To Vaccinate or Not to Vaccinate

4 June 2015

Last week, an e-mail popped into our in box calling for voters in California and Vermont to campaign against state laws that will limit the allowable

exemptions from mandatory vaccinations. Sent by an

organizations called Citizens for Health, the appeal cites

“bodily integrity and personal and domestic sovereignty”,

alluding to some vague potential loss of liberty and

founding constitutional principles.

Notably absent from this appeal is any mention of the responsibilities that necessarily accompany freedom. What Citizens for Health considers “the essence of American liberty” – the right to refuse an immunization – inherently includes the ability to pose risk to others. Refusing a vaccination places you at risk for contracting the particular disease. Once infected, you become a vector for transmission. You are now a danger to infants, transplant recipients, cancer patients, those living with HIV/AIDS, the elderly, and others with weakened or compromised immune systems. While you may have the right to place yourself at risk, that right does not extend to posing danger to others.

There is a powerful meme on Facebook that asks “Remember that time you got polio? Of course not, because your parents had you vaccinated.” There is no arguing with that sentiment. The statistics speak for themselves. The absence of smallpox in our world is a result of what Citizens for Health term “forced medical treatments.” Perhaps equally troubling is that this freedom from illness is enjoyed because herd immunity is gained via widespread immunization. Those demanding the right to refuse vaccination rely on others to provide this protection. There is something perversely shortsighted and selfish in this. Guaranteeing others the basic liberty we enjoy is an essential aspect of our freedom. Concentrated self-interest is not.

Princeton University officials decided Monday to make available a meningitis vaccine that hasn't

Communicable diseases are an historic challenge where people assemble from many locations. Military training bases, colleges, and universities are particularly susceptible because people spend an extended amount of time in close proximity. Although relatively rare, the effects of bacterial meningitis are serious enough that it is not unusual to require immunization in these venues. The small but significant outbreak at Princeton warrants attention and action.

The issue with this particular outbreak is that it is from a strain atypical to the United States. That it appeared at the university is not unusual, as several of the victims had been traveling or interacted with others who had recently travelled to areas where the type B strain is more common. Princeton University, state health, and CDC officials faced an unusual but not daunting decision. The Bexsero vaccine has not been authorized for administration in the United States – it is pending FDA review – but has been approved and used effectively in Europe and Australia. Given that one in ten young adults does not survive type B meningococcal bacteria infection, authorizing voluntary immunization under informed consent is a reasonable choice.