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Carly Fiorina Is Against Vaccine Mandates But She's For Them But Also Against Them

This article is more than 8 years old.

There are two reports out this morning that Carly Fiorina, the former Hewlett-Packard chief executive who is running for the Republican presidential nomination, has taken a stand on vaccines: parents should be able to make the choice whether or not to vaccinate their children.

"When in doubt, it is always the parent's choice," Fiorina said according to the Washington Post’s Jenna Johnson. "When in doubt, it must always be the parent's choice."

But she also said that she approves of preventing children from attending public schools if they do not have certain immunizations. This is all any laws for compelling vaccine administration do.

“When you have highly communicable diseases where you have a vaccine that’s proven, like measles or mumps, then I think a parent can make that choice, but then I think a school district is well within their rights to say, ‘I’m sorry, your child cannot then attend public school,'” Fiorina explained to reporters after the event, according to Time’s Zeke Miller.

This is not usually the decision of the local school district – making it so would be a politically conservative support of local government – but of state law. But all the much-publicized California law to force vaccinations does is remove exemptions that allowed children to attend public school (also, actually, private school and day care) without getting their shots if their parents had a religious or philosophical justification for not vaccinating. Nobody is going around vaccinating children at gunpoint. So that would actually mean that Fiorina is for strengthening vaccine laws, but is cleverly making it seem as if she is against doing so.

But then Fiorina apparently went a step further, saying that while some vaccines, like those for measles or mumps, should be mandated, those for other diseases should not. She seems to be speaking specifically about vaccines from the human papilloma virus, or HPV. Those vaccines are Merck ’s Gardasil and GlaxoSmithKline ’s Cervarix.

According to both reports, Fiorina recounted how her daughter was “bullied” by a school nurse into allowing Fiorina’s preteen granddaughter to get the HPV shot. What’s not really clear, though, is why she thinks the HPV vaccine is different. HPV is a virus spread largely in the teen and college years, through sex, that causes a lot of problems years later. The Centers for Disease Control & Prevention estimate that HPV causes 33,200 cases of cancer in the U.S. each year, including both cancers of the cervix and of the throat. Moreover, while cervical cancer is becoming less common, throat cancer caused by HPV is increasing.

There are some arguments against HPV vaccines. While they clearly prevent infection with HPV, we don’t know that they prevent cancer. Studies to prove that would take too long. Woman still need to get pap smears of other tests to screen for cervical cancer even if they have been vaccinated. There are also some people who think, based on anecdotal evidence, that the vaccines have serious side effects. But many large studies have repeatedly failed to back up this contention.

In fact, HPV vaccines could turn out to be a lot like the vaccine for another cancer causing virus, hepatitis B, which is also sexually transmitted. Drug companies like Gilead Pharmaceuticals are excited about the global opportunity of treating hep B, which is common in Asia. But they won’t be making money on it in the U.S., where babies usually get a vaccine invented by Merck decades ago that gives lifelong prevention against infection – and that has resulted in much lower rates of liver cancer here than in other countries.

What is true is that we need much better ways of watching for vaccine side effects. But the solution here is not allowing local school boards to make decisions about vaccination. It is partly because of our fear of federal, top-down regulation that Americans don’t have health care ID numbers that would make data sharing easy, and would create a national health records system that would make it easier to track how safe and effective medicines are in the real world. But some other countries do have such systems, including Sweden and Denmark, where studies have not found evidence of side effects from the HPV vaccine.

Attempts to contact Fiorina’s office were unsuccessful.

Update: Fiorina made a comment to MSNBC that clarifies her stance. “The state law is really clear on this stuff and I don’t understand why the media keeps turning it into controversy,” she told msnbc. “People who have true religious convictions are protected. State law says a school for instance can prevent a child who hasn’t been vaccinated from going to school and I believe fundamentally parents have a choice. There is nothing new about that, there is no new ground.”

That basically means that while she may think the California law goes too far, she supports the status quo for vaccination mandates. I still think that her comments reveal that she hasn't thought vaccine issues through, especially when it comes to the HPV vaccine. But it's worth noting that some other articles  that say that she supports giving kids measles are going a bit far. Fiorina's ideas may be badly thought out, and she's not helping public health by implying there might be legitimate reasons other than religion to say no to vaccines. But they are not out-of-the-ballpark dangerous as, say, Michelle Bachmann's were last election cycle.

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