Bill Gates, Microsoft Word and Vaccine Exemption

In Bill Gates' 2010 letter to the Bill and Melinda Gates Foundation, Bill Gates opens his section on childhood vaccination:

"Vaccines are a miracle because with three doses, mostly given in the first two years of life, you can prevent deadly diseases for an entire lifetime. Because the impact is so incredible, vaccines are the foundation’s biggest area of investment—more than $800 million every year—and the return is substantial. We are working to get other donors to put more resources into vaccines because we still have big challenges. The first challenge is to invent them, and the second is to make sure they reach everyone who needs them. Achieving full coverage is hard in poor countries, where cost and delivery are big barriers."

Vaccines are as close to a miracle as modern science gets. The incalculable human suffering prevented by modern vaccination programs dwarfs perhaps any other human achievement. And it is a frustrating reality that achieving full coverage is difficult in poor countries. But we have dangerous gaps in the first-world coverage as well. According to the March 22 online edition of the journal Pediatrics, a deliberately unvaccinated child returned from a trip to Switzerland to San Diego infected with measles and sparked the largest outbreak in nearly two decades. The conclusions of the Pediatrics study are unequivocal:

The importation resulted in 839 exposed persons, 11 additional cases (all in unvaccinated children), and the hospitalization of an infant too young to be vaccinated. Two-dose vaccination coverage of 95%, absence of vaccine failure, and a vigorous outbreak response halted spread beyond the third generation, at a net public-sector cost of $10 376 per case. Although 75% of the cases were of persons who were intentionally unvaccinated, 48 children too young to be vaccinated were quarantined, at an average family cost of $775 per child. Substantial rates of intentional undervaccination occurred in public charter and private schools, as well as public schools in upper-socioeconomic areas. Vaccine refusal clustered geographically and the overall rate seemed to be rising. In discussion groups and survey responses, the majority of parents who declined vaccination for their children were concerned with vaccine adverse events.

First-world countries still reap the returns that make vaccination such an obvious choice for the Gates Foundation in the third world.

And yet, when I went to write a letter of recommendation for one of my students this afternoon and opened a "new letter" template in Word, I noticed among the list of options (a template that you can automatically download) is an "Immunization Waiver":

(Click images to embiggen.)

This horrid little download reads as follows:

To Whom It May Concern:

This letter is a request to exercise my right to waive immunization requirements for my son/daughter, ___________. This request is made based on my personal and philosophical beliefs.

I agree to hold _________________ harmless in the event of any possible illness or injury resulting from waiving my immunization requirement.

I would like to call your attention to two issues. The first is that microbes do not give a tiny Tunisian two-step about either your personal convictions or your philosophical beliefs. The second is that I would be horrified if my immunocompromised child had to attend school with your unvaccinated kid. Also, did you not see that whole injury or illness sentence at the end there? Do you think that applies just to other peoples' kids?

I see an $800,000,000 discrepancy between the social aims that Bill Gates is promoting and what Microsoft, of which he remains non-executive chair, is promoting. The two seem to me to be hopelessly at cross-purposes. Of course, Microsoft need not contribute to a major American public health problem by aiding the anti-vaccine movement. I would very much like to see Microsoft in line with its founder's vision of a healthy humanity and appeal to powers that be to drop this template from their server.

HJ