 
To: Members of the Senate HEWI Committee: The Association of American Physicians and Surgeons, a national organization founded in 1943 that represents physicians in all specialties, opposes the enactment of Senate Bill. 04-139, “Concerning notification to persons of immunizations for their children under specified circumstances.” This bill would involve the Department of Public Health and its unspecified “contractors” in routine contacts between physicians’ offices and their patients. It is a physician’s responsibility to notify his patients of needed medical procedures. This should be a confidential process that helps to strengthen the patient-physician relationship, and provides an opportunity to discuss other issues of concern. It is not appropriate for a taxpayer-funded agency, or contractors possibly in the employ of a special interest group, to take over such functions. Immunizations, like all medical interventions, involve risk:benefit considerations. Each patient deserves an individualized assessment by a physician who knows the patient and is directly responsible for that patient’s welfare. The assessment of a particular patient’s needs, and the process of obtaining informed consent, cannot be delegated to a government agency or contractor. Immunization schedules are guidelines, not necessarily suitable for every patient in every circumstance. Government agencies by their nature can only follow a rigid, one-size-fits-all structure, which could be harmful to some individuals. The assertion that Colorado is last in vaccinating toddlers has been refuted convincingly. In any event, there is no evidence that the proposed legislation could, in itself, increase the number of children immunized without applying governmental coercion to what should be a decision between patients (or their parents) and a personal physician. Lockstep adherence to a fixed schedule is not a good measure of public health. There are many medical reasons for variation from the schedule (such as intercurrent illnesses) even if one is fully committed to giving every dose of every recommended vaccine. Some vaccines, such as the varicella vaccine, have not been used long enough to determine whether they make any significant improvement in health outcomes; the contrary could actually be true. For some, such as hepatitis b, the evidence supporting safety in infants and children is scanty and outweighed by the risk of serious adverse effects, in the opinion of many physicians. Although Channel 9 News may assert that Colorado is free of fatal or serious vaccine reactions, such reactions are usually attributed to something else, and at best only 10 percent of acknowledged reactions are believed to be reported. There is mounting evidence that the devastating epidemic of neurodevelopment disorders and other chronic diseases could be attributed in part to vaccine reactions. The Institute of Medicine has acknowledged the biologic plausibility of an association and the need for more research. Absolute safety cannot be guaranteed, as mandatory vaccine advocates admit. It is a serious violation of civil liberties to force them on unwilling patients. Having a government agency or contractor take over the function of “reminders” puts inordinate pressure on parents to comply out of fear of government repercussions (such as confrontations with Child Protective Services) instead of thoughtful decisionmaking with recognition of their statutory and constitutional rights. Public health departments are stretched thin nationwide. Scarce public health dollars should not be diverted to Big Brother functions. Your constituents are smart enough to make their own vaccine decisions. Governmental resources are better spent on informing citizens than on monitoring them. This legislation should be defeated. Please feel free to call me if you have any questions or desire further information. My direct line is (520) 323-3110.
Jane M. Orient, M.D., F.A.C.P.
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