Tuesday, March 30, 1999
Vaccine rule draws outcry
Ohio requires hepatitis B shot
BY MICHAEL HAWTHORNE
Enquirer Columbus Bureau
COLUMBUS Without debate, Ohio lawmakers required every child entering kindergarten or first grade this fall to be immunized against hepatitis B, a potentially fatal disease that attacks the liver.
But the effort to protect public health has turned into an emotional debate about the politics of medicine, parental rights and vaccination risks that could scuttle the requirement before it starts.
State Rep. Dale Van Vyven, a Sharonville Republican who slipped an amendment requiring the hepatitis B vaccine into an unrelated bill last year, is pushing to suspend the law until the issue is settled.
I feel guilty that we didn't have any public hearings on this last year, said Mr. Van Vyven, chairman of the House Health, Retirement and Aging Committee. I didn't realize there was any opposition.
He acknowledged he tucked the immunization requirement into a bill dealing with solid waste at the behest of a lobbyist for SmithKline Beecham, a Philadelphia-based pharmaceutical company that makes the hepatitis B vaccine.
The vaccine also is widely supported by physicians. Thirty-eight states require it before children enter school, usually along with shots for polio, diphtheria, tetanus, pertussis, mumps, measles and rubella.
Even though 87 percent of children in Ohio already are fully immunized against hepatitis B by age 3, pediatricians and public health experts say the requirement is needed to catch the remaining 13 percent who aren't vaccinated.
Like AIDS, the communicable disease is transmitted by exposure to infected blood or bodily fluids and can be passed by infected mothers to their children. Between 4,000 and 5,000 people die each year from the disease in the United States, and more than 200,000 new cases are reported yearly.
The sad fact of the matter is that no Ohio citizen needs to contract hepatitis B, said Dr. William D. Carey, a liver specialist at the Cleveland Clinic. With the development of extremely safe and effective vaccines, hepatitis B could go the way of smallpox as a scourge disease.
Vaccination opponents, though, say the disease isn't a problem in Ohio and contend the three-dose vaccine has potentially devastating side effects.
Their case picked up momentum in January after the ABC-TV newsmagazine 20/20 aired a report questioning the safety of the vaccine. Some doctors suggest it can be linked to multiple sclerosis, arthritis and lupus.
After the report aired, lawmakers in Ohio and Indiana moved to suspend hepatitis B laws they enacted just last year.
This is the first vaccine I can think of that is being given for what is largely a sexually transmitted disease, said Kristine Severyn, a Dayton pharmacist and director of Ohio Parents for Vaccine Safety.
Children younger than 10 accounted for only two of the 94 cases of hepatitis B reported in Ohio in 1997, Ms. Severyn said, citing statistics she culled from the Ohio Department of Health.
While Ohio law allows parents to reject any immunizations for their children based on medical, religious or philosophical objections, Ms. Severyn said notification of the risks is inadequate.
She also objects to the way the requirement was added to state law, suggesting it had more to do with the profits of drug makers than public health.
This is all about politics and making money, not medicine, she said.
Not so, said Rick Koenig, a spokesman for SmithKline Beecham.
We're following the lead of all the major public health organizations, he said.
Indeed, pediatricians and state and federal health officials strongly support use of the vaccine. But the 20/20 report has caused enough of a furor that the American Academy of Pediatrics has hired Cohen & Wolfe, a New York public relations firm, to help defend it.
Statistics cited by Ms. Severyn are misleading because many cases of hepatitis B are not reported, said Randy Hertzer, spokesman for the state health department.
This disease can make you ill, but perhaps not ill enough to seek medical treatment, Mr. Hertzer said. It can surface years later with a vengeance, leading to cirrhosis or cancer of the liver. If we have a vaccine that can stop it, we should use it.
Debate is scheduled to continue April 15 before Mr. Van Vyven's committee.
All we're attempting to do is have this aired publicly, he said. If the vaccine turns out to be good public policy, we'll just let the bill (to suspend the requirement) die.
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