Yale School of Public Health Professor Linda Niccolai, PhD, has worked extensively on human papillomavirus vaccination, specifically on how a widely available vaccine can prevent young people from getting this virus that can cause six types of cancer later in life.
The HPV vaccine works, but a significant number of young people still do not receive it. An important reason for this is that it is not required to enroll in school.
However, many children also do not receive other life-saving vaccinations that are required to attend school by obtaining a religious exemption. Niccolai took her vaccine expertise to Hartford this week and testified before the state legislature’s Public Health Committee on a vaccination bill that would overturn religious exemptions and mandate that all children receive certain vaccinations before allowed to enroll in schools (public and private) unless they have a medical exemption.
She said Bill 5044 is an evidence-based public health measure that will protect the health and safety of children and adults alike. Niccolai submitted written testimony in support of the bill and also testified in person before the committee during a daylong and sometimes raucous public hearing at the state capitol.
“Now is the time to enact [this bill] with confidence that it will save lives and protect the public health,” Niccolai said. “It is now the responsibility of our elected officials, with the support of their constituents, to do what they have been elected to do, and that is to protect the public’s health with evidence-based and constitutionally sound policies.”
Here is a full transcript of Niccolai’s written remarks to the legislature’s Public Health Committee:
“Legislation that promotes vaccination, including policies that strengthen school entry requirements, can be passed with confidence to protect the health of Connecticut residents and save lives. My support for this policy is grounded in two arguments: (1) scientific evidence for vaccine safety and (2) legislative precedence for the obligation of elected officials to protect the well-being of their constituents.
- As a scientist, I can speak as an expert on the topic of vaccine safety because the evidence is grounded in rigorous scientific research. No medical product, device, or drug is more extensively studied for safety than vaccines. Vaccine critics claim that thousands of people have been injured by vaccines. We hear this over and over. I’d like to clarify what these numbers mean. The numbers we hear about (‘thousands’) come from the federal Vaccine Adverse Event Reporting System (VAERS). VAERS is a national reporting system to which people send reports about events that occurred after vaccination. The purpose of VAERS is to detect possible safety problems. It is not designed to determine if a vaccine caused a health problem. Additional research is necessary to assess the real (not perceived) association of adverse events due to vaccines.
- The second argument I’d like to address is parental autonomy. This one is perhaps a little more difficult than safety as it is not a scientific argument but rather one that reflects more personal views on how we understand the role of government in our democracy. As elected officials, you know that there are limits on parental autonomy. This country has a long legislative history that recognizes that rights of parents are not without limits. Furthermore, this history has enjoyed broad support from constituents. For example, parents are required to follow laws about motor vehicle safety including the use of child safety seats, booster seats, and seatbelts for their children. The vast majority of people agree these are sound and important laws.
This can best be explained through an analogy. The information that we get from VAERS is like a report stating that after drinking a cup of coffee, 10,000 people sneezed. What you hear from the critics is just that number: 10,000. However, what that number represents is a collection of anecdotes, not scientific evidence. How can we know if drinking coffee is associated with sneezing? We need more information. For example, we would need to know how many people drank coffee. We would also need to know how many people didn’t drink coffee and then sneezed. Collectively, this information tells us about whether coffee drinking increases risk for sneezing. This is the work that scientists do in follow-up research studies to the reports gathered by VAERS (that you do not hear about from the critics). These robust and reassuring studies have consistently demonstrated the safety of all vaccines used in the US today. Simply put: science is on the side of safety.
The robustness of the vaccine safety monitoring system in the US is best demonstrated by an example. A vaccine against rotavirus, an infection that causes serve gastrointestinal disease, was first used in the US in October 1998. By May 1999, reports to VAERS signaled concern about intussusception, an obstruction of the bowel. Scientific investigations began immediately, the possible risk was confirmed, and the vaccine was pulled from the market by October 1999. So, within one year, a vaccine that was determined to have a serious side effect was identified and removed from use. This experience offers clear evidence that the systems established to detect and respond to vaccine safety concerns work well in the US. Thus, we can all be reassured that all vaccines on the market today are safe.
Regarding vaccination policies specifically, courts have consistently upheld the constitutionality of school entry requirements for vaccinations over the past 150 years. Courts have repeatedly declared that vaccine policies do not violate the rights of individuals because they are a reasonable exercise of state’s authority to protect the public’s health and safety that is supported by the US Constitution. Courts have also noted that an individual’s right to education does not outweigh the state’s need to prevent the spread of infectious diseases. Regarding religious freedom specifically, laws also state that the right to practice religion freely does not include the liberty to put one’s child in harm’s way, for example, by withholding lifesaving treatment. This also does not include the liberty to expose one’s child to infectious diseases and subsequently all other members of the community.
In conclusion, scientific evidence and legislative precedence are clear that now is the time to enact HB 5044 with confidence that it will save lives and protect the public health. It is now the responsibility of our elected officials, with the support of their constituents, to do what they have been elected to do, and that is to protect the public’s health with evidence-based and constitutionally sound policies.
Thank you for your consideration of my arguments in support of HB 5044.
Disclosure: I have served as scientific advisor for Merck on vaccine impact studies.”