Spillover Cards

File Notes for Vaccine DAsThere are two ways this vaccination argument can be run:

1. Surveillance module: Surveillance functionally solves vaccination. The evidence on this is more specific to disease surveillance and tracking, so it’s questionable whether the plan links or not. I don’t recommend reading the surveillance module as much.

2. Culture of rights module: In the status quo, the pro-vaccination movement is gaining influence, but the plan reverses it by boosting a “culture of rights” that is used by anti-vaccination proponents to justify their beliefs. There are some decent cards in here that say anti-vaccination activists will use the rhetoric of things like Roe v. Wade and GMOs to anti-vaccination rights of parental “choice” and “freedoms”.

For the aff section, there is not as much evidence, but I think it is fairly easy to win no link and no impact.

1NC Materials

1NC — Privacy LinkThe plan builds on the virtuous cycle for privacy to create more reforms.Ozer 12 — Nicole Ozer, the Technology and Civil Liberties Policy Director at the ACLU of Northern California (ACLU-NC), where she developed the organization's Demand Your dotRights online privacy campaign, 2012 (“Putting Online Privacy Above The Fold: Building A Social Movement And Creating Corporate Change” New York University Review of Law & Social Change, Lexis)As noted in Part I, n226 one of the primary challenges of establishing a privacy social movement is sustainability. While the privacy community has had success in the past in addressing specific incidents, these successes did not initially lead to a coherent and sustainable privacy social movement. n227 More recently, however, advocates have successfully leveraged the environmental changes discussed in Part II to win specific battles to protect individual privacy. The privacy community has also used those victories to reinforce the climate for change and support the discussion necessary to sustain the nascent social movement. This has helped to create a much-needed "virtuous cycle " n228 in which each successful advocacy effort reinforces awareness of the ongoing issues concerning online privacy and makes it easier both to challenge specific practices in the future and to lay the groundwork for broader-reaching change.

1NC — Vaccine Surveillance ModuleBulk surveillance solving disease now – it’s key to efficient medical databases that can predict patterns and detect outbreaks – prefer this in the context of evolving diseases and rapid spread. Santos and Bernardino 6 – Ricardo Jorge Santos, holds a PhD Information Sciences & Tech, faculty member of the Centre of Informatics and Systems of the University of Coimbra; Jorge Bernardino, faculty member of Engineering Institute of Coimbra at the Polytechnic Institute of Coimbra, 2006 (“Global Epidemiological Outbreak Surveillance System Architecture”, 10th International Database Engineering and Applications Symposium, December 14, Available Online at 10.1109/IDEAS.2006.27 via MSU Library, accessed 7/14/15, KM)

Diseases such as avian influenza, severe acute respiratory syndrome (SARS) and Creutzfeldt-Jacob syndrome represent a new era of biological threats. Nowadays, these hazards breed, mutate and evolve at tremendous speed. Furthermore, they may spread out at the same speed as which we travel. This reveals an urgent need for an agent capable of dealing with such threats. Data warehouses are databases which provide decision support by on-line analytical processing (OLAP) techniques. We present the architecture for an effective information system infrastructure enabling the prediction and near real-time detection of disease outbreaks, using knowledge extraction algorithms to explore a symptoms/diseases data warehouse in a continuous and active form. To collect such data, we take advantage of the Internet and features existing in today’s common communication devices such as personal computers, portable digital assistants and cellular phones. We present a case-simulation based on a small

country, showing the system can detect an outbreak within hours or even minutes after its physical occurrence, alerting health decision makers and providing quick interaction and feedback between all users. The architecture is also functionally independent from its geographical dimension. 1. Introduction A data warehouse (DW) provides information for analytical processing, decision making support and data mining tools. A suitable data model is the core of representing part of the real world in the context of a database. Although many modeling techniques expressed in extended multidimensional data models were proposed in the recent past [5], many major issues such as information system architectures for specific health issues are not properly reflected.

Diseases such as avian influenza, SARS and the Creutzfeldt-Jacob syndrome represent a new era of biological threats. New stripes of viruses and bacterias are becoming increasingly aggressive and rapidly adapting to resist vaccines and medication. The speed at which these diseases are mutating and evolving, combined with the fact that they may spreadout at the same rate as people and animals travel, greatens the risk for a major epidemic or pandemic outbreak. It is therefore crucial to detect when a potential outburst might by taking place in order to contain it as quickly as possible and minimize damage it may cause. Our architecture fulfils that need, using knowledge extraction algorithms to explore a symptoms/disease DW, looking for patterns of symptoms to predict the occurrence of a potential outbreak. We also present an experimental evaluation using a case-simulation for a small country. The rest of this paper is organized as follows. In section 2, we refer issues and existing solutions in epidemics and health information systems. In sections 3, 4 and 5, we respectively present our architecture, its database and the main algorithms and methods for outbreak prediction and detection. In section 6 a simulation of the system working for a small country such as Portugal is presented and the final section contains concluding remarks and future work. 2. Background and related work Accessing the Internet today, we can find several institutional and enterprise web portals which provide trustworthy health information (including epidemic and pandemic) such as in [1] by the Aberdeen Group, [7] by Great Britain’s NHS, the World Health Organization [10]. We can also use web applications to perform a risk analysis on contagious diseases which can be disseminated through animal contact [9]. The work in [4] refers the importance of mathematical models given historical disease data as a

mean of predicting and evaluating forms of action in certain situations. We can also use the Internet for reporting diseases to adequate health services, like what is done by the United States’ Centre for Disease Control in what they refer to as “communicable diseases”. However, with new emerging diseases, using historical data based contention plans will not be an efficient way to handle the problem, as shown in [8].

Innovative solutions have emerged based on telecommunication and informatics technology, such as the EMPHIS Project [2], following the perspective and vision of the future presented in [6] by Great Britain’s NHS. The architecture presented takes the next step,

combining database, knowledge extraction and telecommunication technologies to aid global health in rapidly predicting and/or detecting the occurrence of epidemic outbreaks, which is vital for minimizing losses

and containing potential hazards. 3. The surveillance system’s architecture  The technological evolution in telecommunications and portable computerized devices makes it possible today to have real-time information availability, practically without geographical dependencies. Taking advantage of an agent with the highest level of availability such as the Internet, our architecture provides the

infrastructure for collecting data of occurring symptoms and diseases, and points examples on how to effectively and efficiently process this

data to discover symptom and disease associations. This is done achieved by inserting patient symptoms and diseases data in a web server database, which collects all information in a given geographical region and ships it to a DW located in a health decision centre. If the number of discovered cases within that region is considered relevant as a possible epidemic indicator, health decision makers and medical staff are immediately alerted. The architecture has 3 bottom-up tiers or levels, as seen in Figure 1. Symptom/disease data is uploaded by medical staff using personal devices with internet access, such as mobile phones, PDAs or common personal computers, getting stored in the second tier web servers. Each web server has the database and software applications needed to support the first tier requested services. The decision making server in the last tier holds a DW processing non- stop knowledge extraction algorithms finding disease record counts and symptoms/disease patterns in a defined geographical area. If a relevant number of suspicious patterns of symptoms or confirmed occurrences of diseases are detected, health decision makers and medical staff are immediately alerted. Figure 1 represents an example of an implementation covering three defined geographical areas. A major advantage in our proposal is

that once the disease/symptom data is recorded, the detection process is much faster than bureaucratic processes used today. Nowadays, when a major disease is observed, medical staff fill in paperwork reporting those cases to entities such as the CDC in the United States or the NHS in Great Britain. These entities process and analyze the amount of cases received from each region and decide if that amount should be considered relevant. These processes usually take days, or, at least, many hours. Furthermore, if a “minor” disease is observed, such as a simple flu,

for instance, it is not considered as relevant to report. Although it may be a “minor” disease, if it were to occur in a considerable

amount of cases within the same region, it could become an important issue. With our system, this would be almost immediately detected and alerted; in the traditional existing processes it would not be detected, or, in the best case, would be noticed only after some time. For each medical staff disease or symptom input, they may not even physically know, see or even be in contact with each other, but their

medical records will be matched almost in a real-time manner, detecting the possibility of an epidemic occurrence. Each second tier web server must contain the following components in order to insure the systems interaction and functionality: a) a data mart containing the database structure and all supporting data for the geographical region and population it serves; b) a web interface for first tier users to input data and to promote interaction between third tier users (health decision makers) and first tier users (medical staff); c) a software application available to first tier users for downloading, which allows working offline the Internet and capable of uploading that data to the second tier web servers whenever requested. This would allow medical staff to work at any location without Internet access; d) a software server component responsible for shipping the collected data to update the third tier

DW server. 4. The surveillance system’s database Today, most database systems offer features that go beyond management of static data and most information systems are powered by a database. The job of a database is to store data and answer queries. By contrast, the job of an information system is to provide a service, which are semantic entities entailing considerations that span the life cycle of the larger system [3]. Traditionally, database systems have been passive, storing and retrieving data in direct response to user requests without initiating any operations on their own. As the scale and complexity of data management increased, interest has grown in bringing active behaviour into databases, allowing them to respond independently to data-related events. Therefore, given the usage we wish to provide our database, we can look at it as an active database as discussed in [3], for it will be continuously querying and analyzing data

and reporting it to the users makers involved in an interactive form. The database holds patient symptoms and disease data records, including both humans and animals. Based upon the characterization of these entities and their attributes, we propose in Figure 2 the partial DW schema supporting human disease outbreak detection. The schema for outbreak prediction is similar and given by adding tables relating to symptom data. The schema for animal disease outbreak detection and prediction are similar to the human schema, linking each animal with the human to which it belongs.

Anti-vaxxers cause outbreaks of dangerous diseases – highly contagious diseases means it will spread quickly. Sifferlin 14 — Alexandra Sifferlin, Alexandra Sifferlin is a writer for TIME. She covers public health issues including infectious and chronic disease, big ideas in medicine, and breaking news, 3-17-2014 ("Here are some diseases we're seeing thanks to anti-vaxxers," TIME, 3-17-2014, Available Online at http://time.com/27308/4-diseases-making-a-comeback-thanks-to-anti-vaxxers/, Accessed 7-14-2015)These should be avoidableNew York City isn’t an anomaly, though. Diseases that are and have been avoidable in the U.S. thanks to vaccines, are resurfacing all across the country. Measles, for instance, was considered wiped out in 2000, but there have been several outbreaks in the past few years. This map shows outbreaks of vaccine-preventable diseases since 2008 (click on “Map” and select which diseases and regions you want to see).The emergence of these diseases — especially measles — is alarming, and mostly due to parents in the U.S. not vaccinating their kids. “If you are unvaccinated and you come in contact with measles, there’s a 90% chance you will get it,” says Jason McDonald, a spokesperson for the Centers for Disease Control and Prevention (CDC).

Though measles outbreaks are primarily linked to unvaccinated people, McDonald notes that some vaccines aren’t foolproof. For example, the whooping-cough vaccine may lose its efficacy over time. And, overall, most people do get their vaccinations. A CDC report looking at children entering kindergarten for the 2012–13 school year in all U.S. states found that more than 90% of these kids had their vaccines.Still, there are people — including public figures and celebrities — who don’t vaccinate their kids and promote their choices. Most infamously, Jenny McCarthy has espoused her antivaccination position because she believes vaccines are full of toxins and cause autism. When she recently posed a question on Twitter about finding a mate, the vaccination backlash was loud and clear.Just how harmful are these notions, though? Below are some preventable diseases making a vicious return thanks to people not getting their vaccinations.MeaslesAccording to the CDC, for every 1,000 children who get the measles, one or two will die. Currently, public-health workers are worried about the situation in New York, but just in the past three months, there have been reported cases of the disease in Massachusetts, Illinois and California. The CDC reports that from Jan. 1 to Feb. 28, 2014, 54 people in the U.S. have reported being infected with measles. On average, there are about 60 cases reported in the U.S. every year. Most people in the U.S. are vaccinated against the measles, but since measles is still around in other countries, those who travel outside of the U.S. can contract it if they are not vaccinated. New York City has not been able to confirm the source of the disease.MumpsAs recently as Monday, health officials confirmed 23 cases of mumps at Ohio State University. In 2011, there was a mumps outbreak on the University of California at Berkeley campus, with 29 reported cases confirmed by the CDC. The source of the outbreak was thought to be an unvaccinated student who had spent time traveling in Western Europe where there is still a presence of mumps. In 2013, a slightly smaller outbreak of the disease broke out among students at Loyola University in Maryland. The last major occurrence was in 2006, when there was a multistate outbreak of 6,584 reported cases. Less than 20 cases a year was considered usual at the time.Whooping CoughWhooping-cough outbreaks are thought to be spurred by waning immunity from the vaccine. However, a 2013 study published in the journal Pediatrics reports that California’s worst whooping-cough outbreak, which infected more than 9,000 people, was also encouraged by a large number of kids who were unvaccinated.Chicken PoxIn 2012, a county in Indiana experienced a major chicken-pox outbreak of more than 80 cases, which was thought to start from an unvaccinated child. The vaccine is 90% effective, so it’s possible for people who have been vaccinated to contract the disease.

1NC — Vaccine Culture of Rights ModuleThanks to anti-vaccination proponents, measles risk is high now – pro-vaccination public opinion is reversing the trend. Salzberg 15 – Steven Salzberg, Bloomberg Distinguished Professor of Biomedical Engineering, Computer Science, and Biostatistics at Johns Hopkins University, former researcher at The Institute for Genomic Research with a focus in sequencing the genomes of many bacteria, including those used in the 2001 anthrax attacks, member of the Human Genome Project and the co-founder of the influenza virus sequencing project, 2015 (“Anti-Vaccine Movement Causes Worst Measles Epidemic In 20 Years”, Forbes, February 1, Available Online at http://www.forbes.com/sites/stevensalzberg/2015/02/01/anti-vaccine-movement-causes-worst-measles-epidemic-in-20-years/, accessed 7/20/15, KM)

Measles is now spreading outward from Disneyland in California, in the worst outbreak in years. The epidemic is fueled by growing enclaves of unvaccinated people. The CDC reports that in just the past month, 84 people from 14 states contracted measles, a number that is certainly an under-estimate, because the CDC doesn’t record every case. California alone has 59 confirmed cases, most of them linked to an initial exposure in Disneyland. A majority of people who have gotten sick were not vaccinated. For

years, scientists (including me) have warned that the anti-vaccination movement was going to cause epidemics of disease. Two years ago I wrote that the anti-vaccine movement had caused the worst whooping cough epidemic in 70 years. And now it’s

happening with measles. Finally, though, the public seems to be pushing back. Parents are starting to wake up to the danger that the anti-vax movement represents to their children and themselves. What’s sad about

this – tragic, really – is that we eliminated measles from the U.S. in the year 2000, thanks to the measles vaccine. As this CDC graph shows, we’ve had fewer than 100 cases every year since. But we had 644 cases in 27 states in 2014, the most in 20 years. And 2015 is already on track to be worse. Measles may become endemic in the U.S, circulating continually, thanks to the increasing numbers of unvaccinated people. Until now, each outbreak was caused by someone traveling from abroad and bringing measles to us. The anti-vaccine movement has turned this public health victory into defeat. Anti-vaxxers have been relentless in the efforts to spread misinformation. Despite overwhelming scientific evidence that vaccines are beneficial, they endlessly repeat a variety false claims, such as: Vaccines cause autism. They don’t. The preservative thimerosal in vaccines causes autism. It doesn’t. Natural immunity is all you

need. It isn’t. Measles infects 90% of people exposed to it unless they are vaccinated. A healthy lifestyle will

protect you from measles. It won’t. Now, finally, some parents are pushing back. Parents and schools in California, where the

epidemic began, are concerned that their children will be exposed to measles from unvaccinated children in schools. And the schools are starting to do something they should have done long ago: send the unvaccinated kids home. The problem arises from California’s vaccine exemption policy: although public schools require kids to be vaccinated, parents can exempt their kids simply by saying they have a personal objection to vaccination. It’s not just California: only two states, Mississippi and West Virginia, don’t allow parents to claim a philosophical or religious exemption to vaccines And Colorado has the worst rate of vaccination, at just 82%, primarily due to parents claiming a

“philosophical” exemption. These parents are the anti-vaxxers. Thanks to them, we now have large pockets of unvaccinated children through whom epidemics can spread further and faster than we’ve seen in decades. The CDC

reports that in 2014, 79% of measles cases in the U.S. involving unvaccinated people were the result of personal belief exemptions. Anti-vaxxers don’t recognize the threat their behavior poses to others, especially to children whose immune systems aren’t functioning properly. CNN reported this week on the case of Rhett Krawitt, a 6-year-old California boy who has gone through 4 years of chemotherapy for childhood leukemia. His leukemia is in remission and he’s back in school, but the treatment wiped out his immunity, and he’s still not ready to get vaccinated. If Rhett gets measles, he might not survive. His father Carl wrote to school district officials to ask them to ban unvaccinated children from school. Krawitt expects the schools to deny his request. Meanwhile, the parents who refuse to vaccinate their kids aren’t budging. The New York Times reported on one mother, Crystal McDonald, who refused to vaccinate any of her four children, after “researching the issue” by reading anti-vaccine websites. When their high school sent her daughter home for two weeks, the daughter asked if she could get the measles shot so she could return. As quoted in the Times, McDonald told her daughter “I said ‘No, absolutely not.’ I said I’d rather you miss an entire semester than you get the shot.’” Where does this breathtaking science denialism come from? It’s been building for years, as I and many others have written. The wave began with a 1998 paper published in The Lancet by Andrew Wakefield, claiming that the MMR vaccine was linked to autism. Wakefield’s work was later shown to be fraudulent, and his claims about the

vaccine “dishonest and irresponsible.” After lengthy investigations, the paper was retracted and Wakefield lost his medical license. Despite this very public repudiation, Wakefield has stuck to his claims, though, and has spent much of the past 15 years speaking (or perhaps “preaching” would be a better term) to anti-vaccine groups, to whom he is a kind of folk hero. It’s not just Wakefield, though. Anti-vaccine messages have been broadcast aggressively by the group Generation Rescue, led by former Playboy playmate and MTV host Jenny McCarthy, and by Age of Autism, a group dedicated to the proposition that vaccines cause autism. (Age of Autism is doing it again right now.) And just last summer, Robert F. Kennedy Jr. published a new book further promoting the long-discredited claim that thimerosal causes autism. Most of the anti-vax crowd have no scientific training or expertise, which might explain (but doesn’t excuse) their complete ignorance of the science. Over the past 15 years, dozens of studies involving hundreds of thousands of people have shown convincingly that neither vaccines nor any of the ingredients in them are linked to autism. Vaccines are not only safe, but they are perhaps the greatest public health success in the history of civilization. Measles, though, is dangerous. The CDC’s Anne Schuchat had a message for parents this week: “I want to make sure that parents who think

that measles is gone and haven’t made sure that they or their children are vaccinated are aware that measles is still around and it can be serious. And that MMR vaccine is safe and effective and highly recommended.” Make no mistake, measles is a very dangerous infection. In the current outbreak, 25% of victims have ended up in the hospital. And it is extremely infectious: the CDC’s Schuchat explained that: “You can catch it [measles] just by being in the same room as a person with measles even if that person left the room because the virus can hang around for a couple of hours.” Perhaps the Disneyland epidemic, which has now spread to 14 states, will finally convince parents, schools, and state legislatures that they need to insist that children get vaccinated before going to school. Perhaps it will also convince parents to stop listening to nonsense, and choose wisely by getting their children vaccinated against measles. We won this battle before, and we can win it again.

Anti-vaccination parents view the debate as a matter of the right to choose – plan gives their views legitimacy. AP 15 – The Associated Press, 2015 (“Anti-vaccination parents explain their perspectives: 'We are not anti-science'”, AP, February 23, Available Online at http://www.oregonlive.com/health/index.ssf/2015/02/anti-vaccination_parents_expla.html, accessed 7/14/15, KM) Anti-vaccination parents include a mix of views -- from religious communities to families practicing alternative medicine and

libertarians who shun government interference. But many are Americans with college degrees living in liberal communities such as Santa Monica or Marin County in California and Portland, said Gary Freed, a professor of pediatrics at the University of Michigan. Most hesitant parents do not avoid all vaccinations. They typically under-vaccinate, either delaying the shots until their child is older or refusing certain vaccines while continuing with others, Freed said. The parents who spoke to AP recounted spending hundreds of hours reviewing medical studies, books and news stories and networking on social media. They cited cases of children who were supposedly hurt by vaccines and the existence of a government-run vaccine injury-compensation program. And they worried about the oversight of pharmaceutical companies that reap profits from vaccines and are shielded from liability when a vaccine causes harm. Moore said she read a 1998 study published in The Lancet journal by Dr. Andrew Wakefield, who raised the possibility of a link between the measles-mumps-rubella vaccine, bowel disease and autism. She said she knows the study was later discredited and retracted. She believes the research was inconclusive. Moore concedes that the vast majority of studies show vaccines are safe, but she says some research points to inconsistencies, unknowns or negative effects that deserve further investigation. And while autism is still a concern, Moore and others also worry about how exposure to chemicals, bad nutrition and stress can affect genes and health. They say large doses of synthetic additives found in vaccines, including aluminum and mercury, can harm the immune and digestive systems and brain. They're believers in living naturally and eating organic food who also question

the safety of genetically modified organisms, pesticides and other common substances such as flame retardants and plastics. "There are so

many environmental toxins, but anything in my children's world that I can influence I do," Moore said. The CDC has phased out a mercury-containing preservative in vaccines as a precautionary measure, and the agency says vaccines containing aluminum pose

extremely low risk to infants. Federal officials also say GMOs in foods are safe, as are pesticides if used according to labels. These parents say they should be able to decide whether their child undergoes a medical procedure -- a decision, they say, that goes to the core of what it means to have freedom of choice. "I have the right to decide what to put into my child's body," said Heather Dillard, a mom in Springfield, Missouri, who is also a registered nurse.

"Nobody has the right to put toxic chemicals into my son's bloodstream. That's taking my rights away , and it's very scary to me." Dillard said she decided against vaccinating because her first child was born a preemie and has autism. Dillard does not believe vaccines caused the autism, but the disease led her to do a lot of research about health. She says she now chooses to

build her son's immunity naturally, through diet, while avoiding shots or other medication. Dillard and others say they are not worried about measles because their children have strong immune systems. They cite statistics: Out of the 1,000-plus measles cases in the past decade, there was not a single death. "What I'm more nervous about is the hysteria that would result," if her children were to get ill, Moore said. Moore said she does worry about affecting children who are immune-compromised and cannot be vaccinated. Before visiting friends with babies or young children, she said, she always informs them her twins are not vaccinated "so they have the power to make a choice." She also keeps the girls home at any sign of sickness. Researchers say berating parents who oppose vaccines will not persuade anyone and only puts people on the defensive. Educational messages from health officials may also make little difference and could, in fact, be counterproductive, said Brendan Nyhan, assistant professor of government at Dartmouth College. A study conducted by Nyhan and his colleagues last year showed that when parents were presented with evidence that vaccines do not cause autism or that measles cause great harm, some ended up feeling even more ambivalent. "We tend to be skeptical toward information that contradicts our existing views," Nyhan said. If Oregon were to take away the right to a vaccine exemption, Moore said, she would likely home-school her twins. She's keeping an open mind about vaccinating as her children get

older, but hopes more studies on the long-term effects of vaccines can help dispel her doubts. "I worry about living in a society that's progressively more intolerant toward any dissent," Moore said. "All scientific advances have come from questioning the status quo."

Anti-vaxxers cause outbreaks of dangerous diseases – highly contagious diseases means it will spread quickly. Sifferlin 14 — Alexandra Sifferlin, Alexandra Sifferlin is a writer for TIME. She covers public health issues including infectious and chronic disease, big ideas in medicine, and breaking news, 3-17-2014 ("Here are some diseases we're seeing thanks to anti-vaxxers," TIME, 3-17-2014, Available Online at http://time.com/27308/4-diseases-making-a-comeback-thanks-to-anti-vaxxers/, Accessed 7-14-2015)These should be avoidableNew York City isn’t an anomaly, though. Diseases that are and have been avoidable in the U.S. thanks to vaccines, are resurfacing all across the country. Measles, for instance, was considered wiped out in 2000, but there have been several outbreaks in the past few years. This map shows outbreaks of vaccine-preventable diseases since 2008 (click on “Map” and select which diseases and regions you want to see).The emergence of these diseases — especially measles — is alarming, and mostly due to parents in the U.S. not vaccinating their kids. “If you are unvaccinated and you come in contact with measles, there’s a 90% chance you will get it,” says Jason McDonald, a spokesperson for the Centers for Disease Control and Prevention (CDC).Though measles outbreaks are primarily linked to unvaccinated people, McDonald notes that some vaccines aren’t foolproof. For example, the whooping-cough vaccine may lose its efficacy over time. And, overall, most people do get their vaccinations. A CDC report looking at children entering kindergarten for the 2012–13 school year in all U.S. states found that more than 90% of these kids had their vaccines.Still, there are people — including public figures and celebrities — who don’t vaccinate their kids and promote their choices. Most infamously, Jenny McCarthy has espoused her antivaccination position because she believes vaccines are full of toxins and cause autism. When she recently posed a question on Twitter about finding a mate, the vaccination backlash was loud and clear.Just how harmful are these notions, though? Below are some preventable diseases making a vicious return thanks to people not getting their vaccinations.MeaslesAccording to the CDC, for every 1,000 children who get the measles, one or two will die. Currently, public-health workers are worried about the situation in New York, but just in the past three months, there have been reported cases of the disease in Massachusetts, Illinois and California. The CDC reports that from Jan. 1 to Feb. 28, 2014, 54 people in the U.S. have reported being infected with measles. On average, there are about 60 cases reported in the U.S. every year. Most people in the U.S. are

vaccinated against the measles, but since measles is still around in other countries, those who travel outside of the U.S. can contract it if they are not vaccinated. New York City has not been able to confirm the source of the disease.MumpsAs recently as Monday, health officials confirmed 23 cases of mumps at Ohio State University. In 2011, there was a mumps outbreak on the University of California at Berkeley campus, with 29 reported cases confirmed by the CDC. The source of the outbreak was thought to be an unvaccinated student who had spent time traveling in Western Europe where there is still a presence of mumps. In 2013, a slightly smaller outbreak of the disease broke out among students at Loyola University in Maryland. The last major occurrence was in 2006, when there was a multistate outbreak of 6,584 reported cases. Less than 20 cases a year was considered usual at the time.Whooping CoughWhooping-cough outbreaks are thought to be spurred by waning immunity from the vaccine. However, a 2013 study published in the journal Pediatrics reports that California’s worst whooping-cough outbreak, which infected more than 9,000 people, was also encouraged by a large number of kids who were unvaccinated.Chicken PoxIn 2012, a county in Indiana experienced a major chicken-pox outbreak of more than 80 cases, which was thought to start from an unvaccinated child. The vaccine is 90% effective, so it’s possible for people who have been vaccinated to contract the disease.

2NC/1NR Materials — Privacy Link

2NC Privacy Winners Win LinkPlan shores up support for privacy which spills over.Ozer 12 — Nicole Ozer, the Technology and Civil Liberties Policy Director at the ACLU of Northern California (ACLU-NC), where she developed the organization's Demand Your dotRights online privacy campaign, 2012 (“Putting Online Privacy Above The Fold: Building A Social Movement And Creating Corporate Change” New York University Review of Law & Social Change, Lexis)Unlike modern software, privacy practices and laws do not auto-update. There must be sustained public pressure to support real change. Since 2009, the privacy community has been able to leverage factors to start to build a viable social movement to push for legal and policy change. The next several years will be significant in determining whether a privacy social movement is able to grow and mature like the environmental movement by utilizing recent successes and current attention to put down roots, mobilize broad public support, and achieve major reforms. It is my hope that, by reflecting on recent successes related to online privacy, identifying factors that have contributed to these advances, and [*281] suggesting a focus for privacy work that can reinforce these factors and break down remaining obstacles, this article contributes to the discussion of why and how the privacy community should build and sustain a viable social movement. If the privacy community can continue building the necessary infrastructure and taking the strategic policy steps necessary to increase transparency about how an individual's own information flows through the data ecosystem, it will be possible to sustain a large-scale social movement to ensure that, as technology advances, privacy protections are safeguarded in the modern digital world.

Studies prove that awareness of privacy consequences create impetus for more privacy.Lewis, Kaufman, and Christakis 8 — Kevin Lewis, Ph.D. candidate in the Department of Sociology at Harvard University, Jason Kaufman, Ph.D., is a research fellow at the Berkman Center for Internet & Society at Harvard University, Nicholas Christakis, M.D., Ph.D., M.P.H., is a Professor in the Department of Sociology and Health Care Policy at Harvard University, 2008 (“The taste for privacy: An analysis of college student privacy settings in an online social network” Journal of Computer-Mediated Communicaiton 14(1) Wiley)Finally, our data are relevant to understanding online privacy more generally—especially within fledgling communication technologies like SNSs. In Ruling the Waves: Cycles of Discovery, Chaos, and Wealth From the Compass to the Internet, Debora Spar (2001) argues that new technologies tend to undergo a predictable pattern of transitions. At first, they are concentrated only among a small group of “innovators.” This phase is characterized by excitement, freedom, and creativity. Next, the technology becomes “commercialized,” as the lay public rushes en masse to adopt it. Eventually, however, this rapid growth outstrips the spirit of the innovative period. Problems of coordination and competition foster “creative anarchy” and the search for freedom is replaced by a demand for property rights. Finally, government enters the scene, restoring order at the behest of the very pioneers who once sought to escape it. While not identical in form, the negotiation of privacy in online settings may be characterized by a similar pattern. When a new technology such as Facebook is released, there is a high degree of ambiguity over appropriate norms of conduct—the very definition of this space as public or private is contested. College students, professors, parents, employers, and Facebook itself each have different and potentially conflicting interests in the way the technology is used. Students are surely aware that the information they post is “public”—but the full extent and possible consequences of this

display may not be recognized by all. Slowly but inevitably, excitement outstrips precaution. The technology diffuses throughout the population, and users provide ever more data on their profiles—all the while maintaining the (rather permissive) default privacy settings, not yet having reason to do otherwise (see Mackay, 1991). Eventually, however, this behavior becomes consequential. The boundary between public and private is suddenly and unequivocally asserted by virtue of being overstepped. Users venture too far into public space with private details, and the consequence is a crashed party, a lost job opportunity, or—at an extreme—sexual assault or identity theft. Awareness is suddenly raised for a certain type of user: those users concerned with safety, or with maintaining a division between their public “face” and their online profile, or whose own high level of online activity gives them a better perception of their surroundings; this awareness spreads, most directly through the social ties represented by Facebook friendships and cohabitation. Communication about the importance of noncommunication takes place. The upshot of this process is that a normative boundary emerges where before none existed. Facebook is increasingly recognized as a space within which some precaution must be exercised, and users respond by retreating behind a virtual line of privacy—in proportion to the extent to which their awareness has been raised by a concern that applies to them personally. Here, we have considered such a progression from excitement and ambiguity to (self-) regulation. However, rather than regulation being at once explicit, legal, and externally imposed (by government), the public/private boundary on Facebook is implicit, normative, and internally negotiated. We may thus see new online spaces as “self-regulating systems” where awareness is the impetus for change and equilibrium the final product—both proceeding along a pattern of predictable regularities. In the meantime, researchers of SNSs will watch their study populations wax and wane, and the sites themselves may become less open and more exclusive. Whether users will still “Facebook” in the future to share ideas and social ties, or whether the form and/or site of these interactions will change, remains to be seen.

2NC Congressional Action LinkThe plan enables reform and self-regulation — it reclaims congressional decision-making authority on intelligence and spurs executive actionBerman 14 — Emily Berman, Visiting Assistant Professor of Law, Brooklyn Law School, LL.M. (Masters of Law) from New York University School of Law, J.D. from New York University School of Law, B.A. from Duke University, 2014 (“Regulating Domestic Intelligence Collection,” Washington & Lee Law Review (71 Wash. & Lee L. Rev. 3 ), Available Online to Subscribing Institutions via EBSCO Host)The FBI’s mandate to protect civil liberties can be viewed as a “secondary” mission—one that frequently comes into tension with its primary mission of preventing security threats.256 Studies show that an agency will focus on what it considers to be its primary mission, and it will shirk on performing “secondary” or less easily evaluated goals.257 As a secondary mission, protection of civil liberties is, therefore, sure to be short-changed in favor of security in the same way that environmental concerns have so often gone under-addressed in favor of development or other economically profitable activities. 2. Relieving the Tension Among Multiple MissionsFortunately, several administrative law strategies suggest ways to ensure that the Guidelines regime sufficiently takes into account civil liberties concerns as well as security concerns.258 Though all of the options discussed below are possible paths to follow, the final two approaches discussed below seem particularly promising. Congress Reclaims Authority. One option, of course, is for Congress simply to relieve an agency of responsibility for one of [End of p. 67] the competing goals, reclaiming that decision-making authority for itself .259 Following revelations of civil liberties violations in the 1970s, Congress reclaimed some decision-making authority regarding the executive’s surveillance powers by enacting the Foreign Intelligence Surveillance Act (FISA).260 Or Congress could generate more piecemeal limitations, barring particular techniques that pose threats to civil liberties, or defining the circumstances under which such techniques could be used.Congress could, for example, statutorily reinstate the rule regarding the use of undercover agents to investigate First Amendment protected activities as it existed in the Guidelines in 2001, which required that the FBI have probable cause or a reason to believe a crime had been committed before sending an agent into the meetings of a religious or political group.261 Congress need not legislate to bring such changes about. If Congress wanted to alter particular investigative tactics, or even to pressure the Justice Department to adopt of its own volition the type of procedural framework suggested in this Article, it has an array of tools at its disposal to press for its desired policy change. Just the threat of legislation, so long as it is credible, can spur executive action . Recall that the original Attorney General’s Guidelines were implemented to sap the momentum from Congress’s efforts to enact a legislative charter for the FBI.262 So long as the option of enacting an FBI charter remains a viable means for Congress to limit the Attorney General’s discretion when it comes to FBI investigations, the threat of such legislation can be used to press for Congress’s desired policy outcomes. Congress possesses carrots as well as sticks—its control over the FBI and Justice Department’s budget also can impose a great [End of p. 68] deal of pressure for policy change. Given the political economy of this policy area,263 however, reliance on Congress to reconcile the tension between the FBI’s security mission and civil liberties is not the most promising route.

2NC Privacy Policy LinkPrivacy policies like the aff build the infrastructure for future privacy social movementsOzer 12 — Nicole A. Ozer, the Technology and Civil Liberties Policy Director at the ACLU of Northern California, developed the organization's Demand Your dotRights online privacy campaign, 2012 (“Putting Online Privacy Above The Fold: Building A Social Movement And Creating Corporate Change,” New York University Review of Law & Social Change (36 N.Y.U. Rev. L. & Soc. Change 215), Available Online to Subscribing Institutions via Lexis-Nexis)ConclusionUnlike modern software, privacy practices and laws do not auto-update. There must be sustained public pressure to support real change. Since 2009, the privacy community has been able to leverage factors to start to build a viable social movement to push for legal and policy change. The next several years will be significant in determining whether a privacy social movement is able to grow and mature like the environmental movement by utilizing recent successes and current attention to put down roots, mobilize broad public support, and achieve major reforms. It is my hope that, by reflecting on recent successes related to online privacy, identifying factors that have contributed to these advances, and [*281] suggesting a focus for privacy work that can reinforce these factors and break down remaining obstacles, this article contributes to the discussion of why and how the privacy community should build and sustain a viable social movement. If the privacy community can continue building the necessary infrastructure and taking the strategic policy steps necessary to increase transparency about how an individual's own information flows through the data ecosystem, it will be possible to sustain a large-scale social movement to ensure that, as technology advances, privacy protections are safeguarded in the modern digital world.

2NC New Reform LinkEven limited reform created some momentum — plan creates the opportunity for further reformKopstein 15 — Joshua Kopstein, cyberculture journalist and researcher focusing on Internet law and disorder, surveillance and government secrecy, 2015 (“USA Freedom Act gives NSA everything it wants — and less,” Al-Jazeera America, June 2nd, Available online at http://america.aljazeera.com/blogs/scrutineer/2015/6/2/usa-freedom-act-gives-nsa-everything-it-wants--and-less.html, Accessed 7-21-15)Even people within the NSA have been candidly celebrating the Freedom Act's surveillance “reforms,” calling it “a nothingburger for the privacy community.” And they might be right — with so many overlapping and redundant surveillance authorities, it'd be foolish to think the Freedom Act has ended bulk collection in any significant capacity.That doesn't mean there's no reason to celebrate the first step, but Congress will have to hit the ground running if it wants to build on the Freedom Act's momentum . In the House, Reps. Thomas Massie, R-Ky., and Zoe Lofgren, D-Ca., are already proposing an amendment to an upcoming “must-pass” Department of Justice appropriations bill that would stop the agency from compromising encryption standards, a measure that was removed from the original Freedom Act. (In September of 2013, Snowden revealed that the NSA and its British counterpart GCHQ routinely inject vulnerabilities into commonly used encryption software and influence the development of crypto standards from within the scientific community.)A separate amendment to the same bill, by Lofgren and Republican Ted Poe of Texas, would also block the FBI from demanding these encryption backdoors. And another from Colorado Democrat Jared Polis would block the Drug Enforcement Administration from collecting bulk phone records — a response to recent reports that the agency for decades ran a domestic phone records database that preceded the NSA's.Barring all that, the next major opportunity to challenge NSA surveillance won't be until 2017, when Section 702 of the Foreign Intelligence Surveillance Act is due to expire. But now that more transparency is in place, Congress has a chance to make up for the Freedom Act's shortcomings by putting the wheels in motion for real, comprehensive reform.

They Say: “Link Non-Unique — Generic”Privacy movement is losing momentum — success strategies haven’t translated into wins.Hosein 09 — Gus Hosein, Executive Director of Privacy International and Previous Visiting Senior Fellow at the London School of Economics and Political Science, 2009 (“Challenges in Privacy Advocacy,” Reinventing Data Protection, Edited By Serge Gutwirth, Yves Poullet, Paul De Hert Cecile de Terwangne, Sjaak Nouwt, pg. 254-255)Over the past decade the landscape for privacy protection has transformed. A decade ago, privacy groups were focused on a number of policing and national security campaigns (e.g., closed-circuit television cameras), communications surveillance (e.g., surveillance being designed into the infrastructure), communications security (the ‘crypto-wars’) and free expression issues (particularly on-line issues). Privacy campaigners also focused on the private sector surveilling its customers, whether through collecting medical records (e.g., US laws on health insurance), financial records (e.g., credit records), or the then-budding area of electronic commerce. Campaign successes were achieved through coalition building and educational campaigns on the importance of privacy. Media organisations were becoming more aware of these challenges and began regularly covering some of these issues, though they were often too arcane for the general population. Politicians were coming to terms with the new political realities of the globalisation of markets, the movement of people and data across borders and technological advancements. It was still a nascent field in many ways, with a few strong leaders and small groups making the most out of their small resources. In the last ten years, the challenges grew, the coalitions fragmented and the moods of the public and the media fluctuated. The level of uncertainty rose, along with the stakes. Privacy groups were caught in the storm of trying to research the policies while rushing out responses to media and political developments. A number of successful ‘response’ strategies emerged. Media organisations around the world documented the greater incursions upon the private lives of the individual, with a particular focus on the actions of the US government even if it meant ignoring domestic programmes. Parliaments and privacy commissioners issued condemnations and damning analyses of proposed plans to collect, profile and share data. Legal and academic institutions released studies assessing proposed policies and identifying the fault lines. Some national constitutional courts released opinions that upheld the right to a private life, though surprisingly the number of cases brought before these courts dwindled. Despite these response strategies there have been practically no clear ‘wins’ in the past decade . Indeed, some amendments to policies have increased oversight and reduced harms. Some policies have withered, such as the data profiling of US citizens, whether under the ‘Total Information Awareness’ project (TIA) or the ‘Computer Aided Passenger Pre-Screening Program’ (CAPPS II), though the creators of these systems are insisting that these programmes be offered lifelines. Meanwhile, Europe seems set to become the next home of data-mining as these systems are the subject of government-funded research and play a key component in future government plans. As examples, the EU-funded iTRACS consortium is conducting research into data mining techniques that can be applied to financial, travel and communications data, albeit in a privacy protective way (if this is possible); and the EU plans for next generation border management that involves the collection and mining of travel, biographic, biometric and behavioural data. Just as bad policies travel worldwide, rarely has a privacy-invasive bill not become law, a technological infrastructure not been developed, a data collection scheme abandoned. Even the withering programmes and policies have returned under new guises. As examples, data

profiling systems re-emerged in the US to be applied at the border under the ‘Automated Targeting System’; UK Parliamentary initiatives to reduce the invasiveness of plans to analyse communications records were corroded when the UK government managed to push a more invasive policy through the European Union; data breach legislation is being watered down to minimise the impact upon companies while disarming the rights of consumers. Many of these surveillance initiatives outlast the campaigns to oppose them. Often the decisions to implement surveillance systems take place behind closed doors, after controversies have subsided to some extent. The Passenger Name Record debate is a key example of this: original campaigns in 2003 against the US plans seem to lead somewhere as the EU was rejecting US demands for data from EU carriers. By 2004 a limited agreement was settled upon and another campaign followed that questioned the legality of the agreement. Many twists and turns later, we ended up in 2006 with an interim agreement that was worse and in 2007 with an agreement that was even worse than that. In the end, the EU agreed to an expansive regime of data sharing with the US because, behind closed doors, the EU was hoping that the US would offer data from its own carriers to the EU for its own expansive purposes. Campaigners tried as much as they could to follow this arcane issue during its 5 year gestation period but they were eventually shut out of a negotiations process involving secret agreements and oversight arrangements that involved non-disclosure agreements.

No momentum for privacy reform now — only the most privacy conscious of individuals disrupt big data’s controlMohan 13 — Vivek Mohan, Associate with the Science, Technology and Public Policy Program's (STPP) Project on Technology, Security, and Conflict in the Cyber Age (Cyber Project) at the Harvard Kennedy School's Belfer Center for Science and International Affairs, J.D. from Columbia, 2013 (“Privacy Consciousness in the Big Data Era,” Hive, May 13th, Available online at http://belfercenter.ksg.harvard.edu/publication/23095/privacy_consciousness_in_the_big_data_era.html, Accessed 7-20-15)Exploring how we are coping with our inability to answer the questions "who owns my data? And…why do they have it?" has become an increasingly popular topic for the mainstream media (notably, the Slipstream column in the New York Times). But prayers for regulation aside, the collection, use, and resale of data that was once exceptionally private is here to stay. I'm not here to vilify data collectors — far from it. Despite my strong inclination towards maintaining the traditions of days past (I'm probably the only person in his twenties who still reads physical newspapers), societal inertia cannot be held up ipso facto to argue for stronger privacy protections when we ourselves are responsible for sharing the data that is now traversing the endless servers of cyberspace. The benefits of the big data revolution are myriad, cut across sectors, and the best is surely yet to come.But how did we get to the point where I — theoretically a privacy and cybersecurity expert — find myself inured to the amount of data that I'm signing away the rights to at any given time? (Although, I must say it is comforting to say that it's not quite 1984 in the land of big data — Google Now seems to think I'm a Cubs fan). To focus the conversation a bit, let's focus on mobile — and let's talk about how application and ecosystem developers together have, for lack of a better word, conspired to remove bargaining power over data ownership from the individual.We are all (presumably) familiar with the process of installing an app on a smartphone. Once an app has been located on Google Play or the Apple App Store, we tap "install," whereupon we are presented with

a list of device features that the app requests permission to access. I'm sure many of you — like me — have asked yourself "Why does that program need access to my GPS location?" It's even possible that when faced with a particularly egregious misrepresentation as to what's new in an app, you have refused to update. But that puts you in the minority — the rest of us absentmindedly tap "Accept and Download" and move on living our monitored lives.How many crashes do you think were fixed by Facebook having more access to location data?How did we end up here? Well, app developers have a pretty sweet deal given the current mobile ecosystems. In a classic case of fine print combined with unequal bargaining power, the ability of consumers to control their data have been eviscerated in a totally legal way. If you don't agree to the proposed permissions, you can take your smartphone and go home — you don't get to play with the latest, greatest apps. Those responsible for the major mobile ecosystems — Apple and Google — made a decision at some point, perhaps for technical reasons, to disallow users from toggling individual permissions on an app — it is all or nothing.In this world, why wouldn't Facebook throw the kitchen sink of permissions in? Only the most privacy conscious of individuals would be willing to give up the benefits of such a critical app for the marginal, ineffable privacy benefits — after all, the preinstalled Google Maps is already collecting your location — what's the matter if Facebook has it as well?In essence, the bigger and more valuable the app, the more able the developer is to collect data — on the terms that he or she sees fit. If the terms of service of the app say the data can be resold, that's that — the consumer has entered into a contractual relationship with the developer — in law school, we called this a "meeting of the minds." I'd argue that given current data collection practices, consumers and data collectors are about as far as possible from reaching a "meeting of the minds" each time an app is downloaded.From a legal standpoint, this is all squeaky-clean. There isn't much law enforcement can do about it — disclosure cures all, and the major ecosystems are quick to disclose what apps are, at a hardware level, able to do. The Federal Trade Commission and state attorneys general, the agencies empowered to protect consumers, find themselves hamstrung absent a misrepresentation — and even in the most egregious cases, this usually ends up leading to a minor civil settlement and a change in the privacy policy — not exactly the biggest win for consumers.As an entrepreneur developing applications that take advantage of the plentiful data collected and disseminated by today's app economy, it's easy to be of the mindset that collecting all the data that you can and sorting it out later is the best way to go. But it is important to take a strategic view — the present inequality in bargaining power will not last forever. Those developers are privacy conscious, and expressly so, will be hailed as leaders when the pendulum of privacy norms in our society swings the other way. That said — don't hold your breath for Congress .

No momentum for change — actors like Verizon and Google have historically determined the future of surveillanceAgur 13 — Colin Agur, a PhD candidate in communications at Columbia University and a visiting fellow at Yale Law School’s Information Society Project, 2013 (“Negotiated Order: The Fourth Amendment, Telephone Surveillance, and Social Interactions, 1878-1968,” Information & Culture: A Journal of History, Volume 48, Number 4, Available Online to Subscribing Institutions via Project Muse)

For researchers of telecommunications and the law, the history of telephone surveillance offers important lessons. In telephone surveillance [End of p. 441] we see how decisions by actors gave a device a particular social meaning and how that meaning evolved over time and space thanks to an ongoing negotiation process among the key actors. Human agency played a significant role in the formation of rules on telephone surveillance, and the social organization that emerged in the late 1960s was the result of a long-term negotiation involving a wide range of participants. Thus, rather than a case of a technology determining or (in the words of Thomas Hughes) giving “momentum” to a set of social changes,112 the jurisprudence governing telephone surveillance has been constructed by those who were able to establish practices and norms in telephony. In our efforts to understand the negotiation of telephone surveillance law and Fourth Amendment jurisprudence, Balkin’s theory of cultural software serves us well. By examining a long-term economy of exchange involving technological, institutional, and cultural inputs, we can understand the social organization of the law. And by focusing on the negotiations and contexts in which they took place, we can understand the role of ideology in institutional practices, Supreme Court decisions, and legislation. At the same time, the history of telephone surveillance law helps us see the limitations of ideology and the importance of human agency. The actions of key agents, from engineers to administrators to lawmakers to judges, each contributed to ideology, which in turn shaped the evolution of Fourth Amendment jurisprudence.

They Say: “Link Non-Unique — NFA”The link is unique — the New Freedom Act allowed momentum to dissipate and extended 215Raimondo 14 — Justin Raimondo, an American author and the editorial director of Antiwar.com, 2014 ("The ‘USA Freedom Act’ Is A Fraud," Antiwar.com, November 17th, Available Online at http://original.antiwar.com/justin/2014/11/16/the-usa-freedom-act-is-a-fraud/, Accessed 7-21-2015)Some civil liberties groups, like the ACLU and the Electronic Frontier Foundation, argue that the present bill is "a first step," and is better than nothing. This is nonsense: this bill is worse than nothing. With the passage of the USA Freedom Act the momentum for real reform will be blunted and allowed to dissipate . Further efforts to roll back the awful power of the NSA will be met with cries of "Didn’t we already do this?" If this bill passes, the Washington insiders will win out, and the Surveillance State will remain intact – arguably even more powerful than before.Some may say: But aren’t you taking an all-or-nothing attitude? The answer is: not at all. A real reform means a partial reining in of the NSA, with no new extensions of its reach. This bill includes a full-scale codification of abuses coupled with ambiguous and easily reinterpreted "reforms" that don’t mean what they appear to mean.

New surveillance reform reaffirms a changing political climateThe Hill 15 — The Hill, 2015 (“Spy critics eye next targets,” Byline Julian Hattem, June 4 th, Available Online to Subscribing Institutions via Lexis-Nexis, Accessed 07-14-2015)Critics of government surveillance hope they're in the middle of a sea change.Passage of legislation this week to rein in the National Security Agency was the first major congressional action to limit government spying in a generation, and it was a move away from the aggressive national security measures put in place after the Sept. 11, 2001 attacks.But whether the congressional view of surveillance has changed for good remains to be seen , with the battle over NSA reform set to play out again during the 2016 race for the White House.Civil libertarians on both sides of the aisle vowed to harness the momentum of their victory on the USA Freedom Act to push for other protections."This is only the beginning," said Sen. Ron Wyden (D-Ore.), one of Congress's most vocal privacy hawks. "There's a lot more to do."The USA Freedom Act renews Section 215 of the Patriot Act and two other provisions that had expired on Monday morning. But in doing so, it also ends the NSA's bulk collection of U.S. phone records and other data.The bill reauthorizes the Patriot Act provisions through Dec. 15, 2019, setting the stage for another showdown during the next administration.But civil libertarians want to go much further to curb government spying.

2NC/1NR Materials — Vaccine Surveillance

Uniqueness – Surveillance now good Vaccination surveillance solves preventable disease now – surveillance is key to refining coverage goals, effectiveness, and research. Smith et al 11 – Philip J. Smith, PhD, Professor of Chemical Engineering at the University of Utah; David Wood, MD, nationally and internationally recognized cancer surgeon; and Paul M. Darden, MDc, General Pediatrics Professor and Section Chief at the College Of Medicine/Peds at the University of Oklahoma, 2011 (“Highlights of Historical Events Leading to National Surveillance of Vaccination Coverage in the United States”, National Center for Biotechnology Information, Available Online at h http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3113425/, accessed 7/14/15, KM) **edited for gendered language

The number of cases of most vaccine-preventable diseases is at an all-time low,147 and hospitalizations and deaths from these diseases have also shown striking decreases. Our national vaccine recommendations in the

U.S. target an increasing number of vaccine-preventable diseases for reduction, elimination, or eradication.148 This success has been achieved at least in part because vaccination coverage among young children in the U.S. has reached record highs with estimated national coverage that exceeds 90% for many recommended vaccines.110 Achievement of this success has been due in part to the assessment of vaccination coverage. Assessment enables vaccination program managers to learn the extent to which their efforts have achieved vaccination coverage goals and to implement interventions or change policies to improve coverage. Also,

assessment is an essential component in evaluating vaccine effectiveness, examining the relationship between increased coverage and population disease burden, monitoring vaccine safety, and studying public perceptions about vaccines. Across the U.S., both the rich and poor149 live with little concern for many infectious diseases

because of the great effort and sacrifice that has been made to develop and implement vaccination programs.150 For the first time in

the history of humankind, there is a nation where there is freedom from the fear of illness or death from what

were formerly endemic killer diseases. Maintenance of that freedom depends, in part, on remembering what has gone before us, removing the barriers that remain in affording access to safe and effective vaccines for all people, using science to discover ways to prevent

other diseases we have not yet conquered, and remaining diligent about knowing where we are through continued assessment of how well the nation is protected from vaccine-preventable diseases.

Link – Surveillance/trackingSurveillance and tracking is key to effective vaccination – polio proves. Ahmed 15 – Beenish Ahmed, World Reporter at ThinkProgress, former NPR Kroc Fellow, holds an MPhil in Modern South Asian Studies from the University of Cambridge as a Fulbright Scholar to the United Kingdom, 2015 (“How One Country Deals With Anti-Vaxxers: Arrest Them”, Think Progress, March 4, Available Online at http://thinkprogress.org/world/2015/03/04/3629337/pakistan-polio-arrests/, accessed 7/14/15, KM)

Last year while I was in Pakistan, a bus I took from Peshawar to Islamabad was hailed down by a small team of polio vaccinators. This wasn’t surprising – we had after all, left a city the World Health Organization has called the single “largest reservoir” of the polio virus – but what proceeded seemed to undermine any hope that the disease which has been eradicated in most of the world can be fully snubbed out in Pakistan. The bus driver pulled over to a small gravel patch just as stretches of mustard fields and mud huts turned into modern walled bungalows with tidy little gardens. The vaccinator who had hailed us down strode over, pulled open the door, and pointed at two small children clinging sleepily to their mothers in the first row of seats. “Have your kids been given drops?” one of the health workers asked, using a general term for polio vaccines, which are to administered orally for times before a child turns six. The two women nodded. “My son was given drops at school,” one woman added for good measure. “All right,” the vaccinator said, “You can go.” He slammed the sliding door closed and tapped on it twice. With that, the bus rumbled away from the city from which a full 90 percent of polio cases in Pakistan and where the majority of cases in Afghanistan originated in 2013. Along with Nigeria, the two neighboring countries of Pakistan and Afghanistan are the last hold-outs against full vaccination against the virus which can forever cripple or even kill its victims. Given the dire situation, authorities are taking more severe measures to combat the spread of the disease. On Tuesday, police in Peshawar arrested more than 450 parents for refusing to vaccinate their children against polio. “[The arrests were] the last resort as there was no other option. There is a lot of pressure on the local administration to tackle these refusals,” Pervez Kamal Khan, the head of health services in the province of Khyber Pakhtunkhwa said. According to national

figures, 60,000 children have not received the polio vaccine because their parents did not consent to it. Among the three countries where polio is endemic, Pakistan is the worst at containing the spread of polio – not least because of a violent campaign on the part of terrorist groups to kill polio vaccinators and to discredit the actual intention of the polio vaccine. The threat posed by groups like the Taliban is not to be understated: it’s estimated that more than twice as many people were killed while administering the vaccine

than people who died because of polio last year. Still, militant attacks and extremist ideologies are not the only reason Pakistan has struggled to eradicate polio. It’s also just hard to keep tabs on which children have been vaccinated and which have not as I saw firsthand on that bus to Islamabad last spring. The vaccinator didn’t ask for identification numbers for the children. He didn’t ask for the vaccination documents children are given when they are vaccinated. He simply took their

mothers’ responses as the truth – and, in so doing, may have let two cases of the highly contagious disease infect others. “Surveillance underpins the entire polio eradication initiative,” notes the Polio Global Eradication Initiative. “Without surveillance, it would be impossible to pinpoint where and how wild polio virus is still circulating, or to verify when the virus has been eradicated in the wild.” And yet, from what I saw while in Pakistan, very little in the way of

surveillance is actually taking place. Polio vaccinators risk their lives to prevent children from developing the virus, but without tracking who they reach, their work – and their deaths – may all be in vain.

National surveillance and data collection is crucial to solving preventable disease – disease reporting, vaccination history, hospital records, and medical databases are all surveillance techniques that are necessary and sufficient. Roush 14 – Sandra Roush, MT, MPH, Surveillance Officer for the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, former Director of the Florida Hepatitis and Liver Failure Prevention and Control Program in the Florida Department of Health, 2014 (“Chapter 19: Enhancing Surveillance”, Center For Disease Control and Prevention, April 1, Available Online at http://www.cdc.gov/vaccines/pubs/surv-manual/chpt19-enhancing-surv.html, accessed 7/14/15, KM)

Surveillance activities are critical to detecting vaccine-preventable diseases and gaining information to help control or address a problem. However, complete and accurate reporting of cases is dependent on many factors, such as reporting source, timeliness of investigation, and completeness of data. In addition, various methods for conducting surveillance are used to collect information, depending on disease incidence, specificity of clinical presentation, available laboratory testing, control strategies, public health goals, and stage of vaccination program. For vaccine-preventable diseases, passive surveillance is the most common method, although active surveillance may be needed in special surveillance situations. Active surveillance is often short-term and usually requires more funding

than passive surveillance. Common systems used for disease surveillance include national notifiable disease reporting; physician, hospital, or laboratory-based surveillance, population-based surveillance.[1] Sentinel surveillance involves a limited number of recruited participants, such as healthcare providers or hospitals, that report specified health events that may be

generalizable to the whole population.[2] The National Notifiable Diseases Surveillance System (NNDSS)[3] is the passive surveillance system that includes all the diseases and conditions under national surveillance. Efforts are being made to integrate and enhance the surveillance systems for national notifiable diseases. A collaborative effort between CDC and state and local health departments is in progress to enhance surveillance system capabilities with the implementation of the National Electronic Disease Surveillance System (NEDSS).[4,5,6] NEDSS will eventually replace the National Electronic Telecommunications System for Surveillance (NETSS) and will become the electronic system used to report national notifiable diseases and conditions in the United States and territories. Enhancing the surveillance system is only one part of improving surveillance data; data for notifiable diseases are still dependent on reporting, timeliness and completeness. This chapter outlines activities that may be useful at the state and local level to improve reporting for vaccine-preventable diseases. Some are more routinely used (encouraging provider reporting), while others, such as searching laboratory or hospital records, may be more helpful under certain circumstances. Encouraging Provider Reporting Most infectious disease surveillance systems rely on receipt of case reports from healthcare providers and laboratories.[7-8] These data are usually incomplete and may not be representative of certain populations; completeness of reporting has been estimated to vary from 6% to 90% for many of the common notifiable diseases.[9] However, if the level of completeness is consistent, these

data provide an important source of information regarding disease trends and characteristics of the persons affected. Some mechanisms to encourage healthcare provider reporting are described here. Promoting awareness of the occurrence of vaccine-preventable diseases Some healthcare providers may be particularly likely to encounter patients with vaccine-preventable diseases. For example, they may see immigrants and travelers returning from areas where vaccine-preventable diseases are endemic. Promoting awareness of reporting requirements Although there is a list of diseases designated as nationally notifiable by the Council of State and Territorial Epidemiologists in conjunction with CDC,[10-11] each state has laws or regulations stipulating which diseases are reportable.[7][11] Efforts should be made to increase healthcare providers’ awareness of their responsibility to report suspected cases.[12-16] The list of reportable diseases with detailed instructions explaining how, when, and to whom to report cases should be widely distributed within each state. Mailings, e-mail list serves, websites, in-service and other continuing education courses, and individual provider interaction may be used to accomplish this goal. However, while these are all examples of possible methods to raise awareness of reporting requirements, studies of interventions have demonstrated that telephone and other personal contact with individual healthcare providers, rather than groups, is most effective.[17] For example, interaction with healthcare providers in the Vaccines for Children program offers an opportunity to promote awareness of reporting requirements. Face-to-face communication is the most direct and dynamic means of communication, allowing feedback and responses to overcome objections and concerns.[18] A study on mandatory chronic disease reporting by physicians suggests that public health should emphasize both the legal and public health bases for reporting.[19] Giving frequent and relevant feedback Providing regular feedback to healthcare providers and others who report cases of vaccine-preventable diseases reinforces the importance of participating in public health surveillance.[20] Feedback should be timely, informative, interesting, and relevant to the provider’s practice. Ideally, it should include information on disease patterns and disease control activities in the area. Some examples of methods of providing feedback are monthly newsletters, e-mail list serves, regular oral reports at clinical conferences such as hospital grand rounds, or regular reports in local or state medical society publications. Contact with individual providers may be most effective. Examples of positive individual interaction for giving feedback on disease reporting include the following: Providing feedback to the provider on the epidemiologic investigations conducted for their patients; Providing feedback to the provider, in addition to the laboratory, for any cases that were first reported to the health department by the laboratory (or other source); Using every professional interaction with the provider to at least briefly discuss surveillance issues. Simplifying reporting Reporting should be as simple and as painless as possible for the healthcare provider. State health department personnel should be easily accessible and willing to receive telephone reports and answer questions. Reporting instructions should be simple, clear, and widely distributed to those who are responsible for disease reporting. Ensuring Adequate Case Investigation Detailed and adequate case information is crucial for preventing continued spread of the disease or changing current disease control programs. The following steps are essential to ensuring adequate case investigation. Obtaining accurate clinical information During a case investigation, clinical information (e.g., date of symptom onset, signs and symptoms of disease) about a case-patient is often obtained by a retrospective review of medical records and interviews with the case-patient, family, friends, caretakers, and other close associates of the case-patient. Detailed and accurate information (e.g., date of onset, laboratory results, duration of symptoms) may indicate the source of the infection and possible contacts, allowing interventions to prevent the spread of disease. This clinical information also may be aggregated by disease to study

other aspects of the diseases (e.g., trends, incidence, prevalence). For vaccine-preventable diseases, vaccination history is particularly important for determining whether the case represents a vaccine failure or a failure to vaccinate. In addition to medical and school records, the state’s immunization registry may be used to provide the most complete vaccination history information. Obtaining

appropriate laboratory specimens Efforts should be taken to ensure that healthcare providers obtain necessary and appropriate laboratory specimens. For example, specimens for bacterial cultures should be taken before administering antibiotics, and paired sera are often required for meaningful serologic testing. For more information on laboratory support for vaccine-preventable disease surveillance, see Chapter 22, “Laboratory Support for the Surveillance of Vaccine-Preventable Diseases.” Ensuring access to essential laboratory capacity Availability of laboratory testing needed to confirm cases of vaccine-preventable diseases must be assured. Additional testing, such as serotype, serogroup, and molecular testing provides epidemiologically important information that can support disease control and prevention activities. Healthcare providers should be encouraged to contact the local or state health department for assistance in obtaining appropriate laboratory testing. Laboratory testing needed to confirm diagnoses of public health significance is a public responsibility and should be made available at no cost to the patient. For information on laboratory support available in individual states, contact the state health department. Investigating contacts Identification of all case contacts and follow-up of susceptible persons may reveal previously undiagnosed and unreported cases. This investigation will also reveal persons eligible for any indicated prophylaxis, thereby facilitating disease control efforts.[21] Improving the Completeness of Reporting Complete reporting involves accounting for as many cases of vaccine-preventable diseases as is possible. Completeness of reporting can be enhanced in many ways,[22] including using electronic laboratory reporting,[23-28] searching hospital and

laboratory records, using administrative datasets, and expanding sources of reporting. Searching hospital and laboratory records For some vaccine-preventable diseases, a regular search of laboratory records for virus isolations or bacterial cultures may reveal previously

unreported cases.[13] Likewise, hospital discharge records may also be reviewed for specific discharge diagnoses,[12], [27] such as Haemophilus influenzae meningitis, tetanus, and other vaccine-preventable diseases. Such searches may assist in evaluating completeness of reporting and may help improve reporting in the future.[20],

[30] Identifying the source of missed cases may lead to modifications that make the surveillance system more effective and complete. Although not a substitute for timely reporting of suspected cases, such searches can supplement reporting when resources

for more active surveillance are unavailable. Using administrative datasets Administrative datasets, such as Medicare or Medicaid

databases or managed care organization databases, may be useful for surveillance; when linked to immunization records, administrative records have been useful for monitoring rare adverse events following vaccination.[31-32] However, unless extensive efforts are made to validate diagnoses, misclassification is likely.[33] Most vaccine-preventable diseases are now rare, and data quality may be insufficient for these datasets to be useful adjuncts to vaccine-preventable disease surveillance.[34]

2NC/1NR Materials — Vaccine Culture of Rights

Uniqueness – pro-vaccination trends now Pro-vaccination movement gaining steam now – plan reverses the trend. Alcindor 14 – Yamiche Alcindor, USA TODAY national breaking news reporter, holds a Master's degree in Broadcast News and Documentary Filmmaking from New York University and BA in English and International Relations from Georgetown University, 2014 (“Anti-vaccine movement is giving diseases a 2nd life”, USA Today, April 8, Available Online at http://www.usatoday.com/story/news/nation/2014/04/06/anti-vaccine-movement-is-giving-diseases-a-2nd-life/7007955/, accessed 7/20/15, KM)

Now Mitchell, who takes care of her son full time, and Jeremiah, who faces more reconstructive surgeries, work with Meningitis Angels, a non-

profit that supports families affected by bacterial meningitis and advocates for vaccinations. Other organizations including the National

Meningitis Association, Every Child By Two, and PKIDs combine personal stories and scientific evidence to encourage vaccinations. From the medical side of the equation, some physicians have resorted to their own defenses to protect their patients from those who won't vaccinate. Doctors at Olde Towne Pediatrics in Manassas, Va., won't take new patients if the parents don't plan to vaccinate their children. It's not clear how many other physicians do the same, as experts say no comprehensive studies of the practice have been done. "We don't want to put our patients at risk because people for their own personal reasons don't want to vaccinate," said Anastasia Williams, a managing partner of the practice who has been a

pediatrician for 15 years. "We are doing our due diligence to protect our children who wait in our waiting room." Several states have also worked to make getting an exemption tougher. In Colorado, where 4% of kindergartners last year didn't have their

shots for non-medical reasons, a proposed bill sponsored by State Rep. Dan Pabon, a Democrat from Denver, would require parents to get a doctor's note or watch a video about risks before opting out of vaccines. VACCINE SKEPTICS

Such measures offend Sarah Pope, a Tampa mother of three, and Shane Ellison, a father of three in Los Angeles. They both decided against vaccinating their kids because they fear the potential side effects. In 2006, all three of Pope's children — now 9, 11 and 15 — contracted whooping cough, the same disease that killed Brady. Seven years earlier, Pope had decided against vaccinating any of her children. After seven weeks of coughing, and with treatment by a holistic doctor and natural supplements, all three recovered without complications, she says. "I wasn't scared by it," says Pope, 49, who runs The Healthy Home Economist, a healthy living website and blogs about

vaccines. "People only see the bad with infectious diseases. But infectious diseases do help children strengthen their bodies." Pope and Ellison say it is unfair to pressure parents into using vaccines that aren't 100% effective. However, doctors note that all drugs — even aspirin — have risks, and none is 100% effective. High vaccination rates can protect even unvaccinated people by lowering the level of infectious disease in the community, a phenomenon known as herd immunity, says Hinman, a senior public health scientist at the Task Force for Global Health. The more people who are vaccinated, the less likely anyone in that community will be infected. Though vaccines are considered safe, Schuchat points out that they can cause reactions in some children, which in rare cases can be serious. But one of the most publicized fears of the anti-vaccine movement — that they cause autism — has been debunked by dozens of studies that have found no link. Even so, parents like Ellison, 39, don't buy it, and he points out that he comes to the issue with some expertise: He has a master's degree in organic chemistry and used to work in the pharmaceutical industry designing medicines. His children — 6 months old, 8 and 12 — were all born at home. Aside from one visit to an emergency room for a bruised finger, none of them has ever been to a doctor, and they're all healthy, he says, except for the occasional sore throat or common cold. "The doctors all have the same script for vaccines," says Ellison, who runs The People's Chemist, a website about health. He is working to build and support his children's natural immune system using three healthy meals a day, exercise and sunshine. He says if his kids get sick he would rather rely on emergency care than vaccines. "It's much more soothing to trust emergency medicine than a vaccine, which for me is like playing Russian roulette," he says.

Preventable diseases are making a comeback – numerous areas are potential hotspots – the amount of influence of the anti-vax movement is the critical factor. Alcindor 14 – Yamiche Alcindor, USA TODAY national breaking news reporter, holds a Master's degree in Broadcast News and Documentary Filmmaking from New York University and BA in English and International Relations from Georgetown University, 2014 (“Anti-vaccine movement is giving diseases a 2nd life”, USA Today, April 8, Available Online at

http://www.usatoday.com/story/news/nation/2014/04/06/anti-vaccine-movement-is-giving-diseases-a-2nd-life/7007955/, accessed 7/20/15, KM) Kathryn Riffenburg decided on a closed casket for her baby's funeral. She didn't want her family to see what whooping cough, her son's first illness, had done to 9-week-old Brady Alcaide. The nearly forgotten disease, which has in recent years afflicted thousands of Americans, left Brady's tiny body swollen and unrecognizable. So his mother dressed him in a white baptismal suit and hat and tucked him into a tiny white casket. Brady's burial came just four weeks after his first laugh — inspired by her version of I'm a Little Teapot — and two weeks after his family learned that he had contracted a vaccine-preventable illness. "It just seemed like it was impossible," says Riffenburg, 31, of Chicopee, Mass. "It felt like we were dropped in The Wizard of Oz. We went from sitting in the hospital day by day, waiting for him to get better for almost two weeks, to doctors telling us we had a 50/50 chance he was going to make it." The mother, who was inoculated years before giving birth to Brady, later learned that she could have gotten a booster shot during her pregnancy that likely would have saved Brady's life. Although

Riffenburg didn't know to get revaccinated, people actively choosing not to are helping diseases once largely relegated to the pages of history books — including measles — make a comeback in cities across the nation, according to the Centers for Disease Control and Prevention. Recent measles outbreaks in New York, California and Texas are examples of what could happen on a larger scale if vaccination rates dropped, says Anne Schuchat, the CDC's director of immunizations and respiratory diseases. Officials declared measles, which causes itchy rashes and fevers,

eradicated in the United States in 2000. Yet this year, the disease is on track to infect three times as many people as in 2009. That's because in most cases people who have not been vaccinated are getting infected by others traveling into the United States. Then, Schuchat says, the infected spread it in their communities. The 189 cases of measles in the U.S. last year is small compared with the 530,000 cases the country used to see on average each year in the 20th

century. But, the disease — which started to wane when a vaccine was introduced in 1967 — is one of the most contagious in the world and could quickly go from sporadic nuisance to widespread killer. Measles kills about once in every

1,000 cases. As cases mount, so does the risk. "We really don't want a child to die from measles, but it's almost inevitable," says Schuchat. "Major resurgences of diseases can sneak up on us." Michaela Mitchell watches her son Jeremiah, 10, play Xbox in his bedroom in Tulsa. Mitchell is teaching Jeremiah how to live again after meningitis contracted from an outbreak at his school forced doctors to amputate both his arms and legs.Michaela Mitchell watches her son Jeremiah, 10, play Xbox in his bedroom in Tulsa. Mitchell is teaching Jeremiah how to live again after meningitis contracted from an outbreak at his school forced doctors to amputate both his arms and legs. Vaccination rates against most diseases are about 90%. Fewer than 1% of Americans forgo all vaccinations,

Schuchat says. Even so, in some states the anti-vaccine movement, aided by religious and philosophical state exemptions, is growing, says Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia. He points to states like Idaho, Illinois, Michigan, Oregon and Vermont — where more than 4.5% of kindergartners last year were unvaccinated for non-medical reasons

— as examples of potential hot spots. Such states' rates are four times the national average and illustrate a trend among select groups. "People assume this will never happen to them until it happens to them," Offit says. "It's a shame that's the way we have to learn the lesson.

There's a human price for that lesson." The most vulnerable are infants who may be too young to be vaccinated, children with compromised immune systems and others who may be unable to be vaccinated for medical reasons, scientists say. In communities across the nation, Americans of all stripes are making dangerous decisions to reschedule or forgo immunization, says Alan Hinman, a scientist who sits on the scientific advisory board of Voices for Vaccines, which supports and advocates for on-time vaccinations. The anti-vaccination movement has picked up steam in the past decade with support from celebrities such as actress Jenny McCarthy, actor Aidan Quinn and reality TV star Kristin Cavallari, who last month said not vaccinating was "the best decision" for her children. Many continue to believe the debunked idea that vaccines cause autism, while others don't trust the federal government or the pharmaceutical companies responsible for these vaccines. DISEASE CAN STRIKE ANYWHERE Riffenburg hopes her family's experience will serve as a wake-up call. At first, Brady seemed to have a simple cold. As his symptoms worsened, Riffenburg and her fiancé, Jonathan Alcaide, took him to the hospital, where doctors suspected he had whooping cough. Two weeks later, Brady stopped breathing. His brain was without oxygen for some time, and he was put on life support, where Riffenburg said the horrific effects of the disease made her child become unrecognizable. A day later, she made the excruciating decision to take him off machines. The child died while cradled in her arms. "I hope Brady has saved babies and protected them because we have spread his story," RIffenburg says. Since then, Riffenburg has made sure that her fiancé and her two daughters, now 7 and 10, get all of their booster shots. She was also inoculated while pregnant with her now 1-year-old son, Jaxon. And she insisted everyone — including doctors, family members and even the hospital photographer — got booster shots before they came near Jaxon. It is not clear where Brady contracted whooping cough. Schuchat says

that is precisely why communities must maintain high vaccination rates. Many might not know they are carrying a disease but can still be contagious and pass it on before symptoms arrive. "It doesn't have to be on an airplane or at an airport. It could be at a grocery store or the concert you went to," Schuchat says. During a 2008 measles outbreak in San Diego, CDC officials were shocked to find school districts where one in five children were not vaccinated against the disease, she says. Last year,

California had the largest number of unprotected kindergartners not vaccinated for their parents' philosophical reasons: 14,921. This year, 49 cases of measles had been reported by March. The state had four cases by that time last year.

Uniqueness – Yes influenceChanging the minds of anti-vaccination parents is possible – now is key. Palmer 15 – Katie Palmer, senior associate editor at Wired covering science and health, member of the Science, Health and Environmental Reporting Program (SHERP) at NYU's Arthur L. Carter Journalism Institute, recipient of the Jeffrey Owen Jones Fellowship in Journalism, 2015 (“How to Get Silicon Valley’s Anti-Vaxxers to Change Their Minds”, Wired, February 12, Available Online at http://www.wired.com/2015/02/get-silicon-valleys-unvaccinated-change-minds/, accessed 7/22/15, KM)

THERE’S BEEN A lot of shaming and blaming of the anti-vaccination crowd in response to the Disneyland measles outbreak ( even we did it). And when we released our investigation of vaccination rates at Silicon Valley preschools, people were justifiably angry: Every unvaccinated kid at

those schools threatens the greater community’s protection against disease. But yelling at anti-vaxxers won’t change their minds—which is what we need most to prevent more outbreaks. That begs the question: What can turn them around? After writing about how vaccinated people got measles in California, I read the comments posted about it on Facebook. Among the anti-vax commenters, there were a few science-hating, vitriol-slinging, homeopathy-hawking kooks. But the vast majority were…

reasonable. Take this person, for example: Someone strong enough to get the vaccine (and thus be conferred limited immunity for 2-10 years) is likely strong enough to handle the disease and consequently have real life-long immunity, which is what is really needed for “herd immunity” to actually work. This person is wrong, of course, but there’s some science—or at least some attempts at using science—in there. It’s

worth repeating, clearly: Refusing vaccines is a bad choice, but anti-vaxxers aren’t evil for making that choice. Every parent who turns down a vaccine is simply trying to make the right decision for their kid. As long as that motivation exists, there’s a chance that a parent can be convinced that vaccination is the safest choice—for their child, and those around them. To figure out how to turn that “no” into a “yes,” it’s important to know how

that decision occurred in the first place. As Amy Wallace explained in a WIRED cover story, vaccine refusal comes down to one emotion: fear. Or, in the current environment, the lack of it. Thanks to the success of vaccination programs, many Americans have never seen a single case of measles—they didn’t get it themselves, and probably don’t know anyone who’s had it. That interferes with how they process fear in two ways. Number one, we get responses like this one (from that same story, on Facebook): Measles is not a dangerous disease, it is just a normal childhood disease, it’s safer to get antibodies from the actual virus than from vaccines. Unvaccinated children have higher and stronger immune systems, so they fight it fast… Measles has, for many, become a hypothetical disease. And a hypothetical disease isn’t scary. “People become desensitized to the seriousness of the disease when they’re not exposed,” says Kristin Hendrix, a pediatric researcher at Indiana University School of Medicine. Measles was eradicated in the US in 2000, so even if you’ve seen a case, you probably haven’t met someone who pulled the short straw: The one person in 10 who gets an ear infection, potentially resulting in deafness, or the one in 20 who gets pneumonia, or the one in 1,000 who develops encephalitis—or dies. Which leads us to number two. The risk of vaccines—the one in 3,000 chance of seizure for the MMR, or the one in more than a million chance of a serious allergic reaction—starts to seem much bigger in comparison to those fading memories of measles past. “Parents can be scared very easily by hearing about potentially negative consequences,” says Gary Freed, a pediatric researcher at the University of Michigan. And the act of stabbing your kid in the arm with a needle is far more immediately threatening than the potential exposure to measles, especially if you’re counting on her not being exposed to the disease in the first place. My husband nearly died from the tetanus vaccine when he was a kid. Fear is a powerful, often irrational emotion. No matter how many times you drive home the statistical near-impossibility of a negative vaccine reaction, it’s often overlooked in the face of a personal anecdote. If someone has a relative who had a bad reaction to a vaccine—or even a great-aunt on Facebook whose friend’s daughter became withdrawn after one—the immediacy of that story will carry more cognitive weight than numbers. Humans are big on narrative. Science (usually) is not. So now, medical professionals and researchers must figure out how to use information—cold, impersonal facts—in a way that can counteract the power of that primal (and inaccurate) risk calculation. That job is far harder than it used to be. Doctors once were the primary source of medical information, but now it’s everywhere online—some of it true, some of it not, and the vast majority somewhere in between. That’s a problem, because humans suffer from a major case of confirmation bias. “We seek out and gravitate toward information that confirms what we know to be true,” says Hendrix. Sometimes confirmation bias is so extreme that it even turns positive messages into negative ones: One paper last year found that while pro-vaccine information corrected some misperceptions about vaccines—like the fallacy that it

causes autism—reading it actually made some resolutely anti-vax parents even less likely to vaccinate. Unfortunately, recent research has shown that presenting provaccine messages and evidence to anti-vaxers only makes them become more ingrained in their misguided beliefs. Researchers don’t have any great ideas about how to change the

“stickiness” of bad information once it gets that distorted. But there’s hope. There always have been a certain number of staunchly anti-

vaccine parents—researchers estimate about 2 percent of parents fall into that camp, and that number isn’t changing much. It’s a second

group of parents and patients—the so-called vaccine-hesitant—that are the ones fueling the fire of vaccine refusal.

But they’re also the ones that still may be open to change . Doug Opel is a pediatrician at Seattle Children’s Hospital

working to target those fence-sitters with individually tailored information. “Parents themselves can have a hard time knowing where they are, or they don’t fully disclose what they think about vaccines in an appointment,” says Opel. “That turns a pediatric appointment into a chess match.” Opel’s shot at a solution is a 15-question survey that gives parents a score on a scale of 0 to 100—over 50, and you’re much less likely to vaccinate. He’s most interested in targeting parents in that 50-to-80 range, by addressing their specific concerns in one-on-one conversations instead of relying solely on an impersonal Vaccine Information Statement from the CDC. It’s not an easy job: Any conversation he has with a parent is going head-to-head with personal horror stories from Facebook friends and anti-vaccine celebrities. “We know that personal narratives and anecdotes that are emotionally laden are very persuasive,” says Hendrix, “and that people play into fear-based information more than positive information.” Anti-vaccine stories are so powerful because they capitalize on both of those persuasive

techniques. But two can play at that game. With this major outbreak—which has racked up 103 cases at last count—to play into the fear of parents, and a potent narrative to boot (Wow, we’re not even safe in the Happiest Place on

Earth), this might just be a pro-vaccine story that can change some minds. “Normally, pro-vaccine messages don’t have the splash and the buzz of a crisis,” says Freed. “Now we do.” It may just be that the anti-vaccine movement has created the outbreak that could kill it.

Pro-vaccination is changing minds – recent California measles outbreak is persuading “vaccine-hesitant” parents to get vaccinated. Frankel 15 – Todd Frankel, reporter for the Washington Post, teaches journalism at University of Washington-St. Louis, won several journalism awards, including a National Headliners Award, Livingston Award finalist, and a member of the 2009 Pulitzer Prize finalist team for breaking new, 2015 (“Forget ‘anti-vaxxers.’ The Disney measles outbreak could change the minds of an even more crucial group.”, The Washington Post, January 26, Available Online at http://www.washingtonpost.com/news/storyline/wp/2015/01/26/forget-anti-vaxxers-the-disney-measles-outbreak-could-change-the-minds-of-an-even-more-crucial-group/, accessed 7/22/15, KM)

The child was behind on her vaccinations. Wendy Sue Swanson took note of this as she talked with the girl’s parents last week at a medical

clinic in Mill Creek, Wash., outside Seattle. Swanson, like many pediatricians, sometimes needed to coax parents to get the shots for their children. A few might be unmovable in their objections. But most were like this couple: A mom and dad who might harbor doubts or were just behind schedule. They were at least willing to listen. Now, Swanson had a new way to prod parents like them: Discussing the Disney measles outbreak in California, which has spread to at least 68 people in 11 states since Jan. 1 and raised alarms about the reemergence of a disease once considered all but vanquished. There was something powerful about the disease hitting a popular, recognizable vacation spot.

The girl got her vaccination. Her parents were on board. “Their eagerness was different,” Swanson said later. “I think it is changing people.” Much of the scrutiny in the Disney measles outbreak has fallen on an entrenched anti-vaccination movement in places such as Orange County, Calif., home to the two Disney theme parks where the outbreak gained its foothold.

These “anti-vaxxers” are viewed as dead-set against vaccinations. But doctors believe the current outbreak could change the minds of a less-known but even larger group: parents who remain on the fence about the shots. These “vaccine-hesitant” parents have some doubt about vaccinations, leading them to question or skip some shots, stagger their delivery or delay them beyond the recommended schedule. An estimated 5 to 11 percent of U.S. parents have skipped at least one vaccination or delayed a shot, according to studies. That compares to only 1 to 3 percent of parents who object to all

vaccinations. Boosting compliance among the “vaccine hesitant” population could have major public health implications, doctors say, especially because last year the United States had its highest number of measles cases since 1977. The topic of “vaccine hesitant” patients has become the focus of a growing body of medical research in recent years. Doctors are trying to understand what triggers vaccine worries and which strategies work best for overcoming those fears. Doctors spend many office hours trying to convince these parents that the scientific evidence proves the shots are, in fact, safe and effective. But these hesitant parents have been bombarded by conflicting information. And they don’t view all of the shots the same way. The vaccine to protect against measles, mumps and

rubella faces particularly strong resistance as a result of thoroughly discredited studies linking the vaccine to autism. So some parents, even those generally open to other vaccines, push to delay or skip this one. The shot is supposed to be given at 12 months and again at age 4. “One of the problems that vaccines face now is they work too well,” said Michael Smith, a pediatric infectious disease specialist at the University of Louisville School of Medicine in Kentucky, who has studied vaccine-hesitant parents. Parents don’t have experience with measles, how children can become very ill and in rare cases suffer brain swelling or even die, Smith said. At the same time, these parents are confronted with stories about the unexplained rise in the U.S. autism rate. “I can understand as a parent why you’d skip the vaccine if you’d been convinced that it’s a

choice between giving my kids a shot or giving my kid autism,” Smith said. But the Disney outbreak changes the discussion. Now, doctors have an event to point to. The threat is no longer abstract or distant. “This is definitely going to be a talking point that pediatricians should keep in their back pockets,” Smith said. Studies have shown that “anti-vaxxer” parents are likely to remain steadfast in their opposition. Barbara Loe Fisher, president of the National Vaccine Information Center, a group that raises doubts about the shots, said she was not convinced that the Disney outbreak was even a story about the dangers of being unvaccinated. “I don’t think we know completely what’s going on,” Fisher said. But physicians such as Kathryn Edwards of the Vanderbilt Vaccine Research Program said the measles vaccine is at least 99 percent effective after the second dose. And measles is one of the most communicable diseases, much more so than the flu. The dangers posed by the disease have been forgotten. Many U.S. doctors have never even seen it. Edwards still recalls the only patient she ever saw with measles, years ago when she was a medical resident. He died. “So I have a lot of respect for measles,” Edwards said. At Boston Children’s Hospital, pediatrician Claire McCarthy said she is always happy when parents decide to vaccinate their children against measles in particular. She worries about the current situation in California. And she plans to use the Disney outbreak to try to convince hesitant parents that vaccinations are the right choice. “I am planning on talking this one up a lot with families,” McCarthy said. “I think this probably will make a difference.”

Uniqueness booster – anti-vaccination brink

Anti-vaccination movement is gaining momentum now – that’s leading to outbreaks of preventable disease – case studies prove the long-term effects will be catastrophic. Offit 14 – Paul Offit, American pediatrician specializing in infectious diseases and an expert on vaccines, immunology, and virology; co-inventor of a rotavirus vaccine that has been credited with saving hundreds of lives every day; Maurice R. Hilleman Professor of Vaccinology and Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania; Chief of the Division of Infectious Diseases; member of the Centers for Disease Control (CDC) Advisory Committee on Immunization Practices; Founding Board Member of the Autism Science Foundation, 2014 (“The Anti-Vaccination Epidemic”, Wall Street Journal, September 24, Available Online at http://www.wsj.com/articles/paul-a-offit-the-anti-vaccination-epidemic-1411598408, accessed 7/20/15, KM)

Almost 8,000 cases of pertussis, better known as whooping cough, have been reported to California's Public Health

Department so far this year. More than 250 patients have been hospitalized, nearly all of them infants and young children, and 58 have

required intensive care. Why is this preventable respiratory infection making a comeback? In no small part thanks to low vaccination rates, as a story earlier this month in the Hollywood Reporter pointed out. The conversation about vaccination has changed. In the 1990s, when new vaccines were introduced, the news media were obsessed with the notion that vaccines might be doing more harm than good. The measles-mumps-rubella (MMR) vaccine might cause autism, we were told. Thimerosal, an ethyl-mercury containing preservative in some vaccines, might cause developmental delays. Too

many vaccines given too soon, the stories went, might overwhelm a child's immune system. Then those stories disappeared. One reason was that study after study showed that these concerns were ill-founded. Another was that the famous 1998 report claiming to show a link between vaccinations and autism was retracted by The Lancet, the medical journal that had published it. The study was not only spectacularly wrong, as more than a dozen studies have shown, but also fraudulent. The author, British surgeon Andrew

Wakefield, has since been stripped of his medical license. But the damage was done. Countless parents became afraid of vaccines. As a consequence, many parents now choose to delay, withhold, separate or space out vaccines. Some don't vaccinate their children at all. A 2006 study in the Journal of the American Medical Association showed that between 1991 and 2004, the percentage of children whose parents had chosen to opt out of vaccines increased by 6% a year, resulting in a more than twofold increase. Today the media are covering the next part of this story, the inevitable outbreaks of vaccine-preventable diseases, mostly among children who have not been vaccinated. Some of the parents who chose not to vaccinate were influenced by the original, inaccurate media coverage. For example, between 2009 and 2010 more than 3,500 cases of mumps were reported in New York City and surrounding area. In 2010 California experienced an outbreak of whooping cough larger than any outbreak there since 1947. Ten children died. In the first half of 2012, Washington suffered 2,520 cases of whooping cough, a 1,300% increase from the previous year and the largest outbreak in the state since 1942. As of Aug. 29, about 600 cases of measles have occurred in the U.S. in 2014: the largest outbreak in 20 years—in a country that the Centers for Disease Control and Prevention declared measles-free in 2000. Who is choosing not to vaccinate? The answer is surprising. The area with the most cases of whooping cough in California is Los Angeles County, and no group within that county has lower immunization rates than residents living between Malibu and Marina Del Rey, home to some of the wealthiest and most exclusive suburbs in the country. At the Kabbalah Children's Academy in Beverly Hills, 57% of children are unvaccinated. At the Waldorf Early Childhood Center in Santa Monica, it's 68%, according to the Hollywood Reporter's analysis of public-health data. These are the kind of immunization rates that can be found in Chad or South Sudan. But parents in Beverly Hills and Santa Monica see vaccines as unnatural—something that conflicts with their healthy lifestyle. And they have no problem finding fringe pediatricians willing to cater to their irrational beliefs. These parents are almost uniformly highly educated,

but they are making an uneducated choice. It's also a dangerous choice: Children not vaccinated against whooping cough are 24 times more likely to catch the disease. Furthermore, about 500,000 people in the U.S. can't be vaccinated, either because they are receiving chemotherapy for cancer or immune-suppressive therapies for chronic diseases, or because

they are too young. They depend on those around them to be vaccinated. Otherwise, they are often the first to suffer. And because no vaccine is 100% effective, everyone, even those who are vaccinated, is

at some risk. Parents might consider what has happened in other countries when large numbers of parents chose not to vaccinate their children. Japan, for example, which had virtually eliminated whooping cough by 1974,

suffered an anti-vaccine activist movement that caused vaccine rates to fall to 10% in 1976 from 80% in 1974. In 1979, more than 13,000 cases of whooping cough and 41 deaths occurred as a result. Another problem: We simply don't fear these diseases anymore. My parents' generation—children of the 1920s and 1930s—needed no convincing to vaccinate their children. They saw that whooping cough could kill as many as 8,000 babies a year. You didn't have to convince my generation—children of the 1950s and 1960s—to vaccinate our children. We had many of these diseases, like measles, mumps, rubella and chickenpox. But

young parents today don't see the effects of vaccine-preventable diseases and they didn't grow up with them. For them, vaccination has become an act of faith. Perhaps most upsetting was a recent study out of Seattle

Children's Hospital and the University of Washington. Researchers wanted to see whether the whooping cough epidemic of 2012 had inspired more people to vaccinate their children. So they studied rates of whooping cough immunization before, during and after the epidemic. No difference. One can only conclude

that the outbreak hadn't been large enough or frightening enough to change behavior—that not enough children had died. Because we're unwilling to learn from history, we are starting to relive it. And children are the victims of our ignorance. An ignorance that, ironically, is cloaked in education, wealth and privilege.

Vaccination critics are gaining influence – can even sway anti-vax legislation. Gumbel 15 – Andrew Gumbel, foreign correspondent for The Guardian in Europe, the Middle East, and the United States, 2015 (“US states face fierce protests from anti-vaccine activists”, The Guardian, April 10, Available Online at http://www.theguardian.com/us-news/2015/apr/10/anti-vaccine-protest-california-facts, accessed 7/20/15, KM)

Four months after a measles outbreak at Disneyland, state legislators seeking to tighten immunisation laws across the country are running the gauntlet of anti-vaccination activists who have bombarded them with emails and phone calls, heckled them at public meetings, harassed their staff, organized noisy marches and vilified them on social media. Three states blindsided by the activists’ sheer energy –

Oregon, Washington and North Carolina – have either pulled back or killed bills that would have ended a non-specific “personal belief” exemption for parents who don’t want to vaccinate their children. Now the battleground is California, which bore the brunt of the measles outbreak at the beginning of the year and saw school closures, extraordinary

quarantine measures and a vigorous public debate lamenting the fact that a disease declared eradicated 15 years ago is once again a

public health threat. A health committee meeting in Sacramento, the state capital, on Wednesday turned into a tense showdown between lawmakers seeking to argue that the science is unequivocally on the side of universal vaccination, and activists accusing them of being in the pocket of unscrupulous big pharmaceutical companies. One activist,

Terry Roark, told the state senate committee her child had died from a vaccine and feared others could be next if parents lost the right to decide what was in their best interests. “Innocent people will die,” she said tearfully. “Innocent children will be killed.” The meeting degenerated at points into yelling and screaming, and two activists were removed. Lawmakers promoting the new law were tenacious in their own way, challenging the claim that the bill would force vaccinations even on children with legitimate medical reasons not to have them. A doctor sympathetic to the anti-vaccination movement was ultimately forced to concede the bill contained no such language. “The

danger I feel as a policymaker is that when assertions are made in public comment that aren’t fact-based, that’s irresponsible,” state senator Holly Mitchell said. She and the co-sponsors of the bill, a doctor from northern California and the son of a polio

survivor from southern California, have become hate figures to the movement and they and their staff have been chased and shouted at. The southern California co-sponsor, Ben Allen, told the Guardian that while many of his detractors were respectful he’d also been bewildered by “Facebook memes of me as a Nazi doctor”. He added: “Some of them have definitely crossed a line.” The activists were boosted by the participation of a Kennedy: the environmentalist and civil rights activist Robert F Kennedy Jr, son of the murdered attorney general and nephew of the murdered president, who has written a book denouncing the use of mercury traces in a vaccine ingredient, which repeated peer-reviewed studies have found to be safe and which has now largely been phased out. Kennedy showed a documentary based on his book, spoke at a rally and likened vaccinations to the Holocaust. Medical experts and legislators supporting the bill

say vaccinating as many people as possible is vital to provide so-called herd immunity – a degree of protection strong enough to cover infants too young for vaccinations or those too sick to receive them. The more alarmist, contrary story of an out-of-control medical establishment covering up the “truth” – that vaccinations are responsible for an alarming spike in children diagnosed with autism – is the view of a tiny minority, perhaps 5% of the population. But the minority is a strikingly vocal one. In North Carolina, state senator Terry Van Duynsa described

the backlash to a bill she sponsored as “very swift and very furious”. “It created an environment that made it difficult to just even talk about it,” she told the NPR radio affiliate in Charlotte.

Link – Generic

Framing the debate in terms of rights is dangerous – the language of “choice” and “freedom” conveniently justifies anti-vaccination that endangers society as a whole. Thornton 15 – Paul Thornton, Los Angeles Times’ letters editor, 2015 (“Opinion Vaccine skeptics and Chris Christie say it's about choice. They're wrong”, LA Times, February 2, Available Online at http://www.latimes.com/opinion/opinion-la/la-ol-chris-christie-vaccines-choice-20150202-story.html, accessed 7/14/15, KM)

Chris Christie and vaccine skeptics say they want choice. What about those who can't be vaccinated? Vaccine skeptics

have exchanged autism for an appeal to choice as their cri de coeur "Choice" is a great word -- it has a universal, empowering appeal, and it's useful for winning a debate. Women's rights activists were smart decades ago to call their side of the abortion debate "pro-choice," asking us to ignore our feelings on the procedure itself and trust women enough to make their own

medical decisions. So it's no surprise that vaccine skeptics have now changed the subject from their rightly

ridiculed nonscientific claims on autism to the freedom to parent as they wish -- in other words, to make their own choices. And it appears they've convinced New Jersey Gov. Chris Christie (or maybe not), who says that even though vaccinating children is crucial and that his own kids got their shots, choice is great too, and parents deserve to have some when it comes to stopping the spread of communicable illness. Yes, we can note the irony of this being the same governor who recently locked a nurse in a tent to protect New Jersey from an Ebola virus this woman wasn't

carrying, but that's beside the point. What's important is that Christie's statement (you might even call it gaffe) represents the latest strategy for the vaccine skeptics: They're trying to win apologists for their cause, not an argument on the efficacy of vaccines. Whether you agree with them doesn't matter -- you could even ridicule their efforts to

pass off fraud as science in linking vaccination to autism. But freedom is a core American value, and everyone deserves to make his or her own choices, especially when it comes to parenting. This is Christie's logic. Christie isn't the only one making this argument. As I've noted before, this appeal to choice has replaced autism as

our letter writers' preferred anti-vaccine argument. In response an editorial last week calling for an end to California's personal-

belief exemption for parents who would rather not vaccinate their children, a small handful of readers hyperbolically accused The Times' editorial board of favoring totalitarianism (one said, "Sorry, but we don’t live in Nazi Germany"). Previously, a reader from Nevada whose letter was published -- much to the dismay of at least a dozen others

who sent us their own responses to their letter -- wrote that "freedom means choice. Plain and simple. Without choice, we are not a democracy." He continued: "It is my choice whether or not I want to be vaccinated. It is your choice whether or not to wash your hands or take basic public health precautions. It is an individual's choice whether he or she wants to gamble with their child's life. It is not your place to say what they have to do." Here’s the problem: This isn’t about choice, and vaccine skeptics' use of freedom instead of autism as their new cri de coeur exposes the joyful self-centeredness of their obstinacy. Any pediatrician (well, perhaps not all pediatricians) will tell you a parent's decision to vaccinate is as much about other children as their own. Parents who vaccinate their children not only protect their own kids as well as pick up some of the slack for the mothers and fathers who refused vaccination, they also help to protect those who cannot get immunized. It's sad for anyone to come down with a preventable disease, but lost in our focus lately on the children of vaccine-skeptical parents who have come down with measles are those who rely on the rest of us

who can choose to immunize to make the right choice. These people -- organ transplant recipients, cancer survivors and infants, among others -- might not have the choice that Christie and others champion.

The vaccination debate will come down to rights – SB 277 proves. Herbert 15 – Steven Herbert, Night Editor of City News Service, 2015 (“Opponents of new California vaccination law gathering signatures to overturn it”, LA Daily News, July 15, Available Online at http://www.dailynews.com/health/20150715/opponents-of-new-california-vaccination-law-gathering-signatures-to-overturn-it, accessed 7/16/15, KM)

Opponents of SB 277, a recently signed law requiring almost all schoolchildren in California to be vaccinated against diseases such as measles and whooping cough, received permission Wednesday to begin gathering signatures that would qualify a referendum to overturn it. “This referendum is not about vaccinations. It is about defending the fundamental freedom of a parent to make an informed decisions for their children without being unduly penalized by a government that believes it knows best,” said former Assemblyman Tim Donnelly, the referendum’s proponent. Valid signatures from 365,880 registered voters — 5 percent of the total votes cast for governor in the 2014 general election — must be submitted by Sept. 28 to qualify the measure for the November 2016 ballot, according to Secretary of State Alex Padilla. Q&A: What you need to know about California’s new SB 277 If the attempt to overturn SB 277 qualifies for the ballot, its provisions would be suspended. The bill, signed into law by Gov. Jerry Brown on June 30, eliminates vaccination exemptions based on religious or personal beliefs. It will require all children entering kindergarten to be vaccinated unless a doctor certifies that a child has a medical condition, such as allergies, preventing it. The legislation was prompted in part by an outbreak of measles traced to Disneyland that began in late December and ultimately spread to more than 130 people across the state. Cases were also reported in Arizona, California, Colorado, Nebraska, Oregon, Utah and Washington state.

Making broad claims about the importance of civil liberties is hazardous – antivaxers will be making the same assertions – listen to how this “pro choice antivaxer” frames the debate—Fisher 14 – Barbara Loe Fisher, Co-founder & President of the National Vaccine Information Center, 2014 (“Vaccination: Defending Your Right to Know and Freedom to Choose”, National Vaccine Information Center, November 13, Available Online at http://www.nvic.org/nvic-vaccine-news/november-2014/vaccination--defending-your-right-to-know-and-free.aspx, accessed 7/16/15, KM)

Following is a referenced excerpt from a keynote presentation given by Barbara Loe Fisher at the 2014 U.S. Health Freedom Congress in Minneapolis, Minnesota. View the video of her full 75 minute presentation here. The public conversation about whether we should have the freedom to choose how we want to maintain our physical, mental, emotional and spiritual health has become one of the most important public conversations of our time. It is a conversation that challenges us to examine complex public policy, scientific, ethical, legal, philosophical, economic, political and cultural issues. This may appear to be a new conversation but it has been around for centuries. 1 At the center of this new and old public conversation about health and freedom, is the topic of vaccination. 2 3 What unites those defending an open discussion about vaccination and health is a commitment to protecting bodily integrity and defending the inalienable right to self-determination, which has been globally acknowledged as a human right. 7 8 9 Whether you are a health care professional practicing complementary and alternative medicine or specializing in homeopathic, naturopathic, chiropractic, acupuncture, or other holistic health options, 10 or you are a consumer advocate working for the right to know and freedom to choose how you and your family will stay well, many of you have a deep concern about health and freedom. Vaccination: Most Hotly Debated of All Health Freedom Issues The most divisive and hotly debated of all health freedom

issues is the question of whether individuals should be at liberty to dissent from established medical and government health policy and exercise freedom of thought, speech and conscience when it comes to vaccination. 11 12 13 In the health freedom movement, there are some who will defend the legal right to purchase and use nutritional supplements, drink raw milk, eat GMO free food, remove fluoride from public water systems and mercury from dental amalgams or choose non-medical model options for healing and staying well, but are reluctant to publicly support the legal right to make vaccine choices. A Sacrosanct Status for Vaccination Vaccination is a medical procedure that has been elevated to a sacrosanct status by those in control of the medical-model based health care system for the past two centuries. Vaccination is now being proclaimed as the most important scientific discovery and public health intervention in the history of medicine. 14 15 16 Using religious symbols and crusading language, medical scientists describe vaccination as the Holy Grail. 17 18 19 20 Vaccines, they say, are going to eradicate all causes of sickness and death from the earth and anyone who doubts that is an ignorant fool. 21 22 23 24 25 In the 1970’s, pediatrician and health freedom pioneer Robert Mendelsohn, who

described himself as a medical heretic, warned that medical science has become a religion and doctors have turned the act of vaccination into

“the new sacrament.” 26 In the 21st century, if you refuse to believe that vaccination is a moral and civic duty and dare to question vaccine safety or advocate for the legal right to decline one or more government recommended vaccines, you are in danger of being branded an anti-science heretic, a traitor and a threat to the public health. 27 28

You are viewed as a person of interest who deserves to be humiliated, silenced and punished for your dissent. 29 30 31 32 Exercising Freedom of Thought, Speech and Autonomy “To learn who rules over you, simply find out who you are not allowed to criticize,” said Voltaire, 33 34 the great 18th century writer during the Age of Enlightenment, who was imprisoned several times in the Bastille for defending freedom of thought and speech before the French Revolution. As contentious as the public conversation about

vaccination, health and autonomy has become, we cannot be afraid to have it. There has never been a better time to challenge those ruling our health care with an iron fist. We have the power and all we need to do is exercise it.

Information is Power We have the tools in the 21st century to bring about a modern Age of Enlightenment 35 that will liberate the people so we can take back our freedom and our health. The electronic communications revolution has provided a global platform for us to access the Library of Medicine 36 and evaluate the quality and quantity of vaccine science used to make public health policy and create vaccine laws. The World Wide Web allows us to circumvent the paid mainstream media dominated by industry and governments and publicly communicate in detail on our computers, tablets and smart phones exactly what happened to our health or our child’s health after vaccination. 37 38 39 40 We are connected with each other in a way that we have never been before and it is time to talk about vaccines and microbes and the true causes of poor health. It is time to face the fear that we and our children will get sick and die if we don’t believe and do what those we have allowed to rule our health care system with an iron fist tell us to believe and do. Who Will Control the Multi-Trillion Dollar

U.S. Health Care System? What is at stake in this debate between citizens challenging the status quo and those resisting constructive change is: Who will control the multi-trillion dollar U.S. health care system? 41 If people have the right to know and freedom to choose how to heal and stay healthy, a free people may think independently

and choose to spend their money on something different from what they have been carefully taught to spend their money on right now. 42 A free people may reject sole reliance on the expensive and, some say, ineffective pharmaceutical-based medical model that has dominated US health care for two centuries. 43 44 45 A free people may refuse to buy and eat GMO foods. 46 A free people may walk away from doctors, who threaten and punish patients for refusing to obey orders to get an annual flu shot or decline to give their children every single government recommended vaccine on schedule – no exceptions and no questions asked. 47 The most rational and compelling

arguments for defending health freedom, including vaccine freedom of choice, are grounded in ethics, law, science and economics. The human right to voluntary, informed consent to vaccination is the best example of why Americans must not wait any longer to stand up and defend without compromise the inalienable right to autonomy and protection of bodily integrity.

Anti-vaccination advocates see the debate as a civil liberties issue – protests prove. Mara 15 – Janis Mara, covers education for the Marin IJ and has won many awards for business coverage, live-blogging, and investigative work, 2015 (“Vaccination law critics hold protest at Golden Gate Bridge”, Marin Independent Journal, July 3, Available Online at http://www.marinij.com/health/20150703/vaccination-law-critics-hold-protest-at-golden-gate-bridge, accessed 7/16/15, KM)

Corte Madera chiropractor Donald Harte addresses protesters about the new California school vaccines law before demonstrating on the

Golden Gate Bridge on Friday. Alan Dep — Marin Independent Journal About 200 opponents of California’s new law mandating vaccination for nearly all the state’s schoolchildren protested at the Golden Gate Bridge on Friday, wearing

bright red and vowing, “We’re not going away.” The protest took place three days after Gov. Jerry Brown signed into law Senate Bill 277. The law requires immunization against diseases including measles and whooping cough in order to attend public or private school. Before the bill passed, parents could cite personal or religious beliefs to decline vaccination. Some medical problems, such as immune system deficiencies, will still be exempt under the new law. “We are large, we are powerful and we are going to be heard,” said event organizer Brandy Vaughan of the Council for Vaccine Safety during the rally. Adults, children and even one German Shepherd dog wore bright red T-shirts, many of them emblazoned with anti-vaccine slogans and images of syringes. “All of the nation of Islam are sincerely concerned about any law that imposes needles into the arms of men, women and children,” said Minister Keith Muhammad, an official speaker at the event and a local

student representative of Louis Farrakhan, the leader of the religious group Nation of Islam, in Oakland. “Autism in black children increased with the MMR,” Muhammad said, referring to the measles-mumps-rubella vaccine. VACCINE, AUTISM In 1998, Andrew Wakefield and 11 other co-authors published a study in The Lancet, a respected medical journal, suggesting a link between this vaccine and autism. Subsequently, the study was retracted by The Lancet and Wakefield’s medical license was revoked. “Study after study has not found a link between vaccines and autism,” Marin Public Health Officer Matt Willis said at a March vaccination forum in San Rafael held by Marin’s public health department, the Marin County Office of Education and Kaiser Permanente. “The incidence of measles in California is very small and many of those who suffered were vaccinated,” Muhammad said. The speaker was referring to an outbreak of measles that started in Disneyland in December and eventually sickened more than 140 people. Of the California measles cases reported in January in which vaccination status was known, 80 percent weren’t vaccinated, according to Dr. Gil Chavez, state epidemiologist. “The majority of people who got measles were unvaccinated,” according to the website of the Centers for Disease Control and Prevention. The assertion was referring to the 178 measles cases reported in

the United States between Jan. 1 and June 26 of this year. “Are you ready to fight for your rights?” asked Rachelle Emery, who lobbied against the bill. The crowd roared back, “Yes!” Emery called for “an investigation of our legislators,” specifically Sen. Richard Pan, D-Sacramento, a pediatrician and an author of the bill. Joshua Coleman of Roseville, who lobbied in Sacramento against SB 277, said, “We need to recall Senator Richard Pan.” He also urged the

audience to educate the public on the issue. “Is not injecting poison into a child, child abuse? Think about this!” Donald Harte, a Corte Madera chiropractor, told the group. PROCESSION After the speakers held forth, the group marched across the bridge, carrying signs with slogans such as ”No forced vaccination,” and, “In matters of conscience, the law of the majority has no place” — Mahatma Gandhi.” A wagon with a bright red canopy holding three children was part of the procession. Two of the children belonged to Megan Fleming. “I have a background in Ayurvedic medicine and I read a lot of studies on holistic healing modalities before I had children,” the Mill Valley resident said. “I had a

different perspective of what it means to create health. I did my research. I had an instinct that I did not want to just go along with what I was being told,” Fleming said. “Medical choice is a human right. One of the issues with this is that vaccine studies are done by the companies that manufacture the vaccines. It would be good to have independent studies,” Fleming said.

Link – Privacy The right to privacy becomes a tool for anti-vaccination parents to refuse vaccination – immunization is seen as an “intrusion”.Friedersdorf 15 – Conor Friedersdorf, staff writer at The Atlantic, where he focuses on politics and national affairs, holds a Master’s degree in Journalism from New York University and BA in Politics, Philosophy, and Economics from Pomona College, 2015 (“Should Anti-Vaxers Be Shamed or Persuaded?”, The Atlantic, February 3, Available Online at http://www.theatlantic.com/politics/archive/2015/02/should-anti-vaxxers-be-shamed-or-persuaded/385109/, accessed 7/14/15, KM)

While anti-vaxer ignorance has caused great damage, the vast majority are not, in fact, especially selfish people. But I part with the commentators who assume that

insulting, shaming, and threatening anti-vaccination parents is the best course, especially when they extend their logic to politicians. For example, Chris Christie is getting flak for "pandering" to anti-vaccination parents. He said, "We vaccinate ours kids, and so, you know that’s the

best expression I can give you of my opinion. You know it’s much more important what you think as a parent than what you think as a public official. That’s what we do. But I understand that parents need to have some measure of choice in things as well, so that’s the balance the government has to decide." Those remarks could be improved upon. Indeed, Christie's office released a clarifying statement after his original comments came under criticism. But isn't Christie's approach more likely to persuade anti-vaccine parents than likening their kids to bombs? Let's emulate the New Jersey governor. If I could address any anti-vaccine parents reading this article: Like you, I looked into the scientific evidence with an open mind. When I regard conventional wisdom or the ruling establishment to be wrong, I'm always eager to publicly dissent. In this case, I came to the same conclusion as my own hyper-cautious mother: Not only would I definitely vaccinate my own kid if I had one—the case is so strong that, were standard vaccinations more expensive, I'd spend 20 percent of my income to get my kids their shots. That's how high my confidence is in their safety and importance. And if you're surprised by this measles outbreak, you underestimated the costs of your choice, which you'd be smart to reverse as soon as possible. Testimony from people who actually have kids is, of course, going to be more credible. (See Roald Dahl's story about his daughter for a particularly affecting testimony.) I'd urge parents with the impulse to shame and insult to try that approach instead, not just because it strikes me as more likely to persuade the typical anti-vaccine parent, but due to the conviction that while anti-vaxer ignorance has caused great damage, the vast majority are not, in fact, especially selfish people, and characterizing them as such just feeds into their mistaken belief system. Put another way, the parents I know who vaccinated their children, mine included, were not acting selflessly or sacrificially to protect the herd. They were appropriately confident that vaccinating their kids would significantly increase rather than reduce their chances of surviving and thriving in this world. Well-informed selfish people get vaccinated! Like Chris Mooney, I

worry about this issue getting politicized. As he notes, there is presently no partisan divide on the subject. "If at some point, vaccinations get framed around issues of individual choice and freedom vs. government mandates—as they did in the 'Christie vs.

Obama' narrative—and this in turn starts to map onto right-left differences ... then watch out," he writes. "People could start getting political signals that they ought to align their views on vaccines—or, even worse, their vaccination behaviors—with the views of the party they vote for." As a disincentive to this sort of thinking, folks on the right and left would do well to reflect on the fact that the ideology of anti-vaxers doesn't map neatly onto the left or right, with the former

willing to use state coercion and the latter opposing it. For example, consider some of the standard language used to talk about abortion. If you're a progressive

who believes in both a constitutionally guaranteed right to privacy and a moral right to autonomy over one's body, do you also believe that choices about vaccinations ought to be between patients and doctors, and that the state has no right to intrude on such a sensitive matter? If you're a conservative who believes that the community has a role in safeguarding innocent babies, even when that infringes on a parent's choices and bodily autonomy, do you also believe vaccinations can be compelled by the state? I don't mean to suggest that the abortion and vaccination debates map onto one another perfectly—only to illustrate that legally compelling vaccinations would be both consistent with and in tension with other positions taken by both the left and right. Personally, I can think of hypothetical situations where I'd support compelled vaccination and others where I'd staunchly oppose them, based not only on specific facts about the world, a given disease, and the vaccine against it, but also on the question of whether such a law would really improve public health outcomes.

Link – Constitution Anti-vaccination proponents base their arguments in the Constitution too – according to this anti-vaxer, it’s a “fight for inalienable rights to freedom”Fisher 14 – Barbara Loe Fisher, Co-founder & President of the National Vaccine Information Center, 2014 (“Vaccination: Defending Your Right to Know and Freedom to Choose”, National Vaccine Information Center, November 13, Available Online at http://www.nvic.org/nvic-vaccine-news/november-2014/vaccination--defending-your-right-to-know-and-free.aspx, accessed 7/16/15, KM)

NVIC: Defending Ethical Principle of Informed Consent I and the more than 100,000 followers and supporters 48 of the non-profit charity, the National Vaccine Information Center, take an informed consent position with regard to vaccination. Since our founding in 1982, we have defended the ethical principle of informed consent to vaccine risk-taking because vaccines are pharmaceutical products that carry a risk of injury, death and failure, 49 and because informed consent to medical risk taking is the central ethical principle guiding the ethical practice of medicine. 50 We support the “first do no harm” precautionary approach to public policymaking, which focuses on how much harm can be prevented from a policy or law and not how much harm is acceptable. 51 NVIC Supports Your Health

Choices & Vaccine Exemptions We do not advocate for or against use of vaccines. We support your human and legal right to make informed, voluntary health care decisions for yourself and your children and choose to use every government recommended vaccine, a few vaccines or no vaccines at all. 52 NVIC has worked for more than 30 years to secure vaccine safety and informed consent provisions in public health policies and laws, including flexible

medical, religious and conscientious belief vaccine exemptions. We are doing this in an increasingly hostile environment created by an industry-government-medical trade alliance that is lobbying for laws to compel all Americans to use every government recommended without deviation from the official schedule or face a growing number of societal sanctions. 53 Although historically, children have been the target for vaccine mandates, authoritarian implementation of federal vaccine policy is not just for children anymore, it is rapidly expanding to include all adults. 54 55 Californians Stood Up for Personal Belief Vaccine Exemption In 2012, many California residents traveled to Sacramento to protest a law introduced by a pediatrician legislator to make it harder for parents to file a personal belief vaccine exemption for their children to attend school. They responded to Action Alerts we issued through the online NVIC Advocacy Portal and lined the halls of the state Capitol building, many with their children, and waited for hours and hours to testify at several public hearings. Mother after mother and father after father, grandparents, nurses, doctors and students of chiropractic, came to the public microphone. Some talked about how vaccine reactions left their children sick and disabled but they can’t find a doctor to write a medical exemption so their children can attend school; others talked about how their babies died after vaccination; and others simply opposed restriction of the legal right for parents to make medical decisions for their minor children. It was a remarkable public witnessing by articulate, courageous citizens pleading with their elected representatives to do the right thing. The right thing would have been for lawmakers to vote to leave the personal belief vaccine exemption alone so parents could continue to make vaccine decisions for their minor children without being forced to beg a hostile doctor or government official for permission to do that. That didn’t happen. 56 Today, parents in California are forced to pay a pediatrician or other state-approved health worker to sign a personal belief vaccine exemption and the doctor can refuse to sign and parents are reporting many pediatricians ARE refusing to sign. Californians Inspired Colorado Citizens to Stand Up in 2014 Yet, because in 2012 California citizens made a powerful public statement by participating in the democratic process and taking action with calls, letters, emails and personal testimony, in 2014 Colorado citizens were inspired to do the same when the personal belief vaccine exemption was attacked in that state. Because in 2012 enough people in California did not sit back and assume the job of defending health freedom would get done by someone else, in 2014 enough people in Colorado did not assume it would get done by someone else. 57 And this time, we were able to hold the line and protect the personal belief vaccine exemption in that state from being eliminated or restricted. 58 This time, there were enough

lawmakers in Colorado, who listened and carefully considered the evidence. 59 They did not cave in to pressure from drug industry, government and medical trade lobbyists labeling a minority of citizens as “ignorant,” “selfish,” “crazy” and in need of having their parental and civil rights taken away for defending the human right to self determination and informed consent to vaccine risk-taking. The Right to Make a Risk Decision Belongs to You I do not

tell anyone what risks to take and never will. The right and responsibility for making a risk decision belongs to the person taking the risk. When you become informed and think rationally about a risk you or your child will take - and then follow your conscience - you own that decision. And when you own a decision, you can defend it. And once you can defend it, you will be ready to do

whatever it takes to fight for your freedom to make it, no matter who tries to prevent you from doing that. Einstein: “Never do anything against conscience” Albert Einstein, who risked arrest in Germany in the 1930’s when he spoke out against censorship and persecution of minorities, said, “Never do anything against conscience even if the State demands it.” 64 It takes strength to act

independently. When the herd is all running toward the cliff, the one running in the opposite direction seems crazy. People who think rationally and act independently even when the majority does not, may be the only ones to survive! Gandhi: “Speak Your Mind” Gandhi was often persecuted by the ruling majority for challenging their authority and using non-violent civil disobedience to publicly dissent. He said, “Never apologize for being correct, for being ahead of your time. If you’re right and you know it, speak your mind. Even if you are a minority of one, the truth is still the truth.” 65 Sharing what you know to be true empowers others to make conscious choices. Jefferson: “The Minority Possess

Their Equal Rights” The authors of the U.S. Constitution made sure to include strong language securing individual liberties, including freedom of thought, speech and conscience. They did that because many of the families immigrating to America had personally faced discrimination and persecution in other countries for holding beliefs different from the ruling majority. In his first Presidential inaugural address, Thomas Jefferson warned: “All, too, will bear in mind this sacred principle, that though the will of the majority is in all cases to prevail, that will to be rightful must be reasonable; that the minority posses their equal rights, which

equal law must protect, and to violate would be oppression.” 66 Getting Vaccinated Is Not A Patriotic Act There is no liberty more fundamentally a natural, inalienable right than the freedom to think independently and follow your

conscience when choosing what you will risk your life or your child’s life for. And that is why voluntary, informed consent to medical risk taking is a human right.

Link – Util There’s no getting out of the link – anti-vaccination advocates would love to get down with the 1AC and criticize utilitarianism together – listen to this deontological spiel by an anti-vaxer. Fisher 14 – Barbara Loe Fisher, Co-founder & President of the National Vaccine Information Center, 2014 (“Vaccination: Defending Your Right to Know and Freedom to Choose”, National Vaccine Information Center, November 13, Available Online at http://www.nvic.org/nvic-vaccine-news/november-2014/vaccination--defending-your-right-to-know-and-free.aspx, accessed 7/16/15, KM)

A Utilitarian Rationale Turned Into Law It is important to note that the Supreme Court ruling in Jacobsen v Massachusetts at the turn of the 20th

century was clearly based on a utilitarian rationale that a minority of citizens opposing vaccination should be forced to get vaccinated in service to the majority. Utilitarianism was a popular ethical theory in the late 19th and early 20th century in Britain and the U.S. and was used by government officials as a mathematical guide to making public policy that ensured “the greatest happiness for the greatest number of people.” 112 113 Today, utilitarianism has a much more benign and lofty name attached to it:

“the greater good.” Minorities At Risk When State Employs Militant Utilitarianism Perhaps that is because utilitarianism went out of fashion in the mid-20th century after, beginning in 1933, the Third Reich employed the utilitarian rationale as an excuse to demonize minorities judged to be a threat to the health and well being of the State.114 Enlisting the assistance of government health officials, 115 116 117 118 the first minority to be considered expendable for the good of the State were severely handicapped children, the

chronically sick and mentally ill, the “useless eaters” they were called. 119 120 And when the reasons for why a person was identified as a threat to the health, economic stability, or security of the State grew longer to include minorities who were too old or too Jewish or too Catholic or too opinionated or simply unwilling to believe what those in control of the State said was true….as the list of those the State branded as persons of interest to be demonized, feared, tracked, isolated and eliminated grew, so did the collective denial of those who had yet to be put on

that list. 121 122 Jacobsen v Massachusetts Used to Embrace Eugenics in U.S. Prophetically, in 1927, U.S. Supreme Court Justice Oliver Wendall Holmes invoked the Jacobsen v. Massachusetts “greater good” utilitarian decision to justify using the heel of the boot of the State to force the sterilization of a young Virginia woman, Carrie Buck, who doctors and social workers incorrectly judged to be

mentally retarded like they said her mother was. 123 In a chilling statement endorsing eugenics, 124 Holmes revealed the morally corrupt core of utilitarianism that still props up mandatory vaccination laws in the U.S. Pointing to the Jacobsen vs. Massachusetts decision, Holmes declared that the state of Virginia could force Carrie Buck to be sterilized to protect society from mentally retarded people. Coldly, Holmes proclaimed, “three generations of imbeciles are enough” and “The principle that sustains compulsory vaccination is broad enough to cover cutting the fallopian tubes.” 125 The 1905 U.S. Supreme Court majority made fundamental scientific and ethical errors in their ruling in Jacobsen v. Massachusetts. It is clear that medical doctors cannot predict ahead of time who will be injured or die

from vaccination and that is a scientific fact. 126 127 Utilitarianism Is A Discredited Pseudo-Ethic Utilitarianism is a discredited pseudo-ethic that has been used to justify horrific human rights abuses not only in the Third Reich but in human scientific experimentation and the inhumane treatment of prisoners and political dissidents here and in many countries, which is why it should never be used as a guide to public policy and law by any government. Although we may disagree about the quality and quantity of the scientific evidence used by doctors and

governments to declare vaccines are safe at the population level, at our peril do we fail to agree that, while the State may have the power, it does not have the moral authority to dictate that a minority of individuals born with certain genes

and biological susceptibilities give up their lives without their consent for what the ruling majority has judged to be the greater good.

SpilloverYes spillover – anti-vaccination advocates use Court cases, pro-choice rhetoric, and even GMOs to justify their beliefs.McGough 15 – Michael McGough, Los Angeles Times’ senior editorial writer that writes about law, national security, politics, foreign policy and religion, holds a Master’s degree in law from Yale Law School, 2015 (“Opinion: A Supreme Court quote anti-vaxxers will love”, LA Times, February 5, Available Online at http://www.latimes.com/opinion/opinion-la/la-ol-vaccines-supreme-court-parents-20150203-story.html, accessed 7/14/15, KM)

The Supreme Court has recognized the right of parents to make choices for their children The anti-vaccination movement has an interesting connection to the judicially created right to abortion Vaccination is the latest test of parental

authority The refusal of many parents to vaccinate their children against measles has become a political story. Some (but not all) Republican presidential hopefuls are giving aid and comfort to anti-vaxxers. Meanwhile, some have argued (unpersuasively) that President Obama is guilty of the same sort of pandering. Outside the realm of electoral politics, a debate rages over whether credulity about the “dangers” of vaccination is primarily a feature of right-leaning libertarians or liberals who also harbor ridiculous fears about genetically modified food. No one to my knowledge has mentioned that the anti-vaccination movement also has an interesting connection to the Supreme Court and the judicially created right to abortion. In 1925, in Pierce vs. Society of Sisters, the court struck down on constitutional grounds an Oregon law that required children to attend only public schools. Ruling in favor of an order of Catholic nuns and a military academy, the court held that the law “unreasonably interferes with the liberty of parents and guardians to direct the upbringing and education of children.” The decision includes this famous sentence: “The child is not the mere creature of the state; those who nurture him and direct his destiny have the right, coupled with the high duty, to recognize and prepare him for additional

obligations.” This ringing affirmation of parental authority continues to resonate in conservative and libertarian circles. The website of the Home School Legal Defense Assn. says it was established “to defend and advance the

constitutional right of parents to direct the education of their children and to protect family freedoms." In American law as well as in American culture, parents rule. - But does the Constitution really give parents the power to decide how their kids will be educated? Not explicitly, but the court located such a right in the 14th Amendment, which says that no state may “deprive any person of life,

liberty, or property, without due process of law.” In a previous decision, the court had said that liberty “denotes not merely freedom from bodily restraint” but also a constellation of other fundamental rights. Now for the

abortion connection. The landmark Roe vs. Wade decision cites Pierce vs. Society of Sisters. Like the right to shape your child's education, a woman’s right to abortion (rooted in a larger right of privacy) is derived from a broad reading of “liberty.” Many Americans are offended by the idea that abortion rights are fundamental; but some of those same people would enthusiastically agree with the court that parents have a constitutional right to shape the upbringing of their children -- whether the issue is education or medical care. I’m not saying that the Supreme Court necessarily would strike down a law requiring vaccination with

no exemptions. But the court’s statement that “the child is not the mere creature of the state” isn’t that far removed from New Jersey Gov. Chris Christie’s insistence in his vaccination comments that “parents need to have some measure of choice in things as well.” A reader complained that I "said, basically, that the U.S. Supreme Court supports parents' rights over health concerns on vaccinations, citing a parochial school case from 1925. The analogy is incorrect; the Supreme Court clearly stated in 1905 that health concerns justify mandatory vaccinations." Actually I didn't say that the Supreme Court would strike down a requirement that children be vaccinated. In fact, I wrote: "I'm not saying that the Supreme Court necessarily would strike down a law

requiring vaccination with no exemptions." My point was the Supreme Court had used very expansive language about parental rights similar to that employed by opponents of vaccination (and supporters of home-schooling). But I

should have mentioned the 1905 ruling, which involved the prosecution of an adult who declined to be vaccinated for smallpox. (Here's the court's ruling in Jacobson vs. Massachusetts.)

Spillover will occur – both politicians and advocates will make the connection between the plan and anti-vaccination rights – Roe v. Wade proves. Napolitano 15 – Andrew Napolitano, former judge of the Superior Court of New Jersey, senior judicial analyst at Fox News Channel. Judge Napolitano has written nine books on the U.S. Constitution. The most recent is Suicide Pact: The Radical Expansion of Presidential Powers and the Lethal Threat to American Liberty, 2015 (“To Vaccinate or Not To Vaccinate? Why We Should Consult Roe v. Wade”, Reason.com, February 5, Available Online at http://reason.com/archives/2015/02/05/to-vaccinate-or-not-to-vaccinate, accessed 7/16/15, KM)

New Jersey Gov. Chris Christie unwittingly ignited a firestorm earlier this week when he responded to a reporter's

question in Great Britain about forced vaccinations of children in New Jersey by suggesting that the law in the U.S. needs to balance the rights of parents against the government's duty to maintain standards of public health. Before Christie

could soften the tone of his use of the word "balance," Kentucky Sen. Rand Paul jumped into the fray to support the governor. In doing so, he made a stronger case for the rights of parents by advancing the view that all

vaccines do not work for all children and the ultimate decision-maker should be parents and not bureaucrats or judges. He argued not for balance, but for bias—in favor of parents. When Christie articulated the pro-balance view, he must have known that New Jersey law, which he enforces, has no balance, shows no deference to parents' rights, and permits exceptions to universal vaccinations only for medical reasons (where a physician certifies that the child will get sicker because of a vaccination) or religious objections. Short of those narrow reasons, in New Jersey, if you don't vaccinate your children, you risk losing parental custody of them. The science is overwhelming that vaccinations work for most children most of the time. Paul, who is a physician, said, however, he knew of instances in which poorly timed vaccinations had led to mental disorders. Yet, he was wise enough to make the pro-freedom case, and he made it stronger than Christie did.

To Paul, the issue is not science. That's because in a free society, we are free to reject scientific orthodoxy and seek unorthodox scientific cures. Of course, we do that at our peril if our rejection of truth and selection of alternatives results in harm to others. The issue, according to Paul, is: WHO OWNS YOUR BODY? This is a question the government does not want to answer truthfully, because if it does, it will sound like Big Brother in George Orwell's novel 1984. That's because the government believes it owns your body. Paul and no less an authority than the U.S. Supreme Court have rejected that concept. Under the natural law, because you retain the rights inherent in your birth that you have not individually given away to government, the government does not own your body. Rather, you do. And you alone can decide your fate with respect to the ingestion of medicine. What about children? Paul argues that parents are the natural and legal custodians of their children's bodies until they reach maturity or majority, somewhere between ages 14 and 18, depending on the state of residence. What do the states have to do with this? Under our Constitution, the states, and not the federal government, are the guardians of public health. That is an area of governance not delegated by the states to the feds. Of course, you'd never know this to listen to the debate today in which Big Government politicians, confident in the science, want a one-size-fits-all regimen. No less a champion of government in your face than Hillary Clinton jumped into this debate with a whacky Tweet that argued that because the Earth is round and the sky is blue and science is right, all kids should be vaccinated. What she was really saying is that in her progressive worldview, the coercive power of the federal

government can be used to enforce a scientific orthodoxy upon those states and individuals who intellectually reject it. In America, you are free to reject it. Clinton and her Big Government colleagues would be wise to look at their favorite Supreme Court decision: Roe v. Wade. Yes, the same Roe v. Wade that 42 years ago unleashed 45 million abortions also defines the right to bear and raise children as fundamental, and thus personal to parents, and thus largely immune from state interference and utterly immune from federal interference. Paul's poignant question about who owns your body—and he would be the first to tell you that this is not a federal issue—cannot be ignored by Christie or Clinton or any other presidential candidate. If Paul is right, if we do own our bodies and if we are the custodians of our children's bodies until

they reach maturity, then we have the right to make health care choices free from government interference, even if our choices are grounded

in philosophy or religion or emotion or alternative science. But if Paul is wrong, if the government owns our bodies, then the presumption of individual liberty guaranteed by the Declaration of Independence and the Constitution has been surreptitiously discarded, and there will be no limit to what the government can compel us to do or to what it can extract from us—in the name of science or any other of its modern-day gods.

Link booster – rights key

The defense of personal freedoms are the largest internal link – outweighs any other anti-vax defenses. Earl 15 – Elizabeth Earl, citing Nadja Durbach, a professor of history at the University of Utah, 2015 (“The Victorian Anti-Vaccination Movement”, The Atlantic, July 15, Available Online at http://www.theatlantic.com/health/archive/2015/07/victorian-anti-vaccinators-personal-belief-exemption/398321/, accessed 7/20/15, KM)

After germ theory was expanded upon and researchers developed vaccines, the British government outlawed variolation, which still carried some risk of killing the person it was meant to protect, in the Vaccination Act of 1840. Safer vaccines, which contain a weakened form of a particular disease, replaced variolation, which was a controlled exposure to a disease by injecting a healthy person with some of the infected pus or fluid of an ill person. To encourage widespread vaccination, the law made it compulsory for infants during their first three months of life and then extended the age to children up to 14 years old in 1867, imposing fines on those who did not comply. At first, many local authorities did not enforce the fines, but by 1871, the law was changed to punish officials if they did not enforce the requirement. The working class was

outraged at the imposition of fines. Activists raised an outcry, claiming the government was infringing on citizens’ private affairs and decisions. Many of the concerns of the 19th century, such as the role of government in personal choices, have reemerged. Over the course of a decade, multiple prominent scientists threw their support behind the anti-vaccination movement as well. “Every day the vaccination laws remain in force parents are being punished, infants are being killed,” wrote Alfred Russel Wallace, a prominent scientist and natural selection theorist, in a vitriolic monograph against mandatory vaccination in 1898. He accused doctors and politicians of pushing for vaccination based on personal interest without being sure that the vaccinations were safe. Wallace cited statistics from a report by the Registrar-General of deaths from vaccination from 1881 to 1895, showing that an average of 52 individuals a year died from cowpox or other complications after vaccination. Wallace pointed to the deaths to assert that vaccination was useless and caused unnecessary deaths. Pro-vaccinationists cited other statistics from London, where the number of deaths from smallpox fell significantly between the 18th and 19th centuries, after the discovery of vaccination. The National Vaccine Establishment figures claiming that nearly 4,000 people died in the city each year from smallpox before the discovery of vaccination, which Wallace and other anti-vaxers claimed was a grossly inflated figure. The Statistical Society of London noted in its journal in 1852 that “smallpox has greatly prevailed,” saying that vaccination was insufficient but that the registrars of the various counties were optimistic that it could work in the future. British government chose not to answer, staying silent behind the law as protests mounted. Epidemic disease was a fact of life at the time. Smallpox claimed more than 400,000 lives per year throughout the 19th century, according to the World Health Organization. Nadja Durbach, a professor of history at the University of Utah and the author of Bodily Matters: The Anti-Vaccination Movement in England, 1853-1907, says a major difference between the 19th century movement and today’s is that anti-vaxers in the past were more aware of the consequences of their choice: Disease was still rampant. Despite the existence of vaccines, thousands still died of infectious disease every year. Today, in most developed countries, large-scale epidemics are confined to the annals of history or to flash-in-the-pan flare-ups such as MERS in South Korea. By the time of the Leicester protest, public opinion was souring toward vaccination. The injections were not completely without risk, with a percentage of those who received the vaccination becoming ill, and riots broke out in towns such as Ipswich, Henley, and Mitford, according to a 2002 paper in the British Medical Journal. The Anti-Compulsory Vaccination League launched in London in 1867 amid the publication of multiple journals that produced anti-vaccination propaganda. Another chapter cropped up later in the century in New York City to spread the “warning” about vaccines to the United States. Under this pressure, the British government introduced a key concept in 1898: A “conscientious objector” exemption. The clause allowed parents to opt out of compulsory vaccination as long as they acknowledged they understood the choice. Similar to today’s religious exemptions in 47 U.S. states and the personal belief exemptions in 18 states, according to the National Conference of State Legislatures, the parents signed paperwork certifying that they knew and accepted the risks associated with

not vaccinating. Modern vaccination activists come from a different world than those in the 19th century. While anti-vaxers today are largely upper middle class, the crowd opposing vaccination in the 19th century was largely composed of lower- and working-class British

citizens, according to Durbach. “They felt that they were the particular targets, as a class group, for vaccination and for prosecution under

the compulsory laws,” she says. “This was part of a larger expression of their sense of themselves as second-class

citizens who thus lacked control over their bodies in the way that the middle and upper classes did not.” Unless the root issues are addressed, the anti-vaccination movement will continue to resurface with different faces. By the close of the 19th century and the dawn of the 20th, the protests had come to a head. The anti-vaccination sentiment had spread to the U.S., garnering support in urban centers such as New York City and Boston. The British government ceded its stringent line to the protests of the people. The law was amended yet again in 1907 to make the exemptions easier to obtain—because of an extensive approval process, many parents could not obtain the necessary paperwork to claim the exemption before the child was more than four months old, past the deadline. The U.S. government, however, took a harder tack. In the 1905 Supreme Court ruling in the case of Jacobson v. Massachusetts, the court upheld

the state government’s right to mandate vaccination. The Massachusetts Anti-Compulsory Vaccination Society lobbied hard for the court to rule in favor of the plaintiff, but all they won from the decision was the provision that individuals cannot be forcibly vaccinated. The protests quieted after these two decisions, but small pockets of unease have

now bubbled up again. Durbach said that unless the root issues are addressed—the boundaries of personal freedom versus social obligations—the movement will continue to resurface with different faces.

2NC/1NR Impacts — Privacy Link

Privacy movements hurt economy The privacy movement could tank the economy — hurts advertising, small business, and innovation Wheeler 12 — Eric Wheeler, CEO and co-founder of 33 across, a company specializing in building tools for online publishers, 2012 ("How 'Do Not Track' is poised to kill online growth," CNET, 9-20-2012, Available Online at http://www.cnet.com/news/how-do-not-track-is-poised-to-kill-online-growth/, Accessed 7-20-2015)Most painful, consumers themselves would end up suffering, gaining "privacy" (whatever that means in the context of anonymous data collection) at the cost of online subscription fees, less interesting and innovative online experiences, and less relevant advertising. On top of that, get ready for maximally confusing, overboard, opt-in mechanisms on every Website you visit. We are headed for what feels like an anti-Internet, not a privacy movement.New "Do Not Track" policy could come out as soon as next year, so before it's too late, we need to step back and consider what's really at stake.Compromising a $300 billion industry Online advertising has been one of the few unqualified success stories in our economy in recent years. By building a better infrastructure -- enabling brands to underwrite content and show relevant advertising -- the online ad industry has achieved an enviable growth rate. The Interactive Advertising Bureau (IAB) recently reported record ad revenues of $8.4 billion for the first quarter of 2012, a 15 percent increase year-over-year. According to a recent Harvard study commissioned by the IAB, the online advertising ecosystem now accounts for $300 billion of economic activity and 3.1 million jobs within the U.S.But take away ad targeting, and the anonymous data collection that makes it possible, and the bottom drops out virtually overnight . Goodbye, relevant and effective ads, healthy rates, and healthy growth; welcome back, paywalls, jumping monkey ads, static tech growth, opt-in consent mechanisms and deep profiles tied to your personal information to replace anonymous, cookie-based behavioral advertising.Handicapping small businessThe perils of "Do Not Track" extend well beyond the ad industry. Small publishers and startup ventures alike stand to lose the most under more stringent online restrictions. Most of these companies depend heavily on advertising to generate revenue. Not just any advertising--but interest-based advertising provided by responsible third parties committed to strict industry regulation. Unable to leverage a targeted ad model, they'll likely drive consumers away when left only with paltry generic ads that scream for attention rather than attracting it through relevance -- and they'd have to run a lot more of them, cluttering the screen and infuriating consumers.Better yet, they would have to employ subscription models where consumers pay a la carte to visit websites, for email, social networking, music, casual games, and other services. A double hit on the economy: take away small businesses' means to make money and make consumers spend more. Good luck with that one.Stifling innovationAnonymous user data is far more than just a lens for ad delivery; for many startups, it's the life's blood of innovation . Once upon a time, a startup called Amazon revolutionized online retail, in part by

leveraging behavioral shopping data that it gathered about its customers: by all accounts, this data has become a core piece of its shopping recommendation engine.Similarly, Netflix uses anonymous, real-time user data to inform recommendations for its customers. The data Trulia processes helps real estate agents improve their listings, and enables consumers to buy or sell homes at the optimal time. Groupon uses mobile location data, as well as anonymous information on users' habits and interests, to help local businesses deliver daily deals to the right consumer at the right time and place.The common denominator among all of these companies is that they use anonymous data to gain insight into their customers' favorite activities, interests, and connections, enabling them to create highly valuable online experiences that otherwise would have been impossible to deliver. Is the FTC or W3C really aiming to prevent the next Amazon or Netflix from emerging?

Privacy movements threaten autonomous carsAny advantages of autonomous cars require data collection and coordination that is threatened by privacy movementsKohler and Colbert-Taylor 14 — William J. Kohler, Chief Legal Officer and Corporate Secretary at Dura Automotive Systems, LLC, and Alex Colbert-Taylor, J.D. Student at University of Michigan Law School, 2014 (“Current Law And Potential Legal Issues Pertaining To Automated, Autonomous And Connected Vehicles,” Santa Clara High Technology Law Journal (31 Santa Clara Computer & High Tech. L.J. 99), Available Online to Subscribing Institutions via Lexis-Nexis)V. Privacy and Data UseFar more profusely than today's vehicles, mature and market-ready autonomous vehicles will generate and broadcast personal data, the use and storage of which will implicate important privacy rights in complicated ways that will likely have to be faced well before Level 3 and Level 4 vehicles become a commercial reality. n131 Although exclusively sensor-based autonomous vehicles are certainly a possibility, n132 many of the most compelling reasons for adopting self-driving cars are dependent on the vehicles sharing and coordinating data with each other, both locally and through centralized infrastructure. It is self-evident that the efficient management of traffic at intersections, the intelligent distribution of traffic to minimize congestion, and the ability of autonomous vehicles to safely travel in close-packed platoons, for instance, are all largely or completely reliant on communication both between the individual vehicles and other cars in the vicinity, and between the autonomous vehicles and an external network. Even if this [*121] data is scrubbed of unique individual identifying markers, for instance VIN-numbers, or IP-or MAC-addresses, data-mining techniques will almost certainly be able to reconstruct personal identifying information about particular vehicles and by extension their regular occupants. n133 The way this data is used will be the subject of regulation and legal controversy. Concerns about user privacy have already drawn substantial attention from the media. n134[Note to fellow students: Level 3 — Limited Self-Driving Automation, Level 4 — Full Self-Driving Automation]

Autonomous cars are threatened by privacy movementsKohler and Colbert-Taylor 14 — William J. Kohler, Chief Legal Officer and Corporate Secretary at Dura Automotive Systems, LLC, and Alex Colbert-Taylor, J.D. Student at University of Michigan Law School, 2014 (“Current Law And Potential Legal Issues Pertaining To Automated, Autonomous And Connected Vehicles,” Santa Clara High Technology Law Journal (31 Santa Clara Computer & High Tech. L.J. 99), Available Online to Subscribing Institutions via Lexis-Nexis)The 2012 push for consumer privacy protections seems to have made little progress, but there is some recent movement in Washington with respect to automakers' usage of personal data. In a December 2, 2013 open letter to auto industry executives, Senator Edward Markey of Massachusetts raised concerns about the disclosure of individual user data and aggregated data from vehicles currently on the market, seeking information from automakers as to whom this data is shared with or sold to, how long the data is kept, whether vehicle users have any option to delete this data or else to have it not retained at all, and similar questions. n191 Senator Markey requested that automakers respond to his inquiry no later than January 3, 2014. n192 The Senator has not disclosed whether any responses were submitted, and if so, whether these responses will be made public.

2NC/1NR Impacts — Vaccine DAs

Warming/EnvironmentVaccinations are key to adapt to warming.Schulman 15 — —Jeremy Schulman, Jeremy Schulman is based in Mother Jones' Washington bureau and works on the Climate Desk partnership. He was previously editor-in-chief of The American Independent and research and investigative director at Media Matters for America, 2-11-2015 ("Vaccines are one of our best weapons against global warming," Mother Jones, 2-11-2015, Available Online at http://www.motherjones.com/environment/2015/02/vaccines-measles-rotavirus-climate-change, Accessed 7-16-2015)Sen. Rand Paul (R-Ky.) has suggested that vaccines cause "profound mental disorders." Paul has also said he's "not sure anybody exactly knows why" the climate changes. So the likely presidential contender would probably find this fact pretty confusing: According to leading scientists, vaccines are among the "most effective" weapons in our arsenal for combating the threats that global warming poses to human health.In its landmark report (PDF) last year, the UN's Intergovernmental Panel on Climate Change warned that global warming poses a range of health threats—especially in the developing world. Warmer temperatures and changes in rainfall will reduce crop production, leading to malnutrition. Foodborne and waterborne illnesses will become a bigger problem. And, some scientists argue, diseases like malaria will spread as the insects that carry them migrate to new areas.So how should humanity adapt to these dangers? The IPCC report lays out a slew of public health interventions, including widespread vaccination:The most effective measures to reduce vulnerability in the near term are programs that implement and improve basic public health measures such as provision of clean water and sanitation, secure essential health care including vaccination and child health services, increase capacity for disaster preparedness and response, and alleviate poverty.There are a number of reasons that vaccines will play an important role in our efforts to adapt to a warming world. The most obvious is their ability to protect vulnerable populations from diseases that will be made worse by climate change.A prime example is rotavirus, a vaccine-preventable disease that can cause severe diarrhea. It killed roughly 450,000 children in 2008—mostly in South Asia and sub-Saharan Africa, according to the World Health Organization. "There is evidence that case rates of rotavirus are correlated with warming temperatures and high rainfall," according to Erin Lipp, an environmental health professor at the University of Georgia and a contributor to the IPCC report. This is particularly true in developing countries with poor sanitation and drinking water sources, Lipp explained in an email."A child weakened by measles is more likely to die from the malnutrition caused by climate change."There are other, less direct, ways in which climate change can exacerbate a wide range of existing public health problems. Take measles, which is currently making a comeback in the United States—thanks in large part to the unscientific claims of the anti-vaccination movement. Measles killed nearly 150,000 people worldwide in 2013; it's particularly common in parts of sub-Saharan Africa and South Asia that have extremely low vaccination rates—areas that will be hit especially hard by the impacts of climate change.Unlike with rotavirus, there's no direct relationship between measles and global warming. But Kirk Smith—an environmental health expert at UC, Berkeley, and a lead author of the IPCC chapter on health impacts—points out that "a child weakened by measles is more likely to die from the malnutrition

caused by climate change." In other words, anything we can do to reduce the impact of existing health problems will be even more important in a warming world. And vaccinating children, he says, is one of the most cost-effective public health tools we have.Diseases like measles pose another threat, as well, says Alistair Woodward, who is also a lead author of the IPCC chapter. Woodward, an epidemiologist at the University of Auckland, points out that extreme climate events—crop failures in Africa, flooding in Bangladesh, and even storms like Hurricane Katrina—can displace large numbers of people. "In these circumstances, with crowding and poor living conditions, all the basic public health services are put under great strain," said Woodward in an email. "The risks of infection go through the roof, for all communicable diseases…So ensuring that people are vaccinated is a logical thing to do as part of managing the risks of a rapidly changing climate."Of course, making sure people are inoculated against deadly diseases isn't easy. In the developing world, vaccination campaigns have to overcome transportation and security issues, as well as poor local health care systems. And these challenges, says Woodward, can dwarf the problems caused by the anti-vaxxer movement.

Anti-Vaxxers lead people to question environmental science.Romm 15 — Joe Romm, Joe Romm is a Fellow at American Progress and is the Founding Editor of Climate Progress, which New York Times columnist Tom Friedman called "the indispensable blog" and Time magazine named one of the 25 "Best Blogs of 2010." In 2009, Rolling Stone put Romm #88 on its list of 100 "people who are reinventing America." Time named him a "Hero of the Environment″ and “The Web’s most influential climate-change blogger." Romm was acting assistant secretary of energy for energy efficiency and renewable energy in 1997, where he oversaw $1 billion in R&D, demonstration, and deployment of low-carbon technology. He is a Senior Fellow at American Progress and holds a Ph.D. in physics from MIT, 2/9/2015 ("Medical Ethicist: Anti-Vaxxers Are Like Climate Science Deniers," ThinkProgress, 2/9/2015, Available Online at http://thinkprogress.org/climate/2015/02/09/3620665/anti-vaxxers-like-climate-science-deniers/, Accessed 7-14-2015)If you feel a moral obligation to embrace science-based strategies to protect “unsuspecting infants” from serious dangers, should you be more concerned about those who oppose mandatory vaccinations for childhood diseases or those who oppose mandatory action against climate change?That was a trick question: You should be exceedingly concerned about both, even though the dangers are very different in both timing and scale. Arthur Caplan, director of the Division of Medical Ethics at NYU Langone Medical Center’s Department of Population Health, explains in the Washington Post:Thankfully, only a few physicians in America have embraced fear-mongering in the middle of this dangerous and costly measles epidemic. They deserve a place of honor next to climate-change skeptics, anti-fluoridation kooks and Holocaust deniers. They doubt the facts, ignore established evidence and concoct their own pet theories. They shouldn’t be allowed near patients, let alone TV cameras. But because their suggestions are so surprising and controversial, they often find themselves on cable news shows and in news reports about the “anti-vaxx” crowd. Their power, therefore, is radically disproportionate to their numbers.Precisely.Yet from MSNBC’s “Morning Joe” Scarborough to the Wall Street Journal’s editorial board, many leading conservatives want you to think that it’s only that vaccine science that provides enough certainty to require government action. They are wrong. They ignore established evidence that the world’s leading

scientists and governments have “high confidence” the world faces “severe, pervasive and irreversible impacts for people and ecosystems” — devastating impacts that occur “even with adaptation” if we keep listening to the do-little or do-nothing crowd.Last week, :“There is not, at least in the science community, a debate about [vaccines causing autism] anymore,” MSNBC’s Scarborough said last week. “This is not even close, this is not even close — there is still a debate on climate change, the effects of climate change, how quickly climate change is coming on us. How much man contributes. There are a thousand different variables in that debate.”Not quite. There is very little debate in the scientific community about the conclusion that humans are the primary contributor — by far — to recent warming. The world’s largest general scientific society, the American Association for the Advancement of Science, explained this in its blunt 2014 climate report, “What We Know”:The science linking human activities to climate change is analogous to the science linking smoking to lung and cardiovascular diseases. Physicians, cardiovascular scientists, public health experts and others all agree smoking causes cancer. And this consensus among the health community has convinced most Americans that the health risks from smoking are real. A similar consensus now exists among climate scientists, a consensus that maintains climate change is happening, and human activity is the cause.We have a similar obligation to protect people from the dangers posed by climate change that we do to protecting people from the dangers posed by second-hand smokeScarborough apparently has no idea that the best estimate of climate scientists is that humans are responsible for all of the warming we have suffered since 1950. As the most recent IPCC report summarizing the recent scientific literature observations explains, “The best estimate of the human-induced contribution to warming is similar to the observed warming over this period.” That line was sufficiently uncontroversial it was signed off on by all the major governments in the world.The main “debate” on climate change among scientists is just how catastrophic the “irreversible” warming we face will be if we keep doing little or nothing to sharply reverse emissions trends, which is to say, if we keep listening either to people like Scarborough (aka the cocksure ignorati) or to the professional deniers.Amazingly, the foremost climate-science-denying editorial page in the country — which belongs to Rupert Murdoch’s Wall Street Journal — is shocked, shocked that leading Republican politicians like Gov. Chris Christie (R-NJ) and Sen. Rand Paul (R-KY) have indicated doubt about vaccine science:As for Mr. Paul, he will have to avoid these libertarian dormitory passions if he wants to be a credible candidate. Government doesn’t “force” parents to vaccinate children. The states impose penalties (such as barring attendance in public schools) on those who pose a risk to public health by refusing vaccinations against infectious diseases. This strikes us as a legitimate use of state “police powers” under the Constitution. It is also a reasonable and small sacrifice of liberty to prevent the potentially fatal infection of unsuspecting infants at Disneyland.So it is a reasonable and small sacrifice of liberty to protect unsuspecting infants from serious harm by having the state impose penalties for those who don’t adhere to what science says is the optimal prevention strategy, in the case of vaccines. But for the Journal, it is wildly unreasonable and a major assault on liberty to protect unsuspecting infants — and billions of others — from serious harm by having the state impose penalties for those who don’t adhere to what science says is the optimal prevention strategy, in the case of climate change.

The Journal routinely spreads long-debunked disinformation, smears climate scientists and denigrates the entire climate science enterprise. A particularly inane a May 2013 op-ed actually urged “more atmospheric carbon dioxide”! Scientifically, that would be comparable to an op-ed urging “less vaccination.”The Journal editors have a real contender in their pro-vaccine editorial for the most unintentionally hypocritical science piece of the year, especially with its final paragraph lecturing us on “human progress”:“Let’s chalk up the weird science of Messrs. Paul and Christie to a lack of information, and we’re happy to send them 13 years of vaccine editorials if they want to study up,” the editorial concludes. “The not-so-great measles vaccine debate of 2015 is one of those events that makes us wonder if there is such a thing as human progress. But then we live in America, so we know there’s hope.”Seriously, the Journal bemoaning whether “there is such a thing as human progress” is like Bernie Madoff bemoaning whether there is such a thing as business ethics or Chief Justice John Roberts bemoaning the overabundance of corporate money in politics….Again, it’s OK to use state power to protect “unsuspecting infants” from unvaccinated kids because science says so — and the WSJ will send you 13 years of editorials on the subject. But if you want to use state power to protect unsuspecting infants — and everyone else — from catastrophic climate change because science says so, well, the WSJ can send you 13 years of anti-science climate denial opposing all action and trashing our leading scientists.One final note: In his Washington Post piece, Caplan puts anti-vaccination doctors in the same category as “climate-change skeptics” and “Holocaust deniers.” I discussed my views on the term “deniers” in my December, post about the statement issued by four dozen leading scientists and science journalists/communicators urging the media to “Please stop using the word ‘skeptic’ to describe deniers” of climate science.

Disease — Measles ExpensiveMeasles outbreaks cost a lot of money.Mnookin 15 — Seth Mnookin, 7-14-2015 ("» The financial implications of the US measles outbreaks," No Publication, 7-14-2015, Available Online at http://blogs.plos.org/thepanicvirus/2011/05/25/the-financial-implications-of-the-us-measles-outbreaks/, Accessed 7-14-2015)Earlier today, the CDC released a report about the measles outbreaks that have been occurring across the country since the beginning of the year. (Hat tip to USA Today‘s Liz Szabo for this story.) I wrote a fair amount about measles in my book, and one reason measles outbreaks are so scary (and so difficult to contain) is that measles is the most infectious microbe known to man–it’s transmission rate is around 90 percent. It has also killed more children than any other disease in history.If you’re skeptical about the correlation between measles vaccination rates and the spread of the disease, or about the danger deliberately unvaccinated members of the population pose to infants, you should check out the CDC’s figures. They’re pretty stunning:* There have been 118 reported measles cases in the first nineteen weeks of the year — which is the highest number of infections for that period since 1996. That’s particularly noteworthy because, as the CDC points out, “as a result of high vaccination coverage, measles elimination (i.e., the absence of endemic transmission) was achieved in the United States in the late 1990s and likely in the rest of the Americas since the early 2000s.”* Eighty-nine percent of all reported cases have been in people who’ve been unvaccinated. Almost 20 percent of that figure is made up of children who were less than a year old. That means they were too young to have received the first dose of the measles-mumps-rubella (MMR) vaccine, which is given once between the ages of twelve and fifteen months and again when a child is between four and six years old. Another twenty percent of the total number of reported infections were in children between the ages of one and four.* Forty percent of the infections recorded so far this year have resulted in hospitalization — and 98 percent of the people who were hospitalized were unvaccinated. In its typically understated manner, the CDC noted that “nine [of the hospitalized patients] had pneumonia, but none had encephalitis and none died”– which is another way of saying that encephalitis and death are potential complications of serious cases of pneumonia.The most significant factor in the spread of measles in the United States is the increase of pockets of the country where vaccination rates have declined below the level needed to maintain herd immunity`– and, similar to what occurred in the UK in the early part of the last decade, that decline can be traced back to the press-fueled panic sparked by anti-vaccine messiah Andrew Wakefield’s discredited, retracted, and possibly fraudulent twelve-child case study linking the MMR vaccine to autism.Indeed, it’s striking just how many of the infections are clustered around Minnesota, where anti-vaccine activists have been for years targeting an immigrant Somali community…and where Wakefield has made multiple trips over the past several months:Reported measles cases in US, Jan 1-May 20 2011Anyone curious about how quickly a series of small measles conflagrations can spread horribly out of control should check out the situation currently unfolding in France, which is in the third year of a nation-wide outbreak.^ In 2007, the number of reported cases in France was around forty. The next year, they jumped to six hundred…and they’ve been rising ever since. So far in 2011, there have been

more than 6,400 infections in the country. Translated to a population the size of the US’s, that would represent a jump from 188 cases to more than 28,000.The toll that would take on the nation’s health-care infrastructure is mind-boggling. Consider this: In 2008, a deliberately unvaccinated patient of “Dr. Bob” Sears caught measles while on vacation in Switzerland. That single infection ultimately resulted in a total of 12 cases…and the total cost of containing the outbreak topped $150,000.FOOTNOTES` The beginning of this sentence had previously read, “The most significant factor in the spread of measles in the United States is declining vaccination rates.” As some readers have pointed out, the overall vaccination rates in the country have more or less stayed the same; the issue is the increase in individual communities where vaccine refusal has grown.^ France also illustrates how the result of vaccine panics can be similar even when the roots causes are completely unrelated: A recent British Medical Journal story titled “Outbreak of measles in France shows no signs of abating” points out that “the publication in the Lancet in 1998 of the research article by Andrew Wakefield purporting to show a link between the MMR vaccine and autism had no significant effect on uptake of the MMR vaccine in France. The main vaccine controversy in France has centred on that against hepatitis B, and this has taken its toll on immunisation campaigns as a whole.”

Measles are really expensiveHaelle 15 — Tara Haelle, I am a freelance science journalist and photojournalist who specializes in reporting on vaccines, pediatric and maternal health, parenting, nutrition, obesity, mental health, medical research, environmental health and the social sciences. My work has appeared in Scientific American, the Washington Post, Politico, Slate, NOVA, Wired, Science and Pacific Standard, and I write regularly for HealthDay, Frontline Medical Communications and my science and health mom blog Red Wine & Apple Sauce. I was the health editor at Double X Science and am currently co-authoring an evidence-based parenting book due in late 2015. I received my master's in journalism at the University of Texas at Austin (also my undergrad alma mater), and I teach journalism at Bradley University in Peoria, Ill. I previously taught high school and often think of my journalism as a form of teaching, by helping others understand science and medical research and by debunking misinformation about vaccines, chemicals and other misunderstood topics, 2-11-2015 ("Measles Outbreak in Dollars and Cents: It Costs Taxpayers Bigtime," Forbes, 2-11-2015, Available Online at http://www.forbes.com/sites/tarahaelle/2015/02/11/measles-outbreak-in-dollars-and-cents-it-costs-taxpayers-bigtime/, Accessed 7-14-2015)The official measles count is up to 121 cases in 17 states, the CDC reported on Monday, and 85 percent of those resulted from the outbreak stemming from the Disneyland exposure. That’s more cases than were seen in all of 2012 – and it’s only February.Much virtual ink has been spilled in the past several weeks about what an awful disease measles can be, about the impact of irresponsible doctors’ advice, and about the ramifications of not vaccinating on those unable to be vaccinated.But only a handful of folks have talked about costs. Measles is expensive. Really expensive. And even if you live in a highly vaccinated area with no outbreaks, a measles case in your state – that’s a third of the U.S. right now – still means health department tax dollars diverted from other programs to deal with a disease that was eliminated from the U.S. in 2000.

“These outbreaks have economic costs. They are disruptive,” said Gregory Poland, head of the Mayo Clinic's Vaccine Research Group. “The smaller ones have cost a couple hundred dollars in public resources, and one cost nearly a million dollars. It’s on the lesser side – health is more important – but it consumes public health resources that could be applied to the other pressing problems we face.”In 2011, the cost of 107 cases spread across 16 outbreaks cost local and state health departments an estimated $2.7 million to $5.3 million. Because measles is so contagious, infecting 90 percent of susceptible individuals and remaining airborne up to two hours after an infectious person has left the area, the number of contacts a single case can generate grows exponentially once an outbreak begins. The cases in 2011 involved contacting somewhere between 8,900 and 17,450 individuals, which required 42,000 to 83,000 personnel hours.The outbreak tied to Disneyland is responsible for approximately 85% of the cases to date. Photo from the CDC.The outbreak tied to Disneyland is responsible for approximately 85% of the cases to date. Photo from the CDC.During another outbreak in 2008, during which an intentionally unvaccinated 7-year-old boy returned from Switzerland with the virus, San Diego grappled with 11 additional cases, costing taxpayers $10,376 per case. That outbreak involved more than 800 exposed individuals, including 48 children too young to be vaccinated who had to be quarantined at a family cost of $775 per child.Among the ten measles cases in Illinois, eight are infants too young to be vaccinated, which means it’s highly likely that other infants in those classrooms were exposed and may need to be quarantined for up to three weeks. If so, the costs will very likely be higher than they were in 2008.Then there are the family costs of an actual measles case, which lasts about seven to ten days, though those costs are a bit harder to measure, according to health economist Adam Powell, president of Payer+Provider Syndicate Healthcare Consulting.“While this cost can be absorbed by many employees through the use of sick days, employees with lower incomes are the least likely to have sick leave,” Powell said. “The Economic Policy Institute reported that the median wage for people without sick days is $10 per hour. Assuming the person works five days a week, missing a week of work would cause a loss of $400. If the absence extended to eight days of work and two days of weekend as a result of a ten day illness, the loss would be $640.”But that figure only accounts for an estimate of lost wages, not the any additional costs such as hospitalization. “After factoring in the cost of medical care, expenses could be even higher,” Powell said.Contrast those numbers with the cost of the MMR (measles-mumps-rubella) vaccine, which prevents the measles in 95 percent of those who get one dose and 99 percent of those who get both doses. A provider under a CDC contract, such as those using the Vaccines for Children program, pays $19.91* for a single pediatric dose of MMR (or $37.04* for an adult dose), and the private sector price is $59.91*.Even those costs are not ones that consumers would have to pay, however.“Although there is a cost to the vaccine, it is not borne by insured patients,” Powell said. “The Affordable Care Act requires that the MMR vaccine be fully covered without patient cost sharing in its provisions requiring the coverage of preventive services.”It’s long been clear that the risk-benefit calculation from a health and scientific perspective comes down heavily in favor of the vaccine. Measles kills approximately one in 1,000 to 3,000 cases, and it causes brain damage from encephalitis in one in 1,000 cases, not including the individuals who develop

pneumonia or other complications. The vaccine, by contrast, most commonly causes a fever, joint pain or mild rash and can cause a fever-caused seizure in one of 3,000 doses, a low platelets count (that usually resolves on its own) in one of 30,000 doses, or, in extremely rare situations, a severe allergic reaction in one in a million doses.The cost-benefit calculation in dollars and cents looks pretty similar.

RacismDiseases like measles disproportionately hurt African American communities.Walks 15 — Dr. Ivan Walks, Dr. Ivan C. A. Walks,M.D. serves as Chief Executive Officer of Ivan Walks and Associates LLC. Dr. Walks served as Chief Health Officer of the District of Columbia. Dr. Walks serves as Director of VisionQuest National, Ltd. He served as Director of the District's Department of Health. Dr. Walks developed proactive community partnerships, reduced infant mortality, insured immunization for all children attending schools, and served as its incident commander during the 2001 anthrax attack. Dr. Walks' contributions to public health policy have been recognized by various state and national organizations and he is the recipient of the Leadership Washington Founder's Award for Leadership and Community Service. Dr. Walks also serves on the faculty at the public health schools of George Washington University and Howard University. He received his medical degree from the University of California, Davis and he is a graduate of the Neuropsychiatric Institute at UCLA, 2-4-2015 ("Irresponsible Anti-Vax Politics Could Transfer the Risks of Disease to Communities of Color," Root, 2-4-2015, Available Online at http://www.theroot.com/articles/politics/2015/02/anti_vaccine_politics_puts_people_of_color_at_risk.html, Accessed 7-14-2015)As the Center for American Progress’ Sam Fulwood III aptly pointed out in his recent analysis of the impact of the economic downturn in communities of color, there’s an old saying that also applies when we’re talking about health outcomes: “ When white folks catch a cold, black folks catch pneumonia .”And with the concerns of urban communities already less heard and less addressed in general, it’s crucial that science and data dictate vaccination policy—not politics. So when our leaders make misguided and misinformed statements outside their space of expertise, it can undermine medical professionals who are trying to save lives.Of course, that may not be the first thing on the minds of Republican presidential aspirants like Gov. Chris Christie of New Jersey and Sen. Rand Paul of Kentucky, who made irresponsible assertions this week that it’s OK for parents to choose to ignore the science when it comes to decisions about the vaccination of their children. While Christie quickly backpedaled on his statements after a firestorm of public criticism, Paul—who is a physician—doubled down, stating that vaccines were to blame for “profound mental disorders” such as autism. This is simply not true.These scientifically baseless assertions can lead to profoundly dangerous public health policy, particularly in communities of color. The ramifications for many African Americans and other minority groups are greater than for those who have better access to quality health care—as has been shown—even as the Affordable Care Act takes shape. These concerns are primary in densely populated urban centers or metropolitan areas, where communities of color are disproportionately concentrated.As The Guardian’s health editor Sarah Boseley correctly points out, infectious diseases “spread horrifyingly fast in cities.” This was one major reason why, during my time as chief health officer of Washington, D.C., we instituted an ambitious citywide emergency school immunization campaign in 2002 upon finding 21,000 public school students who had not been vaccinated to meet established standards. This was considered one of the largest immunization drives in U.S. history, and within just eight weeks we experienced a 99 percent success rate.There was no conversation about choice, simply a conversation about how we could best protect the nearly 600,000 residents in the nation’s capital and the tens of millions of people from across the world

who visit each year. And at that time we were extremely sensitive about contagions and the spread of lethal infections, especially in the immediate wake of managing the country’s first bioterrorism attack. What’s significant to note here is that we did this in a city that had, at the time, a majority-black population (more than 56 percent) and a public school population that is overwhelmingly African American. In describing these communities, we frequently use the term “underserved.” But in reality, communities of color in highly populated metro areas are highly underresourced. This makes these communities much more vulnerable to major epidemics, including measles. The need for surge capacity and an adequate emergency health care response is critical.Measles is actually much more contagious than another disease that recently grabbed headlines, Ebola. Which makes the current political “debate” peculiar. Elected officials like Christie didn’t hesitate to quarantine medical staff returning from fighting the disease in West Africa but appear somewhat nonchalant about fast-infecting measles. More alarming, and what some political leaders won’t say, is that diseases like measles will spread faster in cities.That will put people of color, especially African Americans, in the direct line of epidemiological fire, since nearly 20 of the largest cities in 13 states have black populations of 50 percent or higher.The last major outbreak of measles in the United States erupted less than 25 years ago. More than 56,000 Americans were infected, including 11,000 nationwide who were hospitalized and, sadly, 123 reported fatalities. And as the Centers for Disease Control and Prevention later found, a disproportionate share of those infected were “inner-city, American Indian, Hispanic, non-Hispanic black and low-income children aged five years [or younger] who had not been vaccinated.” In fact, the CDC discovered that “[r]acial/ethnic minority children were at three to 16 times greater risk for measles than were non-Hispanic white children.”This risk disparity is of particular concern to public health professionals and planners, and it was a main driver behind the federal government’s creation of the Childhood Immunization Initiative in 1993.For those who advocate for “choice,” it’s not an urban issue, but it is an example of mostly more affluent individuals imposing their preference on underresourced and vulnerable populations of color—which means, ultimately, that they are transferring the risk.

Anti vaxxers are privileged, although diseases mainly impact people of color. Broadbent 15 — Elizabeth Broadbent, 2-9-2015 ("Why Vaccination Refusal Is a White Privilege Problem" xoJane, 2-9-2015, Available Online at http://www.xojane.com/issues/vaccination-refusal-white-privilege, Accessed 7-16-2015)Vaccines work. Anti-vaxxers will argue otherwise, but if they’re given airtime, this will degenerate — like most vaccine discourse — into comparative science, misinformation, name-calling, and finally heated charges of baby-killing. Someone will say all anti-vaxxers should be locked up, and someone else will invoke Hitler. So we’re skipping that part. If you’re interested in reading it, see the comment sections of every vaccine article ever.Instead, let’s look at the parents who refuse routine childhood vaccinations — and what that means.There are two categories of kids without a full complement of routine vaccinations. Researchers call the first category the “undervaccinated”: kids who have not received, for one reason or another, their all of their childhood shots. According to a study published in Pediatrics, these children tend to share

several characteristics. Most live near the poverty level, in a central city. Their mothers are unlikely to be married or to have a college degree. And, most tellingly, undervaccinated children tend to be black.Children without vaccinations, on the other hand, are generally referred to as “free riders”**: kids whose health gets a free ride from the immunity of the vaccinated people surrounding them (i.e. “the herd”). Their parents present a radically different profile from those of the undervaccinated kids. Free riders’ mothers tend to be married and college-educated. Their household income generally averages above $75,000. And those free riders are overwhelmingly white.Ouch.It doesn’t take a methodological study to make sense of these numbers. Low-income city-dwelling mothers are less likely to enjoy easy access to the vaccinations themselves; one Los Angeles mother told a reporter that she had to schlep two kids on two different buses to get to her local clinic. “These simple things were pretty difficult to get through,” she says. This doesn’t count the difficulties of making appointments in between full-time work and childcare, not to mention navigating the bureaucracy of Medicaid. These children’s parents may worry about the ramifications of vaccine-preventable disease. But poverty can make it hard to do much about it. When you’re worried about keeping the lights on, the rent paid, and the car running, routine vaxes understandably aren’t high on your priority list.Free riders, on the other hand, have easy access to vaccines — but choose not to use them. Free riders’ parents believe vaccination itself to be far more dangerous than the risk of contracting a vaccine-preventable disease. The maladies they attribute to standard childhood shots go way beyond the Jenny McCarthy/Andrew Wakefield autism debacle; they now include mercury and aluminum poisoning, increased risk of asthma, allergies, ADHD, ear infections, sinusitis, and brain damage of all stripes. If you can imagine a health concern, you can blame it on vaccines.These parents tend to get their information about vaccination from like-minded parents, listservs, online groups, and natural-health gurus like Dr. Mercola and Dr. Tenpenny — both notoriously anti-vaccination. They rely, in fact, not on pediatricians, with their one-size-fits-all vaccine schedule, but on their own research: conducted mostly on the Internet, where stories of legitimate vaccine injury pass through news sites and Facebook groups like a horror-show version of Telephone.Instead of vaccinations, free riders’ parents claim other means of keeping their kids healthy. As Public Health professor Jennifer Reich argues, parents of non-vaccinated children believe breastfeeding, superior nutrition, and controlled environments (i.e., not daycare) keep disease at bay. Unfortunately for most kids, these are all benefits of privilege.With the lack of adequate maternity leave and laws to protect mothers’ rights to pump breast milk, nursing in America has become a purview of the privileged mother, whose job — or whose decision to stay home — allows a stable nursing relationship. And despite WIC, SNAP, and other variations of food stamps, access to fresh, healthy food is also often out of reach for the poor, especially those who inhabit so-called food deserts. Finally, working mothers must rely on some kind of childcare, often institutionalized daycare. Undervaccinated children simply don’t have access to the mythical protection free riders’ parents invoke. As one such mother tells Reich, "I think there are some vaccines that maybe some kids, maybe it’s okay for them to have, because maybe their parents. . . aren’t at all educated and . . . so maybe they do need to rely more on outside sources, because that is being done to them.”Moreover, in general, children living in poverty have more government intervention in their lives. While it varies from state to state, and even social worker to social worker, many WIC recipients are required

to produce shot records for their children. Social Services may use a lack of vaccinations as evidence of neglect. And as Reich says, more privileged parents “address experts as consultants and refuse their advice without fear of reprisal, choices less readily available to less privileged families, whose rejection of expert advice more easily results in state intervention, even around vaccination.” A poor black woman refusing to give her kid an MMR shot might not just get the side-eye. She might earn herself a visit from Social Services.Free riders’ parents also often claim vaccine-preventable diseases are less dangerous than the vaccines themselves, particularly with illnesses like measles. Chicken pox (varicella) is seen as particularly innocuous, partly because most adults remember suffering through it with little more than an itch or two, and partly because of rumors that the vaccine will leave children vulnerable to shingles later in life (it won’t). Whatever the dangers of the diseases, allowing children to catch them costs time and money: time taken off work to care for them, lost wages, and doctors’ bills. It’s more than many parents can afford, especially those without access to family or medical leave. As a rule, poor people don’t throw pox parties.Basically: It takes money and time to refuse vaccinations. And it’s a lack of that same money and time that often unintentionally keeps parents from fully vaccinating their children.This has serious public health repercussions. The head of the Sabin Institute for Vaccine Research, Peter Hortez points out that when vaccine rates start to drop, the people who suffer will be “people who live in poor, crowded conditions. So it’s going to affect the poorest people in our country.” Privileged, usually white, free riders, who enjoy limited social contact, superior nutrition, and better medical care will likely have a lower incidence of complications of death from those diseases. The undervaccinated will be the ones to suffer: overwhelmingly black children from low-income families.The anti-vaccine movement, then, affects more than just the privileged children whose parents choose to forgo vaccination. As scientists at Johns Hopkins recently said while investigating a whooping cough outbreak, “geographic pockets of vaccine exemptors pose a risk to the whole community.”That whole community doesn’t just include the usual suspects: infants, the elderly, the immuno-compromised, the vaccinated for whom the antigen simply didn't take. It also includes the marginalized who lack easy access to basic health care. Those marginalized communities are usually people of color. The anti-vaccination community is overwhelmingly white. In a very real sense, this leaves two distinct undervaccinated populations in America: privileged (largely) white people who’ve chosen to eschew modern medicine, and underprivileged minorities whose poverty has placed them, unwillingly, in that position. And it’s the latter who will suffer more gravely for it, because the same economic and health factors that make their children vulnerable to undervaccination make them vulnerable to the worst effects of the diseases themselves.Privileged white people refuse the vaccines in the name of individual freedom. And public health suffers; this especially affects the lives of the poor. This will, of course, provoke unmitigated outrage from the anti-vaccination community as a whole. Is the anti-vax movement itself racist? No. But it’s buttressed by class and race privilege. A drop in vaccination rates poses a danger to us all. But it poses a special danger to those least able to cope with serious illness, and least likely to be (unintentionally) fully vaccinated: minority, city-dwelling children.

Anti-Vaxxers = Anti-scienceAnti-vaxxers are proponents of anti-science.Huppke 15 — Rex W. Huppke, after earning a master’s degree from the University of Missouri Graduate School of Journalism, he launched his career working for the Associated Press in Indiana, In 2003, he joined the staff of the Chicago Tribune, writing about everything from gang violence and inner-city poverty to the glory of competitive arm wrestling and a southern Illinois town famous for its albino squirrels, 2-3-2015 ("The anti-vaccine crowd could use an anti-science expert," The Chicago Tribune, 2-3-2015, Available Online at http://www.chicagotribune.com/news/opinion/huppke/ct-talk-huppke-vaccines-20150203-story.html, Accessed 7-16-2015)I’m not exactly sure what "science" means. I could look it up in a dictionary, but I don't believe in dictionaries. I've heard they cause brainwashing and are in the pocket of Big Lexicography.Besides, as a word-user, I think I'm best-qualified to determine the meanings of my words. That's why I pancake eggplant every chance I schadenfreude.It's thanks to that kind of logic that America faces the return of the once-eradicated measles virus. A small, vocal and highly insufferable portion of the population has taken it upon themselves to doubt the irrefutable scientific evidence that childhood vaccinations are safe and effective. And so they don't vaccinate their kids.According to the Centers for Disease Control and Prevention, there are now more than 100 measles cases in 14 states. And that's just in January. For all of last year, there were 644 cases in 27 states."We are very concerned by the growing number of people who are susceptible to measles, and to the possibility that we could have a large outbreak in this country as a result," CDC Director Tom Frieden said Sunday on CBS's "Face the Nation."President Barack Obama also addressed the vaccination debate, telling NBC News: "You should get your kids vaccinated — it's good for them. We should be able to get back to the point where measles effectively is not existing in this country."The problem is, we've got too many people who believe in "ecneics" (pronounced eck-nakes), which is "science" spelled backward. While scientists study the physical and natural word and reach consensus based on experimentation and observation, ecneictists (eck-nake-tists) look at a scientific consensus and then decide the opposite is true because that's what they want to believe.A new Pew Research Center study highlights the growing gap between scientists and ecneictists. Asked if childhood vaccines, including one for measles, should be required, 68 percent of adults said yes compared with 86 percent of scientists with the American Association for the Advancement of Science. There was a 37-point gap between scientists and the public on whether climate change is "mostly due to human activity," with 50 percent of adults saying yes versus 87 percent of scientists.And on whether it's safe to eat genetically modified foods, nearly 90 percent of scientists said yes compared with only 37 percent of non-scientists.In most rifts between scientists and those who doubt them, someone claiming a certain level of expertise jumps in and sides with the regular folks, giving "proof" that their anti-science belief must be true. It could be anyone from a Greenpeace agricultural activist to a global-warming-denying politician to an anti-vaccine doctor.One such pseudo-expert who has stood up for the anti-vaccine crowd lately is Jack Wolfson, an Arizona-based cardiologist, formerly of Chicago. According to his website, Wolfson became aware of

the "brainwashing of medical training" after meeting the woman who would become his wife, a chiropractor with "a heavy focus on nutrition and healthy, chemical-free living."It's your classic cardiologist-meets-chiropractor, cardiologist-falls-in-love-with-chiropractor, caridologist-becomes-opponent-of-well-established-medical-science story. Totally legit.Now Wolfson is saying things like this to the Washington Post: "Don't be mad at me for speaking the truth about vaccines. Be mad at yourself, because you're, frankly, a bad mother. You didn't ask once about those vaccines. You didn't ask about the chemicals in them. You didn't ask about all the harmful things in those vaccines. ... People need to learn the facts."The fact is that people like Wolfson are shameless opportunists who encourage parents to embrace an arrogant, reckless and unhealthy belief. And because people want so desperately to believe what they believe — science be damned — Wolfson and his ilk probably make good money being contrarians.So count me in. If you're a practicing science-denier and need someone to shamelessly vouch for your harebrained belief, I'm the expert for you — assuming you have a lot of money.It's a well-established fact(oid) that journalists know a little about everything and a lot about nothing. That makes me the perfect person to speak with great authority about things with which I am barely familiar.Say you don't believe in electricians. I wholeheartedly agree, and will stake my years of occasionally using the word "electrician" in newspaper stories on the belief that no "trained and licensed expert" knows the wiring in your house better than you do.If that wiring is faulty and your house burns down, that's just nature's way of saying you need a new house. And if the fire from your house spreads across the whole neighborhood, that's not your fault. You can't be held responsible for the flammability of other people's homes.See how easy this is?Based on the swift and utterly absurd resurgence of measles, it seems being an advocate for incorrect causes might be a growth industry. And if people continue to doubt science, it seems like measles might be the least of our problems.Which is why I shall pancake eggplant every chance I schadenfreude.

Antiscience is growingOtto 12 — Shawn Lawrence Otto, Co-founder of ScienceDebate.org and author of Fool Me Twice: Fighting the Assault on Science in America. He is recipient of IEEE-USA's Award for Distinguished Public Service and writes for the Huffington Post and blogs at Neorenaissance.org, Shawn Lawrence Otto is an American novelist, nonfiction author, filmmaker, political strategist, speaker, science advocate, and screenwriter and co-producer of the movie House of Sand and Fog, 10-16-2012 ("Antiscience Beliefs Jeopardize U.S. Democracy," No Publication, 10-16-2012, Available Online at http://www.scientificamerican.com/article/antiscience-beliefs-jeopardize-us-democracy/, Accessed 7-20-2015)It is hard to know exactly when it became acceptable for U.S. politicians to be antiscience. For some two centuries science was a preeminent force in American politics, and scientific innovation has been the leading driver of U.S. economic growth since World War II. Kids in the 1960s gathered in school cafeterias to watch moon launches and landings on televisions wheeled in on carts. Breakthroughs in the 1970s and 1980s sparked the computer revolution and a new information economy. Advances in biology, based on evolutionary theory, created the biotech industry. New research in genetics is poised to transform the understanding of disease and the practice of medicine, agriculture and other fields.

The Founding Fathers were science enthusiasts. Thomas Jefferson, a lawyer and scientist, built the primary justification for the nation's independence on the thinking of Isaac Newton, Francis Bacon and John Locke—the creators of physics, inductive reasoning and empiricism. He called them his “trinity of three greatest men.” If anyone can discover the truth by using reason and science, Jefferson reasoned, then no one is naturally closer to the truth than anyone else. Consequently, those in positions of authority do not have the right to impose their beliefs on other people. The people themselves retain this inalienable right. Based on this foundation of science—of knowledge gained by systematic study and testing instead of by the assertions of ideology—the argument for a new, democratic form of government was self-evident.Yet despite its history and today's unprecedented riches from science, the U.S. has begun to slip off of its science foundation. Indeed, in this election cycle, some 236 years after Jefferson penned the Declaration of Independence, several major party contenders for political office took positions that can only be described as “antiscience”: against evolution, human-induced climate change, vaccines, stem cell research, and more. A former Republican governor even warned that his own political party was in danger of becoming “the antiscience party.”Such positions could typically be dismissed as nothing more than election-year posturing except that they reflect an anti-intellectual conformity that is gaining strength in the U.S. at precisely the moment that most of the important opportunities for economic growth, and serious threats to the well-being of the nation, require a better grasp of scientific issues. By turning public opinion away from the antiauthoritarian principles of the nation's founders, the new science denialism is creating an existential crisis like few the country has faced before.In late 2007 growing concern over this trend led six of us to try to do something about it. Physicist Lawrence M. Krauss, science writer and film director Matthew Chapman (who is Charles Darwin's great–great-grandson), science philosopher Austin Dacey, science writer Chris Mooney, marine biologist Sheril Kirshenbaum and I decided to push for a presidential science debate. We put up a Web site and began reaching out to scientists and engineers. Within weeks 38,000 had signed on, including the heads of several large corporations, a few members of Congress from both parties, dozens of Nobel laureates, many of the nation's leading universities and almost every major science organization. Although presidential hopefuls Barack Obama and John McCain both declined a debate on scientific issues, they provided written answers to the 14 questions we asked, which were read by millions of voters.In 2012 we developed a similar list, called “The Top American Science Questions,” that candidates for public office should be answering [see “Science in an Election Year” for a report card by Scientific American's editors measuring how President Obama and Governor Mitt Romney did]. The presidential candidates' complete answers, as well as the responses provided by key congressional leaders to a subset of those questions, can be found at www.ScientificAmerican.com/nov2012/science-debate and at www.sciencedebate.org/debate12.These efforts try to address the problem, but a larger question remains: What has turned so many Americans against science—the very tool that has transformed the quality and quantity of their lives?

Antiscience grows on the political systemOtto 12 — Shawn Lawrence Otto, Co-founder of ScienceDebate.org and author of Fool Me Twice: Fighting the Assault on Science in America. He is recipient of IEEE-USA's Award for Distinguished Public Service and writes for the Huffington Post and blogs at Neorenaissance.org, Shawn Lawrence Otto is an American novelist, nonfiction author, filmmaker, political strategist, speaker, science advocate, and screenwriter and co-producer of the movie House of Sand and Fog, 10-16-2012 ("Antiscience Beliefs

Jeopardize U.S. Democracy," No Publication, 10-16-2012, Available Online at http://www.scientificamerican.com/article/antiscience-beliefs-jeopardize-us-democracy/, Accessed 7-20-2015)A Call to ReasonToday's denial of inconvenient science comes from partisans on both ends of the political spectrum. Science denialism among Democrats tends to be motivated by unsupported suspicions of hidden dangers to health and the environment. Common examples include the belief that cell phones cause brain cancer (high school physics shows why this is impossible) or that vaccines cause autism (science has shown no link whatsoever). Republican science denialism tends to be motivated by antiregulatory fervor and fundamentalist concerns over control of the reproductive cycle. Examples are the conviction that global warming is a hoax (billions of measurements show it is a fact) or that we should “teach the controversy” to schoolchildren over whether life on the planet was shaped by evolution over millions of years or an intelligent designer over thousands of years (scientists agree evolution is real). Of these two forms of science denialism, the Republican version is more dangerous because the party has taken to attacking the validity of science itself as a basis for public policy when science disagrees with its ideology.It gives me no pleasure to say this. My family founded the Minnesota Republican Party. But much of the Republican Party has adopted an authoritarian approach that demands ideological conformity, even when contradicted by scientific evidence, and ostracizes those who do not conform. It may work well for uniform messaging, but in the end it drives diverse thinkers away—and thinkers are what we need to solve today's complex problems.This process has left a large, silent body of voters who are fiscally conservative, who believe in science and evidence-based policies, and who are socially tolerant but who have left the party. In addition, Republican attacks on settled scientific issues—such as anthropogenic climate change and evolution—have too often been met with silence or, worse, appeasement by Democrats.Governor Romney's path to endorsement exemplifies the problem. “I don't speak for the scientific community, of course, but I believe the world is getting warmer,” Romney told voters in June 2011 at a town hall meeting after announcing his candidacy. “I can't prove that, but I believe based on what I read that the world is getting warmer, and number two, I believe that humans contribute to that.” Four days later radio commentator Rush Limbaugh blasted Romney on his show, saying, “Bye-bye nomination. Bye-bye nomination, another one down. We're in the midst here of discovering that this is all a hoax. The last year has established that the whole premise of man-made global warming is a hoax! And we still have presidential candidates who want to buy into it.By October 2011 Romney had done an about-face. “My view is that we don't know what's causing climate change on this planet, and the idea of spending trillions and trillions of dollars to try and reduce CO2 emissions is not the right course for us,” he told an audience in Pittsburgh, then advocated for aggressive oil drilling. And on the day after the Republican National Convention, he tacked back toward his June 2011 position when he submitted his answers to ScienceDebate.org.Romney is not alone in appreciating the political necessity of embracing antiscience views. House Speaker John A. Boehner, who controls the flow of much legislation through Congress, once argued for teaching creationism in science classes and asserted on national television that climate scientists are suggesting that carbon dioxide is a carcinogen. They are not. Representative Michele Bachmann of Minnesota warned in 2011 during a Florida presidential primary debate that “innocent little 12-year-old girls” were being “forced to have a government injection” to prevent infection with human

papillomavirus (HPV) and later said the vaccine caused “mental retardation.” HPV vaccine prevents the main cause of cervical cancer. Religious conservatives believe this encourages promiscuity. There is no evidence of a link to mental retardation.In a separate debate, Republican candidate Jon Huntsman was asked about comments he had made that the Republican Party is becoming the antiscience party. “All I'm saying,” he replied, “is that for the Republican Party to win, we can't run from science.” Republican primary voters apparently disagreed. Huntsman, the lone candidate to actively embrace science, finished last in the polls.In fact, candidates who began to lag in the GOP presidential primaries would often make antiscience statements and would subsequently rise in the polls. Herman Cain, who is well respected in business circles, told voters that “global warming is poppycock.” Newt Gingrich, who supported doubling the budget of the National Institutes of Health and who is also a supporter of ScienceDebate.org, began describing stem cell research as “killing children in order to get research material.” Candidates Rick Perry and Ron Paul both called climate change “a hoax.” In February, Rick Santorum railed that the left brands Republicans as the antiscience party. “No. No, we're not,” he announced. “We're the truth party.”Antiscience reproductive politics surfaced again in August, this time in one of the most contested U.S. Senate races. Todd Akin, who is running in Missouri against Claire McCaskill, said that from what he understood from doctors, pregnancy from rape is extremely rare because “if it's a legitimate rape, the female body has ways to try to shut that whole thing down.” Akin sits on the House Committee on Science, Space, and Technology, which is responsible for much of the U.S. federal science enterprise, so he should be aware of what science actually says about key policy issues. In fact, studies suggest that women are perhaps twice as likely to become pregnant from rape, and, in any event, there is no biological mechanism to stop pregnancy in the case of rape. Akin's views are by no means unusual among abortion foes, who often seek to minimize what science says to politically justify a no-exception antiabortion stance, which has since become part of the 2012 national GOP platform.A look at down-ticket races suggests that things may get worse. The large crop of antiscience state legislators elected in 2010 are likely to bring their views into mainstream politics as they eventually run for Congress. In North Carolina this year the state legislature considered House Bill No. 819, which prohibited using estimates of future sea-level rise made by most scientists when planning to protect low-lying areas. (Increasing sea level is a predicted consequence of global warming.) The proposed law would have permitted planning only for a politically correct rise of eight inches instead of the three to four feet that scientists predict for the area by 2100.

Knowledge and facts are key to prevent anti-scienceOtto 12 — Shawn Lawrence Otto, Co-founder of ScienceDebate.org and author of Fool Me Twice: Fighting the Assault on Science in America. He is recipient of IEEE-USA's Award for Distinguished Public Service and writes for the Huffington Post and blogs at Neorenaissance.org, Shawn Lawrence Otto is an American novelist, nonfiction author, filmmaker, political strategist, speaker, science advocate, and screenwriter and co-producer of the movie House of Sand and Fog, 10-16-2012 ("Antiscience Beliefs Jeopardize U.S. Democracy," No Publication, 10-16-2012, Available Online at http://www.scientificamerican.com/article/antiscience-beliefs-jeopardize-us-democracy/, Accessed 7-20-2015)An Existential Crisis

“Facts,” John Adams argued, “are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” When facts become opinions, the collective policymaking process of democracy begins to break down. Gone is the common denominator—knowledge—that can bring opposing sides together. Government becomes reactive, expensive and late at solving problems, and the national dialogue becomes mired in warring opinions.In an age when science influences every aspect of life—from the most private intimacies of sex and reproduction to the most public collective challenges of climate change and the economy—and in a time when democracy has become the dominant form of government on the planet, it is important that the voters push elected officials and candidates of all parties to explicitly state their views on the major science questions facing the nation. By elevating these issues in the public dialogue, U.S. citizens gain a fighting chance of learning whether those who would lead them have the education, wisdom and courage necessary to govern in a science-driven century and to preserve democracy for the next generation.

Anti-science Impact — AuthoritarianismAntiscience leads to authoritarian regimes, dominant narratives win and the voter remains uninformed.Otto 12 — Shawn Lawrence Otto, Co-founder of ScienceDebate.org and author of Fool Me Twice: Fighting the Assault on Science in America. He is recipient of IEEE-USA's Award for Distinguished Public Service and writes for the Huffington Post and blogs at Neorenaissance.org, Shawn Lawrence Otto is an American novelist, nonfiction author, filmmaker, political strategist, speaker, science advocate, and screenwriter and co-producer of the movie House of Sand and Fog, 10-16-2012 ("Antiscience Beliefs Jeopardize U.S. Democracy," No Publication, 10-16-2012, Available Online at http://www.scientificamerican.com/article/antiscience-beliefs-jeopardize-us-democracy/, Accessed 7-20-2015)An Antiscience PhilosophyIf both Democrats and Republicans have worn the antiscience mantle, why not just wait until the pendulum swings again and denialism loses its political potency? The case for action rests on the realization that for the first time since the beginning of the Enlightenment era in the mid-17th century, the very idea of science as a way to establish a common book of knowledge about the world is being broadly called into question by heavily financed public relations campaigns.Ironically, the intellectual tools currently being used by the political right to such harmful effect originated on the academic left. In the 1960s and 1970s a philosophical movement called postmodernism developed among humanities professors displeased at being deposed by science, which they regarded as right-leaning. Postmodernism adopted ideas from cultural anthropology and relativity theory to argue that truth is relative and subject to the assumptions and prejudices of the observer. Science is just one of many ways of knowing, they argued, neither more nor less valid than others, like those of Aborigines, Native Americans or women. Furthermore, they defined science as the way of knowing among Western white men and a tool of cultural oppression. This argument resonated with many feminists and civil-rights activists and became widely adopted, leading to the “political correctness” justifiably hated by Rush Limbaugh and the “mental masturbation” lampooned by Woody Allen.Acceptance of this relativistic worldview undermines democracy and leads not to tolerance but to authoritarianism. John Locke, one of Jefferson's “trinity of three greatest men,” showed why almost three centuries ago. Locke watched the arguing factions of Protestantism, each claiming to be the one true religion, and asked: How do we know something to be true? What is the basis of knowledge? In 1689 he defined what knowledge is and how it is grounded in observations of the physical world in An Essay Concerning Human Understanding. Any claim that fails this test is “but faith, or opinion, but not knowledge.” It was this idea—that the world is knowable and that objective, empirical knowledge is the most equitable basis for public policy—that stood as Jefferson's foundational argument for democracy.By falsely equating knowledge with opinion, postmodernists and antiscience conservatives alike collapse our thinking back to a pre-Enlightenment era, leaving no common basis for public policy. Public discourse is reduced to endless warring opinions, none seen as more valid than another. Policy is determined by the loudest voices, reducing us to a world in which might makes right—the classic definition of authoritarianism.Reporters who agree with this statement will not dig to get to the truth and will tend to simply present “both sides” of contentious issues, especially if they cannot judge the validity of scientific evidence. This

kind of false balance becomes a problem when one side is based on knowledge and the other is merely an opinion, as often occurs when policy problems intersect with science. If the press corps does not strive to report objective reality, for which scientific evidence is our only reliable guide, the ship of democracy is set adrift from its moorings in the well-informed voter and becomes vulnerable once again to the tyranny that Jefferson feared.

Anti-science Impact — WarmingWarming and public health are inextricably linked.Abrams 15 — Lindsay Abrams, Lindsay Abrams is an assistant editor at Salon and a former writer and producer for The Atlantic's Health Channel, 2-6-2015 ("What the anti-vaxx backlash can teach us about climate change: We need to be way angrier," Salon, 2-6-2015, Available Online at http://www.salon.com/2015/02/06/what_the_anti_vaxx_backlash_can_teach_us_about_climate_change_we_need_to_be_way_angrier/, Accessed 7-20-2015)The words were barely out of the 2016 hopefuls’ mouths before they were quickly made to regret them.The backlash to comments made by Chris Christie and Rand Paul this week — suggesting that parents should be able to choose whether to vaccinate their children — was fast, furious and nearly universal, even among conservative news outlets. To wit: Fox News host Megyn Kelly stood up for “Big Brother” as a means of ensuring herd immunity. Breitbart News argued that Christie and Paul deserved the media criticism being hurled their way. And, in a stinging rebuttal, the Wall Street Journal editorial board rebuked Paul for “indulging bad science,” calling vaccination laws “a reasonable and small sacrifice of liberty to prevent the potentially fatal infection of unsuspecting infants at Disneyland.”It was a bipartisan takedown driven not by politics, but a much deeper sense of moral outrage: that it is wrong to ignore science, and a downright crime when, in so doing, you put our children’s health at risk. And as a society, we will not tolerate it.Now, if only we could take that same outrage and channel it at climate change — and the denialists running our government.The scientific consensus on man-made climate change, after all, is incredibly strong, and the health impacts of burning fossil fuels are undeniable. Air pollution is the “single largest environmental health risk” facing the world today, as well as a leading cause of cancer, and children are particularly vulnerable to its effects. Last June, when the EPA introduced its plan to limit pollution from coal-fired power plants, it emphasized the fact that we’d feel the benefit, first, in our lungs. Indeed, the American Lung Association predicted the rules could prevent up to 4,000 premature deaths and 100,000 asthma attacks in their first year alone. The agency took the same tack this past November when it unveiled its proposal to crack down on smog-causing ozone, arguing that the current standard of 75 parts per billion is too weak to protect public health.Even if mitigating climate change was only a side effect of creating cleaner air, such policies would still be worth pursuing. But climate change is a public health threat in its own right, creating the conditions for new and intensified risks, many of which we’re already experiencing.In an investigative piece for Mother Jones, David Ferry attempts to garner outrage for the plight of prisoners in California’s Central Valley, thousands of whom have fallen ill from valley fever. The potentially fatal disease, contracted from fungal spores and kicked up by dust, is raging through the Southwest, fueled in part by a climate that’s becoming increasingly hot and dry. “If valley fever was endemic to the hills above Rodeo Drive or the boulevards of Palo Alto and struck down Caucasians with the ferocity it lays out African Americans,” Ferry charges, “it would be the kind of public health emergency that sends Anderson Cooper into the field with a face mask.” And as climate change worsens, experts say, so too will the epidemic.Then, there are the mosquitoes, which are growing in number and range where climate change leads to warmer and wetter conditions. As the insects continue to creep north, as scientists predict, the U.S. could see dengue fever epidemics of the sort that created a public health emergency in Central

America last summer. (Globally, a recent study found, billions more will become newly vulnerable to the disease.) Meanwhile, other diseases Americans have barely if ever even seen before — like the painful, mosquito-born chikungunya — are posing a brand-new threat: Researchers at Yale University have warned of the potential for “a historic epidemic on U.S. shores.” And Chagas disease, which is already gaining a foothold in Texas, is similarly poised to explode. Referring to the need for expensive, long-term treatment and the disease’s disproportionate effect on the poor, tropical disease experts at Baylor College of Medicine in Houston dubbed it “the new AIDS of the Americas.”The list of climate-change threats goes on: air pollution from increased wildfires, the rising threat of waterborne illness, the health risks and hazards posed by natural disasters and the mental health impacts that can arise in their aftermath. A recent survey of members of the American Thoracic Society — physicians who specialize in respiratory and critical care — revealed that the majority are already seeing symptoms in their patients that they believe are linked to climate change. That includes an increase in chronic respiratory disease from air pollution, but also increases in symptoms of allergies and in injuries attributed to extreme weather.And that’s to say nothing of the threats of extreme heat, itself already the leading cause of weather-related deaths in the U.S. The National Climate Assessment warns that heat waves are projected to increase in frequency, intensity and duration, putting urban populations, and the poor in particular, at risk of death due to heat stroke, as well as cardiovascular, respiratory and cerebrovascular disease.Over and over again, it’s the most vulnerable — children and the elderly, the sick and the immunocompromised, the poor and certain minority groups — who get thrown under the bus when leaders ignore the risks in favor of scoring political points.If the U.S. could get a handle on reducing greenhouse gas emissions, a recent study in the journal Climatic Change concluded, we could save between $6 billion and $14 billion in healthcare costs in 2020 – and between $10 billion and $24 billion if we really cracked down. Climate policy, in other words, is public health policy, and ignoring the science behind the former is a direct attack on the latter. This isn’t a new idea, but it’s one that’s failed, thus far, to trigger our primal desire to protect the commons from the anti-science antics of the few.Why aren’t we angrier? Climate change is a more abstract issue, to be sure, as well as one that lacks a clear villain — it’s easier to castigate a small group of people for threatening the larger public than to acknowledge the culpability we all share in climate change, not to mention the sacrifices we’ll all have to make to address it head-on. The anti-vaxxer community may be an intractable force, but they’ve got nothing compared to the money and power wielded by special interests insisting that climate change is a giant hoax — and who, in so doing, lead others to believe that the science isn’t nearly as settled as it in fact is.But where anti-vaxxers and climate deniers differ, the same logic that caused us to lash out at politicians pandering to the former should carry over to the latter. Science denial, in all its forms, has consequences. And it’s about time we stopped tolerating it.

EconomyVaccinations greatly help third world economies. Berkley, 12— Seth Berkley, Seth Berkley is the founder and former president and CEO of IAVI. A medical doctor specializing in infectious disease epidemiology, Seth currently serves as president and CEO of the GAVI Alliance. Before launching IAVI in 1996, Berkley was an officer of the Health Sciences Division at the Rockefeller Foundation. Prior to that, he worked for the Center for Infectious Diseases of the US Centers for Disease Control and Prevention, the Massachusetts Department of Public Health, and for the Carter Center, where he was assigned as an epidemiologist at the Ministry of Health in Uganda. Seth played a key role in Uganda’s first national HIV sero-survey and helped develop its National AIDS Control programs. He has been featured on the cover of Newsweek, recognized by TIME magazine as one of the "100 Most Influential People in the World" and by Wired Magazine as among "The Wired 25"—a salute to dreamers, inventors, mavericks and leaders. He has consulted or worked in more than 25 countries in Asia, Africa and Latin America. Berkley received his undergraduate and medical degrees from Brown University, and trained in internal medicine at Harvard University, 12-7-2012 ("How vaccines save lives, grow economies," CNN, 12-7-2012, Available Online at http://www.cnn.com/2012/12/07/opinion/vaccine-gavi-seth-berkley/, Accessed 7-21-2015)We all know that vaccines save lives by protecting people against disease. What is less well-known is that vaccines also are an engine for economic growth -- far beyond their health benefits.I am reminded of this in Tanzania this week, where my organization, the GAVI Alliance, is hosting a conference for its partners. GAVI's mission is to save children's lives and protect people's health by increasing access to immunization in developing countries.We don't do this alone. We have many partners, including prominent companies that work closely with GAVI. They recognize that in addition to the humanitarian need, countries such as Tanzania are emerging markets that can fulfill their economic ambitions only if they also can ensure good health for their citizens.The private sector is a critical part of the equation. Our corporate partners know they can do well by doing good.Consider Tanzania. It has an ambitious five-year development plan that aims to transform the country into a middle-income economy by 2025. The plan includes critical funding to ensure a healthy population by strengthening the health system, which will significantly improve child and maternal mortality rates.Tanzania already has begun this process by working closely with GAVI and its partners to significantly increase its routine vaccine coverage rates to above 90% today from 79% in 2001, the year before GAVI began its work there, according to data from the World Health Organization and UNICEF. At the same time, Tanzania's GDP growth has been astounding, rising to $23.7 billion last year from $10.2 billion in 2001, according to the World Bank.Is there a connection? Further study is needed in the case of Tanzania. But we know for a fact that vaccines -- in addition to saving lives and improving health -- are the cornerstone of a vibrant economy, fuel growth and serve as a magnet for foreign investment. Indeed, research has shown vaccines to be among the most cost-effective investments in global development.This has been borne out of several independent studies that look beyond the health impacts toward areas such as cognitive development, educational attainment, labor productivity and financial attainment.

In other words, healthier children -- spurred by immunization -- attend school more often, learn more while they are there and remain in school longer. As adults, they therefore are more productive, earn more money, save and invest more, and live longer. Healthier children also spread less disease through the adult population, further increasing productivity.These academic papers, including one recently published that focuses on how to measure the economic benefits of the HPV vaccine, are getting noticed in African countries -- not only by health ministers, but also by finance ministers and other officials.For instance, I attended a landmark meeting in Tunis in July organized by the African Development Bank, where its President Donald Kaberuka brought together a variety of ministers and experts to discuss how to allocate budgets and make healthcare a national priority.I was in Tunis because of the wide recognition that immunization can be the high-octane fuel that leads to increased trade, capital infrastructure projects and technological improvement.This brings me back to the private sector and the benefits many companies now see in playing a role in supporting global health, including immunization services. One benefit, of course, is humanitarian. The GAVI Alliance -- with help from partners such as UNICEF, WHO, the Bill & Melinda Gates Foundation, the World Bank and donors -- has helped countries immunize 370 million people, saving more than 5.5 million lives since 2000.GAVI now is in the midst of helping immunize another quarter billion people, which could save an additional 4 million lives by 2015. The private sector is involved, providing core business skills to tackle key obstacles to immunization in the developing world.For example, GAVI is working with a leading telecommunications company to explore the use of its mobile technology with hopes of improving vaccine stock management in implementing countries and alerting parents when children are due for vaccines.GAVI is constantly looking for partners to lend their business savvy to help us accomplish our mission. An increasing number of them are responding, compassionate in their outlook while aware of the underlying economic value of vaccines.They understand that this is the highest return on investment they could ever make.

Vaccination saves a ton of moneyNaprawa, 15 — Amanda Z. Naprawa, Amanda Z. Naprawa is an attorney and will receive her Masters of Public Health from the University of California, Berkeley, in spring 2015. She is also the mother of 2 young children. She is passionate about immunization as a mother, lawyer, and public health advocate, 6-9-2015 ("Vaccines Don't Just Save Lives—They Save Money," @berkeleywellness, 6-9-2015, Available Online at http://www.berkeleywellness.com/healthy-community/contagious-disease/health-care-policy/article/vaccines-save-more-lives, Accessed 7-21-2015)Vaccines are considered to be among the greatest human inventions of all time. They are directly responsible for the increased life expectancy we enjoy by preventing childhood death from diseases such as measles, pertussis, and diphtheria. The CDC estimates that, among children born in the last 20 years, vaccinations will prevent more than 21 million hospitalizations and 732,000 deaths.But beyond saving lives, this reduction in disease means a reduction in the cost of treating these illnesses. Which translates into vaccines being not only lifesaving, but money-saving as well.How exactly do vaccines save money? When a child gets sick with a vaccine-preventable illness (as with any very serious illness), she will need to seek treatment and this of course is going to cost something. Now if the child gets a serious complication, she may need to be hospitalized. So there are hospital bills, medications, and doctor visits before, during, and after the illness. Tragically, if there are long-term

complications, such as deafness from mumps or brain damage from measles, there will be costs associated with this as well (adaptive devices, special education requirements, etc).One study in the journal Pediatrics examined the total costs associated with a variety of vaccine-preventable diseases—and thus the savings incurred by vaccinating—and the results were impressive. For example, the cost per hospitalization for an infection with haemophilus influenza type B (Hib), a very serious bacterial illness,with resulting meningitis can cost over $43,000. An estimated 19,000 cases of Hib infection will be prevented over the lifetimes of children born in 2009 because of routine immunization, saving an estimated $1.8 billion in disease-treating costs. When you add in all the other diseases that we routinely vaccinate against in the United States, the estimated savings are staggering.In economic terms, those are considered "direct costs"—that is, the money that goes directly to the care of an ill child. But it's important to remember that when a child gets sick and hospitalized, there are costs beyond simply treating the illness. Her parents may have to take time off of work, incurring lost income. There may be insurance copayments to meet. If the child has long-term consequences from the illness, there may also be lost opportunities for income. And should this child have inadvertently exposed others, there might be a cascading public health crisis, with daycares shut and public health agencies mandating quarantines.Public savingsThe public can incur significant expenses from nonvaccination as well, often referred to as "societal" or "indirect" costs. For example, it can cost public health departments close to $10,000 per day to contain an outbreak such as the recent measles outbreak—including identifying all possible infections, making contact with people who may have been exposed and following them for the entire incubation period, issuing orders to exclude unvaccinated children from school, working with other local health departments and hospitals on containment and treatment protocols, and providing additional vaccinations. The average outbreak control period is 18 days; that’s $180,000 to control a disease that could have been prevented through vaccination.These costs, both direct and indirect, are so impressive that it’s considered financially irresponsible to limit access to routine immunizations based on family income or insurance status. In 1994, the U.S. government began a program called Vaccines for Children, which provides vaccines to children who would otherwise not be able to afford them. This program is estimated not only to have saved countless children from illness and death, but also to have saved nearly $259 billion in direct costs and

$1.38 trillion in total societal costs. Think about that: $1.38 trillion saved by vaccines. Honestly, that number makes the 238,857 miles between here and the moon sound like a short stroll, doesn’t it?The money-saving effect of vaccines is not limited to the United States. Worldwide, the three vaccine-preventable diseases that lead to the greatest mortality in children age 5 and under are pneumococcal disease, rotavirus, and Hib infection. Those children who survive these diseases may suffer long-term complications such as blindness, deafness, or mental retardation. It is estimated that if, over the next decade, we were to begin widespread vaccination against just three diseases (Hib, pneumococcal, and rotavirus) in the world's 73 poorest countries, it would save an estimated $63 billion in treatment and lost productivity costs.So there you have it. We know vaccines save lives. But it turns out they also save money, directly and indirectly. Yet one more reason to make sure you and your loved ones are fully vaccinated.

Vaccination saves over a trillion dollars.Whitney et al. 14 — Cynthia G. Whitney, MD1, Fangjun Zhou, PhD2, James Singleton, PhD2, Anne Schuchat, MD1, 1 National Center for Immunization and Respiratory Diseases, CDC; 2Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, 4-25-2014 ("Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013," No Publication, 4-25-2014, Available Online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6316a4.htm, Accessed 7-22-2015)The Vaccines for Children (VFC) program was created by the Omnibus Budget Reconciliation Act of 1993 (1) and first implemented in 1994. VFC was designed to ensure that eligible children do not contract vaccine-preventable diseases because of inability to pay for vaccine and was created in response to a measles resurgence in the United States that resulted in approximately 55,000 cases reported during 1989–1991 (2). The resurgence was caused largely by widespread failure to vaccinate uninsured children at the recommended age of 12–15 months. To summarize the impact of the U.S. immunization program on the health of all children (both VFC-eligible and not VFC-eligible) who were born during the 20 years since VFC began, CDC used information on immunization coverage from the National Immunization Survey (NIS) and a previously published cost-benefit model to estimate illnesses, hospitalizations, and premature deaths prevented and costs saved by routine childhood vaccination during 1994–2013. Coverage for many childhood vaccine series was near or above 90% for much of the period. Modeling estimated that, among children born during 1994– 2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths over the course of their lifetimes, at a net savings of $295 billion in direct costs and $1.38 trillion in total societal costs. With support from the VFC program, immunization has been a highly effective tool for improving the health of U.S. children.Data from the 1980s suggested that measles outbreaks were linked to an ongoing reservoir of virus among high-density, low-income, inner-city populations (2). Although most children in these settings had a health-care provider, providers missed opportunities to give measles vaccine when children were in their offices, sometimes referring low-income children to another clinic where vaccines were available at no cost (3). Approximately 50% of children aged <19 years are eligible to receive vaccines through VFC (Immunization Services Division, National Center for Immunization and Respiratory Diseases, CDC, unpublished data, 2014).* Children can receive VFC-provided vaccine if they are Medicaid-eligible, uninsured, American Indian/Alaska Native, or, for underinsured children (i.e., whose health insurance does not fully cover immunizations), when they are receiving services at a federally qualified health center or rural health clinic (1). By providing vaccine for eligible children, at no charge, to public and private health-care providers who are enrolled in VFC, the program helped reinforce the "medical home." Inclusion of specific vaccines in VFC is determined by recommendations of the Advisory Committee on Immunization Practices (ACIP).To assess improvements in coverage during the VFC era, data were obtained from the United States Immunization Survey (USIS) for the period 1967–1985, the National Health Interview Survey (NHIS) for 1991–1993, and NIS for 1994–2012 (3,4). Children included in USIS and NHIS were aged 24–35 months and those in NIS were aged 19–35 months. USIS and NHIS data were from parental recollection of vaccines received, and NIS data were obtained through provider report.The cost-benefit model for U.S. children born during 1994–2013 employed methods previously used for children born in 2009 (5). A decision analysis birth cohort model was constructed using data on immunization coverage; vaccine efficacies from published literature; historical data on incidence of

illnesses, hospitalizations, and deaths from vaccine-preventable diseases before immunization was introduced; and recent vaccination period data (through 2013, if available; otherwise 2012 data were used for 2013) on these same disease outcomes. Vaccines included all those universally recommended for children aged ≤6 years except influenza vaccine, which has been modeled separately (6), and hepatitis A vaccine. Infants in hypothetical birth cohorts from the period 1994–2013 were followed from birth through death. Benefits of immunization included savings in direct and indirect costs that accrued from averting illnesses, hospitalizations, and deaths among the 20 birth cohorts. Program costs included vaccine, administration, vaccine adverse events, and parent travel and work time lost. Costs were adjusted to 2013 dollars, and future costs related to disease were discounted at 3% annually. The cost analysis was conducted from both health-care (direct) and societal (direct and indirect) perspectives, and net present value (net savings) was calculated.†When the VFC program began in 1994, vaccines targeting nine diseases were provided: diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b disease, hepatitis B, measles, mumps, and rubella (Figure). During 1995–2013, five vaccines were added for children aged ≤6 years: varicella (1996), hepatitis A (1996–1999 for high-risk areas, 2006 for all states), pneumococcal disease (7-valent in 2000, 13-valent in 2010), influenza (ages 6–23 months in 2004 and ages 6–59 months in 2006), and rotavirus vaccine (2006). Since 1996, coverage with 1 dose of a measles-containing vaccine has exceeded Healthy People§ targets of 90%, up from <70% before the 1989–1991 outbreak (Figure). For other vaccines licensed before VFC, coverage also was higher in the VFC era, as measured by NIS, than in the pre-VFC era, as measured by USIS. In general, coverage for new vaccines introduced during the VFC era increased rapidly.Among 78.6 million children born during 1994–2013, routine childhood immunization was estimated to prevent 322 million illnesses (averaging 4.1 illnesses per child) and 21 million hospitalizations (0.27 per child) over the course of their lifetimes and avert 732,000 premature deaths from vaccine-preventable illnesses (Table). Illnesses prevented ranged from 3,000 for tetanus to >70 million for measles. The highest estimated cumulative numbers of hospitalizations and deaths that will be prevented were 8.9 million hospitalizations for measles and 507,000 deaths for diphtheria. The routine childhood vaccines introduced during the VFC era (excluding influenza and hepatitis A) together will prevent about 1.4 million hospitalizations and 56,300 deaths.Vaccination will potentially avert $402 billion in direct costs and $1.5 trillion in societal costs because of illnesses prevented in these birth cohorts. After accounting for $107 billion and $121 billion in direct and societal costs of routine childhood immunization, respectively, the net present values (net savings) of routine childhood immunization from the payers' and societal perspectives were $295 billion and $1.38 trillion, respectively.

Ableism

Reject the ableist discourse surrounding vaccination debates – whether vaccines cause autism or not is irrelevant – treating autism as a negative condition comes from an incredibly neurotypical position of privilege. Thériault 15 – Anne Thériault, Toronto-based writer and activist, 2015 (“What vaxxers and anti-vaxxers are missing: Autism isn’t the worst thing to happen to a child”, Quartz, February 11, Available Online at http://qz.com/340623/what-vaxxers-and-anti-vaxxers-are-missing-autism-isnt-the-worst-thing-to-happen-to-a-child/, accessed 7/20/15, KM) Here are some typical arguments put forward by parents who choose not to vaccinate their otherwise healthy child (by “healthy” I mean they’re not asking for an exemption because the child is immunocompromised or otherwise couldn’t medically tolerate vaccinations). For this example, I will pull quotes directly from a recent New York Times Article, Vaccine Critics Turn Defensive Over

Measles: “It’s the worst shot,” [Missy Foster, mother to an 18 month old daughter] said, with tears in her eyes. “Do you want to wake up one morning and the light is gone from her eyes with autism or something?” and Kelly McMenimen, a Lagunitas parent, said she “meditated on it a lot” before deciding not to vaccinate her son Tobias, 8, against even “deadly or deforming diseases.” She said she did not want “so many toxins” entering the slender body of a bright-eyed boy who loves math and geography. You’ll notice a common theme in these defenses—the brightness of or light in their children’s eyes. This is a direct reference to Jenny McCarthy’s narrative of the “light” leaving her son’s eyes after he was vaccinated. It’s used by parents who don’t want to say the word “autism” but want to imply that they’re scared their kid will become autistic (or something similar). Here’s what McCarthy said to Oprah in 2007: “Right before his MMR shot, I said to the doctor, ‘I have a very bad feeling about this shot. This is the autism shot, isn’t it?’ And he said, ‘No, that is ridiculous. It is a mother’s desperate attempt to blame something,’ and he swore at me, and then the nurse gave [Evan] the shot,” she says. “And I remember

going, ‘Oh, God, I hope he’s right.’ And soon thereafter—boom—the soul’s gone from his eyes.” Now consider the standard response from vaccine advocates to stuff like this—it’s always, without fail, “Vaccines don’t cause autism.” Because they don’t, right? They absolutely, scientifically do not cause autism. That’s a solid fact. But here’s what everyone gets wrong: regardless of whether or not vaccines cause autism, our entire conversation surrounding them is completely ableist. When those in the anti-vaccination movement treat autism as a calamity far worse than a debilitating disease or death, that is ableism. What we also need to recognize is that every time we respond to fear-mongering about vaccines and autism with the words, “don’t worry, vaccines don’t cause autism,” that is also ableist. Because instead of pointing out that, hey, autism and neurodiversity are far from the worst things that could happen to a parent,

“vaccines don’t cause autism” falls into the same narrative as “vaccines cause autism”—both suggest that autism is this boogeyman that lives under our kids’ beds that could strike at any time. Even though telling people that vaccines don’t cause autism is factual, the way in which it’s said only validates people’s negative view of autism. Says Allison Garber, an autism activist whose most recently claim to fame is being blocked by Jenny McCarthy on Twitter, “The language from both sides of the vaccine camps is definitively ableist. What’s even more jarring is that neither side seems to ever want to invite someone who is, you know, actually autistic to the party. I guess that’s because it would be awkward if they were actually in the room when we were all talking about how somebody’s

neurological makeup is a tragedy to be feared and avoided at all costs.” Instead of reassuring parents that vaccines don’t cause autism (which, again: factually true), why don’t we start refuting anti-vaccination advocates with the fact that autism isn’t a catastrophe . Why not start sending them links to blogs and articles written by people who actually have autism. Why not say something like, “it’s been proven that there’s no link between vaccines and autism, but I think it would be great for you to re-evaluate why you think so negatively of autism.” And for the love of Pete can we please stop talking about how autistic people have no light in their eyes or no soul or whatever. First of all, you’re confusing vampirism with autism. Second of all, how can you talk about real, living people like that? Would you tell Temple Grandin to her face that the “light” (whatever that even means) is missing from her eyes? If you went to a book reading by John Robison, would you greet him afterwards with the words “So, what’s it like not having a soul? Do you still have a

reflection? Can you eat garlic? Do you sleep in a coffin?” Autistic people aren’t “gone.” Their brains function differently than neurotypical brains, which often leads to them becoming overwhelmed by outside stimuli in a way that other people might not. So, in a sense, they’re more present than many of us are—they’re bombarded by sights, sounds and smells that neurotypical people can ignore or dismiss. They are very much “here,” trying way harder than most to process what “here” is.

So get out of here with your misinformed ideas about autistic people having no light in their eyes or no soul. Get out of here and maybe go

meet an actual autistic person. At the end of the day, words matter and how we talk about issues matters. And when those of us who believe it’s important for children to be vaccinated keep pulling out “but vaccines don’t cause autism” without following it up

with some kind of explanation that also autism isn’t a tragedy, we need to consider the impact our words might have. Because of course the end goal is to vaccinate every child eligible for vaccination, but we don’t need to throw autistic people under the bus to accomplish that goal. The debate about vaccination should be autism-inclusive, and that means re-evaluating the way we talk about autism and vaccines. Because while it’s great to raise a happy healthy kid, you can do that without turning them into an anti-autism bigot.

The anti-vax propaganda tactic of characterizing autism as “worse than death” is dehumanizing and false – voting neg against anti-vaccination is the first step to deconstructing ableism in society. Raygender 15 – Raygender, social justice blogger that focuses on police brutality, racism, LGBTQ issues, and mental health issues, 2015 (“Ableism, Disability, and The Conversation About Vaccines: An Autistic Perspective”, Raygender, February 6, Available Online at https://raygender.wordpress.com/2015/02/06/ableism-disability-and-the-conversation-about-vaccines-an-autistic-perspective/, accessed 7/21/15, KM)

There’s been a lot of talk about vaccines lately, and how diseases that were once almost eradicated are starting to come back because unvaccinated children are being exposed, or exposing others, to viruses. I’m glad this issue is getting more attention. It’s something we need to talk about! Vaccines have genuinely improved society by preventing people from contracting some illnesses they could potentially die from. Now that people are avoiding them, some of those diseases are coming back, and putting people’s lives at risk. I would be even happier if the

mainstream conversation reflected the conversation that’s been happening in the autistic community for years. That’s right — autistic people have been speaking out about vaccines ever since the anti-vaccination movement began. From the very beginning, the anti-vaccination movement has been an autism issue. You cannot talk about one without the other. People’s reasoning for avoiding vaccines stems from the idea that childhood vaccines cause autism, and that autism must be avoided at all costs. To leave this out is to skip over one of the many ways the anti-vaccination movement is hurting people. The anti-vaccination movement has its origins in the work of Andrew Wakefield — a former medical researcher who published a study in 1998 claiming that the measles vaccine was responsible for the supposed “autism epidemic.” No researchers could reproduce Wakefield’s claims — a sure sign in the scientific community that a theory is false — and in 2004, an investigation revealed that Wakefield had conflicts of interest and had committed misconduct. This included subjecting the children involved in his study to unnecessary, abusive medical procedures. Sadly, debunking Wakefield’s study was not enough to stem the tide of the anti-

vaccination movement. The idea that childhood vaccines caused autism fits perfectly into people’s ideas about the so-called “autism epidemic.” It’s a fact that autism diagnoses are on the rise, but it’s not a fact that this is because of vaccines, or chemicals, or television, or smart phones, or anything else. In fact, the most likely “cause” is simply that doctors are getting better at diagnosing people. There’s nothing sinister behind it, and there’s certainly nothing sinister about autism itself — something else that autistic

people have had a hard time convincing others of. Even if vaccines did cause autism — which, seriously, we have no actual proof that they do — why is that enough motivation to risk destroying herd immunity and creating a measles epidemic? You can die of measles; you can’t die of autism. The answer, of course, is ableism. People are afraid of disability. And it goes beyond just worrying that if disabled, they won’t be able to work or they’ll be excluded

from society. People think disability is a fate worse than death, when really it’s just another aspect of human diversity. And this attitude of fear is extremely harmful. Just look at Jenny McCarthy and her organization Generation Rescue, who have led the anti-vaccine movement, at the cost of thousands of lives. Generation Rescue’s name refers to “rescuing”

children from autism, or rescuing society from the “autism epidemic.” Autism isn’t something anyone needs to be “rescued” from; it is not holding children hostage, like another organization, Autism Speaks, has claimed. It is not depriving families of the “normal” child they feel they deserve to have, and it is not a danger to society. In fact, “rescuing” children from autism is far more dangerous. Therapies used to “treat” autism, like Applied Behavior Analysis, use the same principles

as gay “conversion” therapy — in other words, the goal is to make the patient behave in socially acceptable ways, which means suppressing their own, natural ways of behaving — something that is best accomplished by abuse, and can lead to lifelong trauma. Parents have also been

known to give their children bleach enemas, beat them, and “train” them like dogs, all in an attempt to “rescue” them from autism. Now, that this issue is hitting the mainstream, we have a unique opportunity to talk about autism and abliesm. The anti-vaccination movement is based on fear of autism. It is based on the idea that autistic children are soulless — that, in the words of one horrific advertisement, “you can’t die from autism, but you can’t really live

with it either.” This attitude just creates even more fear. People with a range of disabilities are affected by the vaccination issue. People with vulnerable immune systems are put at risk, with the message that if they can’t survive without the aid of

medical science, they’re somehow a drain on society. And autistic people, or anyone else with a condition that’s supposedly caused by vaccines, is told that they are soulless monsters, not even really alive, and that parents are right to do everything in their power to avoid having a child like them. Even well-intentioned pro-vaccine advocates have fallen into the trap of ableism. It’s very easy to ignore the deeper issues all together. The facts say vaccines don’t cause autism. So many people have assured parents that they have nothing to worry about; vaccines won’t cause their child to come down with a horrible

disease. But autism isn’t a horrible disease. It isn’t monstrous or tragic. And as long as people think it is, and avoid speaking out against fear, autistic people will continue to suffer. Just as all disabled people suffer when people think our lives are tragic, and that we are burdens. I hope that the mainstream conversation on vaccines has room for these issues. Illnesses like those we vaccinate against in early childhood are terrible, and can affect anyone. They can kill. This is not preferable to autism. It is not preferable to the disabilities that might result from illnesses like polio or meningitis. Disabled people

are better off alive because all people are better off alive. This should be the focus, because so many lives are being threatened by the anti-vaccine movement. People are at risk for dying from preventable diseases, and autistic people are at risk for dying at the hands of caretakers and parents who see them as a burden. My greatest hope is that we can eliminate these deaths completely if we stand together and remember that autism isn’t anything to be scared of.

Autism is not a “tragedy”, “burden”, or “crisis” – challenging the ableist logic of things like anti-vaccination is key to breaking down neurotypical constructions of disability that shape policies and cause violence. Kurchak 15 – Sarah Kurchak, writer and autistic advocate, 2015 (“Autistic people are not tragedies. My life has value and joy”, The Guardian, April 30, Available Online at http://www.theguardian.com/commentisfree/2015/apr/30/autism-is-not-a-tragedy-take-it-from-me, accessed 7/21/15, KM) The existence of autistic people like me is not a “tragedy”. Yet many autism awareness narratives insist it is because they prioritize the feelings of neurotypicals (non-autistic people) and dismisses the rest of us as little more than zombies. And when people buy into this idea, it actively hurts autistic people. When I was finally diagnosed with autism spectrum disorder six years ago, I wouldn’t shut up about it. In part, this was because I, like many autistics, tend to perseverate about the things that intensely fascinate me and, at that moment, there was nothing more fascinating to me than discovering that there was an explanation for all of my sensory sensitivities, social issues, repetitive behaviors and obsessive interests. I also believed in the importance of autism awareness. But once I started participating in awareness campaigns I found the same overly simplistic and fear-mongering message over and over again: autism is a “crisis”. According to the highly influential charity Autism Speaks (which doesn’t have a single autistic person on its board), autistic people are “missing” – we leave our family members “depleted. Mentally. Physically. And especially emotionally.” Defining our existences solely as a tragedy for non-autistic people is

hurtful on a personal level. No one deserves to be told that they are nothing but a burden to the people who love

them and everyone has the right to feel like their lives have value. But it also has troubling implications for public policy. If autism is only presented as an unequivocally terrible curse that must be “cured” and eliminated, then charities that are primarily focused on finding a cure – like Autism Speaks – will continue to receive the bulk of ASD-related funding and volunteer hours. Even if a cure is possible or preferable

(both of which are arguable) these wild stabs at hunting down genetic bogeymen in the hopes of eliminating them in the future do nothing

to improve the lives of the autistic people and their caregivers who are struggling with a scarcity of both resources and understanding right now. This line of thought also eclipses more nuanced discussions

that might help to make life more manageable for the people who make up this so-called autism epidemic. If you spend time following hashtags like #ActuallyAutistic and the work of organizations like the Autistic Self Advocacy Network

and the Autism Women’s Network, a cure is the last things on any of our minds. We want to talk about autism acceptance. We want people to understand that everyone on the spectrum, verbal or otherwise, has value and we want to work so that everyone has a voice, be it verbal, written, assisted or otherwise. We want to talk

about which therapies and treatments are actually effective for us and which ones are detrimental to our well-being. And we want to know how we can create an environment in which autistic children are not at constant risk of wildly disproportionate punishment due to misunderstanding and fear. This is a particular concern with autistic children of color who face both ableism and racism, like 12-year-old Kayleb Moon-Robinson, who was charged

with a felony after kicking a garbage can. Genuine awareness of autistic people, of our lives, our needs and our value, could greatly improve the lives of people both on and off the spectrum. Autistic people and our allies just need the rest of the world to stop spreading “autism awareness” long enough to actually listen and gain some.

The anti-vaccination movement is wrong – it’s not “vaccines versus autism”, but “vaccines versus ableism” – discussion now is key to reverse the ableist fallacy of anti-vaccination. Kurchak 15 – Sarah Kurchak, writer and autistic advocate, 2015 (“I’m Autistic, And Believe Me, It’s A Lot Better Than Measles”, The Archipelago, February 6, Available Online at https://medium.com/the-archipelago/im-autistic-and-believe-me-its-a-lot-better-than-measles-78cb039f4bea, accessed 7/21/15, KM) Vaccines don’t cause autism. But even if they did, is being like me really a fate worse than death? The autistic brain is not particularly good at understanding irony, and yet most people I’ve met on the autism spectrum have, over time, developed a pretty strong grasp of the concept. Many of us have even managed to teach ourselves how to wield it. I’ve begun to suspect that this is due to our constant hands-on experience. Having an autism spectrum disorder in an ableist world means that you’re constantly exposed to cruel irony. Most frequently, this comes in the form of neurotypical (i.e. non-autistic) people who tell you, incorrectly, that you can’t or don’t feel empathy like them, and then stubbornly refuse to care about your feelings when they claim that you’re lost, that you’re a burden, and that your life is a constant source of misery for

you and everyone who loves you. There’s also my current favorite: parents who are willing to put the lives of countless human beings at risk because they’re so afraid that the mercury fairy will gives their kids a tragic case of autism if they vaccinate. Gotta protect the kids from not being able to feel empathy — who cares whether other children live or die? No matter what other lofty ideas of toxins and vaccine-related injury anti-vaxxers try to float around in their defense, that’s really what all of this is about: we’re facing a massive public health crisis because a disturbing number of people believe that autism is worse than illness or death. My neurology is the boogeyman behind a completely

preventable plague in the making. The anti-vaccination movement is a particularly bitter issue for me because it doesn’t just dehumanize me as an autistic person; it also sets off two of my biggest triggers. Like many people on the spectrum, I don’t handle it well when people are 1) wrong, and 2) unfair. I’ve always struggled to be patient with people who are clearly and obstinately wrong. Most of my elementary school report cards contained some variation of “Sarah does not suffer fools gladly” and I can’t honestly say that

I’ve made significant improvements in that arena since then. And people who refuse to vaccinate their children because they believe that vaccines cause autism are wrong. Andrew Wakefield’s infamous study that linked autism to the MMR vaccine, which first sparked anti-vax panic in 1998, was called into question in 2004 and fully retracted in 2010. Wakefield, who misrepresented or altered the subjects’ medical histories over the course of his research, lost his license that same year. No scientist has been able to reproduce his results. Major studies by The Journal of Pediatrics and the Institute of Medicine have failed to find any link between vaccines and

autism. This should be more than enough to persuade a rational person that vaccines are safe — or at least as safe as any other simple

medical procedure — but there is nothing even remotely rational about the anti-vaccination movement. It’s a dangerous and infuriating melange: poorly articulated fears of “toxins,” a failure to understand the difference between correlation and

causation, misleading articles on truther websites, and conspiracy theories that would make Fox Mulder and The Lone Gunmen blush. I can’t even begin to wrap my head around anti-vaxxers’ reasoning. How can you find fault with every single bit of evidence that we have, from every single source, about the safety of vaccines? How can you

continuously misread every single fact about their contents? How can you disregard the efficacy of vaccines in the fight against deadly and debilitating illnesses across the globe? If you can’t disregard it, how can you not care? If there really is a connection between autism and vaccines — which there’s not — and Big Pharma and/or The Man really are causing autism through vaccinations, what on earth do

you think the end game of this conspiracy is? What upsets me more than the wrongness, though, is the dangerously unfair behavior that results from it. When someone believes asinine things about vaccines, it hurts humanity on an intellectual level. When they put those beliefs into action and refuse to vaccinate their children, it puts all of us at risk of serious illness and death. The current measles outbreak, which has now infected over 100 people in 14 states and is currently spreading into Canada, is a glaring example of what can happen when people put their (ignorant) personal whims against the well-being of their community. Through no fault of their own, unvaccinated children, immunocompromised people, babies too young to receive the vaccination and the occasional vaccinated person (no vaccine is 100 per cent because science is not magic) across the continent are suffering from an infection that was essentially eliminated from the U.S. in 2000. All

because a sizable group of mostly-privileged parents have decided that reviving a group of life-threatening diseases and potentially inflicting them on their loved ones and neighbors is infinitely preferable to having an autistic child. I take the decision not to vaccinate personally. I’ve tried to have empathy for the other side, I’ve tried to tell myself that it’s none of my

business, but I can’t and it is. Someone who refuses to vaccinate their children because they’re afraid of autism has made the decision that people like me are the worst possible thing that can happen to their family, and they’re putting everyone at risk because of it. I’ve been told by some anti-vaxxers that they don’t mean my brand of autism; they mean non-verbal autism, or as they are so fond of calling it, “profound autism.” I’m not about to take any solace in the idea that they’re willing to make exceptions for autistic people who can perform as neurotypical, or at least pose as little annoyance to neurotypicals as possible. That just means that I will cease to be of any value to these people if I am no longer able to pass as one of them, and that they see no value and no humanity in anyone who communicates or behaves differently from them. Tell me again who has the empathy problem? The best that I can muster in the anti-vaxxers’ defense is that they’re not 100 per cent responsible for the anti-autism sentiment fueling their movement. The idea that autism is an unparalleled tragedy didn’t happen in a vacuum. It came from the very people who claim to support us. Take Autism Speaks, for example. The world’s most prominent autism-related charity has a pretty cuddly exterior. Celebrities toss money at it. People wear blue things to help it raise awareness. It claims to help autistic people and their families. Why would anyone question its intentions? It would be absolutely absurd to run a charity for people you hate, after all. Right? But Autism Speaks isn’t really a charity for autistic people. It’s a charity for neurotypical people who have been afflicted with the horror of having autistic people in their lives. Since its inception in 2005, Autism Speaks has perpetuated the idea that people with autism are a burden and somehow “lost,” and they’ve refused to listen to any actual autistic people who disagree with their party line. It’s supported a number of dangerous and dubious treatments, like electroshock therapy and chelation, a lead poisoning treatment that has many risks and no proven benefit as an ASD cure, all in the name of making autistic people appear more neurotypical. Its official statements consistently refuse to acknowledge any humanity in autistic people, or recognize that their families experience anything other than abject misery. In its 2013 Call For Action, founder Suzanne Wright, who has an autistic grandson, wrote that families with an autistic member “are not living. They are existing. Breathing — yes. Eating — yes. Sleeping — maybe. Working — most definitely — 24/7. This is autism. Life is lived moment-to-moment. In anticipation of the child’s next move. In despair. In fear of the future. This is autism.” And honestly, that’s one of the less offensive things she’s said about us. This is far from true for the countless families who have spoken out against Autism Speaks. It’s certainly not the case for mine. We are all, last I checked, living. We work together to bridge our differences in communication, sensitivities, attributes, and detriments to go about our lives in a way that expands far beyond the moment-to-moment. We’re no more or less imperfect or tragic than the average family. We don’t even have measles. I have good days where my strange and intense interests give me a unique perspective in my writing and my focus helps me get it down on paper. I have bad days where I can’t ride public transit without having a panic attack and I have to leave the room when my husband chews food because I find the sound of it unbearable and overwhelming. I have stimmed to my heart’s content and I have hit myself. Throughout all but the worst of it — depression is a common comorbidity of autism, likely because living in the neurotypical world is often trying — I’ve been pretty sure that I am “living,” and better for it. Throughout all of it, my loved ones have preferred my autism to my possible illness or death, or the deaths of others. I’d say I was grateful, but really, this should be a given. Autism Speaks is currently urging parents to vaccinate their children, though it was funding and supporting vaccine-related research as recently as 2009. But it continues to spout the kind of anti-autism rhetoric that made people who aren’t so great with critical thinking so scared in the first place. I’m not sure what the cure is here. Anti-vaxxers are very dedicated to being wrong. As The New York Times’ Brendan Nyhan discovered last year, they’re more resistant to irrefutable facts than vaccinated kids are to preventable

diseases. But I’m at least a little bit hopeful that renewed interest in anti-vaxxer rhetoric, spurred by the current measles outbreak, will inspire a more thorough discussion about autism like Anne Theriault’s and Jen Zoratti’s excellent work on the topic (full disclosure—I’m quoted in the latter piece)—and that this discussion will do some good. For starters, we could

talk about people on the spectrum like we’re better than measles, like we’re human, or like we’re there at all. Long before the fear of autism threatened everybody’s lives and well-being via the anti-vaccination movement, it threatened the lives and well-being of autistic people through isolation, improper treatment, and even outright murder. Even if we can’t eliminate these deaths — and I hope to Temple Grandin that we can — the way that people respond to the current public health clusterfuck still offers us a chance to save lives.

We must actively reject ableism and confront abled privilege – ableism shapes our assumptions and understanding of the world, dehumanizing those lacking privilege. Phillips 15 – Kiah Phillips, contributor to Respectfully Connected, a blog that focuses on ableism and emphasizes neurodiversity, 2015 (“So, What is Ableism?”, Respectfully Connected, February 27, Available Online at http://respectfullyconnected.blogspot.com/2015/02/so-what-is-ableism.html, accessed 7/21/15, KM)

Ableism is a form of discrimination or prejudice against individuals with physical, mental, or developmental disabilities that is characterized by the belief that these individuals need to be fixed or cannot function as full members of society (Castañeda & Peters, 2000). As a result of these assumptions, individuals with disabilities are commonly viewed as being abnormal rather than as members of a distinct minority community (Olkin &

Pledger, 2003; Reid & Knight, 2006). Because disability status has been viewed as a defect rather than a dimension of difference, disability has not been widely recognized as a multicultural concern by the general public as well as by counselor educators and practitioners. Laura Smith, Pamela F. Foley, and Michael P. Chaney, “Addressing Classism, Ableism, and Heterosexism in Counselor Education”, Journal of Counseling & Development, Summer 2008, Volume 86, pp 303-309. When our boy was first diagnosed as autistic, I had never heard the term "Ableism". I have to be honest, I probably still didn't hear it until well beyond the first anniversary of that day. I had no idea of just how much this concept, this idea, this reality was going to coincide with our boy's life then - and to a lesser but still significant extent, our lives as parents too, for very different reasons of course. However, once my thinking shifted from the pathology perspective; common among most professional "experts" and vast numbers of parents, to the neurodiversity model,

I began to recognise the degree to which the thinking of many neurotypical people revels in the inherent discrimination, prejudice and privilege of ableism. These same people would be aghast at comments containing racism, sexism or homophobia as but three examples, yet when it comes to ableism, somehow there is a collective societal blind spot - or so it would

seem. So what is going on here? Could it really be that people simply do not know what ableism is? - at least in the

sense that they don't see it as obviously as they would other forms of discrimination, or are people aware and as a society, we willfully turn our heads in ignorance the way we used to in relation to discrimination in other areas such as race or sexuality? In other words, is this an issue of recognition or willful ignorance? For me personally, I have to own it; I was painfully ignorant of the issues facing

people with disabilities but I cannot ignore the fact that I also carried a privilege that I was not even aware of: I am neurotypical and in a

society where (currently) the majority is neurotypical and all infrastructure and societal norms fit around that majority, which means I have advantages conferred upon me that I do not have to think about, hence - to some extent - my lack of awareness. That makes my life easier - and even possible, in some instances. These are things that a person with a different neurological make-up, such as autism, cannot take for granted. Every institution of society is based around a neurology that differs from theirs and this places them at an immediate disadvantage. You might think, well, autistic people should just try to fit in, or that society has a right to expect all people to conform to the socially acceptable ways of behaving, socially acceptable values or ideas of what a successful, "functioning" person looks like. If you do, either by accidental default or by willful ignorance, you are exhibiting ableism. Just as I used to, before my beautiful boy opened my eyes and tore open my mind and my heart. When was the last time someone insisted on using functioning labels in a conversation with you about a person who is autistic? How often have you heard "experts" claim that autistics must be able to pass as indistinguishable from their neurotypical peers? How often have you heard it said that autistics must not engage in self-stimulatory behaviour because it makes them stand out? What about repetitive actions or "hyper-focus on a specific interest"? I know that you'll have heard people tell you that this prevents the autistic person from functioning. I know that I have. But break it down......please; Functioning as what? Because as far as I understand it, an autistic whom is engaging in those self-regulatory actions, is functioning well as an autistic person, which is who they are, after all is said and done. But wait - the assumption is that the goal is to function as closely to neurotypical as possible, right? To fit into the society that is established around the normative values of it's majority? You see I have an issue with that right there; because that is ableism. There are many variations on this theme. I read commentary constantly where parents concern themselves that their autistic child may never marry and have children; that they may not achieve financial success (whatever that means) or have a career. Aside from the fact that many autistic people do, despite all obstacles, meet those measures of success, there are

many people with a neurotypical neurology who do not. I wonder why there is a generally held assumption that an autistic person only meets with deemed success when they are able to pass as a neurotypical person or adopt

the values of a society whose majority does not speak for them? The undercurrent of every conversation that involves autistic people needing to be fixed, to fit in, to be cured, to be avoided in the first place, to engage in normative behaviour, to not perseverate on specific interests, to change who they are, is underpinned by the ableist assumption that to be neurotypical is better, that neurological variance is "less than". Less than what? Let me try that another way, if you will: how would it sit with you if I said that women were less valuable than men? That Asian people were better than Europeans? That homosexual people should be forced to marry into heterosexual couplings? You see the nonsense - not to mention the outrage that these views would cause? Yet I can be told that my

beautiful child should be everything that he is not and cannot ever be (without destroying himself in the process) - and scant few of my neurotypical brethren are here to pick up the mantle of outrage and demand change. I ask myself: Is it because they are willfully looking the other way? But you. I am hoping that you, you will stand with me.

Ableist Discourse bad

Discourse matters – the language of anti-vaccination proponents can and does hurt people with disability. Marcotte 15 – Dawn Marcotte, creator and CEO of www.ASD-DR.com, an online searchable database to help autistic teens and young adults identify colleges that provide support services specifically for autistic students, 2015 (“Accidental Ableism”, Autism Daily Newscast, February 23, Available Online at http://www.autismdailynewscast.com/accidental-ableism/23452/dawnmarcotte/, accessed 7/21/15, KM)

It was not something I concerned myself with too much as I consider myself to be a pretty good person who doesn’t discriminate against

anyone. I certainly never thought it would apply to my daughter. Then I read an article talking about the vaccine-causes-autism issue. This issue is in the forefront of news again, due to the recent outbreak of measles across the country. The

article pointed out that most, if not all, of these articles were ableist because they talk about whether vaccines cause autism or not, as if autism is a disease. This concept never even occurred to me until I read this article. I can think of several times where I have left comments or written articles that used much the same language. For this I am sorry and can only

hope that I have not offended anyone. More importantly the article got me thinking about how the use of language and social media can be so powerful. I don’t think most people really consider how the words they use can be interpreted in different ways, but in today’s web connected world, words are even more important. You don’t know who will read what you have written and more than likely you won’t ever have a chance to explain a word that someone else may find

offensive. It is also important to remember that once you post something, it is out there forever. So all those families, friends and parents who post about the trials and triumphs of their children, it is important to stop and wonder how those same children will feel when they read it themselves. It doesn’t matter how old they are now – eventually they will see what is written. Will it make them happy it was posted or embarrassed and angry? It doesn’t matter if the post is well intentioned or not. Posting on Facebook asking the public to send birthday greetings may seem like a nice thing to do, but I often wonder if those parents have asked that child permission before they post. Does the child really want the world to know they don’t have any friends? Do they really want greetings from people who send them only because they feel sorry for them and will never hear from again? Do they even care about getting birthday greetings? or is the parent assuming a feeling the child doesn’t actually have? It seems that as parents we tend to make a lot of assumptions, myself included, about how our children feel or think – without asking them. Our priorities are not always theirs and it is time to step back and take an honest look at how we behave online. As a freelance writer I tend to share a lot of stories about our experience with autism and raising an autistic daughter. I never really asked her if it was okay to share these stories and just assumed she wouldn’t care because I keep her anonymous. However I am making a commitment that from now on I will check with her first, before sharing anything online that refers to her or her experience. I am going to work hard to

remember that everyone deserves respect. If I post something that I would find embarrassing if it were about me then I just

shouldn’t post it. I think understanding that ableism doesn’t just apply to ‘other‘ people, but to everyone is an important step in autism awareness. I only hope that other parents will take note and start to think more about what they post.

Aff Answers

Privacy Link

No SpilloverNo spillover — pro-privacy legislative action is dependent without crisis.Kerr 4 — Orin S. Kerr, Associate Professor of Law, George Washington University Law School, B.S.E. 1993, Princeton University; M.S. 1994, Stanford University; J.D. 1997, Harvard Law School, 2004 (“Technology, Privacy, And The Courts: A Reply To Colb And Swire,” Michigan Law Review (102 Mich. L. Rev. 933), Available Online to Subscribing Institutions via Lexis-Nexis)Contrary to Swire's suggestion, I think that statutory protections also tend to reach a middle ground. If there is a general trend toward lesser statutory protection over time, it is not clear to me. Swire focuses on the fact that Congress did not act on an Internet privacy bill that the House Judiciary Committee approved in 2000, but then passed the USA Patriot Act in 2001. To Swire, this suggests that the legislative process is broken: Congress passed (bad) pro-government legislation but not (good) pro-privacy legislation, leading to less privacy. n19 I find it difficult to draw a lesson from this example. It is worth noting, however, that in Swire's own example the legislative process rejected FBI and DOJ proposals and instead attempted to push the law in a strongly pro-privacy direction. Then, when Congress passed some of the proposals a few years later, it did so only under remarkable circumstances and even then only subject to a sunset provision. n20 If Swire's example is supposed to show a trend toward [*938] lessening privacy protection over time, then it is at best a mixed signal. More broadly, the privacy/security pendulum swings both ways ; while there may be times of crisis when the pendulum swings in favor of law enforcement, there are other periods when the pendulum swings in favor of privacy. I would pose this question to Swire: if there is a systematic tendency toward greater surveillance, in what year was privacy most protected by the legislative process? In 1960, when federal law did not forbid wiretapping? In 1970, before FISA was enacted? In 1980, before Congress passed ECPA?

Turn: Surveillance BacklashTurn: Surveillance causes public backlash which increases privacy.Moncrieff, Venkatesh, and West 9 — Simon Moncrieff, research fellow in the Department of Computing at Curtin University of Technology, Svetha Venkatesh, professor in the Department of Computing at Curtin University of Technology, and Geoff West, professor in the Department of Spatial Sciences at Curtin University of Technology and at the Cooperative Research Centre for Spatial Information, 2009 (“Dynamic privacy in public surveillance” Computer, 42(9) http://dro.deakin.edu.au/eserv/DU:30044204/venkatesh-dynamicprivacy-2009.pdf) As surveillance becomes increasingly intrusive, public opposition to these technologies will grow. Lawmakers will be pressured to force organizations that develop and deploy surveillance systems to incorporate additional privacy protections. However, because legislation tends to lag behind technology, such measures will inevitably inhibit preexisting systems’ functionality. Designing surveillance systems with privacy in mind, rather than as an afterthought, will accelerate the adoption of privacy policies in surveillance and reduce the impact of enforced privacy measures.6 For example, Google did not foresee privacy issues with Street View and thus did not incorporate privacy protections into the initial release of this feature in 2007. In response to public outcry, the company instituted several measures including the blurring of facial images and vehicle number plates and reducing image resolution to limit discernible information about pedestrians and vehicles. However, there is still considerable debate as to whether these measures go far enough; other identifying data such as location, clothes, and stature/gait are evident in Street View and may violate local privacy laws.

Link Non-UniqueLink non-unique — people are concerned about their privacy nowTrujillo 15 — Mario Trujillo, Professor in the Engineering department at University of Wisconsin – Madison, PhD from the University of Illinois, 2015 (“Poll: Large concern over data collection through smart devices,” TheHill, January 15th, Available online at http://thehill.com/policy/technology/228472-poll-large-concern-over-data-collection-through-smart-devices, Accessed 7-20-15)Nearly eight in 10 people are concerned about their personal information being collected through smartphones and other devices, according to a poll released Monday. The survey commissioned by TRUSTe, a consumer privacy company, also found that 69 percent of people believe they should own the data that is collected through their smart devices. Twenty percent, on the other hand, believe the benefits of the products outweigh privacy concerns. Eighty-seven percent expressed concern about their personal information being used in ways they are not aware of. Eighty-six percent said they are concerned about identity theft or their device being infected by malware. Seventy-eight percent expressed concern about their geographical location being unknowingly revealed.

Link non-unique — NFA, Snowden, activists, journalists, and increased internet useBartlett 15 — Jamie Bartlett, Director of the Centre for Analysis of Social Media, 2015 ("How we all became obsessed with online privacy," Content Loop, June 16th, Available Online at http://www.content-loop.com/how-we-all-became-obsessed-with-online-privacy/, Accessed 7-20-2015)It began with radical 'cypherpunks' who wanted to destroy the state. Now it's a hot-button issue for every Facebook user. How did the notion of internet privacy gain so much traction, and where will it take us next?Cast your mind back to just 5 or ten years ago. Did you ever think about data, your digital footprint, the NSA, or what happened to your social media posts? Doubtful, even though you might have been doing much the same online. The question of internet privacy wasn’t something many of us gave much thought to.In the last couple of weeks, a handful of events have demonstrated how much that has all changed. Earlier this month the US Congress passed the ‘Freedom Act’ (which, in American tradition, stands awkwardly for Uniting and Strengthening America by Fulfilling Rights and Ending Eavesdropping, Dragnet-collection and Online Monitoring). It placed limits of mass data collected on US citizens by the National Security Agency, something many privacy advocates thought impossible. Last week, David Anderson published an independent review of the UK government’s investigatory powers – it’s very good by the way – and made over 100 recommendations about how to make surveillance simpler, clearer, and with more oversight. Perhaps even more surprising, although barely reported, Facebook decided to allow users to send encrypted messages on their messenger service.This is all driven by growing pubic concern of course. According to the 2014 Deloitte Data Nation survey, 24 per cent of people in the UK do not trust any type of organisation with their personal information. Recent research by my think-tank Demos found half of young people said they were either extremely or very concerned by ‘online privacy’ – more than environmental issues, immigration, tax avoidance, or the EU. There are more people are using tools and techniques to cover their digital tracks, especially since Edward Snowden blew his whistle.Internet privacy has become a major political and social preoccupation. But very few people know much about the origins of the idea. The hope that modern, digital cryptographic software could change

society goes back to the 1990s Californian ‘Cypherpunks’ (a mash up of the word cypher with cyber-punk). All were radical libertarians and early adopters of computer technology, sharing an interest in the effects it would have on politics and society. But while many West Coast liberals at the time were toasting the dawn of a new and liberating electronic age, these Cypherpunks spotted that networked computing might just as likely herald a golden age of state spying and control. They all believed that the great political issue of the day was whether governments of the world would use the internet to strangle individual freedom and privacy through digital surveillance, or whether autonomous individuals would undermine and even destroy the state through the subversive tools digital computing also promised.At their first meeting, Tim May, as close to a leader as the group ever had, set out his vision to the excited group of rebellious, ponytailed twenty-and thirty-somethings. If the government can’t monitor you, he argued, it can’t control you. Fortunately, said May, thanks to modern computing, individual liberty can be assured by something more reliable than man-made laws: the unflinching rules of math and physics, existing on software that couldn’t be deleted. ‘ Politics has never given anyone lasting freedom, and it never will, ’ he wrote in 1993. But computer systems could. What was needed, May argued, was new software that could help ordinary people evade government surveillance.The group quickly grew to include hundreds of subscribers who were soon posting on a dedicated email list every day: exchanging ideas, discussing developments, proposing and testing cyphers. This remarkable email list predicted, developed or invented almost every technique now employed by computer users to avoid government surveillance. Tim May proposed, among other things, secure crypto-currencies, a tool enabling people to browse the web anonymously, an unregulated marketplace—which he called ‘BlackNet’—where anything could be bought or sold without being tracked. Twenty years before the notorious Silk Road.Ultimately they also hoped their endeavors would eventually bring about an economic, political and social revolution. In 1994 May published Cyphernomicon, his manifesto of the cypher-punk world view, on the mailing list. In it, he explained that ‘many of us are explicitly anti-democratic and hope to use encryption to undermine the so-called democratic governments of the world.’ On the whole, the cypherpunks were rugged libertarians who believed that far too many decisions that affected the liberty of the individual were determined by a popular vote of democratic governments. They saw internet privacy as the way out. (Julian Assange was joined the mailing list in late 1993 or early 1994).Of course, not everyone who cared about internet privacy shared the cypherpunks’ view that internet privacy was a route to pulling down governments. Each time governments – especially the US government - overreached by trying to spy on citizens too much, new movements and organisations would join the fray. And through the course of the 1990s and 2000s, internet privacy slowly started to inch into people's peripheral vision as something worth worrying about.But it's really only the last 5 years or so that it's moved from periphery to centre. Partly it's Snowden. Partly it's the relentless work of activists and journalists who share concerns. But mostly it's the amount of time we now spend online, and a dawning realisation that all that data we produce must be going somewhere. These days we share inordinate amounts of digital information about ourselves: our bank details, our love life, our holiday snaps; our whole lives are online. And it’s no longer just governments snaffling it all up – it is private companies, too. Think for a moment: do you ever wonder why it is that we get all these amazing internet services – Facebook, Twitter, YouTube, Gmail – for free? I rarely think about it, either, because I’m used to it all just being there, and always working. But it costs an awful lot of money to run these platforms: the server space, the highly skilled engineers, the legal teams. We are paying all right, just not in cash. We pay with our data and our privacy.

Public opinion is moving in favor of privacy — Congressional security rhetoric is the only opposition Margolis 13 — Jason Margolis, reporter on economics and politics, M.A. in Journalism from the University of California at Berkeley, citing Joseph Nye, former Dean of the John F. Kennedy School of Government at Harvard University, PhD in political science from Harvard University, 2013 (“After Snowden, Global Debate Over Privacy vs. National Security Gaining Momentum,” PRI, July 17th, Available Online at http://www.pri.org/stories/2013-07-17/after-snowden-global-debate-over-privacy-vs-national-security-gaining-momentum, Accessed 7-22-15)Those figures mirror the mood in the US: There's a clear conflict between the need to protect our national security and our civil liberties.There's a pendulum that constantly moves between security and privacy needs, said Harvard political scientist Joseph Nye, author of the new book, "Presidential Leadership and the Creation of the American Era." �"I mean we saw it in the Civil War when Lincoln suspended Habeas Corpus, or in World War II when Franklin Roosevelt basically interned American citizens of Japanese origin,"� he said. "And then later the country swung back to saying this was excessive." �Nye said nearly 12 years after the September 11th attacks the pendulum is beginning to swing back toward more calls for civil liberties. He adds Congress and the Administration need to find an acceptable middle ground.That's difficult, because many members of Congress say the surveillance programs are working successfully and have thwarted terrorist attacks.

The link is non-unique – people are concerned with their privacy – prefer our studiesDoherty 13 — Carroll Doherty, director of political research at Pew, develops the research agenda, masters in international studies and bachelor in political science, regularly provides public opinion for BBC and NPR, 2013, (“Balancing Act: National Securityand Civil Liberties in Post-9/11 Era” Pew Research Center, June 7th, Available Online at http://www.pewresearch.org/fact-tank/2013/06/07/balancing-act-national-security-and-civil-liberties-in-post-911-era/, Accessed 07-14-15The revelations that Obama administration secretly collected phone records and accessed the internet activity of millions of Americans have raised new questions about the public’s willingness to sacrifice civil liberties in the interests of national security. Since 9/11, Americans generally have valued protection from terrorism over civil liberties, yet they also have expressed concerns over government overreach and intrusions on their personal privacy. Security First. Since shortly after 9/11, Pew Research has asked whether people’s greater concern is that anti-terror policies will go too far in restricting civil liberties, or that they won’t go far enough in adequately protecting the country. The balance of opinion has consistently favored protection. Most recently, in 2010, 47% said they were more concerned that government policies “have not gone far enough to adequately protect the country,” while 32% said they were more concerned that “they have gone too far in restricting the average person’s civil liberties.” But Fewer See Need to Sacrifice Civil Liberties. Yet fewer Americans think it will be necessary to sacrifice civil liberties to combat terrorism than did so shortly after the 9/11 attacks. In a poll conducted in 2011, shortly before the 10th anniversary of 9/11, 40% said that “in order to curb terrorism in this country it will be necessary for the average person to give up some civil liberties,” while 54% said it would not. A decade earlier, in the aftermath of 9/11 and before the passage of the Patriot Act, opinion was nearly the reverse (55% necessary, 35% not necessary).

The link is non-unique – Snowden leaks made people concerned about their privacyPierce June 5th — Charles Pierce, working journalist since 1976, author of four books, 2015, (“There Would Be No USA Freedom Act Without Edward Snowden,” Esquire, June 5 th, Available Online at http://readersupportednews.org/opinion2/277-75/30564-there-would-be-no-usa-freedom-act-without-edward-snowden, Accessed 07-14-15

The passage of the USA Freedom Act paves the way for telecom companies to assume responsibility of the controversial phone records collection program, while also bringing to a close a short lapse in the broad NSA and FBI domestic spying authorities. Those powers expired with key provisions of the Patriot Act at 12.01 am on Monday amid a showdown between defense hawks and civil liberties advocates. The American Civil Liberties Union praised the passage of the USA Freedom Act as "a milestone" but pointed out that there were many more "intrusive and overbroad" surveillance powers yet untouched. The ambivalence about Edward Snowden, International Man Of Luggage, all clears away at one simple point -- without him, none of this happens. Without what he did, nobody looks closely enough at the NSA and its surveillance programs even to think of reforming them even in the mildest way, which is pretty much what this is. Without what he did, the conversation not only doesn't change, it doesn't even occur. Oregon senator Ron Wyden, a Democrat on the intelligence committee who has railed against NSA surveillance for years, praised the breakthrough but said the work is far from complete. "This is the only beginning. There is a lot more to do," Wyden told reporters after the vote. "We're going to have very vigorous debate about the flawed idea of the FBI director to require companies to build weaknesses into their products. We're going to try to close the backdoor search loophole – this is part of the Fisa Act and is going to be increasingly important, because Americans are going to have their emails swept up increasingly as global communications systems begin to merge." Without what Edward Snowden did, even these first tremors of a rollback from the politics of fear that have encrusted the country in the wake of the attacks of September 11, 2001 would not have been felt in Washington this week.

Vaccine DA — Culture of Rights Uniqueness

Non-unique – Culture of privacy/rights now

Increasing numbers of young people think parental choice outweighs mandatory vaccination – age is the most influential factor – it comparatively outweighs other variables like class, race, gender, and political affiliations. Anderson 15 – Monica Anderson, Research Analyst at Pew Research Center, holds a Master’s degree in Communication, Culture, and Technology from Georgetown University and a BA in Political Science and Feminist Studies from Southwestern University, 2015 (“Young adults more likely to say vaccinating kids should be a parental choice”, Pew Research Center, February 2, Available Online at http://www.pewresearch.org/fact-tank/2015/02/02/young-adults-more-likely-to-say-vaccinating-kids-should-be-a-parental-choice/, accessed 7/14/15, KM)

As the number of measles cases linked to the California outbreak climbs to over 100, health officials are urging parents to properly immunize their children, citing unvaccinated individuals as a main contributor to the disease’s spread. Some have linked the outbreak to the anti-vaccination movement – a group whose members claim vaccinations are unsafe and ineffective. A Pew Research Center report released last

week shows that a majority of Americans say children should be required to get vaccinated. Further analysis of the survey data reveals significant age differences in views about vaccines. In 2009, by contrast, opinions about vaccines were roughly the same across age groups. Also, some modest partisan divisions have emerged since 2009, when Pew Research last polled on the issue. Overall, 68% of

U.S. adults say childhood vaccinations should be required, while 30% say parents should be able to decide. Among all age groups, young adults are more likely to say vaccinating children should be a parental choice. Some 41% of 18- to 29-year-olds say parents should be able to decide whether or not their child gets vaccinated; only 20% of adults 65 or older echo this opinion. Measles Cases fall with vaccine Older Americans are strong supporters of requiring childhood

vaccinations – 79% say they hold that view, compared with 59% of those under 30. One possible reason that older groups might be more supportive of mandatory vaccinations is that many among them remember when diseases like measles were common. Prior to the first licensed measles vaccine in 1963, hundreds of thousands of measles cases were reported annually in the U.S. In 1958 alone, there were more than 750,000 cases. A decade later, in 1968, that number fell to about

22,000, according to an analysis of data from the Centers for Disease Control and Prevention. Today, measles cases are extremely rare, but the CDC reported a spike in 2014, with more than 600 measles cases, the first such jump in more than a decade. The CDC attributed the increase to an outbreak among unvaccinated Ohio Amish communities and cases related to an outbreak in the Philippines. Although some

have linked the anti-vaccination movement to more-affluent, highly educated parents, Pew Research data show little difference in people’s views based on income or education. Vaccines Public Opinion About 30% of adults living in households earning $75,000 or more a year say parents should decide whether or not their child gets vaccinated. This holds true even among the highest of earners (those in households making $100,000 or more). These opinions are on par with people living in lower- and middle-

income households. Men and women share similar views on whether vaccines should be required or not and opinions on this issue vary little by race. At the same time, slightly more parents of minor children than those without children believe

vaccinating children is a parental choice. There are slight differences in views about vaccines along political lines. A majority of Democrats (76%), Republicans (65%) and independents (65%) say that vaccines should be required. But Republicans and independents are somewhat more inclined than are Democrats to say that parents should be able to decide. In 2009, there was no difference in views on vaccinations along party lines.

Non-unique – No pro-vax influence

Influencing anti-vaccination proponents is impossible – a consensus of studies agree. Marcotte 14 – Amanda Marcotte, American blogger who writes on feminism and politics, 2014 (“According to a New Study, Nothing Can Change an Anti-Vaxxer’s Mind”, Slate, March 3, Available Online at http://www.slate.com/blogs/xx_factor/2014/03/03/effective_messages_in_vaccine_promotion_when_it_comes_to_anti_vaxxers_there.html, accessed 7/22/15, KM)

While some false beliefs, such as astrology, are fairly harmless, parents who believe falsely that vaccination is dangerous or unnecessary for

children present a real public health hazard. That's why researchers, publishing in Pediatrics, decided to test four different pro-vaccination messages on a group of parents with children under 18 and with a variety of attitudes about vaccination to see which one was most persuasive in persuading them to vaccinate. As Chris Mooney reports

for Mother Jones, the results are utterly demoralizing: Nothing made anti-vaccination parents more amendable to vaccinating their kids. At best, the messages didn't move the needle one way or another, but it seems the harder you try to persuade a vaccination denialist to see the light, the more stubborn they get about not vaccinating their kids. Brendan Nyhan of Dartmouth College and his colleagues tested four different messages on parents. Mooney describes them: The first message, dubbed "Autism correction," was a factual, science-heavy correction of false claims that the MMR vaccine causes autism, assuring parents that the vaccine is "safe and effective" and citing multiple studies that disprove claims of an autism link. The second message, dubbed "Disease risks," simply listed the many risks of contracting the measles, the mumps, or rubella, describing the nasty complications that can come with these diseases. The third message, dubbed "Disease narrative," told a "true story" about a 10-month-old whose temperature shot up to a terrifying 106 degrees after he contracted measles from another child in a pediatrician's waiting room. The fourth message was to show parents pictures of children afflicted with the diseases they could get without vaccination. Both the pictures and the horrible story about measles increased parental fears about vaccinations. Researchers don't know why but theorize that the problem might be that invoking fears of sick children just makes parents more fearful in general of all risks, whether real or imagined. The cooler, more distant "disease risks" message didn't change parents' minds either way, but what was most startling was what happened with the message correcting misinformation on autism: As for "Autism correction," it actually worked, among survey respondents as a whole, to somewhat reduce belief in the falsehood that vaccines cause autism. But at the same time, the message had an unexpected

negative effect, decreasing the percentage of parents saying that they would be likely to vaccinate their children. In other words, learning that they were wrong to believe that vaccines were dangerous to their kids made vaccine-hostile parents more, not less likely to reject vaccination. Mooney calls this the "backfire effect," but feel free to regard it as

stubborn, childish defensiveness, if you'd rather. If you produce evidence that vaccination fears about autism are misplaced, anti-vaccination parents don't apologize and slink off to get their kids vaccinated. No,

according to this study, they tend to double down. This reaction, where people become more assured of their stupid opinions when

confronted with factual or scientific evidence proving them wrong, has been demonstrated in similar studies time and time again. (This is why arguing with your Facebook friends who watch Fox News will only bring you migraines.) Mooney suggests that state governments should respond by making it harder to opt out of vaccinations. That would be helpful, but there's also some preliminary research from the James Randi Educational Foundation and Women Thinking Inc. that shows that reframing the argument in positive terms can help. When parents were prompted to think of vaccination as one of the steps you take to protect a child, like buckling a seat belt, they were more invested in doing it than if they were reminded that vaccine denialists are spouting misinformation. Hopefully, future research into pro-vaccination messaging, as opposed to just anti-anti-vaccination messaging, will provide further insight.

The influence of the pro-vaccination movement is irrelevant – studies say there’s only a risk that pro-vax messages make it worse – anti-vaccination parents are too suspicious of the science. Alter 14 – Charlotte Alter, covers women, culture, politics and breaking news for TIME, 2014 (“Nothing, Not Even Hard Facts, Can Make Anti-Vaxxers Change Their Minds”, Times, March 4, Available Online at http://healthland.time.com/2014/03/04/nothing-not-even-hard-facts-can-make-anti-vaxxers-change-their-minds/, accessed 7/22/15, KM) Maybe there should be a vaccine for stubbornness, because it sure seems tough to cure. A new study shows that when presented with four different scientifically proven arguments that vaccinations are safe, some anti-vaccination parents seemed even less inclined to innoculate their kids against measles, mumps and rubella (MMR) once they saw the evidence. “We shouldn’t overestimate how effective facts and evidence are in convincing people to accept a

claim and change their behavior,” said Brendan Nyhan, who authored the study published in Pediatrics, “but throwing facts and evidence at them isn’t likely to be the most effective approach.” Nyhan and his colleagues surveyed almost 1,800 parents of young children after seeing one of four vaccination messages similar to those provided by the CDC. The first messages were focused on conveying the dangers of measles, mumps, and rubella: the “Disease Risk” message detailed the medical risk of contracting MMR, the “Danger Narrative” told the story of a woman whose son contracted the measles from another child and got a 106-degree fever, and the “Disease Images” showed disturbing pictures of infected children. A fourth message, “Autism Correction,” provided heavy scientific evidence that

disproved the link between vaccinations and autism. All that sounds convincing, but none of it really works. The researchers found that none of the four messages significantly increased rates of intended vaccination (they only measured whether

parents intended to vaccinate, not whether they actually did) and some even provoked an anti-vaccination backlash. The least successful messages were “Disease Narrative” and “Disease Images,” which actually increased the misconception that vaccinations will have negative side effects by 6%, and looking at the photos of the sick kids increased the subjects’ perception that vaccines cause autism. Nyhan said that he thought this was because when people saw children in distress, they became preoccupied with other dangers their child

could encounter. “Disease Risks” and “Autism Correction” had slightly better results, but neither seemed to convince parents. And while “Autism Correction” proved to some parents that there’s no link between vaccines and autism, it produced a strong backlash in others that just reinforced their sense that vaccinations are a conspiracy theory. Only 45% of the already anti-vaccine parents said they would vaccinate after they saw the “Autism Correction”

message, compared to 70% of the control group. Nyhan thinks that these parents are suspicious of the scientists and that the

pro-vaccine movement is trying to pull a fast one on them. “People think, ‘what are they trying to convince me?'” he explained. “The ‘don’t worry, don’t worry, everything is safe’ approach is not often effective, because they think ‘why are they trying so hard to reassure me that everything is safe?'” The fact that none of these messages were particularly effective is a little disconcerting considering that vaccinations only work if a majority of the population is vaccinated. And Nyhan also pointed out that these diseases are more dangerous than ever, because MMR is so rare that

we almost never encounter them. Regardless, it seems that the CDC has a serious PR problem, since none of their pro-vaccination messages seem to actually convince people. “We need to test the messages we use in public health the way we test other kinds of inventions,” Nyhan said. “There isn’t a crisis now, but this is about making sure we don’t have one.”

Pro-vaccination has zero influence – there’s too much skepticism in its benefits and acceptance of the vaccine-autism link. Our evidence assumes events like the Disneyland outbreak, or as anti-vaxxers like to say, “hype”. Haberman 15 – Clyde Haberman, American journalist who was a longtime columnist and correspondent for The New York Times, 2015 (“A Discredited Vaccine Study’s Continuing Impact on Public Health”, New York Times, February 1, Available Online at http://www.nytimes.com/2015/02/02/us/a-discredited-vaccine-studys-continuing-impact-on-public-health.html?_r=0, accessed 7/22/15, KM)

In the churning over the refusal of some parents to immunize their children against certain diseases, a venerable Latin phrase may prove useful: Post hoc, ergo propter hoc. It means, “After this, therefore because of this.” In plainer language: Event B follows Event A, so B must be the direct result of A. It is a classic fallacy in logic. An outbreak of measles several weeks ago at Disneyland in Southern California focused minds and deepened concerns. It was as if the amusement park had become the tragic kingdom. Dozens of measles cases have spread across California. Arizona and other nearby states reported their own eruptions of this nasty illness, which officialdom had pronounced essentially eradicated in this country as recently as 2000. But it is back. In 2014, there were 644 cases in 27 states, according to the Centers for Disease Control and Prevention. Should the pace set in January continue, the numbers could go still higher in 2015. While no one is known to have died in the new outbreaks, the lethal possibilities cannot be shrugged off. If the past is a guide, one or two of every 1,000 infected people will not survive. To explore how matters reached this pass, Retro Report, a series of video documentaries studying major news stories of the past and their consequences,

offers this special episode. It turns on a seminal moment in anti-vaccination resistance. This was an announcement in 1998 by a British doctor who said he had found a relationship between the M.M.R. vaccine — measles,

mumps, rubella — and the onset of autism. Typically, the M.M.R. shot is given to infants at about 12 months and again at age 5 or 6. This doctor, Andrew Wakefield, wrote that his study of 12 children showed that the three vaccines taken together could alter immune systems, causing intestinal woes that then

reach, and damage, the brain. In fairly short order, his findings were widely rejected as — not to put too fine a point on it — bunk. Dozens of epidemiological studies found no merit to his work, which was based on a tiny sample. The British Medical Journal went so far as

to call his research “fraudulent.” The British journal Lancet, which originally published Dr. Wakefield’s paper, retracted it. The British medical authorities stripped him of his license. Nonetheless, despite his being held in disgrace, the vaccine-autism link has continued to be accepted on faith by some. Among the more prominently outspoken is Jenny McCarthy, a former television host and Playboy Playmate, who has linked her son’s autism to his vaccination: He got the shot, and then he was not O.K. Post hoc, etc. Steadily, as time passed, clusters of resistance to inoculation bubbled up. While the nationwide rate of vaccination against childhood diseases has stayed at 90 percent or higher, the percentage in some parts of the country has fallen well below that mark. Often enough, these are places whose residents tend to be well off and well educated, with parents seeking exemptions from vaccinations for religious or other personal reasons. At the heart of the matter is a concept known as herd immunity. It means that the overall national rate of vaccination is not the only significant gauge. The rate in each community must also be kept high to ensure that pretty much everyone will be protected against sudden disease, including those who have not been immunized. A solid display of herd immunity reduces the likelihood in a given city or town that an infected person will even brush up against, let alone endanger, someone who could be vulnerable, like a 9-year-old whose parents rejected inoculations, or a baby too young for the M.M.R. shot. Health professionals say that a vaccination rate of about 95 percent is needed to effectively protect a community. Fall much below that level and trouble can begin. Mass vaccinations have been described by the C.D.C. as among the “10 great public health achievements” of the 20th century, one that had prevented tens of thousands of deaths in the United States. Yet diseases once presumed to have been kept reasonably in check are bouncing back. Whooping cough is one example. Measles draws especially close attention because it is highly infectious. Someone who has it can sneeze in a room, and the virus will linger in the air for two hours. Any unvaccinated person who enters that room risks becoming infected and, of course, can then spread it further. Disneyland proved a case in point. The measles outbreak there showed that it is indeed a small world, after all. What motivates vaccine-averse parents? One factor may be the very success of the vaccines. Several generations of Americans lack their parents’ and grandparents’ visceral fear of polio, for example. For those people, “you might as well be protecting against aliens — these are things they’ve never seen,” said Seth Mnookin, who teaches science writing at the Massachusetts Institute of Technology and is the author of “The Panic Virus,” a 2011 book on vaccinations and their

opponents. Mr. Mnookin, interviewed by Retro Report, said skepticism about inoculations is “one of those issues that seem to grab people across the political spectrum.” It goes arm in arm with a pervasive mistrust of many national institutions: the government that says vaccinations are essential, news organizations that echo the point, pharmaceutical companies that make money on vaccines, scientists who have hardly been shown to be error-free. Then, too, Mr. Mnookin said, scientists don’t always do themselves favors in their choice of language. They tend to shun absolutes, and lean more toward constructions on the order of: There is no vaccine-autism link “to the best of our knowledge” or “as far as we know.” Those

sorts of qualifiers leave room for doubters to question how much the lab guys do, in fact, know. Thus far, the Disneyland measles outbreak has failed to deter the more fervent anti-vaccine skeptics. “Hype.” That is how the flurry of concern in California and elsewhere was described by Barbara Loe Fisher, president of the National Vaccine Information Center, an organization that takes a dim view of vaccinations. The hype, Ms. Fisher said in a Jan. 28 post on her group’s website, “has more to do with covering up vaccine failures and propping up the dissolving myth of vaccine acquired herd immunity than it does about protecting the public health.” Clearly, she remained untroubled that most health professionals regard her views as belonging somewhere in Fantasyland.

Anti-vaxxers are winning the propaganda fight – they are dominating sites like Twitter and using social media to collectively harass pro-vaccination individuals. DiResta and Lotan 15 – Renee DiResta, Principal of O'Reilly AlphaTech Ventures and Gilad Lotan, Chief data scientist at betaworks, 2015 (“Anti-Vaxxers Are Using Twitter to Manipulate a Vaccine Bill”, Wired, June 8, Available Online at http://www.wired.com/2015/06/antivaxxers-influencing-legislation/, accessed 7/22/15, KM) To take a closer look at how anti-vax Twitter organizes its attacks, specifically against the California legislation, we analyzed the hashtags used by people in the network. In network graphs like the one above, circular nodes are Twitter handles; larger nodes indicate accounts with more followers within the network, making their tweets more likely to be seen and acted upon. That’s called “high centrality.” The lines between the

nodes represent follower relationships. Different colors represent communities of people who are sharing a similar message, and the distance between regions is based on common ties—the closer a colored group is to another, the more shared connections its members have, and the

more likely information is to spread amongst the groups. Much like any other group with a message, anti-vaxxers have leveraged Facebook, Twitter, and YouTube for quite some time. In the early days, the majority of their activism focused on propagating the myth of the autism-vaccination connection. In August of 2014, anti-vax activity began to coalesce into one primary hashtag: #cdcwhistleblower, a reference to an anti-vaxxer conspiracy theory that claims the CDC is concealing information that proves a link between

the MMR vaccine and autism in African American children. Within two days, autism-vaccine proponents had looped in celebrity sympathizers such as Donald Trump and Rob Schneider to amplify their message. Andrew Wakefield, author of the original fraudulent study linking MMR and autism, got involved. CDC scientists responded, but the idea of the conspiracy—and the hashtag—continued to grow in popularity. There were 250,000 #cdcwhistleblower tweets between August 18 and December 1 of 2014. A whopping 63,555 of these came from 10 prominent anti-vax accounts. In terms of massive events and national conversations, 250,000 tweets is rather small (there were 19.1 million tweets sent in a 12 hour period about the Oscars). But it became

apparent to anti-vax leaders that this Twitter hashtag had attracted a loyal following among true believers. And so, in December 2014, “hashtag organizers” began to publish nightly “Trends and Tips” (TaTips) instruction videos on YouTube, containing instructions on what to tweet to advance the cause, and to improve the SEO of “vaccine questioning” websites. There are over 150 of these videos now—a testament to how much the anti-vax movement prioritizes Twitter. Like any good brand, that messaging has evolved to tie to current events—including legislation to increase vaccination rates. As the California personal exemption bill progressed, tweets with the #cdcwhistleblower hashtag started to shift to include #sb277, the number of the bill. When we dig into the activity in the #sb277 hashtag over time, trends and ties emerge. If you look at the first network graph, several distinct clusters emerge based on the hashtags and topics tweeted by each account. In other words, we didn’t search for the group labels deliberately; they revealed themselves. Pink is tweeters focused on anti-vax content; orange is the autism community. These groups tweet about many of the same topics, but don’t share the exact same material or use the same hashtags. Blue are social conservatives, many of whom use popular Tea Party hashtags. The long strands between the blue groups and the anti-vaxxer group indicates minimal overlap among accounts following each other; the networks are not tightly connected. But as you look at this second network graph, you can see how antivax political strategy has shifted. A new group emerges in the space between “Antivax

Twitter” and “Conservative Twitter”—we call it “vaccine choice” Twitter. The tweeters are the same individuals who have long been active in the autism-vaccine #cdcwhistleblower network. And originally, much of the content shared in #sb277 focused on the same anti-vax

pseudoscience underlying #cdcwhistleblower. However, as bad science and conspiracies repeatedly lost in legislative votes, anti-vaxxers updated their marketing: They are now “pro-SAFE vaccine” parental rights advocates. Instructions to the group now focus on hammering home traditionally conservative “parental choice” and “health freedom” messaging rather than tweeting about autism and toxins. Twitter activity around #sb277 is part of a multipronged strategy

that takes place alongside phone, email, and fax campaigns, coordinated by well-funded groups including the Canary Party and the NVIC. The net effect is that legislators and staffers feel besieged on all fronts. In one unfortunate video, a movement leader encouraged supporters to use Twitter to harass and stalk a lobbyist, who has since filed police reports. In a very recent creation, that same leader excoriates her “Twitter army” for diluting the power of the #cdcwhistleblower movement by creating their own hashtags rather than using the ones they’ve been assigned. She also requests that the entire network tweet at Assembly representatives to inform them that their political careers will be over if they vote in favor of SB277. Much like Food Babe leverages

her #foodbabearmy to flood corporations with demands for change, the goal of anti-vax twitter is to dominate the conversation and make it look as if all parents are vehemently opposed to the legislation. The other finding from observing anti-vax network graphs is that despite the vast majority vaccinating—national vaccination rates remain above 90 percent—there is no offsetting pro-vaccine Twitter machine; most parents simply vaccinate and move on with their lives. People don’t organize in groups

around everyday life-saving measures; there is no pro-seatbelt activist community on Twitter. The recent emergence, lack of central coordination, and weak connections seen among pro-vaccine Twitter users, who often use the hashtag

#vaccineswork, means that the pro-vax message (in green) is not amplified to the same degree. “Tweetiatrician” doctors, lawyers, and pro-vaccine parents often do attempt to join the conversation around the antivax hashtags. Unfortunately, many of the most active accounts experience the same attention received by the legislators: They become the target of harassment that includes phone calls to their places of employment, tweets posting identifying information or photos of their children, or warnings that they are being watched.

Pro-vaccine activists and legislators alike often encounter paranoia when they attempt to engage the anti-vax community. They face accusations of being shills paid by Big Pharma to sway the narrative and keep “vaccine choice” activists from spreading The Truth. Like many fringe communities, while the group is extremely well-organized and passionate they are largely tweeting into an echo chamber. Twitter users who don’t look for these hashtags would likely not know that they exist. Besides occasional celebrity amplification, very little percolates out to a mainstream audience or trends at a meaningful level. And even theoretically-sympathetic affinity groups that they occasionally reach out to, such as anti-GMO, conservative, and autism groups, are not amplifying their hashtags. However,

the broader public health implications of propagating these memes and articles make anti-vax

activities more than a bizarre online curiosity. Most of the material that the #cdcwhistleblower accounts tweet are

designed to erode confidence in vaccination. The goal is to make new parents question everything, says anti-vax leader Dana

Gorman in one of her instructional videos. Public health officials are concerned. “It is important to remember that today, the vast majority of people follow the recommended vaccine schedule—they take the advice of their doctors, supported by professional medical

bodies and the WHO,” says Gary Finnegan, editor of Vaccines Today. “However, it is essential that when people go online for information they are left with the clear impression that vaccines are safe and effective.” If that’s going to change, the people fighting misinformation need to understand how it gets spread in the first place.

Vaccine DA — Link Answers

Link turn – big data

Big data link turns their unfounded vaccination claims – by using datasets, big data allows for powerful visual representations of the impact of immunization. Munro 14 – Dan Munro, write about the intersection of healthcare innovation and policy, Quora Top Writer from 2013 to 2015, 2014 (“Big Data Crushes Anti-Vaccination Movement”, Forbes, January 23, Available Online at http://www.forbes.com/sites/danmunro/2014/01/23/big-data-crushes-anti-vaccination-movement/, accessed 7/21/15, KM) For years it’s been relatively easy to ignite medical controversy with emotional (but often anecdotal) evidence. TV is a popular format for doing just that. It’s quick, colorful and dramatic (and increasingly in high-def and big-screen). Add a well known celebrity (or two) and the effects can be powerful, long term and hard to refute. Much of that power, however, is changing and will continue to change with large datasets that are

freely available online – or soon will be. When we talk about the science of “Big Data” as a new discipline, it’s often the datasets that

we’re referencing – and the visualization of those datasets can be equally powerful and dramatic. As a single example, I wrote about the release of one such dataset on hospital pricing released last year by the Government (here). On Monday, Aaron

Carroll (over at the Incidental Economist here) highlighted another chart that was based on a dataset recently published by the Council On Foreign Relations. The chart shows ”vaccine preventable outbreaks” around the world

from 2006 to present day. The original chart is online here and is interactive by year, outbreak type, location and number of people. The data covers outbreaks for Measles, Mumps, Rubella, Polio, “other” – and is also available as a downloadable CSV file (for use with most spreadsheet applications – here). The CSV data also includes source citation, country,

longitude/latitude, number of cases and fatalities by outbreak type. The graphic and the data it represents is a compelling argument against those who think that the vaccinations themselves are dangerous and should be avoided. The Mayo Clinic has a great Q&A section which flatly states: “Vaccines do not cause autism. Despite much controversy on the topic, researchers haven’t found a connection between autism and childhood vaccines. In fact, the original study that ignited the debate years ago has been retracted.” Mayo Clinic – Childhood Vaccines: Tough questions, straight answers (here)

Alt causes

Too many alt causes to solve immunization, especially internationally – anti-American sentiment, religious differences, logistical issues, cost. Welsh 15 – Teresa Welsh, foreign affairs reporter at U.S. News & World Report, 2015 (“Anti-Vaccine Movements Not Unique to the U.S.”, US News, February 18, Available Online at http://www.usnews.com/news/articles/2015/02/18/anti-vaccine-movements-not-just-a-us-problem, accessed 7/22/15, KM)

With widespread access to medical care and immunizations, the U.S. typically doesn't see massive outbreaks of preventable diseases like the

measles. But American anti-vaxxers – parents who refuse to have their children vaccinated and seek exemptions from immunization

requirements – aren't alone in their misgivings: Skepticism abounds in many other countries about the safety and effectiveness of disease-fighting injections. “There is opposition to vaccine I think in every country around the world, and the nature of the opposition varies from place to place,” says Dr. Alan Hinman, a senior

public health scientist with The Task Force for Global Health. Vaccine hesitancy, according to a World Health Organization working group created to study the phenomenon, is a “delay in acceptance or refusal of vaccines despite availability of vaccine services." The group studied

the issue for more than two years and found that it is “complex and context-specific, varying across time, place and vaccines.” “It can be due to religious beliefs, it can be through personal beliefs or it can just be through misinformation on the need and importance of vaccination,” says Hayatee Hasan, a technical officer in the WHO's Department of Immunization, Vaccines and Biologicals. In the U.S., where a recent measles outbreak has renewed calls for parents to vaccinate their children, some parents are still hesitant to do so because of a 1998 study linking the vaccine for measles, mumps and rubella to autism, even though that study has long since been debunked. Similarly, misconceptions about the potentially adverse effects of vaccinations also impact the rates at which certain communities abroad vaccinate their

children. Researchers often cite an episode in northern Nigeria about a decade ago, when political and religious leaders instructed parents not to immunize their children against polio. The leaders said they believed the vaccines could be contaminated with an antifertility agent meant to sterilize the population, as well as with HIV, and immunizations stopped. Polio cases spread,

and the vaccines were shown not to have been tainted. “The leaders actually admitted that they didn’t really believe the vaccine was contaminated, but they were opposed to the polio eradication effort because they viewed it as a Western-led activity,” Hinman says. In India, suspicion of the West also has sparked aversion to vaccinations. Lois Privor-Dumm, director of policy, advocacy and communications at the Johns Hopkins Bloomberg School of Public Health's International Vaccine Access Center, says her team works with Indian physicians to provide them with data so they can make informed

decisions about immunizations. She says some vaccines have been widely accepted in India for years while other, newer vaccines have been resisted because they aren't manufactured by Indian suppliers and Indians think they are too expensive. Distrust of efforts to battle disease also isn't unique to immunization programs. In West Africa – the heart of the recent Ebola epidemic – some have considered Ebola a government conspiracy or not a real malady, and vulnerable residents have resisted amending burial practices to avoid spreading the disease. Health workers trying to increase awareness about the dangers of Ebola have even been attacked and killed. The WHO working group found that efforts tailored to specific countries are most effective in addressing vaccine hesitancy around the

world. In Bulgaria, an analysis of the Roma population – a nomadic ethnic group also known as Gypsies – found the main reason the community resisted vaccination wasn’t a lack of knowledge about vaccines or a lack of confidence in their effectiveness; rather, it

was due to a lack of immunization programs that were welcoming to Roma. For that community, the quality of the patient’s encounter with a health worker was the most important factor. "These diagnostic findings were used to tailor and target programs designed to address the main cause of Roma vaccine hesitancy," the working group explained.

Religious beliefs also have been a barrier to vaccination efforts around the world, with some Muslim communities in the U.K. objecting to porcine elements in a nasal flu vaccine. The porcine gelatin is used to stabilize the vaccine, but Islam does not permit the consumption of pork. Officials have also sought to allay concerns among Jews in the U.K. about the vaccine. Last year in Kenya, a group of Catholic bishops vocally opposed a WHO-led tetanus vaccination campaign because they said the immunization was “laced” with a birth-control hormone that could eventually

lead to sterilization. The bishops were suspicious of the campaign, which targeted women of reproductive age, and said they were convinced it was "a disguised population control program.” They also said the Catholic Church had not been given “adequate stakeholder engagement.”

"There’s the belief that vaccines may be some type of plot against their religion" to control the population, Privor-Dumm says. All 50 U.S. states have immunization requirements for public school students, but vaccine mandates vary around the world. In Canada, only a small number of provinces require vaccinations for students, while a study of Iceland, Norway and 27 European Union countries published in 2012 found that 15 countries had no vaccination requirements. Vaccine opposition in England dates

back to the 1800s, when people objected to smallpox vaccinations. Many low-income countries also lack an advisory body to make vaccine recommendations, so governments often take the WHO's advice for what vaccines to recommend to their populations. Dr. Kathy Neuzil, program leader for vaccine access and delivery at PATH, an international nonprofit that focuses on global

health, says many developing countries also lack a program the U.S. has to provide compensation for those who suffer a vaccine-related injury. Neuzil notes that adverse effects such as sudden illness from vaccinations do occur, so the medical community must be careful to document such cases to show that they are very rare. But proximity doesn't necessarily prove cause: A child could have a seizure for the first time two hours after being vaccinated – leading parents to believe the vaccination caused the problem – but that may not be the case, Neuzil says. “Some of these adverse events or safety concerns are going to occur by chance, but it’s very difficult as a mother to not believe that a vaccine may have caused something that’s temporally related,” Neuzil says. In developed countries like the U.S., Hasan says the WHO leaves it to national health authorities to address vaccine hesitancy, because they are better able to identify the cause behind it. “Is it because people don’t understand the need for immunization? Is it because people are questioning does vaccine cause autism, even though billions of children around the world have been vaccinated with the measles vaccine since the 1960s?” Hasan asks. Measles was declared eliminated from the U.S. in 2000. In comparison, Hinman says there are more than 100,000 deaths from the disease around the world each year, mostly in India and sub-Saharan Africa, where children rarely receive vaccinations for it. “That means that today’s parents of young children [in the U.S.] have never seen measles. It also means that many younger physicians have also not seen measles, and so it’s difficult for them to maintain what we consider to be the proper respect for a highly contagious and potentially fatal disease,” Hinman says. Heidi Larson, an anthropologist who leads The Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine, says the “back-to-nature movement” fueling oppositions to vaccines in the U.S. is also present in Japan and elsewhere. Some also refuse vaccinations because they object to government intervention, she says. But in some developed countries, Hasan says, children are not vaccinated simply because their parents don’t have time to take them to the doctor. Some children receive a first round of vaccinations, but don’t get booster shots and therefore don’t develop full immunity. And in poorer countries where parents must travel long distances to clinics or take time off work, time constraints and transportation can also be barriers. Many parents and caregivers in developing countries also simply

haven't learned why vaccines are important. Logistically, it can be difficult for health workers to reach populations to educate them about the necessity of immunization, while properly storing vaccinations that require refrigeration also presents a challenge for ensuring populations are vaccinated according to schedule. The Gavi Alliance, an organization that seeks to improve access to vaccines in poor countries, says the key to the success of an immunization program is having buy-in from the community. And when children aren't vaccinated, it can impact more than just their immunity to particular diseases, Privor-Dumm says. Healthy children don't have to miss school and can stay on track to climb out of poverty. While some Americans have grown “complacent” about vaccinations, Neuzil says, parents in poorer countries can't afford that luxury. “That’s a major difference as compared to these places where it’s … an everyday part of their life that children are dying from vaccine-preventable diseases,” Neuzil says.

Budget cuts are an alt cause – the CDC is targeting vaccinationsNACCHO 15 — NACCHO, The National Association of County and City Health Officials (NACCHO) represents the nation's 2,800 local governmental health departments. These city, county, metropolitan, district, and tribal departments work every day to protect and promote health and well-being for all people in their communities. For more information about NACCHO, please visit www.naccho.org, 2-2-2015 ("NACCHO Expresses Concern Over the President's Budget Cuts To Immunization Funding During Measles Outbreak," 2-2-2015, Available Online at http://naccho.org/press/releases/budget-proposal-2016.cfm, Accessed 7-21-2015)Washington, D.C. (February 2, 2015) - The National Association of County and City Health Officials (NACCHO) today expressed concern that the Obama Administration is proposing to cut discretionary funding for immunization and other programs that are key to preventing disease outbreaks and other disasters, especially while the country is in the midst of a measles outbreak. It is the role of local health departments to monitor, prevent, and control disease to reduce health risks through vaccine awareness and immunization programs. The President's FY2016 budget proposal cuts funding to the

Centers for Disease Control and Prevention's (CDC) immunization program by $50 million. The program supports the purchase of vaccines, as well as immunization operations at the local, state, and national levels. According to CDC, the United States experienced a record number of measles cases during 2014, with 644 cases from 27 states. In January 2015 alone, 102 people from 14 states were reported to have measles. NACCHO commends other aspects of the budget, including the $141 million increase to the CDC and removing the harmful across-the-board budget cuts that have kept discretionary spending at historically low levels. The budget also provides new funding for important public health activities, such as viral hepatitis prevention, antibiotic resistance, drug overdose prevention, and the strategic national stockpile. "Despite this new funding, the President's budget misses an important opportunity to bolster the capacity of the nation's public health departments to prevent infectious disease outbreaks, including those that are vaccine preventable," said NACCHO's executive director Robert M. Pestronk.

No link – Court rulings solve

No link – Courts have already ruled multiple times that mandatory vaccination is constitutional – no risk the plan’s surveillance reform overturns vaccination rulings. Farias 15 – Cristian Farias, Legal Affairs Writer with a special focus on civil rights, criminal justice, and the U.S. Supreme Court, holds a JD from City University of New York School of Law, 2015 (“Yes, the Government Can Make You Vaccinate Your Child”, New Republic, February 3, Available Online at http://www.newrepublic.com/article/120950/courts-have-upheld-governments-constitutional-right-vaccine-laws, accessed 7/20/15, KM) New Jersey Governor Chris Christie’s comments on Monday—later clarified—that the government has to find a “balance” between public health policy and giving parents "some measure of choice" has renewed the debate over vaccine laws. But it’s instructive to remember that

the Supreme Court settled the question of compulsory vaccinations more than 100 years ago. And just last

month, the U.S. Court of Appeals for the Second Circuit, which sits in Manhattan, cited that century-old precedent in rejecting a constitutional challenge to a New York law requiring that all kids attending public schools be vaccinated. The case involved a group of parents who had religious objections to the law. Two of the parents, both of them Catholic, had obtained religious exemptions for their children, which the law permits so long as the parents “hold genuine and sincere religious beliefs” against vaccines; the law also contains a separate exemption for medical reasons. The parents balked, however, when their kids were excluded from school after a schoolmate contracted chicken pox. It turns out a separate New York regulation provides that children with immunization exemptions be excluded from attendance in the event of an outbreak. Unhappy with both the law and the regulation, the parents sued in federal court. A third parent also sued, but on the grounds that she couldn’t obtain a religious exemption. At a hearing, the woman had testified that decisions about her child’s health were guided “strictly by the word of God.” But the judge, after hearing the woman testify that vaccination “could hurt my daughter. It could kill her.... It could cause any number of things,” found the woman’s

religious beliefs to be neither genuine nor sincere, but merely health-related. The court denied her request. That’s when the three parents joined forces and mounted a constitutional challenge to New York’s vaccination requirement. They threw

the book at the state, arguing, among other things, violations of their rights under the First and Fourteenth Amendments, as well as under state and municipal law. The rub of their arguments: that the state was infringing on their liberty and religious interests. A federal judge in Brooklyn dismissed all their claims. That’s when the Second Circuit court, as it’s wont to do on appeal, took up all of these grievances anew and rejected them one by one. Citing Jacobson v. Massachusetts, the 1905 case, a three-judge panel ruled in a short opinion that New York was well within its “police power” to mandate vaccinations for schoolchildren. Since immunizations are “in the interest of the population as a whole,” the court said they trump the parents’ individual wishes. The court brushed aside their claim that “a growing body of scientific evidence demonstrates that vaccines cause more harm to society than good,” noting that only the legislature—and not the parents or the court—could make the call on the alleged body of evidence. Turning to the parents’ religious claims, the court relied on a 1944 case, Prince v. Massachusetts, where the Supreme Court stated that a parent “cannot claim freedom

from compulsory vaccination for the child more than for himself on religious grounds.” The court went on to note that the First Amendment right to religious freedom “does not include liberty to expose the community or the child to communicable disease or the latter to ill health or death.” And because the law compelling vaccinations is neutral—that is, it applies to everyone and doesn’t specifically target a particular religion—no constitutional violation occurred. Plus, two of the parents had received exemptions, so the court viewed New York’s limited exclusion during an outbreak as permissible. Of course, the ruling is only binding within the context of public education; nothing prevents the parents from homeschooling their children and keeping them vaccination-free. And it remains to be seen whether these parents

will be appealing to a higher court to review the case. But given that the Supreme Court has already spoken loudly on the matter, here’s hoping faith in the judgment of the courts and the rule of law will prevail.

Vaccine DA — Impact Defense

Anti-scienceThere is science behind anti-vaxxer’s claims. Walia 13 — Arjun Walia, 8-2-2013 ("Polish Study Confirms Vaccines Can Cause Large Number of Adverse Effects," Collective-Evolution, 8-2-2013, Available Online at http://www.collective-evolution.com/2013/08/02/polish-medical-school-study-determines-vaccines-can-cause-irreparable-harm/, Accessed 7-22-2015)Despite the conviction of the necessity and safety of vaccinations, there are a number of studies coming forward that illustrate the potential dangers they may pose. A scientific review published by the Department of Paediatric Rehabilitation from the Medical School at the University of Bialystok has determined that there are a number of neurological adverse events that follow vaccination. This research is specific to Polish vaccinations, but is still useful given the fact that many ingredients used and examined in the study are still used in vaccinations all over the world.The University of Bialystok is a well known medical university that has published a tremendous amount of research on various topics. The evidence that’s out there supporting the hazards of vaccines is irrefutable. There is a lot of research that medical professionals are not privy to, this is credible research coming out of Universities done by doctors and professors. Medical professionals are usually guided to research done by pharmaceutical companies and the vaccine manufactures themselves. It’s important to look at both sides of the coin, and examine all information available before coming to a conclusion.It is not reasonable to assume that manipulation of the immune system through an increasing number of vaccinations during critical periods of brain development will not result in adverse neurodevelopment outcomes(1)The study addresses the use of vaccines in terms of adverse effects, immune system effects, neurological symptoms following vaccinations and a history of vaccines demonstrating little benefit. We often hear of studies only from the western world, expanding our sphere of research to a global one provides us with a broad range of information coming from a variety of different sources. A report like this coming from a medical school should not be taken lightly. It coincides with a lot of other research that’s emerging to suggest that vaccines can be hazardous to human health.Post-Vaccine Neurological ComplicationsThe authors focused on thimerosal, otherwise known as ethylmercury. It’s known to be a key ingredient in vaccines for preservation. A number of conditions are associated with thimerosal including toxicity of the heart, liver, kidneys and the nervous system. Over the last two decades, neurological conditions such as epilepsy, autism, ADHD and mental retardation have increased dramatically all over the world.From the 1990s new vaccines for infants containing thimerosal began to be used in America. In the DTP, Hib and Hep B vaccines, children received a dose 62.5 ug of mercury, which is 125-fold more than the dose considered safe, which is 0.1 ug a day. These reports were the reason that Scandinavian countries already prohibited the use of mercury in 1990(1)Research has shown that there is a direct relationship between thimerosal and the rate of autism. The paper determined that there was also a correlation between the number of measles-containing vaccines and autism prevalence during the 1980’s. A couple of years ago, an Italian court ruled that the MMR vaccine was the cause of Autism in the case presented. A recent study by the University of British Colombia came out exposing the HPV vaccine as being dangerous to health as well. UBC doctors also

exposed a Vaccination cover-up, demonstrating through official documents that vaccine manufactures have been aware of their adverse effects for a number of years.Adverse EffectsReports in many Polish and foreign medical journals lead us to conclude that postvaccinal complications among children can be observed in sporadic cases and that they are disproportionate to the benefits of vaccination in the elimination of dangerous diseases in childhood(1)This study and many others leave little doubt that vaccines can be extremely hazardous to human health.They first illustrate the adverse effects that occur shortly after vaccination as they are acknowledged by Polish law. These include:Local reactions, including:local reactions after the BCG (tuberculosis) vaccineswellinglymphadenopathyabscess at the injection sitePostvaccinal adverse events of the central nervous system:encephalopathyfebrile convulsionsnon-febrile convulsionsparalytic poliomyelitis caused by vaccine virusencephalitismeningitisGuillain-Barré syndromeOther adverse events following immunization:joint painhypotonic-hyporesponsive episodefever above 39°Cthrombocytopeniacontinuous inconsolable cryingNext they explore the fact that the vaccine schedule has increased dramatically since the time of these studies and antigens are being injected again and again.Doctors and researchers point to the worsening state of the health of the child population since the 1960s, which coincided with increasingly introduced vaccinations. Allergic diseases, including asthma autoimmune diseases, diabetes and many neurological dysfunctions-difficulty in learning, ADD, ADHD, seizures, and autism – are chronic conditions, to which attention has been brought(1)As far as immune system effects, they go on to state that the common practice of administering more than one adjuvant at a time or repeatedly injecting the same antigen can produce autoimmune disorders. They also point out that the toxicity of adjuvants can produce a range of adverse reactions. The hepatitis B vaccine has been known to cause Fatal Auto-Immune Disorder.Experimental evidence clearly shows, that simultaneous administration of as little as two to three immune adjuvants, or repeated stimulation of the immune system by the same antigen can overcome genetic resistance to autoimmunity(1)We continue to vaccinate en mass despite the growing body of evidence that clearly reveals how vaccines can be harmful to the body. The manner in which the body responds to vaccines is not well

understood. With the amount of studies published, alarm bells should be ringing for the medical industry to start making adjustments and at least warning parents. This isn’t meant to create an anti-vaccines position, but instead to look at all the facts vs. just some.Often times, Doctors are not fully aware of the dangers associated with vaccines nor the ingredients and studies available to show they can be hazardous. Doctors should be encouraged to independently seek out a variety of sources and look at a variety of journals on the subject. It is quite possible that they would realize the vaccine world is not black and white and serious consideration needs to be taken when looking at the current vaccine schedule.A burgeoning body of evidence shows that immune molecules play integral roles in CNS development, affecting processes such as neurogenesis, neuronal migration, axon guidance, synaptic connectivity and synaptic plasticity. Despite the dogma that peripheral immune responses do not affect CNS function, substantial evidence points exactly to the contrary. Thus, it is not reasonable to assume that manipulation of the immune system through an increasing number of vaccinations during critical periods of brain development will not result in adverse neurodevelopment outcomes(1)

Ableism — No solvency

The neg’s narrow focus on autism in the vaccination debate is insufficient – a complete critical examination of ableist structures and mindsets should be the priority. Choicewords 14 – Choicewords is a blog that highlights the young people’s views on issues related reproductive justice and gender equity, 2014 (“Challenging Ableism: Autism and the Conversation About Vaccines”, Unite for Reproductive and Gender Equality, March 24, Available Online at http://urge.org/challenging-ableism-autism-and-the-conversation-about-vaccines/, accessed 7/21/15, KM)

Recently there has been a debacle in the public health field about the connection between vaccines and autism. The Center for Disease Control will tell you there is no connection, while plenty of Americans and Jenny McCarthy believe that there is a definite link between the two. First off, there is such a range of autism. I will be using the term autism spectrum disorders (ASD) to cover the range of them, including Asperger syndrome, since there is rarely the distinction around this conversation. If you are not familiar with ASD, check out what information the Center

for Disease Control has. But I am not here to debate with you about whether vaccines “cause” ASD. But here’s the thing: Why are we so afraid of autism and children with disabilities? One of the problems I have

with this debate is how we talk about oppression and autism. Why is it that we talk about being afraid of having children with autism, rather than ways to change ableist mindsets? I acknowledge that the quality of

life with autism is not high for a number of reasons beyond social circumstances; but why aren’t we focusing on eliminating oppression, rather than the disorder itself? Why is our biggest debate about whether or not autism is caused by vaccines, rather than why kids with ASD are more likely to grow up to be unemployed, or why children of color with ASD are less likely to have access to services? Ableism and ableist language is a huge problem in public health communities, with language about “eliminating” particular disabilities being very prominent. While the intentions of folks in the public health field are to improve the well-being of the community, it ignores how this language impacts how people with ASD are perceived. When we put down ASD, we are putting down people with ASD. When we talk about “preventing” ASD, we are creating a hierarchy of, able bodies >disabled bodies. It perpetuates oppression of

people with ASD. In social justice, we also must ask the question to ourselves: why are we so obsessed with “curing” disabilities, instead of focusing on making life easier for folks with disabilities? Why are we so content with putting expensive prosthetic limbs on people with an amputated leg, instead of making the 2nd floor of a building accessible? This is especially true in reproductive justice movements, when we consider the ethics of

terminating pregnancies with fetuses with disabilities and predicting them in utero. In the end, our obsession with curing and preventing disabilities comes down to internalized ableism, and people being terrified of themselves or their children being diagnosed with a disability. Ultimately, creating accessible and accepting spaces, uplifting voices of folks with ASD and other disabilities, and dismantling an ableist mindset should be our priority, rather than dueling out how to prevent autism in the battle of the vaccines.

Counterplan

CP CardEnforcement of DO NOT TRACK solvesStrauss, Spring 2014 (Benjamin, JD Candidate 2014, “ONLINE TRACKING: CAN THE FREE MARKET CREATE CHOICE WHERE NONE EXISTS?” Chicago-Kent Journal of Intellectual Property Lexis)Any legislation aimed at protecting Internet privacy should aim at shedding light on what information is being collected, and provide some enforceable mechanism for consumers to opt out of Internet tracking. A Do-Not-Track regime should grant consumers the opportunity to voice their opposition to being tracked, and require that the preference be honored. Thus far, any attempt for the market to establish voluntary compliance with Do-Not-Track headers has failed. Critics argue that advertisers have no incentive to provide robust privacy protections for consumers because they derive much of their revenue from Internet tracking and profiling. n243 I disagree. The incentives have simply not been sufficient so far. People are still using Google even though they (should) know that their online activity is being tracked. Presumably it does not bother a significant number of consumers enough to stop or switch services. If companies are not losing visitors due to their tracking policies, why change? One solution is to implement a legally-binding Do-Not-Track regime. As outlined above, the technology is simple. Users may simply activate the Do-Not-Track preference in their browser or mobile device. This preference, however, must be universally applicable to cookies, mobile apps, in-store mobile analytics software, and traditional web browsing. It should also be simple, with clear instructions provided by the software or device provider. A legally-binding Do-Not-Track regime would only require a law mandating that webhosts (or $=P568 controllers) honor the users' preference. There does not need to be, nor should there be, a centralized Do-Not-Track list. A government-controlled centralized list carries privacy risks of its own. n244 The legislation should permit the FTC or FCC to impose fines or other administrative sanctions similar to those in China's draft amendments discussed above. n245 In addition, the legislation should also provide individuals with a legal claim against companies who do not honor their preference to not be tracked. However, administrative enforcement is likely to be more successful as many individuals will lack the time and resources to litigate against information-collecting giants such as Google. Some argue the system should be Do-Not-Track by default, thus requiring individuals to opt in if they do not mind being tracked. n246 This, however, is not necessary and poses greater consequences than an opt-out system. Any opt-out regime runs the risk of fundamentally altering the economic paradigm of the Internet. If enough people opt out, service providers will be stripped of the economic incentive to offer free services. Without advertising revenue, it is unlikely that Google will continue to offer free services such as Gmail, Google Drive, and Google Docs. If everyone is automatically opted out, it is likely far fewer people would opt in, thus exacerbating this problem. n247 A Do-Not-Track by default system might even cause behavioral advertising to "wither to insignificance," even though it offers value for many customers, "most of whom don't mind the practice." n248 Additionally, the Digital Advertising Alliance (DAA) argues against Do-Not-Track as the default setting because it purportedly does not represent user choice. n249 The DAA even declared it would ignore Internet Explorer's Do-Not-Track header because Microsoft (by way of Internet Explorer 10) was essentially making the Do-Not-Track decision on behalf of its users. n250 An opt-out regime would likely suffice so long as it permits privacy-concerned individuals to browse anonymously at their election, and the DAA would have no argument against the choice manually activated by the user. $=P569 Enforcement legislation might not be the best solution to the problem. Critics, including Michigan Congressman Fred Upton, are highly skeptical of Congress' or the

government's ability to "keep up with the innovative and vibrant pace of the Internet without breaking it." n251 Upton believes that "[c]onsumers and the economy as a whole will not be well served by government attempts to wrap the Web in red tape." n252 As detailed above, the E.U. Directive has already been criticized for failing to keep up with innovation as the rules on data exportation and transfer to third countries were deemed "outmoded" by the RAND Corporation. n253 This is perhaps a compelling argument considering the government's inability to build a functioning health care website after throwing $ 600 million at it. n254 Enforcement legislation also fails to address the global nature of the Internet. As seen with the E.U. Directive, enforcement outside the sovereign's jurisdiction is impossible without international cooperation, thus inhibiting the effectiveness of the privacy program. The world, along with the Internet, will only become increasingly more globalized. Considering the United States has yet to institute an opt-out protocol on a national scale, it is very unlikely a global consensus will be reached to establish an international standardized opt-out protocol. The free market, however, can traverse international borders. Enforcement legislation may not be required if the market can incentivize companies to honor Do-Not-Track requests by users or alter their profiling practices to dissuade consumer discomfort. Transparency or "right of access" laws (as seen in the E.U. Directive and PRC Decision) could provide this incentive. If users are permitted access to what information is collected about them, and how that information is used, perhaps we can indeed shed light on the largely hidden, highly lucrative world of the personal data market. If users object to the type of information collected or the way in which the information is used, consumers can opt out. If the opt-out preference is not honored, consumers can voice their opinions in other ways. Users can essentially "vote with their feet" by switching to services that have less intrusive tracking policies or to companies that honor tracking requests. When companies begin to experience a loss in revenue by way of fewer active users, they will be forced to alter their practices. Twitter has recently announced it will honor Do-Not-Track settings in $=P570 users' browsers when it launches its ad exchange. n255 Perhaps this is evidence that the market is gradually adapting to consumer preference in this area. Google and other "free" service providers could incentivize individuals to forego opting out in exchange for access to these free services. Additionally, Google could offer these same services for a fee to consumers who choose to opt out of tracking. This would place a value on an individual's privacy on the Internet. If users place a value on their Internet privacy that is higher than the fee charged for these services, they will continue to opt out. However, if users wish to continue to use the free services, they can do so in exchange for their consent to tracking by the service provider. Essentially, this places a monetary value on a user's browsing profile and can at least provide some return to the users whose data is being collected and exploited. It is perhaps a utopian idea of market economics, and it is unclear whether such a system would be sustainable, but it is an alternative solution to a stagnant legislature who has failed to seriously address online privacy.