The current issue of the Journal of the American Medical Association (JAMA) has a viewpoint article on the current controversy on vaccines. The article, written by attorney Lawrence Gostin, focuses on the public health and vaccine law as well as discussing the ethics involved in the question. He also touches on a bit of the politics surrounding the vaccination controversy.
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Gostin starts often by mentioning that the number of some vaccine preventable diseases has been slowly increasing over the past several years. He focuses on the recent increase in measles cases, many coming from the outbreak that started at Disneyland this year and has spread to at least 17 states. He says that there is an ethical question here that involves parent's rights to raise their children as they see fit v. when that right causes harm to others.
He then discusses mandatory vaccinations and the germane law on the subject as well as exemptions to those laws based on medical, religious or philosophical grounds. He makes the point that states often allow for parents to refuse vaccinations because of political pressure, not because of medical evidence. Some states make it very easy to not vaccinate a child. They may just require a letter from the parents to the school district stating that the parents oppose vaccination. Other states may require a letter from the church that the parents attend. Other states may require additional, more official, paperwork. http://www.ncsl.org/.... 2015 Gostin also briefly mentions Rand Paul's statement on vaccinations causing physical and psychological disorders and debunks it.
The author suggests that some people are advocating for actions against the anti-vaccine group members. But he feels that legal sanctions against those who refuse to vaccinate may produce a public opinion blowback. And he advocates, to a degree, for some level of parental choice in vaccinating. Even though the scientific consensus is that vaccines are overwhelmingly safe and have saved tens of millions of lives over the past several decades, there is the extremely rare serious complication that may occur from vaccination. (A Pew research poll, released yesterday shows that 83% of Americans believe that measles vaccines are safe for children http://www.people-press.org/... [Though this poll was not available when the article was written.]) He feels that being proactive in taking legal steps against those who will not vaccinate might produce a public backlash against vaccine requirements.
Gostin suggests that a better way to address the problem and get more patients into compliance with vaccination would be to limit the "opt-out" ability and make those who attempt to not vaccinate their children follow a more rigorous and uniform procedure. He suggests things like having the parents undergo counseling about their ideas and be exposed to education about vaccines, requiring that they complete affidavits, following up with the health department, etc. In other words placing a burden on the parents that they would have to fulfill, rather than just allowing them to type up a letter and mail it in to their local school district.
The author's article is a good treatment of the public health issues, law and ethics surrounding vaccinations. He also touches on the political and media agendas that are involved. It's definitely well worth the time (probably about 5 minutes) to read through it and think about the points he raises. The article is available in its entirety, for free, on the JAMA website, no registration required. Read it here: http://jama.jamanetwork.com/...
I'm not sure that I agree with all of his points, but I can understand his reasoning. I think that the criteria to opt-out of vaccination should be clearly defined and have a rigorous scientific basis. We also need to consider whether there is a real need for exemptions for religious reasons or for philosophical reasons. I agree that there should be more of a burden on the parents who want to opt out. They should have to have some form of counseling and education about vaccines, their choices and the potential harms to their children, themselves and others. Perhaps those who had to invest their time, effort and money, had to justify their reasons, had to meet with health department officials to make their cases, would give serious consideration to consenting to vaccinations. Read the viewpoint and see what you think.