In public health bill, a contagion of fear
The banner, bold and provocative, was tattooed with a syringe, skull and crossbones, and a call to action: “Say no to forced vaccination.’’
The message, delivered last week on Beacon Hill, was aimed at a seemingly prosaic piece of legislation that aims to better define – and, in some respects, restrict – the emergency powers of the state’s public health officials.
Within the bill’s arcane language, a 16-month-old activist coalition sees government authority run amok: mandated vaccinations, quarantines, arrests, fines. Swine flu, they warn, will be the virus that opens the door to the public health police.
“We have a concern that we will be forced to be quarantined if we refuse the vaccine,’’ said Laura Jackson, president of the Liberty Preservation Association of Massachusetts, which mustered 30 to 40 members for the lobbying drive. “What I’d like to see done with this law is have it burned.’’
Those concerns, public health authorities insist, are entirely unfounded. But the association’s multimedia campaign – aired over talk radio and its website – compelled state Public Health Commissioner John Auerbach to send an italicized, bold-faced missive to legislators, stressing that “mandatory vaccination is not and has never been part of the plan or discussion in Massachusetts’ pandemic response.’’
The bill, Auerbach and other top officials said in interviews, would never force anyone to be vaccinated unwillingly, and its extraordinary measures – such as quarantining people who decline inoculations – would be reserved for equally extraordinary times, such as a bioterror attack or the emergence of a highly lethal, rapidly spreading germ. Swine flu, caused by the H1N1 virus, is not such a germ, Auerbach said.
The protest by the group, whose founders supported Republican Ron Paul in the 2008 presidential election, reached its pitch at an especially delicate moment for public health authorities. Auerbach’s letter demonstrates that his agency is worried the dissent could raise doubts about vaccination and imperil an unprecedented campaign to inoculate millions this fall against the seasonal flu and the swine strain.
“Accuracy of information is going to be key in terms of the public understanding what they should do,’’ Auerbach said in an interview.
In the opposition to Massachusetts’ revised public health emergency law, as well as in the combustible health care town hall meetings that greeted some members of Congress this summer, analysts see more than traditional conservative concerns about individual liberty and big government.
They also find signs of deeper worries about a world descending into uncertainty, with panic over economics and the emergence of a novel flu strain.
“It doesn’t surprise me that when you have another epidemic, another threat of a disease, then you get emotions tweaked up, and separately in the health care debate, we’ve seen a rise in emotionalism replacing logic,’’ said Gene W. Matthews, a senior fellow at the University of North Carolina’s Institute for Public Health.
Matthews was among those who presided over efforts to update public health emergency regulations when he was the top attorney at the US Centers for Disease Control and Prevention.
The terrorist attacks of Sept. 11, 2001, and the arrival of anthrax-laced letters at congressional and media offices a month later revealed a largely ignored truth about those laws: In many states, they had not been updated for decades.
A team led by Lawrence O. Gostin, a Georgetown University law professor, drafted the language that has served as a model for Massachusetts’ proposed law and for revised rules adopted in 37 states so far.
“Most of the laws were very antiquated,’’ Matthews said, “and they didn’t recognize concepts of due process and individual rights and legal evolution that had occurred in the last 50 years.’’
In times of emergency, medical authorities had long possessed sweeping powers to do what was necessary to protect the public’s well-being. According to the state Department of Public Health, such emergencies have been declared only three times since the 1970s, with the most recent being a 2006 order for aerial spraying to combat Eastern equine encephalitis in Southeast Massachusetts. In 1993, when West Stockbridge’s water supply ran dry, the agency used its powers to tap water from a private source. And in the 1970s, the state took control of a financially teetering nursing home.
The updated legislation, passed by the Senate in late April and awaiting action in the House, carries penalties for certain violations: People who refuse orders to remain isolated could face up to a month in jail and fines as high as $1,000 a day.
But the proposed law also would, in certain instances, provide a check on the power of health officials. For example, a judge’s approval would now be needed before a government agency could perform tests or a physical examination on someone thought to present a significant medical risk to the community.
Bob Dwyer, an opponent of the law, said the Liberty Preservation Association was “not trying to say don’t take the vaccines’’ against the flu.
Still, he said, he believes the emergency law “violates numerous rights that we have in the Bill of Rights and the Constitution,’’ including the right to freely assemble. The law is unnecessary, he insisted, because most people don’t need the threat of legal action to persuade them to remain home when they’re sick.
It’s understandable that some people might greet talk of quarantines with trepidation, said Valerie Bassett, executive director of the Massachusetts Public Health Association.
But such measures, taken in rare circumstances, are “the same reason you drive within the lane on the highway,’’ Bassett said. “It’s about the protection of health and life.’’