These days, many consider diseases like measles, mumps, rubella, and pertussis to be things of the past. Mandatory vaccinations have largely eradicated them, along with several other contagious diseases, from the lives of the vast majority of Americans. Unfortunately for the cause of public health, a growing number of American parents are taking advantage of relaxing standards to opt out of inoculating their children. This growing problem raises the question of how the government should balance personal liberty and the right of parents to make health decisions for their children with their obligation to protect public health.

The laws on public vaccination are currently left up to the individual states. These vary a bit depending on where a person lives. Every state in America allows children to begin school without a full vaccination record for a verifiable medical reason; in this case the doctor believes that for some reason the child’s health is better served without the standard vaccines. The standard health problems that limit inoculation are usually fear of an allergic reaction or a compromised immune system. All but two states offer a religious belief exemption. This allows those whose faith prohibits vaccines for any reason to choose not to have their children inoculated. These exemptions have various degrees of strength from state to state. Finally, twenty states offer a Personal Belief Exemption. This allows anyone to opt out of vaccinating their children if their personal beliefs do not include vaccination for any reason. Anti-vaccination advocates use these Personal Belief Exemptions to prevent immunization for reasons as varied as fear of side effects, autism, and encroachment on their personal liberty. It is believed by vaccine advocates that these PBEs have have contributed to several mini-epidemics of formerly eradicated diseases and are likely to contribute to several more.

There are at least three recent measles outbreaks in North America. Vancouver is dealing with one due to infected foreign tourists in town for the recent Olympic games passing the disease to unvaccinated Canadians. Brooklyn is also suffering from an outbreak attributed to foreign tourists. San Diego is dealing with another one thanks to a small child bringing back measles from an overseas trip. He passed it on to other unvaccinated children and it was passed on to some children too young to have received the MMR injection.

These mini-epidemics demonstrate the need for mandatory vaccinations in an increasingly global economy. A basic tenet of the science of vaccinations is the importance of herd immunity. This term refers to how the safety to public health comes not just from individual protection but to the disease being unable to gain a foothold through widespread protection of a community. A CDC report on incidences of pertussis found a 90% higher incidence rate in states with lax standards for their PBEs. Studies such as this, combined with a growing rate of these mini-epidemics, make a strong case for increased regulations regarding inoculation of children.

Despite the obvious benefit to public health and safety, the federal government cannot just enact sweeping laws requiring inoculation. These regulations are currently under the umbrella of the states. Health organizations like the CDC and the FDA have no authority to enforce any sort of legislation on vaccines. In addition, the states have traditionally been reluctant to force those who claim religious exemptions into inoculating their children. Many states don’t even verify claims for religious reasons. Message boards abound on the internet helping parents evade the required rounds of treatment. McCarthy v. Boozman challenged the religious exemption in Arkansas on the grounds that it violated the 1st and 14th Amendment rights for non-denominational, nonsectarian individuals who might not qualify for the exemption. The case led to a loosening of vaccination standards and set less strict philosophical exemptions in their place. The view that forced inoculations are an encroachment on individual civil liberties has been around since the 19th century. This is the crux of the anti-vaccination movement; fears of autism and other health problems being caused by the vaccines themselves may make for flashier headlines, but these parents are demanding the right to make their own decisions regarding the health of their children.

How does the government balance these conflicting problems? No one wants the government legislating their parenting style, but the government is quick to step in when other domestic problems occur. Statistics prove the benefits of widespread vaccinations far outweigh any potential harm. However, many parents are adament that vaccinations have harmed their child and have violated their rights. Should there be more regulations to ensure that young children receive the necessary antibodies to combat preventable illnesses, particularly when their parents’ religious and philosophical convictions are against vaccinations?

Posted by Becky on April 19, 2010 at 4:01pm.