A Vaccine Discussion for All of the People: An Open Letter

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In this open letter to public health officials penned by Ann Rosen, a plea is made to oust the campaign to villainize critical thinking and autonomy and instead have an open discussion about public health that would serve the needs of everyone

Dear Public Health Officials,

Over the course of this pandemic, we have all been invited to revisit our assumptions and priorities, acknowledge failings in systems that have long been in place and try to work toward better solutions. I am writing to ask you to join me in doing the same so we can bring public health goals back to a community level.

Local Government or Local Application of Big Government?

In recent years, our local health boards have become heavily invested in advancing legislation and imposing ordinances geared toward restricting the rights of citizens in the name of public health. This is particularly true when it comes to vaccine mandates and our right to refuse. Aggressive top-down vaccination campaigns have hijacked public health discussions, making it increasingly difficult for public voices to be heard. 

Agencies like the National Association of City and County Health Officials (NACCHO) have appropriated our public health departments to advance CDC agendas and drawn them further from the needs of our communities. Informed and influenced by regulatory agencies and special interest groups that do not accurately reflect the needs of communities, it seems as though our health departments are no longer empowered to engage in problem-solving at a local level.

For example, in 2019 in my home state, the New Jersey Association of City and County Health Officials (NJACCHO) distributed $2.3 million[i] in tax-payer supported funding to local health agencies to "strengthen communicable disease response." The Westfield Regional Board of Health (BOH) received $95,000, which it used to purchase a refrigerated truck for vaccination distribution.

While this can serve a useful purpose, it's clear that such funding is conditional and influences the direction of BOH efforts. Initiatives[ii] like the Influenza Honor Roll recognize agencies that successfully promote flu shots in local populations while New Jersey's Hot Shots for Tots immunization campaign "encourages childcare and preschool facilities to promote immunization best practices and to improve immunization rates." 

But are these campaigns really contributing to the overall health of our populations? In New Jersey, where children 6 to 59 months of age attending licensed childcare and preschool facilities have been required to receive the flu vaccine since 2008, autism rates have skyrocketed. Preschoolers in New Jersey have the highest rate of autism in the U.S., and Rutgers researchers reported that rates have increased faster in children living here, showing a 48% spike between 2010 and 2014.[iii]

We need our health departments to stop and review these initiatives to see if they make sense, but that's hard to do when those same initiatives are linked to government funding and support. 

My concern is that, if local health departments can only act as an extension of larger government agencies with fixed agendas, communities will be unable to work with them to make positive impacts. Furthermore, with increasing media censorship even at the local level, it is virtually impossible for alternative perspectives to find a route into public discourse. Where can the citizens go to advocate for their own health choices? 

Manufacturing Problems to Enforce 'Solutions'

New Jersey's vaccination rates remain high, with over 94% of children meeting all immunization requirements in 2019 to 2020.[iv] Only 2.7% of children have religious exemptions statewide. With medical exemptions only accounting for 0.2% of students, that leaves 2.1% of children who are either out of compliance or unaccounted for.

Before our health agencies endorse bills that impact the ability of citizens to exercise their religious beliefs, can we ask that they first assess and address the health needs and choices of that 2.1%? But this isn't just a New Jersey issue. 

In 2015, the National Vaccine Advisory Committee issued a report titled Assessing the State of Vaccine Confidence in the United States: Recommendations from the National Vaccine Advisory Committee.[v] Although the report acknowledged, "Vaccination rates among children are high and, for most parents, following the recommended schedule is the norm," the Vaccine Confidence Working Group was created in 2013 to address concerns about "evidence that more parents are hesitant about or delaying vaccination."

The report cited its end goal as "achieving acceptance by parents and health-care providers of all Advisory Committee on Immunization Practices (ACIP)-recommended vaccinations for children at recommended ages" and noted that "more efforts are needed to identify, develop and evaluate strategies and approaches to find the ones that facilitate or instill confidence."

Curiously, the report fails to address any of the concerns that pose an obstacle to vaccine confidence in a meaningful way. This is a theme that has persisted in public health discussions. Health officials at all levels double down on assertions of safety and efficacy and vocally support vaccine mandates rather than acknowledging the very real concerns of parents and others who have reservations about a rapidly growing vaccination schedule and the continuous infringements on our constitutional rights.  

Meanwhile, bills linked to additional vaccine mandates and the removal of parental and religious rights continue to be proposed throughout the country, and a number of states have already eliminated philosophical and religious exemptions to vaccinations.

The erosion of the doctor-patient relationship is evidenced by changes in scope of practice that reduce physicians to technicians who are no longer free to practice medicine to the best of their ability. Many physicians are reluctant to write medical exemptions for vaccinations, even for patients who they know are at risk for adverse reactions, because it may threaten their medical licenses.

New Jersey's medical exemption criteria are so limiting that children essentially have to suffer from a severe anaphylactic reaction to a vaccine to qualify for a medical exemption (in the case of most vaccines)[vi] -- and only to that specific vaccine.

Simultaneously, the U.S. is in the midst of a serious chronic disease epidemic, impacting well over 50% of the population, putting many families between a rock and a hard place as they weigh the risks and benefits of various vaccines. This pandemic has demonstrated just how devastating these vulnerabilities can be when it comes to navigating immune activation events that include both acute infections AND vaccination.

At the 2019 Global Vaccine Safety Summit, Dr. Heidi Larson, director of the Vaccine Confidence Project, acknowledged that "we need much more investment in safety science,"[vii] adding, "we have a very wobbly health professional frontline that is starting to question vaccines and the safety of vaccines."

WHO's chief scientist, Dr. Soumya Swaminathan, seemed to agree. "I don't think we can overemphasize the fact that we really don't have very good safety monitoring in many countries, and this adds to the miscommunication the misapprehensions because we're not able to give clear-cut answers when people ask questions about the deaths that have occurred due to a particular vaccine," she said at the same conference.

As it turns out, neither a public health crisis nor a vaccine hesitancy problem can be solved with Band-Aids. Perhaps in both cases, we would be better off strengthening a foundation than wasting so much time and resources fighting an enemy. After all, dissenting voices and viral infections only pose serious threats to failing systems.

Yet, rather than revisiting clinical trial designs and safety data, these same regulatory authorities and alphabet agencies have since teamed up with tech/social media companies, journalists, AI surveillance groups, fact-checkers and "health experts" to skip ahead to messaging strategies that will promote vaccine compliance.

Anyone who questions the prevailing narrative is now branded an "anti-vaxxer" or "conspiracy theorist" and therefore a "global public health threat,"[viii] a "threat to national security"[ix] or even a "terrorist" if mainstream media is to be believed. This for wanting to preserve the right to refuse a medical intervention with no liability and known risks.

When #Resistance Becomes Inconvenient

Organizations like the Public Good Projects (PGP) and Agence France-Presse (AFP)[x] have set about monitoring "vaccine hesitancy" on social media, and instead of listening to concerns, they have mined public expression as data to be used in the creation of communications strategies.

The information is provided to organizations like Poynter's CoronaVirusFacts Alliance, Stronger.org and ShotsHeard.org to arm them in their campaigns against parents with the audacity to voice some of the same concerns that were acknowledged by our highest-ranking public health experts. 

But as legislators in Trenton, New Jersey, discovered in December 2019 into January 2020, parents are undeterred when it comes to the health of their children and they will fight to preserve the right to make medical decisions for their families. Thousands protested outside of the State House in the freezing cold for hours and even days to stop a draconian bill that would have removed parental rights and religious exemptions to vaccines for all students from day care through college. 

To be clear, these parents were not there as anti-vaxxers, but rather to defend their right to choose medical interventions on their own terms. Many of them had reached out to their legislators and welcomed the opportunity to have an open dialogue. More often than not, they are simply seeking the opportunity to be heard and understood.

It was particularly disheartening for these same parents to discover that Project VCTR had tracked all social media activity related to overwhelming opposition to the New Jersey religious exemption bill and used it to create a "NJ Case Study,"[xi] a gaps analysis to understand their opponents' (namely parents') drivers to success in preventing this bill from moving forward -- clearly, a data collection exercise that could serve useful in future attempts to advance this same legislation.

The concerns of these parents were referred to as "talking points." Their perspectives were reduced to "framing." Despite these obstacles, parents and other medical freedom supporters have worked together to create NJ Public Health Innovation Political Action Committee (NJPHIPAC),[xii] "an independent, non-profit, non-partisan, grassroots Political Action Committee" with a mission to "protect and strengthen the constitutionally guaranteed and fundamental rights of New Jersey residents to make all medical decisions for themselves and their families without government interference." 

But not long after its public launch, BOH members initiated a strategy to derail their efforts. Noting the creation of NJPHIPAC at their February meeting,[xiii] the New Jersey Local Boards of Health Association addressed plans to create a pledge to prevent state legislature elected officials from accepting funding from "anti-vaccination groups." Is it now the role of public health officials to determine who elected officials can receive support from?

The Campaign to Villainize Critical Thinking and Autonomy

This focus on manufacturing consent has continued throughout the pandemic. This past summer, Yale University initiated a clinical trial to study Covid-19 vaccine messaging.[xiv] The trial examined how different messages related to personal freedom, economic freedom, guilt, embarrassment, anger, trust in science, bravery, community interest and self interest can influence not only our decision to get a Covid vaccine, but also our likelihood of fearing and/or judging people who refuse the shot.

In June, the WHO hosted its first Infodemiology Conference geared at managing the "infodemic" of "misinformation" that threatened Covid-19 vaccination efforts. During his keynote talk, Dr. Saad Omer, director of the Yale Institute of Global Health, noted that vaccine decisions are value-based decisions and recommended "appealing to values to change behavior." He then provided the following example of using this approach successfully:

"We wanted to test out, can we have a purity-based message? So we showed them (young people) pictures of genital warts and described a vignette, a narrative, a story, talking about how someone got genital warts and how disgusting they were and how pure vaccines are that sort of restore the sanctity of the body. 

So we just analyzed these data. This was a randomized control trial with apriori outcomes. We found approximately 20 percentage point effect on people's likelihood of getting an HPV vaccine in the next 6 months."

Other speakers at the infodemiology conference repeatedly addressed the need to stop the spread of misinformation, which seems to be any information that interfered with vaccine compliance. They made recommendations about toolkits for health practitioners and local public health officials. They spoke of the need to restore trust and to counter those who were "trying to undermine science."

They talked about teaming up with media and human rights organizations. Some even suggested mimicking the "tactics of anti-vaxxers," whatever that means. (If it means returning to a genuine concern about the health and wellbeing of children, then I heartily support it.)

In March 2021, the pandemic relief package included another $1 billion to "boost vaccine confidence,"[xv] and I have to wonder if our tax dollars are ultimately subsidizing the demise of free will. Our regulatory authorities created a playbook and I am observing its impacts in real time in the form of proposed legislation, media stories and, sadly, increasing fear and division within our communities. 

At this point even the concerns of vaccine developer Geert Vanden Bossche,[xvi] immunologists like Hooman Noorchashm[xvii] and former Pfizer Chief Scientist Mike Yeadon[xviii] are ignored when they speak out against the prevailing scientific narrative. Witnessing this, I can't help but recall the warning of holocaust survivor and medical activist Vera Sharav in aptly titled article, "Beware of Medicine Marching in Lockstep with Government."[xix] Because this is where we seem to be. 

It is clear that you, as our local health officials, have received a loud and clear message. Unfortunately, however, it may not be the message of the public and it doesn't speak to health.

So I am asking in earnest: Can we please go back to the beginning and have a conversation that includes the voices and the needs of all of the people? Are you willing to invite the public into a public health discussion and let us review our concerns as you review yours? Can we examine the science together and make room for questions? Our communities deserve an opportunity to create real healing. 


[i] State of New Jersey Department of Health November 20, 2019 https://nj.gov/health/news/2019/approved/20191120a.shtml

[ii] State of New Jersey Department of Health, Vaccine Preventable Disease Program https://www.state.nj.us/health/cd/vpdp.shtml

[iv] NJ.gov, Number and Percentage of Children Meeting All Immunization Requirements by Grade Type and County, New Jersey, 2019-2020 https://www.nj.gov/health/cd/documents/status_report/2020/all_schools_vac.pdf

[vi] New Jersey Department of Health, Vaccine Preventable Disease Program https://www.nj.gov/health/forms/imm-53.pdf

[xii] NJ Public Health Innovation Political Action Committee https://njphipac.org

[xiii] New Jersey Local Boards of Health Association February 13, 2021 https://njlbha.org/wp-content/uploads/2021/03/Minutes-February-13-2021.pdf

[xiv] ClinicalTrials.gov, COVID-19 Vaccine Messaging, Part 1 https://clinicaltrials.gov/ct2/show/NCT04460703

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