With the possible exception of municipal drinking water, nothing has saved more lives than vaccines.

Cheap, safe and easy to use, vaccines have already wiped out smallpox, one of the great scourges of days past, and they’ve allowed humanity to come stunningly close to consigning polio to the history books as well.

Vaccination against polio began with the Salk vaccine in 1955. In 1952, nearly 3,000 people had died from polio and children in “iron lungs” populated wards in most hospitals. By 1991, however, the disease had been eradicated in the Western hemisphere. U.S. Food and Drug Administration

Many other infectious diseases are on the ropes, mere shadows of what they once were.

Given the success of immunization efforts, it’s perhaps a little hard to understand the referendum Tuesday asking voters to reverse a new state law that ensures greater vaccination rates. The law says parents can no longer use religious or philosophical arguments to avoid getting their children immunized.

Why, after all, would parents want to expose their own sons and daughters to serious and potentially deadly diseases that are almost entirely preventable? Why would they want to risk the health of others who can’t receive immunizations for medical reasons?

The answer, for many of those who oppose the new law, is simply this: choice.

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“This is an area where parents need to be able to make choices,” said Gerald Nadeau, a chiropractor in Auburn.

Nadeau said he is not anti-medicine or anti-vaccine.

“I am a freedom of choice and a freedom of religion person,” Nadeau said.

He expressed concern that under the law approved by the Legislature last year — now on hold pending the outcome of Question 1 — “people are being forced to do something” whether or not they think it’s necessary or wise.

Other foes of the new vaccine requirements have their own, sometimes quirky reasons for their positions, rooted in personal experiences or an unwillingness to go along with what many others would consider accepted science.

Meanwhile, those who support the law — including every major medical group in Maine, from the Maine Medical Society to the Barbara Bush Children’s Hospital – say that removing nonmedical exemptions for required vaccines will help prevent outbreaks of harmful diseases and protect those with compromised immune systems who can’t get vaccines.

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Dr. Mina Assadollahzadeh, a primary care physician in Lewiston who opposes repeal of the new law, said she encourages skeptical parents to go along with vaccines for their children’s safety but also because there is a need “to protect everybody else.”

She said failing to vaccinate can put babies, the elderly and people with certain health issues at risk.

National Institute of Allergy and Infectious Diseases

“What you do affects them,” Assadollahzadeh said she tells parents. “You do have a responsibility to your community.”

Medical experts argue there are no legitimate grounds for anyone to oppose vaccination for anything other than medical reasons.

“When someone chooses not to vaccinate, that decision can jeopardize the health and safety of entire communities, especially the weakest and most vulnerable among us,” Nancy Beardsley, a top official at the Maine Center for Disease Control and Prevention, told legislators last year.

“Those who are unable to be vaccinated, such as young infants, pregnant mothers or children with cancer, face the most risk from disease complications,“ she said.

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MEASLES IN HEBRON

Even when nobody is suffering from a serious health problem, preventable and potentially dire diseases can create a crisis.

Consider what happened when a student at Hebron Academy came down with the measles in the spring 1994.

After some high-stress weeks of study, Emily Harvey Garcia said she was taking an Advanced Placement test when she suddenly felt so tired she couldn’t even complete the exam.

Her parents took her to the doctor, who ran some tests and discovered she’d come down with the measles. They never figured out where or how she was exposed.

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Garcia, who is completing medical studies to become a physician, said she didn’t get especially ill.

Still, a student sick with measles created a furor at her school, forcing faculty to scatter, classrooms to close and learning to grind to a halt for perhaps a week, recalled former teacher Silver Moore-Leamon of Auburn.

Arthur Harvey, a Hartford resident who grows organic wild blueberries, said Emily, his daughter, who never got vaccinated, was the only student stricken there at the time.

Harvey remembers it as “no big deal” and dismissed measles as “a trivial childhood disease” that nobody dies from.

After his daughter’s diagnosis, a state epidemiologist urged him to get his son vaccinated quickly. Harvey said he opted to do nothing.

Though measles in its heyday used to kill 500 or so Americans annually, Harvey’s bet worked out. His daughter bounced back and his son never got sick.

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Garcia said her brother never showed any symptoms but wound up with an immunity to measles, an indication he was also exposed.

“We’re an organic family,” Harvey said. “We’re very particular about what we give our kids.”

He never expected, though, to give his children the measles.

Moore-Leamon said what occurred at the Hebron Academy is a perfect example of what happens when someone with a “cockamamie desire to crunch granola” refuses to do right by the greater community.

“This was a whole bunch of kids and working adults whose lives were totally disrupted by one family’s decision” to reject vaccinations, she said, adding that it could have been much worse if others had fallen ill.

“It’s scary for people, I guess,” Garcia said.

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Since vaccines have put an end to most preventable disease, they rarely occur any longer, Moore-Leamon said, and people don’t remember what it was like in times past, when children got seriously sick and homes were quarantined and sometimes people died.

“We have forgotten,” she said.

 

IMMUNIZATION SUCCESS

Cases of measles, mumps, rubella and diphtheria are each down by more than 99% since the pre-vaccine era, state statistics show.

A century ago, diseases that are preventable with today’s vaccines killed nearly 2,000 Mainers annually, including about 50 every year who got the measles.

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Thanks to vaccines, the last death in Maine from smallpox came in 1929, the last fatality from diphtheria in 1964, the last from whooping cough in 1967 and the last from tetanus in 1970.

As a consequence, Assadollahzadeh said, “I have no idea what diphtheria would look like in a patient” because she’s never seen someone with the disease.

Vaccines are not 100% effective, however, and there are some people who can’t get them for medical reasons.

As a result, experts say there is a big value in creating what it is called a “herd immunity” that ensures there isn’t a pool of people big enough to keep deadly viruses circulating. That means ensuring nearly everybody be immunized, they say.

Without herd immunity, “you’re putting all of the other children at risk,” said Annie Rice, a physician assistant who specializes in primary care in Lewiston.

A U.S. government chart that explains the concept of herd immunity for vaccinations. NIAID

WHY MAINE LAWMAKERS TOOK ACTION

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Supporters of the new law that removed nonmedical exemptions say only three states in the country have higher rates than Maine of parents opting out of childhood vaccinations, which is creating a situation where community immunity is jeopardized.

In Maine in 2019, there were 372 cases of the highly infectious-but-preventable disease, with the median age of 13 for those stricken. Twenty-three of the cases involved babies less than a year old, state health records show.

Health officials say Maine’s high rate of exemptions for nonmedical reasons — 5.3% of all students — contributed to recent outbreaks of whooping cough, also known as pertussis.

Studies by the U.S. Centers for Disease Control have found that vaccinations for children born between 1994 and 2018 kept 936,000 people alive who would otherwise have died, prevented 419 million viral illnesses and saved $1.9 trillion in costs associated with diseases.

One study cited by the World Health Organization found, for example, that without DTP vaccination in the United States, whooping cough cases could be 71 times more common and deaths from the disease would be four times higher.

“It is both common sense and borne out in practice that the only way to stop or slow the spread of communicable disease during an outbreak is to have children immunized. If there are exceptions to that rule the protection is weakened,” Steven Bailey, executive director of Maine School Management Association, testified in Augusta.

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As part of a national trend to get more children vaccinated, most states have already adopted vaccination requirements that leave no room for philosophical objections for entry into public schools.

ARE VACCINES DANGEROUS?

The Mayo Clinic says the risk of a vaccine causing serious harm is “extremely small” and the benefits of vaccines “are much greater than the possible side effects for almost all children.”

“Vaccines are overwhelmingly safe and studied so well,” Rice said. After reviewing the medical literature, the American Academy of Pediatrics called vaccines “extraordinarily safe.”

A 2015 study by the CDC reviewed extensive medical reports and declared they show that “vaccines are rigorously tested and monitored and are among the safest medical products in use.”

Despite millions of vaccinations annually in the U.S., it said, serious reactions are uncommon and deaths “very rare.”

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The bottom line, Assadollahzadeh said, is that the tiny risk from a vaccine “is nothing compared” to the risk of getting sick from a preventable illness.

 

BUT WHAT ABOUT THAT THING I SAW SOMEWHERE?

Opponents often spread rumors and unscientific claims that vaccines cause illnesses, autism and more.

There is a lot of misinformation out there, Rice said.

Harvey agrees, but from the other perspective, saying he doesn’t put a lot of faith in the statistics offered by the medical establishment.

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He told a story about a soldier he knew who got a handful of vaccines shortly before getting shipped out unexpectedly to Afghanistan.

A week later, the young man was dead, supposedly of a heart attack. Harvey said it was likely a reaction to the vaccines.

That’s the kind of tale that many anti-vaxxers latch onto — what seem like impossible-to-deny scenarios that led to a toddler’s illness or a teen’s moroseness or a soldier at the height of health suddenly dead.

That these things also happen in the absence of vaccines — the pre-vaccine era was chock full of young people dead or scarred for life — is rarely noted.

A February study by the Annenberg Public Policy Center of the University of Pennsylvania found that nearly one in five Americans who rely on social media for medical information mistakenly believe that vaccines cause autism, contain toxins or that it’s safer to spread out the recommended vaccine schedule.

There is no scientific evidence for any of those assertions.

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But many believe them anyway, in part because it is virtually impossible to prove such tales are false. Science can only say there is little or no evidence to back them up.

The wariness of some has become a danger.

“Vaccine hesitancy — the reluctance or refusal to vaccinate despite the availability of vaccines — threatens to reverse progress made in tackling vaccine-preventable diseases,” WHO said in citing the development as one of the top problems facing global health.

Taking note of the trend as it laid out its support for the new law, the Maine Council of Churches said the effort to push a people’s veto of the stricter vaccination law “is poorly informed and sadly unethical.”

“We cannot reconcile our moral conscience, grounded in the biblical command to ‘love our neighbors as ourselves,’ with the actions of those who would knowingly harm others to allay misguided fears caused by a hoax,” said the group, which represents seven denominations and 417 congregations.

Leamon-Moore said the notion that somebody’s personal feelings should trump the community’s need for safety is simply wrong. Part of living with other people, she said, is to accept that it limits personal autonomy a bit for the good of all.

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LIFE, LIBERTY AND THE PURSUIT OF HAPPINESS

For Nadeau, it’s not about the pros and cons of vaccination. It’s about liberty.

He said he worries that mandating vaccines is just another step on what could prove “a slippery slope” toward a time when government edicts routinely trump personal choice.

For Laura Columbia, a parent of two in Farmington, that argument doesn’t hold water.

Columbia told legislators that parents are required to keep children safe.

She said she supports, for instance, the legal obligation “to buckle our children into car seats” and to feed, clothe and otherwise provide them with essentials.

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“Vaccinating our children is another common sense measure to meet the basic needs of our children,” Columbia said. “Vaccines are an easy way to protect our children from harm.”

Safe or not, Donna Haitwell of Auburn warned legislators that creating the requirement would be an unwarranted step that “violates the very covenant this country was founded on.”

One of the country’s founders might not agree. George Washington, who nearly died of smallpox at the age of 19, didn’t hesitate to order the inoculation of his entire army during the Revolutionary War.

“This Expedient may be attended with some inconveniences and some disadvantages, but yet I trust, in its consequences will have the most happy effects,” the commanding general and future president wrote.

Thomas Jefferson, who wrote the Declaration of Independence, was so enthralled by the discovery of a smallpox vaccine that he made sure members of his household received it and encouraged others to do so as well.

In the summer of 1801, Jefferson declared that “it will be a great service indeed rendered to human nature to strike off from the catalogue of its evils so great one as the smallpox.”

“I know of no one discovery in medicine equally valuable,” Jefferson concluded.


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