LDS Religious Exemptions from Vaccination

[Duncan]

Just now, Yirgacheffe said:

Will the church send the young man if he refuses to be immunized?  And does the father get to say whether or not his 18 year old young man will be vaccinated or does he get to make that medical decision himself?

Apparently there was another girl in our stake, same kind of deal but went to Guatemala? she didn't get immunized but they can't force you to get them so enter at your own risk I guess and if you get sick, well what can you do?

[Yirgacheffe]

1 hour ago, Duncan said:

Apparently there was another girl in our stake, same kind of deal but went to Guatemala? she didn't get immunized but they can't force you to get them so enter at your own risk I guess and if you get sick, well what can you do?

That seems contrary to the link that Calm posted?

[waveslider]

1 minute ago, Yirgacheffe said:

That seems contrary to the link that Calm posted?

My son recently went to the Philippines. Some of his vaccinations were required, while others were optional. Perhaps Guatemala might just be the optional kind. Or perhaps the first presidency felt like that sister should still go, at her own risk.

[Duncan]

Just now, Yirgacheffe said:

That seems contrary to the link that Calm posted?

I dunno, it's what my stake clerk bro told me. If I were to go to Guatemala or Wyoming or Southern Alberta or something i'd be getting all the shots I could get!

[Calm]

The ones required by the receiving country would not be considered at one's own risk.  The Church could risk being kicked out of that area for missionary work.  The US may allow for religious exemptions in traveling, but I highly doubt if there is an additional wait time,paperwork, or something else that makes it even more complicated, there are plenty of Canadian and US missions to send those who opt out to.

 

[Calm]

Vaccinations are not required by Guatemala, but very recommended by the WHO and the CDC:

https://travel.state.gov/content/passports/en/country/guatemala.html

In the past I can see the Church allowing missionaries to decide, nowadays I think there is too high a risk of being sued by any that are put at risk by that choice, including missionaries' family who later blame the Church for not keeping a missionary stateside even if it was a personal choice not to vaccinate (our child wasn't fully informed about the risk, we understood they wouldn't be sent to high risk areas, we thought they would get all the medical care they needed, we have been promised healing blessings would work and they lied to us, etc. etc.)

If my daughter ever agrees to have missionaries teach her for reactivation, they will be required to be up in their shots as well as have the current flu shot and if not, we will be requesting a different pair.

Edited November 14, 2016 by Calm

[bluebell]

7 hours ago, Duncan said:

I dunno, it's what my stake clerk bro told me. If I were to go to Guatemala or Wyoming or Southern Alberta or something i'd be getting all the shots I could get!

Wyoming/Montana requires so many shots because of the Native American reservations.  I always thought it was so crazy because those of us who live there don't have to get them. 

[Duncan]

10 minutes ago, bluebell said:

Wyoming/Montana requires so many shots because of the Native American reservations.  I always thought it was so crazy because those of us who live there don't have to get them. 

I was just joking!!! But I remember when I was getting my shots done the shot list always had you need this shot for this place and Montana seemed to be on every one!!! I was like what is happening there?!

[bluebell]

30 minutes ago, Duncan said:

I was just joking!!! But I remember when I was getting my shots done the shot list always had you need this shot for this place and Montana seemed to be on every one!!! I was like what is happening there?!

The missionaries who get sent to Wyoming/Montana have to get the same shots as those that go over seas to crazy places like Africa or down to South America.  We always thought it was hilarious!

[Kenngo1969]

9 hours ago, Duncan said:

I dunno, it's what my stake clerk bro told me. If I were to go to Guatemala or Wyoming or Southern Alberta or something i'd be getting all the shots I could get!

Yeah, I hear there are a lot of .... ummm, exotic ... diseases in Southern Alberta!  

[Kenngo1969]

34 minutes ago, bluebell said:

The missionaries who get sent to Wyoming/Montana have to get the same shots as those that go over seas to crazy places like Africa or down to South America.  We always thought it was hilarious!

Posted the above to Duncan before I saw this.  Yep, there are a loooot of exotic diseases in Wyoming/Montana!  

[pogi]

On ‎11‎/‎13‎/‎2016 at 8:58 AM, thesometimesaint said:

Please explain how it works.

Seriously?  Why?  You can look it up if you don't understand, but I suspect you are asking more to test me.  Vaccination and public health is kind of what I do.  I have read all of the CDC books on vaccination and infectious diseases (yellow book and pink book), and I am required to keep up with the latest literature.  I am kind of required to understand this stuff for my job.

On ‎11‎/‎13‎/‎2016 at 8:58 AM, thesometimesaint said:

It is simple you don't have the right to infect other people against their will. The government has an affirmative responsibility to protect its citizens against disease.

It is not that simple.  When the risk for death and serious adverse reaction to vaccine is greater than risk for disease, there is absolutely an ethical dilemma that should be considered.  I don't have the right to "intentionally" (that is the key word you left out) infect someone else in some states, but not all.  Not vaccinating is not intentional infection, especially when the risk of becoming infected is near zero.  Good luck proving that one in court!  However, contracting hep b, for example, then having sex without disclosing that you are infected might be illegal in some states, but not all.

Edited November 14, 2016 by pogi

[pogi]

On ‎11‎/‎13‎/‎2016 at 4:43 PM, Duncan said:

This came up today actually. There is this strange guy in our ward and his son is going to Portugal on a mission in the spring. The papers say he is supposed to be vaccinated for things and to get that done prior to the mission. Well, this dad doesn't want it done and he told me that God will protect him and I said well, Pres. Hinckley gave training at one of those worldwide training broadcasts years ago now he said something like "it just doesn't work that way" If you can protect your kid why wouldn't you? So, I mean I don't know what will happen but I wish them well, if he doesn't actually get vaccinated.

"Many believe that God will provide, but we cannot sit idly by and expect to get results. The Lord requires us to work for that which we seek. If we do our part and exercise faith, then we are promised he will help us in all our righteous undertakings. However, if we do not do our part, how can we expect the help of our Heavenly Father? Our late President David O. McKay said, “The rich rewards come only to the strenuous strugglers.” Elder O. Leslie Stone, April 1973 GC

 

I actually work closely with the church and go to the quarterly meetings where infectious disease and vaccination requirements are discussed for the different missions.  The infectious disease doctors that I work with play a role in deciding which vaccinations should be required for which countries.  Each mission has different vaccination requirements depending on location.  Portugal does not require any special travel related vaccines, however, they are required to be up to date with certain regular childhood immunizations or they will not be allowed to serve outside the country.

I agree with President Hinckley, prayer is not an effective vaccine. 

You asked, "If you can protect your kid, why wouldn't you?"  That is a very good question.  So, when the risk of death and serious adverse event from vaccination is greater than the risk from disease, what is the most likely way to protect your kid?

Edited November 15, 2016 by pogi

[pogi]

15 hours ago, Duncan said:

Apparently there was another girl in our stake, same kind of deal but went to Guatemala? she didn't get immunized but they can't force you to get them so enter at your own risk I guess and if you get sick, well what can you do?

That is not how it works.  The Guatemala mission requires the typhoid fever shot along with other regular childhood immunizations, or they cannot serve in Guatemala.

Edited November 14, 2016 by pogi

[pogi]

14 hours ago, waveslider said:

My son recently went to the Philippines. Some of his vaccinations were required, while others were optional. Perhaps Guatemala might just be the optional kind. Or perhaps the first presidency felt like that sister should still go, at her own risk.

The typhoid vaccine is not optional for Guatemala mission.  The Philippines also requires Typhoid, while the Japanese Encephalitis (JE) vaccine is optional.  JE is a mosquito bourn illness, it is an extremely low risk infection (<1 case per 1 million travelers), but it is also extremely life-threatening (20%-30% case fatality, while 30%-50% of survivors will have serious neurologic, cognitive, or psychiatric sequel.).  It is optional because it is so low risk however.  It is also extremely expensive.  2 doses at $312/dose.

Edited November 14, 2016 by pogi

[pogi]

6 hours ago, Calm said:

The ones required by the receiving country would not be considered at one's own risk.  The Church could risk being kicked out of that area for missionary work.  The US may allow for religious exemptions in traveling, but I highly doubt if there is an additional wait time,paperwork, or something else that makes it even more complicated, there are plenty of Canadian and US missions to send those who opt out to.

Most countries do not have vaccine requirements for entry.  A few where yellow fever is endemic or epidemic require yellow fever vaccination.  If you do not have a yellow fever certificate, you will not make it past the airport in those countries.  There are only a couple exceptions, for example if you are attending the Hajj (the pilgrimage to Mecca) a polio booster is required.  Other than that, there really are no requirements.  The requirements for missionaries are not based on country requirements, but are internal requirements of the church for service to those countries of risk.  

[Duncan]

Just now, pogi said:

That is not how it works.  Guatemala requires the typhoid fever shot along with other regular childhood immunizations, or they cannot serve in Guatemala.

That's what he told me but maybe he didn't know everything either so who knows!

[pogi]

6 hours ago, bluebell said:

Wyoming/Montana requires so many shots because of the Native American reservations.  I always thought it was so crazy because those of us who live there don't have to get them. 

Quote

The missionaries who get sent to Wyoming/Montana have to get the same shots as those that go over seas to crazy places like Africa or down to South America.  We always thought it was hilarious!

That must be a myth going around.  The church might require regular childhood immunizations for service to those areas and perhaps a meningococcal vaccine, but no travel related vaccines are required.  There is no risk or requirement for yellow fever, Japenese encephalitis, or typhoid vaccines. 

Edited November 14, 2016 by pogi

[Calm]

16 minutes ago, pogi said:

The typhoid vaccine is not optional for Guatemala. 

Are you sure typhoid is required and not just recommended?  None of the websites I visited said it was required that I could tell.

Perhaps you mean required by the Church.

Edited November 14, 2016 by Calm

[pogi]

26 minutes ago, Calm said:

Are you sure typhoid is required and not just recommended?  None of the websites I visited said it was required that I could tell.

Perhaps you mean required by the Church.

You are right, that is what I meant.  You must have quoted me before I re-worded it to avoid confusion

Edit to add:  I actually re-worded a different post, silly me for making the same mistake twice.

Edited November 14, 2016 by pogi

[Calm]

Thanks.  Your info in this thread has been very interesting and I do believe the question of cost benefit needs to be addressed, though I probably tend towards more provaccine when it comes down to the less obvious debates than it appears you do (I get you are not questioning it when the numbers are relatively clear about the benefit, only when the stats open the question of which outcomeis more likely combined with potential significant harm).

Edited November 14, 2016 by Calm

[pogi]

24 minutes ago, Calm said:

Thanks.  Your info in this thread has been very interesting and I do believe the question of cost benefit needs to be addressed, though I probably tend towards more provaccine when it comes down to the less obvious debates than it appears you do (I get you are not questioning it when the numbers are relatively clear about the benefit, only when the stats open the question of which outcomeis more likely combined with potential significant harm).

Thanks Calm! to give you guys a better idea of where I am coming from I will share something from a project that I am working on:

A Morbidity and Mortality Weekly Report (MMWR) published in April of 1999, reported on the impact of vaccines over the 20^th century.  It stated that “vaccines are one of the greatest achievements of biomedical science and public health (1).”  I agree with that statement.  The positive impact of vaccination on disease rates in America is undeniable.  In fact, vaccination efforts have been so successful, and disease rates are so low, that I believe we have reached a tipping point for the first time in the United States, where the risks of serious adverse events from vaccination may actually be greater and of more concern than the diseases that they aim to protect against.  

This change in balance leaves us in a bit of a medical and ethical quandary that few are willing to recognize.  The overwhelming popularity and achievements of vaccination throughout the 20^th century have given vaccines an almost sacrosanct status.  They have earned unwavering and unquestioning devotion in the medical field and in the public eye through their undeniable history of life-saving qualities.  But when a vaccine has become more dangerous than the disease that it protects against, is it time to re-evaluate how we administer that vaccine in the US?  Is it ethical to mandate such a vaccine?  Should the parent have the right to become informed as to the risks and decide which option poses the greatest risk for their child under the direction of a qualified medical professional who actually knows the risks (aka informed consent)?  Should the government (unlicensed medical professionals) ran by politicians who may be influenced by big pharmaceuticals (the nation’s top contributors and lobbyists to candidates and parties) be making these personal medical decisions for us? 

If you had asked me one year ago about vaccination, I would have snubbed any “ignorant”, “reckless”, or “crazy” person who chose not to vaccinate his or her child.  Ironically, it took me becoming a public health nurse in international travel medicine before my unquestioning and unwavering vaccination stance began to stumble.  It all started with my research of the yellow fever vaccine.  

In the 1600’s, slave ships from West Africa imported yellow fever, a mosquito borne illness, to the Americas.  In the late 1600’s, outbreaks were reported on the eastern coast of the United States, including New York, Boston, and Charleston.   The Capital of the United States was in Philadelphia in 1793.  That year, a yellow fever epidemic struck the capital city, reportedly killing around ten percent of the total population.  George Washington fled the city to avoid infection.  The yellow fever epidemic of 1793 is one of the reasons why the capital of the United States is no longer in Philadelphia.  In the mid 1800’s, annual outbreaks in New Orleans led to more than 26,000 infections.  The last outbreak in the US was in New Orleans in 1905.

In 1930, 2 yellow fever vaccines were developed.  According to the CDC, the attenuated live yellow fever vaccine made from the 17D strain has historically been considered to be “one of the safest and most effective live virus vaccines ever developed.”  The vaccines were used for 20 years without hesitation before Doctors became concerned about encephalitis rates following vaccination in infants (yellow fever vaccine-associated neurotropic disease).  It wasn’t until 1998 (68 years after the vaccine was developed) that it was discovered that the vaccine, on occasion, was actually mimicking the wild virus itself, causing multiple organ failure and death (yellow fever vaccine-associated viscerotropic disease) in patients, and has gone undetected throughout the years.  Previously healthy people were actually getting yellow fever like disease from the vaccine and were dying from it.  Especially at high risk are those over the age of 60.  Despite the CDC’s assurance that the vaccine was sufficiently tested and found to be one of the “safest…live virus vaccines ever developed”, it took nearly 7 decades of use before we learned otherwise.  It is in fact one of the most dangerous vaccines in current use.

Because of the risks associated with the vaccine, we don’t just give it to any international traveler anymore.   In international travel medicine, we are always careful to perform a pre-travel assessment, including the patient’s itinerary, age, medical history, length of travel, outdoor activities, etc., and only recommend vaccination when the risk of disease is estimated to be greater than the risk of adverse reaction to the vaccine.  That is the recommendation of the CDC, and it makes perfect sense!  This is often called a “risk benefit analysis”.  For me, I prefer to call it a “risk vs risk analysis”, because the benefit of a vaccine can only be quantified by estimating the risk of a disease, so really we are comparing the risk of a vaccine against the risk of a disease (risk vs. risk).  In doing so, we should always advise and encourage for the option with the lowest risk of harm.  As the Hippocratic Oath states, “first, do no harm”.

It occurred to me, “why don’t we perform this same risk vs. risk assessment before recommending any vaccine?”    I took it at face value that the risk for disease is greater than the risk for vaccination because “everybody” recommends that your child should be vaccinated.  Partly out of curiosity but mostly because of the fact that my wife was pregnant at the time with our first child, I wanted to find out what the risks actually are for both disease and vaccination.  Something I probably wouldn’t have done before learning about the risks of yellow fever vaccine.

Our child was a miracle child.  We had been trying for nearly 10 years to have a baby with no success.  We were told after several failed procedures that having a biological child was probably not going to happen for us.  We were devastated, but eventually came to accept that reality…until that reality changed.  We don’t know, why, what, when, where or how (well, we kind of know how!), but it happened, and we were going to do everything in our power to protect our little guy. 

After doing a little research, and finding it more difficult than I expected to find full and accurate information, I wondered, “do parents have any idea of what the risks are for disease?”  “What about vaccine risks?”  Without this information, are parents even capable of “informed consent”?  The Vaccine Information Statements prepared by the CDC which we give to all vaccine recipients do briefly review the disease and some risks of the vaccine, but I have discovered that they fall short of offering the patient a full and fair comparison of the risks of vaccine vs. disease.  Many patients do not receive these information statements until after they are injected with the vaccine, or as the syringes are being filled, many never receive these statements at all.

The other thing that occurred to me while researching the yellow fever vaccine is that “safe” is a relative term.  Sure, for the vast majority of individuals vaccines have little to no ill effect at all.  However, vaccines are potentially harmful to some and may not be viewed as safe from the victim’s perspective.  A parent who witnesses or suffers because of the disability or death of a previously healthy child from vaccination may not agree that all vaccines are “safe”.  The risks may be low, but if the risks of vaccination are actually greater than the risks for disease, wouldn’t administering the vaccine to protect against disease be kind of like replacing your child’s BB gun with a shotgun because BB guns are dangerous?  

Also, when the CDC, WHO, ACIP, drug companies etc. claim a vaccine is safe, one must recognize that this claim is based on extremely limited clinical trials and postlicensing experience in terms of low numbers of participants, lack of true double blind studies, and short onset of symptoms period studied, often only looking for reactions a few days after vaccination, when reactions can take much longer to present.   These limited studies simply cannot give us an accurate depiction of all associated risks with vaccines.  Again, it took nearly 7 decades before we realized that the yellow fever vaccine was causing serious injury and/or death at a rate of 4.3 cases per 100,000 doses for those under the age of 60, and at a rate of 8.3 cases per 100,000 doses in those over the age of 60.  We have been selling between 150,000 doses to 350,000 doses annually to give you an idea of just how many people have been killed or injured over the years from a vaccine that the CDC was calling the “safest” vaccine ever made.

It is very safe to say that the risks of vaccination are actually greater than what is being reported, due to the limitation of both the clinical trials, postliscensure studies, and the Vaccine Adverse Event Reporting System, or VAERS.  Which the CDC admits only accounts for around 10% of actual adverse events.   

                I suspect that parents are not the only uninformed ones when it comes to knowing the estimated risk of disease compared to the risk of vaccination.  I certainly was uninformed, and I was a public health nurse!  It has been my experience that most doctors and nurses are not aware of what the risks are (in terms of numbers and statistics) for vaccines and the diseases they aim to protect against.  Most practitioners are aware of maybe 3-4 of the most common mild side effects (local redness, tenderness, or swelling etc. at the injection site) and the “extremely rare” allergic reaction, but are generally unaware of the many, many, other common and less common mild, moderate, and severe reactions.  They are also generally completely unaware of the estimated risk for disease. 

                My intentions are to sustain and defend the medical ethic of informed consent by educating with reliable and detailed information for better informed practitioners, politicians, and parents.  I will do this by creating more comprehensive Vaccine Information Statements and detailed risk vs risk analysis for each of the vaccines and diseases that they aim to protect against.

[ERMD]

On 11/11/2016 at 11:19 AM, pogi said:

P value???

That's what I thought.  If you're going to try to use statistics to prove a point, you need an understanding of statistics.  You are claiming that data state something that is contrary to what it is actually stating.

[ERMD]

On 11/11/2016 at 0:06 PM, pogi said:

Hearken back to your microbiology days, that fact was drilled into my head in microbiology.    I don't have my text book any more to use as a reference but the children's hospital of Philadelphia will corroborate my point:

http://www.chop.edu/centers-programs/vaccine-education-center/vaccine-safety/immune-system-and-health

If you're going to cut and paste, use the entire quote.  Again, reality is different from the point you are trying to make.  I don't know what your background or area of expertise is, but it is certainly not medicine, and you are promulgating some very bad information.

 

The rest of your snippet:

 

"Whereas immunity from disease often follows a single natural infection, immunity from vaccines usually occurs only after several doses. However, the difference between vaccination and natural infection is the price paid for immunity.

The price paid for immunity after natural infection might be pneumonia from chickenpox, intellectual disability from Haemophilus influenzae type b (Hib), pneumonia from pneumococcus, birth defects from rubella, liver cancer from hepatitis B virus, or death from measles.

Immunization with vaccines, like natural infections, induces long-lived immunity. But unlike natural infection, immunization does not extract such a high price for immunity.

If you could see the world from the perspective of your immune system, you would realize that where the virus or bacteria comes from is irrelevant. Your immune system “sees” something that is foreign, attacks it, disables it and then adds it to the memory bank so it can react more quickly the next time it encounters it.

The differences between a vaccine and getting the disease naturally are the dose and the known time of exposure.

• Dose — When someone is exposed to viruses or bacteria naturally, the dose is often larger, so the immune response that develops will typically be greater — as will the symptoms. However, when scientists are designing vaccines, they determine the smallest amount of virus or bacteria needed to generate a protective immunologic response.
• Time of exposure — Most of the time, we do not know when we are exposed to viruses and bacteria; however, when we take our children to the doctor’s office for a vaccine, we do know. In essence, we are controlling their exposure to the viruses or bacteria that the vaccines protect against because we know when and where they occur. In contrast, and more typical of the norm, we don’t know what viruses or bacteria they might be exposed to from the door knob to the office, the books in the waiting room, or the toddler at the restaurant we go to after the office visit.

Of interest, a few vaccines induce a better immune response than natural infection:

• Human papillomavirus (HPV) vaccine — The high purity of the specific protein in the vaccine leads to a better immune response than natural infection.
• Tetanus vaccine — The toxin made by tetanus is so potent that the amount that causes disease is actually lower than the amount that induces a long-lasting immune response. This is why people with tetanus disease are still recommended to get the vaccine.
• Haemophilus influenzae type b (Hib) vaccine — children less than 2 years old do not typically make a good response to the complex sugar coating (polysaccharide) on the surface of Hib that causes disease; however, the vaccine links this polysaccharide to a helper protein that creates a better immune response than would occur naturally. Therefore, children less than 2 years old who get Hib are still recommended to get the vaccine.
• Pneumococcal vaccine — This vaccine works the same way as the Hib vaccine to create a better immune response than natural infection.

So, in summary, vaccines afford us protection with lesser quantities of virus or bacteria and the control of scheduling the exposure."

 

Hib and Pneumococcus are notorious killers of children, and pneumococcal pneumonia kills the elderly (it's what killed Jim Henson).  These vaccines have virtually eliminated some terrible childhood diseases.

You are out of your league here.

Edited November 14, 2016 by ERMD

[waveslider]

1 hour ago, pogi said:

The typhoid vaccine is not optional for Guatemala mission.  The Philippines also requires Typhoid, while the Japanese Encephalitis (JE) vaccine is optional.  JE is a mosquito bourn illness, it is an extremely low risk infection (<1 case per 1 million travelers), but it is also extremely life-threatening (20%-30% case fatality, while 30%-50% of survivors will have serious neurologic, cognitive, or psychiatric sequel.).  It is optional because it is so low risk however.  It is also extremely expensive.  2 doses at $312/dose.

I know that. My son took both the non optional and the expensive optional vaccinations. I never said I knew about vaccinations for Guatemala only that it was possible that perhaps they only had the optional vaccinations. Thanks for clearing that up, since you know.