Blue Envelopes in Washington State

 In The Politics of Autism, I discuss interactions between first responders and autistic people.  Some jurisdictions allow autistic drivers to ask for a blue envelope to disclose the driver's diagnosis in case of an accident or traffic stop.  Others have ID cards.

A release from Washington State Rep. Carolyn Eslick:

Legislation aimed at preventing misunderstandings during traffic stops and improving safety for drivers with autism and other neurodivergent conditions has been signed into law by Gov. Bob Ferguson.

House Bill 2323, sponsored by Rep. Carolyn Eslick, directs the Washington State Department of Licensing to establish a statewide Blue Envelope Program. The envelope will hold essential documents, including vehicle registration and proof of insurance, and include printed guidance for drivers and responding officers on how to communicate during a traffic stop.

The concept was first adopted statewide in Connecticut in 2020 and has since been implemented through a mix of state laws and local law enforcement programs across the country.

Research shows interactions with law enforcement are not uncommon for people on the autism spectrum, with a significant share of young adults reporting being stopped and questioned by police. In high-stress situations, some individuals may have difficulty responding quickly or may exhibit behaviors that can be misinterpreted. Sensory triggers such as flashing lights, sirens and rapid commands can heighten stress and complicate communication.

“This is about protecting people in a moment when a simple misunderstanding can have serious consequences,” said Eslick, R-Sultan. “For someone who processes the world differently, a traffic stop can be overwhelming and frightening. Through this bill, we are providing a clear way for drivers to communicate their needs and help officers respond with awareness, patience and understanding so everyone gets home safely.”

Under the law, blue envelopes will be available at no cost at driver licensing offices statewide and by request. Participation is voluntary, and no medical documentation is required. The Department of Licensing will also provide information about the program online.

House Bill 2323 passed the House on a 92-1 vote and the Senate 47-0 before being signed into law. It takes effect June 11.

Purple Alerts Under Consideration in Washington State

The Politics of Autism discusses the problems of wandering and day-to-day safety.

From the Urbatsch Law Firm:

• Purple Alerts are a public notification system designed to help locate adults with cognitive, intellectual, or developmental disabilities who have gone missing. These individuals are not currently covered by existing alert systems, such as Amber Alerts or Silver Alerts.
• Addressing a critical gap in existing state alert systems, Purple Alerts ensure that intellectually disabled adults who are reported missing receive appropriate attention and that the public is aware of the specific circumstances.
• Currently, only five states (Florida, Maryland, Kansas, Mississippi, and Connecticut) have enacted Purple Alert systems.
• Purple Alerts can also inform law enforcement about the nature of a missing person’s disability. This can help enable a more appropriate and calm interaction when the person is located.

A week ago, KIRO-TV reported:

The Washington State Senate passed a bill that could make it easier to find missing people who are vulnerable adults or have disabilities.

The “Purple Alert,” also known as Senate Bill 6070, was passed unanimously on Thursday.

The alert could help to find missing people after a group of High School Seniors at Lake Washington High School advocated for the bill.

The bill will establish an alert system for people with disabilities and vulnerable adults.

Lawmakers hope the alert will help quickly find missing people.

It will be similar to alerts for older people who go missing.

The bill is headed to the state legislature’s House of Representatives.

From the Washington Autism Alliance: on Why SB 6070 Matters

• Clear standards for danger Families and law enforcement currently lack consistent guidance on when a missing person is truly endangered. SB 6070 clearly defines high-risk situations, including when someone has a developmental disability, dementia, serious mental health crisis, suicidal ideation, or other conditions that prevent safe self-care.
• Faster action when it counts The bill clarifies when courts may authorize rapid action to locate a missing endangered person, ensuring help is not delayed by uncertainty during life-threatening situations.
• Focus on the most vulnerable SB 6070 centers those at the greatest risk when missing, including minors, vulnerable adults, people with developmental disabilities, individuals experiencing acute mental health crises, and people with Alzheimer’s disease or other dementias.
• Strong guardrails and accountability This bill includes strict limits on how tools may be used, requires court approval or rapid post-use judicial review in emergencies, limits data collection to what is necessary, and requires deletion of non-relevant information. The focus remains on recovery and safety, not surveillance.

Maddie White at KING-TV:

The proposal was inspired by the disappearance of 21-year-old Jonathan Hoang, who has the mental capacity of a 9-year-old and vanished last March. His family believes foul play may be involved. “It’s very likely he was abducted,” said his sister, Irene Pfister.

For nearly a year, the Hoang family has lived without answers. “They told me and my parents, ‘It’s not a crime to go missing,’” said Pfister. She described the emotional toll of his disappearance, saying, “Just to wake up one morning and someone you love, they’re gone with no, no sign, no trace, and like, it’s like he’s disappeared off the face of the Earth.”

Although adults with autism who go missing in Washington are eligible for an Endangered Missing Persons Advisory, Hoang’s case highlights what his family sees as confusion around how and when those alerts are used. “I think there is this misunderstanding,” Pfister said, noting that autism “is a spectrum, and it’s called a spectrum for a reason.”

In Hoang’s case, an Endangered Missing Persons Advisory (EMPA) was issued on the fifth day after his disappearance. Pfister believes hesitation stemmed from uncertainty over her brother’s cognitive abilities. “Despite our family sharing that he wouldn’t be able to get home,” she said.

The sheriff's office said the EMPA "does not trigger a mass notification system" such as a cellphone push alert, as an Amber Alert does, and that highway signs are only used when a vehicle is involved, which wasn't applicable in Jonathan's case. Considering the limitations, the sheriff's office said they decided to first lean into other communication tools to alert the public.

States Warn About Shrub Oak

In The Politics of Autism, I discuss the use of restraint and seclusion, along with cases of abuse.  In America's complex system for dealing with autism, oversight is uneven, and people on the spectrum can fall through the cracks.

Jennifer Smith Richards and Jodi S. Cohen at Pro Publica

Two more states are now scrutinizing a New York boarding school for autistic students and have warned school districts about troubling conditions there.

In Connecticut, education officials visited Shrub Oak International School and alerted districts that a state watchdog group determined there were ongoing “serious safety concerns” at the unregulated for-profit private school. Separately, the state’s Department of Developmental Services, which serves residents with intellectual disabilities and autism, has decided to stop sending more students there, an agency spokesperson told ProPublica. That agency described the facility as looking “more akin to a penal institution than an educational campus.”

Washington education authorities, meanwhile, visited Shrub Oak this month and warned school districts to contact the state before considering enrolling students there. Officials are reviewing the state’s relationship with the school, officials told ProPublica.

The scrutiny of Shrub Oak comes as a ProPublica investigation published in May documented how parents and workers repeatedly asked New York authorities to investigate their concerns at the school to no avail.

Removing the MMR Personal Belief Exemption

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.   And among those diseases could be COVID-19.

Tyler P. Moore and colleagues have an article at The American Journal of Public Health titled "State Policy Removing the Personal Belief Exemption for Measles, Mumps, and Rubella (MMR) School Immunization Requirement, Washington State, 2014–2022."

Objectives. To assess the impact of Washington State’s 2019 Engrossed House Bill (EHB) 1638—which removed measles, mumps, and rubella (MMR) personal belief exemptions—on MMR vaccine series completion and exemption rates in K–12 students.

Methods. We used interrupted time-series analyses to examine changes in MMR vaccine series completion rates before and after EHB 1638 was passed and the χ2 test for differences in exemption rates.

Results. EHB 1638 implementation was associated with a 5.4% relative increase in kindergarten MMR vaccine series completion rates (95% confidence interval = 3.8%, 7.1%; P ≤ .001), and results were similar with Oregon as a control state (no change observed in Oregon; P = .68). MMR exemptions overall decreased 41% (from 3.1% in 2018–2019 to 1.8% in 2019–2020; P ≤ .001), and religious exemptions increased 367% (from 0.3% to 1.4%; P ≤ .001).

Conclusions. EHB 1638 was associated with an increase in MMR vaccine series completion rates and a decrease in any MMR exemption. However, effects were partially offset by an increase in religious exemption rates.

Public Health Implications. Removal of personal belief exemptions for the MMR immunization requirement only may be an effective approach to increase MMR vaccine coverage rates statewide and among underimmunized communities. (Am J Public Health. Published online ahead of print May 18, 2023:e1–e10. https://doi.org/10.2105/AJPH.2023.307285)

ISAAC Alerting Act

In The Politics of Autism, I write about the everyday struggles facing autistic people and their families -- including safety during emergencies.

A release from Rep. Cathy McMorris Rodgers (R-WA):

Eastern Washington Congresswoman Cathy McMorris Rodgers (WA-05) today introduced the bipartisan Information Sharing and Advanced Communication (ISAAC) Alerting Act to improve 9-1-1 emergency response for people with disabilities.

“The idea of this legislation was brought to me by an amazing mom and advocate named Holly from Spokane. She’s an ability advocate in memory of her son Isaac, and she’s made a difference in our community with the ISAAC Alert System, which is currently helping emergency responders in Eastern Washington and Idaho better aid people with disabilities,” said Rodgers. “Far too often, first responders lack critical information and training when responding to people with disabilities. This can put families, first responders, and people with disabilities at risk during emergency situations like the wildfires currently burning across our communities. By requiring the FCC to examine the feasibility of implementing a 9-1-1 disability alerting system, the ISAAC Alerting Act will help identify and address the challenges first responders face in these situations. It will improve the overall quality of care when a first responder enters a home and may need to provide unique assistance to someone with a disability.”

The ISAAC Alert system currently operates in cooperation with Spokane County Dispatch and the Spokane Fire Department. The namesake of the Isaac Alert is Isaac Lytle, a Spokane resident with Autism Spectrum Disorder who passed away in 2007. Isaac inspired his mother, Holly, to help families who were struggling with the hardships of having a loved one with autism.

“I feel very fortunate that Spokane County has the technology, infrastructure and support from local first response agencies to make ISAAC Alerts available to our disability community,” said Holly Goodman, ISAAC Foundation Founder. “There is a tremendous amount of comfort knowing first responders arriving at your home have important information to help them navigate an emergency more effectively with your loved one with a disability. Seeing our information sharing system implemented nationwide would be a dream come true.”

Today, the ISAAC Foundation provides educational, emotional, and financial support programs to families affected by autism in Spokane, Stevens, Lincoln, Whitman, and Kootenai Counties. The ISAAC Foundation worked with Spokane County Dispatch to create the ISAAC Alert system to inform law enforcement if there is someone with a disability in a residence they are responding to.

The ISAAC Alerting Act would assist in expanding that alerting system nationwide, as well as direct the Federal Communications Commission to prepare a report on a 9-1-1 disability alerting system to identify improvements that need to be made.

Cathy was joined in introducing this legislation by Congresswoman Debbie Dingell (MI-12).

“We have a responsibility to ensure law enforcement agencies and first responders have vital information they need when responding to emergency calls to keep themselves and the public safe,” said Dingell. “With this legislation, we will take a critical first step in ensuring law enforcement and first responders are better equipped to respond to 911 calls from households with an individual with a disability.”

NOTE: Cathy first learned about the ISAAC Foundation in 2016 and was inspired by Holly’s commitment to honoring her son, Isaac, through outreach and engagement in the autism and disability communities. Understanding the value the ISAAC Alert System has brought to families and first responders in Eastern Washington, as well as the challenges communities across the country have faced when trying to implement a similar system, Cathy sought to create a pathway for a nationwide disability alerting system. The ISAAC Alerting Act is the first step in this process.

CLICK HERE to read the bill.

Jill Biden, Autism, and the Military

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families.  As many posts have discussed, the challenges are especially great for military families.

Abbie Shull at The News Tribune (Tacoma, WA) reports that Dr. Jill Biden visited Joint Base Lewis-McChord on March 9., touting a relaunch of a military family outreach program she started during the Obama administration.

Biden toured the Children's Museum on JBLM with Gov. Jay Inslee and I Corps commander, Lt. Gen. Randy George. The museum is a joint effort between the base and Children's Museum of Tacoma and is set to formally open April 24.

The director of learning experiences at the museum, Alyssa Tongue, showed Biden the new water feature and a sensory exhibit and "calm room" designed for children on the autism spectrum.

...

Biden's visit is part of an ongoing effort to relaunch Joining Forces, a program she started with former first lady Michelle Obama during the Obama administration. Biden said Joining Forces focused on employment, education and wellness programs for military families, and she hopes to continue those efforts while listening to the evolving needs of the families.

...

Biden also met with representatives from the JBLM Center for Autism Resources and Education Services (CARES) program which supports families who have children or dependents on the spectrum. JBLM CARES is the only program of its kind in the Department of Defense, which has made the base home to the largest population of military dependents with autism.

62nd Airlift Wing Lt. Col. Rebecca Christi is a developmental behavioral pediatric fellow at Madigan Army Medical Center and the mother of two children with autism. Christi told Biden how JBLM's resources have made it easier for her children to receive specialized education that was unavailable at her previous duty stations.

Christi said she was glad Biden seems ready to focus on the needs of families with special needs children.

"We need to focus on sustaining the model that JBLM has provided," Christi said. "Getting appropriate classroom placement for my son has been essential."

"Disturbing Reports" -- OCR Probes Pandemic Special Ed in WA and IN

 In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters.  And coronavirus is proving to be the biggest disaster of all. Providing education is proving to be very difficult.

 Hannah Furfaro  and Dahlia Bazzaz report at  the Seattle Times:

The U.S. Department of Education’s Office for Civil Rights is investigating Seattle Public Schools after hearing “disturbing reports” about how the district handled special education during the pandemic.

In a letter sent Tuesday to Superintendent Denise Juneau, department officials cite concerns that some students with disabilities went without specialized instruction — and some teachers weren’t allowed to provide it.

“According to one local news report last spring, the District told its special education teachers ‘not to deliver specially designed instruction,’ and disallowed them from ‘adapt[ing] lessons to each child’s needs,’” wrote Kimberly M. Richey, the Education Department’s acting assistant secretary for civil rights. “OCR [Office of Civil Rights] is concerned that the District has failed to provide a ‘free appropriate public education’ to each qualified student with a disability as required by federal law and denied students with disabilities equal access to education.”

The U.S. Department of Education’s Office for Civil Rights is investigating Seattle Public Schools after hearing “disturbing reports” about how the district handled special education during the pandemic.

In a letter sent Tuesday to Superintendent Denise Juneau, department officials cite concerns that some students with disabilities went without specialized instruction — and some teachers weren’t allowed to provide it.

“According to one local news report last spring, the District told its special education teachers ‘not to deliver specially designed instruction,’ and disallowed them from ‘adapt[ing] lessons to each child’s needs,’” wrote Kimberly M. Richey, the Education Department’s acting assistant secretary for civil rights. “OCR [Office of Civil Rights] is concerned that the District has failed to provide a ‘free appropriate public education’ to each qualified student with a disability as required by federal law and denied students with disabilities equal access to education.”

Arika Herron at the Indianapolis Star:

 The U.S. Department of Education’s Office of Civil Rights is investigating the Indiana Department of Education over what it called, in a letter sent Tuesday to Education Secretary Katie Jenner, “disturbing reports” that the state denied students with disabilities equal access to education during the COVID-19 pandemic.

Under federal law, schools are required to provide a "free appropriate public education" to each qualified student with a disability.

In its letter, OCR said it was concerned that Indiana had failed to do so and was “particularly troubled” by reports that parents of disabled students in Indiana schools have filed multiple complaints with IDOE alleging that students were forced by local school districts into “one size fits all” remote learning programs, instead of individualized programs designed to meet the need laid out in their Individualized Education Plans or 504 Plans. Qualifying students with disabilities are guaranteed services, spelled out in their IEP or 504 Plan, to meet their unique needs and ensure they have equal access to a free public education.

Important Early Episode in Special Education

 In The Politics of Autism, I write about special education and the Individuals with Disabilities Education Act.  The law was originally the Education for All Handicapped Children Act.  There were forerunners.

Andrea Brown at Herald.net:

It was 1970, the start of a decade of change.

A motley crew of two bell-bottomed men in their early 20s and four women twice their age piled into a VW van with balding tires and set out from Seattle on road trips around Washington.

They talked to parents, teachers, politicians — anybody who would listen and also those who wouldn’t.

Their goal: overhaul the state school system to educate all students with disabilities, not just the most high-functioning.

Janet Taggart was one of the moms in the tan van. She had a daughter who was among 4 million American children being refused a public education. She didn’t think that was fair. Neither did the other three women in the van, two of whom had sons with autism.

The guy with the long dark sideburns behind the wheel, Bill Dussault, was a second-year law student at the University of Washington. The moms recruited him and a fellow classmate to write a bill that would give all children the right to an education. Back then, the few school programs outside of institutions were for children with mild learning disabilities. Thousands in Washington were excluded, with no recourse. Disability laws didn’t exist.

...

Their mission was to pass a law with teeth. What they came up with was short yet pointed, and the genesis for a civil rights milestone.

Eight months after their first September road trip, Gov. Dan Evans signed House Bill 90 “Education for All” into law in May 1971. It was the first law in the United States that mandated a state to educate all special needs children, regardless of the level of disability.

Triage

In The Politics of Autism, I discuss the day-to-day challenges facing autistic people and their families. Those challenges get far more intense during disasters.  And coronavirus is proving to be the biggest disaster of all.

People with autism and other disabilities have faced discrimination in organ transplants.  Now they face discrimination in the availability of ventilators.

Amy Silverman at Pro Publica:

Advocates for people with intellectual disabilities are concerned that those with Down syndrome, cerebral palsy, autism and other such conditions will be denied access to lifesaving medical treatment as the COVID-19 outbreak spreads across the country.

Several disability advocacy organizations filed complaints this week with the civil rights division of the U.S. Department of Health and Human Services, asking the federal government to clarify provisions of the disaster preparedness plans for the states of Washington and Alabama.

The advocates say the plans discriminate against people with intellectual disabilities by deprioritizing this group in the event of rationing of medical care — specifically, access to ventilators, which are in high demand in treating COVID-19 cases. More than 7 million people in the U.S. have some form of cognitive disability.

Some state plans make clear that people with cognitive issues are a lower priority for lifesaving treatment. For instance, Alabama’s plan says that “persons with severe mental retardation, advanced dementia or severe traumatic brain injury may be poor candidates for ventilator support.” Another part says that “persons with severe or profound mental retardation, moderate to severe dementia, or catastrophic neurological complications such as persistent vegetative state are unlikely candidates for ventilator support.”

...
“What we’re seeing here is a clash between disability rights law and ruthless utilitarian logic,” said Ari Ne’eman, a visiting scholar at the Lurie Institute for Disability Policy at Brandeis University. “What this is really about at the end of the day is whether our civil rights laws still apply in a pandemic. I think that’s a pretty core question as to who we are as a country.”

Physician-Parent Advocates Vaccination

In The Politics of Autism, I look at the discredited notion that vaccines cause autism. Twitter, Facebook, and other social media platforms have helped spread this dangerous myth. Measles can kill.

Dr. Shikha Jain at The Hill:

The Seattle Public School system has taken a massive leap towards protecting their students from life-threatening illnesses by requiring all students to have received their measles, mumps, and rubella vaccine before returning to school Jan. 8.

...

Vaccinations have been proven to be active and safe in numerous studies. An often quoted, but thoroughly debunked case series published by a now-discredited physician attempted to link the MMR vaccine and autism. Unfortunately, the misinformation that was spread by this paper has led to decades of dangerous, uninformed decision making by well-intentioned parents and caregivers.

As a physician and a mother, despite knowing all of the science and the safety of vaccines, I am embarrassed to say even I paused for a second before my first child receiving her first vaccine.

I recalled all of the sensationalized false data dispersed online since the 1998 paper was reported. When celebrities tout expertise on the subject and nationally attempt to discredit scientific fact and evidence, these doubts can creep into the most educated and informed and lead to dangerous decisions.

...

In 2019, Washington had two outbreaks of measles and one case unrelated to the explosion. There were 87 cases total, most cases in this state since 1990.
...

Unfortunately, there are many vaccine myths continually perpetuated, leading to individuals making decisions that they believe are informed, but are based on inaccurate data.

To addresses, the most dangerous myths, first are that no data has ever shown a link between autism and the MMR vaccine.

Autistic Congressional Candidate

In The Politics of Autism, I write:  "Support from the general public will be an important political asset for autistic people. Another will be their sheer numbers, since a larger population of identified autistic adults will mean more autistic voters and activists"

Zack Budryk at The Hill:

A Washington state candidate running to succeed retiring Rep. Denny Heck revealed he is autistic Wednesday, citing teen climate activist Greta Thunberg as inspiration.

I've spent a long time thinking about whether I would talk publicly about this. I'm running for Congress & I know people will judge me for it. But I've seen how much @GretaThunberg has helped the conversation around it & I've decided to be open about it too. I'm autistic.

— Joshua 4 Congress (@Joshua4Congress) December 17, 2019

Collins, a 26-year-old truck driver, is currently the only declared Democratic candidate in the race for the state’s 10th District. The Democratic primary is set for Aug. 4, 2020.
Collins, a self-identified socialist, says on his campaign site that his experience as a trucker and navigating a complex, insufficient safety net shaped his views.

“[A] decade in the workforce has made the truth clear: our lives are made difficult on purpose. This system has been created and maintained by the people who own basically everything to protect their power,” he writes. “If we’re well-paid, secure in our housing, and educated, we demand a far bigger share.”

Although speculation abounds that historical statespeople who predate the modern understanding of autism, such as Thomas Jefferson, may have been on the spectrum, Collins would be the first openly autistic member of Congress.

Little Progress on Curbing Vax Exemptions

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing disease to spread.

Michael Ollove at Stateline:

Despite the worst measles outbreak in decades, few state legislatures this year have reconsidered the exemptions that families use to avoid inoculating their children.
As many legislative sessions wind down, only Washington state, which has had one of the highest numbers of measles cases, has sent a measure to the governor’s desk.
...
Every state allows schoolchildren to skip inoculations for medical reasons, such as a compromised immune system or an allergy to a vaccine’s components. And all but three states — California, Mississippi and West Virginia — also give passes to families who claim personal or religious objections to vaccinations.

In many states, that number has been growing. For example, the Houston Chronicle reported this week that nonmedical exemptions granted in Texas rose 14% in 2018-2019, continuing a 15-year upward trajectory.

To be sure, the current outbreak began after most state legislative sessions were underway. But proposals to scale back exemptions that did emerge faced vehement opposition from “anti-vaxxer” groups, which scuttled them in several states.

Dr. Sean O’Leary, a Colorado pediatrician who serves on the infectious diseases committee of the American Academy of Pediatrics, blamed such groups for the failure of a bill in his state.

“The anti-vax groups are loud and pretty organized and have worked for years,” he said.

They were organized in Oregon, at Aubrey Wieber reports at The Salem Reporter  that legislation to end non-medical exemptions died in the state senate.

[P]olitical spending reports filed with the state Elections Division show that the political action committee of one of the groups most active against HB 3063, Oregonians for Medical Freedom, has received nearly $160,000 in political donations since. A good chunk of that money — $87,443 — came from Portland venture capitalist Jonathan Handley and his wife Lisa. They haven't contributed since 2017.

The Handleys' son was diagnosed with autism and Jonathan Handley wrote a book about a connection between autism and vaccines. Over the years there have been many reports and theories on a connection between vaccines and autism, but the scientific community has repeatedly debunked them.

...

Oregonians for Medical Freedom is based in Hillsboro and was registered as a nonprofit last February by the law private firm of Andrew Downs, who also serves as legal counsel for the Senate Republican office.

...
The term "medical freedom" is inherently political. It originated in libertarian circles and is a term used by famed libertarian Ron Paul. Similarly minded groups in several states use the term medical freedom or something similar.

...
Sen. Sarah Gelser, D-Corvallis, said she is worried the success of the opponents could become a playbook for other issues. The opposition pulled people from all walks of life. Some, Gelser said, were pleasant and respectful... Others, she said, made physically and sexually violent threats, wearing the yellow stars of David and making analogies to gas chambers, communism and Jim Crow laws. "I got this heinous email about being raped and being raped harder," Gelser said. "In the past 24 hours, I have been called a turd sandwich, a whore, the C-word, I have been invited to lick, suck and bite various body parts, some of which I've never heard of."

...

 One of those who became a regular at the Capitol was Raisa Piatkoff of the Russian Old Believer community in Woodburn. Her community is against the bill for religious reasons.

Tight-Knit Communities and Vaccine Hesitancy

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.   This bogus idea can hurt people by allowing disease to spread.

Sumathi Reddy at WSJ:

In 2017 it was a Somali community in Minnesota. In 2014 it was the Amish in Ohio. This year, it is Orthodox Jewish communities in New York and Eastern Europeans in Washington state.

Insular and close-knit religious or cultural groups have seen some of the worst measles outbreaks in the U.S. in recent years.

About 75% of measles outbreaks over the past five years—defined as three or more linked cases—took place in such tightknit communities, says Nancy Messonnier, acting director of the CDC’s Center for Preparedness and Response, and an expert on immunization and respiratory diseases. Such groups share the same culture and are often somewhat isolated from the larger community.

...
In Ohio, when a measles outbreak hit an Amish community in 2014, they were willing to get the MMR vaccine when they saw the effect the disease was having, says Michael Brady, associate medical director at Nationwide Children’s Hospital in Columbus. The issue wasn’t the vaccine, he says, but their philosophy of not accepting anything from the government.

In Washington state where a measles outbreak has been contained, advocates and health experts say there is documented vaccine hesitancy in the Ukrainian and Russian-speaking populations.

Tetyana Odarich, a family medicine physician in Portland, Ore., sees many patients from the Ukrainian and Russian community in the area and says roughly half don’t want to get their children vaccinated.

Measles in 2019

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

CDC reports: From January 1 to 31, 2019, 79 individual cases of measles have been confirmed in 10 states. The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, New Jersey, New York, Oregon, Texas, and Washington.

Rachel Frazin at The Hill:

Hundreds of anti-vaccination supporters demonstrated outside a public hearing in Washington state on Friday to protest a bill that would make it harder for families to opt out of mandatory vaccinations for children, the Associated Press reported.

The protest took place amid the state's worse measles outbreak in more than two decades. Health officials have reported at least 56 cases in Washington and Oregon.

An estimated 700 people demonstrated in Olympia, Washington, most of whom opposed stricter requirements, The Washington Post reported.

Wendy Orent at LAT:

The mystery is why they choose to believe such anecdotal “evidence” instead of the vast amount of scientific research that has found vaccines to be safe. One paper still cited by vaccine skeptics was published in 1998 by British physician Andrew Wakefield and colleagues. The article, which suggested a link between the measles vaccination and autism, has since been retracted and repeatedly disproved, and Wakefield has lost his British medical license. Yet his discredited autism hypothesis still resonates in the superheated atmosphere of anti-vaccine websites.

Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine and father of an autistic daughter, has watched the anti-vaccine movement closely. What surprises him, he said, is how activists “fine-tune the appeal to the local political environment. In Texas, anti-vaxxers use terms like “medical freedom” and “personal choice,” while in the Pacific Northwest, they talk about purity and toxic ingredients, said Hotez, author of “Vaccines did not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad." 

Russian social media trolls have promoted the bogus vaccine-autism connection.   Haider Warraich at Vox:

“Taking on the misinformation campaign about vaccines has become more complex now that research is demonstrating that a large amount of the social media posts represent state-sponsored cyberwarfare, particularly from Russia,” said Robert Califf, a former commissioner of the Food and Drug Administration who now leads the Forge, Duke University’s center for health data science. The center is now mounting an effort to understand and address misinformation on the internet.

Measles Wildfire

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

Kirk Johnson at NYT:

Measles, declared eliminated as a major public health threat in the United States almost 20 years ago, has re-emerged this winter in the Pacific Northwest and other states where parents have relatively broad leeway over whether to vaccinate their children.

Seventy-nine cases of measles have been reported by the Centers for Disease Control and Prevention since the start of this year. Fifty cases of the highly contagious disease were in Washington State.

An outbreak of measles has also occurred in the Orthodox Jewish community in Brooklyn, where 64 confirmed cases of measles were reported, mostly late last year. That outbreak began, the C.D.C. said, when a child who had not had a measles vaccination caught the virus on a visit to Israel, where a large outbreak of the disease was occurring.

Lena H. Sun and Maureen O'Hagan at Wash. Post:

The Pacific Northwest is home to some of the nation’s most vocal and organized anti-vaccination activists. That movement has helped drive down child immunizations in Washington, as well as in neighboring Oregon and Idaho, to some of the lowest rates in the country, with as many as 10.5 percent of kindergartnersstatewide in Idaho unvaccinated for measles. That is almost double the median rate nationally.

Libertarian-leaning lawmakers, meanwhile, have bowed to public pressure to relax state laws to exempt virtually any child from state vaccination requirements whose parents object. Three states allow only medical exemptions; most others also permit religious exemptions. And 17, including Washington, Oregon and Idaho, allow what they call “philosophical” exemptions, meaning virtually anyone can opt out of the requirements.

All those elements combine into a dangerous mix, spurring concern about the resurgence of a deadly diseasethat once sent tens of thousands of Americans to hospitals each year and killed an estimated 400 to 500 people, many of them young children.

“You know what keeps me up at night?” said Clark County Public Health Director Alan Melnick. “Measles is exquisitely contagious. If you have an under-vaccinated population, and you introduce a measles case into that population, it will take off like a wildfire.

Dr. Haider Warraich at Vox:

If they are effective, preventive therapies treat events that a person will never witness. So a patient who takes a statin might never experience the heart attack it prevented but might experience side effects, or simply the inconvenience of taking a medication sometimes with no perceived benefit. This is unlike treatments that are therapeutic for symptoms or obvious physical manifestations of diseases after they have developed. For example, while many patients may overstate the risks of statins, the benefits of treatments such as coronary stents, which are used to increase blood flow in blocked or narrowed arteries supplying the heart to manage heart attacks and chest pain, are frequently inflated.

Outbreaks of measles in the US, largely driven by refusal of a critical mass of parents in a community to have their children vaccinated, could be a result of this phenomenon. Rumors and fears that have taken hold of largely well-educated, concerned, and well-meaning parents, connected through online networks, are fueling the anti-vaxxer movement.

Yet perhaps the answer to this modern disease that appears to have landed straight out of a Black Mirrorepisode might also lie in the online networks that have helped foment this in the first place. A team of scientists successfully predicted the measles outbreak at Disney World in 2014 using machine learning to analyze social media posts and search engine behaviors two years in advance.

Antivax Harm

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

Molly Enking, and Natalie O'Neill at The Daily Beast:

A measles outbreak in the Pacific Northwest ballooned to 35 cases over the weekend, and officials are bracing for even high numbers in two states where parents can choose not to vaccinate their kids for personal reasons.

The affected area—Clark County, Washington, and King County, Oregon— has one of the country’s largest concentration of unvaccinated residents.

“Oregon and Washington are two of 18 states that can choose not to vaccinate because of ‘personal or philosophical’ reasons,’” Peter Hotez, a microbiologist at Baylor University who has studied anti-vaxxer hotspots, told The Daily Beast.

“The parents who chose not to vaccinate tend to be far-left or far-right politically,” he said. “It seems to be the only thing the far left and far right can agree on.”

Shelia Poole at The Atlanta Journal-Constitution:

Georgia health officials on Tuesday confirmed three cases of measles, all within the same metro Atlanta family.

No additional information was released about the family, including the ages of those affected, which county they lived in or where they could have contracted the disease.

The only information released is that none of those who fell ill had been vaccinated.

 Josh Bloom and Alex Berezow at Newsweek:

Anti-vaxxers claim that if vaccines are so effective, the unvaccinated have nothing to worry about. This is a malicious lie. No vaccine is 100% effective, and many can wear off over time. Additionally, some children cannot be vaccinated because they are either too young—the vaccine is not given before age 12 months—or too sick (for instance, immunocompromised) to receive vaccines. These children rely on the rest of us to protect them, a concept known in public health as “herd immunity.”

The purposeful misinformation that pollutes the Internet is categorically wrong; there is no valid reason whatsoever to avoid fully vaccinating your child according to the CDC’s recommended schedule.

Vaccines do not cause autism. This theory, which was spawned by a fraudulent get-rich scheme in the 1990s, has been shown repeatedly to be without any merit. Another fear, that there are “too many” vaccines, is also false. When your child crawls around on the floor licking his hands, he is exposed to far more antigens than those found in all vaccines combined. He is inadvertently “vaccinating” himself all day long.

Meghan Keneally at ABC:

Vaccines are universally backed by respected scientists and federal agencies, but that isn’t enough to convince every parent to vaccinate their children.

The decision to fly in the face of near universal scientific opinion doesn't come as a result of a lack of intellect, however, as experts who have studied vaccines and immunology acknowledge that many parents who don't vaccinate their children are well-educated.

They also appear to be the victims of a widespread misinformation campaign, the experts said.

Daniel Salmon, who is the director of the Institute of Vaccine Safety at Johns Hopkins University, said that existing research suggests that there are some common attributes that many parents who choose not to vaccinate their children share.

"They tend to be better educated. They tend to be white, and they tend to be higher income. They tend to have larger families and they tend to use complementary and alternative medicine like chiropractors and naturopaths," Salmon said.

Russia has contributed to vaccine disinformation. 

Northwest Measles

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.  Antivax sentiment has been strong in the Pacific Northwest.

Amir Vera at CNN:

As of Saturday, there are 32 confirmed cases of measles in Washington -- an outbreak that has already prompted Gov. Jay Inslee to declare a state of emergency.

"Measles is a highly contagious infectious disease that can be fatal in small children," Inslee said in his proclamation Friday, adding that these cases create "an extreme public health risk that may quickly spread to other counties."

As of Saturday, there were 31 cases of the measles in Clark County, which sits on the state's southern border, just across the Columbia River from Portland, Oregon. Of the 31 cases, 21 are children between the ages of 1 and 10 years old.

There is also one case in King County, which includes Seattle. While the King County website says the man in his 50s is a "suspected case," the governor said in a news release it is a confirmed case of measles.

It's no surprise but #Clark County WA #measles outbreak has now "jumped across the Columbia" to #Multnomah County OR, where in @PLOS we found really high #vaccine exemption rates due to #antivax movement. The outbreak may have entered a new expanding phase https://t.co/3cU9gug646

— Prof Peter Hotez MD PhD (@PeterHotez) January 26, 2019

Who caused 2019 WA-OR #measles epidemic (in order):
1. Organized #antivax lobby - 400 phony websites, FB, books, PACS
2. Cowardice/ignorance from WA-OR legislatures/leaders throwing kids under the bus for political expediencies
3. Near zero advocacy
That's why I wrote the book pic.twitter.com/MUuE07dk0B

— Prof Peter Hotez MD PhD (@PeterHotez) January 26, 2019

Study Finds that Inclusion Works

In The Politics of Autism, I write about special education and inclusion.

The National Center for Analysis of Longitudinal Data in Education Research (CALDER) finds in a new report that inclusion works. The abstract:

We use longitudinal data on all high school students in Washington State, including postsecondary education and workforce outcomes, to investigate predictors of intermediate and postsecondary outcomes for students with disabilities. We pay particular attention to career and technical education (CTE) enrollment and the extent of inclusion in general education classrooms, as prior research suggests these factors may be particularly important in influencing the outcomes of students with disabilities. We
estimate models that compare students with other students within the same school district, who are receiving special education services for the same disability, and have similar baseline measures of academic performance and other demographic information. We find generally weak relationships between CTE enrollment in any particular grade and intermediate and postsecondary outcomes for students with disabilities, though we replicate earlier findings that students with disabilities who are enrolled in a “concentration” of CTE courses have higher rates of employment after graduation than
students with disabilities who are similar in other observable ways but are enrolled in fewer CTE courses. We also find consistently strong evidence that students with disabilities who spend more time in general education classrooms experience better outcomes—fewer absences, higher academic performance, higher rates of grade progression and on-time graduation, and higher rates of college attendance and employment—than students with disabilities who are similar in other observable ways but spend less time in general education classrooms. [emphasis added]