Iowa immunization advocates have recently received support from federal and state legislators. In a February 21 letter to members of Congress, U.S. Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Washington) and four House members highlighted the importance of immunizations. At the same time, members of the Iowa House Human Resources Committee have resisted efforts to weaken Iowa’s compulsory immunization law.
Federal letter. The federal letter notes progress from 1963, when four million people were infected with measles to 2000, when the CDC declared the disease eliminated. In a step backward, however, there were 667 measles cases in 27 states in 2014 – an outbreak tied to lower vaccination rates in some communities. Cases of pertussis (“whooping cough”) also continue to occur despite a vaccine to prevent the disease.
The federal letter stresses the importance of widespread vaccination to create “herd immunity,” which protects children – particularly those who cannot be vaccinated — from disease through the vaccination of those around them. The letter concludes, “The science is clear: FDA-licensed vaccines are proven to be safe and effective, and save the lives both of those who receive them and vulnerable individuals around them. . . . Simply put, vaccines save lives.”
Iowa legislation. Because of bipartisan opposition, the Iowa House Human Resources Committee has not held a vote on legislation (HF 7) that would allow a “personal conviction” exemption to the state’s compulsory immunization law. By this week’s end, the bill will be officially dead for this year. By a 2-1 vote, a subcommittee had advanced the bill despite widespread opposition in a January 24 public hearing. An Iowa-AAP board member, Dr. Nathan Boonstra, spoke against the bill at the hearing.
Despite widespread opposition in a hearing on February 23, by a 2-1 vote, a subcommittee advanced to the House Judiciary Committee legislation, HSB 133, that vastly expands gun rights. Almost two dozen spoke against the bill, criticizing many of its provisions, including those:
- Removing a minimum age for possessing a revolver or pistol
- Expanding “stand your ground” rights
- Increasing risks from expanding the right to carry firearms in public spaces, like schools, hospitals, and the Capitol
- Creating a lifetime permit to carry weapons
- Removing the obligation to obtain a permit to acquire a firearm
- Making records of permit holders confidential
The bill’s provision expanding the right to use lethal force drew the most criticism, with warnings of increased deaths and risk to people of color. Two opponents of this provision are quoted in a Des Moines Register article.
The Iowa-AAP has registered against the bill, objecting to a provision allowing a child of any age to possess a pistol or revolver. Opposing this provision on behalf of Iowa-AAP and Blank Hospital, pediatrician Dr. Amy Shriver (pictured) noted how 18,000 children are killed by firearms annually in the United States. Citing her clinical experience, Dr. Shriver contended that most children under the current limit of 14 years old lacked the maturity to safely use handguns.
The American Academy of Pediatrics believes that, “The absence of guns in homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents.” The Iowa-AAP will continue its opposition to the bill, including at a March 2 legislative breakfast co-hosted with Blank Hospital.
Update: Both chambers approved the gun bill, which the Governor signed on April 13.
The Iowa-AAP has registered against new legislation (SF 254) restricting a health professional’s communications with patients about firearms. The legislation provides that a licensed health professional “shall not inquire about or otherwise request information about a patient’s or client’s ownership or possession of firearms.” A health professional violating this proscription could be guilty of a serious misdemeanor – punishable by up to a one-year sentence and fine of $1,875.
If enacted, SF 254 would be only the second state law imposing such a constraint on health professional communications with patients. The law disregards research showing the important role pediatricians and other physicians can play in protecting children from firearm injury or death. According to the American Academy of Pediatrics, “asking a parent a question about gun ownership can open up an opportunity to educate parents about potential dangers to which their child is exposed.” Such “anticipatory guidance” is a “major component” of pediatric care helping patients and their families “know what to watch for in the future.”
Further, the Iowa bill likely violates the First Amendment Right to free speech – as Florida just learned after six costly years of unsuccessful litigation defending a similar law. A 2011 Florida law proscribed medical professionals from inquiring about a patient or family member’s ownership of a firearm or ammunition unless relevant to personal safety. It also directed that medical professionals refrain from “unnecessarily harassing” patients about firearms.
Soon after the law’s enactment, doctors and medical groups secured a federal court order enjoining its enforcement. Subsequent court and appellate actions led to a February 16 decision by the 11th Circuit Court of Appeals finding that the Florida law violated the First Amendment’s guarantee of free speech. In a 10-1 decision and 90-page decision, the court also declared the “unnecessary harassment” provision unconstitutionally vague under the Fourteenth Amendment.
The court decision is a landmark one, with implications beyond Florida — as noted in a New York Times article. In a statement expressing delight with the court decision, the American Academy of Pediatrics president Fernando Stein, M.D. declares, “Pediatricians routinely counsel families about firearm safety just as they offer guidance on seat belt use, helmets and parental tobacco use to reduce the risk of injury to children where they live and play. These are all topics that families should feel very comfortable talking about with their pediatrician.”
As of February 18, Blank Hospital, the Iowa Medical Society, and the Iowa Psychological Association have also registered against SF 254, which has been referred to the Senate Human Resources Committee. A subcommittee has not been appointed.
Update: This legislation did not advance.
Despite fifty minutes of largely critical testimony on February 6, a divided Senate subcommittee approved legislation (SSB 1051) to legalize sales of fireworks in Iowa. The sales can occur in tents or buildings in time periods overlapping July 4 and January 1. Senators Jake Chapman (R-Adel) and Jason Schultz (R-Schlesweig) supported the bill, which Senator Janet Petersen (D-Des Moines) opposed.
Representatives of health organizations, local government, firefighters, veterans, and EMS personnel spoke against the legislation, citing:
* The high risk of injuries to children (e.g., the rate of child injuries from fireworks is six times higher in Missouri, — where sales are legal – than in Iowa)
* The increased risk of anxiety and PTSD from fireworks
* The inherent hazardous character of fireworks and the difficulty of ensuring a safe distance
* The increased demand on EMS and firefighters, especially in rural areas dependent on volunteers
* The lack of an opt-out option for local governments
The Iowa-AAP has registered against the legislation, which now goes before the Senate State Government Committee. The Des Moines Register has a long report on the hearing.