New Vaccination Bills Move Through Legislature, Opposed By Arizona Medical Association

Published: Tuesday, February 26, 2019 - 12:11pm
Updated: Wednesday, February 27, 2019 - 3:41pm
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STEVE GOLDSTEIN: Three bills related to vaccination and immunization coverage in Arizona are making progress at the state legislature, as they've all been approved on party-line votes by the House Health and Human Services Committee. One aims to expand vaccine exemption categories while the second would require doctors to give children a blood test to see if they actually need the vaccine. The third bill would provide parents with information about vaccine ingredients and potential risks. The Arizona Medical Association has come out against the bills, and Pediatric Critical Care Physician Dr. Brigham Willis — representing the association — joined me earlier to talk about that. I began by asking him about his experience, as a critical care doctor in seeing and helping young patients who may have gotten diseases for which there are vaccines.

BRIGHAM WILLIS: It's a difficult thing because vaccinations have been so incredibly effective over the years that we don't, as a population, see the effects of these deadly diseases like polio, and diphtheria, and pertussis, haemophilus influenzae B anymore because the vaccinations work. We just don't see them very commonly. I'm a pediatric critical care physician and I unfortunately see the kids who do get those diseases and end up dying from them. And so the devastating effects of those are very personal to me. I've seen children, infants, dying of pertussis, causing their hearts to fail, their lungs to fill up with fluid and having them die on ventilators. We see kids with encephalitis for measles. It's really quite chilling to see what people used to see back in the earlier parts of history when we didn't have these vaccinations. So for me, it's very easy and visceral to see the effects and the benefits of vaccination. But for most people, they don't see those. They just see getting an injection for unclear reasons.

GOLDSTEIN: Have you spoken with parents of patients, in this case, that have expressed to you concern about vaccines and yet perhaps they've still had their children vaccinated? Is this something that we have seen, that you've actually seen in practice and not just at the legislature as many of us have seen recently?

WILLIS: Oh, extensively. I mean most parents are very pro-vaccination — let’s just put that out there — because they understand the benefits but there's a definite subset of parents who have strong concerns about the content of the vaccines or whether they're effective. And also the fact that they talk to other parents who are convinced that their injuries to children happened because of the vaccine. So it is a significant population out there that has concerns about them and don't see the benefits. And so one of the challenges being a pediatrician is working with those families and trying to educate them as to the benefits without causing enmity and causing an adversarial relationship.

GOLDSTEIN: How do you counter that without the enmity coming down? Can you have a nice calm discussion about it and explain the benefits versus the perceived detriments by some?

WILLIS: I think that's really important. And the best thing you can do is try and lay out the best evidence for why vaccines are effective, and without getting emotional about it. I know pediatricians can get emotional, parents can get emotional and so if you can establish a relationship where you can communicate to parents that you're just trying to help their children, I think that's the best way to go. The difficulty is that there is obviously a very, very low rate of reactions that happen to vaccines, anaphylaxis and those kind of things. But the rate of adverse reactions is so incredibly low compared to the huge number of children's lives who are saved but that's the conversation you have to have, is the greater good of having the vaccinations so dramatically outweighs the low incidence of adverse reaction. That's what needs to be put out there through education.

GOLDSTEIN: People who are supporting these bills will say that parents deserve more information. They should know what's in the vaccines, and then on the counter side, people would say, well, parents should know information about how positive vaccinations have been. When it comes to knowing what is in vaccines, should parents know that? In some cases, are they impossible for anyone other than a scientist actually understand what's in them?

WILLIS: I mean, people are smart and they can understand it but I think that having a long laundry list of the ingredients that might occur in the production of the vaccines serves to only scare them and makes parents focus on these very, very small levels of chemicals or something that are unavoidably necessary in the production of the vaccines versus the incredibly large benefit they're going to get from it. A great example is a lot of parents get concerned about formaldehyde being in the vaccines. There are tiny, tiny amounts of formaldehyde because it's necessary as a preservative and to keep the vaccines effective. The formaldehyde is actually a naturally occurring molecule in our bodies. It's used in various biologic processes, and the amount of formaldehyde in the vaccines is so incredibly minute it would have no measurable effect on any human person.

GOLDSTEIN: Let me ask you one other question about one of the specific bills that would require doctors to offer parents a blood test to determine whether their child needs a vaccine or is already immune. Would that actually be something that would be testable?

WILLIS: It's actually one of the more concerning bills because the blood tests that test whether you have antibodies to a disease or not, number one, is not reliable in a lot of cases. Whether or not you have antibodies is not a very good representation of whether a population would be affected by a vaccine. And then also it's really dangerous for children because under the first year of life, and definitely the first six years of life, your antibody titers have no bearing on your immunity because you have antibodies from your mother that have no relationship to whether you're immune. So those tests wouldn't tell you anything about whether a child should receive a vaccine. The other problem with that is it introduces another level of delay or potential missing of vaccinations. So you're going to have people requesting the test and then not getting it done and delaying the vaccination. So the net effect will be to reduce overall vaccination rates, which I think is a really bad idea.

GOLDSTEIN: Dr. Brigham Willis is a pediatric critical care physician. He was speaking on behalf of the Arizona Medical Association.

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