Pennsylvania Coalition for Informed Consent and NVIC

Anti-vaccination cartoon, 1890s. The College of Physicians of Philadelphia

The Pennsylvania Coalition for Informed Consent (PCIC) formed in March 2015, in the wake of the measles outbreaks that began in December 2014. During that time, Pennsylvania legislators introduced a bill to eliminate philosophical belief exemptions to school vaccinations, to which PCIC objected. PCIC has ties to the National Vaccine Information Center (NVIC), a group that provided strategic support at the time of PCIC’s founding. PCIC is neither, they say, for nor against vaccination, and their mission is “to preserve the vital personal freedom and human right to informed consent, privacy, and choice for medical procedures in Pennsylvania.” Clearly, though (and this is easy to glean from their Facebook), they are hostile to vaccination.

I received an email recently from PCIC that discussed a current concern of the group. Here in Pennsylvania, the Department of Health is seeking changes to state health regulations relating to school vaccination requirements. A major focus of these changes is to shorten the current eight-month grace period for a child to comply with certain vaccination requirements. The current regulations allow for a child to begin school in September but not show proof of vaccination or comply with exemption procedures until April of that school year. This grace period is thought by some to be the reason that the state’s kindergarten vaccination rates are so low (for example, 2014-15 two-dose measles, mumps, and rubella vaccine compliance is estimated in Pennsylvania kindergartners to be 91.7% as compared with 94.0% nationally [CDC, 2015]). The Pennsylvania Department of Health seeks to change the grace period for some vaccines to just a few days. The full list of changes to immunization regulations it proposes is here

Another concern of PCIC, probably encouraged by NVIC, is adult vaccination. PCIC refers to the Department of Health and Human Service’s February 2015 draft National Adult Immunization Plan, which analyzes the state of adult immunization in the US and makes recommendations for improving vaccination access and rates. PCIC links to an NVIC analysis of the plan, which makes some claims about the intentions of HHS that don’t sound right to me. NVIC says, “the NAIP contains objectives that foster partnerships with your employer and your community and religious organizations to make you and all adults get every federally recommended vaccine according to the government-approved schedule.” A photograph of a street sign accompanies the text: it shows the intersection of Church and State street. Clearly, NVIC is playing on its audience’s fears about individual autonomy, threats to religious freedom, and the role of the government in health matters. How well founded are their statements? Is it true that community and religious groups will, at the direction of the federal government, force us to get vaccinated? Here’s what the NAIP objectives actually say about this:

Objective 3.3. Educate and encourage other groups (e.g., community- and faith-based groups) to promote the importance of adult immunization.

3.3.1. Engage community leaders in reaching the public with information about the importance of adult immunization.

3.3.2. Encourage the development of adult immunization champions across all sectors.

The only other reference to religious groups comes later the document when it refers to a partnership among HHS’s Office of Minority Health, Walgreens, and community- and faith-based groups that resulted in the immunization of 780,000 individuals against influenza. This example seems to be very weak evidence to support NVIC’s claim that religious groups will enforce federal vaccination recommendations.

NVIC is also concerned about privacy and data security in the NAIP’s plans to make better use of immunization information in electronic health records (EHRs) and immunization information systems (IISes). Given that a goal of NAIP is to “strengthen the adult immunization infrastructure,” it’s not surprising that the plan would encourage the use of digital tools to do so. The emphasis in the plan is to increase the ability of data transfer between EHRs and IIses so that accurate immunization information is available to the patient and all of her care providers. As to NVIC’s concern that the NAIP doesn’t address privacy issues, it doesn’t. Those issues, however, are addressed within the realm of IIS and EHR oversight.

PCIC is probably not the only state group that is taking talking points and strategy from NVIC. More than 100 years of history demonstrate that anti-vaccination groups have been very effective at uniting to tap in to fears about immunization and individual rights.

Image: Anti-vaccination cartoon, 1890s. This particular cartoon was reproduced in the anti-vaccination press, with different captions given for the figures depending on the location of publication. The Historical Medical Library of The College of Physicians of Philadelphia. Scrapbook of Anti-Vaccinations Clippings. 8c242