Health Care Bill Will Fund State Vaccine Teams to Conduct ‘Interventions’ in Private Homes

There is a knock at the front door. Peeking through the window, a mother sees a man and a woman, both in uniform. They are agents of health-care reform.

“Excuse me, ma’am,” says the man. “Our records show that your eleven-year-old daughter has not been immunized for genital warts.”

“And your four-year-old still needs the chicken-pox vaccine,” says the woman.

“He will not be allowed to start kindergarten unless he gets that shot, you know,” says the man—smiling from ear to ear.

“So, can we please come in?” asks the woman. “We have the vaccines right here,” she says, lifting up a black medical bag. “We can give your kids the shots right now.”

Is this a scene from the over-heated imagination of an addlepated conspiracy theorist? Or is it something akin to what is actually envisioned by the health-care reform bill approved this week by the Senate Health, Education, Labor and Pension Committee.

The committee’s official summary of the bill says: “Authorizes a demonstration program to improve immunization coverage. Under this program, CDC will provide grants to states to improve immunization coverage of children, adolescents, and adults through the use of evidence-based interventions. States may use funds to implement interventions that are recommended by the Community Preventive Services Task Force, such as reminders or recalls for patients or providers, or home visits.”

Home visits? What exactly is the state going to do when it sends people to “implement interventions” in private homes designed “to improve immunization coverage of children”?

Title III of the bill is entitled, “Improving the Health of the American People.” It includes four subtitles. They are: “Subtitle A: Modernizing Disease Prevention of Public Health Systems,” “Subtitle B: Increasing Access to Clinical Preventive Services,” “Subtitle C: Creating Healthier Communities,” and “Subtitle D: Support for Prevention and Public Health Information.”

The program authorizing home “interventions” to promote immunizations falls under “Subtitle C: Creating Healthier Communities.” This subtitle directs the secretary of health and human services to “establish a demonstration program to award grants to states to improve the provision of recommended immunizations for children, adolescents, and adults through the use of evidence-based, population-based interventions for high-risk populations.”

The bill lists eight specific ways that states may use federal grant money to carry out immunization-promoting “interventions.” Method “E” calls for “home visits” which can include “provision of immunizations.”

Says the draft bill: “Funds received under a grant under this subsection shall be used to implement interventions that are recommended by the Task Force on Community Preventive Services (as established by the secretary, acting through the Director of the Centers for Disease Control and Prevention) or other evidence-based interventions, including—“(A) providing immunization reminders or recalls for target populations of clients, patients, and consumers; (B) educating targeted populations and health care providers concerning immunizations in combination with one or more other interventions; (C) reducing out-of-pocket costs for families for vaccines and their administration; (D) carrying out immunization-promoting strategies for participants or clients of public programs, including assessments of immunization status, referrals to health care providers, education, provision of on-site immunizations, or incentives for immunization;(E) providing for home visits that promote immunization through education, assessments of need, referrals, provision of immunizations, or other services; (F) providing reminders or recalls for immunization providers;(G) conducting assessments of, and providing feedback to, immunization providers; or (H) any combination of one or more interventions described in this paragraph.”

Many vaccines routinely administered to children in the United States are utterly uncontroversial. But in recent years there have been controversies about the chicken pox vaccine and the vaccine for HPV, which causes genital warts, which can cause cervical cancer.

On March 15, 2007, Bloomberg news summarized a study published in the New England Journal of Medicine, which discovered that the chicken pox vaccine does not provide permanent protection against chicken pox, leaving children who have been immunized vulnerable to getting ill with the virus later in life when it can cause a more serious bout of the disease.

“Merck & Co.'s chickenpox vaccine weakens as children age, possibly leaving them vulnerable to a more serious infection as adults, a U.S.-sponsored study in California found,” reported Bloomberg. “The power of the vaccine, Varivax, the only one available in the United States against chickenpox, starts to fade after five years, according to the study in today's New England Journal of Medicine. The results suggest that children should get a second dose, which advisers to the Centers for Disease Control and Prevention recommended in June.”

Bloomberg quoted the study as saying, "Waning immunity is of particular public health interest because it may result in increased susceptibility later in life, when the risk of severe complications may be greater than that in childhood.”

In March of this year, the Washington Post reported about the controversy sparked when the Merck pharmaceutical company campaigned to have states mandate that school girls receive Gardasil, its vaccine against HPV.

“Merck also began an ambitious marketing campaign and lobbying push to persuade states to add the vaccine to the list of those required for children to attend school,” reported the Post. “But the company eventually abandoned the strategy in the face of an intense backlash from critics who argued that the decision should be left to parents. Although many states considered such mandates, so far only Virginia and the District have imposed one, and [a Merck official] said the company has no plans to pursue that strategy again."

The Post's report noted that at least some experts questioned the wisdom of promoting use of the vaccine when its long term impact is still unknown.

“Federal health officials, Merck and others say they are confident that the vaccine is safe," reported the Post. "But some experts said they are concerned that there is insufficient evidence about how long Gardasil's protection will last, whether serious side effects will emerge and whether the relatively modest benefits for boys are worth even the small risks associated with any vaccine."

...and the sky is blue. So what.

So, if you actually used your brain before your mouth, you would have realized that my comments were spot-on.

Provision (D) Carrying out immunization-promoting strategies for (1)participants or clients of public programs, including assessments of immunization status, referrals to health care providers, education, provision of on-site immunizations, or (2) incentives for immunization;

Provision (E) providing for (3) home visits that promote immunization through education, assessments of need, referrals, provision of immunizations, or (4) other services;

Q1. Who comprise the largest and most at-risk group of participants or clients of public programs?

A: Illegal aliens.

Q2. What sort of incentives for immunization would there be?

A: Given what this Administration has done, it would be money to Blue States, and groups like ACORN and La Raza, and threats to Red States, and groups like PutChildrenFirst.Org, The National Vaccine Information Center (NVIC), and Vaccination Liberation.

Q3. How will home visits be carried out?

A: Being "anti-vaccination" is one of the red flags of rightwing extremism, as defined by our Department of Homeland "Insecurity." I have no doubt that a database of gun owners will be crosschecked against a database of "high-risk individuals in need of vaccinations but who may violently protest against it" and home visitors will be suitably "protected."

Q4. What kinds of other services?

A: The sky's the limit. Registering them to vote as Democrats will be one "service." Getting them to join ACORN will be another "service." Helping them become citizens will be a third service.

Basically, any time the government makes a nebulous statement, we need to watch out. Reality check.

Merck’s ProQuad Vaccine Linked To Convulsions

MMR and Chickenpox Combination Vaccine Increases Risk of Fever-Related Seizures

Although Merck's literature and that of various other researchers note that antibody to the varicella zoster virus (VZV) remains high even twenty years after vaccination, almost all openly admit that this is due to a booster effect from subclinical re-infection from naturally occurring chickenpox occurring (years) after vaccination-that is, one gets the vaccine, and then is later exposed to a child who has a real case of the chicken pox, which serves to "booster" the child who originally received the vaccine. Unfortunately, in the future, if the incidence of chickenpox decreases, subclinical re-infection (i.e., the "booster phenomenon) will become rarer and one will have to rely solely on the vaccination's immunity.

The literature, however, clearly notes that both vaccine-induced immunity fades with time, specifically: humoral immunity (Asano, Pediatrics 12/1977; Bogger, J. of Inf. Dis. 8/1982) and cell mediated immunity (CMI) [Gershon JID April, 1990) either drops dramatically or gives far lower levels of protection than natural varicella infection when measured months after vaccination instead of years (when the booster effect has already occurred).

For example, Bogger notes that the antibody level following natural infection is more than twenty-five times as high as that found in vaccinated individuals when measured fourteen months after exposure; he also notes that antibody levels fell more than eight-fold within a fourteen-month period whether one had acquired natural varicella or had been vaccinated, thus giving a strong indication of what can be expected once the booster effect diminishes.

Gershon notes that the stimulation index (SI)-the measure of CMI-is over fourfold greater in adults after natural infection than adults who received the vaccination. What happens if vaccinated adults are found to be susceptible? Researchers for Merck claim that they could be revaccinated, but this may not be so simple. As internists know, most adults never get their 10-year tetanus updates-compliance may be a problem and travelers will have to make sure they are "up to date" when flying to any country in which they might be exposed to the virus.

Another potentially serious problem concerns the newborn child of the vaccinated mother. Normally about 95% of U.S. born mothers have been exposed to the varicella virus and pass the antibodies on to their newly born babies which give them protection for the first five and one-half months of life. Newborns who get the varicella virus without having maternal antibody protection are known to be at high risk for mortality (31%) (Preblud, Pediatrics, Suppl. 1986, p.731.)

Will the newborn baby who is born to the mother who was vaccinated as a child still receive enough (any?) antibody, and will he or she now be vulnerable to the virus at this critical stage when the baby's immune system may not be able to fight the virus?

The second point is the presence of a seemingly overt bias which appears evident in a number of papers concerning the costs/benefits of the vaccine. It is true that 60 - 90 people die each year from the virus-about 40% of these are adults and 25% are immunocompromised children. As noted, we really do not know if the long-term mortality will decrease with mass vaccination although it would appear that some reduction is likely. Merck is estimated to receive $150 million annually from sales (Severyn, 1995) which American families will fund either through higher taxes or via higher insurance premiums. Of note, each year 2000 youngsters drown and 600 die in bicycle accidents. Is it not likely that if we were to spend $150 million annually in safety programs and radio and television awareness ads that fewer youngsters would die from these causes as well?

Third, no one has a definite sense of what will happen to the incidence of herpes zoster in the future. It is true that the rate of zoster in vaccinated children does not appear to exceed the zoster rate in children after natural exposure, but as Merck freely admits, no one knows what will happen in the future: "The long-term effect of Varivax on the incidence of herpes zoster, particularly in those vaccinees exposed to natural varicella is unknown at present." (Merck, 1995 Varivax insert).

Fourth, it is a bit disconcerting to note that 11 out of 26 papers that I reviewed concerning the varicella vaccine had been funded by Merck. Some of this is probably unavoidable since Merck is the sole manufacturer of the vaccine. Unfortunately, it does not look good, when a cost/benefit study is funded by the same drug organization which manufactures the drug (Huse, 1994). Neither can one take comfort when one notes in the paper entitled "Recommendations for the Use of Live Attenuated Varicella Vaccine,"(Hall Carolyn et. al., Pediatrics, May 5, 1995) that the recommendation committee members of the American Academy of Pediatrics members are listed at the end of the paper: two of the authors might catch one's attention-one is a member of the Food and Drug Administration and another has previously published a paper that was funded by Merck! This hardly makes for an independent process. Members of the FDA, Merck and the American Academy of Pediatrics should not be issuing collaborative opinions in a process that is supposedly being evaluated independently!

Finally, an ethical controversy has started regarding the source of the cell line in which the vaccine is currently grown (MRC-5). Pro-life groups have taken note that this cell line (MRC-5) was derived from an aborted child: "Fetal lung tissue taken from a 14 week-old male fetus removed for psychiatric reasons from a 27 year-old woman..." (Jacobs, Nature 7/11/70.) Merck freely admits that vaccinees will receive DNA from this very same cell line: the vaccine contains "residual components of the MRC-5 cell line including DNA and protein." Which patients are ever told that the vaccine their children are about to receive contains DNA from surgically aborted babies?

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