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A Skirmish Over the Hepatitis B Vaccination

The New York Times
New Jersey Edition
Sunday, July 18, 1999

By LISA SUHAY

Health Department Steps In And Leaves the Parents Out

For as long as the vaccine for Hepatitis B has been in general use, some parents have been fighting it.

Now it is New Jersey's turn.

By late June - the last legislative session before the summer recess - a measure making the Hepatitis B vaccine mandatory for all school age children had already passed the State Assembly and was headed for a Senate vote.

Until that time, the State Department of Health had supported the measure. But then the Senate added an amendment - introduced by State Senator C. Louis Bassano, a Republican from Union - that would have allowed parents to decide whether to inoculate their children for Hepatitis B - usually transmitted through sexual contact or intravenous drug use - and the measure was left off the legislative calendar.

At that point, state health officials chose to take it out of the hands of legislators and began writing a rule requiring the vaccination - without allowing parents the option of refusing.

Mr. Bassano put it this way in a telephone interview: “They wanted the summer to write it themselves using the power to make rules and regulations to subvert the legislative process. They didn't want parents to have a choice and this was the way to achieve that goal.''

Assemblyman John Wisniewski, a Democrat from Sayreville who was co-sponsor of the bill, said in a telephone interview: “The language in the amendment was just too broad. It almost seemed to negate the mandate. Still, I would have continued to support it if the Health Department had not made the decision to write it while the Senate was out of session for the summer. After all, something is better than nothing.''

Mr. Bassano and some parents now say they are prepared to fight the department's mandate and demand public hearings on the basis of medical concerns and the right of parental choice.

“We're not talking about a childhood disease here,'' Senator Bassano said. “This is an attempt to deal with the problems faced by drug users, homeless people and those who keep company with hookers.''

He said the health department supported the legislation until he added the amendment allowing parents a philosophical objection. Currently in New Jersey, parents can claim only a religious objection to vaccination.

 Mr. Bassano said mandating the vaccine raised several questions that had to be addressed through the legislative process.

“Some parents in my constituency have concerns over the safety record of this vaccine,'' he said. “They say giving this vaccine to children is more risk than benefit. These questions were asked of me by parents and I think they should be considered publicly.''

The Hepatitis B vaccine was approved by the Food and Drug Administration in 1986, and the advisory committee on immunization practices of the Centers for Disease Control and Prevention issued a recommendation for universal use of the vaccine in newborns and children in 1991.

 The vaccination is now mandatory in 42 states - including New York, Connecticut, Pennsylvania and Delaware. But for as long as the vaccine has been used, some parents have fought it.

The National Vaccine Information Center, a parent's group in Washington, issued a report last year stating that of the millions of children born last year in the United States, a total of 24,775 adverse events, including 439 deaths, said to be linked to the vaccine were reported to the Federal drug agency.

Barbara Loe Fisher, a co-founder of the group, said the raw numbers of reported adverse effects linked the vaccine to long-term “multiple sclerosis-like symptoms, including joint pain, and cognitive problems.''

 But a spokeswoman for the F.D.A., Lenore Gelb, cautioned against drawing conclusions from the data.

“We would have to separate out the reports filed from those complaints that we found to be really vaccine related,'' Ms. Gelb said. “There are a lot of things that happen to children that could account for the damage in the claims filed.''

Aside from concerns over possible ailments possibly related to the vaccine, Senator Bassano said the number of reported cases of Hepatitis B among children in the state was too low to justify a mass vaccination.

 He cited New Jersey Department of Education records for children, from birth to age 18, that showed only three cases of Hepatitis B among the state's children in 1997. In two cases, he said, the victims were 15 and the third was 18.

Speaking of the rules being drawn up by the Health Department, Mr. Bassano said: “They are trying to treat the wrong set of people with this vaccine. They can't reach the adults through education, so this is their solution. I think it is a poor one.''

But Marilyn Riley, a department spokesperson, said the mandate was part of a larger effort to update the state's vaccination rules.

“This is being done because all the department's vaccination rules are about to sunset (expire) in April of 2000, ‘’Ms. Riley said, referring to when the rules would expire. “That made it a good time to include the Hepatitis B vaccine in with the others.”

She said the mandate would go through the Public Health Council and should be released in the next several months. “There is a 30-day period for public comment once it's written,'' she said.

But Mr. Bassano said that was not good enough, contending that his constituency wanted to add the parental choice amendment or stop the mandate.

While the New Jersey mandate will require all children be vaccinated against Hepatitis B by the time they reach school age, or age 5, Ms. Reynolds said hospitals have adopted the practice of urging parents to immunize their children at birth.

“I think it's because the baby is right there where they have more control over the situation,'' she said. “They were testing the mothers for the disease and deciding on a case by case basis about the babies. Now, I guess they just decided to skip testing the mothers and just immunize all the babies.''

According to Ms. Reynolds, the Hepatitis B vaccine is the only inoculation given at birth. Children then get booster shots, one at 2 months of age and another at 4 months.

All other immunizations - including measles mumps and rubella (MMR), diphtheria, tetanus and pertussis (DPT), polio (orally administered) and Hepatitis A and Influenza B and chicken pox - are administered at 2 months and again at 4 months, 8 months and 10 months.

“Once the level of availability and use of a certain vaccine becomes routine and people get used to it, then states begin to mandate it,'' Ms. Reynolds said. “Since so many states are suddenly making these mandates, the Hepatitis B vaccine must have reached that sort of comfort level with the general public.''

 She added: “We cannot say that vaccines are 100 percent safe. We cannot say they are 100 percent effective. We can say that the benefits outweigh the risks. Consider the risk from the diseases themselves. We cannot risk the return of these diseases.''

But Jackie French of Cranford is not sure.

Mrs. French is the mother of three children ages 9, 6 and 2. She says her youngest child, Patrick, suffered permanent damage after receiving his third booster for diphtheria, tetanus and pertussis (DPT).

Now she makes it her business to investigate whatever vaccine is proposed for mandatory use.

It was Mrs. French, pleading with Mr. Bassano, that led the Senator to look further into the issue and to draft the amendment allowing parents to forego the vaccination based on philosophical objections.

“We were doing something to protect our child from disease and instead it has destroyed our lives,'' Mrs. French said.

Michael Belkin, a financial and economic forecaster from Manhattan, has been at the forefront of the fight against the Hepatitis B vaccine since the death of his 5-week-old daughter Lyla Rose in September 1998.

In May, Mr. Belkin was the lead witness in Congressional hearings into the Hepatitis B vaccine. He says his daughter became fussy after the vaccination, went to sleep and never woke up.

He said an autopsy ruled out choking, but found swelling of the brain.

”Look in any neurology textbook and it will tell you about post-vaccinal encephalomyelitis, brain swelling following vaccination,'' Mr. Belkin said. ``It can happen with any vaccination.''

He called the Hepatitis B vaccine “the Ford Pinto of the vaccine world with the exploding gas tank. It should not be given to newborns or small children.''

Sue Collins of Long Hill Township presents the kind of situation that the state Department of Health worries about. She does not vaccinate her son for any disease, and plans to educate him at home.

Mrs. Collins said that after reading about the possible adverse effects associated with vaccinations, she chose not to inoculate her son Zachary, now age 3, for anything.

Mrs. Collins, who runs a support group called Freedom of Vaccine Choice, said: “A lot of people don't want to hear about the risks. They don't want to buck the system. They would rather paint us as crazies or fanatics, when we are simply asking for the right to make an informed decision.''

For her part, Mrs. French said that while she will never again immunize a child for any disease, she is not asking other parents to adopt her attitude.

“What I want is for parents to ask more questions and have the freedom to make the decision for themselves once they have learned all they can,'' she said. ``Parents shouldn't have to lie to the government claiming some religious belief when they really object to the safety of the vaccine or the rationale behind it.''