The US states of California, Washington, and New York have passed, are reviewing bills, which amend vaccination exemption for medical, philosophical or religious beliefs.
In California, the bill SB276, in which doctors are sanctioned for granting improper medical exemptions for vaccinations required for entry into daycare or school, was passed by California’s Assembly Health Committee.
The bill also gives the California Department of Public Health the ability to review and reject any child’s medical exemption if they attend a school or daycare with immunization rates less than 95%, which 20% of the schools and daycares in the state currently fall under.
According to a paper written by Michael Smith, associate professor of pediatrics at Duke University, published on vaccine manufacturer Merck’s website, vaccine exemptions in the US increased from 1% in 2006 to 2% in 2017. He added, that some states reported 6% of children receiving exemptions. Alongside these rising rates, the cases of vaccine-preventable disease in children have also increased.
Children whose parents refused one or more vaccines for nonmedical reasons are 23 times more likely to contract pertussis, or whooping cough, 8.6 times more likely to contract varicella, the virus that causes chickenpox, and 6.5 times more likely to contract a pneumococcal disease, according to Smith.
‘Devastating’ but not directly impactful
A spokesperson for GlaxoSmithKline told us that the company is “deeply concerned” about the impact on anti-vaccination and vaccine hesitancy on public health and it is “devastating to see people of all ages suffer needlessly from a disease like measles that is easily preventable through vaccination.”
However, anti-vaccination is not a direct component of its manufacturing planning, instead, the spokesperson stated, “vaccine hesitancy is a complex, global, societal issue since the advent of vaccines.”
GSK stated that it intends to focus on consumer education and reporting its research, safety testing, and regulatory oversight that goes into vaccine development.
Measles outbreak aligns with increased production
Even though anti-vaccination rates seems to be ticking upwards, with a 1% growth over ten years, Merck, known as MSD outside North America, the only producer of the measles, mumps, and rubella (MMR) vaccine in the US, bumped up its production rates amidst the measles outbreak.
In April 2019, the center for disease control (CDC) reported 704 cases of measles in the US, most cases involving a child who was not vaccinated. During this outbreak, a spokesperson for Merck told us that the company took steps to increase its production of the MMR-II vaccine to ensure availability.
Merck also reported an increase in sales of its chickenpox and MMR vaccines in the first quarter of 2019 by 10%; however, it accounted for this increase in revenue to selling vaccinations to private clinics, which pay more than the US government.
Removal of thimerosal
One of the reasons in which parents seek exemption from vaccinations is the belief that certain components of vaccines may cause autism spectrum disorder. Thimerosal, a mercury compound no longer used in childhood vaccines, was one of these materials.
The compound was used as a preservative in some multi-dose vaccines and is metabolized to ethylmercury, which is eliminated from the body quickly and is a different compound to methylmercury, which is not eliminated quickly and can be toxic to humans.
Vaccine manufacturers removed thimerosal from childhood vaccines in 2001 because of theoretical concerns, despite no studies showing any harmful effects. Thimerosal is still used in vaccines for influenza and many vaccines for adults or for use in developing countries.
According to the US Food and Drug Administration, the compound was never used in MMR vaccinations, pneumococcal conjugate vaccines, or vaccines to prevent against varicella, or polio.
Removing thimerosal, which was not recommended by the World Health Organization, as the compound shows no clinical evidence of toxicity in routine use, did not lessen the number of parents that still seek exemption from vaccines.