Should Vaccination Be Compulsory?

Jamie Hakham

This is a discussion about the how vaccination should occur, rather than the concept of it. That is, we’re not going to be discussing autism, mercury poisoning, or any other discredited, unscientific, or just plain wrong arguments so-called anti-vaxxers use when dismissing vaccines. Got that? Good!

Let’s instead boil this argument down into its simplest form. Should my choice, as the individual, to not vaccinate my child, be considered more important than the government’s advisement to the contrary? Or, to put that into plain English: is personal choice more important than common welfare? In case you should run out of topics to discuss on Christmas day, we’re going to give a brief overview of both sides of the vaccine argument, and some links to further reading. Won’t that be fun!

Arguments for

There are two main arguments here: a scientific one, and a legal one:

First off, there are always going to be people who, for whatever medical reason, can’t be vaccinated. This is usually due to advanced age, congenital illness, or some other medical condition – but also includes those who are also too young to have received their vaccines yet. These people rely on what is known as ‘Herd Immunity’. This refers to a state where an overwhelming majority of people (around 95%) are vaccinated against a disease. This means that the disease can’t travel through the population to reach those who aren’t protected against it.

vacc

The benefits of herd immunity (Image Credit: wikimedia)

Therefore, if vaccination isn’t compulsory, it’s nigh-on impossible to make sure that these vulnerable members of society are protected by the rest – think back to the recent outbreaks of measles in the US and UK that claimed the lives of people who were unable to be vaccinated due to health reasons.

Secondly, and here it’s going to get a bit legal-ese, we have to deal with what’s known as personal autonomy, and how that relates to parental consent. That is, is it right for you to refuse vaccination for yourself, but also for your children? Refusing vaccination for yourself is your personal choice – you become a ‘fringe rider’ of society’s healthcare, benefiting from it without participating. While ethically dubious, it’s well within your rights over your body.

However, if the question concerns your child, it all gets a little bit more complex. That’s because your kid can’t legally consent to anything – it’s not their choice. Therefore, you, as the parent, are legally capable of consenting for them in matters like vaccination. But, this child also has the right to a healthy life, up to and including preventative measures – like vaccination. If your personal views mean that your child doesn’t receive such preventative measures, it conflicts with that right. Therefore, if vaccination isn’t compulsory, how can society be sure that the rights of that child are upheld?

Arguments against

 There’s a couple of reasons here, and they’re both relatively practical:

Firstly, this discussion does not claim that vaccination is a bad thing. Rather, compulsory vaccination has been shown, counterintuitively, to be less effective at increasing vaccination coverage, due to exemptions, as in the US, or due to it’s simple unenforceability, as in Italy. It’s suggested that this was because people are more likely to do something if they are empowered to do it, rather than forced. And, with trust in government at all-time lows, compulsory vaccination is likely to lead to even greater levels of truancy.

A better system is the one currently in use in the UK, where vaccination is free, and strongly recommended. The result is a vaccine coverage of roughly 94%, which is directly comparable to the US for the same vaccines, for significantly less bureaucratic effort.

Secondly, studies have shown time and time again that people are poor assessors of risk, and that most opposition of vaccines is linked to a poor understanding of the facts and risks involved. Many people misunderstand the chemistry, biology of vaccines, show a lack of appreciation for the statistics involved, or have issues outside of the science of vaccines. Forcing these people to do something they don’t understand is a sure-fire way to make martyrs of them, gaining them publicity and popularity. For example, Jenny Mccarthy, a now well known anti-vaxxer, who has become one of the louder voices linking vaccination with autism.

Surely, as modern society, we should focus on educating those less knowledgeable, in order to allow them to appreciate their actions. When Italy moved from a compulsory to a more liberalised system, they found that simply providing and disseminating correct information was hugely important in increasing vaccine uptake. And furthermore, increasing scientific literacy should be a general goal for all of us, and this is a perfect ground to educate those who need it.

Summary

Vaccination is, in the scientific consensus, an ethical imperative. It’s our first line of defence against some of the worst diseases in the world. In almost every case the risk of side effects is significantly lower than the risks posed by the disease vaccinated against. Ethically, it is imperative that every single eligible individual is vaccinated, for the good of the whole community.

In practice, however, forcing the thing seems to have unwanted negatives, either because people don’t understand the science, or are mistrustful of its source. In this modern age of information, however, is it a government’s prerogative to supply the facts, or should people come to conclusions on their own?

Food for thought

Jacobsen vs Massachusetts: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449224/

CDC: http://www.cdc.gov/vaccinesafety/concerns/multiple-vaccines-immunity.html

Opticon: http://www.ucl.ac.uk/opticon1826/archive/issue8/articles/Article_Biomed_Sc_-_Fine-Goulden__Vaccination_Publish.pdf

BMJ: http://www.bmj.com/press-releases/2012/05/14/should-childhood-vaccination-be-mandatory

Economist: http://www.economist.com/blogs/freeexchange/2015/02/archives

Herd Immunity: http://www.metronews.ca/views/2015/02/10/why-vaccines-for-kids-should-be-mandatory.html

Forbes: http://www.forbes.com/sites/robertpearl/2015/02/05/measles-vaccination-must-be-mandatory/#89b1acf7d987

NYT: http://www.nytimes.com/roomfordebate/2014/03/23/making-vaccination-mandatory-for-all-children/in-britain-vaccinate-with-persuasion-not-coercion

Cultural Perspectives: http://www.historyofvaccines.org/content/articles/cultural-perspectives-vaccination

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s