Vaccination and Medical Politics

1. Vaccination and Medical Politics Ferryal Basbeth Departemen Ilmu Kedokteran Forensik dan Medikolegal Departemen Bioetik dan Humaniora YARSI School of Medicine Jl. Letjen Suprapto Cempaka Putih 10510 Jakarta Pusat, basbethf@gmail.com, 081513611827

2. Routine childhood immunizations are compulsory in a small number of developed countries, including the United States of America, France, Italy, Poland, UK, Taiwan, and many number of developing countries including Indonesia • There is nothing new about compulsory immunization, nor about anti-vaccination movements. • But vaccines are unique among public health measures, in that their administration occasionally causes injury. Should routine childhood immunizations be compulsory? Historical Perpective

3. The British Vaccination Act of 1853 made smallpox vaccination compulsory for all infants in the first 3 months of life, and made defaulting parents liable to a fine or imprisonment • The State of Massachusetts introduced compulsory smallpox vaccination in 1809, while in 1922 the Supreme Court upheld laws requiring vaccination for school entry • In the 1970s unimmunized children were excluded from school during measles outbreaks. • Sanctions for non-compliance also vary, and some States threaten to take child care proceedings if there is persistent failure to immunize.

4. Hazardous biological materials.Needed experiment to find an effective dose. There are some people who should get mudharat (harm/hazard) • No one really safe. Everyone hasa chance to suffer due toconsequences vaccine • Preventive; still many other prevention efforts forraising system imun in society, preserving environmental balance and the control of agents (germs) • Ahadith, Word of the Messenger of Allah, which means, "Can not create harm (hazards) to myself, and should not also make harm to others." (Reported by Ahmad and IbnMajah). • “Tidak boleh membuat mudharat (bahaya) pada diri sendiri, dan tidak boleh pula membuat mudharat pada orang lain”.(HR Ahmad dan Ibnu Majah). Vaccine Fact

5. Children need to be protected from dangerous infectious diseases, State has a right to the protection afforded by immunization. • If some parents will be negligent with respect to this duty, the state must accept that it has the duty to ensure that each child is immunized Why state do obligation vaccination

6. For examples seat-belt legislation and motorcycle helmets. • Sanctions for disobeying regulations are usually fines, and possible loss of driving license for frequent offenders. • There is an important difference between immunization, which involves the injection of foreign material, even though with the intention of protecting the recipient and the community, and the compulsory use of seat belts, and crash helmets. • Immunization is an invasive but helmet is not invasive Vaccination and seat belt legislation

7. In the United States, 6.2% ofadolescents have sexual intercourse for the firsttime before 13 years of age, and the median ageat the time of first sexual intercourse is 16 to 17 years • The June 2006 licensure of Merck’s human papillomavirus(HPV) vaccine, Gardasil, and the recommendationof the Advisory Committee on ImmunizationPractices that it be routinely given togirls starting at 11 or 12 years of age set off a flurry of state-level policymaking Vaccination and Pharmaceuticals Collaboration

8. USA, however, the Michigan Senate had legislated in September 2006 for all for use in female patients between the ages of 9–26 and boys aged 9–15in the vaccination programe • Owner Merck Pharmaceuticals was former director of the War Research Service (Department of War Studies), who in 1940, believed to be U.S. Health and Medical Committee of the Council for National Defense (Health and Medical Committee of the U.S. Defense Council), for the study of biological weapons Vaccination and Pharmaceuticals Collaboration

9. Rotavirus vaccineat least a hundred babies causing intestinal obstruction and at least one person death, The vaccine is still in the marketbecause Paul Offit, and John Modlin are CDC advisory committee members and one of the owners of shares in Merck, had "bought" the Advisory Committee on Immunization Practices (ACIP) and the FDA (The Food Drug Administration). Vaccination and Pharmaceuticals Collaboration

10. Respect for parental autonomy, a child cannot make an autonomous decision about immunization • These rights comes from the fact that they are pregnant, give birth and raise children, and have an emotional investment and financially for their child's future Antivaccination Activism

11. Thereis so many proof that the vaccination program resulted in serious health problems, the number of cases continues to rise. Such as autism, cancer and tumors autoimmune diseases, diabetes in children, and sudden infant death syndrome • Yellow fever vaccine has caused yellow fever in a small number of recipients, and six deaths have been reported from fulminant yellow fever acquired from the vaccine • The 6% of events that were considered to be serious included Guillain–Barré syndrome, venous thromboembolism, and death Adverse Effects of Immunization

12. In the U.S., many bad reactions of vaccination such as DPT (Diphtheria, Pertussis, Tetanus), Hib (Haemophilusinfluenzae b), MMR (Measles, Mumps, Rubella), OPV (Oral Polio Vaccine), which was recorded only by the VAERS (Vaccine Adverse Events The Reporting System), from 1999 until the end of 2002 there were 244.424 cases, with 2.866 cases of death. • Research Ribeiro and his colleagues, in Salvador, Brazil, which was published in the Journal of Infectious Diseases, January. 2003, showed Hib vaccination increased eight times the incidence of infection Haemophilusinfluenzae type a meningitis • Durationof immunogenicity and clinical efficacy fron HPV vaccineis unknown, and they don’t know whether boosters are needed. True effect of vaccination on the incidence of cervical cancer and other HPV-related cancers is not actually known. Areas of Uncertainty

13. Why WHO aggressively encourage the developing countries to promote vaccinationbut notfor health promotion? • Whydo many gene mutation occur and result the wild virus today: H5N1, Meningitis meningitidis, Plasmodium malariae, HIV, Simian Immunodeficiency Virus (SIV), HPV, are these biological weapon? Vaccine as A Biological Weapon

14. The U.S. rejection of the application protocol agreement BWC (Biological Weapons Convention) containing termination biological and chemical weapons program, in July 2002. • The willingness of the United States retaining the activity of health research institutions-military, like Namru-2 (Naval Medical Research Unit Two) in Indonesia, which is a research center of the tropical variety of harmful bacteria, such as malaria, dengue fever, typhoid, cholera, tuberculosis, HIV / AIDS and swine flu. Vaccine as A Biological Weapon

15. Standard prevention of HIV and HPV from the WHO does not prohibit sexual activity to prevent HIV and HPV, it makes anxiety that administering thevaccine may lead to increased sexual activity in teenagers, such as • Commercial sex does not transmit AIDS, but not using a condom in a sexual relationship does, • Vaccination and Safe sex are basic to breaking the vicious cycle of HIV/AIDS transmission and HPV • These structural characteristics of neoliberalist capitalism, which help spread AIDS. It calls “risk contexts”. • Is it Hegemony Capitalism? Blame and Safe Behaviours

16. Hegemony is the dominance of one group over other groups, with or without the threat of force, to the extent that, for instance, the dominant party can dictate the terms of trade to its advantage; more broadly, cultural perspectives become skewed to favor the dominant group. Hegemony controls the ways that ideas become “naturalized” in a process that informs notions of common sense • “…Dominant groups in society, including fundamentally but not exclusively the ruling class, maintain their dominance by securing the ‘spontaneous consent’ of subordinate groups, including the working class, through the negotiated construction of a political and ideological consensus which incorporates both dominant and dominated groups.” (Strinati, 1995: 165) Hegemony Capitalism

17. Vaccination from Islamic point of view

18. Sahih International It is He who created for you all of that which is on the earth. "Dia-lah Allah, yang menjadikan segala yang ada di bumi untuk kamu (manusia), (QS.2:29) It means Allah never created damage on this earth, and Allah keeps the balance. So where does gene mutation come from and result the wild virus?

19. Sahih International And the heaven He raised and imposed the balance "Dan Allah telah meninggikan langit; dan Dia menjaga keseimbangan." – QS 55:7

20. Sahih International  And Who makes (things) according to a measure, then guides (them to their goal), "dan Dia yang menentukan kadar (masing-masing), dan memberi petunjuk." – (QS.87:3) all of Allah's creatures, whether human, plant, animal, virus, bacteria have a degree (a measure), and Allah keeps them and their harmony

21. Sahih International Corruption has appeared throughout the land and sea by [reason of] what the hands of people have earned so He may let them taste part of [the consequence of] what they have done that perhaps they will return [to righteousness]. "Telah tampak kerusakan di darat dan di laut, (yang) disebabkan karena perbuatan tangan manusia, supaya Allah merasakan kepada mereka sebagian dari (akibat) perbuatan mereka, agar mereka kembali (ke jalan yang benar)." – (QS.30:41)

22. Sahih International Indeed, he was unjust and ignorant. Sesungguhnya manusia itu amat zalim dan amat bodoh," – (QS.33:72)

23. The importance of restoring the world in its balance. • Releasing the world from the threat of germs engineered. • Release the world from grip global capitalism and the dominance of the corporation • Return to the way of Islam QS: An Nisa 174 Sahih International O mankind, there has come to you a conclusive proof from your Lord, and We have sent down to you a clear light. "Hai manusia, sesungguhnya telah datang kepadamu, bukti kebenaran dari Rabb-mu, (Muhammad dengan mu'jizatnya), dan telah kami turunkan kepadamu, cahaya yang terang-benderang (Al-Qur'an)." – (QS.4:174) Conclusion

24. Isaacs D,Kilham HA and Marshall H , Should routine childhood immunizations be compulsory?J. Paediatr. Child Health(2004)40, 392–396 • Emmerich N, Whatever happened to medical politics?J Med Ethics 2011;37:631e636 • Wood F, Morris L, Davies M et all, What constitutes consent when parents anddaughters have different views about having the HPVvaccine: qualitative interviews with stakeholders, J Med Ethics 2011;37:466-471 • Kahn JA, HPV Vaccination for the Preventionof Cervical Intraepithelial Neoplasia, N Engl J Med 2009;361:271-8. • Colgrove J, Abiola S, and Mello MM, HPV Vaccination Mandates — Lawmaking amid Political and Scientific Controversy, n engl j med 363;8 august 19, 2010 • English V, Hamm D, Harrison C, et all, Mandatory Vaccination?, J Med Ethics 2007;33:123-124 • Warraich HJ, Religious Opposition to Polio Vaccination, EmergInfect Dis. 2009 June; 15(6): 978. • MelloMM,Abiola S,and Colgrove J, Pharmaceutical Companies’ Role in State VaccinationPolicymaking: The Case of Human PapillomavirusVaccinationAm J Public Health. March 15, 2012: e1–e6. References

25. http://setkab.go.id/berita-5429-tahun-ini-pemerintah-salurkan-dana-untuk-puskesmas-rp-109-triliun.htmlhttp://setkab.go.id/berita-5429-tahun-ini-pemerintah-salurkan-dana-untuk-puskesmas-rp-109-triliun.html • https://extranet.who.int/aim_elearning/id/finance/market/market/factors/index.html • Rimland, B. Vaccinations: The Overlooked Factors. Autism Research Review International.Vol 12, No1. 1998. • William Carlsen: "Rogue Virus in the Vaccine -- Early Polio Vaccine Harbored Virus NowFeared to Cause Cancer in Humans." San Francisco Chronicle, July 15, 2001.http://www.chronicillnet.org/articles/paralyticpolio.html. • Radowitz, J V. MMR Has Strong Association With Autism. U.S Research. 9 August. 2002. • Smith, K.J. Vaccine Maker Admits NZ Meningococal Vaccine May Not Work- and Could Be Dangerous. What Your Doctor Will Never Tell You.Vol.4. N0.1 October-November . • VAERS: In USA 1999-2002 dalam What Your Doctor Will Never Tell You. Vol 4.No 1. Oktober- November 2004. • Measles outbreak in 31 schools:risk factors for vaccine failure and evaluation of selective revaccination strategy. Department of Preventive Medicine and Biostatistics, University of Toronto, Ont. Canadian Medical Association Journal. 150 (7):1093-8, April. 1994. • Vranewsletter, Fall 2003: 'Message to Autism Conference' by VieraScheibner, PhD. Here's Health,March, 1980. http://www.whale.to/vaccines/stewart.html ). • Acute Flaccid Paralysis -- Canadian Paediatric Surveillance Program 1999:http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/01vol27/dr2707ea.html • USAID. Peningkatan Cakupan & Mutu Pelayanan Imunisasi Melalui Jalur Swasta. Millenium Challenge Corporation Indonesia/Immunization Project.

26. Samuel, O. Penularan Polio Besar-besaran Dilaporkan Terjadi di Nigeria. Associated Press Writer,2004. dalam Gray, J. D. Bayang Gurita. Iqra Insan Press. Jakarta. 2007. Hal 169-179. • I. Roitt, “Regulation of Immune Response”, dalam Roitt I., Brostoff Imunologic and Male D (eds), Immunology, St. Louis-Toronto:Mosb, 1993. • Jawetz, E., Melnick, J. L., Adelberg, E. A., Brooks, G. F., Butel, J. S. dan Ornston, L. N. Mikrobiologi Kedokteran. Edisi 20. EGC. Jakarta. 2002 • Thompson, N. P., Montgomery, S. M., Pounder, R. E., Wakefield, A. J. Is measles vaccination a risk factor for infammatory bowel disease? Lancet 1995; 245: 1071-74. • Ekbom, A. , Wakefield, A. J., Zack, M dan Adami, H. O. Perinatal Measles Infection and subsequent Crohn’s disease. Lancet . 1994; 344:508-10. • Effectiveness of Pneumococcal vaccine. The Lancet . 1998; 351:1961-2 • Rimland, B. Vaccinations: The Overlooked Factors. Autism Research Review International. Vol 12, No1. 1998. • William Carlsen: "Rogue Virus in the Vaccine -- Early Polio Vaccine Harbored Virus Now Feared to Cause Cancer in Humans." San Francisco Chronicle, July 15,2001.http://www.chronicillnet.org/articles/paralyticpolio.html. • Radowitz, J V. MMR Has Strong Association With Autism. U.S Research. 9 August. 2002. • Smith, K.J. Vaccine Maker Admits NZ Meningococal Vaccine May Not Work- andCould BeDangerous. What Your Doctor Will Never Tell You.Vol.4. N0.1 October-November 2004. • http://quran.com/4