BioA 206 Assignment 3

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University of Washington *

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Sociology

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Apr 3, 2024

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BIOA 206 Plagues and Peoples Assignment 3 Read the assignment VERY CAREFULLY! And ideally MULTIPLE TIMES! There Is a lot of detail in here that you need to be aware of. Scenario: It is June 2035. COVID-19 has long since become part of the regular winter respiratory burden, in part due to the spread of less virulent variants, and in part due to additional vaccines and drug treatments. The crisis years of 2020-2022 are a distant memory. Meanwhile, Washington State has just had two measles outbreaks, totaling 120 cases, the largest number of cases in decades. Most of them are children. Other Western states have also seen outbreaks. Thankfully, there have been no deaths (typically about 1 in every 500 children with measles dies, so no deaths at this scale is normal). Because of the recent outbreak, vaccination rates have recently risen again in the state. Before the start of the outbreak, they were at about 90% overall, with variation across the state (for example, 95% in Pierce County but 85% in San Juan County). As of now (i.e. June 2035), they seem to be above 95% in every county. The legislature and governor are considering changes to current vaccination policies. These polices require vaccinations for children entering child care, pre-school or school, with exemptions allowed on medical and religious grounds. Washington State used to also have a philosophical (also called a personal belief) exemption, but this was removed in 2019. A religious exemption requires that the parents or guardian certify that their religious beliefs prohibit them from vaccinating their child; a philosophical exemption is broader, in that they only need to certify that they are philosophically opposed to vaccination for any reason, religious or not. Children who are home-schooled have no measles vaccine requirement. Here in June 2035, there are two competing bills in the legislature: one to remove the religious exemption and one to add a philosophical (personal belief) exemption. Task : You are a legislator in the Washington State House of Representatives. You must provide a public statement on whether you support or oppose each bill. You can choose to support one or the other of the bills, or to support neither and keep the status quo. (You can’t support both, since this creates a legal and logical contradiction). If you wish, you can also consider introducing your own bill to change current policies in a different way. Because you are a strong leader and effective politician, you want your statement to address the concerns of different sides, not only those of your supporters. You aim to explain, in non- judgmental language, that you understand both the costs and benefits of the different positions, but that in the end you favor one side. And you aim to include in your statement a range of authoritative sources on the effectiveness of vaccines, and their risks, as well as the nature of herd immunity and its impacts (see note below on sources). Note that there is *no correct answer* in terms of whether you oppose or support each bill. These bills involve tradeoffs between public safety and individual liberty which are inherently unresolvable through science alone. There are, however, appropriate ways to employ and explain accurate and authoritative

information in explaining your position, and to do so using language that encourages dialogue rather than division. If you choose to draft an alternative bill with a different approach, you will need to explain the alternative in the final question. You have chosen to release your statement in the form of a Q&A. It must fit in a standard press release, so your legislative assistant has given you strict word count limits. This assistant has experienced your wordiness before; she says that she will not read beyond the word limits, so anything over them will be ignored. Seriously – she is not kidding about this – she's a busy person with many tasks to complete. Your legislative assistant really is awesome; she has already written the intro paragraph and the questions for you, and you just need to type up the answers, in a separate document (no need to include all of these instructions). Your legislative assistant will take it from there! A note on sources. For this exercise, please include in-line citations to any facts or figures you bring into the discussion. Use any format you wish as long as you are consistent. Reference the source in a short form wherever you use it in your answer, for example (Goodreau 2018) or (CDC 2016). Provide a bibliography of all sources at the end. The bibliography does not count in the word limit. Sources must have a reasonable level of authoritativeness. This is a tricky concept to define absolutely. At one end are highly authoritative sources like articles in the academic literature, or reports from agencies like the Centers for Disease Control or the World Health Organization who are tasked with sifting through all of the available data and synthesizing it for public use. At the other end are blogs by individuals operating outside a professional context, which are not required to undergo any review by anyone other than the author before being publicized, and for which the author is not professionally responsible for the results. Of course, scientists are humans, and government agencies are made up of humans, and neither can be assumed to be perfect or completely unbiased; a critical eye on the potential limitations is always useful, here and in life generally. And information about trends in popular perceptions or alternative perspectives may certainly be obtained through a consideration of individual experiences such as those found in blogs and similar postings. Professional bloggers represent a particularly challenging gray area these days. A reminder : we discussed in class how the critical vaccination threshold for measles has been calculated to be in the range of 90-95%. There is no need to do any calculations for this assignment – only to understand this concept and think about what it really means in practice. Some additional notes. Like many states, Washington has seen multiple changes to its vaccination rules over the years. It had a philosophical exemption in place for measles for many years, and many states still do. When Washington removed the philosophical exemption in 2019, the bill passed the State House of Representatives 56 to 40 and the State Senate 25 to 22 – in other words, a division of opinion here remains a very real part of our (and all) societies.

Almost all states (including Washington) do not require vaccination against COVID-19 to enter day care or K-12 school. Draft letter to complete Dear Constituents: As you may have heard, the state legislature is considering House Bills 2178 and 2179, which would remove the religious exemption for measles vaccinations in Washington State, or add a philosophical (personal belief) exemption, respectively. In the former case, any child whose parents wish to send them to day-care or school (public or private) would be required to provide their children with measles vaccination, unless they had a medical condition that prevented them from receiving vaccines. In the latter case, parents who opposed vaccinations but did not belong to a formal religious organization that opposes vaccination would be exempted. In both cases, parents would still have the option to home-school their children if they wished to opt out. I imagine that you have many questions about vaccines, and about the bills and my stance on them, which I would like to answer here. Let me give you some background, before I explain my position.  “How does the measles vaccine work? Is it safe?” [max 150 words] The measles vaccine strengthens the immune system's response by exposing it to antigens, which are weakened forms of the measles virus. These antigens teach the body's immune system to recognize and get rid of the disease, they don't cause fatal illnesses and are extremely safe and effective. The vaccine comes in two doses children between the ages of 12 and 15 months receive the first dose and those between 4 and 6 years old are given the second dose before beginning school. Unlike the more severe symptoms of a true measles infection, the antigens in the vaccine may cause small skin patches or a mild to moderate fever (CDC, 2021). These side effects are harmless, they can even indicate that the immunization is effectively boosting the development of immunity. If you're vaccinated your body is better prepared to fight off the virus, if you come in touch with someone who is infected.  “I have heard of cases of children developing a variety of conditions after the measles vaccine, including autism. What do we know about the link between measles vaccination and autism or other diseases? [max 100 words] There is no relationship between the measles vaccine and autism, these allegations are from 1998 research that raised this possibility and were later extensively examined and withdrawn. It was fake data, the doctor involved in the "study" suffered many repercussions including having their medical license revoked. Numerous investigations conducted following these incidents have demonstrated that there is no connection between autism the measles, mumps, and rubella (MMR) vaccination. The largest research was published in April 2015 in JAMA that looked at the medical records of almost 95,000 kids which proved the MMR vaccine does not increase the likelihood of autism (Mayo Clinic, 2022).  Discussions of school vaccines often focus on the concept of “herd immunity.” What is that, how does it work, and why is it important here? [max 150 words] Herd immunity develops when a significant portion of a community develops immunity to an infectious illness, the danger of it spreading from person to person lowers and herd immunity

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occurs. Those who are not immune are indirectly protected since the continuous transmission of the disease is relatively little. Through vaccinations or previous exposure to the illness, individuals can develop an immunity. Herd immunities can be beneficial by minimizing the number of susceptible individuals. It’s still possible for the disease to spread to non-immune people, such as those who are unable to receive vaccinations or have a weak immune system and are unable to tolerate such vaccinations. School vaccination requirements protect kids and teenagers by ensuring their protection at school, where there is a greater risk of vaccine- preventable illness transmission. The spread of an infection or illness may cause a significant crisis, a high rate of school absences, and growing healthcare costs. Different disease thresholds affect the percentage of a population that needs to be immune to develop herd immunity. For measles, to acquire herd immunity and end continuous disease transmission, more than 95% of the population must be immune.  I have heard that vaccination rates are now above 95% on average in every county in Washington State children, and that a 95% vaccination rate is high enough to prevent new epidemics of measles. Is there really anything to worry about? [max 100 words] While high vaccination rates are important for preventing outbreaks, there are still some concerns. There is not a 100% vaccination rate meaning that some individuals can still contract the virus. A herd community will be in Washington meaning that most of the population will be immune to the virus but the ones that aren’t will be affected as well as their children. There is also the concern that other states might not have a high vaccination rate as the state of Washington. Another issue is that the unvaccinated population can travel in and out of state likely spreading the virus.  I have heard that most states do not require COVID-19 vaccines to attend school, but most do require measles vaccines, even though COVID-19 has killed many Americans in the last 20 years, and measles has not caused a single death in the US since 2015. Why is this the case? [max 100 words] Most individuals are reluctant or refuse to receive vaccinations. There are many challenges associated with managing a pandemic necessitate distinct strategies to ultimately curb it to intermittent outbreaks like to the measles. Adult and pediatric immunization programs have been the main means of preventing measles epidemics. If a new generation isn't vaccinated, they run the risk of getting measles, which permits the virus to spread throughout that population.  Given all of this, do you support HB 2178? HB 2179? Why or why not? [ max 200 words]

After reviewing all the information, I do not endorse HB 2178 or HB 2179. The strict vaccination regulations are designed to safeguard vulnerable populations unable to afford immunizations due to medical conditions. The measles virus impacts T cells, B cells, and macrophages, suppressing them and contributing to high mortality rates from secondary infections, with its contagious nature affecting various cell types throughout the body (Goodreau, 2024). Mandatory vaccination programs not only shield susceptible individuals, curbing outbreaks but also build on the achievements of previous immunization efforts. These initiatives are crucial for public health, fostering education and awareness to encourage voluntary vaccination. The allowance for religious or philosophical beliefs underscores individual liberty and autonomy, with some parents asserting their right to choose medical professionals based on personal beliefs. When making informed decisions about vaccination programs, public health officials and legislators rely on scientific data, expert opinions, and community input. One of the greatest medical achievements and a mainstay of public health is vaccines. For vaccination to be as successful as possible, especially in protecting the most susceptible members of the population, herd immunity must be achieved. Bibliography: Centers for Disease Control and Prevention. (2021, January 26). About measles vaccination . https://www.cdc.gov/vaccines/vpd/measles/index.html Jennifer LeGare, N. P. (2022, March 24). Autism-vaccine link debunked . Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/autism- vaccine-link-debunked Professor Steven Goodreau (2024) Measles virus

BioA 206 Assignment 3

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