美國對待麻疹流行的態度 (轉貼自TIME, 兩篇文章的合併)
美國最近如火如荼上演有關疫苗的事, 記得稍瞄了一下報導, 各州施打率都超高的, 最低都有85%以上. 現又有加州大學規定一定要打, 不打, 不給入學? 如果我還在19, 20歲, 傻儍地會聽學校的話, 但以現在的想法, 會讓我很爭扎.....
記得好像國中二年級, 有德國麻疹, 我們全班全輪過一圈, 我大概是中間得到的, 不知誰傳給我, 只知道我好了以後, 換坐我隔壁的美女同學得, 她氣到一個學期不跟我講話. 有一次還趴在桌上啜泣, 以為她要毀容了. 天曉得, 我也是受駭者. 忘了症狀是什麼? 好像臉上有紅斑? 忘了是否打過疫苗? 好像沒有, 是不是全部, 也忘了....總之, 大人們說, 得過以後自動有抗體, 確實也是這樣. 我這樣想, 身體也這樣反應.
H1N1爆發期間, 有小朋友注射疫苗致死, 大大改變我對疫苗的看法, 近年更是反方意見興起, 多所討論, 科學發達的美國, 面對流行病的態度, 居然仍是恐懼當頭, 單方論點當道, 好像沒有second opinion, 沒有公開論證, 讓我頗感驚訝. 其實, 疫苗也是一種藥. 而且, 打疫苗進入未感染的體內, 是在欺騙天生的免疫系統, 免疫系統有時會反應過度, 回頭打自己人, 變成未戰(流行病)先死的案例.....以及後遺症等等. ...
大學入學要依是否打預防針決定; 再來, 未施打的同學不鼓勵到校上課; 現在加上, 要把(未施打疫苗的家庭)名單公布出來? 不影響個資嗎? 打不打, 是一種自由意志的選擇, 自由意志的選擇下, 卻區隔成兩個人群...形成對立?~~ @@
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以下是賽斯訊息的通訊人珍(Jane Roberts)所做的一份整理, 僅作參考 (很可惜, 1970年代的當時, 對於可能有的團體歧視效應有更多著墨.....):
雖然預防接種計畫有種種缺點, 但絕大多數的我們仍相信它的效果, 賽斯明確不建議我們現在就放棄. 要等到個人信念強化到不需要這個<醫療拐杖>為止. 到那天, 可能還需要一點時間. 但我們可試著減少依賴度, 避免只為趕流行跑去挨一針.
在我們的社會, 當大家都這麼做, 只有你一人依照信念不這麼做, 是不容易的. 但部份疫苗, 像百日咳, 腮腺炎, 麻疹, 德國麻疹, 都一直有相當大的爭議. 往往只有部份效果, 卻會引發不同副作用, 反應從短暫, 永久到致命. 我強烈建議父母應徹底探討瞭解小孩要打的各個疫苗的利弊得失.
節錄自個人與群體事件的本質, page 43
註: 臉友的回應
其實這次Measles 的流行就是因為許多小朋友家長認為注射疫苗可能是造成 Autism的原因,所以沒有施打。平時正反兩面也多有討論的,還有一點就是有些人是基於宗教信仰的原因而不打的。
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University of California to Require Measles Shots for Students
The University of California will require incoming students to be vaccinated for measles and other diseases beginning in 2017, as the current outbreak that began at Disneyland continues to spread.
The new policy has far-reaching implications, with nearly 250,000 postgraduate and undergraduate students across University of California’s 10 campuses.
“The University of California will require incoming students to be screened for tuberculosis and vaccinated for measles, mumps, rubella, chicken pox, meningococcus, tetanus and whooping cough, under a plan set to take effect in 2017,” the UC said in a statement.
The policy has been in the works for a year, but it is being announced at a critical time for vaccinations. California is dealing with a rash of measles infections, a highly contagious disease that began at Disneyland in December and leaving more than 100 people ill across 14 states since then.
Health experts have attributed the California outbreak to increasing numbers of parents’ decision not to immunize their children against measles. Parents’ fears that vaccines cause autism stem from a single paper in the late 1990s, which today has been debunked as false.
Highly infectious diseases like measles and mumps can be particularly virulent on college campuses, where students live in close quarters. A mumps outbreak at Ohio State University last year infected 447 people.
Unvaccinated Families’ Addresses Should Be Made Public
The names and addresses of parents who won't vaccinate their children should made available on the Internet through a public registry
I’d be more than happy to see this proposal become law. But the politics of reducing parental choice are fraught, and there are limits to the law’s ability to compel good parenting. There’s also a hard cultural fact: few things are more fundamentally Californian than the freedom to believe whatever pseudo-religious or pseudo-scientific nonsense you choose. So, one way or another, it’s likely that parents will still find ways to avoid vaccinating their children, despite the risks to both their own kids and their communities.
A tougher, smarter way of dealing with anti-vaccine parents would be to target not their choice—but the secrecy that surrounds that choice.
Under today’s privacy laws, public schools and health authorities must protect the identity of parents who choose not to vaccinate. That’s wrong for many reasons. First, the secrecy effectively forces public employees, whose first duty should be to the public safety, to be enablers of those who threaten that safety. Second, parents who endanger the community’s health don’t deserve official protection. And third, the confidentiality of such exemptions makes it harder for those families who vaccinate their children to protect themselves.
People deserve privacy in their private spheres. But a parent who won’t vaccinate is not making a private health decision: She is making a public health decision that profoundly affects others.
So let’s treat the exemption she obtains as the public act it is. Every single exemption request should be reviewed in a public meeting and approved by a public body (like a city council or school board). And if the exemption is approved, basic information—the parent’s name, address, and the vaccinations declined—should be available on the Internet via a publicly maintained registry.
The virtues of disclosure are clear. Having your family’s name published as a potential hazard to public health would be a strong disincentive to obtaining an exemption for all but the most committed (i.e., delusional) anti-vaxxers. And the rest of us would be able to identify our unvaccinated neighbors, and our children’s unvaccinated schoolmates. This would be especially helpful to pregnant women and the parents and caregivers of children who are either too young to be vaccinated (the first measles mumps rubella vaccine isn’t given until after a baby’s first birthday) or have serious diseases like cancer (as in the case of the Marin County six year old recovering from leukemia) that compromise immune systems and preclude vaccination.
In effect, the question of how to handle unvaccinated children and their parents would move from the realm of school administrators to the community at large. And the community level is where the question is best addressed, since we encounter the unvaccinated not only at school but also in parks, churches, and stores.
There is some risk of community and personal conflict in this shift, to be sure, and anti-harassment laws would have to be strictly enforced. But there would also be potential for the kind of conversations necessary to change minds and get more children vaccinated.
Those who have studied the question of how to convince people to vaccinate report that the voices of distant authorities—public health departments, governors, even President Obama—aren’t particularly effective, given deep public distrust of institutions. People you know—neighbors, friends, co-workers—make better emissaries to the unvaccinated. But you can only be an emissary to unvaccinated neighbors or friends if you know they are unvaccinated.
The recent legislation acknowledges this need for conversation with a proposed requirement that all parents be notified of the vaccination rates at their kids’ schools. But that doesn’t go far enough. Indeed, it might create additional anxiety by instigating guessing games and speculation, without triggering the desirable peer pressure of true disclosure.
Some committed opponents of vaccines may howl about their identities being made public or about the exposure of their children, but such objections are easily turned back against them. If you believe you have the absolute power to make whatever decision you want for your children, why would you deny me the right to do the same, including the right to decide whether my children should be going on play dates to the homes of people who have recklessly opted out of modernity?
That response may sound harsh and insufficiently sensitive to privacy. But for better and for worse, it fits the obligations of 21st century childrearing. As a parent myself, I’m repeatedly reminded—by doctors, nurses, public officials, schools, and the dozens of legal waivers that daily life requires me to sign—that I am required to know everything I can about my kids. I’m supposed to know where they are at all times, and to monitor every minute of exercise and each spoonful of sugar. I’m supposed to find out everything I can about the kids they hang out with, and I’m supposed to monitor all their online movements. It’s no coincidence that most successful public service announcement series in America, now celebrating its 25th anniversary, is NBC’s “The More You Know.”
There are other good ideas out there for putting pressure on parents who don’t vaccinate. You could hand out stickers or buttons to all vaccinated schoolchildren—creating a social pressure on those who don’t. Laws could permit insurers to raise the premiums of those who don’t vaccinate (right now, insurers can only set rates based on age, geography and tobacco use). A new tort could be created to permit people who incur medical and other costs because of an outbreak to sue and recover damages from the unvaccinated. I particularly like a proposal from Dorit Rubinstein Reiss, a law professor at UC Hastings, to charge a significant fee for vaccine exemptions to cover the costs of an outbreak.
This issue is personal. My own children are still little, and it will be a few more years before all three are old enough to have had all their vaccinations. Media outlets have recently compiled data on the number of vaccination exemptions in California schools, and it bothers me that, of the 95 kids who attend kindergarten with my oldest son at our local public school, three are unvaccinated because their parents have obtained Personal Belief Exemptions.
I should have the right to know who those families are. And I look forward to the day when I can engage them in a conversation about what our families owe each other.
Joe Mathews is California & innovation editor at Zócalo Public Square, for which he writes the Connecting California column.