Folmsbee: Time to end vaccine opt-outs?

Sai Folmsbee, Columnist

Vaccines do not cause autism.

In fact, a huge number of scientific studies have investigated the adverse events of vaccination and found no connection with autism. But despite the evidence, there has been a steady increase in vaccination exemption rates among children. And it is worrying, because outbreaks of once preventable diseases are rising. To combat this, many physicians and scientists are pushing for better medical education and for patient counseling to get more parents to vaccinate their children. But new research shows that such education may actually spread anti-vaccination fears. Soon, in this battle over vaccines, we may be forced to reconsider parents’ role over their children’s healthcare.

As much as we trust in the power of the truth, recent research has shown that even the notion that vaccinations may have risks may be enough to scare parents away.  In a recent study, after being presented with information educating parents on how vaccines were safe and effective, respondents were more likely to refuse vaccinations for their children. In a way, even though parents may understand the scientific evidence, the mere act of acknowledging the vaccine scaremongering might be enough to frighten parents into submission. We all imagine parents as loving and rational caretakers of their children, but it appears unfounded fear has a way of clouding parental judgment.

There is a solution to the vaccination crisis, but it is not pleasant. Currently, parents have the ability to opt out of vaccinating their children, sometimes with a specific religious exemption, but often only requiring a signature. But there is a fundamental issue here that both physicians and parents are hesitant to discuss: Children are not autonomous agents. Parents do not have the right to provide inadequate care for their child, and because of this, our society has built a legal safety net to prevent abuse and neglect to these children. Since our current vaccination policy may contradict this, we may have to consider eliminating vaccine exemptions all together.

There already are both medical and legal precedents for this kind of dramatic action. Jehovah’s Witnesses do not receive blood transfusions as part of their faith, a decision respected by physicians who understand the patient’s right to choose whether or not to undergo medical treatment. However, that right does not extend to the children of Jehovah’s Witnesses.  In cases where blood transfusions are necessary for the medical care of minors, the decision-making power can be legally transferred away from the parents. Until an individual reaches adulthood, our society has placed value in protecting them, even if it means protecting them from themselves and their parents. 

But should a similar course of action be taken with vaccinations? This would not be an easy solution to implement, in both ethical and practical terms, as neither physicians nor parents are excited at the prospect of a legal battle over children. But it is becoming increasingly clear that the lack of vaccinations is posing a very serious risk to the public at large.

Already, there are increasing outbreaks of vaccine-preventable diseases.  Last month, there was a measles outbreak in New York City, and some of those infected were children too young to get the vaccine. This illustrates the true harm of falling vaccination rates.  When a population remains vaccinated, safety comes from an effect known as “herd immunity.” It’s not that the vaccine is perfect, but rather that since nearly everyone is protected, the viruses have little chance of spreading to other people. This is the only line of defense for those who cannot get vaccinated. This includes individuals with certain medical conditions and very young infants, who themselves must rely on the vaccinations of the healthy population for their own safety.

As more individuals refuse to vaccinate their children, diseases once thought eradicated are rising again. This serves as a grim reminder of humanity’s remarkable ability to simultaneously have the brilliance to cure an illness and the audacity to refuse that cure. If vaccination rates do not remain strong in the face of these outbreaks and parental education does not become more effective, dire action may be needed. Unfortunately, the best solution may be to remove the option of opting out, and forcibly provide vaccines to the children of parents unwilling to vaccinate or unable to understand the many benefits provided by vaccines.

Sai Folmsbee is a Feinberg graduate student. He can be reached at [email protected]. If you would like to respond publicly to this column, send a Letter to the Editor to [email protected].