Brian Poland

Conversations About Life

Term Paper
4/22/14
Mandatory Vaccines
Vaccines have been available to the masses in the United States since the 1950s. As a
direct result diseases that used to show up in the hundreds of thousands of cases per year now are
kept to nearly zero cases. More and more vaccines for extremely contagious diseases have been
developed as the years have gone by, and the number of vaccines that kids are required to have
has increased to 14
1
. Children receive 26 inoculations by the age of two
2
. In spite of advanced
technology regarding vaccines, vaccine preventable diseases are on the rise again in the United
States. For example, cases of the measles in the United States have been at around 60 per year
over the past 10 or so years, but recently the numbers have been closer to 200 cases
3
(220 in
2011 and 112 as of April 19, 2014)
4
. In California there have already been 56 confirmed cases
this year, and in New York City there have been 25
5
.While the numbers are nowhere near the
number of cases that were reported in 1950 (around 500,000 in the US)
6
, this is high for a disease
that has a vaccine that is 99% effective after 2 boosters. Cases of whooping cough in infants and
even mumps cases have been reported this year in increased numbers as well, and a general trend

1
"Measles." WHO. N.p., n.d. Web. 09 Apr. 2014. Measles
2
"The Problem With Dr Bob's Alternative Vaccine Schedule."
3
Sheridan, Kerry. Yahoo! News. Yahoo!, 06 Apr. 2014. Web. 10 Apr. 2014.
4
Measles
5
Alcindor, Yamiche. "Anti-vaccine Movement Is Giving Diseases a 2nd Life." USA Today. Gannett, 08 Apr. 2014. Web. 19 Apr.
2014.
6
Measles
of vaccine preventable diseases being on the rise is apparent. This growth happens to be
occurring at the same time that an anti-vaccine movement is gaining popularity. In Idaho,
Illinois, Michigan, Oregon and Vermont 4.5% of kindergarteners went unvaccinated for non-
medical related issues
7
. Outspoken advocates of forgoing all vaccines have concerns, including
that it is unsafe and that big medicine is just trying to get more money out of Americans
8
. The
policy across the U.S is varied; in 20 states parents have the right to opt out of vaccines for
religious or philosophical reasons, yet in some states when parents refuse to vaccinate they can
have their children taken away by child protective services. The right to not vaccinate children
has become a debated issue. The arguments against vaccinating, however, simply dont have the
science to back up the claims, and the human rights argument and the utilitarian argument
strongly support that the policy should be that children, barring a medical complication, should
have to get vaccinated, especially when the effect on the community as a whole is taken into
account.
One of the main arguments that people give for allowing parents the choice to opt out of
vaccinating their child is a rights argument. They claim that the parents have the right to make
judgment calls, medically or morally, for their children until they are old enough to know better.
Our current system reflects this belief to a great extent, and parents have a lot of control over
their children up until the age of 18. For example, parents have the right (within reason) to make
medical decisions for their children until they are 18 with regards to hospital treatment. For
perhaps a more closely related example, parents have the right to circumcise their children before

7
"Measles Outbreaks 2014." About.com Pediatrics. N.p., n.d. Web. 08 Apr. 2014.
8
Raff, Jennifer. "Dear Parents, You Are Being Lied To." The Huffington Post. TheHuffingtonPost.com, 08 Apr. 2014. Web. 10
Apr. 2014.

they are even able to talk. This is not a medically necessary procedure in most cases, but it is a
religious or moral decision that the parents make for the child. (it is, however, another argument
completely whether this should be allowed). The logic behind this is that the child is unable to
properly make the decisions for itself, so the parents are responsible. The moral and physical
wellbeing of the child is placed in the hands of the parents.
While discussing rights, however, the counterargument to this has to be brought up. What
rights does the child have to protect itself from parental or other harm? Children do have the
same basic rights that adults have according to the International Human Rights Law (with some
suspended until the age of 18 such as the right to marriage). Arguably, the childs right to life is
infringed upon in this circumstance. Harm statistically is more likely to befall the child if it goes
unvaccinated. This increased chance for contracting the diseases and the potential harm the child
could receive make for a compelling argument that not vaccinating creates a harmful situation
for children. Even if the chances of contracting the disease are less than 1 in 100,000 the kind of
suffering that would occur makes this a significant point.
Interesting to note is that many of the concerns that anti-vaccination advocates bring up
are either based on false studies or invalid claims
9
. The study that linked autism to vaccinations
has been redacted for falsifying results, and numerous independent studies have confirmed that
autism is not a side effect of vaccines. The only legitimate claim that parents make is that in a
miniscule amount of cases an unpredictable allergic reaction can occur. This, however, is mild
and nowhere near comparable to the diseases the vaccines prevent.

9
"The Problem With Dr Bob's Alternative Vaccine Schedule." The Problem With Dr Bob's Alternative Vaccine Schedule. N.p.,
n.d. Web. 11 Apr. 2014.
People that are against vaccines say that because there are pros and cons the choice is
theirs. If the parents see that the benefits outweigh the downsides then they can vaccinate. They
argue that it is a matter of perspective and judgment and so it should be deferred to the parents.
However, the science is there to back up that the medically responsible decision is to vaccinate,
and the diseases that the child could contract are painful and in some cases disfiguring and
deadly. Vaccines, according to all studies, are incredibly safe, and therefore the rights argument
is won by the child. The childs right to a healthy life is infringed upon by the parents illogical
decision. The parents delusions about the hazards of vaccines are not credible and cannot be
taken into account here. This is similar to the scenario in which parents refuse lifesaving
treatment in hospitals. Parents that refuse treatment for their children are often overruled by a
medical board and treatment is administered anyway, regardless of philosophical reasons given
by the parents. When the potential harm to the child is great, parents lose the right to choose in
many cases, and so should be the case in this situation.
The second arguments (concerning parents vs children) that can be made by both sides
are utilitarian arguments. The relative happiness in this case is rather trivial, as many parents
seem irrationally upset by the fact that their children need to be taking vaccines, and the
percentage of these children that actually contract disease has to be factored into how much
suffering the children actually go through. Irrational or not though, happiness is happiness, and
depending on your point of view, you could say that the happiness of the parents outweighs the
potential unhappiness of the children, or that the unhappiness caused by the diseases (probability
factored in) outweighs the happiness of the parents. It is hard to definitively say one way or
another who wins the utilitarian argument in this case, especially when dealing with such low
odds. Certain diseases cause much more harm than others, and considering that many parents are
against vaccines based on the sheer number of them, perhaps at a certain number of vaccinations
happiness is maximized. This is nigh on impossible to determine, and a much more pertinent
utilitarian argument will be made later.
Another aspect of the effects of unvaccinated children is the community impact that it
has. Vaccines are 99% effective in creating immunity, but only around 94-96% of the population
needs to be immune to eradicate a disease
10
. This is the power of herd immunity. Infectious
diseases, when confronted with a population that is 96% immune, cease to infect people. The
disease fails to penetrate through the sea of immune people. An important thing to know about
vaccines is that in immunosuppressed children, or otherwise unhealthy children, vaccines may
not be an option. Hundreds of thousands of people in the US are unvaccinated not by choice
11
.
Infants under the age of one oftentimes have immune systems that cannot handle the vaccines
available as well. These people rely on herd immunity to avoid the diseases. The collective
immunity of the population keeps them from getting the diseases, but if more and more people
are unvaccinated by choice the community loses its herd immunity. The diseases dont
discriminate between those who went unvaccinated for medical and nonmedical reasons (and in
a large amount of cases the diseases do a lot more damage to the immunosuppressed). An
example of this is when a 9 month old Massachusetts baby died of whooping cough
12
, a vaccine
preventable disease. The infant could not have received the vaccine yet, and it was relying on the
herd immunity of the community around it to support it until it could. The impact of people that
dont vaccinate on a community is easily seen. States that have the religious and philosophical
exemptions have higher rates of the diseases
13
, and in small towns in which local preachers or

10
Measles
11
Offit, Paul A. "Medscape Log In." Medscape Log In. N.p., 12 July 2010. Web. 19 Apr. 2014.
12
Alcindor
13
Offit
other figureheads speak out against vaccination outbreaks occur more frequently
14
. Those who
can vaccinate have a social obligation to get vaccinated in order to prevent the diseases from
spreading through the population, causing harm to those that would have vaccinated if they had
the chance to.
From a rights standpoint multiple things have to be considered. Everyone has a right to
life, and everyone has a right (with certain restrictions) to interacting with people in a public
setting. Children do have the right to attend public school, and as it stands in the states with the
exemptions, children can attend school without getting vaccinated
15
. Given this fact, and the
nature of many of the diseases that are vaccinated for, it is reasonable to make the claim that if
someone were to be infected, they would go to school and expose the others to the disease
(measles are contagious up to four days before the rash appears). Unvaccinated students put
students that could not vaccinate in harms way. This is a completely sensible reason to not want
your children to go to school, especially if the reason that vaccination was missed was some sort
of immune system weakness. In this scenario, it makes sense that it is considered a violation of
the right to attend a public school. By not vaccinating their children, these parents are infringing
upon the rights of other parents and other kids to attend public school. This idea translates into
other public places, and even hospitals. Hospitals especially support the rights argument for
mandatory vaccines, as people have an undeniable right to hospital treatment in the face of a life
threatening injury or disease. This being said, people who are in hospitals are much more
susceptible to disease, and if the extremely infectious diseases that have been eradicated by
vaccines are resurfaced, massive outbreaks could occur and complications could endanger
peoples lives and wellbeing. People that could not vaccinate have to either forgo schooling and

14
Offit
15

being in crowded public places or face an environment where contracting a disease is a reality.
Given the nature of the diseases vaccines prevent, it makes sense to say that by not vaccinating
their children these parents are causing harm to those that could not vaccinate. This is a clear
violation of rights and this supports the idea that vaccines should be mandatory regardless of
parental objection.
Another powerful argument for the mandating of vaccinations is a utilitarian argument
with respect to the community. The happiness of the parents and kids from both sides has to be
considered in this case. Obviously the happiness of the parents and kids that were unvaccinated
remains the same as discussed earlier, but now the happiness of the others in the community has
to be considered as it has been decided that going unvaccinated affects the entirety of the
community. If some avoid vaccination the paranoia and/or the negative consequences of public
isolation cause a significant amount of unhappiness to those that could not vaccinate, and this is
assuming that the disease doesnt spread through the community. If the disease spreads, then an
entirely new level of unhappiness is reached by the parents and children that contracted the
disease. Those with the disease deal with the symptoms and the rest of the non-immune
community worries about contracting the disease. The movement against vaccines is bigger than
it should be, but it is not big enough to justify a utilitarian argument in its favor. The unhappiness
of the community would outweigh the happiness of the parents that refused vaccination. The
utilitarian argument goes to those in favor of mandatory vaccines.


Coincidentally, the measles outbreak of 1989 was the reason that many states made
vaccinations mandatory in the first place. Not enough people were vaccinated and cases went
from 3000 a year to 18000 a year for a period of roughly 2 years
16
. Vaccines were not as
effective back then, but researchers attributed the declining in vaccinations to the outbreak. This
created a panic and states pushed legislature that mandated vaccines. Parents rushed to get
vaccines for their children and researchers pushed for a more effective vaccine. The effect of this
was a rapid decline in measles cases immediately following the huge outbreak
17
. Measles was
even declared eradicated in 2000
18
. A similar situation to the one in 1989 is happening now as
more and more children are going unvaccinated. Measles is on track to have three times as many
cases as in 2009, nine years after the disease was declared eradicated. If more and more children
go unvaccinated even more diseases may be given a second life. The trend is undeniable, the
science is clear, and the rights and utilitarian arguments both point to the same policy change. All
things considered the policy nationwide should be changed so that vaccines are mandatory for
children, regardless of parental opposition.






16
Orenstein, Walter A. "The Role of Measles Elimination in Development of a National Immunization
Program." Medscape. N.p., n.d. Web. 19 Apr. 2014.
17
Offit
18
Alcindor
Works Cited

Alcindor, Yamiche. "Anti-vaccine Movement Is Giving Diseases a 2nd Life." USA Today.
Gannett, 08 Apr. 2014. Web. 19 Apr. 2014.
"Measles." WHO. N.p., n.d. Web. 09 Apr. 2014. Measles
"Measles Outbreaks 2014." About.com Pediatrics. N.p., n.d. Web. 08 Apr. 2014.
Offit, Paul A. "Medscape Log In." Medscape Log In. N.p., 12 July 2010. Web. 19 Apr. 2014.
Orenstein, Walter A. "The Role of Measles Elimination in Development of a National
Immunization Program." Medscape. N.p., n.d. Web. 19 Apr. 2014.
Raff, Jennifer. "Dear Parents, You Are Being Lied To." The Huffington Post.
TheHuffingtonPost.com, 08 Apr. 2014. Web. 10 Apr. 2014.
Sheridan, Kerry. Yahoo! News. Yahoo!, 06 Apr. 2014. Web. 10 Apr. 2014.
"The Problem With Dr Bob's Alternative Vaccine Schedule." The Problem With Dr Bob's
Alternative Vaccine Schedule. N.p.,