Mandatory Vaccinations: Exploring the Pros and the Cons

"That night she became agitated and feisty, then she fell asleep and never woke up."

This is one father's account of the negative affects that resulted from the mandatory Hepatitis B vaccination on his 5-week-old little girl (Blevins, 49). It isn't the only account that a parent has of their child suffering or even dying after receiving a mandatory vaccination; there are many. There are, however, also many accounts of children suffering under the wrath of the diseases that such vaccinations have been designed to prevent. Given these two very real and very different realities, should those who fear the adverse affects that vaccinations may have on their children be forced to vaccinate their children? There are many things that must be taken into consideration when deciding if the mandatory childhood vaccinations should in fact be mandatory. One has to weigh the potential risks of the vaccination against the potential risks of the diseases those vaccinations are designed to prevent. They must also take into consideration whether individual liberties out weigh public good, or if the public good is worth sacrificing to protect individual liberties. Most importantly we must come to a conclusion regarding whether or not the vaccinations are necessary, or if the diseases that we are vaccinating against do not pose a threat any longer.

Why should vaccinations be mandatory?

The obvious answer to the question of why vaccinations should be mandatory would be to prevent the harmful effects of those diseases that we vaccinate against; and they have been proven to be effective, sometimes for up to 15 years (Mansfield, 25). Do we know, however, what contracting such diseases results in? We know that the outcome can be bad, but just how bad? It is necessary to prove that the negative effects that can result from the contraction of one of these diseases are worse than the effects that can result from the vaccination itself, we must also show that the effects are more likely to occur.

Today there are nine mandated vaccinations and over 200 in development (Schumacher, 89). Because of this I feel it is very important for our society and government to make a decision regarding whether or not such vaccinations should be mandatory. Some of the diseases that we vaccinate for right now can have devastating effects on those who are unfortunate enough to contract them. Diseases such as the following:

Diphtheria is an acute respiratory illness where a membrane forms that covers the throat and as a result makes it difficult to breathe (Schumacher, 89).
Whooping cough, also known as Pertussis, is named after the whooping sound that is made by its victims during one of their terrible coughing spells (Schumacher, 89).

Mumps, yet another disease that there exists a vaccination for can result in swollen facials glands (Schumacher, 89).

Tetanus is a life threatening disease if contracted, whose mortality rate can be as high as 50%, and results from deep puncture wounds (Schumacher, 89).

A vaccination was created to protect individuals against Measles in 1963; this disease is a respiratory viral infection that can be identified by the pink spots it can produce, covering those infected (Schumacher, 89).

German Measles, or Rubella, is hardly seen in a child, however, can pose a serious risk to a pregnant woman in her first trimester (Schumacher, 89).

Hepatitis B, a rather new addition to the list of mandate vaccinations, is a disease that attacks the liver (Schumacher, 89).

Chickenpox is the most recent vaccination added to the list and the disease causes an irritating rash that covers the body (Schumacher, 89).

Polio is a disease the can result in paralysis (Schumacher, 89).

Meningitis is most commonly caused by Haemophilus Influenza, and results in the inflammation of the brain and spinal cord (Schumacher, 89).

These infectious diseases induce enormous morbidity and mortality throughout the world, infectious diseases are by far the leading cause of death for children in developing countries; therefore, the major goal of public health agencies in both industrialized and less-developed countries is to reduce the persistent occurrence of vaccination-preventable diseases (Phillipson, 611).

Many may wonder why it is necessary to have everyone vaccinated, since the majority of people to get vaccinated, and therefore the chance of the disease being spread is slim, however, herd immunity is necessary for the success of the vaccination (Freeman, 21). This means that a sufficient amount of people must be vaccinated in order to protect those who have been vaccinated, only to have the vaccination not work. If herd immunity is not achieved then if those who have unsuccessfully been vaccinated come into contact with those who have not been vaccinated, and who are carrying those diseases in which we vaccinate against they may catch that disease, and the chance of this maybe considered unfair by those who choose to vaccinate (Parkman, 40). It is not enough for those who chose not to vaccinate their kids to only take into consideration that most people in the United States are vaccinated and therefore the risk of catching such a disease is slim, since these diseases are not limited to the United States, and therefore illegal immigrants can spread them. Also, we can use undeveloped countries as an example of why we need to continue vaccinating.

In foreign countries where herd immunity is not achieved, the development of the country is slowed. Every minute a child dies of measles in Africa (Cuttino, 26), an unnecessary statistic, given that there is a vaccination that could prevent it. This incomprehensible amount of death occurring in an undeveloped country prevents such a country from becoming developed. If people are constantly dying from diseases like measles, then there will not be a large enough population to run the complex system it takes to develop a country. Thus the development of undeveloped countries is slowed by the lack of immunity to such diseases. In our country, which is developed, we would most likely suffer from a slowed economy, and since our economy is already not doing so well, I don't think it can afford another hit.

A specific example of what can happen when parents fail to vaccinate their children can be seen in Boulder, Colorado, in the community school of Shining Mountain Waldorf School (Allen, 40). Nearly half of the 292 students attending this school have not received all their vaccinations, and some have not received any. The result of the decrease in complete vaccinations in this town has been a revival of whooping cough (Allen, 40). In Colorado, the only requirement for exemptions from vaccinations is a parental signature stating such (Allen, 40). Many of the parents in Colorado and states like Colorado who are moving toward an anti-vaccination trend are doing so because of an unexplained increase in autism, asthma, and multiple sclerosis (Allen, 40). Shining Mountain director, Robert Schiappacasse, recalls his daughter's own experience with whooping cough, even though she had been immunized. She suffered no lasting effects, however, when the baby of one of the school's secretaries encountered this same illness he coughed himself into a hernia. Johnnie Egars, a parent of a child who attends Shining Mountain remembers how when his daughter came into contact with the illness she would cough and cough until she threw up and then begin the cycle all over again (Allen, 40). The constant presence of whooping cough in Boulder has some parents of outlying cities angered (Allen, 40). Like most in Boulder, Ann Marie Bailey, a nurse epidemiologist, is tolerant of the decision that parents are making not to vaccinate their kids, she cedes that parents have the right to decide what is best for their kid, even if that means not vaccinating them (Allen, 40). We then have to ask, however, what about those parents, who practiced their right by vaccinating their kids, yet the vaccination didn't work and now they are being infected by those who chose not to vaccinate?

Even if we feel that we could solve the debate over vaccinating rights by containing all those who chose not to vaccinate to a small town, we have to realize that this issue has to be dealt with on a global scale, since that is how is it affecting us. For example, there has been a heated debate over whether or not restaurant workers should be required to get a Hepatitis A vaccination before they are allowed to work. This debate stems from the highly publicized recent outbreaks of Hepatitis A in several food chains. There were two Subways in Seattle, a Carl Jr.'s restaurant in Spokane and The Crab House in Orlando Florida who all were hit by the Hepatitis A outbreak (Silver, 60). These restaurant workers prepare our food, and if they are not vaccinated for these types of diseases, then who knows how quickly an outbreak could spread. In this case you have to ask yourself, which do I value more, my individual liberty, or my safety? This may lead to someone arguing that if we did decide that we valued our safety more, there are still threats to safety that come with getting the vaccination itself, however, there are possible ways to prevent such threats.

The RAST Test, is a simple, risk free test that is used to determine if someone is allergic to a certain substance. This test is usually administered if someone has a skin condition preventing the standard skin test from being accurate. This test simply involves to drawing of some blood that will be exposed to the certain substance so that it can be monitored for certain reactions (HealthAtoZ.com). Although it is more expensive than the skin test, it has the capability of saving lives. If this test were to be performed before a vaccination was prescribed then the worry over an allergic reaction to that vaccination could be eliminated.

Why should vaccinations be optional?

"Give me liberty or give me death!" Is this really how we feel about vaccinations? In some cases this is the only option, sometimes if people are not given the liberty to decide whether or not to vaccinate they will die, granted they may not know this when they are denying the vaccination, but they maybe forced to learn the harsh lesson after being convinced or forced to receive the vaccination. This was the determining factor for Dawn and Scott Richardson, who weren't sure they wanted to vaccinate their daughter after their cat went into shock following an immunization, and then in the process of researching they talked to the parents of a 3-month-old who had not wanted to vaccinate their child, but were convinced by the doctor to do so, and afterwards their child ended up dying (Schultz, 65). It is for reasons like this that our country values liberty on both a public and individual basis so much, and therefore we do not favor community or collective decisions (Freeman, 21). These people feel that mandatory vaccinations, with no option, are a direct violation of their right to privacy. I think that if we are going to require that someone's privacy be violated, then we should make sure it is necessary, and in the case of vaccinations, it very well may not be necessary.

When it comes to things like vaccinations, it is usually the health conscience people who receive them, by this I mean those who come to the doctor during every cold, and illness, these people who most likely are health enough to be able to fight off the diseases that we immunize for, and if they aren't the first time, they will be able to build immunities against these diseases. Therefore, it is not right to allow healthy people to suffer vaccination related illnesses to protect those who are not health conscience (Freeman, 21), especially since vaccinations do not work for everyone, so in all reality we are having healthy people take a major risk for something that might not even be effective. Probably the most important reason that vaccinations should not be without option is that patients who go in to receive vaccinations do not necessarily know all the risks they face (Schumacher, 89).

Besides for the minor side effects that may be expected following vaccinations, such as fever, vomiting, soreness at the injection site, and gland swelling (Kritz, 34), vaccinations have also been blamed for autism and resultant bowel disorders (Burke, 10), asthma, multiple sclerosis, and in cases of allergic reactions, death (Allen, 40). Dr. Wakefield has a theory that autism stems from a severe immune reaction to something in the vaccination (Park, 53). He has published a paper showing that children with autism and bowel disorders have higher levels of measles particles in their intestinal tissue than normal children do (Park, 53). If what has been presented so far scares you, there are still vaccinations coming in the future to take into consideration.

Past Vaccinations Revisited: The Smallpox Vaccination

Over the course of the past year our country has suffered such horrific attacks without any warning, and this raises concerns for many. A major concern that our country is dealing with right now is the threat of biological warfare, smallpox to be more specific (Park, 47).

The smallpox vaccination has not been used since 1984 on children, and there has not been a case of smallpox on earth since 1977 (Cowley, 45). Part of the reason, however, that the risks of the vaccination were determined to outweigh the benefits was because the disease was declared eradicated in 1980 (Cowley, 45). It has since been discovered, however, that there is the possibility that countries such as Iraq have been able to obtain the disease and may be breeding it for the purpose of biological warfare (Park, 47). Thus the question arises; Should we resurrect the smallpox vaccination as part of the mandated vaccinations?

When the vaccination was originally abandoned it was believed that if a case of smallpox was discovered the "ring method" would be adequate enough is limiting the spread of the disease. This method involves vaccinating all those who would be in contact with the person who had contracted the disease (Cowley, 47). As it stands right now, doctors feel that this is still the best method to deal with the smallpox issue since the vaccination threatens to result in adverse reactions and in death in about 1 in a million cases (Cowley, 45). What happens, however, is doctors change their minds as threats increase, and they decide that the smallpox vaccination should be reintroduced? Knowing that doctors had originally abandoned the vaccination because of its known risks, and that no known cases of smallpox exist, should people be forced to receive the vaccination anyways? This question is not one that we have to answer right now, however, as threats increase, it may become one that we will have to face soon. With Isreal already starting to vaccinate their people (Guterl, 52), we quite possibly could be next inline to vaccinate.

In conclusion, I feel that vaccinations should not be without option. We, as free American citizens, should be allowed to chose whether or not we want to vaccinate our kids, and whether or not we want to continue our own vaccinations. It seems that the suffering under the wrath of both the disease and the vaccination are about equal. I feel however, that if you suffer under the disease you have a better chance of survival than if you are to suffer under the vaccination. This is probably partially due to the fact that when you are not vaccinated you kind of have an idea of what you might be suffering from when you catch the disease, however, with doctors not completely informing the parents of the possibly side effects of the vaccination, children who suffer from adverse effects as a result of the vaccination may not know what is going on. Also, I personally value my liberties, and the liberties of the public, more than I value safety from a danger that is not guaranteed but rather just a possibility. Reading the accounts given by parents who were convinced by their doctors to vaccinate their children against their better judgment was heartbreaking. Their regret for what they did, and their realization of what it means is more than I care to be responsible for, which is what would happen if I endorsed mandatory vaccinations for everyone. I do not want to be someone who supports something that could be responsible for killing someone's child. If someone's child were to die because of a lack of vaccination then that would be the result of an individual decision, and that would be something they would have to deal with.

Bibliography

Allen, Arthur. "Bucking the Herd." Atlantic Monthly. September 2002: 40, 42.

Blevins, Sue A. "Shots in the Dark." Reason. July 1999:49-51.

Burke, Maria. "Every Parent's Choice?" Chemistry & Industry. 18 February 2002:10.

Cowley, Geoffrey. "The Plan to Fight Smallpox." Newsweek. 14 October 2002:45-52.

Cuttino, Phyliss A. "Where a Child Dies Each Minute." UN Chronicle. June/August 2002:26.

Freeman, Phyllis. "The Biology of Vaccines and Community Decisions to Vaccinate." Public Health Report. January/February 1997:21.

Guterl, Fred. "Assessing the Threat." Newsweek. 14 October 2002:52.

Kritz, Francesca. "Total Vaccine Guide." Baby Talk. May 2001:34-35.

Mansfield, Peter. "Mindless MMR." The Ecologist. March 2002:25.

Park, Alice. "Are the Shots Safe?" Time. 6 May 2002:53.

Park, Alice. "Smallpox Vaccines for Everyone?" Time. 29 October 2001: 47.

Parkman, Paul d. "We Can't Forget the Value of Vaccines." FDA Consumers. July. August 2002:40.

Phillipson, Tomas J. "Private Vaccination and Public Health: An Empirical Examinations for U.S. Measles." The Journal of Human Resources. Summer 1996: 611-630.

Schultz, Stacey. "Parents Who Don't Vaccinate Play a Risky Game." U.S. News & World Report. 23 November 1998:65.

Schumacher, Karin. "Informed Consent: Should It Be Extended to Vaccinations?" Thomas Jefferson Law Review. Fall 1999:89-119.

Silver, Deborah. "Debate Over Hepatitis A Vaccinations Accelerates." Restaurants & Institutions. 15 April 2001:60.

"Tests & Procedures: RAST Test." HealthAtoZ.com 1999-2002. 4 November 2002 .