Our government and public institutions must protect us against the unvaccinated

Our government and public institutions must protect us against the unvaccinated
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Earlier this year, my friend adopted an adorable puppy that we named Bruno in a squealing fit of joy in the middle of Petsmart; we stocked up on puppy toys and treats on our way home. Two weeks later, he was dead.

The culprit: distemper, a highly contagious vaccine-preventable disease that, because of his young age and the series of vaccines he needed overtime, he was not yet immune to. It was devastating to watch helplessly as this virus swiftly and mercilessly ravaged his little body. It was among the worst suffering I have ever witnessed a living being endure, and I am a nurse. 

Thankfully, humans cannot contract distemper. However, we are prone to its highly contagious relative, measles, which has made a resurgence in 2019, with the most number of cases reported since 1992. Standing on the precipice of an extremely preventable public health crisis, state governments are taking action.


In 2019, Washington enacted a new law that no longer allows exemptions for school-aged children from the measles, mumps, and rubella (MMR) vaccine for philosophical or personal reasons.

Amidst this backdrop, including high profile stories of people with measles traveling through five airports in recent weeks, Seattle Public Schools (which, along with most of those airports, resides in one of the 25 counties at highest risk of a measles outbreak) recently announced that students who do not have documentation of the MMR vaccine or a religious or medical exemption by Jan. 8 will not be allowed back at school. 

While some, including Governor Jay Inslee, who signed the bill into law, do not think this does enough to protect the health of children and other vulnerable groups, it is a step in the right direction.

Other states trying to tighten up vaccine laws or preserve current strict laws that have proven effective in maintaining herd immunity should not give in to the harassmentmisinformation, and ideological opposition to government-mandated vaccinations for school-aged children, be it the MMR vaccine alone (as is the case in Washington) or the whole range of childhood vaccinations (such as in Mississippi).    

To be sure, we must protect our rights to make health-related decisions that impact our bodies. To violate our right to bodily autonomy for one type of health decision is to set a dangerous precedent for violating our right to bodily autonomy for other health decisions. But as much as Americans love the narrative of individual liberty and personal responsibility in all realms of life (including health), infectious diseases do not conform to these principles.


They lay bare the cold hard reality that humans are interconnected social creatures whose decisions — and germs — impact others. When healthy people refuse to vaccinate themselves and their kids based on a philosophical or personal objection, they place others who cannot personally be immunized due to medical reasons — people who have a right to be in public spaces where germs are transmitted— at risk for being exposed to devastating illnesses without their knowledge or consent.

This includes infants and children who have no autonomy in making their own healthcare decisions, people of all ages who are immunocompromised, and pregnant women. When people falsely claim religious exemptions, an era where fewer people are affiliated with a religion (and no dominant religion is opposed to vaccines), they make a mockery out of those who have legitimate religious objections and jeopardize their freedom of religion. 

It cannot be overstated: vaccines are one of the greatest public health achievements in human history. They have been so effective that the overwhelming majority of Americans cannot imagine how utterly devastating these diseases can be because almost no one —including healthcare providers — has seen the diseases unfold before their eyes. This makes it difficult for some to balance the potential risks and benefits of vaccines.

Yet the evidence overwhelmingly supports the safety of vaccinations. When I ask my public health nursing students to debate the pros and cons of mandating vaccinations for school-aged children using the best available scientific evidence to support their position, nobody wants to sign up for the side arguing against vaccinating children.

That is because there is no solid scientific evidence to support that vaccines are harmful. There are anecdotes of adverse events (that, while unfortunate, are isolated cases rather than widespread occurrences) and fake scientific evidence that — despite being retracted a decade ago — fuel the misconceptions of those who believe vaccines are unsafe. Despite being safe, vaccines are so carefully monitored that any serious hypothetical harm would be quickly identified and controlled before becoming widespread, much like the constant recalls for romaine lettuce. 

In this age of subjective truth and fake news, the efficacy and safety of vaccines for the overwhelming majority of people are about as objective of truth as we can have. In an ideal world, people would voluntarily vaccinate their children before sending them to school. But until we reach that point, states are well within their rights to protect the common good by mandating some or all vaccinations for school-aged children. However, laws mandating vaccination are useless unless they can be enforced.

Therefore, we must also be sure that children have access to healthcare to ensure they receive vaccines. Since school nurses are largely responsible for ensuring students are up-to-date on vaccines, we must ensure schools are adequately staffed with nurses. We must increase funding for local, state, and federal public health agencies to combat falling vaccine rates, ensure everyone has access to vaccines, and monitor the spread of infectious diseases so we can intervene early.

Finally, we must advocate protecting the health of our children and most vulnerable citizens, including voting for representatives across all levels and sectors of government who will support common-sense vaccination laws rather than peddling anti-vaccination conspiracies that have no basis in well-conducted science. To do anything less is harmful to our economy (given the cost of treating disease) and neglectful of our children and neighbors. 

Karen Johnson is a public health nurse and associate professor from the School of Nursing at the University of Texas at Austin and a Public Voices Fellow of The Op-Ed Project.