’s 11th-hour demands had roiled the Legislature and frustrated the bill’s supporters, all of whom were caught by surprise when he announced them in a tweet this week.\u003c/p>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>It prompted several newspapers across California to editorially question the freshman governor’s commitment to limiting vaccine exemptions during a year of record measles outbreaks.\u003c/p>\n\u003cp>Senate President Pro Tem Toni Atkins, a fellow Democrat from San Diego, said both chambers plan to vote on the companion bill on Monday, with the understanding that Newsom would then sign the original measure.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Signing the bill would also counter opponents who have threatened and harassed Pan and other lawmakers over the pending legislation, she said: “It is important that we send the message that loud and violent will not drown out reason and science in how we govern California.”\u003c/p>\n\u003cp>The last-minute amendments are unlikely to mollify opponents who have swarmed the Capitol and had hoped Newsom might veto the bill, given his insistence on significant changes in June and again this week.\u003c/p>\n\u003cp>But the compromise pleased the bill’s supporters.\u003c/p>\n\u003cp>American Academy of Pediatrics, California, chief executive Kris Calvin and Vaccinate California executive director Leah Russin both praised Newsom and Pan for working out their differences.\u003c/p>\n\u003cp>Russin called the agreement “a victory for science over fear and for sound public health policy over conspiracy and misinformation,” while also urging Newsom to immediately sign the bill already on his desk.\u003c/p>\n\u003cp>Calvin said her group supports the amendments if it means both bills become law.\u003c/p>\n\u003cp>“We are perfectly satisfied that this bill will satisfy its objective of making sure that bogus medical exemptions are uncovered … while protecting valid medical exemptions,” Calvin said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>Destination: Bulgaria. A tiny country in Eastern Europe typically overlooked by American tourists. But my husband’s father grew up in Bulgaria, so it’s long been on our travel list.\u003c/p>\n\u003cp>It’s also on the list of countries with measles outbreaks. Bulgaria has had almost 800 cases this year, \u003ca href=\"https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/\" target=\"_blank\" rel=\"noopener\">according to the World Health Organization\u003c/a>.\u003c/p>\n\u003cp>In California, four of the five outbreaks that occurred in the state this year were linked to international travel. Most travelers were infected in the Philippines or Ukraine, which are experiencing severe outbreaks, and 37% of cases were imported from Europe overall. New measles infections continue to be reported, with California now at 65 cases \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">as of Aug. 14\u003c/a>.\u003c/p>\n\u003cp>[aside tag='measles' label='More on measles']\u003c/p>\n\u003cp>Measles is highly contagious. If someone who’s sick visits a popular tourist site and coughs, or rides the subway and sneezes, the virus can live in the air for two hours after they leave. If people who are unvaccinated pass through the same place, 90% of them will get sick.\u003c/p>\n\u003cp>That’s why my travel nurse wanted to check on my vaccination status before I left for Bulgaria. This is routine for Gen Xers and Millennials born in the ’70s and ’80s because when the measles, mumps, rubella vaccine (MMR) was first introduced in 1971, scientists recommended just one dose. But over the years, they noticed some kids still got measles. It wasn’t until 1989 that they \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm\" target=\"_blank\" rel=\"noopener\">changed the guidelines\u003c/a> to two doses.\u003c/p>\n\u003cp>But a lot of people, like me, who are now in their 30s and 40s, aren’t sure if they ever got the second dose.\u003c/p>\n\u003cp>So my travel nurse recommended I go to the lab to get a blood test to check my immunity. It’s a basic test that looks for antibodies to measles and should come back positive or negative, yes or no.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>Vaccinated, But Still Getting Sick?\u003c/b>\n\u003cp>\u003cspan style=\"font-weight: normal\">\u003cbr>\nIn California, the vast majority of measles cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">in adults – 77%\u003c/a>. What’s more, a majority of cases – 51% – have been in people who were already vaccinated: 44% had two doses of the measles vaccine and 7% had one. How is this possible?\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">Back in the 1970s, when the current measles vaccine was first developed, health officials recommended people get one dose. But over the years, they noticed it only worked for 93% of people who got it – about 7% still got sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">So, in 1989, they recommended people get two doses of the vaccine. And that worked for 97% of people. But that still leaves 3% of people who are fully vaccinated susceptible to the disease.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“We do believe that there are some people who get two doses of measles vaccine and were never immune,” said Dr. James Watt, chief of communicable disease control at the California Department of Public Health. “For some reason their body just didn’t respond to the vaccine. And that’s why the vaccine is 97% effective and not 100% effective.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">That’s why you can have people who are fully vaccinated still get measles. And in California, we have a high vaccination rate. So because we have more vaccinated people, they make up a higher proportion of those who get sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“Just an illustration of that is that some of the adult cases we have had have been in health care workers, who tend to have a higher vaccination coverage than the general population,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">The takeaway, Watt said, is that the measles vaccine is still one of the most effective vaccines we have. It’s the reason measles was declared eradicated from the U.S. almost 20 years ago. Today, most measles cases we see here are imported from other countries.\u003cbr>\n\u003c/span>\u003c/p>\u003c/aside>\n\u003c/div>\n\u003cp>But my results came back “borderline.” In other words, maybe I’m immune, maybe I’m not.\u003c/p>\n\u003cp>“The blood test is imperfect,” said Dr. Art Reingold, a professor of epidemiology at UC Berkeley. “If you have antibodies, then we’re pretty certain you’re immune. But if you don’t have antibodies you may still be immune, but your antibodies are not detectable by the test.”\u003c/p>\n\u003cp>So it’s possible I got a false negative. But there’s no way to know for sure.\u003c/p>\n\u003cp>“I know a lot of people who would say that’s a good reason not to do testing,” Reingold said with a laugh. “Because you get these results, you don’t know how to interpret them, people worry.”\u003c/p>\n\u003cp>So now what? My doctor suggested getting another dose of measles vaccine. It’s safe. But when I look into it, it turns out, there are some side effects in adults that don’t occur in babies: \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK234372/\" target=\"_blank\" rel=\"noopener\">25% of women and teenage girls\u003c/a> get acute arthritis one to three weeks after getting the vaccine.\u003c/p>\n\u003cp>That would be right in the middle of my trip, right when my husband and I are due to arrive at Bulgaria’s Black Sea Coast.\u003c/p>\n\u003cp>I imagined lying on the beach, meditating on the rolling waves — wracked with joint pain.\u003c/p>\n\u003cp>“That would suck,” I said to my husband, when we talked it through.\u003c/p>\n\u003cp>“Yeah,” he replied. “But wouldn’t it be more of a bummer to get measles?”\u003c/p>\n\u003cp>So I went back to the experts. This time I spoke with Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital.\u003c/p>\n\u003cp>“I can fully appreciate getting measles is not something you want,” she said.\u003c/p>\n\u003cp>She tells me not to worry about the acute arthritis, which really means sudden onset and short lived. And she says the joint pain is typically mild, nothing a couple ibuprofen wouldn’t take care of.\u003c/p>\n\u003cp>On top of that, the side effect is caused by the rubella part of the measles, mumps, rubella vaccine, and rarely occurs in women who have had one dose of MMR already.\u003c/p>\n\u003cp>“I would say that if the choice is between ‘I’m a little worried that I may get this arthritis or some joint pain,’ versus ‘I’m going someplace where I’m really going to be at risk for measles,’ the balance would swing towards being vaccinated for sure,” Winston said.\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital']‘I would say that if the choice is between “I’m a little worried that I may get this arthritis or some joint pain,” versus “I’m going someplace where I’m really going to be at risk for measles,” the balance would swing towards being vaccinated for sure.’[/pullquote]\u003c/p>\n\u003cp>But before I went through the trouble of another medical visit, I wanted to make sure I really needed it. My mom was a nurse, and she kept my pediatric vaccine records. Squeezed in the margin, scrawled in black pen, it says that I got a second dose of the vaccine when I was 11. But the handwriting is hard to read and it looks so … unofficial. This is why I got the blood test.\u003c/p>\n\u003cp>Winston tells me, in general, medical records are more reliable than the blood test.\u003c/p>\n\u003cp>“For somebody who knows that they have been vaccinated, who has their history, you would actually be considered immune regardless of what your blood test shows,” she said.\u003c/p>\n\u003cp>Bottom line, if you’re not sure what your vaccination status is and you’re traveling to a country with a known measles outbreak, there’s no harm getting a second dose of vaccine. But if you know you’ve had two doses, there’s no benefit to getting a third.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Destination: Bulgaria. A tiny country in Eastern Europe typically overlooked by American tourists. But my husband’s father grew up in Bulgaria, so it’s long been on our travel list.\u003c/p>\n\u003cp>It’s also on the list of countries with measles outbreaks. Bulgaria has had almost 800 cases this year, \u003ca href=\"https://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/active/measles_monthlydata/en/\" target=\"_blank\" rel=\"noopener\">according to the World Health Organization\u003c/a>.\u003c/p>\n\u003cp>In California, four of the five outbreaks that occurred in the state this year were linked to international travel. Most travelers were infected in the Philippines or Ukraine, which are experiencing severe outbreaks, and 37% of cases were imported from Europe overall. New measles infections continue to be reported, with California now at 65 cases \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">as of Aug. 14\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Measles is highly contagious. If someone who’s sick visits a popular tourist site and coughs, or rides the subway and sneezes, the virus can live in the air for two hours after they leave. If people who are unvaccinated pass through the same place, 90% of them will get sick.\u003c/p>\n\u003cp>That’s why my travel nurse wanted to check on my vaccination status before I left for Bulgaria. This is routine for Gen Xers and Millennials born in the ’70s and ’80s because when the measles, mumps, rubella vaccine (MMR) was first introduced in 1971, scientists recommended just one dose. But over the years, they noticed some kids still got measles. It wasn’t until 1989 that they \u003ca href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/00041753.htm\" target=\"_blank\" rel=\"noopener\">changed the guidelines\u003c/a> to two doses.\u003c/p>\n\u003cp>But a lot of people, like me, who are now in their 30s and 40s, aren’t sure if they ever got the second dose.\u003c/p>\n\u003cp>So my travel nurse recommended I go to the lab to get a blood test to check my immunity. It’s a basic test that looks for antibodies to measles and should come back positive or negative, yes or no.\u003c/p>\n\u003cdiv>\n\u003caside class=\"alignright\">\u003cb>Vaccinated, But Still Getting Sick?\u003c/b>\n\u003cp>\u003cspan style=\"font-weight: normal\">\u003cbr>\nIn California, the vast majority of measles cases have been \u003ca href=\"https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Immunization/measles.aspx\" target=\"_blank\" rel=\"noopener\">in adults – 77%\u003c/a>. What’s more, a majority of cases – 51% – have been in people who were already vaccinated: 44% had two doses of the measles vaccine and 7% had one. How is this possible?\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">Back in the 1970s, when the current measles vaccine was first developed, health officials recommended people get one dose. But over the years, they noticed it only worked for 93% of people who got it – about 7% still got sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">So, in 1989, they recommended people get two doses of the vaccine. And that worked for 97% of people. But that still leaves 3% of people who are fully vaccinated susceptible to the disease.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“We do believe that there are some people who get two doses of measles vaccine and were never immune,” said Dr. James Watt, chief of communicable disease control at the California Department of Public Health. “For some reason their body just didn’t respond to the vaccine. And that’s why the vaccine is 97% effective and not 100% effective.”\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">That’s why you can have people who are fully vaccinated still get measles. And in California, we have a high vaccination rate. So because we have more vaccinated people, they make up a higher proportion of those who get sick.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">“Just an illustration of that is that some of the adult cases we have had have been in health care workers, who tend to have a higher vaccination coverage than the general population,” he said.\u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: normal\">The takeaway, Watt said, is that the measles vaccine is still one of the most effective vaccines we have. It’s the reason measles was declared eradicated from the U.S. almost 20 years ago. Today, most measles cases we see here are imported from other countries.\u003cbr>\n\u003c/span>\u003c/p>\u003c/aside>\n\u003c/div>\n\u003cp>But my results came back “borderline.” In other words, maybe I’m immune, maybe I’m not.\u003c/p>\n\u003cp>“The blood test is imperfect,” said Dr. Art Reingold, a professor of epidemiology at UC Berkeley. “If you have antibodies, then we’re pretty certain you’re immune. But if you don’t have antibodies you may still be immune, but your antibodies are not detectable by the test.”\u003c/p>\n\u003cp>So it’s possible I got a false negative. But there’s no way to know for sure.\u003c/p>\n\u003cp>“I know a lot of people who would say that’s a good reason not to do testing,” Reingold said with a laugh. “Because you get these results, you don’t know how to interpret them, people worry.”\u003c/p>\n\u003cp>So now what? My doctor suggested getting another dose of measles vaccine. It’s safe. But when I look into it, it turns out, there are some side effects in adults that don’t occur in babies: \u003ca href=\"https://www.ncbi.nlm.nih.gov/books/NBK234372/\" target=\"_blank\" rel=\"noopener\">25% of women and teenage girls\u003c/a> get acute arthritis one to three weeks after getting the vaccine.\u003c/p>\n\u003cp>That would be right in the middle of my trip, right when my husband and I are due to arrive at Bulgaria’s Black Sea Coast.\u003c/p>\n\u003cp>I imagined lying on the beach, meditating on the rolling waves — wracked with joint pain.\u003c/p>\n\u003cp>“That would suck,” I said to my husband, when we talked it through.\u003c/p>\n\u003cp>“Yeah,” he replied. “But wouldn’t it be more of a bummer to get measles?”\u003c/p>\n\u003cp>So I went back to the experts. This time I spoke with Dr. Lisa Winston, an epidemiologist at San Francisco General Hospital.\u003c/p>\n\u003cp>“I can fully appreciate getting measles is not something you want,” she said.\u003c/p>\n\u003cp>She tells me not to worry about the acute arthritis, which really means sudden onset and short lived. And she says the joint pain is typically mild, nothing a couple ibuprofen wouldn’t take care of.\u003c/p>\n\u003cp>On top of that, the side effect is caused by the rubella part of the measles, mumps, rubella vaccine, and rarely occurs in women who have had one dose of MMR already.\u003c/p>\n\u003cp>“I would say that if the choice is between ‘I’m a little worried that I may get this arthritis or some joint pain,’ versus ‘I’m going someplace where I’m really going to be at risk for measles,’ the balance would swing towards being vaccinated for sure,” Winston said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "‘I would say that if the choice is between “I’m a little worried that I may get this arthritis or some joint pain,” versus “I’m going someplace where I’m really going to be at risk for measles,” the balance would swing towards being vaccinated for sure.’",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But before I went through the trouble of another medical visit, I wanted to make sure I really needed it. My mom was a nurse, and she kept my pediatric vaccine records. Squeezed in the margin, scrawled in black pen, it says that I got a second dose of the vaccine when I was 11. But the handwriting is hard to read and it looks so … unofficial. This is why I got the blood test.\u003c/p>\n\u003cp>Winston tells me, in general, medical records are more reliable than the blood test.\u003c/p>\n\u003cp>“For somebody who knows that they have been vaccinated, who has their history, you would actually be considered immune regardless of what your blood test shows,” she said.\u003c/p>\n\u003cp>Bottom line, if you’re not sure what your vaccination status is and you’re traveling to a country with a known measles outbreak, there’s no harm getting a second dose of vaccine. But if you know you’ve had two doses, there’s no benefit to getting a third.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "Poll: Voters Give Newsom Lukewarm Reviews for Policies on Wildfires, PG&E Bankruptcy",
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"content": "\u003cp>A new poll says an overwhelming majority of Californians — 78% — are worried that they might have to bear some of the costs for recent wildfires caused by downed utility lines. At the same time, many likely voters are giving Gov. Gavin Newsom a very mixed review for his handling of the PG&E bankruptcy and its aftermath.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-may-2019/\" target=\"_blank\" rel=\"noopener\">poll\u003c/a> from the Public Policy Institute of California also finds a growing number of Californians suffering financial strain due to housing costs, and also finds support for legislative measures to address the state's shortage of affordable shelter.\u003c/p>\n\u003cp>On the subject of wildfires, the PPIC survey found that 41% of likely voters approve of Newsom's overall handling of wildfire prevention and response, with 27% disapproving and 32% saying they don't know.\u003c/p>\n\u003cp>At the same time, just 28% of likely voters approve of Newsom's handling of the PG&E bankruptcy, with 35% disapproving and 37% saying they're not sure.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">[pullquote]'Overall, 47% of likely voters in the poll said they approve of the way Newsom is handling his job as governor.'[/pullquote]\u003c/span>\u003c/p>\n\u003cp>Since the governor took office in January, addressing the financial toll of last year's wildfires and the subsequent bankruptcy of California's largest utility has been a high priority for the Newsom administration. In his first budget, Newsom included $213 million in fuel reduction measures to mitigate wildfires, as well as funds for 13 new year-round fire engines for Cal Fire and $10 million for remote-sensing technology to aid in early detection of wildfires.\u003c/p>\n\u003cp>The governor also recently released a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2019/04/Wildfires-and-Climate-Change-California%E2%80%99s-Energy-Future.pdf\" target=\"_blank\" rel=\"noopener\">plan\u003c/a> to fight wildfires driven by climate change.\u003c/p>\n\u003cp>Unlike his predecessor, Jerry Brown, the new governor has been very critical of PG&E. Last month his office submitted a court filing in the company's bankruptcy case that blasted the utility's request for extra time to submit a reorganization plan.\u003c/p>\n\u003cp>Newsom's response said PG&E's request “reflects no sense of urgency in addressing the serious problems and issues confronting\" the company.\u003c/p>\n\u003cp>\"All should be mindful of PG&E’s history of over two decades of mismanagement, misconduct and failed efforts to improve a woeful safety culture,” the filing said.\u003c/p>\n\u003cp>And Newsom's office says that in the coming weeks the governor will outline additional steps to hold the state’s utilities accountable for fires their equipment starts while also addressing the energy needs of customers and the economy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>There's better news for Newsom in other parts of the survey.\u003c/p>\n\u003cp>Overall, 47% of likely voters in the poll said they approve of the way Newsom is handling his job as governor, while 56% support his budget plan and 68% favor his plan to spend $1 billion to address homelessness, while just 28% oppose it.\u003c/p>\n\u003cp>\u003cstrong>More Feeling the Pain of Housing Costs\u003c/strong>\u003c/p>\n\u003cp>On the subject of housing, the PPIC poll found 52% of respondents said the cost of housing is placing a strain on their households. That's up from 47% two years ago, the PPIC said.\u003c/p>\n\u003cp>The pain is especially acute for people with families and renters: 61% of survey respondents who have children at home and 67% of renters said housing costs are a financial strain.\u003c/p>\n\u003cp>The poll also found strong support for two proposals that have been floated in Sacramento to try to spur the state's cities and towns to approve more housing development.\u003c/p>\n\u003cp>[aside label=\"Pacific Gas and Electric: Wildfire Aftermath\" tag=\"pge\"]The PPIC said 61% of respondents said they'd support Newsom's suggestion to require local governments to approve new housing before receiving state transportation funding. And 62% backed an idea embodied in the now-stalled SB 50, a bill by San Francisco state Sen. Scott Wiener, to require denser development near transit and job centers.\u003c/p>\n\u003cp>The PPIC poll also asked about the hot-button issue of vaccinations. The United States is now facing its worst measles outbreak in more than 20 years. According to the survey, 79% of Californians are very or somewhat concerned the outbreak will get worse. And 73% think parents should be required to vaccinate their children.\u003c/p>\n\u003cp>The state Senate recently passed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a> to tighten California's already strict immunization laws with closer oversight of medical exemptions. The bill is now in the Assembly, although Newsom recently expressed doubts about having the California Department of Public Health oversee medical exemptions, as called for in SB 276.\u003c/p>\n\u003cp>\"I’m a parent, I don’t want someone that the governor of California appointed to make a decision for my family,\" Newsom said at an impromptu press conference at the Democratic convention Saturday. It's unclear, however, whether he would sign or veto the bill.\u003c/p>\n\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A new poll says an overwhelming majority of Californians — 78% — are worried that they might have to bear some of the costs for recent wildfires caused by downed utility lines. At the same time, many likely voters are giving Gov. Gavin Newsom a very mixed review for his handling of the PG&E bankruptcy and its aftermath.\u003c/p>\n\u003cp>The \u003ca href=\"https://www.ppic.org/publication/ppic-statewide-survey-californians-and-their-government-may-2019/\" target=\"_blank\" rel=\"noopener\">poll\u003c/a> from the Public Policy Institute of California also finds a growing number of Californians suffering financial strain due to housing costs, and also finds support for legislative measures to address the state's shortage of affordable shelter.\u003c/p>\n\u003cp>On the subject of wildfires, the PPIC survey found that 41% of likely voters approve of Newsom's overall handling of wildfire prevention and response, with 27% disapproving and 32% saying they don't know.\u003c/p>\n\u003cp>At the same time, just 28% of likely voters approve of Newsom's handling of the PG&E bankruptcy, with 35% disapproving and 37% saying they're not sure.\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400;\">\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/span>\u003c/p>\n\u003cp>Since the governor took office in January, addressing the financial toll of last year's wildfires and the subsequent bankruptcy of California's largest utility has been a high priority for the Newsom administration. In his first budget, Newsom included $213 million in fuel reduction measures to mitigate wildfires, as well as funds for 13 new year-round fire engines for Cal Fire and $10 million for remote-sensing technology to aid in early detection of wildfires.\u003c/p>\n\u003cp>The governor also recently released a \u003ca href=\"https://www.gov.ca.gov/wp-content/uploads/2019/04/Wildfires-and-Climate-Change-California%E2%80%99s-Energy-Future.pdf\" target=\"_blank\" rel=\"noopener\">plan\u003c/a> to fight wildfires driven by climate change.\u003c/p>\n\u003cp>Unlike his predecessor, Jerry Brown, the new governor has been very critical of PG&E. Last month his office submitted a court filing in the company's bankruptcy case that blasted the utility's request for extra time to submit a reorganization plan.\u003c/p>\n\u003cp>Newsom's response said PG&E's request “reflects no sense of urgency in addressing the serious problems and issues confronting\" the company.\u003c/p>\n\u003cp>\"All should be mindful of PG&E’s history of over two decades of mismanagement, misconduct and failed efforts to improve a woeful safety culture,” the filing said.\u003c/p>\n\u003cp>And Newsom's office says that in the coming weeks the governor will outline additional steps to hold the state’s utilities accountable for fires their equipment starts while also addressing the energy needs of customers and the economy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>There's better news for Newsom in other parts of the survey.\u003c/p>\n\u003cp>Overall, 47% of likely voters in the poll said they approve of the way Newsom is handling his job as governor, while 56% support his budget plan and 68% favor his plan to spend $1 billion to address homelessness, while just 28% oppose it.\u003c/p>\n\u003cp>\u003cstrong>More Feeling the Pain of Housing Costs\u003c/strong>\u003c/p>\n\u003cp>On the subject of housing, the PPIC poll found 52% of respondents said the cost of housing is placing a strain on their households. That's up from 47% two years ago, the PPIC said.\u003c/p>\n\u003cp>The pain is especially acute for people with families and renters: 61% of survey respondents who have children at home and 67% of renters said housing costs are a financial strain.\u003c/p>\n\u003cp>The poll also found strong support for two proposals that have been floated in Sacramento to try to spur the state's cities and towns to approve more housing development.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>The PPIC said 61% of respondents said they'd support Newsom's suggestion to require local governments to approve new housing before receiving state transportation funding. And 62% backed an idea embodied in the now-stalled SB 50, a bill by San Francisco state Sen. Scott Wiener, to require denser development near transit and job centers.\u003c/p>\n\u003cp>The PPIC poll also asked about the hot-button issue of vaccinations. The United States is now facing its worst measles outbreak in more than 20 years. According to the survey, 79% of Californians are very or somewhat concerned the outbreak will get worse. And 73% think parents should be required to vaccinate their children.\u003c/p>\n\u003cp>The state Senate recently passed \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a> to tighten California's already strict immunization laws with closer oversight of medical exemptions. The bill is now in the Assembly, although Newsom recently expressed doubts about having the California Department of Public Health oversee medical exemptions, as called for in SB 276.\u003c/p>\n\u003cp>\"I’m a parent, I don’t want someone that the governor of California appointed to make a decision for my family,\" Newsom said at an impromptu press conference at the Democratic convention Saturday. It's unclear, however, whether he would sign or veto the bill.\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>",
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"content": "\u003cp>More than 700 measles cases have been confirmed in 22 states so far this year, with 78 of those cases reported in the previous week, \u003ca href=\"https://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">according to Monday’s update from the Centers for Disease Control and Prevention.\u003c/a> That’s the highest number reported in the U.S. since 1994.\u003c/p>\n\u003cp>[aside label=\"Related\" tag=\"measles\"]\u003c/p>\n\u003cp>Of those cases, more than 500 have been found in people who had not been vaccinated, the federal agency said, including about 400 in mostly Orthodox Jewish communities in the New York region. And late last week, a quarantine order was issued for \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">hundreds of students and staff at two Los Angeles universities\u003c/a> who may have been exposed to measles and don’t have vaccination records.\u003c/p>\n\u003cp>With this latest outbreak comes plenty of angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves) against the highly contagious, yet preventable, disease.\u003c/p>\n\u003cp>As recently as three decades ago, measles was listed by the World Health Organization as one of the five leading causes of death on Earth. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely due to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported what was then the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>\u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx\" target=\"_blank\" rel=\"noopener\">Forty-seven\u003c/a> states still permit parents to opt out of vaccinating their children on religious grounds, and 18 states allow exemptions based on personal or philosophical beliefs (until 2015, \u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements/california.aspx\" target=\"_blank\" rel=\"noopener\">California allowed\u003c/a> both exemptions). Many parents who go this route say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even though no medical evidence actually supports these theories.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://apps.npr.org/dailygraphics/graphics/measles-20190429/\" width=\"700\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>These holdouts mark just the latest chapter in a long, robust history of anti-vaccination movements. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of vaccinations were given more than 200 years ago.\u003c/p>\n\u003cp>Most interesting are the striking cultural similarities and motives of today’s prototypical “anti-vaxers” and their 19th century forebears: Both have typically been cast as either deeply religious or affluent, well-educated and politically progressive, and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner’s the guy to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire civilizations and claiming millions of lives — particularly those of young children — during its sporadic outbreaks. Highly infectious, the disease typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals and can be transmitted to human handlers. \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Jenner extracted pus from a cowpox scab\u003c/a> and inserted it into an incision on the arm of an 8-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cp>Jenner subsequently coined the term “vaccine,” from “vacca,” Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner’s findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the following two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the \u003ca href=\"https://www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization in 1980\u003c/a> declared it the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for it; vaccination is the only means of prevention.\u003c/p>\n\u003ch3>Birth of the Backlash\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: Who wouldn’t raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-16227 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: “This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.” (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure became increasingly accepted by the medical establishment in much of Europe.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>These measures, though, were met with staunch resistance, inciting a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cp>The group’s seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>“As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.”\u003c/em>\u003c/p>\n\u003cp>By the 1870s and ’80s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease’s spread, anti-vaccination campaigns continued to gain momentum in the U.K. and elsewhere. Propaganda literature proliferated as leaders of the movement adeptly tapped into the public’s understandable anxieties about the still nascent procedure. Some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744701\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744701\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\" alt=\"\" width=\"720\" height=\"405\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405-160x90.jpg 160w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from a 1894 anti-vaccination publication. \u003ccite>(Courtesy of the Historical Medical Library of the College of Physicians of Philadelphia)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the largest demonstrations, in Leicester, England, in 1885, drew upward of 100,000 people, with a child’s coffin and an effigy of Jenner among the props exhibited.\u003c/p>\n\u003cp>The rally prompted a government commission to investigate the protesters’ grievances, which eventually concluded that the vaccine was safe and effective. But in a political move to pacify detractors, the report also recommended the abolition of penalties for violators. In 1898, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">the passage of a new national vaccination act\u003c/a> removed such penalties and included a “conscientious objector” clause, allowing parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003ch3>The anti-vax fever spreads to America\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the United States spurred a number of local government vaccine campaigns. That, in turn, prompted fierce opposition, including a visit from William Tebb, a prominent British anti-vaccine activist. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cp>In a response that inflamed tensions and helped further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, inconsistent enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, writes \u003ca href=\"https://www.tulsaworld.com/opinion/columnists/stephen-mihm-how-to-eradicate-outbreaks-of-anti-vaccine-fever/article_4660b867-3b84-58b1-8e2e-73e631c0bdd5.html\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11744718\" class=\"wp-caption alignnone\" style=\"max-width: 758px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744718\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\" alt=\"\" width=\"758\" height=\"441\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg 758w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902-160x93.jpg 160w\" sizes=\"(max-width: 758px) 100vw, 758px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Anti-Vaccination Society of America advertisement from 1902. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fears were also legitimately stoked by the lack of oversight in the production of vaccines, a process primarily controlled by private industry that was loosely regulated and at times resulted in questionable, unsafe products. In one of the worst incidents, nine children in Camden, New Jersey, died after being inoculated with a batch of smallpox vaccine that had been contaminated with tetanus. News of the tragedy prompted Congress to pass the \u003ca href=\"https://history.nih.gov/exhibits/history/docs/page_03.html\" target=\"_blank\" rel=\"noopener\">Biologics Control Act\u003c/a> of 1902, increasing government oversight of the manufacturing process.s\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Massachusetts, mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> — eventually made its way to the U.S. Supreme Court, which ultimately sided with the state, ruling that it was within its power to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">The decision\u003c/a> marked the first Supreme Court case determining the extent of state power in enacting public health law.\u003c/p>\n\u003ch3>Modern times\u003c/h3>\n\u003cp>Anti-vaccination fervor erupted again in England and spread abroad in the latter half of the 20th century, this time after an errant 1970s medical study alleged that the diphtheria, tetanus and pertussis (DTP) vaccine had caused neurological disorders in children. The report fueled a wave of public outcry and subsequent false analyses, leading to decreased vaccination rates and three major outbreaks of pertussis (whooping cough), despite an independent advisory committee confirming the safety of the immunization.\u003c/p>\n\u003cp>The controversy over DTP reached the United States after a 1982 documentary, “DPT: Vaccination Roulette,” and a 1991 book, “A Shot in the Dark,” alleged adverse reactions to the vaccine and questioned its effectiveness. Amid the ensuing media storm, scores of parents formed advocacy groups opposing the immunization and, in several cases, sued vaccine manufacturers. Hoping to not repeat England’s example, U.S. medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention, aggressively countered the false claims, and more effectively stemmed the decrease in vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744712\" class=\"wp-caption alignnone\" style=\"max-width: 2048px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744712\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1920x1280.jpg 1920w\" sizes=\"(max-width: 2048px) 100vw, 2048px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An anti-vaccination parent holds up a prescription document as she waits to enter a hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill in Washington, D.C., on March 5, 2019. \u003ccite>(Jim WATSON/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And then came the \u003cem>anti\u003c/em> anti-measles movement.\u003c/p>\n\u003cp>Despite the MMR vaccine’s safe and effective application since it was introduced in the 1960s, fear over the inoculation spread like wildfire after a 1998 medical study, and a subsequent flurry of media coverage, suggested a connection between the vaccine and the onset of autism. The study was later discredited, and an independent medical board determined that its author, British doctor Andrew Wakefield, had a “fatal conflict of interest” \u003ca href=\"https://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">after revelations\u003c/a> that he had been paid by lawyers representing parents who believed the vaccine had harmed their children.\u003c/p>\n\u003cp>More than a decade later, after numerous subsequent studies that found no evidence of any link between the vaccine and autism, the paper was formally retracted by The Lancet, the journal that first published it, and \u003ca href=\"https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper\" target=\"_blank\" rel=\"noopener\">labeled “utterly false.”\u003c/a> Wakefield \u003ca href=\"https://www.mdmag.com/medical-news/autism_doctor/\" target=\"_blank\" rel=\"noopener\">was also stripped of his medical license\u003c/a>.\u003c/p>\n\u003cp>But the seed had been planted, and parents already skeptical about immunizing their children were further motivated to avoid the vaccine at all costs.\u003c/p>\n\u003cp>Since then, fears have been further inflamed by a number of anti-vaccination campaigns suggesting the linkage to an increased incidence of autism. Perhaps most well-known is the ongoing activism of \u003ca href=\"https://www.cnbc.com/2018/05/10/jenny-mccarthy-talks-to-cnbc-about-autism-and-her-family.html\" target=\"_blank\" rel=\"noopener\">actress and model Jenny McCarthy\u003c/a>, who became the veritable poster child of the anti-vax movement when she began publicly questioning the safety of vaccines after her 2-year-old son was diagnosed with autism.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n",
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"excerpt": "A nationwide measles outbreak has prompted angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves). Here’s some history.",
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"title": "The Feverish Roots of Today's Anti-Vaccine Movement | KQED",
"description": "A nationwide measles outbreak has prompted angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves). Here’s some history.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than 700 measles cases have been confirmed in 22 states so far this year, with 78 of those cases reported in the previous week, \u003ca href=\"https://www.cdc.gov/measles/cases-outbreaks.html\" target=\"_blank\" rel=\"noopener\">according to Monday’s update from the Centers for Disease Control and Prevention.\u003c/a> That’s the highest number reported in the U.S. since 1994.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Of those cases, more than 500 have been found in people who had not been vaccinated, the federal agency said, including about 400 in mostly Orthodox Jewish communities in the New York region. And late last week, a quarantine order was issued for \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">hundreds of students and staff at two Los Angeles universities\u003c/a> who may have been exposed to measles and don’t have vaccination records.\u003c/p>\n\u003cp>With this latest outbreak comes plenty of angry finger-pointing at the small but notorious contingent of Americans who choose not to vaccinate their children (or themselves) against the highly contagious, yet preventable, disease.\u003c/p>\n\u003cp>As recently as three decades ago, measles was listed by the World Health Organization as one of the five leading causes of death on Earth. But by 2000, the disease\u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\"> \u003c/a>was \u003ca href=\"http://www.cdc.gov/measles/about/faqs.html\" target=\"_blank\" rel=\"noopener\">declared “eliminated” in the U.S.\u003c/a>, largely due to the success of statewide public health campaigns to make the MMR (measles, mumps, rubella) vaccine mandatory for children enrolling in public schools.\u003c/p>\n\u003cp>Since then, however, the number of parents requesting religious or philosophical exemptions to state rules has gone up, as have reported measles cases. In 2014, the CDC reported what was then the highest number of cases in over a decade: 644 in 27 states, including one outbreak in an Amish community in rural Ohio infecting more than 300 people.\u003c/p>\n\u003cp>\u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements.aspx\" target=\"_blank\" rel=\"noopener\">Forty-seven\u003c/a> states still permit parents to opt out of vaccinating their children on religious grounds, and 18 states allow exemptions based on personal or philosophical beliefs (until 2015, \u003ca href=\"https://www.nvic.org/vaccine-laws/state-vaccine-requirements/california.aspx\" target=\"_blank\" rel=\"noopener\">California allowed\u003c/a> both exemptions). Many parents who go this route say they doubt the effectiveness of the vaccine or have concerns that it may cause autism or other major health problems, even though no medical evidence actually supports these theories.\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe loading=\"lazy\" src=\"https://apps.npr.org/dailygraphics/graphics/measles-20190429/\" width=\"700\" height=\"600\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>These holdouts mark just the latest chapter in a long, robust history of anti-vaccination movements. Intermittent backlashes against compulsory government vaccination campaigns have arisen ever since the first series of vaccinations were given more than 200 years ago.\u003c/p>\n\u003cp>Most interesting are the striking cultural similarities and motives of today’s prototypical “anti-vaxers” and their 19th century forebears: Both have typically been cast as either deeply religious or affluent, well-educated and politically progressive, and intensely protective of civil liberties and personal choice.\u003c/p>\n\u003ch3>The First Vaccine Revolution\u003c/h3>\n\u003cp>If you know little or care less about smallpox, Edward Jenner’s the guy to thank for that.\u003c/p>\n\u003cp>Among the most gruesome and deadly diseases in human history, smallpox terrorized the world for centuries, ravaging entire civilizations and claiming millions of lives — particularly those of young children — during its sporadic outbreaks. Highly infectious, the disease typically covers the skin in large oozing, pus-filled bumps.\u003c/p>\n\u003cp>In 1796, Jenner, a rural British physician, tested a locally shared theory that milkmaids who contracted cowpox were immune from smallpox. Similar to smallpox but far less severe, cowpox is generally found in animals and can be transmitted to human handlers. \u003ca href=\"http://www.ndm.ox.ac.uk/edward-jenner-museum\" target=\"_blank\" rel=\"noopener\">Jenner extracted pus from a cowpox scab\u003c/a> and inserted it into an incision on the arm of an 8-year-old boy. Although the child contracted a mild virus, he recovered quickly, developing antibodies that built up his immunity to both cowpox and smallpox.\u003c/p>\n\u003cp>Jenner subsequently coined the term “vaccine,” from “vacca,” Latin for cow.\u003c/p>\n\u003cp>Although initially rejected by the British medical establishment, Jenner’s findings were eventually published after subsequent successful trials, and the field of modern immunology was born. The discovery paved the way for vaccine breakthroughs over the following two centuries, including inoculations for polio, tetanus, influenza, rabies, diphtheria and, yes, measles.\u003c/p>\n\u003cp>The smallpox vaccine and its later iterations proved so successful that the \u003ca href=\"https://www.who.int/features/2010/smallpox/en/\" target=\"_blank\" rel=\"noopener\">World Health Organization in 1980\u003c/a> declared it the first disease to be eradicated as a result of global vaccination efforts. To date, there is no cure or treatment for it; vaccination is the only means of prevention.\u003c/p>\n\u003ch3>Birth of the Backlash\u003c/h3>\n\u003cp>Protection from one of the most feared, miserable ailments in human history: Who wouldn’t raise a (sterilized) glass to that?\u003c/p>\n\u003cfigure id=\"attachment_16227\" class=\"wp-caption alignright\" style=\"max-width: 300px\">\u003ca href=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"wp-image-16227 size-medium\" src=\"http://ww2.kqed.org/lowdown/wp-content/uploads/sites/26/2015/02/wolr5328.f1-300x228.jpg\" alt=' 1887 illustration from an anti-vaccination flier. Included in the text: \"This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.\" ' width=\"300\" height=\"228\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An illustration from an 1807 anti-vaccination flier. Included in the text: “This monster has been named vaccination; and his progressive havoc among the human race, has been dreadful and most alarming.” (Courtesy of National Institutes of Health)\u003c/figcaption>\u003c/figure>\n\u003cp>Turns out, lots of folks. As word of the procedure spread, Jenner was ridiculed by a host of angry critics, particularly members of the clergy, who charged that the idea of inoculating someone with pus from a diseased animal was not only revolting but blasphemous. Rumors abounded of vaccinated patients contracting bovine diseases and suffering grotesque reactions. Enough evidence, however, demonstrated the obvious advantages of the vaccination, and the procedure became increasingly accepted by the medical establishment in much of Europe.\u003c/p>\n\u003cp>By the mid-1800s, in the wake of several smallpox outbreaks, the United Kingdom enacted a set of laws making vaccinations compulsory, initially for infants, but eventually for all children up to 14 years old. Cumulative penalties were imposed on violators.\u003c/p>\n\u003cp>These measures, though, were met with staunch resistance, inciting a series of riots. The unrest prompted the creation of the Anti-Compulsory Vaccination League in 1867, whose founders were primarily concerned with what they considered a blatant infringement of personal choice and liberty.\u003c/p>\n\u003cp>The group’s seven-point mission statement, printed on the masthead of its newsletter, included the following pronouncement:\u003c/p>\n\u003cp>\u003cem>“As parliament, instead of guarding the liberty of the subject, has invaded this liberty by rendering good health a crime, punishable by fine or imprisonment, inflicted on dutiful parents, parliament is deserving of public condemnation.”\u003c/em>\u003c/p>\n\u003cp>By the 1870s and ’80s, even as smallpox vaccination techniques were rapidly advancing and helping to contain the disease’s spread, anti-vaccination campaigns continued to gain momentum in the U.K. and elsewhere. Propaganda literature proliferated as leaders of the movement adeptly tapped into the public’s understandable anxieties about the still nascent procedure. Some efforts were successful in temporarily lowering vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744701\" class=\"wp-caption alignnone\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744701\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg\" alt=\"\" width=\"720\" height=\"405\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405.jpg 720w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/lead_720_405-160x90.jpg 160w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A cartoon from a 1894 anti-vaccination publication. \u003ccite>(Courtesy of the Historical Medical Library of the College of Physicians of Philadelphia)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>One of the largest demonstrations, in Leicester, England, in 1885, drew upward of 100,000 people, with a child’s coffin and an effigy of Jenner among the props exhibited.\u003c/p>\n\u003cp>The rally prompted a government commission to investigate the protesters’ grievances, which eventually concluded that the vaccine was safe and effective. But in a political move to pacify detractors, the report also recommended the abolition of penalties for violators. In 1898, \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1123944/#B2\" target=\"_blank\" rel=\"noopener\">the passage of a new national vaccination act\u003c/a> removed such penalties and included a “conscientious objector” clause, allowing parents concerned with the safety of vaccinations to apply for an exemption certificate.\u003c/p>\n\u003ch3>The anti-vax fever spreads to America\u003c/h3>\n\u003cp>In the late 1800s, a series of smallpox outbreaks in the United States spurred a number of local government vaccine campaigns. That, in turn, prompted fierce opposition, including a visit from William Tebb, a prominent British anti-vaccine activist. By 1879, the Anti-Vaccination Society of America was established, followed by the emergence of several local leagues, including the New England Anti Compulsory Vaccination League and the Anti-Vaccination League of New York City. A second national league was formed in the early 1900s. Activists waged court battles to repeal vaccination laws in a number of states, including California, Illinois and Wisconsin.\u003c/p>\n\u003cp>In a response that inflamed tensions and helped further cast vaccination campaigns as an affront to civil liberties, public health officials commonly resorted to heavy-handed, inconsistent enforcement tactics, often vaccinating immigrants and minorities against their will during outbreaks, writes \u003ca href=\"https://www.tulsaworld.com/opinion/columnists/stephen-mihm-how-to-eradicate-outbreaks-of-anti-vaccine-fever/article_4660b867-3b84-58b1-8e2e-73e631c0bdd5.html\" target=\"_blank\" rel=\"noopener\">University of Georgia history professor Stephen Mihm\u003c/a>.\u003c/p>\n\u003cfigure id=\"attachment_11744718\" class=\"wp-caption alignnone\" style=\"max-width: 758px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744718\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg\" alt=\"\" width=\"758\" height=\"441\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902.jpg 758w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/Anti-Vaccination_Society_of_America_advertisement_from_1902-160x93.jpg 160w\" sizes=\"(max-width: 758px) 100vw, 758px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An Anti-Vaccination Society of America advertisement from 1902. \u003ccite>(Wikimedia Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Fears were also legitimately stoked by the lack of oversight in the production of vaccines, a process primarily controlled by private industry that was loosely regulated and at times resulted in questionable, unsafe products. In one of the worst incidents, nine children in Camden, New Jersey, died after being inoculated with a batch of smallpox vaccine that had been contaminated with tetanus. News of the tragedy prompted Congress to pass the \u003ca href=\"https://history.nih.gov/exhibits/history/docs/page_03.html\" target=\"_blank\" rel=\"noopener\">Biologics Control Act\u003c/a> of 1902, increasing government oversight of the manufacturing process.s\u003c/p>\n\u003cp>Following a smallpox outbreak in 1902, the city of Cambridge, Massachusetts, mandated vaccinations for all residents. After one man refused to comply on the grounds that the law violated his right to care for himself, the city filed criminal charges against him. The case — \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/\" target=\"_blank\" rel=\"noopener\">Jacobson v. Massachusetts\u003c/a> — eventually made its way to the U.S. Supreme Court, which ultimately sided with the state, ruling that it was within its power to enact mandatory vaccine laws in order to protect the public in the event of a communicable disease. \u003ca href=\"http://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">The decision\u003c/a> marked the first Supreme Court case determining the extent of state power in enacting public health law.\u003c/p>\n\u003ch3>Modern times\u003c/h3>\n\u003cp>Anti-vaccination fervor erupted again in England and spread abroad in the latter half of the 20th century, this time after an errant 1970s medical study alleged that the diphtheria, tetanus and pertussis (DTP) vaccine had caused neurological disorders in children. The report fueled a wave of public outcry and subsequent false analyses, leading to decreased vaccination rates and three major outbreaks of pertussis (whooping cough), despite an independent advisory committee confirming the safety of the immunization.\u003c/p>\n\u003cp>The controversy over DTP reached the United States after a 1982 documentary, “DPT: Vaccination Roulette,” and a 1991 book, “A Shot in the Dark,” alleged adverse reactions to the vaccine and questioned its effectiveness. Amid the ensuing media storm, scores of parents formed advocacy groups opposing the immunization and, in several cases, sued vaccine manufacturers. Hoping to not repeat England’s example, U.S. medical organizations, like the Academy of Pediatrics and the Centers for Disease Control and Prevention, aggressively countered the false claims, and more effectively stemmed the decrease in vaccination rates.\u003c/p>\n\u003cfigure id=\"attachment_11744712\" class=\"wp-caption alignnone\" style=\"max-width: 2048px\">\u003ca href=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\">\u003cimg loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-11744712\" src=\"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg\" alt=\"\" width=\"2048\" height=\"1365\" srcset=\"https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684.jpg 2048w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-160x107.jpg 160w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-800x533.jpg 800w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1020x680.jpg 1020w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1200x800.jpg 1200w, https://cdn.kqed.org/wp-content/uploads/sites/10/2019/05/GettyImages-1128753684-1920x1280.jpg 1920w\" sizes=\"(max-width: 2048px) 100vw, 2048px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">An anti-vaccination parent holds up a prescription document as she waits to enter a hearing before the Senate Committee on Health, Education, Labor and Pensions on Capitol Hill in Washington, D.C., on March 5, 2019. \u003ccite>(Jim WATSON/AFP/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>And then came the \u003cem>anti\u003c/em> anti-measles movement.\u003c/p>\n\u003cp>Despite the MMR vaccine’s safe and effective application since it was introduced in the 1960s, fear over the inoculation spread like wildfire after a 1998 medical study, and a subsequent flurry of media coverage, suggested a connection between the vaccine and the onset of autism. The study was later discredited, and an independent medical board determined that its author, British doctor Andrew Wakefield, had a “fatal conflict of interest” \u003ca href=\"https://www.historyofvaccines.org/content/articles/history-anti-vaccination-movements\" target=\"_blank\" rel=\"noopener\">after revelations\u003c/a> that he had been paid by lawyers representing parents who believed the vaccine had harmed their children.\u003c/p>\n\u003cp>More than a decade later, after numerous subsequent studies that found no evidence of any link between the vaccine and autism, the paper was formally retracted by The Lancet, the journal that first published it, and \u003ca href=\"https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper\" target=\"_blank\" rel=\"noopener\">labeled “utterly false.”\u003c/a> Wakefield \u003ca href=\"https://www.mdmag.com/medical-news/autism_doctor/\" target=\"_blank\" rel=\"noopener\">was also stripped of his medical license\u003c/a>.\u003c/p>\n\u003cp>But the seed had been planted, and parents already skeptical about immunizing their children were further motivated to avoid the vaccine at all costs.\u003c/p>\n\u003cp>Since then, fears have been further inflamed by a number of anti-vaccination campaigns suggesting the linkage to an increased incidence of autism. Perhaps most well-known is the ongoing activism of \u003ca href=\"https://www.cnbc.com/2018/05/10/jenny-mccarthy-talks-to-cnbc-about-autism-and-her-family.html\" target=\"_blank\" rel=\"noopener\">actress and model Jenny McCarthy\u003c/a>, who became the veritable poster child of the anti-vax movement when she began publicly questioning the safety of vaccines after her 2-year-old son was diagnosed with autism.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>As a \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">measles quarantine\u003c/a> begins at two Los Angeles universities, a bill working its way through the state Legislature would \u003ca href=\"http://bit.ly/fiorefakeexemptions\" target=\"_blank\" rel=\"noopener\">crack down on fake medical exemptions\u003c/a> for vaccines.\u003c/p>\n\u003cp>Recent measles outbreaks in Los Angeles and Butte County have contributed to 38 cases of measles statewide.\u003c/p>\n\u003cp>Some schools around California have vaccination rates of less than 50%, which leads me to believe it's only a matter of time before we have a lot more than 38 people sick with measles.\u003c/p>\n\u003cp>Bring on the \u003ca href=\"https://www.npr.org/sections/health-shots/2019/03/04/699997613/a-large-study-provides-more-evidence-that-mmr-vaccines-dont-cause-autism\" target=\"_blank\" rel=\"noopener\">vaccines\u003c/a>!\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>As a \u003ca href=\"https://www.kqed.org/news/11742926/measles-quarantines-hit-2-los-angeles-universities-amid-nationwide-outbreak\" target=\"_blank\" rel=\"noopener\">measles quarantine\u003c/a> begins at two Los Angeles universities, a bill working its way through the state Legislature would \u003ca href=\"http://bit.ly/fiorefakeexemptions\" target=\"_blank\" rel=\"noopener\">crack down on fake medical exemptions\u003c/a> for vaccines.\u003c/p>\n\u003cp>Recent measles outbreaks in Los Angeles and Butte County have contributed to 38 cases of measles statewide.\u003c/p>\n\u003cp>Some schools around California have vaccination rates of less than 50%, which leads me to believe it's only a matter of time before we have a lot more than 38 people sick with measles.\u003c/p>\n\u003cp>Bring on the \u003ca href=\"https://www.npr.org/sections/health-shots/2019/03/04/699997613/a-large-study-provides-more-evidence-that-mmr-vaccines-dont-cause-autism\" target=\"_blank\" rel=\"noopener\">vaccines\u003c/a>!\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cp>State lawmakers launched debate Wednesday on a new bill targeting doctors who write fraudulent medical notes to excuse children from getting vaccinations required to enter school. The hearing coincided with the recent declaration of measles outbreaks in Los Angeles and Butte County, bringing the number of cases of the virus to more than 30 statewide this year.\u003c/p>\n\u003cp>State Sen. Richard Pan (D-Sacramento) made his case for \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB276\" target=\"_blank\" rel=\"noopener\">SB 276\u003c/a>, saying families are skirting existing California law that forbids exemptions from vaccines for religious or personal objections by finding doctors willing to make up bogus medical excuses.\u003c/p>\n\u003cp>“We witnessed physicians who advertised exemptions for cash on social media and the internet,” Pan said. “We’d see some parents post on social media that their child’s regular physician refused to grant their child a medical exemption so they traveled to go purchase one from a distant physician.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='State Sen. Richard Pan, who is also a pediatrician']‘We witnessed physicians who advertised exemptions for cash on social media and the internet.’[/pullquote]\u003c/p>\n\u003cp>The new legislation would require the state health department to review all medical exemptions and either approve or deny them. It would also create a database to track which doctors are issuing a disproportionate number of medical exemptions. About a hundred doctors, medical students, parents and representatives of hospital and insurance groups lined up to state their support of the bill.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Critics flooded the state Capitol to voice their opposition to the proposal, with hundreds and hundreds of parents, and a handful doctors, lining up for hours to complain of government overreach and interference in the doctor-patient relationship.\u003c/p>\n\u003cp>“I believe in vaccines. I vaccinate my patients and my own children,” said Dr. Nicole Shorrock, a pediatrician from Sacramento. “But I cannot support this bill because it is too extreme. Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.”\u003c/p>\n\u003cp>[pullquote size='medium' align='right' citation='Dr. Nicole Shorrock']‘Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.’[/pullquote]\u003c/p>\n\u003cp>The new bill is a follow-up to Sen. Pan’s earlier law, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener\">SB 277\u003c/a>, passed in 2015, which outlawed personal belief exemptions from vaccinations. Since then, the number of children getting medical exemptions more than tripled, from .2 percent to .7 percent.\u003c/p>\n\u003cp>Two other states – West Virginia and Mississippi – do not allow exemptions from vaccines for religious or personal reasons. West Virginia requires its state health department to vet medical exemptions.\u003c/p>\n\u003cp>Overall, California’s vaccination rate among children entering kindergarten went up in recent years to 95.6 percent, a level public health experts say is needed to create community immunity — when enough of the population is immunized to protect people who cannot be vaccinated, such as infants and people with compromised immune systems.\u003c/p>\n\u003cp>[aside tag='immunizations' label='Coverage of vaccines and immunizations']\u003c/p>\n\u003cp>However, the rising number of medical exemptions is showing up in clusters around the state — in concentrations inconsistent with the number of people who legitimately cannot be vaccinated — and that is leaving some schools with vaccination rates lower than 50 percent.\u003c/p>\n\u003cp>“Students at these schools are at risk for a major outbreak,” said Sen. Pan, who is also a pediatrician. “These schools, with these low vaccination rates, represent the tinder for a disease wildfire that can harm the broader community. California cannot allow a handful of unscrupulous physicians to put our children in danger.”\u003c/p>\n\u003cp>Most doctors in California support vaccination and emphasize the safety and efficacy of vaccines. The California Medical Association, a powerful physician trade group that has often resisted efforts to track or control doctors, endorsed the bill last month.\u003c/p>\n\u003cp>“This new legislation will close a loophole in the current law that has allowed a small handful of rogue doctors to skirt the spirit of the original law and has put millions of Californians at risk,” said Dr. David Aizuss, the medical association president. “All physicians must do their part to protect the health of children and the public at large.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Health Committee passed the bill on Wednesday. It goes next to Senate Appropriations, then faces several more committee votes to pass the Legislature.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Critics flooded the state Capitol to voice their opposition to the proposal, with hundreds and hundreds of parents, and a handful doctors, lining up for hours to complain of government overreach and interference in the doctor-patient relationship.\u003c/p>\n\u003cp>“I believe in vaccines. I vaccinate my patients and my own children,” said Dr. Nicole Shorrock, a pediatrician from Sacramento. “But I cannot support this bill because it is too extreme. Patients have a right to have their medical treatment determined by their doctor, not a governmental appointee.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The new bill is a follow-up to Sen. Pan’s earlier law, \u003ca href=\"https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201520160SB277\" target=\"_blank\" rel=\"noopener\">SB 277\u003c/a>, passed in 2015, which outlawed personal belief exemptions from vaccinations. Since then, the number of children getting medical exemptions more than tripled, from .2 percent to .7 percent.\u003c/p>\n\u003cp>Two other states – West Virginia and Mississippi – do not allow exemptions from vaccines for religious or personal reasons. West Virginia requires its state health department to vet medical exemptions.\u003c/p>\n\u003cp>Overall, California’s vaccination rate among children entering kindergarten went up in recent years to 95.6 percent, a level public health experts say is needed to create community immunity — when enough of the population is immunized to protect people who cannot be vaccinated, such as infants and people with compromised immune systems.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>However, the rising number of medical exemptions is showing up in clusters around the state — in concentrations inconsistent with the number of people who legitimately cannot be vaccinated — and that is leaving some schools with vaccination rates lower than 50 percent.\u003c/p>\n\u003cp>“Students at these schools are at risk for a major outbreak,” said Sen. Pan, who is also a pediatrician. “These schools, with these low vaccination rates, represent the tinder for a disease wildfire that can harm the broader community. California cannot allow a handful of unscrupulous physicians to put our children in danger.”\u003c/p>\n\u003cp>Most doctors in California support vaccination and emphasize the safety and efficacy of vaccines. The California Medical Association, a powerful physician trade group that has often resisted efforts to track or control doctors, endorsed the bill last month.\u003c/p>\n\u003cp>“This new legislation will close a loophole in the current law that has allowed a small handful of rogue doctors to skirt the spirit of the original law and has put millions of Californians at risk,” said Dr. David Aizuss, the medical association president. “All physicians must do their part to protect the health of children and the public at large.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Senate Health Committee passed the bill on Wednesday. It goes next to Senate Appropriations, then faces several more committee votes to pass the Legislature.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp class=\"danger-zone\">In the lead-up to the 2016 U.S. election, Russian bots and trolls took to Twitter and other social media platforms to try to turn Americans against one another. But in addition to spreading false information and interfering in the election, a new study reports, a significant number of these malevolent actors tried to sow discord over vaccines.[contextly_sidebar id=\"U9m2Xosa038xtsfDSwPz5O7TUvqWe42O\"]\u003c/p>\n\u003cp class=\"danger-zone\">An \u003ca href=\"https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.304567\" target=\"_blank\" rel=\"noopener\">analysis of Twitter accounts\u003c/a> previously identified as having been operated by Russian bots and trolls found they dove into the vaccine debate as early as January 2015, the researchers reported. They did not take one side or the other, but seemed to tweet pro-vaccine and anti-vaccine messages in roughly equal measure.\u003c/p>\n\u003cp class=\"danger-zone\">On a variety of issues, the overall aim of the Russian campaign appeared to be to erode social cohesion and generate confusion by amplifying the number of voices taking part in these debates on social media. But in the case of vaccines, that could have increased the misperception that the science on their safety and effectiveness isn’t settled — as is the case — but rather that it is still subject to debate.\u003c/p>\n\u003cp class=\"\">“We do have a very strong suspicion that these accounts were attempting to generate discord,” said David Broniatowski, assistant professor in George Washington University’s department of engineering management and systems engineering and lead author of the study.\u003c/p>\n\u003cp>In the study, published Thursday in the American Journal of Public Health, Broniatowski and his co-authors focused on Twitter, analyzing tweets from accounts that had been identified as having been operated by Russian trolls, bots, and so-called content polluters whose aim is to disseminate spam and malware. The article is titled “Weaponized Health Communications: Twitter Bots and Russian Trolls Amplify the Vaccine Debate.”[contextly_sidebar id=\"9QtW5fawtVoxY4YEBFmA2GatrjvQlfvd\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The researchers compared tweets from the accounts to a selection of tweets from other users to see if the trolls and bots commented on vaccines more frequently than average Twitter accounts. They did.\u003c/p>\n\u003cp>“We found that, yeah, indeed, this was something that does seem to be part of the lexicon of what some of these bots and trolls use,” Broniatowski told STAT.\u003c/p>\n\u003cp>Even though the division of pro- and anti-vacccine tweets was roughly equal, that still skewed the picture of views on vaccines on Twitter, he noted, pointing to \u003ca href=\"http://www.pewinternet.org/2017/02/02/vast-majority-of-americans-say-benefits-of-childhood-vaccines-outweigh-risks/\" target=\"_blank\" rel=\"noopener\">data from the Pew Trust\u003c/a> that shows the vast majority of Americans support vaccination.\u003c/p>\n\u003cp>“We’ve always been a little puzzled why social media looks like there are so many anti-vaxxers,” said Broniatowski. “So even if somebody’s posting 50-50, compared to the Pew data, there are going to be more anti-vaxxers.”\u003c/p>\n\u003cp>Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, said any skepticism about the safety of vaccines risks feeding the concerns of parents who are worried about having their children vaccinated.\u003c/p>\n\u003cp>“The more the vaccine ‘debate’… is amplified it gains an undeserved sense of legitimacy and gives vaccine-hesitant individuals a pretense to forgo vaccination for themselves and their children,” said Adalja, who was harshly critical of the use of vaccinations in efforts to turn people against each other, calling it “overtly nihilistic.”\u003c/p>\n\u003cp>A spokesman for Twitter said that malicious accounts “are likely to target virtually any high profile conversation, since that’s where the views are.”[contextly_sidebar id=\"Q4N5GXoIo4iApYaASdjmnyeqp8POWr3L\"]\u003c/p>\n\u003cp>The spokesman, Ian Plunkett, told STAT that Twitter has aggressively ramped up preventive measures to try to keep such content from general users. In May, he noted, the platform identified and challenged nearly 10 million potentially automated accounts. “We put preemptive measures in place to ensure automated content is filtered from discoverable areas of the services — like trends and search. It’s possible that may users did not see this content before it was suspended,” Plunkett said.\u003c/p>\n\u003cp>Other experts, too, were unsurprised that Russian trolls and bots would delve into vaccines discussions, given the heat the topic can generate.\u003c/p>\n\u003cp>“Vaccination links to deep values around protection, health, harm, and the social contract,” said Julie Leask, an associate professor at the University of Sydney’s Susan Wakil School of Nursing and Midwifery who researches vaccine refusal. “People become highly invested in the discussion, and highly reactive to the notion that people refuse vaccines. The expression of sentiment at the margins — very pro- and very anti-vaccine — generates emotional energy and clicks.”\u003c/p>\n\u003cp>Adam Dunn, an associate professor in the Center for Health Informatics at Australia’s Macquarie University, said responding to this type of activity by internet bots and trolls would be challenging for public health authorities and may rely on the rooting out of the malicious accounts.\u003c/p>\n\u003cp>“The responsibility of managing the health of online conversations may … fall to Twitter itself, and work like this demonstrating the potential for real harm to human health provides a strong impetus for Twitter to act more often and more quickly to identify, isolate, or remove bots and trolls,” Dunn said.\u003c/p>\n\u003cp>Many of the accounts Broniatowski’s group studied have since been shut down, he said. But freeing the Twitter platform of bots and trolls is like playing whack-a-mole, he suggested.\u003c/p>\n\u003cp>For her part, Leask wasn’t certain how Twitter would have an outsized impact on vaccination decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When parents decide not to vaccinate, the decision isn’t usually taken lightly and a few tweets from bots are unlikely to change this trajectory,” she said. “The decision process is much more complex and centered on beliefs, experience and notions of what it means to be a ‘good parent’ held within that community. What we still need to establish is the relative role of social media independent of the influence of peer networks.”\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the lead-up to the 2016 U.S. election, Russian bots and trolls took to Twitter and other social media platforms to try to turn Americans against one another. But in addition to spreading false information and interfering in the election, a new study reports, a significant number of these malevolent actors tried to sow discord over vaccines.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">An \u003ca href=\"https://ajph.aphapublications.org/doi/10.2105/AJPH.2018.304567\" target=\"_blank\" rel=\"noopener\">analysis of Twitter accounts\u003c/a> previously identified as having been operated by Russian bots and trolls found they dove into the vaccine debate as early as January 2015, the researchers reported. They did not take one side or the other, but seemed to tweet pro-vaccine and anti-vaccine messages in roughly equal measure.\u003c/p>\n\u003cp class=\"danger-zone\">On a variety of issues, the overall aim of the Russian campaign appeared to be to erode social cohesion and generate confusion by amplifying the number of voices taking part in these debates on social media. But in the case of vaccines, that could have increased the misperception that the science on their safety and effectiveness isn’t settled — as is the case — but rather that it is still subject to debate.\u003c/p>\n\u003cp class=\"\">“We do have a very strong suspicion that these accounts were attempting to generate discord,” said David Broniatowski, assistant professor in George Washington University’s department of engineering management and systems engineering and lead author of the study.\u003c/p>\n\u003cp>In the study, published Thursday in the American Journal of Public Health, Broniatowski and his co-authors focused on Twitter, analyzing tweets from accounts that had been identified as having been operated by Russian trolls, bots, and so-called content polluters whose aim is to disseminate spam and malware. The article is titled “Weaponized Health Communications: Twitter Bots and Russian Trolls Amplify the Vaccine Debate.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The researchers compared tweets from the accounts to a selection of tweets from other users to see if the trolls and bots commented on vaccines more frequently than average Twitter accounts. They did.\u003c/p>\n\u003cp>“We found that, yeah, indeed, this was something that does seem to be part of the lexicon of what some of these bots and trolls use,” Broniatowski told STAT.\u003c/p>\n\u003cp>Even though the division of pro- and anti-vacccine tweets was roughly equal, that still skewed the picture of views on vaccines on Twitter, he noted, pointing to \u003ca href=\"http://www.pewinternet.org/2017/02/02/vast-majority-of-americans-say-benefits-of-childhood-vaccines-outweigh-risks/\" target=\"_blank\" rel=\"noopener\">data from the Pew Trust\u003c/a> that shows the vast majority of Americans support vaccination.\u003c/p>\n\u003cp>“We’ve always been a little puzzled why social media looks like there are so many anti-vaxxers,” said Broniatowski. “So even if somebody’s posting 50-50, compared to the Pew data, there are going to be more anti-vaxxers.”\u003c/p>\n\u003cp>Dr. Amesh Adalja, an infectious diseases physician and senior scholar at the Center for Health Security at Johns Hopkins Bloomberg School of Public Health, said any skepticism about the safety of vaccines risks feeding the concerns of parents who are worried about having their children vaccinated.\u003c/p>\n\u003cp>“The more the vaccine ‘debate’… is amplified it gains an undeserved sense of legitimacy and gives vaccine-hesitant individuals a pretense to forgo vaccination for themselves and their children,” said Adalja, who was harshly critical of the use of vaccinations in efforts to turn people against each other, calling it “overtly nihilistic.”\u003c/p>\n\u003cp>A spokesman for Twitter said that malicious accounts “are likely to target virtually any high profile conversation, since that’s where the views are.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The spokesman, Ian Plunkett, told STAT that Twitter has aggressively ramped up preventive measures to try to keep such content from general users. In May, he noted, the platform identified and challenged nearly 10 million potentially automated accounts. “We put preemptive measures in place to ensure automated content is filtered from discoverable areas of the services — like trends and search. It’s possible that may users did not see this content before it was suspended,” Plunkett said.\u003c/p>\n\u003cp>Other experts, too, were unsurprised that Russian trolls and bots would delve into vaccines discussions, given the heat the topic can generate.\u003c/p>\n\u003cp>“Vaccination links to deep values around protection, health, harm, and the social contract,” said Julie Leask, an associate professor at the University of Sydney’s Susan Wakil School of Nursing and Midwifery who researches vaccine refusal. “People become highly invested in the discussion, and highly reactive to the notion that people refuse vaccines. The expression of sentiment at the margins — very pro- and very anti-vaccine — generates emotional energy and clicks.”\u003c/p>\n\u003cp>Adam Dunn, an associate professor in the Center for Health Informatics at Australia’s Macquarie University, said responding to this type of activity by internet bots and trolls would be challenging for public health authorities and may rely on the rooting out of the malicious accounts.\u003c/p>\n\u003cp>“The responsibility of managing the health of online conversations may … fall to Twitter itself, and work like this demonstrating the potential for real harm to human health provides a strong impetus for Twitter to act more often and more quickly to identify, isolate, or remove bots and trolls,” Dunn said.\u003c/p>\n\u003cp>Many of the accounts Broniatowski’s group studied have since been shut down, he said. But freeing the Twitter platform of bots and trolls is like playing whack-a-mole, he suggested.\u003c/p>\n\u003cp>For her part, Leask wasn’t certain how Twitter would have an outsized impact on vaccination decisions.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>“When parents decide not to vaccinate, the decision isn’t usually taken lightly and a few tweets from bots are unlikely to change this trajectory,” she said. “The decision process is much more complex and centered on beliefs, experience and notions of what it means to be a ‘good parent’ held within that community. What we still need to establish is the relative role of social media independent of the influence of peer networks.”\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "The Vaccine Dilemma: How Experts Weigh Benefits For Many Against Risks for a Few",
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"content": "\u003cp>You’ve likely seen a version of the image above. Some people observe two faces in profile. Others see a vase.\u003c/p>\n\u003cp>The same phenomenon can occur when scientists look at data, particularly when they try to weigh the benefits and risks of individual vaccines. Vaccines protect huge numbers of people, generally children, from serious diseases, but in rare cases, certain vaccines can tragically cause harm. How do those scientists figure out which to value more?[contextly_sidebar id=\"vM6M1R2zIUt7PSfniSijCNeI1SXmNMTL\"]\u003c/p>\n\u003cp>This dilemma was at the center of last week’s decision by an expert committee advising the World Health Organization to sharply scale back use of a controversial vaccine called Dengvaxia, the first to protect against dengue infection.\u003c/p>\n\u003cp>Two years ago, many of the same experts concluded the vaccine was safe to use in children 9 and older in places where dengue infection is almost unavoidable — even though there were strong theoretical concerns the vaccine might put some vaccinated kids at higher risk of developing a severe form of dengue. Severe dengue can lead to internal bleeding, shock, and even death.\u003c/p>\n\u003cp>Late last year, theory was shown to be reality. After reviewing the data, the WHO’s Strategic Advisory Group of Experts on Immunizations — knows as the SAGE — shifted its stance, recommending last week that the vaccine be given only to children who test positive for a previous dengue infection. A point-of-care blood test doesn’t currently exist, leaving the vaccine’s future in limbo for now.[contextly_sidebar id=\"j6YzLYuARPhSnQ2nKylAVpIU8wdsgIj2\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Benefits trumped theoretical risks. But real risks trumped real benefits — even though the latter outnumbered the former.\u003c/p>\n\u003cp>A variety of factors influence these decisions, according to interviews with public health experts and ethicists who have made or studied them. The severity of disease being prevented and the treatability of the side effects being caused are crucial, as are ethics, public perceptions, and politics. And critically, these days, so is the likelihood that any negative attention generated by one vaccine might stain the reputations of others.\u003c/p>\n\u003cp>Dr. Art Reingold has been involved in countless debates of this type, having served for more than a dozen years on first the SAGE, and later on the corresponding body that advises the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, or ACIP.[contextly_sidebar id=\"xdscPdRSoRoclTtqbEFBgO7cpt3QJHtx\"]\u003c/p>\n\u003cp>“I would say that for many individuals having to vote or being on these committees and weigh in, many of them spend an awful lot of time looking at data and reviewing it and struggling with it when it’s not a slam dunk,” said Reingold, who teaches infectious diseases epidemiology at the University of California, Berkeley’s school of public health.\u003c/p>\n\u003cp>Reingold, whose term on ACIP concluded at the end of last year, noted that while many of that panel’s votes are close to unanimous, some recommendations — or decisions not to recommend a vaccine — are decided by a narrow vote. “And obviously in that instance pretty smart people have come down on different sides of the same question by weighing effectively all the same evidence,’’ he said.\u003c/p>\n\u003cp>\u003cstrong>The Vaccine Calculus\u003cbr>\n\u003c/strong>In some cases, these decisions aren’t that difficult. A flu shot can trigger Guillain-Barre syndrome, though this adverse event is very rare. But influenza infection can also provoke this disorder, a form of progressive paralysis from which most people recover.\u003c/p>\n\u003cp>In other circumstances, the position of the scales — which side is higher, which is lower — tilts over time.\u003c/p>\n\u003cp>Oral polio vaccine has saved untold millions of children from paralysis in the more than half-century it has been in use. But in rare instances the vaccine also paralyzes, a fact that became clear in the first year of its use, back in the early 1960s.\u003c/p>\n\u003cp>Sometimes the paralysis occurs in the child who got the dose of vaccine, or in a close contact of that child, as was reported in 1962. Other times the weakened viruses in the vaccine circulate among unvaccinated children, who ingest them in water or food contaminated with traces of feces. As the viruses travel from gut to gut, they can go rogue — regain the power to paralyze. That phenomenon was first observed in 2000. Yet oral polio vaccine is still used today.\u003c/p>\n\u003cp>[contextly_sidebar id=\"4xoAKYJE6AnYbA5mfYOPli4oSCgYa7Q4\"]As polio eradication efforts have driven down the polio case count to very low levels, the toll of vaccine-related paralysis can surpass the damage caused by the viruses themselves. Last year there were 22 children in the world paralyzed by polioviruses; vaccine viruses crippled 96.\u003c/p>\n\u003cp>The shifting of the risk-benefit ratio for oral polio vaccine led the United States to switch exclusively to injectable polio vaccine in 2000. In 1996, when the decision to phase out oral vaccine was made, eight or nine children a year were being paralyzed by the vaccine, though polio itself hadn’t paralyzed a child in the United States for over a decade.\u003c/p>\n\u003cp>The risk posed by the oral vaccine became intolerable, given there was a safer, albeit more expensive alternative — the injectable polio vaccine does not paralyze. “Obviously thinking on these things can change. The risks and benefits relatively speaking can change,” Reingold said.\u003c/p>\n\u003cp>In 2016, the formulation of the oral vaccines was altered to drop the component that protected against type 2 polioviruses. That part of the vaccine was the most likely to regain the power to paralyze. Type 2 viruses had disappeared in 1999; there was too little benefit and too much risk associated with keeping them in the vaccine.\u003c/p>\n\u003cp>In the case of Dengvaxia, the calculus is not as clear cut. Evidence suggests that in places where about 70 percent of people have been infected at least once with dengue, the vaccine would prevent seven children from getting sick enough to need hospital care for every additional hospitalized case it provoked. In places where 85 percent of people have been infected, there would be 18 hospitalized cases prevented for every one the vaccine created.\u003c/p>\n\u003cp>Some dengue experts have argued those benefits should not be ignored. Others argue those risks cannot ethically be incurred.\u003c/p>\n\u003cp>[contextly_sidebar id=\"YfGTYns6XDY9Onrzu1EUV5DkCwM08fCc\"]The SAGE deliberated over whether it was permissible to use rates of local dengue infection as a substitute for individual testing — in other words, could the vaccine be given, as it had previously recommended, in places where studies show most people have been infected at least once?\u003c/p>\n\u003cp>They concluded both options pose real-world challenges, given the current lack of a rapid, accurate test. But they also noted there is no evidence to date that children who have never been infected with dengue — the ones the vaccine could harm — would ever experience a benefit from Dengvaxia. They worried that wide-scale dengue vaccination programs might be “ethically problematic and have adverse implications for trust and the long-term success of public health programs.”\u003c/p>\n\u003cp>\u003cstrong>Mounting Distrust\u003cbr>\n\u003c/strong>Why have oral polio vaccine risks been tolerated, but Dengvaxia’s deemed serious enough to effectively shelve the vaccine? Here the factors named above plus timing surely play a role.\u003c/p>\n\u003cp>Experts making these types of decisions these days are doing so in a climate of litigiousness and mounting vaccine refusal and hesitancy. Headlines questioning the safety of one vaccine threaten to fuel rejection of others. The government of the Philippines, where Dengvaxia has been given to more than 800,000 children, has threatened legal action against its manufacturer, Sanofi Pasteur.\u003c/p>\n\u003cp>“The public has a whole new understanding of science, data, facts, and fake news,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “We’ve surely had an anti-science movement well before the current situation, but it’s never been as acute.”[contextly_sidebar id=\"MRQx4tKZn53WSvNmnqGKkUDbBGs0RMX9\"]\u003c/p>\n\u003cp>Then there’s the issue of who gets vaccinated. Most of these products are designed to protect children, who hold a special position in discussions of the ethics of medical treatments.\u003c/p>\n\u003cp>The ethical bar must be placed higher when it comes to kids, because they cannot make an informed decision for themselves, said Art Caplan, a professor of bioethics at New York University’s school of medicine. “So I think the issue is not just: Could we accept huge benefits for small risks? Because I think the answer to that is yes. But I think it’s: Can we accept huge benefits for small risks to very vulnerable children?\u003c/p>\n\u003cp>“When you have that child population put knowingly at risk, it gets really hard from the ethics point of view to ignore that,” he said.\u003c/p>\n\u003cp>And society’s tolerance of risk has changed, Caplan argued, pointing to the so-called Cutter incident to make his case.\u003c/p>\n\u003cp>In 1955, it was discovered that children had been mistakenly injected with polio vaccine that contained live viruses. The process by which the viruses in the vaccine were supposed to be inactivated — killed — hadn’t worked. Fifty-one children in the U.S. were paralyzed and five died.\u003c/p>\n\u003cp>But in the 1950s, polio was an enormous threat. Parents lived in fear their children would end up in an iron lung. Polio vaccination resumed. The company that made the vaccine, Cutter Laboratories, didn’t even go out of business. If a similar incident were to happen today, Caplan said, “it would have shut everything down forever.”[contextly_sidebar id=\"TB4CDGkuuXqcHsBv1pEbtZgMooHhybmV\"]\u003c/p>\n\u003cp>Compare that to the case of RotaShield, the first vaccine licensed to protect against rotavirus infection. These common viruses cause devastating bouts of diarrhea in young children, who can end up in the hospital as a result. Every year some children died of these infections in the U.S., but rotaviruses did more damage in the developing world, where stricken kids didn’t have easy access to hospital care.\u003c/p>\n\u003cp>RotaShield was approved in the U.S. in 1998. A year later, Wyeth Laboratories withdrew it from the market after studies showed babies who got it were at greater risk of developing intussusception, a type of bowel blockage that can kill if it isn’t corrected in time. The CDC estimated that for every 10,000 children vaccinated with RotaShield there would be one or two additional cases of intussusception over what is normally seen.\u003c/p>\n\u003cp>Some experts argued that the vaccine should still be marketed in the developing world, where the number of lives saved would far outstrip the cases of intussusception. The WHO estimated that in 2004, more than half a million children died from rotavirus infections, the lion’s share in South Asia and sub-Saharan Africa.\u003c/p>\n\u003cp>“When you think about the risk-benefit equation in a poor country, almost certainly it would have been far better in terms of illness — preventable deaths averted, cost of care reduced — to continue to use that initial rotavirus vaccine or rather to introduce it and use it in poor countries,” Reingold said.\u003c/p>\n\u003cp>But the vaccine’s fate was sealed.\u003c/p>\n\u003cp>“The fact is that the politics around the thing — this vaccine isn’t good enough for rich white children in the United States but it’s OK for poor black children in poor countries — were a non-starter,” he said. “I mean, it just doesn’t sell. Even if that’s still the wisest thing to do.”\u003c/p>\n\u003cp>It was nearly six years before another, safer rotavirus vaccine made it to market, six years during which more than half a million children a year died from rotavirus infections.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/04/23/vaccine-dilemma-weigh-benefits-risks/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>You’ve likely seen a version of the image above. Some people observe two faces in profile. Others see a vase.\u003c/p>\n\u003cp>The same phenomenon can occur when scientists look at data, particularly when they try to weigh the benefits and risks of individual vaccines. Vaccines protect huge numbers of people, generally children, from serious diseases, but in rare cases, certain vaccines can tragically cause harm. How do those scientists figure out which to value more?\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This dilemma was at the center of last week’s decision by an expert committee advising the World Health Organization to sharply scale back use of a controversial vaccine called Dengvaxia, the first to protect against dengue infection.\u003c/p>\n\u003cp>Two years ago, many of the same experts concluded the vaccine was safe to use in children 9 and older in places where dengue infection is almost unavoidable — even though there were strong theoretical concerns the vaccine might put some vaccinated kids at higher risk of developing a severe form of dengue. Severe dengue can lead to internal bleeding, shock, and even death.\u003c/p>\n\u003cp>Late last year, theory was shown to be reality. After reviewing the data, the WHO’s Strategic Advisory Group of Experts on Immunizations — knows as the SAGE — shifted its stance, recommending last week that the vaccine be given only to children who test positive for a previous dengue infection. A point-of-care blood test doesn’t currently exist, leaving the vaccine’s future in limbo for now.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Benefits trumped theoretical risks. But real risks trumped real benefits — even though the latter outnumbered the former.\u003c/p>\n\u003cp>A variety of factors influence these decisions, according to interviews with public health experts and ethicists who have made or studied them. The severity of disease being prevented and the treatability of the side effects being caused are crucial, as are ethics, public perceptions, and politics. And critically, these days, so is the likelihood that any negative attention generated by one vaccine might stain the reputations of others.\u003c/p>\n\u003cp>Dr. Art Reingold has been involved in countless debates of this type, having served for more than a dozen years on first the SAGE, and later on the corresponding body that advises the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, or ACIP.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I would say that for many individuals having to vote or being on these committees and weigh in, many of them spend an awful lot of time looking at data and reviewing it and struggling with it when it’s not a slam dunk,” said Reingold, who teaches infectious diseases epidemiology at the University of California, Berkeley’s school of public health.\u003c/p>\n\u003cp>Reingold, whose term on ACIP concluded at the end of last year, noted that while many of that panel’s votes are close to unanimous, some recommendations — or decisions not to recommend a vaccine — are decided by a narrow vote. “And obviously in that instance pretty smart people have come down on different sides of the same question by weighing effectively all the same evidence,’’ he said.\u003c/p>\n\u003cp>\u003cstrong>The Vaccine Calculus\u003cbr>\n\u003c/strong>In some cases, these decisions aren’t that difficult. A flu shot can trigger Guillain-Barre syndrome, though this adverse event is very rare. But influenza infection can also provoke this disorder, a form of progressive paralysis from which most people recover.\u003c/p>\n\u003cp>In other circumstances, the position of the scales — which side is higher, which is lower — tilts over time.\u003c/p>\n\u003cp>Oral polio vaccine has saved untold millions of children from paralysis in the more than half-century it has been in use. But in rare instances the vaccine also paralyzes, a fact that became clear in the first year of its use, back in the early 1960s.\u003c/p>\n\u003cp>Sometimes the paralysis occurs in the child who got the dose of vaccine, or in a close contact of that child, as was reported in 1962. Other times the weakened viruses in the vaccine circulate among unvaccinated children, who ingest them in water or food contaminated with traces of feces. As the viruses travel from gut to gut, they can go rogue — regain the power to paralyze. That phenomenon was first observed in 2000. Yet oral polio vaccine is still used today.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As polio eradication efforts have driven down the polio case count to very low levels, the toll of vaccine-related paralysis can surpass the damage caused by the viruses themselves. Last year there were 22 children in the world paralyzed by polioviruses; vaccine viruses crippled 96.\u003c/p>\n\u003cp>The shifting of the risk-benefit ratio for oral polio vaccine led the United States to switch exclusively to injectable polio vaccine in 2000. In 1996, when the decision to phase out oral vaccine was made, eight or nine children a year were being paralyzed by the vaccine, though polio itself hadn’t paralyzed a child in the United States for over a decade.\u003c/p>\n\u003cp>The risk posed by the oral vaccine became intolerable, given there was a safer, albeit more expensive alternative — the injectable polio vaccine does not paralyze. “Obviously thinking on these things can change. The risks and benefits relatively speaking can change,” Reingold said.\u003c/p>\n\u003cp>In 2016, the formulation of the oral vaccines was altered to drop the component that protected against type 2 polioviruses. That part of the vaccine was the most likely to regain the power to paralyze. Type 2 viruses had disappeared in 1999; there was too little benefit and too much risk associated with keeping them in the vaccine.\u003c/p>\n\u003cp>In the case of Dengvaxia, the calculus is not as clear cut. Evidence suggests that in places where about 70 percent of people have been infected at least once with dengue, the vaccine would prevent seven children from getting sick enough to need hospital care for every additional hospitalized case it provoked. In places where 85 percent of people have been infected, there would be 18 hospitalized cases prevented for every one the vaccine created.\u003c/p>\n\u003cp>Some dengue experts have argued those benefits should not be ignored. Others argue those risks cannot ethically be incurred.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The SAGE deliberated over whether it was permissible to use rates of local dengue infection as a substitute for individual testing — in other words, could the vaccine be given, as it had previously recommended, in places where studies show most people have been infected at least once?\u003c/p>\n\u003cp>They concluded both options pose real-world challenges, given the current lack of a rapid, accurate test. But they also noted there is no evidence to date that children who have never been infected with dengue — the ones the vaccine could harm — would ever experience a benefit from Dengvaxia. They worried that wide-scale dengue vaccination programs might be “ethically problematic and have adverse implications for trust and the long-term success of public health programs.”\u003c/p>\n\u003cp>\u003cstrong>Mounting Distrust\u003cbr>\n\u003c/strong>Why have oral polio vaccine risks been tolerated, but Dengvaxia’s deemed serious enough to effectively shelve the vaccine? Here the factors named above plus timing surely play a role.\u003c/p>\n\u003cp>Experts making these types of decisions these days are doing so in a climate of litigiousness and mounting vaccine refusal and hesitancy. Headlines questioning the safety of one vaccine threaten to fuel rejection of others. The government of the Philippines, where Dengvaxia has been given to more than 800,000 children, has threatened legal action against its manufacturer, Sanofi Pasteur.\u003c/p>\n\u003cp>“The public has a whole new understanding of science, data, facts, and fake news,” said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy. “We’ve surely had an anti-science movement well before the current situation, but it’s never been as acute.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Then there’s the issue of who gets vaccinated. Most of these products are designed to protect children, who hold a special position in discussions of the ethics of medical treatments.\u003c/p>\n\u003cp>The ethical bar must be placed higher when it comes to kids, because they cannot make an informed decision for themselves, said Art Caplan, a professor of bioethics at New York University’s school of medicine. “So I think the issue is not just: Could we accept huge benefits for small risks? Because I think the answer to that is yes. But I think it’s: Can we accept huge benefits for small risks to very vulnerable children?\u003c/p>\n\u003cp>“When you have that child population put knowingly at risk, it gets really hard from the ethics point of view to ignore that,” he said.\u003c/p>\n\u003cp>And society’s tolerance of risk has changed, Caplan argued, pointing to the so-called Cutter incident to make his case.\u003c/p>\n\u003cp>In 1955, it was discovered that children had been mistakenly injected with polio vaccine that contained live viruses. The process by which the viruses in the vaccine were supposed to be inactivated — killed — hadn’t worked. Fifty-one children in the U.S. were paralyzed and five died.\u003c/p>\n\u003cp>But in the 1950s, polio was an enormous threat. Parents lived in fear their children would end up in an iron lung. Polio vaccination resumed. The company that made the vaccine, Cutter Laboratories, didn’t even go out of business. If a similar incident were to happen today, Caplan said, “it would have shut everything down forever.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Compare that to the case of RotaShield, the first vaccine licensed to protect against rotavirus infection. These common viruses cause devastating bouts of diarrhea in young children, who can end up in the hospital as a result. Every year some children died of these infections in the U.S., but rotaviruses did more damage in the developing world, where stricken kids didn’t have easy access to hospital care.\u003c/p>\n\u003cp>RotaShield was approved in the U.S. in 1998. A year later, Wyeth Laboratories withdrew it from the market after studies showed babies who got it were at greater risk of developing intussusception, a type of bowel blockage that can kill if it isn’t corrected in time. The CDC estimated that for every 10,000 children vaccinated with RotaShield there would be one or two additional cases of intussusception over what is normally seen.\u003c/p>\n\u003cp>Some experts argued that the vaccine should still be marketed in the developing world, where the number of lives saved would far outstrip the cases of intussusception. The WHO estimated that in 2004, more than half a million children died from rotavirus infections, the lion’s share in South Asia and sub-Saharan Africa.\u003c/p>\n\u003cp>“When you think about the risk-benefit equation in a poor country, almost certainly it would have been far better in terms of illness — preventable deaths averted, cost of care reduced — to continue to use that initial rotavirus vaccine or rather to introduce it and use it in poor countries,” Reingold said.\u003c/p>\n\u003cp>But the vaccine’s fate was sealed.\u003c/p>\n\u003cp>“The fact is that the politics around the thing — this vaccine isn’t good enough for rich white children in the United States but it’s OK for poor black children in poor countries — were a non-starter,” he said. “I mean, it just doesn’t sell. Even if that’s still the wisest thing to do.”\u003c/p>\n\u003cp>It was nearly six years before another, safer rotavirus vaccine made it to market, six years during which more than half a million children a year died from rotavirus infections.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This \u003ca href=\"https://www.statnews.com/2018/04/23/vaccine-dilemma-weigh-benefits-risks/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Cuba Has a Lung Cancer Vaccine; Now U.S. Patients Will Test It",
"title": "Cuba Has a Lung Cancer Vaccine; Now U.S. Patients Will Test It",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Mick Phillips' doctor is surprised he's still alive.\u003c/p>\n\u003cp>The 69-year-old Wisconsin man was diagnosed with late-stage lung cancer in 2010 and his doctor said he had less than a year to live.\u003c/p>\n\u003cp>That was six years ago.\u003c/p>\n\u003cp>\"For all intents and purposes he shouldn’t be here,\" says Phillips' oncologist, \u003ca href=\"http://www.fvho.org/providers/timothy-goggins-md/\" target=\"_blank\">Timothy Goggins\u003c/a>.\u003c/p>\n\u003cp>Dr. Goggins and Phillips both credit his survival to a lung cancer drug that isn't available in the U.S. and that Phillips has had to purchase illegally in Cuba.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Cancer won’t be cured, it will be turned into a chronic condition.’\u003ccite>Agustin Lage,Cuba’s Center of Molecular Immunology\u003c/cite>\u003c/aside>\n\u003cp>U.S. researchers think if the treatment works it could be used to prevent lung cancer in patients that are high risk. \u003ca href=\"https://www.roswellpark.org/\" target=\"_blank\">Roswell Park Cancer Institute\u003c/a> in Buffalo, New York has begun testing CIMAvax, the Cuban-developed immunotherapy for lung cancer. If successful, the trial will pave the way for potential FDA approval, after which the drug could become commercially available in the U.S.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The medicine has relatively minor side effects and appears to have \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/02/27/1078-0432.CCR-15-0855\" target=\"_blank\">prolonged the lives of patients\u003c/a> who have stage four lung cancer.\u003c/p>\n\u003cp>CIMAvax stimulates the body's immune system to fight the lung cancer. In this way it's a vaccine, but one that you take to stop the spread of late-stage cancer rather than prevent it in the first place.\u003c/p>\n\u003cp>“It’s like a flu vaccine,\" says \u003ca href=\"https://www.roswellpark.org/grace-dy\" target=\"_blank\">Dr. Grace Dy\u003c/a>, principal investigator for the trial. \"It’s the same concept. You give a drug so the body develops an antibody to the drug;\u003cb> \u003c/b>you’re using your body’s own natural systems to develop a therapy.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Lung cancer kills \u003ca href=\"http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/lung-cancer-fact-sheet.html?referrer=https://www.google.com/\" target=\"_blank\">nearly 160,000 Americans\u003c/a> annually. \u003c/span>Most people are diagnosed at a late stage and more than half die within a year.\u003c/p>\n\u003cp>This is likely the first time the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02955290\" target=\"_blank\">FDA has allowed\u003c/a> a clinical trial of a Cuban-made therapy in a U.S. health care facility. It's not uncommon for the\u003cstrong> \u003c/strong>FDA to allow U.S. clinical trials in order to study therapies from other countries. It is extremely rare, however, for that therapy to come from Cuba.\u003c/p>\n\u003cp>And it's popular\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As of mid-November, nearly 200 people had \u003ca href=\"https://www.roswellpark.org/cimavax-form/?utm_source=page&utm_medium=button&utm_term=form1&utm_content=cimavax\" target=\"_blank\">applied online\u003c/a> to participate in the 60-90 person Phase II and Phase III studies.\u003c/span>\u003c/p>\n\u003cp>\"I’m not surprised that there’s interest,” says Dr. Dy. \u003cspan style=\"font-weight: 400\">“When you have cancer and it’s potentially life-threatening you want to explore all the options.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_281617\" class=\"wp-caption aligncenter\" style=\"max-width: 960px\">\u003cimg class=\"size-full wp-image-281617\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/DrAgustinLage.jpg\" alt=\"Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips.\" width=\"960\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-520x390.jpg 520w\" sizes=\"(max-width: 960px) 100vw, 960px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips. \u003ccite>(Courtesy Maya Phillips)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mick Phillips didn't think he had much longer to live when he brought back CIMAvax from Cuba in 2011 and asked a nurse friend to give him the injections.\u003c/p>\n\u003cp>\"He had a 5 percent chance of living five years,\" says Dr. Goggins who practices at \u003ca href=\"http://www.fvho.org/\" target=\"_blank\">Fox Valley Hemotology & Oncology\u003c/a> in Appleton, Wisconsin.\u003c/p>\n\u003cp>Today, Phillips is in remission from stage 4 lung cancer.\u003c/p>\n\u003cp>\"I keep telling people, if you believe in God, it’s God,\" says Dr. Goggins. \"If you believe in science, it’s CIMAvax.”\u003c/p>\n\u003cp>\u003cstrong>How\u003c/strong> \u003cstrong>the Cancer Vaccine Works\u003c/strong>\u003c/p>\n\u003cp>Lung cancer cells feed off a protein called epidermal growth factor or EGF. The protein supports normal cell growth but also fuels cancer cells.\u003c/p>\n\u003cp>The vaccine triggers the immune system to create antibodies that bind to and remove\u003cb> \u003c/b>EGF, thereby starving the cancer of its \"food.\"\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" src=\"https://www.youtube.com/embed/RaP4TsslJGw?rel=0\" frameborder=\"0\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Normal cells can live without EGF and use other growth-promoting proteins instead. But the cancer cells can't, and without EGF they're unable to multiply and spread.\u003c/p>\n\u003cp>CIMAvax has relatively few side effects when compared to chemotherapy, the traditional standard of care for late stage lung cancer. Chemo is hard on the body because it kills healthy cells (in addition to cancer cells) and causes side effects like hair loss, vomiting, loss of appetite and exhaustion.\u003c/p>\n\u003cp>Because CIMAvax doesn't kill cells, its side effects are relatively minor, such as chills or a fever that can be treated with over-the-counter medications.\u003c/p>\n\u003cp>Cuban patients that responded to CIMAvax had high levels of EGF, and t\u003cspan style=\"font-weight: 400\">heir bodies produced high levels of antibodies to combat the protein after they received the vaccine.\u003cstrong> \u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Roswell Park will be looking to see if the same response emerges in its clinical trial— whether the most significant improvement is in patients with high EGF and antibody levels.\u003c/p>\n\u003cp>If the study shows promise it could be good news for other types of cancer that also rely on EGF, such as prostate, breast and colon cancer.\u003c/p>\n\u003cp>The most recent \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/06/24/1078-0432.CCR-15-0855\" target=\"_blank\">Cuban clinical trial \u003c/a>of CIMAvax is comparatively small at about 400 patients, which raises questions about how reliable the findings are.\u003c/p>\n\u003cp>UCSF oncologist \u003ca href=\"http://www.bivonalab.net/people/\" target=\"_blank\">Trever Bivona\u003c/a> says the study isn't large enough to determine whether the findings are statistically significant.\u003c/p>\n\u003cfigure id=\"attachment_278549\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-278549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg\" alt=\"The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month.\" width=\"1920\" height=\"1240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-160x103.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-800x517.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-768x496.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1020x659.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1180x762.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-960x620.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-240x155.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-375x242.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-520x336.jpeg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month. \u003ccite>(Centro de Inmunología Molecular)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I think we need a bigger more controlled study before making any conclusions,\" Bivona says.\u003c/p>\n\u003cp>The other problem with the Cuba study is that it had no control group. It compared patients getting CIMAvax to patients getting palliative care.\u003c/p>\n\u003cp>\"There may be preliminary findings here,\" Bivona says, \"but it’s certainly not a slam dunk.\"\u003c/p>\n\u003cp>\u003cstrong>Will Cuban Drugs Be Approved Under Trump?\u003c/strong>\u003c/p>\n\u003cp>If you're contemplating a flight to Havana, it's important to note that most U.S. travel to Cuba is still restricted.\u003c/p>\n\u003cp>The \u003cspan style=\"font-weight: 400\">U.S. Treasury Office of Foreign Assets Control says people and companies can \u003ca href=\"https://www.treasury.gov/resource-center/sanctions/Pages/licensing.aspx\" target=\"_blank\">apply for a specific license\u003c/a> to visit Cuba and purchase pharmaceuticals like CIMAvax. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Because the relationship between\u003c/span>\u003cspan style=\"font-weight: 400\"> Cuba and America has warmed, federal officials could potentially approve an application due to this change in \"foreign relations.\"\u003c/span>\u003c/p>\n\u003cp>However, President-elect Donald Trump has vowed to overturn all of President Obama's executive orders. Though it's unclear what that means, Obama's \u003ca href=\"https://www.whitehouse.gov/the-press-office/2014/12/17/fact-sheet-charting-new-course-cuba\" target=\"_blank\">2014 executive order\u003c/a> on Cuba expanded opportunities for Americans to legally visit Cuba.\u003c/p>\n\u003cp>And Vice President-elect Mike Pence has specifically said he will \"\u003ca href=\"http://www.politico.com/story/2016/10/mike-pence-cuba-executive-orders-229827\" target=\"_blank\">reverse Barack Obama’s executive orders on Cuba\u003c/a>.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Regardless, Dr. Dy says CIMAvax won't be available in pharmacies anytime soon. Roswell Park will start phase I of the clinical trial this month and it'll be months before it can start phase II and then phase III. She says an ambitious goal would be to have the medicine available by 2021.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Mick Phillips' doctor is surprised he's still alive.\u003c/p>\n\u003cp>The 69-year-old Wisconsin man was diagnosed with late-stage lung cancer in 2010 and his doctor said he had less than a year to live.\u003c/p>\n\u003cp>That was six years ago.\u003c/p>\n\u003cp>\"For all intents and purposes he shouldn’t be here,\" says Phillips' oncologist, \u003ca href=\"http://www.fvho.org/providers/timothy-goggins-md/\" target=\"_blank\">Timothy Goggins\u003c/a>.\u003c/p>\n\u003cp>Dr. Goggins and Phillips both credit his survival to a lung cancer drug that isn't available in the U.S. and that Phillips has had to purchase illegally in Cuba.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Cancer won’t be cured, it will be turned into a chronic condition.’\u003ccite>Agustin Lage,Cuba’s Center of Molecular Immunology\u003c/cite>\u003c/aside>\n\u003cp>U.S. researchers think if the treatment works it could be used to prevent lung cancer in patients that are high risk. \u003ca href=\"https://www.roswellpark.org/\" target=\"_blank\">Roswell Park Cancer Institute\u003c/a> in Buffalo, New York has begun testing CIMAvax, the Cuban-developed immunotherapy for lung cancer. If successful, the trial will pave the way for potential FDA approval, after which the drug could become commercially available in the U.S.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The medicine has relatively minor side effects and appears to have \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/02/27/1078-0432.CCR-15-0855\" target=\"_blank\">prolonged the lives of patients\u003c/a> who have stage four lung cancer.\u003c/p>\n\u003cp>CIMAvax stimulates the body's immune system to fight the lung cancer. In this way it's a vaccine, but one that you take to stop the spread of late-stage cancer rather than prevent it in the first place.\u003c/p>\n\u003cp>“It’s like a flu vaccine,\" says \u003ca href=\"https://www.roswellpark.org/grace-dy\" target=\"_blank\">Dr. Grace Dy\u003c/a>, principal investigator for the trial. \"It’s the same concept. You give a drug so the body develops an antibody to the drug;\u003cb> \u003c/b>you’re using your body’s own natural systems to develop a therapy.\"\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Lung cancer kills \u003ca href=\"http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/learn-about-lung-cancer/lung-cancer-fact-sheet.html?referrer=https://www.google.com/\" target=\"_blank\">nearly 160,000 Americans\u003c/a> annually. \u003c/span>Most people are diagnosed at a late stage and more than half die within a year.\u003c/p>\n\u003cp>This is likely the first time the \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT02955290\" target=\"_blank\">FDA has allowed\u003c/a> a clinical trial of a Cuban-made therapy in a U.S. health care facility. It's not uncommon for the\u003cstrong> \u003c/strong>FDA to allow U.S. clinical trials in order to study therapies from other countries. It is extremely rare, however, for that therapy to come from Cuba.\u003c/p>\n\u003cp>And it's popular\u003cstrong>.\u003c/strong>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">As of mid-November, nearly 200 people had \u003ca href=\"https://www.roswellpark.org/cimavax-form/?utm_source=page&utm_medium=button&utm_term=form1&utm_content=cimavax\" target=\"_blank\">applied online\u003c/a> to participate in the 60-90 person Phase II and Phase III studies.\u003c/span>\u003c/p>\n\u003cp>\"I’m not surprised that there’s interest,” says Dr. Dy. \u003cspan style=\"font-weight: 400\">“When you have cancer and it’s potentially life-threatening you want to explore all the options.\"\u003c/span>\u003c/p>\n\u003cfigure id=\"attachment_281617\" class=\"wp-caption aligncenter\" style=\"max-width: 960px\">\u003cimg class=\"size-full wp-image-281617\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/DrAgustinLage.jpg\" alt=\"Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips.\" width=\"960\" height=\"720\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-160x120.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-768x576.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-240x180.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-375x281.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/DrAgustinLage-520x390.jpg 520w\" sizes=\"(max-width: 960px) 100vw, 960px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Augustin Lage (left) in Havana with Mick Phillips, researcher Gisela Gonzalez, and Maya Phillips. \u003ccite>(Courtesy Maya Phillips)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Mick Phillips didn't think he had much longer to live when he brought back CIMAvax from Cuba in 2011 and asked a nurse friend to give him the injections.\u003c/p>\n\u003cp>\"He had a 5 percent chance of living five years,\" says Dr. Goggins who practices at \u003ca href=\"http://www.fvho.org/\" target=\"_blank\">Fox Valley Hemotology & Oncology\u003c/a> in Appleton, Wisconsin.\u003c/p>\n\u003cp>Today, Phillips is in remission from stage 4 lung cancer.\u003c/p>\n\u003cp>\"I keep telling people, if you believe in God, it’s God,\" says Dr. Goggins. \"If you believe in science, it’s CIMAvax.”\u003c/p>\n\u003cp>\u003cstrong>How\u003c/strong> \u003cstrong>the Cancer Vaccine Works\u003c/strong>\u003c/p>\n\u003cp>Lung cancer cells feed off a protein called epidermal growth factor or EGF. The protein supports normal cell growth but also fuels cancer cells.\u003c/p>\n\u003cp>The vaccine triggers the immune system to create antibodies that bind to and remove\u003cb> \u003c/b>EGF, thereby starving the cancer of its \"food.\"\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe width=\"100%\" src=\"https://www.youtube.com/embed/RaP4TsslJGw?rel=0\" frameborder=\"0\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>Normal cells can live without EGF and use other growth-promoting proteins instead. But the cancer cells can't, and without EGF they're unable to multiply and spread.\u003c/p>\n\u003cp>CIMAvax has relatively few side effects when compared to chemotherapy, the traditional standard of care for late stage lung cancer. Chemo is hard on the body because it kills healthy cells (in addition to cancer cells) and causes side effects like hair loss, vomiting, loss of appetite and exhaustion.\u003c/p>\n\u003cp>Because CIMAvax doesn't kill cells, its side effects are relatively minor, such as chills or a fever that can be treated with over-the-counter medications.\u003c/p>\n\u003cp>Cuban patients that responded to CIMAvax had high levels of EGF, and t\u003cspan style=\"font-weight: 400\">heir bodies produced high levels of antibodies to combat the protein after they received the vaccine.\u003cstrong> \u003c/strong>\u003c/span>\u003c/p>\n\u003cp>Roswell Park will be looking to see if the same response emerges in its clinical trial— whether the most significant improvement is in patients with high EGF and antibody levels.\u003c/p>\n\u003cp>If the study shows promise it could be good news for other types of cancer that also rely on EGF, such as prostate, breast and colon cancer.\u003c/p>\n\u003cp>The most recent \u003ca href=\"http://clincancerres.aacrjournals.org/content/early/2016/06/24/1078-0432.CCR-15-0855\" target=\"_blank\">Cuban clinical trial \u003c/a>of CIMAvax is comparatively small at about 400 patients, which raises questions about how reliable the findings are.\u003c/p>\n\u003cp>UCSF oncologist \u003ca href=\"http://www.bivonalab.net/people/\" target=\"_blank\">Trever Bivona\u003c/a> says the study isn't large enough to determine whether the findings are statistically significant.\u003c/p>\n\u003cfigure id=\"attachment_278549\" class=\"wp-caption alignright\" style=\"max-width: 1920px\">\u003cimg class=\"size-full wp-image-278549\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg\" alt=\"The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month.\" width=\"1920\" height=\"1240\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3.jpeg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-160x103.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-800x517.jpeg 800w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-768x496.jpeg 768w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1020x659.jpeg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-1180x762.jpeg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-960x620.jpeg 960w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-240x155.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-375x242.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2016/11/CIMAvax-EGF-3-520x336.jpeg 520w\" sizes=\"(max-width: 1920px) 100vw, 1920px\">\u003cfigcaption class=\"wp-caption-text\">The lung cancer vaccine is currently available in Cuba, Peru, Venezuela, Paraguay, Colombia and Bosnia and Herzegovina. U.S. researchers start clinical trials this month. \u003ccite>(Centro de Inmunología Molecular)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\"I think we need a bigger more controlled study before making any conclusions,\" Bivona says.\u003c/p>\n\u003cp>The other problem with the Cuba study is that it had no control group. It compared patients getting CIMAvax to patients getting palliative care.\u003c/p>\n\u003cp>\"There may be preliminary findings here,\" Bivona says, \"but it’s certainly not a slam dunk.\"\u003c/p>\n\u003cp>\u003cstrong>Will Cuban Drugs Be Approved Under Trump?\u003c/strong>\u003c/p>\n\u003cp>If you're contemplating a flight to Havana, it's important to note that most U.S. travel to Cuba is still restricted.\u003c/p>\n\u003cp>The \u003cspan style=\"font-weight: 400\">U.S. Treasury Office of Foreign Assets Control says people and companies can \u003ca href=\"https://www.treasury.gov/resource-center/sanctions/Pages/licensing.aspx\" target=\"_blank\">apply for a specific license\u003c/a> to visit Cuba and purchase pharmaceuticals like CIMAvax. \u003c/span>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">Because the relationship between\u003c/span>\u003cspan style=\"font-weight: 400\"> Cuba and America has warmed, federal officials could potentially approve an application due to this change in \"foreign relations.\"\u003c/span>\u003c/p>\n\u003cp>However, President-elect Donald Trump has vowed to overturn all of President Obama's executive orders. Though it's unclear what that means, Obama's \u003ca href=\"https://www.whitehouse.gov/the-press-office/2014/12/17/fact-sheet-charting-new-course-cuba\" target=\"_blank\">2014 executive order\u003c/a> on Cuba expanded opportunities for Americans to legally visit Cuba.\u003c/p>\n\u003cp>And Vice President-elect Mike Pence has specifically said he will \"\u003ca href=\"http://www.politico.com/story/2016/10/mike-pence-cuba-executive-orders-229827\" target=\"_blank\">reverse Barack Obama’s executive orders on Cuba\u003c/a>.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"info": "Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. For one hour a week, the show tries to lift the veil from the process of \"making media,\" especially news media, because it's through that lens that we see the world and the world sees us",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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