California Senate overwhelmingly passes SB 277, abolishing most opt-outs | Hacker News Reader

California Senate overwhelmingly passes SB 277, abolishing most opt-outs

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54 pointsobeone77 comments

I'm interested to learn about the case law about this as it pertains to the constitutionality of disallowing a religious exemption.

Some common vaccines are derived from human fetal cell lines, and those fetal cell lines are themselves derived from a handful of elective abortions. For many of those vaccines, there are alternatives that are not derived from human fetal cell lines, but not all.

Several religious denominations that oppose abortion, e.g. the Catholic Church, have addressed this issue and said that such vaccines can and should be used, so long as there is no reasonable alternative and there is a proportionate reason. (The Church's reasoning, in case you're curious, is that the vaccines' connection to abortion is considered remote cooperation.)

But even though some denominations see the vaccines as permissible, I suppose it might be possible for a person, motivated by religious belief, to be completely on board with the efficacy of the vaccine but oppose how it was created on moral grounds, and so demand a religious exemption.

Typically in the U.S., religious beliefs must be reasonably accommodated. I would think that someone who objects to the vaccine mandate on religious grounds could make the argument that if it is possible for anyone to be accommodated (in this case, those with medical issues), then accommodation itself should be considered reasonable, and it's just a matter of determining whether accommodating both is so risky as to be unreasonable.

In other words, if we're willing to assume X amount of risk by allowing medical exemptions, then it follows that at least some risk can be tolerated. And if a religious objector can show that additionally assuming Y risk by allowing religious objections is not substantially more risky, then I think they could make the case that it should be considered reasonable to also accommodate religious beliefs.

The medical exemption exists because giving them the vaccine increases risk (to the recipient). It's not a choice regarding acceptable risk; it's consistently choosing the least risky option.

Permitting a small number of exemptions does not compromise hive immunity. Permitting a large number of exceptions does. The article states an objective example of where hive immunity was compromised due to a lack of vaccination. So there is sound scientific reasoning for disallowing religious exemption for public health reasons.

In terms of priorities, it seems reasonable for medical exceptions (eg. "this child is allergic to the vaccination so is more likely to die if it is administered") to come before religious ones ("my child won't suffer from an increased risk of harm [than other children receiving the vaccination] but I don't want the vaccine to be administered").

It might even be reasonable to permit a small quota of religious objections, so that the total number of exceptions does not compromise hive immunity. But then how would it be decided which children would not be permitted in this group?

The other option would be to simply ban children not vaccinated for religious reasons from the ability to spread disease by excluding them from schools. This seems to be the proposition made already though:

> "I am concerned about opportunities for equal education," because unvaccinated kindergarteners would require home schooling, Bates said.

> In terms of priorities, it seems reasonable for medical exceptions (eg. "this child is allergic to the vaccination so is more likely to die if it is administered") to come before religious ones ("my child won't suffer from an increased risk of harm [than other children receiving the vaccination] but I don't want the vaccine to be administered").

It's true that a child immunized against a religious objection won't be physically harmed, but I think that many people who have been forced to do things against their religious objections will tell you that the emotional harm of being forced to violate their religious beliefs is substantial. (Which is why there have been numerous cases throughout history of people who have died rather than violate their faith.)

I know comparing physical harm to emotional harm is hard to do, but I think it's worth pointing out that the "what's the harm?" argument requires a more nuanced understanding of what both sides feel is at stake than is typically considered.

>I'm interested to learn about the case law about this as it pertains to the constitutionality of disallowing a religious exemption.

It has held up in court in Mississippi

http://www.washingtonpost.com/news/storyline/wp/2015/01/30/m...

>But attempts to add a religious excuse there have failed. In 1979, the Mississippi Supreme Court wrote a strongly worded defense of the state program, “Is it mandated by the First Amendment to the United States Constitution that innocent children, too young to decide for themselves, are to be denied the protection against crippling and death that immunization provides because of a religious belief adhered to by a parent or parents?”

Religious practices aren't covered by the Constitution once they start causing death to others. Human sacrifice may be a religious practice but it is one that wouldn't be allowed to be practiced.

> "The only thing we can do is continue to educate our officials" about the personal belief exemption, said Lisa Bakshi, a mother from Placer County. "The parents who do it now do it for very legitimate reasons. We don't do it because we are uninformed."

This isn't being uninformed, it's being actively uninformed.

I certainly hope this makes it past the Assembly and into law. I am stunned at how rancorous the debate has been though. If I ever questioned if there was a problem with science education, that question has been soundly answered. Way too many people are getting through our primary education system with absolutely no understanding of how science, as a process and discipline works. And that is a very sad thing indeed.

Way too many people are getting through our primary education system with absolutely no understanding of how science, as a process and discipline works.

It's a question of trust in scientific authorities, not about their knowledge or lack thereof.

No amount of understanding or attempt at education will dissuade anti-vaccine parents.

Ah, see, these anti-vax parents aren't like yesterday's anti-vax parents: "The parents who do it now do it for very legitimate reasons. We don't do it because we are uninformed."

http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines...

How does one interpret this document? We laugh at the side effects associated with medications when it's on the television but not the FDA documentation for such medications?

Under "CLINICAL PHARMACOLOGY" it reads that MMR "may" cause serious complications and/or death. Further down it reads that the MMR Vaccination may cause serious complications and/or death.

I am confused

I'm not sure if you're trolling or simply misreading that document, but under the section you cited it says that getting Measles, mumps, and rubella can cause serious complications or death. Not the shot which vaccinates against those diseases.

Not trolling. Under "Adverse Reactions", death is included under "Other".

That listing is all of the adverse events that occurred during clinical testing. We don't know if it's the vaccine, or because a kid slipped and hit his head, causing death. If you were to continue reading, you'd see this:

> No deaths or permanent sequelae were reported in a published post-marketing surveillance study in Finland involving 1.5 million children and adults who were vaccinated with M-M-R II during 1982 to 1993.

It's quite unlikely that any of the marketed MMR vaccines have ever caused a death.

I'm having a hard time believing you are not willfully misreading this document.

I nearly died from an MMR shot. I didn't read the linked doc but I can assure you people can die or have very serious complications from the MMR shot.

And was that better or worse than nearly dying from measles?

There's a very small chance of dying from the MMR vaccine. I imagine one is more likely to die from measles itself if unvaccinated.

I had both, the MMR and measles. Clearly the shot didn't work and nearly killed me and so did the measles. Yes a small chance but when you are in that small percentage it really stinks.

Well that sucks. How long ago was this?

The problem is that the word "may" covers a wide range of probabilities. Yes, there is a small but non-zero chance of adverse reactions to the vaccine. But it's orders of magnitude less dangerous than contracting one of the diseases it prevents.

Under "Clinical Pharmacology" it reads that Measels, Mumps and Rubella MAY be associated with serious complications and death. Which "may" is better?

The one in which people get vaccinated.

The one that leads to fewer serious complications and death.

Which is vaccination, by a margin so close to 100% that presenting it as the greater harm and refusing it on that basis is completely untenable.

It's astounding how the more educated and affluent areas are the ones with the highest level of exemptions. So its not so much as science education, but people's disconnect between science in theory and how it's applied in real life.

It's not the middle class or lower middle class and poor who opt out the most but upper middle and wealthy out of irrational fear.

But yes, glad this loophole gets closed.

I keep seeing articles that blame liberals for being anti-vax, but it's the Republicans who actually voted against this measure.

The trouble is, the purpose of the exemption supports traditionally "Republican" ideals of government not getting involved in their religious beliefs. However, there are large numbers of people taking advantage of the exception and they tend to fall into the more "crunchy granola" crowd typically aligned with liberal politics.

Isn't this because the affluent and educated have the time to read about it on the internet and in books? If you don't have the time to read the material, you no choice but to trust your doctor's recommendations.

Should you do so, and keep your objectivity, you'll see that the sensible option is to get all proposed 'mandatory' vaccines. The diseases prevented by them are nothing short of horrible.

> It's astounding how the more educated and affluent areas are the ones with the highest level of exemptions.

Not necessarily. There's also a tragedy of the commons here. If all children but mine are vaccinated, then my child is the safest, since I avoid both disease risk and vaccination risk.

So it can actually be rational to not vaccinate on an individual basis, depending on the state of vaccinations in the population. (On the other hand it is also rational to support a law forcing everything to vaccinate, since that fixes the tragedy by fiat).

What vaccination risk are you referring to, other than people with identified risk, immune deficiency, ec. There is no risk posed by vaccinations.

One other point, is while a local population might be vaccinated, you don't know who is coming in and out, i.e. going through town, one of those could be carrying the disease, so it's still irrational.

I am not so sure it is an issue of understanding science as it is about personal liberties. While I am not opposed to vaccinations, lord knows I have had them all, but I am not keen on government mandates. Especially when the example they give, at least in this article, to support the bill is 136 people out of a state of 37MIL.

If you wish to force vaccination then there needs to be copious oversight of those supplying them.

I wonder if the price for the mandated vaccinations will go up in California if this bill becomes law.

They're free under Obamacare.

They might be free to the consumer but someone is being charged an amount per dose. I wonder if that charge/cost will go up [faster than inflation]. (Why do healthcare and higher-ed costs go up faster than inflation?... because there's guaranteed money involved.)

Note that the 136 do not consist entirely of people who have made the informed choice to opt out.

I'm having trouble seeing the difference between this and the "government mandate" against drunk driving. In both cases, the government is preventing you from recklessly endangering the lives of others (in addition to your own).

If you are anti-DUI laws, then I have questions about your value system, but I will admit that you're at least consistent.

How many peoole have died in this country as a result of someone else not being vaccinated?

Probably thousands (millions?), in times past mostly, because that is when the mass population was not vaccinated. Diseases transmit with much more difficulty if people are vaccinated. Diseases kill some people (let's call them "the weak ones"). If people are vaccinated, diseases do not kill that much (because they do not reach the weak ones). If people are not vaccinated, diseases reach the weak ones, and kill them.

One mandate requires an individual to take risk against their will?

If you don't see the difference between the two mandates above, do you see a difference between government mandating vaccinations and government mandated sterilization or abortion of certain individuals with certain genes/DNA?

> One mandate requires an individual to take risk against their will?

The vaccinations being required provably decrease death rates, which sounds a lot like the opposite of taking a risk.

It's also worth noting that this is not a true mandate. Like how DUI laws only apply to people who choose to drive, vaccines are simply the cost of entry to the public school system.

> do you see a difference between government mandating vaccinations and government mandated sterilization or abortion of certain individuals with certain genes/DNA?

If you can bypass the law by a simple step like not sending your children to public school, and the abortion/sterilization significantly decreases both the risk of death to the person receiving the operation and the general public, then I suspect I would not be opposed to such a measure. I'm having trouble imagining what that scenario looks like, though.

Perhaps now people will stop calling it a 'controversy'? That word makes it the concerns seem legitimate.

There is no such 'controversy' in Brazil, for instance. The vaccination programs have been very successful. Several life-threatening diseases were greatly reduced or even eradicated, no matter how poor the region. We did have a revolt, in 1904 (http://en.wikipedia.org/wiki/Vaccine_Revolt)

Vaccines are one of the humankind's greatest accomplishments. To avoid vaccinations due to fuzzy "religious grounds" is to turn the clock backwards at least a century.

The voluntary consent of the human subject is absolutely essential. http://www.hhs.gov/ohrp/archive/nurcode.html

Great news, this means the vaccination numbers can go back to the western world level in the LA private schools.

http://www.theatlantic.com/health/archive/2014/09/wealthy-la...

What are the 10 vaccines being mandated?

(1) Diphtheria. (2) Hepatitis B. (3) Haemophilus influenzae type b. (4) Measles. (5) Mumps. (6) Pertussis (whooping cough). (7) Poliomyelitis. (8) Rubella. (9) Tetanus. (10) Varicella (chickenpox).

http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?...

For what it's worth, this actually ends up being fewer than ten distinct kinds of inoculations, as 1, 6, and 9 are typically combined as the DTaP/TDaP vaccine, and 4, 5, and 8 are combined as the MMR vaccine. Some do need boosters, though, so I imagine it comes out in the wash.

From http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb...

(1) Diphtheria.

(2) Haemophilus influenzae type b.

(3) Measles.

(4) Mumps.

(5) Pertussis (whooping cough).

(6) Poliomyelitis.

(7) Rubella.

(8) Tetanus.

(9) Hepatitis B.

(10) Varicella (chickenpox).

(11) Any other disease deemed appropriate by the department, taking into consideration the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services, the American Academy of Pediatrics, and the American Academy of Family Physicians.

Item 11 bothers me a bit, I don't want it to become a sales channel for vaccine makers. I think vaccines in 1-10 have a solid public health foundation, but 11 leaves a door open for abuse.

From http://www.leginfo.ca.gov/pub/15-16/bill/sen/sb_0251-0300/sb...: Diphtheria, Hepatitis B, Haemophilus influenzae type b, Measles, Mumps, Pertussis (whooping cough), Poliomyelitis, Rubella, Tetanus, Varicella, and "Any other disease deemed appropriate by the department, taking into consideration the recommendations of the Advisory Committee on Immunization Practices of the United States Department of Health and Human Services, the American Academy of Pediatrics, and the American Academy of Family Physicians."

Judging from the article, I assume that last clause was removed in the final version, but I'm guessing the rest stayed the same.

If you look at the status/history for the bill: http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_2...

It looks like 11 is still there, but I could easily be misinterpreting.

It's about time we stop giving religious beliefs any special treatment at all compared to actual measurable evidence (e.g. inhumanely killing animals, mutilating/indoctrinating children, etc.).

Or tax exempt status for teaching nonsense pseudoscience.

Just FYI, this is an inaccurate headline ("No More Vaccine Exemptions: California Senate Overwhelmingly Passes SB 277").

"No More Vaccine Exemptions" will be true only IF this passes the Assembly, where it faces a tougher fight. (Then the governor must sign it, but this is expected to happen.)

(I wish HN headlines about politics were half as accurate as the technical ones. See also https://news.ycombinator.com/item?id=9276841)

Thanks, we updated the title to more closely match that of the article.

If you see an inaccurate headline you can always email us (hn@ycombinator.com). We change those all the time, but there are too many comments posted here for us to see them all.

"The science is clear: Vaccines are safe and efficacious."

Nothing is 100% safe. So when they say something like this, it's pretty scary. I don't think it's causing autism, but some people do have ill effects due to vaccines.

Some people surely think they suffer ill effects. You get a shot and the next day catch a cold, so you blame the shot. But that's not science.

That's exactly how some vaccines work. See: http://www.bt.cdc.gov/agent/smallpox/vaccination/faq.asp

"Most people experience normal, usually mild reactions that include a sore arm, fever, and body aches."

Except nobody gets the smallpox vaccine.

Yeah, and if you are complaining about the mild immune response caused be an attenuated (or even dead) virus, imagine how worse you would feel when infected by the active pathogen.

This isn't the point. The point is that the ruling said it's "completely safe". Since it's not "completely safe", does this mean I could sue them?

What ruling? Where does it say "completely safe"? It's hard to take you seriously when you're not even correctly identifying the document in question. If anyone is confused, it's you.

Ah, excellent. Taking a more nuanced view than the simple binary "safe" or "not safe".

Let's continue down that path. Since nothing is 100% safe, we ought to choose the most safe option. And since we're talking about government policy here, it's not about what's safest for your kids, but what's safest for everyone. So what's safer, vaccines, or measles?

I think rlpb had it right elsewhere in thread - this is about a tragedy of the commons. Anti-vaxxers don't want to ban vaccines, they want to be the only ones not taking them.

"So what's safer, vaccines, or measles?"

This isn't the point. The point is that from this ruling, a person would assume that it's completely safe with no chance of any ill effects. I've even seen a few posts saying that any ill effects are "old wives tales".

Here is a good list:

http://www.cdc.gov/vaccines/vac-gen/side-effects.htm

From the CDC, which is a good source. Some of these could cause serious problems.

"Anti-vaxxers don't want to ban vaccines, they want to be the only ones not taking them."

Who said anything about anti-vaxxers?

If people in this world are foolish enough to believe that the things Dr. OZ talks about on his show will cure something (I watched the show many times and he has never actually said this), this ruling is pretty dangerous.

>that from this ruling...this ruling is pretty dangerous.

A piece of legislation that hasn't even passed yet is not the same thing as a court ruling.

"California Senate overwhelmingly passes SB 277..."

I guess you missed this part?

>I guess you missed this part?

No.

It is a bill that passed in the Senate. It still has to pass in the Assembly to become law.

Not a court ruling and not yet a law.

Safe is a relative term in medicine. It is unquestionable that for the vast majority of people when vaccinated as directed getting vaccines is much much safer than not getting vaccines. Furthermore, getting vaccines protects society as a whole.

I never said it wasn't safer. However, the vaxxer movement, like the pro-drug movement, likes to believe that there are no bad side effects at all, which is dangerous and a form of propaganda.

It almost makes me wonder if the drug companies are behind many of these laws.

Completely and totally untrue. Safe is a relative term in medicine and always has been.

I am also unaware of a "vaxxor movement."

I see a lot of pro vax people here. (Wonder how many of you actually have children less than 2 years old). Anyway here are some things that concerned me:

1. "Vaccines are safe" - The U.S. has the National Vaccine Injury Compensation Program [1]. In short it pays people who are hurt by vaccines. If vaccines are so safe why is this program needed?

2. "We had these vaccines as Kids" - The vaccine injury program made vaccine manufactures not be liable for injuries cause by their vaccine. This happened in 1988. "Since 1988, the U.S. childhood immunization schedule has rapidly expanded"[2]. In you are older than 28 you did NOT receive a lot of these vaccines as a kid.

There is a whole lot more but I don't feel like writing a book.

[1]http://www.hrsa.gov/vaccinecompensation/index.html [2]http://www.cdc.gov/mmwr/preview/mmwrhtml/00038256.htm

I hesitate to reply here but some additional points to consider (esp. re item 11 in the list of vax): - exponential growth in the number of vaccines over time - non-leathal nature of some of the newer vaccinees i.e common flu (scope creep) - concerns around the early age to be injecting so many foriegn substances (monkey genes) at the same time - trust in a for-profit medical system (revolving door governance) - science is not perfect - mandatory medical procedures should be viewed as a slippery slope - no-one died in the Disneyland outbreak - perspective: "in 2011, outbreaks resulted in over 30,000 cases, 7 deaths" http://shotofprevention.com/2015/01/22/disneyland-measles-ou...

"Season’s failed flu shot raises questions about immunization program" http://www.theglobeandmail.com/life/health-and-fitness/healt...

The common flu is non-lethal? Facepalm

Flu deaths are hard to measure but "CDC estimates that from the 1976-1977 season to the 2006-2007 flu season, flu-associated deaths ranged from a low of about 3,000 to a high of about 49,000 people." - http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.h...

Furthermore, I personally know one of those people killed by the flu.

Jesus...

In medical terms vaccines are incredibly safe. Medicine is a cost-benefits analysis. The risk of getting vaccines (as directed) is much less than getting the diseases vaccinated against.

You have to look at it as "what choice provides the most benefit?" which is how medical interventions work.

This article survives on HN because it strokes people'e scientific literacy egos and lets them feel outraged and/or look down on others. This is not of sufficient intellectual interest to warrant being on the front page.

Maybe a lot of people are interested in the science of ego-stroking.

Science has been growing a strange ego-stroking pop culture faction of late, and it's fairly worrying. It's certainly not an attitude that's actually going to improve anything. All it does is serve to create deeper divides that are even harder to bridge. People just dig in their heels.

I'm sure it's emotionally satisfying for people in some way, but I've come to a place where such an attitude significantly lowers my opinion of the person wielding it.

I think the passage of a law mandating vaccination with no religious exemption is rather interesting, personally. Yeah, the vaccine side is not that interesting. Vaccines are great, we all know it. But the political side is very interesting.

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