Courtrooms are generally not a good place to decide issues of science. I've said this more times than I can remember. Admittedly, courts can at times do pretty well with issues of science. The Vaccine Court is a good example, as is the Autism Omnibus decision, which ruled that the test cases brought before the Vaccine Court to determine if there was a plausible case to show a potential causative relationship between vaccines and autism. The court ruled against the test case complainants, even though the rules of evidence are those of a civil court, in which "50% and a feather" are all that is required for a ruling in favor of the complainant.
On the other hand, there are numerous examples that I can point to where courts got the science badly wrong. The one I always like to cite occurred in the 1980s and 1990s, where lawsuits against Dow-Corning over chronic diseases, such as autoimmune diseases and cancer, claimed to be caused by silicone breast implants, which resulted in Dow Corning agreeing to pay $3.2 billion in settlement in 1998 for tens of thousands of claims, resulting in the company filing for bankruptcy reorganization a few months later. There was only one problem. Science does did not support a link between silicone implants and it never did. Indeed, I remember that the Vaccine Court was created by the National Childhood Vaccine Injury Act of 1986 because of a flood of lawsuits over "vaccine injury."
Unfortunately, yesterday I learned of a decision by the Court of Justice of the European Union that illustrates just how badly courts can get it wrong and is likely to open the way for more scientifically unsupportable rulings, at least in Europe:
The Court of Justice of the European Union ruled Wednesday that courts may consider vaccines to be the cause of an illness, even in the absence of scientific evidence confirming a link.
I can't help but note that this is a very different thing than CNN's profoundly clickbait headline that "Vaccines can be blamed for illness without scientific evidence." A lot of news outlets were guilty of this.
Clickbait-loving editors will be clickbait-loving editors, I guess. Onward::
The EU's highest court said that if the development of a disease is timely to the person's receiving a vaccine, if the person was previously health with a lack of history of the disease in their family and if a significant number of disease cases are reported among people receiving a certain vaccine, this may serve as enough proof.
Yes, you read that right. Basically, the court said that correlation can equal causation. Of course, in some cases, that is true. After all, some correlations do indicate causation. However, as all scientists know, an observation of a correlation is a beginning, not an end. Observed correlations are hypothesis-generating. They are not sufficient to conclusively support a hypothesis. That requires more, a lot more, because correlations alone can be profoundly misleading. There can be confounding factors, such that an observed correlation to one factor (say, factor X) is actually a correlation to another factor (say, factor Y) that happens to be also correlated with factor X. Epidemiologists know this and do their damnedest to account for such confounders.
So what was the case that brought about this most curious ruling? A man with multiple sclerosis claimed that the hepatitis B vaccine caused his disease and sued:
The ruling stemmed from the case of a French man known as J.W. who was vaccinated against hepatitis B in 1998 and developed multiple sclerosis a year later. Multiple sclerosis is a neurological disorder in which the body's own immune system attacks the brain and spinal cord. The disease scars nerve tissue and causes a range of symptoms, from vision problems to paralysis. J.W. died in 2011.
In 2006, J.W. sued pharmaceutical company Sanofi Pasteur, which produced the vaccine, blaming it for his decline in health.
The case was brought before the Court of Appeal in France, which ruled that there was no scientific consensus supporting a causal link and no evidence of a causal link between the hepatitis B vaccine and the man's multiple sclerosis, therefore dismissing the action.
This judgment was appealed and brought to the French Court of Cessation, which took it to the European Court of Justice.
The Court of Justice said that "specific and consistent evidence" relating to timeliness, a prior healthy status, lack of family history and multiple cases may prove to be enough, according to a statement. J.W.'s case referred to the first three criteria.
So let's take a look at the case and see if it even meets the court's criteria—even one of them. Here's the relevant document:
Between the end of 1998 and the middle of 1999 Mr J. W was vaccinated against hepatitis B using a vaccine produced by Sanofi Pasteur. In August 1999, Mr W began to present with various troubles, which led to a diagnosis of multiple sclerosis in November 2000. Mr W died in 2011. Earlier, in 2006, he and his family had brought legal proceedings against Sanofi Pasteur to obtain compensation for the damage they claim Mr W suffered due to the vaccine.
So wait a minute. When, exactly, was Mr. JW vaccinated against hepatitis B? That's a several month window! Then, his symptoms didn't start until months later, although it's unclear from this description how many months. Then, it was more than a year before he was diagnosed with multiple sclerosis. This is hardly "specific and consistent evidence" relating to timeliness. It's the same sort of weak gruel that we usually hear from parents convinced that vaccines caused their children's autism. It's the same sort of thin gruel that we hear from parents who think that Gardasil caused their daughter's premature ovarian failure or even death, with long time frames between vaccination and the onset of symptoms. Moreover, there is plenty of evidence that the hepatitis B vaccine does not cause multiple sclerosis or other nerve demyelinating diseases.
Basically, the European Court of Justice's ruling is very disturbing. Although it is not a decision on a specific case (that is, JW's case), it does represent guidance for European courts in future cases claiming "vaccine injury." In fairness, I do have to repeat that the clickbait headlines about the ruling are also misleading. For instance, as bad as this ruling is, it does not say that "vaccines can be blamed for any illness even with lack of evidence" or that "vaccines can be blamed for diseases without any proof."
If anything, the ruling is far more puzzling than anything else and definitely appears to lower the standard of evidence for vaccine injury causation cases. It is a rather absurd ruling as well. Indeed, the news reports emphasize the absurdity of the ruling, with Dr. Paul Offit noting that using the court's criteria, "you could reasonably make the case that someone should be compensated for developing leukemia after eating a peanut butter sandwich." Now, I love and admire Dr. Offit to death, but unfortunately have to say that I find his example a bit too obvious—a bit too precious—a reductio ad absurdum, because even I, as staunch a proponent of vaccination and opponent of antivaccine nonsense that I am, don't think that a court would, using the European Court of Justice's ruling, find for the plaintiff in a lawsuit against a peanut butter company claiming that its product resulted in his leukemia. Personally, I think that Peter Openshaw, president of the British Society for Immunology and professor of experimental medicine at Imperial College London, nailed the issue more accurately:
"The scientific evidence does not support a link between the hepatitis B vaccine, or any other vaccine in current use, and multiple sclerosis," he said. "To say that there is a link between any vaccine and multiple sclerosis and at the same time to admit that there is no scientific evidence of such a link is illogical and confusing to the public."
Indeed, if you read the actual decision itself, I suspect that you, as I did, will find yourself scratching your head, because the decision is very poorly reasoned. To demonstrate that, it's necessary to quote liberally:
In today’s judgment, the Court holds that evidentiary rules allowing the court, where there is not certain and irrefutable evidence, to conclude that there is a defect in a vaccine and a causal link between the defect and a disease on the basis of a set of evidence the seriousness, specificity and consistency of which allows it to consider, with a sufficiently high degree of probability, that such a conclusion corresponds to the reality of the situation, are compatible with the Directive. Such evidentiary rules do not bring about a reversal of the burden of proof which it is for the victim to discharge, since that system places the burden on the victim to prove the various elements of his case which, taken together, will provide the court hearing the case with a basis for its conclusion as to the existence of a defect in the vaccine and a causal link between that defect and the damage suffered.
OK, so the court can look at claims of correlation, but that doesn't change the burden of proof on the plaintiff to prove all the elements of his case. So what's changed? In any case, the court demonstrates a very poor understanding of science. First, the seriousness of the condition has nothing to do with whether it was caused by vaccines. These are two separate issues. Second, "temporal proximity" is useful for conditions with a rapid and clear onset, such as anaphylaxis. It's not nearly as useful for diseases that often have an insidious onset, like multiple sclerosis. In other words, it's not unreasonable to consider temporal proximity, but what that means for various diseases is so variable and vague that we rely on epidemiology to try to suss out correlations. Third, anecdotes are by their very nature seemingly plausible—and misleading. Large numbers of such anecdotes don't necessarily make them more convincing. Then there's this:
Moreover, excluding any method of proof other than certain proof based on medical research, could make it excessively difficult in many situations or, where it is common ground that medical research neither confirms nor rules out the existence of a causal link, impossible to establish producer liability, thereby undermining the effectiveness of the Directive and its objectives, which are to protect consumer health and safety and ensure a fair apportionment between the injured person and the producer of the risks inherent in modern technological production.
I find such language curious. I don't know EU law here specifically, but the court seems to be implying that for a plaintiff to prevail the standard is evidence beyond a reasonable doubt when in civil cases it's generally a preponderance of evidence (the aforementioned "50% and a feather"). In any event, there is no such thing as "certain proof based on medical research." There never has been and never will be. What there are are probabilities, given that there is inherent uncertainty in all medical research. The questions that need to be determined in any given lawsuit are not whether there is "certain proof" but rather based in probabilities. How much, if at all, does a given exposure (e.g., a vaccine) increase the risk of disease, if increase the risk of disease it even does? How likely is it that the exposure claimed significantly contributed to the development of the disease claimed in this plaintiff? How likely does it have to be that the given exposure caused or contributed to the disease before compensation is warranted? We know from copious evidence that there is no good evidence that the hepatitis B vaccine causes multiple sclerosis or, more properly expressed, detectably increases the risk of multiple sclerosis above that of a population not exposed to the vaccine. In the case of JW, add that evidence to the very weak anecdotal evidence for causation in his case, and the only scientifically supportable conclusion is that it is incredibly unlikely that the hepatitis B vaccine caused JW's multiple sclerosis.
What the Court of Justice seems to be doing is intentionally lowering the bar of evidence for product liability cases, while trying to convince itself that's not what it's doing. In other words, it seems to be trying to have it both ways:
In the present case, the Court considers that the temporal proximity between the administering of a vaccine and the occurrence of a disease, the lack of personal and familial history of that disease, together with the existence of a significant number of reported cases of the disease occurring following such vaccines being administered, appears on the face of it to constitute evidence which, taken together, may lead a national court to consider that a victim has discharged his burden of proof. That could be the case inter alia where that evidence leads the court to consider, first, that the administering of the vaccine is the most plausible explanation for the occurrence of the disease and, second, that the vaccine therefore does not offer the safety that one is entitled to expect.
On the surface, this sounds reasonable, but in reality it paves the way for correlations that don't equal causation (for instance, that are spurious, coincidental, or due to confounders) to result in scientifically unjustifiable decisions in favor of plaintiffs claiming vaccine injury when there is no compelling evidence that vaccines caused whatever condition it is the plaintiff is suing over. Worse, the court uses as its template a case where the temporal correlation is not strong at all and represents it as potentially being sufficiently strong without additional evidence if there are a "sufficient number" of other cases reporting such a correlation. But what is a "sufficient number"? Actually, we already know how to define that number. It's basically what epidemiologists do when they do epidemiological studies. Or, as Openshaw puts it:
"The only alleged evidence that would be worth taking seriously is the alleged numbers of other similar cases," he said. "Those data should be capable of detailed case comparisons for consistency, and probably also orthodox epidemiological study."
Exactly. If there are enough such cases, then science should be able to study them, compare them to the population at large, and determine if there is actually a real correlation and, if there is, whether that correlation is likely to represent evidence of causation. That's what epidemiologists, not judges, are trained to do. Courts should let them do it.
Oh, and news organizations should stop representing this decision as allowing courts to blame vaccines for any disease without evidence. That doesn't help. This ruling is muddled as hell, but it doesn't say anything like that. It does, however, very much appear to lower the bar of evidence for vaccine injury causation claims. That's bad enough.
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The Court of Justice's press release headline:
“Where there is a lack of scientific consensus, the proof of the defect of the vaccine and of a causal link between the defect and the damage suffered may be made out by serious, specific and consistent evidence”
What an incredibly stupid statement! Upon what does the court think that scientific consensus is based, if not serious, specific and consistent evidence? Does the court imagine it can see it when science cannot?
I'm at a conference, and this is a complex decision that I would like to read again more closely before analyzing. I do want to point out, though, that:
A. The ECJ did not actually rule on this case. It answered a specific legal question referred to it by the French high court, which is whether member states, handling a product liability case, can consider things short of clear scientific evidence. The case would have to go back down for decision. The court leaves the choice of standard to the member states.
B. This isn't just about vaccines, and the logic in product liability has always been to give consumers breaks in an era of mass production, because they're in a weaker position.
Doesn't mean it's a good decision, but it's more nuanced than the press release or coverage suggest.
And you're right that the decision isn't a dramatic change in rules of product liability in France. To my understanding, the French standard already allowed finding for plaintiff without clear scientific causation evidence. Since there's an EU directive on the topic, the question here was whether EU preempts using the French standard.
"the seriousness, specificity and consistency of which allows it to consider, with a sufficiently high degree of probability, that such a conclusion corresponds to the reality of the situation," -
Seriousness, specificity and consistency refer to the evidence. It's translated from the French, and is simply the wording of the French legal standard, which is why it sounds strange to us. In lay terms it says that if the circumstantial evidence is good enough, you can find causation even without good scientific evidence for it.
Which is exceedingly problematic from a scientific point of view, because "circumstantial evidence" frequently misleads. That's why we need the controlled investigation of science.
@Orac: the only thing I can think of, regarding the range of when the plaintiff got the vaccine is how it used to be scheduled. I remember when I first got it (as an student employee at the old Harper-Grace hospitals), in 1982 - the first and second vaccines were a month apart, and the third was supposed to be 3 months after that. However, due to nursing school schedules and activities, my 3rd vaccine was nearly 6 months later.
That's the standard for the US, but not necessarily the standard in other countries. IANA European lawyer, but I do know that the French legal system is quite different from those that are based on English common law, such as ours.
One instance of a court getting the science right was when Judge John E. Jones III found against intelligent design in Kitzmiller v. Dover Area School District in 2005, stating in part that "The evidence at trial demonstrates that ID is nothing less than the progeny of creationism." Page 31.
That's an excellent example that I should have mentioned too.
Saw this on CNN yesterday and couldn't believe how low this standard of evidence is. I can see how the judges who issued this opinion might think it reasonable at first blush, but they clearly didn't think through the implications:
1) The development of the disease is "timely" to the vaccination. Many people, including the subject of this case, blame vaccines for conditions they developed months later. In many childhood "vaccine injury" cases the parent bases their claim on the fact that the child had mild or moderate fever, malaise, and/or fussiness immediately after the vaccine - but this is an extremely common reaction experienced by about 10% of young children after getting a vaccine. Simply by chance, you'd expect thousands of people to develop various illness or conditions within, say, a year of getting a vaccine.
2) "Previously healthy with no family history." Except for those born with a congenital defect, everyone who has ever developed an illness or condition was "previously healthy," so this part is completely meaningless. The importance of family history varies quite a bit depending on the disease. This particular case was about multiple sclerosis (MS), so I looked it up; the lifetime risk for someone with no family history is 1 in 330. Having family members with the disease increases your risk, but not by much - even having an identical twin with MS "only" increases your odds of developing the disease to 1 in 5. In short, of the thousands of people you'd expect to develop a disease or condition within a year of getting a vaccine by chance alone, you'd also expect many of them to be previously healthy with no family history of the disease they developed.
3) "If a significant number of disease cases are reported among people receiving a certain vaccine." "Significant" compared to what? Many people get the flu shortly after getting the flu vaccine because it's administered during flu season. No doubt thousands of kids experience earaches, tummy aches, etc., shortly after getting a vaccine because those things are extremely common at the ages when kids are getting their childhood vaccines. An epidemiologist (or anyone with a smattering of common sense, really) would say that "significant" means "significantly more cases than are seem in a similar population that didn't get the vaccine." But that, of course, is exactly the kind of study that scientists already use to determine whether an adverse event is caused by a vaccine - the kind of "scientific evidence" that this court seems to be saying is unnecessary. So what standard do they propose instead? I suspect it's something along the lines of "if enough cases are reported to make the evening news."
It's quite possible that with recessive genes & certain conditions, the family members just didn't marry the "wrong" people to have those conditions manifest themselves in the past.....another reason why this is problematic at best.
Orac writes,
It does, however, very much appear to lower the bar of evidence for vaccine injury causation claims.
MJD says,
In my opinion, lowering the bar of evidence for vaccine-injury causation claims will increase vaccine safety.
For example, a child gets a vaccine manufactured with natural rubber latex and thereafter acquires atopy and allergy-induced regressive autism.
In an effort to increase profits and reduce vaccine-injury claims, pharmaceuticals will be forced to completely eliminate natural rubber latex in the vaccine manufacturing process.
Q. Is this an example of a check-and-balance by the judicial system for the pharmaceutical industry.
And Mr. Dochniak wonders why I keep him in perpetual automatic moderation. He just couldn't resist mentioning Latex. He just couldn't. I let it through to make a point. That's the last time for a while.
@Orac - your patience with MJD is amazing. I just roll my eyes.
MJD, there is absolutely ZERO evidence supporting your claim.
In fact, I've never even heard any other anti-vaxxer make a similar claim. And, since you are probably one of the only people on the planet that is concerned about this, the number of "vaccine injury claims" would not be "reduced" if latex were eliminated, and therefore there would be no incentive for the vaccine manufacturers to remove it (of course, in the U.S. we have the VICP, so it's a moot point here anyway).
@MJD-E
@MJD-As of 2004, only 28 cases of a hypersensitivity reaction to latex had been reported to VAERS (I don't know what the current number is, but I doubt it's that much higher). That is out of millions of patients vaccinated. I know you will ignore me, but really-you are barking up the wrong tree. Latex in vaccines does not cause autism.
BTW, ignore the "@MJD-E" comment above-I accidentally hit "submit comment" too soon.
Thanks for this; the headlines were scary and IANAL.
At least it's not nearly as bad as those poor geologists in Italy who were convicted (it was overturned) of manslaughter for not predicting an earthquake in 2009.
I'll be very interested to read the thoughts of a lawyer who can point out the important differences between Common Law (US/UK/etc) and and Civil Law (France/ Germany/ etc) that impact how this ruling might be applied.
As one who is highly allergic to 'natural rubber latex', I concurre. I don't know about its relation to autism but it has been somewhat of a 'bane' on my life for a very long time.
From a very young age, I remember my lips burning after blowing up party baloons. And later, going to the dentist after the AIDS scare in the '80s.
Now, If I'm getting a blood draw, I still have to remind them that I'm allergic to latex -- And this after a student shoved the needle in sideways and asked for help. The head nurse came to help and only after reminding her of my latex alergy did she don the blue gloves.
Jonas (#17) writes,
I know you will ignore me...
MJD says,
I have to ignore you on this subject based on Orac's attitude in unlucky post #13.
Certainly, Orac will never be able to wipe the egg off his face when it comes to his weakness for perpetual auto-moderation.
Opinions are like a certain bodily sphincter. Everybody has one.
Julian Frost. A sphincter-enveloped void???
Tim, no one is arguing about the existence or seriousness of latex allergies. We all know that they are real, they are serious, and that more needs to be done for people with latex allergies in all medical settings.
If you're not familiar with MJD, he's a regular here who has a serious fixation on latex that is all out of proportion with what is known or reasonable. And it's the only thing he will talk about, given the opportunity. That's why our gracious host (Orac) has placed MJD on permanent moderation. Otherwise that would be quite literally the *only* subject discussed on every single post. It is very frustrating for the other regulars, which can make us a bit short with him.
A sphincter-enveloped void
Worst Hawkwind bootleg album EVER.
1) The development of the disease is “timely” to the vaccination.
"Timely" is the CNN correspondent's weird choice of words. She evidently did not read the court's ruling. I rather suspect that she found a French tabloid report and plagiarised it by running it through Google Translate. Some of the worst grammar errors in the translation were subsequently fixed. but 'timely' remains,
The Court's ruling notes that in earlier French court-hearings, the plaintiffs pointed to the one-month proximity between vaccine and MS diagnosis, while the other side pointed out that the course of MS begins years before it is diagnosed. The French court weighed up these temporal-proximity arguments, and ruled against the plaintiffs. The EU Court of Justice allowed this to stand. I think they are on top of the problem.
3) “If a significant number of disease cases are reported among people receiving a certain vaccine.” “Significant” compared to what?
That, it seems, is for nations' own legal systems to decide. If the plaintiff's experts find that there were 50 cases of vaccine / disease combination in one year, then it is up to the other side's experts to point out that given the number of vaccines and the incidence of the disease, chance alone would predict 55 cases per year.
Think of the Pandemrix / Narcolepsy episode. In that case, "temporal proximity" plus "significant number of cases" was evidence of a causal link, even in the absence of a known mechanism. The evidence was correct and the mechanism was worked out some years later.
European skeptic bloggers are shrugging their shoulders over the ruling and wondering what the fuss is about.
@Eric Lund I don't know the exact French situation: but I do know the Dutch system (also an EU country), that has the same basis (inquisitorial judicial system). The basis of proof is 'legally and convincingly proven'. That entails that if you want to convict someone for a crime, for example, you need a minimum ammount off proof. (two pieces off evidence from two different sources) and you need to convince the judges. If they have doubts or simply believe the a suspect (despite te evidence) they will release him.
Soooooo...... Autism is back on the list of liabilities in the EU? That's literally all I can piece out of this ruling.
Specific vaccine - check
Timely presentation with no family history - check
Large population presenting after the same vaccine - check
No science to back up the correlation - check
Can't wait for that shit storm, law of unintended consequences and all.
Just testing if my first comment went to moderation for the naughty word, or because I've been inactive for a while and may now be a suspected sock of that dirt merchant because of his hacking shenanigans..
:(
It was the sentence enhancer.
Missed you guys!
@HDB #24
Oh, bravo! :-)
@But I play one on tv,
It's not as bad as that. The ruling only applies if there is no evidence either way. Unlike this French case, there is ample research on vaccines and autism. The results of that research are conclusive: there is no causal link between this.
In this case too, there is strong evidence against the link between Hepatitis B and MS. And the court said that a trial court should consider that. It did not decide the issue, and said it needs to be decided case by case. Here is the relevant passage, after an earlier passage said it's okay to consider temporal link and lack of history:
"As stated above, however, any such conclusions can be drawn in a fully enlightened manner in each specific case by the court ruling on the merits of a given case only after that court has duly taken into consideration all the circumstances of the case before it, including in particular all the other explanatory evidence and arguments put forward by the producer challenging the relevance of the evidence relied on by the victim and questioning the plausibility, referred to in the preceding paragraph, of the explanation put forward by the victim."
@MJD (#20). Yes, I know you cannot mention your obsession with latex, but you might want to be willing to consider the following:
#1-There is no good evidence that the true incidence of autism has increased at all. It appears that most (if not all) of the apparent increase is due to increased awareness/broader diagnostic criteria.
#2-There is evidence that autism is already present in utero, prior to the administration of any vaccines. This obviously rules out any link whatsoever between vaccination and autism.
#3-It appears that the cause of autism is genetic. Of note, advanced paternal age has been repeatedly shown to significantly increase the risk of autism, and this is presumably because of the fact that the likelihood of de novo mutations steadily increases with age. It is therefore possible that if there has been some true increase in the incidence of autism, that increase might be the result of more people having kids later in life.
Of course, I'm sure that many others have made you aware of the above many times before, and you have ignored it and maintained that your son "regressed into autism" because of an allergic reaction to latex in a vaccine, despite the evidence against that-so like I said, I don't expect that I (or anyone else) will change your mind on this.
@Jonas: MJD's story of his son's regression has changed so many times, who knows what is true? Originally, it was due to latex balloons at a birthday party, IIRC - it's been so many years that he's been posting variants of the story that I don't remember exactly. And I can't be bothered to go to his "book" to see what version he's touting at the moment.
He said that latex balloons at a birthday part caused his son to regress?! Seriously?!
It was something like, he had a major reaction to latex balloons (but didn't go to the ER or anything!) then regressed after a vaccine subsequent to the allergic reaction. It was a very strange story.
Minor nitpick that MI Dawn has also pointed out: the range of time forgiven for the immunization makes since since typically Hep B vaccination is a three shot series at 0, 1 and 6 months.
IANAL so this may be wrong, but in the UK a decision at the EU court is essentially the equivilent of a US Supreme Court ruling, ie it sets a precedent that lower courts in all of the EU countries must then follow. Although that will presumably not be the case here for much longer.
Yes, the ECJ's interpretation of EU law binds the member state in this case.
MI Dawn (#34) writes,
It was a very strange story.
MJD says,
It's called a hypothesis, scientists and non-scientists use it to express ideas that may solve a problem or bring understanding to the human condition.
The Oracmeister is famous for writing very strange stories that use respectful-insolence to ridicule; it's called "entertainment".
Unfortunately, Orac has been known to inhibit some individuals based on the materials perceived entertainment-value for his voracious minions.
Warning - Vaccine-safety advocates are preferably seen and not heard at the Scienceblogs Respectful Insolence
Although this ruling is unfortunate, I do want to point out that at least one European country-Italy-has taken steps in the right direction when it comes to vaccine policy.
Last month, the Italian government enacted a new compulsory vaccination law, which requires that children be vaccinated against most VPDs by age 6, and reportedly parents can be fined up to $8,000 for refusing to vaccinate their children under the new law.
And, unlike in the U.S., where, in all but 3 states, vaccine-averse parents can get philosophical or religious exemptions, it appears that only medical exemptions will be allowed under the new Italian law.
And that is as it should be, in my opinion. I know many people, even those who are very pro-vaccine, might object to fining parents for refusing to vaccinate their children, but if you think about it, parental vaccine refusal is a form of neglect-and it is a form of neglect that endangers not only the unvaccinated child but also those exposed to the unvaccinated child, so I have no problem at all with the new Italian law.
The new law was prompted by a marked increase in measles cases in Italy-as of last month, 2,395 cases of measles occurred in Italy this year-more than all of the recorded cases of measles in Italy in 2015 and 2016 combined. Apparently, the 5-Star movement, a populist/anti-immigrant political party in Italy, has been promoting anti-vaccine misinformation, which is probably part of the reason that measles cases have increased so much in Italy. Hopefully the new law will reverse that trend.
I think I heard that Germany had implemented a similar law, but I can't recall for sure.
In any case, my point was that it;s not all bad news when it comes to vaccine policy in Europe.
Oh fine, I have two children. As an vaccine expert I am vaccinated since about 25 yrs against influenza. And in the future I will have additional yearly immunisations against influenza. So in future I will die within one year after my last influenza shot. I am a high risk patient because in the past I failed to die within one year after my last influenza vaccine.
But I am convinced in the future this must happen. May be after 30 or 40 immunisations.
So I have to prepare my children to go to the European Court of Justice, that my death was due to the influenza shot.
I hope they are succesfull to get millions of € - each !!!
Almost, but not entirely, off topic -
Last Week Tonight with John Oliver takes on vaccines.
The lads at AoA will not be happy.
I don't know why it is, but Europe is WAY ahead of the US in many areas, however not on debunking quack medicine. In most of the countries, especially Germany, "alternative" medical remedies are paid for by the national health services, and unscientific woo is accepted as mainstream. (See "Heilpraktiker") Remember Switzerland/Germany and the fetal lamb cell therapy? It was finally banned in Germany in the 90's, but is still extant in Switzerland. How come they are so far ahead of us in many areas, but not this one?