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1. Something that we learned about this topic that most surprised us was that the number of medical exemptions for vaccinations in California since the legislation change has tripled since 2016. The legislation changed the personal belief so that the only way children can go to school without being vaccinated was going to be through an exemption from a doctor. Since then the number of exemptions has gone up tremendously and they are finding that doctors all over the states are charging different amounts of money to write the exemptions for these children.

2. Both of us have been vaccinated and we both believe in vaccinating our children. The fact that people aren’t vaccinating puts other people around the world in danger of illness from the outbreaks they cause (for example, the multiple measles outbreaks that have been occurring in multiple public areas). It causes harmful environments to children and adults who can’t be vaccinated for specific health reasons rather than a belief.

3. We found it interesting to find out the large number of people that don’t vaccinate their children with no medical reason behind it. We know that there are many illnesses and diseases that people have that don’t allow them to be vaccinated as it could be more harmful to them but the fact that people are not vaccinating with no medical reason behind it is very surprising and interesting to us. Both of us have never even considered not vaccinating our children.

4. We are most likely to remember that not vaccinating your kids can cause more harm to themselves and others than good.

5. The pseudoscience belief that is most harmful is emotional connection because out of all the reasons for belief an emotional connection can blur rational thought more than any other reason. The least harmful pseudoscience belief is unexplained because there is no telling if anything is true or not as there is no explanation for it.

6. If we could pass on any of our knowledge to a family member or friend the most important thing would be to don’t believe anything unless there is evidence and hard proof to back it up.

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Description: This is an article from City News.  The article is from the Ontario Health Minister about the concerns of the anti-vaccine campaign currently happening.

Connection:  This article is from the Ontario Health Minister,  which connects to appeal to authority beacause the Ontario Health Minister is incharge of administering the health care system and providing services to Ontario.

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An ad campaign from a group of open vaccine skeptics that briefly dotted some streets in the Toronto area represents a "very concerning" development in the ongoing fight against misinformation, Ontario's health minister said Wednesday.

Christine Elliott expressed fundamental disagreement with the billboard ads paid for by Vaccination Choice Canada, an advocacy group that describes its mandate as ensuring people are fully informed and educated about immunizations for themselves and their children.

The campaign, which rolled out across more than 50 digital billboards around the city last week featured a rotation of four slogans and direct questions that a group spokesman said aimed to ensure that Canadians are "truly informed" when they consent to getting vaccinated.

The billboards appeared to have been taken down ahead of schedule on Wednesday. Spadina-Fort York Councillor Joe Cressy said the ads were being removed following "overwhelming public concern."

In a tweet, he commended the sign company for their prompt response and also called for a ban on anti-vaccine ads across the country.

Given the rise of unfounded & disproven anti-vaccination information & the dangerous public health consequences, this incident has demonstrated the need to approach anti-vaccination advertising just like we do with tobacco: to stop it in this city & across the country. 2/2

- Joe Cressy (@joe_cressy) February 27, 2019

The group's vice-president, Ted Kuntz, said the company responsible for disseminating the campaign faced pressure from an "unknown" source to remove the ads, saying the move suggests Ontario's public policy does not support public education.

Elliott disagreed, lamenting the amount of public misinformation on medical subjects, redoubling calls forOntarioresidents to get their vaccines and suggesting failure to do so has already had consequences.

"A certain number of people need to be vaccinated in order for it to be effective," Elliott said after directly criticizing the Toronto-targeted campaign. "It's not necessarily happening now, and we're seeing things come forward like tuberculosis outbreaks in certain parts of Ontario, measles outbreaks and so on. So we are going to continue, through the Ministry of Health, to encourage people to have their children vaccinated and to receive regular inoculations themselves."

Elliott did not offer details on which parts of the province she was referring to.

The billboards at the heart of the campaign are meant to encourage parents to do research before proceeding with immunizations, Kuntz said, adding the group commonly described as "antivaxxers" are in fact former vaccine supporters who have grown "risk-aware" through their own research and experience.

The messages in circulation as part of the campaign were meant to raise questions and spur discussion and deeper research, said Kuntz, who describes himself as the parent of a now-deceased child injured by a vaccine in infancy.

Half the campaign's messages posed the questions "What are the risks?" and "How many is too many?" The other two came in the form of statements - "Educate before you vaccinate" and "No shots, no school? Not true."

Dr. Vinita Dubey, associate medical officer of health at Toronto Public Health, described the messages at the core of the campaign as "half-truths."

Dubey agreed that over-vaccinating children is dangerous, for instance, but said current immunization protocols are safe, evidence-tested and effective in protecting both individuals and broader populations.

She said the same held true for the message challenging vaccination policies in schools. Ontario parents are required to provide vaccination certificates for their children, she said, but noted they also have the option to obtain an exemption for their kids based on medical, religious or philosophical grounds.

"They misrepresent information on vaccines," Dubey said of the billboards. "This is a common tactic that the anti-vaccine movement uses to try and change people's opinion on vaccines, and that is our biggest concern."

Kuntz dismissed Dubey's characterization, calling common critiques of the group's messaging "dishonest."

"A parent can't decide what is best for oneself and one's children without adequate information about the benefits and risks. Good products, backed by solid evidence of safety and effectiveness, are not afraid of educated and informed parents," he said.

The Public Health Agency of Canada said in a statement that Canadian parents "rightly have questions about vaccines," but that the science on the topic is unequivocal.

"Vaccines can prevent infectious diseases that once killed or harmed many infants, children and adults," spokeswoman Anna Maddison said.

"However, there is a small but vocal anti-vaccination community that spreads false information. They use powerful emotional images and misinformation with their message. This creates confusion and fear for parents who are trying to make the best decisions for the health and wellbeing of their children."

Timothy Caulfield, a Canada Research Chair in health law and policy at the University of Alberta, said the number of people who are staunchly opposed to vaccines form a very small minority. Their messaging, however, finds an increasingly receptive ear among the 20 to 30 per cent of Canadians who express "vaccine hesitancy," he said.

Caulfield said science has unequivocally settled the debate, describing a "mountain of evidence" on the pro-vaccination side compared to a "small mound" fuelling the skeptics' arguments.

But he said anti-vaccination messaging is reaching a wider audience, thanks to both social media and broader political forces that have roiled countries around the world.

"The profile of the 'antivax' movement, I think, is connected to this rise in populism and this growing distrust of experts ... and our institutions," Caulfield said. "That gives space to these kinds of views and allows them to flourish."

-
With a file from News Staff

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Anti-vaccine campaign 'very concerning,' says Ontario's health minister

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An ad campaign from a group of open vaccine skeptics that briefly dotted some streets in the Toronto area represents a "very concerning" development in the ongoing fight against misinformation, Ontario's health minister said Wednesday.

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Description: This website talks about the anti-vaccination movement.   This website talks about MMR and autism,  Thimerosal and autism and the use of multiple and simultaneous vaccinations. This website also gives reference to other articles/websites with supporting information.

Connection: Proof by verbosity is a red flag that connects to this website, proof by verbosity applies to this because they are giving an information overload.  The website has links to other articles/websites to give the illusion they know what they are talking about. A reason for belief that connects to this website is ideology.  Social ideology connects to this website because they are targeting a specific group (anti-vaccinators).

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In 1998, Andrew Wakefield and colleagues published a brief report in The Lancet. This report concerned 12 children with developmental disorders and GI problems; 9 of them also had autism. According to the report, parents claimed that 8 of the 12 children had received the combined measles-mumps-rubella (MMR) vaccine within 1 mo before the development of symptoms. Wakefield postulated that the measles virus in the MMR vaccine traveled to the intestine where it caused inflammation, enabling proteins from the GI tract to enter the bloodstream, travel to the brain, and cause autism. This study received significant media attention worldwide, and many parents began to doubt the safety of the MMR vaccine. In another study, Wakefield claimed to find the measles virus in intestinal biopsy specimens of 75 of 90 children with autism and in only 5 of 70 control patients, leading to speculation that the live measles virus in the MMR vaccine was somehow implicated in autism.

Because Wakefield's methodology could show only a temporal association rather than a cause-and-effect relationship, numerous other researchers studied the possible connection between the MMR vaccine and autism. Gerber and Offit reviewed at least 13 large epidemiologic studies, all of which failed to support an association between MMR vaccine and autism ( 1). Many of these studies showed that national trends of MMR vaccination were not directly associated with national trends in the diagnosis of autism. For example, in the UK between 1988 and 1999, the rate of MMR vaccination did not change, but the rate of autism increased.

Other studies compared the risk of autism in individual children who did or did not receive the MMR vaccine. In the largest and most compelling of these studies, Madsen et al assessed 537,303 Danish children born between 1991 and 1998, 82% of whom had received MMR vaccine ( 2). After controlling for possible confounders, they found no difference in relative risk of autism or other autism-spectrum disorders in vaccinated and unvaccinated children. Overall incidence of autism or an autistic-spectrum disorder was 608 of 440,655 (0.138%) in the vaccinated group and 130 of 96,648 (0.135%) in the unvaccinated group. Other population-based studies from across the world have reached similar conclusions.

In response to Wakefield's increased detection of measles virus in intestinal biopsy specimens from autistic children, Hornig et al searched for the measles virus in biopsy samples taken from 38 children who had GI symptoms and were having a colonoscopy; 25 children had autism, and 13 did not ( 3). The measles virus was not detected more often in the children with autism than in those without.

In 2010, The Lancet fully retracted the 1998 publication based on the findings of the British General Medical Council ( 4). Three months after The Lancet's retraction, Wakefield was removed from the UK medical register, with a statement regarding his intentional falsification of his research; as a result, he was barred from practicing medicine in the UK.

Thimerosal is a mercury compound previously used as a preservative in many multidose vaccine vials; preservatives are not needed in single-dose vials and cannot be used in live-virus vaccines. Thimerosal is metabolized to ethylmercury, which is eliminated quickly from the body. Because environmental methylmercury (which is a different compound that is not eliminated from the body quickly) is toxic to humans, there was concern that the very small amounts of thimerosal used in vaccines might cause neurologic problems, particularly autism, in children. Because of these theoretical concerns, although no studies had shown evidence of harm, thimerosal was removed from routine childhood vaccines in the US, Europe, and several other countries by 2001. However, in these countries, thimerosal continues to be used in certain influenza vaccines and in several other vaccines intended for use in adults (see Thimerosal Content in Some US Licensed Vaccines). It is also used in many vaccines produced in developing countries; the WHO has not recommended its removal because there is no clinical evidence of toxicity due to routine use.

Despite the removal of thimerosal, rates of autism have continued to increase, strongly suggesting that thimerosal in vaccines does not cause autism. Also, 2 separate Vaccine Safety Datalink (VSD) studies have concluded that there is no association between thimerosal and autism. In a cohort study of 124,170 children in 3 managed care organizations (MCOs); Verstraeten et al found no association between thimerosal and autism or other developmental conditions, although inconsistent associations (ie, seen in one MCO but not another) were seen between thimerosal and certain language disorders ( 1). In a case-control study of 1000 children (256 with an autism-spectrum disorder and 752 matched controls without autism), Price et al, using regression analysis, found no association between exposure to thimerosal and autism ( 2).

Practitioners who work with parents who are still concerned about thimerosal in the influenza vaccine may use single-dose vials, which do not contain thimerosal.

A nationally representative survey done in the late 1990s revealed that nearly one fourth of all parents felt that their children receive more immunizations than they should. Since then, additional vaccines have been added to the immunization schedule so that by age 6, children are now recommended to receive multiple doses of vaccines for 15 different infections (see Table: Recommended Immunization Schedule for Ages 0-6 yr). To minimize the number of injections and visits, practitioners give many vaccines as combination products (eg, diphtheria-tetanus-pertussis, measles-mumps-rubella). However, some parents have become concerned that children's (particularly infants') immune system cannot handle multiple simultaneously presented antigens. This concern has caused some parents to request alternative immunization schedules that delay and sometimes completely exclude certain vaccines. A recent nationally representative survey found that 13% of parents use such a schedule.

The use of alternative schedules is risky and scientifically unfounded. The official schedule is designed to protect children against diseases when they are most susceptible. Delaying vaccination increases the amount of time children are at risk of acquiring these diseases. In addition, although parents may plan to only delay vaccination, the increased number of visits needed for alternative schedules increases the difficulty of adherence and thus the risk that children will not receive a full series of vaccines. Regarding the immunologic challenges, parents should be informed that the amount and number of antigens contained in vaccines is miniscule compared with that encountered in everyday life. Even at birth, an infant's immune system is prepared to respond to the hundreds of antigens the infant is exposed to while passing through the birth canal and being handled by the (unsterile) mother. Children typically encounter and respond immunologically to dozens and perhaps hundreds of antigens during an ordinary day without difficulty. A typical infection with a single organism stimulates an immune response to multiple antigens of that organism (perhaps 4 to 10 in a typical URI). Furthermore, because current vaccines contain fewer antigens overall (ie, because key antigens have been better identified and purified), children are exposed to fewer vaccine antigens today than they were for most of the 20th century.

In summary, alternative vaccine schedules are not evidence-based and put children at increased risk of infectious diseases. More importantly, they offer no advantage. Using data from the VSD, Smith and Woods compared neurodevelopmental outcomes in a group of children who received all vaccines on time with those who did not ( 1). The children in the delayed group did not do better on any of the 42 outcomes tested. These results should reassure parents who are concerned that children receive too many vaccines too soon.

Last full review/revision May 2018 by Michael J. Smith, MD, MSCE

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Anti-Vaccination Movement - Pediatrics - Merck Manuals Professional Edition

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In 1998, Andrew Wakefield and colleagues published a brief report in The Lancet. This report concerned 12 children with developmental disorders and GI problems; 9 of them also had autism.

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Description: The website Vaccines ProCon.org gives a list of the good and bad of vaccinations.  It lists in columns what the pros of vaccinations and cons of vaccinations are.

Connection:  A red flag that connects with this website is “proof by verbosity”. Proof by verbosity connects to this website because the website is overloading you with information on the pros and cons of vaccinations.  A reason for belief for this website is confirmation bias.  Confirmation bias applies to this website because it is giving both the pros and the cons.  If someone were to look at this website with their set of opinions already in place, it would most likley be confirmed in either the pro or con list.

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Should any vaccines be required for children?

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Description: This is a video from NBC News.  This is a video from the United States, but still talks about the vaccination/anti-vaccination movements which are happening in Canada as well.

Connection: Appeal to authority applies to this video, Dr. Richard Pan says in the video, not vaccinating your children puts other children at risk. A red flag that applies to this video is emotional connection,  this applies to the video because one of the people being interviewed had a child who had a liver transplant.  Her child was unable to be vaccinated due to his sickness, putting him at risk from the other children who aren’t vaccinated.

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Alyssa Hernandez often worries about her 2-year-old son, Noah, when they leave their Sacramento, California home. The little boy, who had a liver transplant when he was 6 months old, cannot get vaccinated against a number of diseases, including highly contagious measles, because his immune system is suppressed due to the transplant.

"I'm scared to take him out," Hernandez said. "I'm scared to have him go to school, because you don't know what's around."

As parts of the U.S. experience some of the worst measles outbreaks in years - largely due to parents who don't vaccinate their children - that fear is understandable. The World Health Organization has ranked resistance to vaccinations as one of the top 10 threats to public health in 2019.

In California, an increasing number of parents are finding ways to avoid immunizations for their children, with the the surprising assistance of medical doctors, a recent study found.

Despite a California law passed after the 2015 Disneyland measles outbreak that got rid of the "personal belief" vaccine exemptions for children entering school, pockets of low vaccination rates have developed in the state. A number of counties are reporting rates lower than 90 percent, the number needed to achieve herd immunity, which occurs when enough people are vaccinated against an infectious disease to protect others in the community who are not.

That is likely due to a surge in medical exemptions- a doctor's note allowing a child to go to school without the required vaccinations, according to research published October in the journal Pediatrics. In some schools the medical exemption rate is as high as 20 percent, according to the California Department of Public Health.

California parents opposed to vaccinations have found a way around the law, with help from doctors willing to write medical exemptions for kids who don't need them. The Pediatrics study found some medical exemptions were being given with inadequate justification, such as "family history of allergies and family history of autoimmune disorders."

'Selling' medical exemptions

The study revealed that the exemptions were being generated by doctors who don't normally treat children and were "coming from physicians who were charging fees."

While some doctors appeared to charge a single fee for a permanent exemption, the researchers discovered that some were giving temporary exemptions, say for three months at a time, and then charging a new fee for each additional exemption.

State Sen. Dr. Richard Pan, a pediatrician who represents California's 6th district, blames a "handful of doctors" for eroding the impact of the vaccination law through the exploitation of a loophole.

"To grant a medical exemption, you don't actually have to give the very specific reason," Pan explained. "You have to cite which vaccines you're giving the exemption for, and the period of time the exemption actually lasts. We've known people to call some of these doctors who don't even require an exam or evaluation. You pay the money and they will give you the medical exemption."

Even when specific reasons are provided in the medical exemption, the conditions cited don't jibe with the science on vaccines, said Dr. Erica Pan, interim Alameda County Health Officer and a clinician professor of pediatric infectious diseases at the University of California, San Francisco. Pan is not related to Dr. Richard Pan.

When vaccination rates fall, children like Noah Hernandez who can't get their shots either because of compromised immune systems or young age are at risk, she said. In the case of whooping cough, "infants don't get fully vaccinated until after infancy," Pan said. "They are at the highest risk for hospitalization or even deaths. They need for the general community to be protected."

Richard Pan doesn't mince his words when he talks about the doctors "selling" exemptions: "The thing we need to recognize is that many of the physicians who have broken their oath, they're doing it for their own pocketbook. It's not based on their expertise. They're monetizing their license," he told NBC News.

An internet search found a number of physician sites aimed at parents opposed to vaccinations.

One listed "vaccine choice doctors by state," while others invited parents to learn more about exemptions.

A site run by Dr. Kelly Sutton claims: "Finally...The Step-by-step Program to Help Protect Your Child from the 'One Size Fits All' California Vaccine Mandate!"

The site offers parents "the tools and knowledge you need to protect your rights as a parent to choose the healthcare of your children," and advertises Sutton's "EXCLUSIVE program for just $97."

In a video on the website, Sutton asks, "With passage of SB277 into law are you overcome with fear that your children will be forcibly vaccinated?"

Sutton maintains she isn't selling exemptions, but instead is giving a more complete visit that includes a detailed exam along with vaccine education.

"Due to pervasive underreporting of vaccine reactions in the United States, a physician should not presume that a previous vaccine reaction or injury has been documented in a patient's chart," Sutton said in an email to NBC News. "Accordingly, it is incumbent upon physicians to thoroughly investigate these matters."

Vaccine and public health experts are disturbed by the new developments in California.

"When the legislature closed the [personal belief exemption] loophole I was very excited," said Dr. Peter Hotez, co-director of the Texas Children's Hospital Center for Vaccine Development and author of "Vaccines Did Not Cause Rachel's Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism Dad."

"One thing that never occurred to me was that physicians would write phony medical exemptions," Hotez said. "That's very scary."

A solution may lie with state medical boards, Hotez said.

The Medical Board of California looks into allegations that physicians are inappropriately issuing exemptions for required vaccinations, said spokesperson Carlos Villatoro, in an email.

"One of the challenges that the board is facing with these types of complaints is that oftentimes the patient's parents do not approach the board with the complaint because they are seeking the medical exemption," said Villatoro. "In these instances, the board must be able to prove good cause to issue a subpoena for the medical records."

The very idea that some physicians could be "selling" exemptions to anti-vax parents, "makes me feel embarrassed for the profession," said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.

"Before there was a vaccine, there were 3 to 4 million people infected with measles, 50,000 hospitalized, 500 who died and many more disabled from conditions like encephalitis," said Wu.

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Who's behind a new anti-vaccine trend in California? Doctors, say health officials

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Alyssa Hernandez often worries about her 2-year-old son, Noah, when they leave their Sacramento, California home. The little boy, who had a liver transplant when he was 6 months old, cannot get vaccinated against a number of diseases, including highly contagious measles, because his immune system is suppressed due to the transplant.

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Description: This is a video from Jimmy Kimmel.  In this video there is a clip of doctors telling people to get vaccinated.

Connection: Appeal to authority applies to this video because Jimmy Kimmel is famous he also had real doctors speak about being vaccinated.  Ideology also applies to this video,  the video is made for people who are pro anti-vaccination.

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Description: This is a video outlining the timelines of vaccinations and anti-vaccinations. It talks about Edward Jenner, the man who first started vaccinating in the late 1700's.

Connection: The red flag that connects to this video is "Ancient Wisdom". Ancient wisdom applies to this video as vaccinations have been dated back to 1798. The reason for belief is "perception and observation" because Dr. Edward Jenner noticed that the workers on his farm were not getting sick from the small pox disease when everyone else was. He then started injecting his family members with puss from sick cows to see if this would prevent the small pox.

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The origins of the anti-vaccine movement

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Description: This is an advertisement from the National Vaccine Information Center. The advertisement is saying not to vaccinate your children as children who are vaccinated are more at risk for life-threatening diseases.

Connection: The red flag in this advertisement is "proof by verbosity" because they are using a paragraph under the main headline and people may read the headline and not wish to continue reading past. The reason for belief that applies to this advertisement is "ideology" because the National Vaccine Information Centre is a social group. This causes people who follow or are involved with this group to gain the same ideas

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Description: This is a photo of a conversation between a doctor and a nurse. They are doing a check up on a baby and discussing giving the baby its vaccinations. The Doctor is trying to say that the baby is healthy so is saying why should it be injected with medicines if it is already healthy.

Connection: The red flag in this photo is "appeal to authority". Appeal to authority applies in this photo because there are two doctors checking the baby. If people were to see this they would believe that vaccinations may be pointless to a healthy baby because the doctor and nurse believe so. The reason for belief that applies to this photo is "perception and observation". The doctor and nurse are observing that the baby is healthy, so they do not feel it is necessary to pump the baby full of vaccinations.

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Description: This photo is outlining the possible outcomes for babies who have been vaccinated.

Connection: The reason for belief in this advertisement is "emotional connection".  Using the pictures of the cute babies with a list of potential harmful side effects beside them, it causes people to picture their babies with these bad things and makes them sad because they are emotionally connected to their children. This makes them not want to vaccinate. The red flag "all natural" connects to this photo because the advertisement is saying in order to keep your babies safe and protected from the listed side effects, you should never vaccinate your kids.

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Made by Kelsey Fraser and Samantha Urquhart