Meryl Nass, MD 
Board Certified in Internal Medicine
210 Main Street
Ellsworth, Maine 04605
phone (207) 610-5885;  fax (207) 610-5886

March 13, 2019

Senator Millett, Representative Kornfield, and members of the Education and Cultural Affairs Committee:

My name is Dr. Meryl Nass. I am here today to oppose LD798 and support LD987.

• I am a physician in Ellsworth, Maine.
• I graduated from MIT and the University of Mississippi School of Medicine.
• In 2010, I was the chair of a commission established by you, the legislature, “to protect the lives and health of members of the Maine National Guard.”
• I have testified to 6 Congressional committees, primarily on anthrax vaccine and Gulf War Syndrome, and the permanent injuries suffered by service-members who received military vaccines of questionable quality.
• There is no crisis of infectious diseases caused by lack of vaccinations, here in Maine or in the rest of the United States.
• The rates of vaccine preventable diseases are approximately the same as always.  I have attached the official statistics, so please check me on this!
• According to the CDC, effective vaccine exemption rates in Maine are not higher than they have been, and they are consistently better than the US average

The truth, not widely known, is that immunocompromised children are not catching diseases from their unvaccinated classmates, and they are not dying. Look at the numbers.

The diseases that persist and have been in the news remain a challenge, simply because the vaccines have a high failure rate–not because of the unvaccinated.

Pertussis is a problem, because the vaccine works poorly.

• 66% of Maine cases were fully vaccinated, 83% partially.
• The TDaP pertussis vaccine is estimated 67% effective the first year after inoculation, but only 9% effective 4 years later. [1]
• Almost all of us are susceptible to pertussis despite vaccination.  I have had pertussis twice.  I am fully vaccinated.
• Given the failure rate of the pertussis vaccine, no herd immunity is possible.  The bacteria regularly circulate in the community, as they would even with a 100% vaccination rate.
• Pertussis is not a major problem for the immunocompromised, who are in fact regularly exposed.

Similarly, Varicella (the virus that causes chickenpox and shingles) cannot be eradicated even with a 100% vaccination rate.

• A full 70% of Maine children who got chickenpox in 2017 had been vaccinated.
• Adults with shingles spread the virus; a disease-free environment cannot be attained.
• Fortunately, children do not die from varicella, even highly immunocompromised children, for whom several treatments are available. There is approximately one child death per year, in the entire US, from Varicella.

By contrast, influenza–the “flu”–kills about 120 children per year in the US, but again, the problem is that the flu vaccine is weak, and protection wears off quickly.

• On average influenza vaccines are 40% effective, according to the CDC. [2]
• Herd immunity cannot be obtained, because even if you vaccinate everyone, the majority will not be immune.
• In the past ten years in Maine, 2 children have died from influenza.

There has been so much talk about measles, but there has been only one case of measles in Maine in 20 years, from a visitor who did not spread it to anyone.

The numbers speak for themselves.  Maine children are already very well protected from those diseases for which we have good protection.  Most cases of ‘vaccine preventable’ diseases in Maine are the result of vaccine failures, not the result of unvaccinated children.

Maine’s current vaccination rates are excellent, and have successfully kept measles, mumps, rubella, diphtheria, polio and other diseases from circulating.

However, the unfortunate fact is that there are no vaccines for the infections that most jeopardize the immunocompromised. Most viruses, fungi and bacteria threatening the immunocompromised have no vaccines against them. Fortunately, the immunocompromised are not catching and dying from vaccine-preventable disease.

If your committee votes to remove exemptions from families that currently avoid immunizations — because parents believe their children are at high risk of an injury — you will cause more vaccine injuries, and possibly deaths.  But what you won’t do is prevent many infections in the rest of the population, since the major reason these diseases circulate is that the vaccines are simply not good enough.

• The truly serious epidemics in Maine students are teen suicides and narcotic drug abuse. I hope your committee finds ways to address them.

Please look closely at the accurate numbers, from the federal and Maine CDC’s.  I am confident they will lead you to oppose this bill.

[1]  https://www.cdc.gov/mmwr/volumes/67/rr/pdfs/rr6702a1-H.pdf
[2] https://globenewswire.com/news-release/2019/03/07/1749613/0/en/Vaccines-Market-worth-over-70bn-by-2025-Global-Market-Insights-Inc.html