Mandatory vaccination is a contentious medical policy in many communities. Scientific evidence in support of mandatory vaccination is undoubtedly strong. However, the inseparable nature of ethics, policies, laws, and politics in such a sensitive field requires careful adjudication. Majority of people have received the recommended vaccines, thus protecting them and those around them from preventable diseases. However, such preventive efforts often face challenges when the issues of balance between freedom of choice and community responsibility are explored. Some people may opt out of the vaccination, in which case they would be exercising their right to choose. Under the circumstances, questions about whether compulsory vaccinations are necessary arise. Nevertheless, some parents harbor very strong reservations about certain medical procedures being forced on their children. The pros and cons of vaccinations have been elucidated. All the 50 states in the US require children entering school to be vaccinated though no federal law exists. All the states have exemptions on medical issues, while some exempt based on religious or philosophical reasons. The annotated bibliography offers insights into some of the issues driving the debate on whether vaccination should be compulsory.
Gostin, L. O. (2015). Law, ethics, and public health in the vaccination debates: politics of the measles outbreak. Jama , 313 (11), 1099-1100.
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Understanding the legal laws and policies surrounding the debate on compulsory vaccination requires recognizing and appreciating the existence of a problem that needs solving. Gostin’s paper is conceptualized from this perspective. The paper cited the CDC’s declaration of elimination of endemic measles, rubella, and congenital rubella syndrome in 2000 and 2004 respectively. Since then, a record number of measles cases was recorded in 2014, with subsequent years also positing hundreds of cases. The paper links the ongoing outbreaks to unvaccinated cases and those whose vaccination status is unknown. Consequently, a historic controversy was reignited about the roles of personal choice and parental rights in advancing the values of public health. Gostin (2015) focuses on three important factors that act as influencers of the controversy: the politics of compulsory vaccination; religious and philosophical exemptions in state mandates; and the tragedy of the commons. The latter highlights parental decisions to opt out of vaccination being risk factors to the safety of other members of the public. Overall, Gostin’s article points out that the debate on the controversial compulsory vaccination has degenerated to medicolegal, ethical, and human rights issues rather than scientific justification of the safety and need for vaccines.
Martinelli, D., Tafuri, S., Fortunato, F., Cozza, V., Germinario, C. A., & Prato, R. (2015). Are we ready to abrogate compulsory vaccinations for children? The opinion of Apulian family pediatricians; Italy, 2013. Human Vaccines & Immunotherapeutics , 11 (1), 146-149.
Martinelli et al (2015) study recognize the dependence of vaccination programs worldwide on the high rates of acceptance and coverage. Nevertheless, the article places significant emphasis on acceptance. Evidence of the improved uptake of vaccines in the UK following the first ever introduction of compulsory vaccination in 1853 is cited as the basis of the paper. However, an overview of mandatory vaccination programs in the EU revealed reluctance by member countries to include compulsory vaccinations with most including at least one mandatory vaccination in their national immunization program. The evident negative attitude inspired a call to examine the need for the abrogation of compulsory vaccination. The article is based on a study conducted in Italy, where vaccination for infants against most diseases is compulsory in almost all regions. Interviews with family pediatricians working in Puglia revealed that some practitioners agreed with the hypothesis of abrogation. However, such views were dependent on the existence of exceptional levels of awareness and adequate organization of vaccination services. The article corroborates the effectiveness of voluntary and recommended vaccinations programs where appropriate frameworks and awareness exist, thus eliminating the need for compulsory vaccinations.
Miller, E. (2015). Controversies and challenges of vaccination: an interview with Elizabeth Miller. BMC Medicine , 13 (1), 267.
The scientific evidence in support of the benefits of vaccinations is overwhelming. However, Miller points out that the evidence has not been given a green light in all spheres. Reservations by opponents of vaccination exist and are related to questions about the safety, efficacy, and necessity of the vaccines. The paper examines the relationship between these factors and thee prospects to refuse and hesitate and the resulting consequences. The author posits that the legitimacy of concerns about vaccines is founded on the fact that they are used to prevent diseases that may no longer pose an immediate threat. Potential reactions upon administration are a trigger for concerns. The article elucidates potential sources of reactions that may be wrongly interpreted as adverse effects of the vaccines. Deliberation on the benefits and detriments of vaccines leads to the opinion that compulsory vaccination is a policy approach in improving compliance. The article articulates issues driving either side of the controversy on vaccination, hence play an important role in understanding whether the need for compulsory vaccinations is justified or not.
Patryn, R. K., & Zagaja, A. (2016). Vaccinations—Between free will and coercion. Human Vaccines & Immunotherapeutics , 12 (8), 2204-2205.
The authors of the article recognize and appreciate the delicate balance between free will and coercion in relation to vaccination. Stakeholders’ attention is drawn to the complexities of compulsory vaccination, notably, the changing social stratification due to migrations, increasing freedom rights, and popularization of anti-vaccine movements. These factors have come to the fore following outbursts of epidemics requiring a balanced approach to addressing the rights of individuals and the need to ensure population health safety. The paper advances the argument that irrational implementation and execution of individual rights paradoxically opposes the health risks associated with failure to vaccinate. The paper explores the legal approach to compulsory vaccinations by examining laws of specific countries and how the addressed the issues of individual autonomy and freedoms in relation to vaccinations. In most instances, coercion conflicts with individual right to refuse any form of medical intervention. Majority of the laws sought to improve vaccination through coercion are discriminatory and punitive. For instance, in 2015, the state of California introduced a duty barring acceptance of unvaccinated children in public schools or theme parks. Other coercive approaches include administrative requirements, and fines, all of which can be challenged legally. Overall, compulsory vaccination is increasingly being perceived from a legal perspective because it infringes on individual rights to freedom of choice.
Randall, K. (2015). Kansas, please protect our children: why Kansas should remove the religious exemption for mandatory school vaccinations. U. Kan. L. Rev. , 64 , 1217.
Randall introduces justification for compulsory vaccination by highlighting the demise of a six-week-old baby that passed away from whooping cough in 2015 in the state of Kansas. It is important to understand that the paper advocates for mandatory vaccinations in schools through the removal of laws exempting individual based on religious issues. The paper revisits the recent outbreaks of preventable diseases across the US that have exposed unvaccinated children to the risk of infection. Kansas is depicted as among the states lacking legal frameworks and policies to protect school going children from the epidemics, thanks to the law exempting parents due to religious beliefs. By examining the legal basis for compulsory vaccinations in other states, Randall seeks to argue the state of Kansas into adopting a policy to abolish exemption based on religious beliefs. Scientific and legal aspects are not the only parameters in the controversy of vaccines as religious and cultural factors exempted by law prove to be influential in the decisions to opt out.
Ritchey, W. J. (2016). Compulsory vaccinations: Balancing the equitable reality of policy power with provider assistance through an improved informed consent process. J. Envtl. L. & Litig. , 32 , 119.
The misinformed conclusions on the relationship between vaccines and other disorders such as autism are highlighted in this paper. The paper establishes the lack of knowledge on the pros and cons of vaccines as the central issue influencing oppositions of vaccination programs. Decisions to forego vaccination are costly in the long run because the individual and those around them are at higher risk. The constitutionality and viability of compulsory vaccination is debatable. However, under the circumstances, the state deemed it reasonable to enforce compulsory vaccinations, a process that must be carefully handled to balance individual interests with those of the state to provide public health safety. Consequently, Ritchey poked holes into some of the existing laws protecting individuals from compulsory vaccination. The paper argued that emphasis should be placed on getting informed consent from parents by improving the process. Public awareness and vaccination programs efficiency are critical in enhancing understanding of the balance of the two sides of the controversy. Simply put, improved informed consent process means an understanding of why vaccination is important, which may eliminate the need for coercion to participate.
Williams, S. E. (2014). What are the factors that contribute to parental vaccine-hesitancy and what can we do about it? Human Vaccines & Immunotherapeutics , 10 (9), 2584-2596.
The article presents a worrying trend – the increase in the number of individuals expressing parental refusal or delay of childhood vaccines. The importance of examining barriers to vaccinations in this population segment is reiterated for the development of remedial strategies. The paper reviews some of the known barriers to vaccinations among vaccine-hesitant parents such as too many vaccines that elicit questions about the necessity and raise concerns of adverse reactions. Parents have different perceptions towards different types of vaccines based on preconceived understanding. Changing such mindsets is a challenge that requires identification of appropriate interventions focused on different types of vaccines. The paper reiterates the need to communicate strategies to alleviate fears and concerns among hesitant parents. Overall, the article highlights that a blanket compulsory vaccination policy that does not look into the root causes of hesitancy or delay is likely to create conflicts because of the potential to undermine social or cultural values harbored by specific segments of the population.
References
Gostin, L. O. (2015). Law, ethics, and public health in the vaccination debates: politics of the measles outbreak. Jama , 313 (11), 1099-1100.
Martinelli, D., Tafuri, S., Fortunato, F., Cozza, V., Germinario, C. A., & Prato, R. (2015). Are we ready to abrogate compulsory vaccinations for children? The opinion of apulian family pediatricians; Italy, 2013. Human Vaccines & Immunotherapeutics , 11 (1), 146-149.
Miller, E. (2015). Controversies and challenges of vaccination: an interview with Elizabeth Miller. BMC Medicine , 13 (1), 267.
Patryn, R. K., & Zagaja, A. (2016). Vaccinations—Between free will and coercion. Human Vaccines & Immunotherapeutics , 12 (8), 2204-2205.
Randall, K. (2015). Kansas, please protect our children: why Kansas should remove the religious exemption for mandatory school vaccinations. U. Kan. L. Rev. , 64 , 1217.
Ritchey, W. J. (2016). Compulsory Vaccinations: Balancing the Equitable Reality of Policy Power with Provider Assistance through an Improved Informed Consent Process. J. Envtl. L. & Litig. , 32 , 119.
Williams, S. E. (2014). What are the factors that contribute to parental vaccine-hesitancy and what can we do about it? Human Vaccines & Immunotherapeutics , 10 (9), 2584-2596.
