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How do we stop the abuse of vaccine exemptions?

Every state has laws mandating vaccines to attend school and daycare.Every state also allows exemptions to those mandates, including:medical exemptions – 50 statesreligious exemptions – 45 statespersonal belief exemptions – 18 statesThe way that these laws and exemptions are set up leaves a lot of room for abuse though.Abuse of Religious ExemptionsHow many religions are actually against kids getting vaccinated?That’s right, almost none.So why are there so many religious vaccine exemptions in most states, especially in states that don’t have a personal belief exemption?Right again.Folks who don’t want to vaccinate their kids, and can’t use a personal belief exemption, just say that vaccinating them would be against their religion.Abuse of Medical ExemptionsThere are some children who shouldn’t be vaccinated.These children can get a true medical exemption to one or more vaccines because they have a real contraindication or precaution to getting vaccinated.“If a child has a medical exemption to immunization, a physician licensed to practice medicine in New York State must certify that the immunization is detrimental to the child’s health. The medical exemption should specify which immunization is detrimental to the child’s health, provide information as to why the immunization is contraindicated based on current accepted medical practice, and specify the length of time the immunization is medically contraindicated, if known.”Dear Colleague letter regarding guidelines for use of immunization exemptionsFortunately, these medical reasons to skip or delay vaccines are not very common and are often temporary. They can include the contraindications and precautionslisted in the package insert for each vaccine and by the Advisory Committee on Immunization Practices, with the most common medical exemptions being:a severe allergic reaction to a previous dosea severe allergic reaction to a vaccine componenta known severe immunodeficiency and live vaccinesa moderate or severe acute illness with or without fever (precaution)a progressive neurologic disorder (precaution)Although it will get you a medical exemption for just $120 in California, a family history of these conditions would not be a reason to skip or delay any vaccines.Most other things are “incorrectly perceived as contraindications to vaccination” and should not be a medical exemptions, including having :a mild acute illness with or without fevera mild to moderate local reactionrelatives with allergiesa family history of seizuresa stable neurologic conditionan autoimmune diseasea family history of an adverse event after DTP or DTaP administrationA medical exemption can also exist if your child already had the disease and so has natural immunity. In most cases, except for chicken pox disease, titers will likely need to be done to prove that your child already has immunity.Stopping the Abuse of Vaccine ExemptionsWe know that vaccine exemptions are being abused.How do you stop it?“Permitting personal belief exemptions and easily granting exemptions are associated with higher and increasing nonmedical US exemption rates. State policies granting personal belief exemptions and states that easily grant exemptions are associated with increased pertussis incidence.”Omer et al on Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.You likely have to make it harder to get a vaccine exemption.Strong exemption laws, which are needed in many states, make it clear that:many exemptions are temporarymedical exemptions are based on ACIP guidelines, current accepted medical practice, and evidence based medicine – not anecdotesreligious exemptions specifically exclude philosophical exemptions and must reflect a sincere religious beliefexempted students will be excluded from school during outbreaksexemptions should include a signed affidavit that is notarizedexemptions should be recertified each yeara separate exemption application will be needed for each vaccineGetting an exemption shouldn’t be easier than getting vaccinated! And it should include some degree of education against the myths and misinformation that scares parents away from vaccinating their kids.“Because rare medically recognized contraindications for specific individuals to receive specific vaccines exist, legitimate medical exemptions to immunization requirements are important to observe. However, nonmedical exemptions to immunization requirements are problematic because of medical, public health, and ethical reasons and create unnecessary risk to both individual people and communities.”AAP on Medical Versus Nonmedical Immunization Exemptions for Child Care and School AttendanceYou could also get rid of nonmedical vaccine exemptions.Of course, for that to work, you can’t allow just anything to count as a medical exemption.“Review of all medical exemption requests will be conducted at the Mississippi State Department of Health by the State Epidemiologist or Deputy State Epidemiologist.”Mississippi Medical Exemption PolicyIn Mississippi, for example, where medical exemptions are reviewed and approved by the State Epidemiologist or Deputy State Epidemiologist, there were just 208 medical exemptions in the whole state during the 2016-17 school year.In some states, rates of medical exemptions might be six or seven times higher. This is mostly seen in states that don’t allow personal belief exemptions and make it difficult to get a religious exemption.That seems to be the case in Nebraska, where there are no personal belief exemptions and you have to submit a notarized statement to get a religious exemptions. Their high rates of medical exemptions likely reflect some abuse and the fact that medical exemptions aren’t reviewed or approved by anyone, they just reflect “that, in the health care provider’s opinion, the specified immunization(s) required would be injurious to the health and well – being of the student or any member of the student’s family or household.”As we are seeing, that simply invites vaccine exemption abuse.Very few states currently require that exemption applications go to the health department for review. Those that do include Alabama, Arkansas, Michigan, Minnesota, Mississippi, and West Virginia.California is notably absent. I guess they didn’t see the potential for abuse when they passed their latest vaccine law. I mean, who could have guessed that doctors would actually be selling medical exemptions to parents based on unrelated conditions, like a family history of diabetes, celiac disease, or autism?The non-medical vaccine exemption form in Colorado includes information on the risks of each vaccine-preventable disease.At the very least, until we have stronger exemption laws, parents who want to get a nonmedical exemption should acknowledge that they understand the risks they are taking when they skip or delay their child’s vaccines.What to Know About Abuse of Vaccine ExemptionsWhile medical exemptions are necessary for kids who have true contraindications to getting vaccinated, stronger laws can help decrease the abuse we see in medical, religious, and personal belief vaccine exemptions.More Information on Abuse of Vaccine ExemptionsACIP – Contraindications and PrecautionsCDC – Who Should NOT Get Vaccinated with these Vaccines?AAP – Medical Versus Nonmedical Immunization Exemptions for Child Care and School AttendanceCDC – State School and Childcare Vaccination LawsSchool Exemption Laws by StateStates With Religious and Philosophical Exemptions From School Immunization RequirementsEliminating Personal Belief Exemptions for VaccinesLaws Limiting Vaccine Exemptions WorkExemptions Permitted For State Immunization RequirementsCDC – Vaccination Coverage for Selected Vaccines, Exemption Rates, and Provisional Enrollment Among Children in Kindergarten — United States, 2016–17 School YearDear Colleague letter regarding guidelines for use of immunization exemptionsWhat is an Exemption and What Does it Mean?Vaccination ExemptionsMississippi Medical Exemption PolicyHow Many People Aren’t Vaccinating Their Kids in Your State?There is a Whole Cottage Industry of Doctors Helping Parents Skip Their Kids’ VaccinesChange in Medical Exemptions From Immunization in California After Elimination of Personal Belief ExemptionsCalifornia Doctors Are Advertising Ludicrous Medical Exemptions to Anti-VaxxersAfter SB 277, medical exemptions for sale, courtesy of Dr. Bob Sears and other antivaccine quacksWhy hasn’t California cracked down on anti-vaccination doctors?After California got rid of personal exemptions for vaccines, medical exemptions went way upWhy You Shouldn’t Shop for Medical ExemptionsColorado’s Non-Medical Vaccine Exemption Form Ruffles Anti-Vaccine FeathersUsing religion to avoid vaccinationReligious Exemption: The Law – a SummaryNon-Medical Vaccine Exemptions: Balancing Parental Rights and Public HealthPraying, in Vain, for ExemptionReligious exemptions for vaccination – abuse and reformMandatory School Vaccinations: The Role of Tort LawStudy – Nonmedical exemptions to school immunization requirements: secular trends and association of state policies with pertussis incidence.Study – Rising rates of vaccine exemptions: problems with current policy and more promising remedies.Study – A longitudinal analysis of the effect of nonmedical exemption law and vaccine uptake on vaccine-targeted disease rates.Legislative Prescriptions for Controlling Nonmedical Vaccine ExemptionsWhy we should eliminate personal belief exemptions to vaccine mandates.Measles Outbreak as a Catalyst for Stricter Vaccine Exemption Legislation.New Study Emphasizes Harm of Vaccine RefusalsNY federal court hands triple loss to anti-vaccination ideologyBattles over non-medical exemptions to vaccination festering in state legislatures

What exactly is diplomatic immunity? What laws can it exempt you from? How can it be overruled or void?

In a general, overall summary, the rules about diplomatic immunity are set forth in the Vienna Convention on Diplomatic Relations ( UNTC ) which states that diplomatic agents including certain members of the diplomatic staff, administrative and technical staff, and service staff of an embassy or consulate enjoy "immunity from the criminal jurisdiction of the receiving state." That means that they cannot be prosecuted for ordinary crimes they might have committed. They also enjoy immunity from civil proceedings unless the case involves property or business interests unrelated to their diplomatic duties.This doesn’t mean that they have get-out-of-jail-free cards. The host country can request a sending country to withdraw a misbehaving diplomat’s immunity so that the person can be prosecuted under local laws. It can also declare the individual PNG (persona non grata) and send him/her home instantly to the embarrassment of the person’s government.

Is the Indian Prime Minister immune to arrests?

Nobody in India is immune from Arrest legallyHowever the PM, CJI, President are the highest ranking authorities in their fields and their arrest would disrupt national matters to great extent.For the PM:-The Law allows FIRs to be registered against an Incumbent PM, also demands that the Incumbent PM attends questioning and interrogations. However arresting the PM requires order from the Supreme Court and permission from the President of the Country, just like to arrest an incumbent CM - HC order + Governor permission is required.Incumbent PMs cannot be part of any Civil Suit during their tenures and even holding such a case would be exempt under law. After leaving office - PMs can be part of Civil suits.For the President:-Registering FIRs or Criminal Case against an Incumbent President is violation of Sovereign Immunity. This means while President is in office - no criminal proceedings , no court appearanes, no requests for attendances can be made to the President.So President cannot be arrested during Office.

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