Dr. Andy

Reflections on medicine and biology among other things

Friday, February 24, 2006

Compulsory vaccination

I occasionally have patients whose parents are strongly against vaccination, usually because they've confused correlation with causality and believe vaccines cause autism. They are often shocked to hear that I've actually given these "poisons" to my own children. I even enrolled my own daughter in a trial of a new combination vaccine as I do think if we could minimize the number of needle sticks that would be good. So I am strongly and consistently pro-vaccination. I regard anti-vaccination folks like creationsists who no amount of reason will reach; although at least I understand the source of creationsists conviction, religous belief. I've left Orac and others to refute the anti-vaccination hysteria.

What I hadn't thought much about was how compulsory vaccination should be. A recent article in the Lancet examines this issue. As a wishy-washy libertarian, I respect the argument that whatever the overall greater good, government compulsion is not to be taken lightly; as one Henning Jacobson argued in 1809, in refusing to be vaccinated against small pox:
A compulsory vaccination law is unreasonable, arbitrary and oppressive, and therefore, hostile to the inherent right of every freeman to care for his own body and health in such way as to him seems best; and that the execution of such a law against one who objects to vaccination, for whatever reason, is nothing short of an assault upon his person
The US Supreme Court rejected that argument. But I also know that there are a lot of idiots out there. In addition, since much of the benefit of vaccine is in herd immunity (no kid born in the US in 2006 is likely to ever actually get polio) there is an issue of equity in that those who forgo vaccination reap the benefits without sharing the risks (small those they are currently).

The UK does not have compulsory vaccination, but retains high vaccination rates as do several northern European countries. In the US, in contrast, school entry is contingent on vaccination, although conscientious objection is allowed in most states. As the article notes, using the school system has the advantage of entrenching the requirement in a bureaucracy that is pretty much immune to political pressure, lack of attention, etc.

I think the US approach gets it about right. Most unvaccinated kids are due to lazy parents and making school entry contingent on vaccination leads to higher vaccination rates. On the other hand, for those few who are really opposed to vaccination, I am not against exceptions. I do think getting an exception should require at least as much effort as being vaccinated, so it is not the easiest way out, as the article suggests it is in some states. I don't see requiring positive action (obtaining an exemption) as unduly burdensome on anyone's freedoms.

I do think there might be some instances (outbreak of disease) when exceptions to vaccination might not be acceptable, even with the loss of freedom that would entail.

17 Comments:

At 2:41 PM, Blogger Flea said...

Dear Andy,

I practice in Massachusetts, the home of Henning Jacobson.

Jacobson's heirs still live here, or so it would seem. I have a large cohort of non-immunizers and partial-immunizers in my practice. And this is a high-vaccination state!

In the first two years of my practice, I was so desperate for patients that I let it be known I could be flexible regarding vaccination schedules. As a result, various internet discussion boards began mentioning my name and before I knew it, patients were driving up to 50 miles to see me (that's a very long way to drive to a doctor in my state).

Don't get me wrong: I recommend vaccination to my patients. I simply trust them to take responsibility for any negative outcome that should arise from their decision. And of course I document all refusals.

In the case of an outbreak, say of measles, I would certainly insist on vaccination.

best,

Flea

P.S. I'm adding you to my blogroll. Nice blog!

 
At 8:54 AM, Anonymous labtech said...

I was pro-vaccination until I had my first child and discovered the ludicracy of current guidelines. They lost my confidence in their recommendations when they wanted to give my 5lb 3 oz, 24hr old child a Hep B shot.
There is absolutely no justification for this practice and they could offer me none. What was even worse was the way they treated me after I refused to sign the consent. One would have thought I was a child abuser or a moron. I am neither. I do categorize those who established current vaccination guidelines as borderline both these things, after investigating the evidence and rationale these guidelines are based on.

 
At 12:03 PM, Blogger Impatient Patient said...

I have a question. After having a tetanus vaccination my oldest had a systemic hives reaction- eight to nine hours later. We went to the allergist four months later and he did the tests- yes she is allergic. We went to the neurologist ten months later- no lasting neurological damage. Good and good. But- no-one can tell me if this can happen again, with greater severity. SO, should she wear a Medic Alert bracelet, etc... in case of a car crash.

Obviously I do not expect an answer. I realize there is great value in vaccines, but there are small risks. No-one has all the answers, and it is frustrating to be told that by professionals, as patients do expect some guidance.

And since no-one can tell me what part of the vaccine the child is allergic to, this worries me as well. Is it the tetanus, or is it one of the additives/preservatives?

We will continue getting the other people in my house vaccinated, and hope that they do not have some wierd reaction. At least I know this time to take the child to the hospital ASAP, as the last time we were thinking it was food or heat at first-partly because this reaction was not mentioned on the Health Unit pamphlet that detailed possible side effects, and it wasn't until I called the Health Unit the next day that I confirmed that it was a reaction to the tetanus vaccine- 1/400,000.

Very wierd and disconcerting. Also very annoying as at first the allergist dismissed the possibility that my kid was actully allergic, and then when she did react, had to back track a bit. It was a good thing I had the same article he quoted with me, as it at least made me feel like less of a freak to know I was right....

 
At 1:32 PM, Anonymous Anonymous said...

My eyebrows hit my receding hairline when they tried to give my newborn infant a Hep B shot.

I politely pointed out that she wasn't likely to be exposed to it at home. not to mention (had they asked) both her parents are vaccinated.

I mean, sheesh. I don't blame vaccines for autism or the like, but just on general principles it seems ludicrous to challenge an infant's system with an unecessary vaccine 1 day after birth.

The sad part if that the system is generally right and seems unable to realize how things like the hep b diminish credibility for alties.

 
At 3:29 PM, Anonymous Anonymous said...

Maternal transmission is an important cause of hepatitis B, and the course of the disease is more severe when it is contracted at a very young age. That's why hepatitis B vaccine is given right away.

We could test the mom instead of giving the vaccine, but the child should have the vaccine at some point anyway, and a few vaccine antigens even on day 1 of life are a drop in the bucket.

 
At 4:07 PM, Blogger Stephen said...

I have sympathy for alergies. While my friends are alergic to most things, and i'm not, i do have an alergic reaction to Nuitrasuite. My diet drink of choice is water. However those pusing the product clearly want it everywhere.

My question is this. Do people who do not have vaccinations reduce the effect for those that do? That is if 3% of the population is not vaccinated, does that mean that there is no way to erradicate the disease? 5%? Does it just take longer?

Leave no part of the gene pool behind.

 
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At 3:55 PM, Blogger Vitamin Lawyer Health Freedom Blog said...

Thank you for posting this important message. The Maryland mass forced vaccination atrocity is a real “line drawn in the sand…” If Americans do not react strongly to this assault on basic human rights, we can expect more such incidents.

The weekend after the “shooting” of all those children, an emergency meeting of health and freedom advocates was held in Tiburon Californian.

The people there adopted The Tiburon Declaration against compulsory vaccination and forced drugging, agreeing to press their grassroots and netroots groups to take up the compulsory vaccination issue and demand that all state legislatures adopt mandatory voluntary vaccination laws allowing anyone to be a conscientious objector to vaccination.

You can read the Declaration at:
http://www.healthfreedomusa.org/index.php?p=460

Ralph Fucetola JD
Trustee, Natural Solutions Foundation
http://vitaminlawyerhealthfreedom.blogspot.com

 
At 5:59 AM, Anonymous Anonymous said...

I am doing a case study on whether vacination should be compulsory...If anyone has any articles i could use please leave a comment.

 
At 10:25 AM, Anonymous Anonymous said...

Having two children severely react to vaccines, would make anyone refuse them after. DPT and MMR to be specific. We have evidence of vaccine strains in their gut tissue and CSF and elevated measles titers (vaccine strain). Unknown to me, my kids had mitochondrial abnormalities, which were undetected before the vaccine. Hanna Poling's case is very similar to mine, and unfortunately, the statutes of limitations have run out on my ability to sue. I pay the consequences of trusting the vaccine prgram, and I pay, for not knowing the healing capital of my children. Who knows what our kids can take in a one size fits all approach? Therefore, I am asking even the doctors to admit that metabolic crisis's, administering tylenols after vaccine fevers (see Dr Torres), certain children have predispositions to injury (MTHFR/COMT and immune abnormalities) and other such practices such as true glutathione loss at time of vaccinations (inability to detox metals) , are resulting in a "GENETIC EPIDEMIC" triggered by ioatragenic vaccines. There is no studies of unvaccinated and vaccinated populations, and the result of ADHD/Autism/Allergies being studied because of them. There are no funded studies with independent researchers who don't have their hands in the pockets of pharma, and there are a lot of refuted claims ther is no links to vaccines and autism, when in reality, there are plenty. Manipulated data sets in CDC studies, and the lack of scoping children's guts, is my loss of faith issue in these people. Ther is VAERS with thousands of claims of injuries and death, and more is coming folks.
Let some parents opt out due to SCIENTIFIC scrutiny/screening of certain kids, and let the rest of you jab your kids, but not mine. My grandchildren are not autistic, because they did not vaccinate, an SMART. HEALTHY. NORMAL. If autism is so genetic (mind you they are all boys), they should have had autism by now

Mandatory vaccines, you can have them, shoot them, snort them, but as for me and my house, we will refuse.

 
At 1:48 PM, Blogger satyagrahi said...

All debate as to whether vaccinations are safe or not is really irrelevant. The real issue is whether individuals have the right to control their own bodies or not. If an individual does not have that right, they are technically the slave of another, in this case a slave of the government. Of course vaccinations have a history of many ill effects, but this back and forth on what study is valid and which is discredited is really just a distraction from the core issue of freedom vs. tyranny. If the government can tell you what you can put in your body, like alcohol but not marijuana, and force you to put something in your body that you don't want, like a vaccine, you are not free. It is always in the name of "safety" that governments violate the rights of the people, and often the "danger" is manufactured by the government officials themselves in order to justify their police-state measures, as was clearly the case with 9/11 and 7/7. Being forcefully vaccinated when you currently have no contagious disease is a “preemptive” attack on your body and a violation of your rights, for a violation of other people's rights that you may never commit.
"Those who would give up essential liberty to purchase a little temporary safety deserve neither liberty nor safety." - Benjamin Franklin

 
At 8:30 PM, Anonymous Anonymous said...

Vaccines should never be compulsory.
If vaccines were to work as advertised, then those who use them should not feel so threatened by those who don't.
Compulsory vaccination is pushed forward for two reasons: 1 - to increase the profits of certain individuals and companies and 2 - because ignorant lawmakers are scared

 
At 8:34 PM, Anonymous Anonymous said...

Pharmaceutical companies always get away with supplying products that have not been adequately tested. Now they are coming up with the Swine Flu Vaccine.
How can they have conducted long term testing if the desease is only a year old?
I guess for them it does not matter what the long term effects could be. Shame on them.

 
At 11:08 PM, Blogger Mindy said...

Vaccines should never be compulsory! HepB vaccine at less than 24hrs old?!?! Give me a break! Now they are saying that vaccine effectiveness(if they worked at all)wears off and teens and adults all now need boosters. So let's say you get your 5yr old vaccinated for the chicken pox, Rarely (if ever) a deadly disease, and let's say 10yrs later the effectiveness wears off and your now 15 yr old get's the chicken pox... it is by far more dangerous(by medical fact)to get the chicken pox at 15yrs than it is at any age up to 10yrs old. It can cause major complications, sterility and even death. Then there is the risk of getting shingles later on in life from the herpes virus in the vaccine! I say, get the chicken pox young, itch, scratch, have a slight fever but become naturally immune with little risk of side effects. AND that's only the beginning...

MC - Mother of 2 totally unvaccinated children - one with Autism, so no, I do not blame vaccines for ASDs

 
At 12:53 PM, Blogger Ana said...

Hi,

In the United States of America, we are fortunate enough to have the Tetanus vaccination; but in developing countries it is not accessible. Here at Disease.com, we admire organizations such as yourself, who have vowed to spread awareness and support extensive research. Disease.com (a website dedicated to disease preventions and treatments) would like to join your cause, by helping you spread awareness. If you could, please list us as a resource or host our social book mark button, it would be much appreciated. It is time we aid those, who can not help themselves.
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Thanks
Ana

 
At 12:59 AM, Anonymous daser said...

everyone need a vacation.. Hawaii maybe :-)

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At 11:32 AM, Anonymous Buy Viagra online said...

The problem with health, it is ignorance, the only way to combat against it. It is to educate the patient. Right now it is quite easy with the Internet but it is a double edge sword because they over think their symptoms

 

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