Should vaccines be mandatory?

Gary Finnegan

Gary Finnegan

March 24th, 2017

Gary Finnegan
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‘The Great Debate: experts explore the balance between freedom of choice and community responsibility’

Most of us have the vaccines our doctors recommend, helping to reduce the risk that we – and those around us – will suffer vaccine-preventable diseases.

But what happens when people opt out?

If you decide not to visit your dentist, choose to eat badly or refuse to wear a helmet while cycling, you put yourself at risk. The direct impact on other people’s health is (pretty much) zero.

With vaccines, the health of your community could be affected. You might catch – and spread – infectious diseases at school, in the workplace or in public places.

If enough people in a community are vaccinated, ‘herd immunity’ can be achieved. This makes it very difficult for infectious diseases to spread because a significant majority of people are protected. 

Given that we have a stake in our neighbours’ vaccination status, is it reasonable to insist that everyone have their vaccines? Should it be a condition of accessing education, employment or social payments?

To help understand the issues at play, we sat down with some leading experts and asked whether mandatory vaccination is the answer to minimising the impact of diseases such as measles, diphtheria and pertussis.

Dr Julie Leask of the University of Sydney, says regulation is useful but that absolute mandates go too far. “We need requirements that encourage parents to get their children fully vaccinated,” she says. “But there need to be exemptions for people that don’t vaccinate. It should be harder to get an exemption than to get a vaccine.”

Regulations work, she notes, and help to push the vaccination rates up. However, hard-to-get exemptions are an important component of ‘firm but fair’ policies. Removing other barriers to vaccination, educating health providers and providing strong information systems are also vital pieces of the puzzle.

It’s not all about childhood vaccination. Dr Leask also points to the risk of disease outbreaks resulting from low vaccination rates in adolescents and adults. This, she says, should be part of a multi-part approach to improving public health rather than expecting mandates alone to solve the problem.

Professor Saad Omer, Emory University, takes a similar view. Mandates should, he believes, be used as ‘nudges’. There should be exceptions for those with strong objections but these must be more difficult to secure than the vaccine itself.

“We have shown that there is a reduction in vaccine refusal – and increase in vaccine coverage – if you change the balance of convenience of obtaining exemptions,” he says.

From an ethical perspective, this is the most defendable option, according to Professor Omer: “That strikes the balance between individual autonomy and the community benefit of vaccines.”

Not everyone is so sure that this approach goes far enough. Will appealing to people’s sense of community, and nudging those who are a little hesitant, be sufficient to reach herd immunity (or ‘community immunity’ as it is something known).

Dr Katie Attwell, Murdoch University in Australia, explains why the concept of ‘community immunity’ lacks meaning for people in an individualistic culture.

“The concept of doing things for others has started to break down with the advent of neoliberal ideology, the cult of the individual, and with the idea that if we make decisions about our lives to benefit ourselves we are rewarded,” she says. “It’s very hard to then make claims that when it comes to vaccination you should be looking after other people.”

In addition to this “community deficit”, Dr Attwell says that for some who refuse vaccines, the very idea of herd immunity is open to question. They may not hold a scientific view but, unfortunately, some people remain unconvinced by research.

“Some parents would not see themselves as free-riders benefitting from other people’s decisions to vaccinate,” she explains. “They don’t see that vaccines work, and that what others are doing impacts on their health and wellbeing.”

In light of this, health policymakers have a serious problem: they are pitching the concept of community immunity to individuals whose faith in ‘community’ and ‘immunity’ are strained.

Now what?

Dr Attwell says it’s time to look at all “tools in the toolbox”. These include persuasion, appealing to people’s values, and ensuring vaccines are accessible.

If all of this is in place and vaccination rates are too low, it may become necessary to consider more “coercive” options. The alternative would be to facilitate outbreaks of disease.

Does this mean we should reluctantly embrace vaccine mandates in Europe or would it do more harm than good?

Watch the videos to get the full story and share your thoughts below.

Comments

  1. Laurence Wells

    Laurence Wells

    May 6th, 2019

    There are several problems with mandating vaccinations. First of all, it directly contravenes patient autonomy. Secondly, it can lead to further deprivation and isolation of groups of people in the community. Thirdly, these groups become hotbeds for the diseases we vaccinate against, and can become a health hazard for the broader community.

    The difficulty lies with the fact that vaccination is very much an issue of public health. A decision to not vaccinate directly impacts on others. With childhood vaccination, there is the additional problem of parental rights vs a physician’s duty of care, and child safeguarding.

    The ideal way is to persuade people via education, to give them all the information available about diseases, about how vaccines work, what side effects can be expected, and help patients or their carers make an informed decision.

    • gabe

      gabe

      August 15th, 2019

      What do you mean “Thirdly, these groups become hotbeds for the diseases we vaccinate against, and can become a health hazard for the broader community.”?

      • Kody

        Kody

        November 23rd, 2020

        I believe what they mean is that the communities where the like mindset of opposing vaccines happens to also be where outbreaks of eradicated disease spawn from.

    • Swarndeep Singh

      Swarndeep Singh

      May 26th, 2020

      Well the people who opt out of vaccination, may be have a death wish. Why should the people who are vaccinated worry. They are protected? Are you trying to say that the people who get vaccinated are still effected by the virus they are vaccinated against? Are you trying to say the vaccines do not work a 100%. What are the protection efficiency results of most vaccines? What are the preservatives used in most vaccines? The pharmaceutical industry lies as much as their predecessors the elixir salesmen. Look at the list of drugs being withdrawn every 10-15 years after the patent period expires, and the litigation against them settled out of court without being publicized.

      • Gary Finnegan

        Gary Finnegan

        May 26th, 2020

        You are making some wild claims, but also raise a few important questions.
        You argue that nobody should care if some people opt out of recommended vaccines. The problem is that some people are too young or too sick to be vaccinated. For example, babies less than one year of age or people who are immuno-compromised – perhaps because they are undergoing cancer treatment or have had an organ transplant.
        They cannot have vaccines and, if infected, are particularly vulnerable to serious illness. So, they rely on the rest of us to be vaccinated so that they viruses are not spreading in the community.
        You also ask whether vaccines are 100% effective. They are not. Some, like measles vaccines, are very highly effective. They protect just about everyone who has them. But it’s always possible that the vaccine won’t work perfectly in an individual. For flu vaccines, we also know that it is harder to boost the immune systems of older people. It’s still worth having flu vaccines if you are old – indeed, they are at the highest risk of dying from flu – but there is no guarantee that it will work. Individuals should choose vaccination to protect themselves, but also because we are a community. In the COVID-19 era, this is becoming clearer than ever. We are all taking steps to protect the most vulnerable in society.

        • Tina

          Tina

          August 25th, 2020

          Well, many very sick people rely on us to be organ donors, so if we die, they can live. So why not make organ donation mandatory.

          It bothers me a lot that I can’t personally decide on my child’s medical interventions (vaccination) in my country. And i am not a bad mother.

          • Tia

            Tia

            February 11th, 2021

            If you think that your beliefs about vaccinations are more important than actual medical professionals, It doesn’t make you a bad mother it just makes you seem very selfish. In the way that you care more about your beliefs than the overall benefit and safety of your community (let alone your own children).

            And about the mandatory organ donation, it’s not at all like vaccinations.

          • Patricia

            Patricia

            June 25th, 2021

            It’s should be a personal choice and needs to stay that way …People own their own body !

          • Brian

            Brian

            August 7th, 2021

            I’m really not sure why there is so much resistance here. There already are vaccine mandates in place in the US.
            If you registered your child for school prior to COVID 19 pandemic, didn’t you have to supply your child’s vaccine records to the school? In order to be registered?
            What about our military servicemen? When they go to basic training, do you think they get to protest the vaccines, all of them, in special meetings with their drill instructors?
            Answer: no. Unless there is a difficult to obtain exemption, usually provided by a healthcare professional, your child cannot be registered, and in the military, vaccines are on order, you get them no matter your beliefs. They are orders that must be followed. Or, you are disciplined for insubordination.
            Long look. If you are middle aged you have been through school. We you immunized?
            Ex military? Did you get all your shots?
            Problem here is political. Right want to drag their feet because they are not in charge.
            This puts the whole country at risk. Such a shame

        • Ranze Mayfield

          Ranze Mayfield

          March 27th, 2021

          Its super respectable to be still replying to comments on this article, that is all.

          • Gary Finnegan

            Gary Finnegan

            October 12th, 2021

            Thanks Ranze

    • Michael Anthony

      Michael Anthony

      March 22nd, 2021

      with the now Covid-19 many kids in my school don’t do anything they are instructed and a lot have been quarantined and still don’t care. i feel that will still not care for this and it won’t change.

  2. Jayden

    Jayden

    November 8th, 2019

    Thanks for the info, I’m doing a speech and that information helps support my opinion, it is very interesting and “community immunity” is the smart option.

    • thomas

      thomas

      January 21st, 2020

      I haft to do a speech on vaccines email me if you can help

  3. Caitlin Mosier

    Caitlin Mosier

    March 1st, 2020

    Why getting vaccines at a young age is important
    I believe that it is very important to vaccinate your kids before you are sending them off to school. There multiple different proven reasons for why you should vaccinate them. After reading a few articles on why kids should be vaccinated I have learned a few things and have come to a few conclusions. States have issued mandatory immunizations requirements for students before they are able to attend public schools because it is the most effective way to achieve ‘herd community’ which is when enough people in a community are getting vaccinated. This will help to fight off infectious diseases within a large population of citizens. With this being said, I agree that the regulations set by states are appropriate for students. I do read and have thought upon what others have said at the fact they believe that regulations are useful, but mandating is too far. I can see one’s side of this and why they consider this. This being said, people have their own beliefs and their own objections and the world cannot force someone to do something they do not think is right. I think the word “mandatory” that is used when taking the steps to get children vaccinated it a key factor in why some parents do choose not to get those shots, or they hesitate on that thought of it more. I agree that the states should have more exceptions for those that object to vaccines. The mandate for vaccine coverage and vaccine refusal needs to find a balance to help get kids and parents on track for vaccinations. On the health side of this, it becomes more of a serious note and is one of the reasons I believe kids should become vaccinated before entering a public school environment. When kids are younger their immune system is very weak. The older they get the stronger it gets. This means they are way more susceptible to getting an infectious disease and it also means that it is going to take them much longer to try and fight off this disease because of their weak immune system. Early on I talked about herd community and why it is beneficial. Not only is it a good thing to achieve herd community, but it is very important to maintain it as well so that it protects not only yourself from getting a virus but those around you with a weak immune system. The thought of children dying before vaccines was a thing is what convinces me the most to get children vaccinated. Vaccines now can prevent many different diseases that some people do not even know about and some that most people do. Such as whooping cough and polio. Many people believe that after an infection goes away your immune system becomes even stronger, but what most people don’t know is that vaccines have part of a disease in them. This may sound bad, but it is more beneficial to a child. The antigen that is being put into the vaccination is weakened to the point that is cannot cause a disease, but it will strengthen your immune system. For these reasons and many more out there, this is why I believe kids should be vaccinated before they are able to attend a public school setting.

    • joe

      joe

      March 2nd, 2020

      who writes this much of a freaking comment you need to calm down now

      Sincerely,
      joe mama

      • joe

        joe

        March 2nd, 2020

        this joe mama dude is really smrt you should listen to him

        Sincerely,
        joe mama

        • joe grandma

          joe grandma

          July 16th, 2020

          Alright daughter you gotta relax. Caitlin is giving some valid points.
          I remember when you were younger you wouldn’t listen to anything I said.

          Sincerely
          Joe Grandma (Joe Mama’s mother)

  4. joe grandpa

    joe grandpa

    January 14th, 2021

    you all need to calm down, grandma is correct and you wouldn’t listen to anything back in the day. Also yall need to grow up or its back to the farm

    Sincerely
    Joe Grandpa (Joe Grandma’s Ex-Husband)

  5. Adam West

    Adam West

    March 15th, 2021

    The idea of community as in the past is dead. My community is my family and friends. Other people are not my business and I’m not interested whether they get the vaccine our not.
    How about all the “experts” out there that speak out against the covid hype that have been silenced? If there is a need for transparency then no one should be silenced or “cancelled” from the news or social media.
    What is legal now may not be legal in the future. Just look back at the last century and draw comparisons. People say you can’t compare, it’s a public health emergency.. Bullshit..!!
    There should not and must not be any coercion or a mandatory push for anything of this nature.
    The same goes for climate change, the opposition is always silenced because the truth hurts and it turns out that the people pushing this are the ones pushing the covid pandemic..
    Step back, take the scare factor or of it, of both and search for more information both for and against.. Make a decision based on reason and the idea that total freedom and liberty, for which so many have died in the past is paramount.
    If not, the future looks bleak indeed. Government must remain in the background, people must be free to make their own decisions. My life and your life or your own responsibility, not others.

    • Dj Philiscious

      Dj Philiscious

      June 29th, 2021

      Champion comment.

  6. Gail Brink

    Gail Brink

    August 19th, 2021

    A young successful, healthy couple in their thirties, who got married in July 2020, whose first baby was born 7 weeks ago….have both succumbed to Covid a week apart. They would have been eligible to get the vaccine from 1st September. This is such a heartbreaking 💔 tragedy.

  7. Jhon Rey

    Jhon Rey

    October 11th, 2021

    Do you agree with mandatory vaccination?

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