“We’re not trying to create policy for other people. We really just want to protect the 400,000 whom we take care of.”
effective in every single person who receives them, “we still can eradicate these viruses in a community by the entire population becoming vaccinated, because it doesn’t have a place to harbor. The virus doesn’t have a place to infect because there are not enough hosts to be vulnerable.” Dr. Kumar, who doesn’t work for ARC, says that when ARC approached
TCMS with the news that it was going to implement the policy, it sought the medical society’s help in finding treatment options for displaced patients. TCMS surveyed pediatric groups in the county, then formed a task force to analyze the results of those surveys to help determine the medical society’s approach. Dr. Kumar says TCMS contemplated a process by which it would steer pa- tients to other practices that might accept them. “We entertained a host of other options, and at the end of the day, we agreed
that we would be there for moral support,” he said. “But because of insurance reasons — and also the volume of patients, which is unknown — we thought that it was inappropriate and out of place for the county medical society to be chan- neling these patients who were displaced. “[For] both ARC and the county medical society, the idea is not that we have
a stick and we’re trying to beat people into vaccinating,” Dr. Kumar added. “It’s quite the opposite. It’s [that] we’re trying to protect those patients who [aren’t] vaccinated from being infected with a vaccine-preventable illness.” In a letter addressed to Dr. Ziari, Fort Worth-area pediatrician Jason Terk,
MD, TPS president, praised Dr. Ziari and ARC for their courage in taking steps to ensure patient safety. “We are very familiar with the challenges of addressing concerns from parents
who are vaccine-hesitant, and we agree that a dialogue must occur between parents who have questions and their pediatricians who have answers to those questions,” Dr. Terk wrote.
THE FINAL STRAW ARC officials had been thinking about instituting a strict vaccination policy even before the measles outbreak that began at Disneyland last December, but Dr. Ziari says that reinforced the potential negative health impact an unvaccinated population can unleash. The California Department of Public Health finally declared that outbreak
over in April, crediting it with 131 measles cases in the Golden State. Reports pegged the total number of resulting cases in the United States at 147, plus 159 others in Quebec, Canada, after one Disneyland visitor returned to a religious community with a low vaccination rate. On July 2, the Washington State Department of Health reported that an au-
topsy on a Clallam County woman who had died in the spring revealed she had died from measles-caused pneumonia. Although the state health department did not connect the woman’s death to the Disneyland outbreak, her illness was the sixth case of measles in Clallam County in 2015 and the first confirmed measles death in the United States since 2003. Nationally, CDC reported 178 cases of measles from the start of 2015 through
June 26, including 117 tied to the Disneyland outbreak. “That’s a huge group of people who were at Disneyland at that moment, but
yet so many of them got sick because these diseases are incredibly, incredibly infectious,” Dr. Ziari said. Dr. Chenven, who said at the news conference that he’s old enough to re-
member the days of polio epidemics, recalled a lecture he received as a medical school student after the advent of the measles vaccine. “The lecturer stood up in front of 200 medical students in the audience, and he said that the aggregate IQ of this audience would be higher if we had this
26 TEXAS MEDICINE September 2015
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