INSTRUCTIONS This assessment has been designed to measure your skills in: critical thinking, research methodology and written communication.

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INSTRUCTIONS This assessment has been designed to measure your skills in: critical thinking, research methodology and written communication. You will submit a one-to-two page document, based on the scenario and questions described below. Your own personal values are important and will influence what you write, but you should base your essay on the evidence provided in the documents and your assessment of those documents. Your submission should follow normal guidelines: double-spaced, 12 point font, one-inch margins, proper spelling and grammar, and no more than 3 pages. SCENARIO Jennifer Smith, whose family moved to Salk County this past winter, wrote a letter to the school board on the topic of vaccinations. Her daughter has cancer and is at heightened risk of further infection. The letter was discussed at a school board meeting in the spring. Marilyn Dixon is a third generation member of Salk County and has written the county School Board in response to the letter from Jennifer. Marilyn believes that forcing vaccinations is an inhumane practice and one that the school board should not support. Marilyn s letter was discussed at a school board meeting, after which the school board was inundated with letters and documents from parents in the school district, arguing both for and against the need for school children to be up-to-date on their vaccinations. The Salk County School Board feels overwhelmed by the amount of information they are receiving and has hired you as a consultant team. The Board has provided you with what they deem to be the key documents they have received and asked your team to write a recommendation for their consideration. As you write your recommendation, be sure to substantiate it by referring to research standards and by addressing the three questions below. QUESTIONS Question 1 What are the strengths and limitations of Jennifer s position on vaccinations? What specific information in the documents led you to this conclusion? Question 2 What are the strengths and limitations of Marilyn s position on vaccinations? What specific information in the documents led you to this conclusion? Question 3 What additional information would you like to have had to come to your own best conclusion on the issues addressed by both Jennifer and Marilyn? Check that you have all of the associated documents (labeled A through F) before you begin.

March 27, 2017 School Board Members Salk County Dear Board Members, Today was supposed to be a great day: our beautiful daughter s first day at her new school. However, when I checked with her teacher, I learned that one of the children in Scarlett's class is not vaccinated. There are many things I would like to say but my conscience stops me. I understand that nothing I say can convince another parent to change their beliefs. It's not going to matter so what is the point. But when I am upset, I write. So here is my letter to that parent: This morning, my daughter got dressed for her first day at the new school. She had a new outfit that she picked out herself. She got her backpack. She was just like your child. Except my daughter is not like your child. My daughter has cancer. She has had a drill bored into her hips. She has been poked with a needle more times than we can count. She has had surgeries, lost her hair, watched friends die. She has suffered through sickness and pain. She has suffered enough. As parents, we have watched all of this. We have held her head as her whole body wretches. We have washed her bloody hands, raw from the medications. We have wiped her bottom while wearing masks and gloves because our own child is too poisonous for us to touch. We have worried and cried and planned. We have suffered enough. We have raised money. We have opened every aspect of our lives to the public to bring awareness in the hopes of a cure. We do this, not for our child, but for yours. We hope to stop this horrible disease in its tracks. We hope that not one more child is diagnosed with cancer, not one more child suffers, not one more child dies. We do this for society, for the greater good. Today my daughter went to school. Tonight, we have to make the decision of whether or not to send her back because you did not vaccinate your child. You put our child at risk with the decision that you made. Now I have to make the decision of how I am going to make my child suffer even more. Do I risk exposing her to a disease that is nearly wiped out in America, brought back by unvaccinated children? Or do I break her heart and tell her that she cannot go to school anymore? A "simple" disease like chicken pox could kill her. We have made enough decisions in the past two years. Decisions that our child's life depended on. You are forcing us to have to make another decision that we shouldn't have to make. We ask one thing of you after all of our suffering. Take care of society, think of the greater good. Vaccinate your children to protect ours. Vaccines do not cause autism. Vaccines do not cause cancer. Vaccines save lives. FACT. Exhibit A

I can call you selfish. I can call you stupid. I can call you names that are a lot worse because I am that angry today. But that won't help me tomorrow. You won't be there to wipe away my child's tears because she can't go back to school or hold her head as she lays in a hospital bed dying of measles. Your decision doesn't truly affect you. You will probably never see the ramifications of your actions. Because we vaccinated our child for the greater good. We vaccinated our child to save yours. I am just a mom, trying to protect her child. The difference is that I have science, facts, and statistics on my side. I am angry, sad, hurt and ultimately helpless. I cannot force the school to tell this child's family to vaccinate or change classes. But I can use my voice to encourage my state to eliminate personal exemptions for school vaccines. I'll just add this small task to my very short list of things to do. This will be a letter that I will never send because I am a coward. I will not confront this family (partially because I don't know who they are). They may never know that my daughter is (or was) in their class. I am too much of a coward to let them know how much they made me and my daughter cry. They will never know how much their decision affected our family. So I ask you, please think of children like Scarlett when you consider vaccinating. And please pray for Scarlett to make it through the year healthy and safe. I ask that my school board members think of children like Scarlett and create a policy that requires all children to be up to date on their vaccinations. Very truly, Jennifer Smith Exhibit A page 2

May 15, 2017 Salk County School Board Salk County Dear Board Members: I am the mother of a daughter who was injured by vaccinations almost 30 years ago, and this is an issue dear to my heart. Since our daughter s reaction, she has had life-long struggles with epilepsy, gut, and autistic issues. Since we didn t want to risk this happening to our next two children, we chose not to immunize them. Ironically, they were the healthiest of all our five as young children. This is why we feel passionate about parents having the freedom to choose whether to immunize their children or not. Some children cannot handle immunizations due to genetic tendencies, low immune systems, allergies, sensitivities, etc. Parents alone, not the government, should be the ones to decide if their children should be immunized. My son told me that the school might require vaccinations for the next school year. I am opposed to this practice and would hate to see other children suffer like my Melanie has suffered all these years. I encourage you to allow parents the right to choose what is best for their children and not force them to subject their children to inhumane practices. Sincerely, Marilyn Dixon Exhibit B

March 10, 2013 - Researcher and physician Dr. Andrew Wakefield presented stunning data at the recent Royal College of Physicians annual conference in London. Dr. Wakefield and his research team demonstrated how the MMR (Measles, Mumps, and Rubella) vaccine, commonly given in childhood, causes autism. Along with many compelling charts, the team presented the following table (reproduced with permission from the authors), which proves this link. Table 1 - Neuropsychiatric diagnoses Chil d Behavioral Diagnosis Exposure identified by parent or doctor Interval from exposure to first behavioral symptoms Features associated with exposure Age at onset of first symptoms Behavior 1 Autism MMR 1 week Fever/delirium 12 2 Autism MMR 2 weeks Self-injury 13 3 Autism MMR 48 h Rash and fever 14 4 Autism? MMR Repetitive behavior, Disintegrativ self-injury, loss of e Disorder? self-help 5 Autism None MMR at 16 Measles vaccine at 15 fol slowing in development. Serious deterioration in behavior immediately after MMR vaccine at 4-5 years. Serious injurious behavior started at 18. 6 Autism MMR 1 week Rash & convulsion; gaze avoidance and self-injury 7 Autism MMR 24 hours Convulsion, gaze avoidance 8 Postvaccinial encephalitis? 9 Autism spectrum disorder 10 Post viral encephalitis? N/A MMR 2 weeks Fever, rash, convulsion, & diarrhea Recurrent otitis media Measles (previously vaccinated with MMR) 1 week (MMR 2 previously) Disinterest, lack of play 24 h Fever, rash, & vomiting 11 Autism MMR 1 week Recurrent viral pneumonia for 8 weeks following MMR 12 Autism None MMR at 15 Loss of speech development and deterioration in language skills noted at 16 Exhibit C N/A Bowel 20 4-5 years 18 4 years 15 21 19 18 15 15 18 2 years 19 2 years

August 7, 2017 Susan Smith Many parents are reluctant to vaccinate their children out of concern about vaccines causing autism. There is new data that supports this claim. Researchers Thomson and Clark recently published a longitudinal study that sought to answer the question Do vaccines cause autism? They collected vaccination rates from state registries. They collected autism diagnoses rates by surveying attendees at annual Children with Autism conferences. In addition, parents from the blog Natural Family were invited to participate to complete surveys. Thomson and Clark constructed the graph (Figure 1) that demonstrates this relationship below. Figure 1 Autism vs. MMR Vaccinations 25 20 15 10 5 MMR Vaccinations Versus Autism 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Autism Diagnoses Per 100,000 MMR Vaccines per 100,000 Exhibit D

Exhibit E

The Salk County School Board is trying to intrude on your healthcare freedom! Attend the school board meeting to protest this intrusion! Vaccines have never been proven to be completely safe! Vaccines cause autism in some children! Vaccines destroy your natural immunity! Big pharma is profiting from the vaccine propaganda! No one should make personal healthcare decisions for your family! Exhibit F