Mandatory Vaccinations Ours Is a Privileged Country.

Mandatory Vaccinations

Ours is a privileged country. Serious communicable diseases are largely controlled in the United States, partly because we have a comprehensive network of public health systems to address pandemic threats, ready access to supplies of vaccines and medicines, hospitals prepared to address communicable disease risks, and because our public school systems require mandatory vaccinations as a requirement of attendance. Certainly, there are exceptions. Children whose parents object to vaccinations because of religious and sometimes philosophical reasons, for instance, can file for exemptions. Vaccine supplies sometimes run short, or become obsolete as viruses mutate over the course of a disease's "season." But, by and large, U.S. citizens enjoy one of the healthiest environments with regard to the spread of disease among developed nations. Recently, however, this status has come under threat -- not from foreigners carrying exotic diseases, not from increasing pest populations in crowded urban areas. But a threat that is as American as apple pie and motherhood. Actually, the threat is motherhood -- or, rather, mothers. And fathers.

Mother knows best. Parents are increasingly demanding that the medical world prove that vaccinations are safe for their children. And even when such proof is forthcoming, some parents hold on to their unsupported beliefs. Happily, there are movements in the United States that promote healthful living, recommending organic foods, low toxin living environments, fresh air, clean water, low carbon footprints, no animal testing of products, and no clear cutting. This is all good and has the potential for far-reaching positive impact on the health of individuals and the planet. Not surprisingly, however, many of these same good-earth-slow-food proponents eschew vaccinations.

In WHO Do We Trust. Incendiary organizations like Vaccine Truth are publishing scary reports of questionable credibility. In what they spin as investigative reporting, these organizations often have to dig very deep and use mile-wide conjecture to generate their data. Here is an example:

Last week, Vaccine Truth highlighted a United States military handbook, "DDT and Other Insecticides and Repellents," published in 1946 that shows chemical compounds used in formulating the pesticide DDT are presently injected into babies. (Frompovich, 2011).

What Vaccine Truth is not saying is that excipients used in the manufacture of vaccines are only present in trace quantities in the final vaccine product. This is true for adjuvants and preservatives as well. There has been a great deal of press about Thimersosal -- a preservative that contains mercury and is used in vaccines -- causing autism or other neurologically-based disorders in children. The theory has been debunked by prominent scientists, but the suspicion lives on. Thimerosal is not used in most vaccines, with flu shots being the exception. It is possible to obtain the more expensive single-dose flu shots that do not contain Thimerosal. The World Health Organization does not believe there is a need to change to single-dose flu shots.

Where Does Culpability Lie? Immunization programs are aimed at stopping the spread of communicable disease for the entire populations of nations. The unit of analysis, from a public health or world health perspective, is the population. Not the individual. Parents who protest mandatory vaccination are not concerned with world health -- but they should be. Mass immunization programs bring about herd immunity -- a condition that occurs when the percentage of people in a population who have been immunized reaches such high levels that they are protected from a certain disease and so are those who have compromised or weak immune systems who cannot be immunized -- "the disease cannot gain a foothold in the community" (Ciolli, 2008). This is a strong benefit that is accrued to all the members of a community, and it also has monetary benefit as disease prevention is cheaper than disease treatment. The threat of a loss of herd immunity in communities due to widespread granting of exemptions has deepened to the point that attorneys are proposing means of "compensating those who have suffered due to a disease outbreak caused by a community's loss of heard immunity" (Ciolli, 2008).

Administrative Responsibilities

A public school administrator or public school nurse is bound by the laws of the state in which they work. Regulations about immunization vary from state to state, and so too do the steps required to file an exemption against having one's child immunized. Public school districts have come to suspect that many exemptions are filed as a matter of convenience and are not based on truly religious or philosophical beliefs. Some parents are just on the cusp, not knowing who to believe or trust, hoping that avoiding immunizations will bring less harm to their individual child than will allowing the immunization.

As public agencies, it is incumbent on public schools to consider the common good -- in this case, herd immunity. It is also important for school districts to consider the legal implications of requiring immunizations, and of the perceived ethical issues of seeming to coerce immunizations in its student population. Attorneys stand ready to support the party of the other side, regardless of which side the public school system finds itself representing. There are, however, ways to work toward protecting herd immunity -- which by state-level votes demonstrates the confidence of the majority of the people -- that do not pose legal risk.