Vaccination Optional for New York City Kids
Monday, July 7, 2008 2:36 PM EDT
Some children are excused from what we all assumed is a basic obligation to society: being vaccinated against serious illnesses that spread so easily in places such as schools. Yet students entering New York City public schools are not required to submit to free and available protection against deadly communicable diseases like tuberculosis and hepatitis. All their parents need do is plead a religious exemption. Through a little-advertised loophole, which acts like a license, spiritual claims are accepted at face value. When it comes to religious diversity, we do not dare open ourselves to charges of intolerance. If sound science offends, that scientific truth is worked over to make it right. Even medicine must be politically correct. That means that since all cultures are equal ( isn't diversity without judgment what America is now about? ), and some cultures ( none of which can be called primitive ) reject Western medicine as the devil's work or the invention of infidels, the rest of us must submit to their prophets even if it means exposure to their disease. We go easy on the credentials of holy men, whatever their so-called teaching. Isn't that the legacy America has come down to?
Many of our new students come from lands with rampant infections, scarce care, and no medical records. Some may bring new strains that are resistant to medicine that has been effective against killer but largely controlled diseases such as tuberculosis. Pathogens that have not been indigenous here are said to be spreading before they can be identified and traced. Some may be spread by casual contact, others not. Because of the source of many cases, general awareness is largely suppressed.
School admission requirements issued by the Department of Health seem to strictly enforce compliance with recommendations of the American Academy of Pediatrics. The religious exemption does not appear on the form given to parents, but like other entitlements, word has gotten out and nobody questions it.
The skin test for tuberculosis is demanded only for students entering secondary schools. Parents, many of whom cannot read, are given printed guidelines to help them interpret the test. A positive result means the student has been exposed to the disease, but usually does not have it. "Usually" should not be good enough. An x-ray, scheduled weeks later, will reveal whether the child is sick.
In the meantime the child can attend school, mingling in an unfavorable environment of crowded halls and sealed rooms.
Hepatitis B, according to the Department of Health, is second only to tobacco as a leading cause of cancer. The National Center for Infectious Diseases warns us even not to share toothbrushes , because of the danger of blood being on them. Blood is spilled every day in most schools, either through common nosebleeds, accidents or fights. In fact, if blood is drawn and either combatant had already been infected by the blood-borne virus that causes AIDS, that part and much more of the child's medical history would remain covert. There is no vaccination against HIV. However, the vaccination against Hepatitis B is safe and effective, but it takes at least four months to get all the needed shots. New York State dictates that all children at least twelve years old or in seventh grade be vaccinated against Hepatitis B in order to "remain" in school. What gives with the keyword "remain"?
Immunizations are not the only health and safety issues that schools must face. There is also the thorny matter of "confidentiality." If the school social worker, psychologist, nurse, or supervisor has authoritative knowledge of the psychopathic history of a student, it is not the right of that child's teachers to know, even though they are charged with the primary responsibility, "in loco parentis" of protecting all the other kids. Sometimes it is an expression of professional arrogance. Sometimes it is a function of law, such as shielding a convicted juvenile felon from the harsh curiosity of everybody else.
The duty to protect students relies on the viable right to know what threats they may confront. It is fine that every school has a state-mandated "Hazard Communication Plan", an "Exposure Control Plan", chemical inventories, a "Hazard Classification List" from the Environmental Protection Agency, another one from the Department of Transportation, a watchdog for the federal Occupational Safety and Health Administration , and numerous other overlapping administrative controls.
Medical knowledge, like all learning, should be applied without apology or appeal to any religious or civil libertarian lobby. When it comes to the common good, there are no special interests. Sensible rules are in place to make schools safe from ringworm and lice, musty rugs and magic marker fumes. We should respond with greater, not lesser, attention to far worse diseases that we have the means to master. Failure to demonstrate that commitment will continue to ail the whole community.
