Vaccines should be a requirement for all kids to prevent the next big outbreak

Vaccines should be a requirement for all kids to prevent the next big outbreak
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On May 10, the Minnesota Health Commissioner Dr. Ed Ehlinger requested emergency funding from state legislators to control “the largest measles outbreak the state has faced in nearly 30 years.”

Over the next three months, the highly infectious virus ripped through a Somali immigrant community in Minneapolis that for years has been a target of the anti-vaccine movement. More than 20 people were hospitalized  (most were children), and the final bill for emergency control measures came to just over $2.3 million in local and state taxpayer dollars.

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Unfortunately, this latest outbreak is just the most recent in a disturbing nationwide trend of re-emerging preventable diseases directly linked to vaccine skepticism and insufficient public policy.

 

The core of the long-standing conflict between vaccine advocates and anti-vaccine protestors boils down to a question of individual versus societal rights: Should the government compel people to be vaccinated in the interest of a healthy society?

To avoid this conflict, governments employ “personal belief” exemptions allowing concerned parents to dodge vaccinating their children. In the U.S., exemption requirements range from philosophical objection (just checking a box in Minnesota) to signing an affidavit that vaccinating your children is contrary to your religious beliefs.

Currently, 47 states allow personal belief exemptions, and 16 retain philosophical belief exemptions similar to Minnesota’s. Although these exemptions represent an attempt to walk an admittedly difficult ethical line, they are simply too harmful to be justified.

While vaccination may seem like an individual health decision, the reality is more complex. Although vaccines are often highly effective, they are never perfect.

Whether for medical reasons, age, or individual vaccine failure, a surprising number of susceptible citizens who cannot be effectively vaccinated exist in all communities. These are the people we protect with public vaccination programs — they rely on the community’s health to avoid being exposed to a disease they can’t fight off themselves.

If your friends and neighbors don’t get sick then you don’t get sick — even if you couldn’t be vaccinated because you were just diagnosed with lymphoma. It’s as simple as that.

By protecting vulnerable individuals from unnecessary disease exposure, vaccination programs can reduce disease far beyond an individual vaccine’s effectiveness. Mumps vaccination programs have returned a 99.8 percent reduction in mumps disease despite a vaccine failure rate of 12 percent. It protects infants, the elderly, cancer patients, and others that cannot be vaccinated in addition to protecting taxpayers that will pay for emergency response. But as powerful a tool as public vaccination is, it is susceptible to rapid local breakdown.

Although we tend to think about vaccination coverage in bulk, these numbers rarely accurately reflect our risk. Our families, neighborhoods, schools, places of worship, and workplaces form our everyday networks, and if even just one of those networks fails to vaccinate their children we risk outbreak — regardless off the larger community’s coverage. Hennepin County, where the Minnesota outbreak started, boasted vaccine coverage of 95 percent in 2016.

The childcare centers that formed the center of the outbreak, however, sometimes reported vaccination rates as low as 33 percent. And while these outbreaks ignite in local networks, they quickly spread into surrounding communities. In this case, more than 8,000 people were unnecessarily exposed.

Put another way, the vast majority of the citizens of Hennepin County contributed to the health of their community by responsibly vaccinating themselves and their children. Those citizens, and their families, were placed in harm's way anyway because a vicious vocal minority was able to target a susceptible subpopulation, and everyone paid the price. As a new father currently exploring daycare options, this is maddening.

Your family and community health depends on the decisions of your neighbors. For this reason, the Supreme Court has consistently, under both liberal and conservative control, upheld the government’s ability to compel vaccination regardless of personal belief.

Mississippi, West Virginia, and California have taken advantage of those rulings and banned all non-medical exemptions through legislative efforts. In California, the result should near 100 percent vaccine coverage to school-aged children by 2022, and the elimination of schools as potential hotspot for infectious outbreaks.

There will always be a vocal minority that either does not understand, or refuses to acknowledge the importance of vaccination programs. Despite these objections, courageous legislation has eradicated smallpox, driven polio from the developed world, and reduced deadly diseases like measles, mumps, and rubella by more than 99 percent. Our legislators can prevent the next Minnesota outbreak simply by requiring vaccination of all of America’s children.

Matthew Woodruff PhD is a research fellow at Emory University’s Vaccine Research Center, and a member of the Scholars Strategy Network.