For years, public health officials have used vaccines to prevent bacterial and viral infections and their sequelae. Recognizing the importance of vaccination, many governments developed mandatory inoculation policies to protect their populace from life-threatening diseases. However, despite federal and state efforts to reinforce this prevention approach, a part of the public continues to have concerns regarding childhood vaccination. These groups, also known as anti-vaccine grouping, continually question the usefulness and safety of vaccines. Their fears have led to the rebellion against mandatory vaccination policies.
For the general population to be safe from infectious diseases, immunization coverage must remain above a certain threshold. Governments can attain this lower limit by mandating vaccination for all eligible individuals. The anti-vaccine groups’ concerns include vaccine safety, ethics, and questions regarding its usefulness. The purpose of this paper is to make a case for mandatory vaccination. I debunk anti-vaccine concerns and justify why vaccinations should be made compulsory. Vaccines should be made obligatory to protect the lives of individuals and communities.
Medical research supports the vitality of compulsory vaccination except where its administration is medically contraindicated. According to Newman, vaccines protect both individuals and communities from transmissible diseases (2). There is also strong evidence supporting the inoculation’s efficacy in facilitating the complete eradication of infectious disorders (Newman 2). For instance, according to Newman, the United States was able to eradicate smallpox and diphtheria through immunization (2).
The country has also managed to eliminate other diseases associated with high morbidity rates, such as measles, mumps, and pertussis. Another study showed that the benefits of vaccines outweighed the risks (Yoo 2). Yoo demonstrated that although present, the side effects of vaccines are rare (2). For example, the life-threatening consequences of the oral polio vaccine are one out of 2.4 million cases (Yoo 2). The extreme rarity of these side effects outweighs the risks associated with non-vaccination. Through vaccination programs, the American government has managed to protect the public from the consequences of these dangerous diseases.
However, the nearly-eradicated diseases are reoccurring due to vaccine hesitancy. Recently, the Centers for Disease Control reported 1,282 cases of measles, an ultimate high since 1992 (“Vaccines” 2). Perhaps, the diseases’ resurgence demonstrates why vaccination is vital. In California, the residents were exposed to an affliction from uninoculated international tourists visiting the California Disneyland theme park.
From the epidemiological data, it was evident that the infection rates would have been lower had the residents been vaccinated. The disease mainly affected uninoculated individuals and communities with large numbers of unvaccinated residents (“Vaccines” 2). Following the disease outbreak, California and other states implemented mandatory vaccination policies and even eliminated religious and philosophical immunization exemptions to raise the community’s inoculation coverage rate.
Experts suggest that mandatory vaccination increases the coverage rate, which, in turn, can result in herd immunity or community protection. Herd immunity is a concept based on the notion that society is indirectly protected against a disease when most people in the community are immune to it (“Vaccines” 2). It safeguards the vulnerable by limiting the probability of successful contact between infected individuals and susceptible people such as young children and those with immunocompromised health systems. When the majority of the population is immunized, it is unlikely that a transmitting case will come in contact with a susceptible individual.
Hence, the transmission chain or human-human interaction sequence is broken even if the community is not 100% immune. As in the case of measles, if the state had an obligatory measles inoculation requirement for all residents, the country’s high infection rates would have been implausible. Gaps in immunization coverage can lead to individual and community susceptibility to contagious illnesses. Compulsory vaccination can resolve this problem as it can increase society’s vaccination coverage and reduce immunization gaps.
Another normative concern linked to mandatory inoculation relates to its ethicality. Various scholars associate mandatory vaccination with the infringement of individuals’ liberties. In the medical sphere, adults have the right to reject health interventions, including immunization. It is considered unscrupulous for healthcare providers to impose health interventions on an individual for whatever reason. Unless an individual is deemed ineligible for making an autonomous decision, healthcare providers cannot inflict their values and beliefs on patients. The United States has policies that sanction immunization as a school entry criterion.
Some of these policies require seclusion and isolation of unvaccinated children during disease breakouts. These school inoculation mandates posit multiple ethical dilemmas, especially when a person’s or societal values and beliefs disagree with the vaccination. For instance, some parents have rejected the HPV vaccination because it contradicts the sex-abstinence message for some religious groups.
However, the ethics surrounding childhood immunization extend beyond personal interests and values. Another moral question that arises from obligatory immunization relates to whether it is ethical to capitalize on concepts such as “herd immunity” to coerce and persuade individuals to accept vaccinations. Ethicists strongly condemn the use of any form of coercion to make people accept risks they are not willing to take. Another moral objection associated with mandatory inoculation relates to distributive justice.
Is it fair to force a particular group to accept or assume certain risks so that another group benefits? Can refusal to immunize be justified even though the objections are based on baseless facts and misinformation? Who will bear the burden and risks of mandatory vaccination? Who will benefit from it? These questions are valid in the medical sphere precisely because personal autonomy, individual choice, and informed consent are the hallmark of healthcare in the United States. Because the U.S healthcare system values autonomy, a person’s refusal of a vaccine can hold ground.
Although these ethical issues may be reasonable, it is unjustifiable to reject vaccination on such grounds. Concerning the concept of herd immunity, inoculation is a common good for any society. The common good theory posits that an individual’s interest is inextricably linked to the community’s good (Yoo 3).
Each member of a given population is obligated to promote the safety and well-being of other community members. In this context, every person has a social responsibility to safeguard other society members from infectious disorders. Therefore, declining immunization for non-medical reasons can jeopardize the community’s well-being, contradicting the common good precepts. From a personal point of view, it is illogical for any individual to refute a policy that provides substantial protection to society’s well-being due to its low and rare risks. With the aforementioned ethical concerns, a balance between respecting patients’ rights and autonomy can be achieved.
Apart from ethical concerns, opponents of mandatory vaccination also cite the safety and effectiveness of vaccines. The typical vaccine safety myths include the following: vaccines cause autism, too many vaccines can negatively affect the immune system, and vaccines can result in life-long neurodevelopment impairment. The U.S. Supreme Court states that no state government should administer a vaccination that is “arbitrary or unreasonable” “cruel or inhuman” or “one that can seriously impair health or possibly cause death” (Newman 3). This limitation has been used by many anti-vaccine groupings as a legal justification to resist immunization. These groups believe that the vaccines’ contraindications listed by the Centers for Disease Control are proof of their unsafe conditions.
Some of the safety myths are not unfounded; instead, they have been supported by clinical studies. For example, the idea that vaccines can cause autism stemmed from the research conducted in 1998, whose findings revealed that measles, mumps, and rubella (MMR) vaccines could cause autism (Newman 3). At the time, the MMR vaccine was compulsory for all children in the United States. It was suggested that thimerosal, a preservative containing ethyl mercury used in making the vaccine, was responsible for the child autism cases (Newman 3). Furthermore, in the United Kingdom, the Health Protection Agency announced that the vaccine against the swine flu could cause Guillain-Barre, a life-threatening nerve disease. Dr. Sherri Tenpenny, a vaccine expert, further argues that “vaccines’ efficacy leaves much to be desired, yet they expose recipients to a wide array of risks” (Newman 3).
Tenpenny used the Hepatitis vaccine to illustrate her point. According to Tenpenny, despite the hepatitis vaccine poses many risks, it only provides ten-year protection against the virus (Newman 3). By the time the vaccinated individual is 12 years old, the immunity against the virus is gone, which required the person to revaccinate (Newman 3). Such kind of proven vaccine ineffectiveness contributed to the hesitancy and opposition against vaccines.
However, these concerns have been debunked by a series of clinical trials and epidemiological studies. Contrary to the perception that MMRs are unsafe, studies have demonstrated that MMR vaccines are not dangerous (Yoo 3). The United Kingdom retracted all publications that insinuated a link between autism and MMR vaccines. Multiple independent reviews have demonstrated that MMR vaccines do not cause autism.
It was determined that the speculated link between MMR and autism was caused by the misrepresentation of biological and clinical data in the former studies. Subsequent surveys refuted the inferred link and established no correlation or causative connection existing between autism and MMR immunization. Therefore, the claims that MMR vaccines are unsafe because they can cause autism is a misconception and, therefore, not a justifiable excuse for rejecting vaccinations.
Another safety concern is based on the notion that too many vaccines can weaken the immune system. A case-control study conducted in six United States healthcare organizations demonstrated that there are no immunological differences between children who had previously been exposed to vaccine antigens and those who had not (Yoo 3). Notably, a ten-year study involving 805,206 children did not find any link between vaccines and immunological deterioration in vaccinated children (Newman 3). The findings of these studies have been supported by other epidemiological research as well.
As previously stated, the ethyl mercury in thimerosal preservatives contained in MMR vaccines was believed to be the primary causative agent for autism. While it is true that mercury is a neurotoxin, the ethylmercury present in MMR vaccines is different from the toxic methylmercury (“Vaccine” 2). The ethylmercury in MMRs can be quickly eliminated from human tissues and, therefore, cannot accumulate in the human body (“Vaccine” 2). Besides, all vaccine components, including preservatives and adjuvants, have to be extensively tested before clinical use. Additionally, vaccinations cannot be administered to individuals for whom the vaccines are contraindicated.
Unless there is a substantial risk of experiencing a negative interaction, rejecting a health intervention only because it has a contraindication is unreasonable. All health interventions carry a certain level of risk: most medical interventions, including drugs, have side effects and always have contraindications for specific health populations or conditions. For example, antiretroviral drugs (ARVs) have several contraindications but are still administered due to their proven benefits. From these studies, it can be surmised that vaccinations are safe and, therefore, should be made mandatory.
The government should mandate vaccinations because they are safe, effective, ethical, and can protect the lives of individuals and the community. The concerns expressed by the anti-vaccine groups are baseless and do not hold any scientific or ethical ground. Various clinical and epidemiological studies have refuted the claims that vaccines are unsafe and ineffective. Therefore, the commonly cited anti-vaccine reasons are false and misleading. Concerning the ethicality of mandating vaccines, this study has demonstrated why mandatory vaccines are ethical. It is socially irresponsible and unethical for any individual to forgo a practice that can prevent the deterioration of other community members’ lives and health. Therefore, the government must reduce transmissible diseases for the common good.
Vaccines should also be made mandatory because they can protect lives. By mandating vaccines, the U.S. government can raise the coverage rate, which may, subsequently, increase herd immunity. Boosting herd immunity indirectly protects the community from infectious diseases. However, because erroneous clinical studies have contributed to vaccine misconceptions, healthcare providers should re-educate the public on vaccination. Health education can improve public awareness of the safety and effectiveness of vaccines.
Works Cited
Newman, Alex. There Is Evidence That Vaccines Promote, rather than Eradicate disease. Edited by Noël Merino, Gale, 2012.
“Vaccines.” Gale, 2020. Gale in Context: Opposing Viewpoints. Web.
Yoo, Jung Kim. The Anti-Vaccine Movement Disregards the Great Success of Vaccines. Edited by Roman Espejo, Gale, 2014.