When is it Okay to Mandate Vaccinations?

UPDATED: There are exceptions for when vaccinations are required in North Dakota public schools. They include religious, philosophical, or moral beliefs which cause a parent to oppose vaccinations. Thanks to Rick Olson for pointing out my ommission.

Also, I fixed a broken link.

Something Rob wrote in this post struck a nerve with me. In writing about madatory vaccinations, Rob said this:

Government vaccination mandates are defensible in some instances. If we want to eradicate certain diseases from our society, or at least have a level of prevention that’s as good as the next best thing, then a critical mass of the public must be vaccinated. Thus, requiring vaccinations in public schools is sound policy.

I happened to a have a conversation about this very topic recently, and I came to a very different conclusion.

Mainly, I don’t know that the need to “eradicate a disease” is a good enough reason to enforce vaccinations, including before attending school.

Let me get some things out of the way in anticipation of your responses: I think every child should be vaccinated. My child is up-to-date on all of them. I think not getting vaccinations, whether it’s because of some unfounded fear of autism, religious qualms, or just plain laziness, is wrongheaded. Vaccines are Good Things. Vaccines save lives.

Is that a good enough reason to mandate them? I’m not so sure. I guess I worry about the slippery slope argument. If public health concerns are a good enough reason to force vaccinations, aren’t they good enough to force things like diet restrictions? Can it be mandated that you refrain from activitity that increases your exposure to certain diseases? Can “risky” sex be outlawed? Alcohol? Smoking in private businesses?

The concensus seems to be that Texas governor Rick Perry made a mistake in mandating an HPV vaccine for girls in his state (the governor himself said he “made a mistake” in a recent debate). However, in North Dakota it is already mandated that a child entering a public school must be vaccinated against the following:

diphtheria, pertussis, tetanus, measles, rubella (German measles), mumps, hepatitis B, haemophilus influenza type b (Hib), varicella (chickenpox), poliomyelitis, pneumococcal disease, meningococcal disease, rotovirus, and hepatitis A.

If we believe that these are “okay”, why not an HPV vaccine? Why is one out of bounds but not others?

If there is a line, where should it be drawn? Does the good outcome of potentially eradicating a disease outweigh the right of an individual to make a potentially bad choice? If so, how far in the direction of government mandates does that line fall?

Jay Winkis

Jay Winkis lives in Horace, ND and works in Fargo. He likes cooking, politics, guitars, books, poker and whiskey, though certainly not in that order. He is either a liberal Conservative or a conservative Liberal, whichever makes you angrier. He blogs at Pocket Jacks.

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  • Hal324

    Very good points, you are 100% correct.

    • http://pocketjacksblog.blogspot.com Jay W.

      Thanks for the support, but to be honest, I’m not so sure I’m correct. There’s two distinct forces pulling at me: the need for public safety and the need for individual freedom in their own health choices.

      I think the idea that vaccinations are required is sort of grandfathered into our conciousness. I had to be vaccinated before I could go to school. That’s the way it’s always been done and there doesn’t seem to be an great societal harm because of it. From that perspective, it seems like a no-brainer.

      But the Rick Perry/HPV thing got a lot of people up in arms, and I’m not 100% sure of the motiviations behind that resistance. Is it because there really is a significant difference between mandating HPV vaccinations and something like, say, tetanus? Is it because of HPV is a sexually transmitted disease and sex makes people uncomfortable?

  • http://sayanythingblog.com Rob

    If we believe that these are “okay”, why not an HPV vaccine? Why is one out of bounds but not others?

    HPV is a bit different given how it’s communicated.  It’s a sexually transmitted disease as opposed to something you can get merely by proximity.

    And to be clear, I’d have a problem if the government were going door-to-door requiring that you put a needle in your arm and take the vaccination.  But making it a prerequisite for pubic school?

    I don’t have a problem with that.

    • http://pocketjacksblog.blogspot.com Jay W.

      HPV is a bit different given how it’s communicated. It’s a sexually transmitted disease as opposed to something you can get merely by proximity.

      Sure, but tetanus isn’t contagious either. Are we saying that contagious diseases are where the line should be drawn?

      • http://sayanythingblog.com Rob

        Well, a kid could get tetanus after hurting themselves on the play ground equipment.

        HPV requires sex.  Not as likely.

        I don’t have any more problem with public schools makind vaccinations pre-requisite to enrollment than I do with public buildings being shut down for smoking.

        • http://pocketjacksblog.blogspot.com Jay W.

          So is the line, vaccines for things kids could get while in school, but not sex-related?

          I’m coming off as snarky, but I am really trying to understand where this line is. I mean, there are lots of things that could happen at school. I mean, hep b is transmitted from sex, sharing needles, handling contaminated blood, and can be passed from an infected mother to an infant while in the womb. How likely is that on a playground?

          It just seems so arbitrary. Like my answer to Hal324 above, it’s like the vaccinations kids are currently required to have are grandfathered into our consciousness. They’re okay because we’re used to it. New ones are taboo. I’m just trying to understand where that comes from.

          • http://sayanythingblog.com Rob

            I plan on having both of my little girls get the HPV vaccines when the time comes.  Little girls turn into young women who have sex.

            But some people don’t like that sort of vaccine, and given that we’re not talking about the mumps or something highly contagious, I don’t see the pressing need to make the vaccine mandatory.

            And, again, I don’t have a problem with making vaccines a pre-requisite to public school.  That’s not quite the same as mandating them given that you can opt-out of public schools.  And when I combine that with my preference in general for school choice, I think it’s a consistent limited government position.

          • dalaibama

            And this is as it should be Rob….If you want it, do it. Nothing should be mandated. If you cannot afford it, it is an entirely different story. But mandated for school entry….no sir.

        • Jamermorrow

          Why do Republicans care about the vaccine I thought they advocated abstinence? Can’t we just educate people on the dangers and nastiness of sex?

    • http://pocketjacksblog.blogspot.com Jay W.

      Also, I think if any vaccination should be required for pubic school, it should be an HPV vaccination! ;)

    • borborygmi

      What was Santorums rebuttle “Why kind of progressive school activities are happening in Texas.” paraphased.  Funniest line last night.

  • Rick Olson

    North Dakota has had a mandatory immunization law since either 1977 or 1979.  Before a child can enter school, they must be up to date on their required immunizations.  A state required certificate must be presented to the school office prior to the start of school, to prove that the child has been vaccinated against or has had the diseases in question (thus having natural immunity).  Exceptions were written into the law where if a child were allergic to a certain vaccine, or if the parents/family/child held sincere religious beliefs against being vaccinated, then admitting the child to school without the vaccinations would be permitted. 

    • http://pocketjacksblog.blogspot.com Jay W.

      Thanks for pointing out the exceptions to the vaccination requirements. I had read those and then just plain forgot to put them in the post. My bad.

      • Rick Olson

        I believe the law does go on to say in North Dakota that in the event that there is an outbreak or epidemic of a disease in a certain area, then the children who have not been vaccinated against said disease may be sent home from school and would not be allowed to return until the epidemic has passed.  I believe that decision would rest with the school district or school board, upon recommendation of public health authorities.

  • Lmlucier

    Should NEVER be mandated for a sain person it is a violation of our civil right. End of conversation. HAving said that I think quaranteen or not allowing to go to public scool or even a reasonable fine may not be such a violation. The notion that one can be forced to ingest something against their or their parents will is totally indefensable. To me Perry has just proven he should not be even considered as a serious candidate much less elected. The opt out mitigates his situation slightly, but his mindset is clear.It should be an informed opt in and free if at all in the public arena.If not free then it is like a mandate to buy health insurance a la Romney care. Perry is disqualified IMO,even before we talk about his Dream Act and other Democrat type policies. What a disaster he would be as President as bad or worse than McCain. We may wish we had Clinton back.

    • Lmlucier

      Look at Perry’s actions not his words. He is a fraud.

    • borborygmi

      When you consider certain diseases are contagious before the carrier is diagnosed then quarantine isn’t the answer and a mandated vaccine is the answer.   I don’t see where  where the HPV fits into the vaccines for: diphtheria, pertussis, tetanus, measles, rubella (German measles), mumps, hepatitis B, haemophilus influenza type b (Hib), varicella (chickenpox), poliomyelitis, pneumococcal disease, meningococcal disease, rotovirus, and hepatitis A.   Althought  chicken pox wasn’t as much of a concern when I grew up.  Parents would send kids over to visit kids with chicken pox so everyone would catch them and become immune at the same time.  

  • WOOF

    It’s OK to mandate vaccinations for people who want to get out of quarantine.

    http://dc347.4shared.com/img/780743091/3f946425/dlink__2Fdownload_2FyxPRswcz_3Ftsid_3D20110913-85

  • mikemc1970

    The government can make you to do anything they want when you’re using their services. They can make you take a drug test or tell you which foods are appropriate to buy in order to receive public assistance. They can make you buy car insurance if you drive on public roads. They can make you vaccinate your child if they go to public schools. If you don’t like it, you can opt out. It’s my belief that only when you can’t opt out, like the Obama health insurance mandate,  that the infringement on personal rights occurs.

  • http://flamemeister.com flamemeister

    There is some evidence that long-term effects on the general population of at least certain vaccines may be very bad indeed.  Europe is much more conservative about their use, especially antibiotics.

  • Rick Olson

    Well, more and more doctors here in the U.S. will flat out refuse to prescribe antibiotics unless they are convinced that the infection that someone is suffering from is not viral in nature.  Antibiotics do nothing for viral infections.  Physicians are well aware of antibiotic overuse and how such can cause antibiotic resistant forms of diseases to mutate.  In fact, Sanford Health here in Fargo (formerly Meritcare) medical providers generally won’t prescribe antibiotics to a patient until the diagnosis of an infection that does require antibioltics has been confirmed through lab analysis, blood tests, etc.

    • borborygmi

      The Doctors actions and you are correct. By over prescribing antibiotics are losing their effectiveness as Bacterial infections will tend to mutate. 

  • Jamermorrow

    Never unless you are a statist thug.

  • borborygmi

    Mass vaccinations happened for polio and Tb.

  • Flamejob5

    I think loosening the current stringent homeschool restrictions in ND would go a long way in allowing more parental choice regarding questionable vaccinations.

    Unless as a parent you’re a licensed, certified teacher in ND, you’re child is basically forced to attend a socialist public indoctrination clinic.

    • Bat One

      Excellent!  Mandated vaccinations is only half the issue.  The other half is mandated public school attendance, which is the excuse used by the states to mandate the vaccinations.  A much better solution, involving less government infringement on our individual liberty would be school vouchers, and allowing the various private schools to mandate vaccinations if they chose to do so.  Mandated public (government) education is more of a problem than state mandated vaccinations.

  • SigFan

    I would be okay with a mandatory anti-liberal vaccine.

    • mikemc1970

      The only real anti-liberal vaccine is the truth.

      • SigFan

        True – now if we could just figure out how to make that injectable.

      • Sparks

        You forgot to capitalize the use of a name.  You might mislead folks into thinking you are talking about the sorts of truth normal people refer to and not the sort you right-wing fanatic asshats refer to, e.g. The Truth.

        • mikemc1970

          Are you going to start going after peoples grammar like Hannitized now? Well if that’s all you got, that’s OK, I understand the concept of limited resources and all.

  • Vlad

    What right do the children have to be protected from easily treatable diseases through vaccinations? 

    Do children have any rights or only their nutjob parents.

    • Bat One

      Do children have any rights or only their nutjob parents.

      How about starting with their Right to be born alive?  Then we can worry about their education in government schools.

      • Neiman

        I agree it should start with right to life, but then the question is – does the State have a right to mandate vaccinations? How does that fit within libertarianism? I think vaccinations are important to protect children and prevent the spread of crippling (I had polio) and fatal diseases. It can be argued children without certain vaccinations should not be allowed in public schools, but then we want them in school. It can be argued if the state can mandate certain vaccinations, what is the limit? How far are you prepared to let the State go in such medical mandates? At what stage did we lose our rights as parents, making all children wards of the State?

        No answers really, but lots of questions and concerns.

    • Diet dee

      there is a vaccine compensation court for a reason, that is reason is that vaccines do damage children( AndVaccine makers can’t be sued). Nutjob parents don’t want there kids on the short yellow bus

  • http://sayanythingblog.com Mountainmouth

    When is it Okay to mandate vaccinations – any time they want COMMRADE

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