Childhood Vaccination Mandates

Ryan Quinlan
Professor Bruce
English 301
9 November 2016
Childhood Vaccination Mandates

A vaccines fundamental purpose is to

Upon achieving herd immunity, the disease has

eliminate diseases, which makes it no surprise

almost no opportunity to infect those who are

that the Center for Disease Controls (CDC) Ten

not capable of being immune, essentially

Great Public Health Achievements of the 20th

eradicating the disease from that portion of the

century had vaccination at the top of their list

population. Although vaccines have done

of initiatives (Abrevaya and

Mulligan, 2011, p. 966).
Vaccinations are of key
importance when it comes to
public health. They provide
individuals protection from
disease and, when

Vaccines have been

instrumental in eradicating
deadly diseases like small
pox and polio and
dramatically decreasing the
incidence of diseases like
measles and mumps
-Jason Abrevaya and Karen Mulligan,
2011, p. 966

wonders for public health,

there is still much
controversy as result of a
study conducted in the
United Kingdom in 1998. In
the aforementioned study,
Wakefield et al argued that

implemented in high numbers, can lead to herd

the MMR vaccine contained toxins that could

immunity, which Jason Abrevaya and Karen

eventually adversely affect the brain. However,

Mulligan of the University of Texas at Austin

researchers have since replicated that study in

define as a level of immunization within the

larger samples in response to Wakefield et als

population that effectively eliminates the risk of

relatively smaller sample and have not been

an outbreak of the disease (2011, p. 966).

able to find a connection between the vaccine

Childhood Vaccination Mandates

and the side effects mentioned in the 1998

the Wakefield et al. study argued that the

study (Recame, 2012, p. 76). Since 1998, the

measles, mumps, and rubella vaccination

controversy of side effects have lingered around

(MMR) contained toxins that could penetrate

the topic of vaccines. Despite the continued

the gastrointestinal tract, eventually affecting

concerns of parents that vaccinations cause

the central nervous system (CNS) and the brain

harmful diseases, childhood vaccinations should

(Recame 2012, Pg. 76). These published findings

continue to be mandated for children entering

are what lead to many controversies and

the public school system because the benefits

distrust of vaccines and sparked many fears

to public health ultimately outweigh the fear of

about other diseases like encephalopathy or

vaccinations causing serious side effects.

epilepsy which could be caused by the

Why do parents choose not to vaccinate?

immunization of children. Emily R. Wolff and

Medical Doctor Dianne J. Madlon-Kay

Vaccinations are a clear benefit to the

war on disease and are essential to eradicating

conducted a study that examined an outbreak

of measles in Minnesota with the purpose of

diseases from

determining if it was less

populations, but

probable for Somali

many parents are

parents to immunize

choosing not to

their children for MMR

vaccinate their

and additional diseases.

children with little

The results concluded

evidence that any

that Somali parents

harm can come from

Infant Vaccination

immunizations. In

https://newsroom.unsw.edu.au/news/science/evolutionwhooping-cough-bacterium-could-reduce-vaccineeffectiveness

the United Kingdom,

were more likely to

choose not to immunize
their children with the

Childhood Vaccination Mandates

MMR vaccine because they believed that the

once back in the United States (Wolff, E. R., &

vaccine could cause autism. The researchers

Madlon-Kay, D. J., 2014, p. 458). After the

also deemed that the sources that contributed

introduction of the vaccine controversy, it only

to parents beliefs of a link between autism and

took a little over a decade for people to cease

the MMR vaccine were friends, the internet,

adhering to the precautionary practice of

and television shows (2014, p. 460). This study

getting the MMR immunization, which had

shows that hearsay has the power to persuade

taken over 30 years to defeat the deadly

parents without any scientific sources to

disease. Since the introduction of the Wakefield

confirm that there is any real harm of using a

et al. study that sparked the public scare that

vaccine.

the MMR vaccine was linked to autism, the

The danger of avoiding immunization

study has been replicated with various

participants and larger sample sizes. Today,

Relying on tabloid journalism and taking

word of mouth as fact without investigating the
validity of the evidence is a dangerous practice
which has contributed to a reversal in disease
eradication. The year 1963 marked the
introduction of an effective vaccine for measles
was that led to a huge drop in cases of measles.
In the year 2000, it was confirmed that the
disease had been eradicated from the United
States, but in 2011, 222 cases occurred, many of
which were credited to travelers who became
infected when abroad and spread the infection

none of these studies have produced any

evidence of linking the MMR vaccine and
autism (Recame, 2012, p. 76). Since the
publishing of the Wakefield study, many people
have continuously heard news of its findings,
and even today people still believe it to be true
despite a wealth of contradictory evidence
debunking its original claims. Rumors Have it,
an article analyzing a study conducted by MIT
professor of Political Science Adam Berinsky,
makes the discovery that attempts at
debunking rumors may only have adverse

Childhood Vaccination Mandates

effects of strengthening them (American

behalf of the child (Sheather, J. 2013, p, 1389).

Association, 2015). This is an issue as many

It is understandable that a parent may view a

unfounded accusations can only grow stronger

mandate for the vaccination of their child as a

the more they are scientifically discredited. In

requirement for entering the public school

the article, Berinsky is quoted Pure repetition,

system as a violation of their rights as legal

we know from psychology, makes information

guardians, but when those rights can affect the

more powerful (American Association, 2015).

health of others, some liberties must be

The debunking of the link between vaccination

reduced. Julian Sheather, Ethics Manager at the

and Autism, although scientifically sound, may

British Medical Association proposes the

only act as a reminder of peoples fears,

scenario that if one were to refuse to be

resulting in growing numbers of people

vaccinated and become a carrier of a disease

believing against scientific proof that vaccines

and then put others at risk of an avoidable

can cause autism or other diseases.

illness, there is a ethical obligation for parents

The question of rights

to immunize their children as it effects the

health of others (Sheather, J. 2013, p, 1390). For

Another controversial topic surrounding

vaccines is that many people feel that
mandating immunizations infringes upon
individual rights and believe they should have
the right to choose whether or not to vaccinate.
When it comes to the medical decisions of a
child, it falls on the childs parent or legal
guardian to act in the childs best interest,
giving parents the right to make decisions on

this reason, a mandate exists throughout the

entire U.S. to vaccinate children before they
enter school with exemptions for medical
exceptions when the vaccination can harm the
childs health and, in twenty states, for personal
or philosophical views (Buttenheim, A. 2011, p.
1). The personal view exception in those twenty
states has gained momentum in recent years, as
the number of kindergarteners with [personal

Childhood Vaccination Mandates

belief exceptions] rose from 9,201 in 2008 to

protected, neither are the individuals who

11,503 in 2010, a 25% increase (Buttenheim, A.

refused vaccination (Hendrix, K. S., Sturm, L. A.,

2011, p. 2). These exemptions pose a problem,

Zimet, G. D., & Meslin, E. M., 2016 p. 274).

and in high numbers, can render the whole

The argument for immunization

mandate ineffective to public health. They

have allowed diseases to remain in the school
population as many children never become
immune. When many children in a population
are not immunized, there is no possibility of
herd immunity, putting those with
compromised immune systems and those
unable to become immune at risk. With this in
mind, new approaches should be implemented
to help reduce exemptions and better counsel
parents away from refusing vaccines to help
protect those who are vulnerable and cannot
make the choice to protect themselves
(Buttenheim, A. 2011, p. 4). It is important to
help people understand that when someone
refuses to immunize themselves or their
children for reasons that arent medical, and
when more individuals choose to act this way,
the well-being of the community is endangered
and when the community is no longer

The Main Campus of the Centers for Disease Control and

Prevention in Atlanta
http://abcnews.go.com/Health/Wellness/cdc-atack-aircontainment-problems/story?id=16557248

In addition to the positive effects to

vaccines already mentioned, there are many
benefits beyond those that just combat the
controversies against them. In the U.S., four
diseases that are known to have killed
thousands, smallpox, polio, measles, and
rubella, are all now eliminated from the U.S.
population and there are many others that have
been significantly reduced, such as tetanus,
mumps, varicella, diphtheria, hepatitis A and B,
and pertussis thanks to immunization (Carrillo-

Childhood Vaccination Mandates

Marquez, M., & White, L., 2013 p. 46). It is no
secret that vaccinations have provided
tremendous benefits to the United States and
the health of its people with the incredible
number of lives that have been protected
against diseases. The Pediatric Academy Society
claims that juvenile vaccinations in the U.S.
avert roughly 10.5 million cases of disease and
33,000 fatalities yearly (Carrillo-Marquez, M., &
White, L., 2013 p. 46). Outside of the vast
amount of lives that vaccines save, there is a
financial benefit as well. The CDC clarifies that
for each one dollar expended on vaccines, the
public theoretically saves six dollars and thirty
cents in medical expenditures because they are
able to avoid the treatment of people who are
unvaccinated (Carrillo-Marquez, M., & White,
L., 2013 p. 46). Vaccines save the lives of the
public and save their money too, making them
an essential public good.

Final considerations
These decisions of whether or not to
vaccinate our children will shape if they will live
in a world where they have to worry about
diseases that were eradicated generations ago.
It is important for parents to educate
themselves on the safety and likelihood of side
effects surrounding vaccination and when
utilizing personal belief exceptions, keep them
to a minimum. This way, all those who use
exemptions, are for religious and medical
reasons keeping those who are not immunized
as a minimum. With respect to the many
positives that are attributed to immunization,
vaccinations should remain to be mandated for
children to enter the public school system
because it helps ensure an overall healthier and
safer public.

Childhood Vaccination Mandates

References

Abrevaya, J., & Mulligan, K. (2011). Effectiveness of state-level vaccination mandates: Evidence from the
varicella vaccine. Journal Of Health Economics, 30(5), 966-976.
American Association for the Advancement of Science. (2015). Rumors Have It. Retrieved from
https://www.eurekalert.org/pub_releases/2015-05/miot-rhi050415.php
Buttenheim, A. (2011). Exposure and vulnerability of California kindergarteners to intentionally
unvaccinated children. LDI issue brief, 18(1), 1-4.
Carrillo-Marquez, M., & White, L. (2013). Current controversies in childhood vaccination. SD Med, 46-51.
Hendrix, K. S., Sturm, L. A., Zimet, G. D., & Meslin, E. M. (2016). Ethics and Childhood Vaccination Policy
in the United States. American Journal Of Public Health, 106(2), 273-278.
Lesser, E. (2012). The main campus of the Centers for Disease Control and Prevention in Atlanta.
Retrieved from
http://abcnews.go.com/Health/Wellness/cdc-atack-air-containmentproblems/story?id=16557248
QMI Agency. (2014). Evolution of whooping cough bacterium could reduce vaccine effectiveness.
Retrieved from https://newsroom.unsw.edu.au/news/science/evolution-whooping-coughbacterium-could-reduce-vaccine-effectiveness
Recame, M. A. (2012). The Immunization- Autism Myth Debunked. International Journal Of Childbirth
Education, 27(4), 76-78.
Sheather, J. (2013). Should childhood MMR vaccination be compulsory? Rights, duties and the public
interest. Human Vaccines & Immunotherapeutics, 9(6), 13891391.

Childhood Vaccination Mandates

Wolff, E. R., & Madlon-Kay, D. J. (2014). Childhood vaccine beliefs reported by Somali and non-Somali
parents. The Journal of the American Board of Family Medicine, 27(4), 458-464.