Should All U.S. States Eliminate Nonmedical Vaccine Exemptions?

VACCINES by Jaime De Fore

We’re all familiar with the routine, yet unpleasant trip to the doctor’s office. Sitting in a cold, stark-white room waiting for the nurse to come in with the dreaded needle and syringe. Yep, it’s that time again. Vaccine time. I’ve allowed nurses to poke and prod at me countless times with little regard other than that uncomfortable pressure. I walk out the door with a sigh of relief, try to rub the sting out of my arm, and bask in my newly acquired passive immunity. It’s a great time to be alive. A relatively painless stick and we’re free from diseases that could have wiped out entire populations a little over a hundred years ago. With the incredible advancements in modern medicine, clean water and even cleaner living conditions, the risk of disease is of little worry to most.

Before the development of vaccines, diseases like Polio, Smallpox, Diphtheria, and Pertussis ran rampant through the U.S killing thousands annually. In my own family, Polio and Pertussis has left a devastating effect. My great aunt contracted Polio when she was young, leaving her with weak bones causing her to break the same femur three times and is now unable to walk without assistance. My grandmother contracted Pertussis and was stricken blind at the age of eight. Neither have been able to work or even live on their own. They were lucky to live, though I can’t help but wonder how much better their lives would’ve been if vaccines had been available at the time.

Vaccines are widely accepted as the most cost-effective and successful method of preventing disease. According to the Pediatric Academic Society, vaccinations prevent 10.5 million cases of infectious diseases and 33,000 deaths per year in the United States (“Vaccines” par. 5). Due to the success of vaccines, it’s no wonder that all states mandate vaccinations for preventable diseases. Vaccine mandates led to the global eradication of Smallpox in 1979, with Polio, Measles, Mumps, and Rubella following close behind. However, there are two categories of exemptions that are allowed, though the laws for each state vary widely. Those that can’t vaccinate, such as the elderly, immune-compromised, and infants, there are medical exemptions. For the rest that have their own reasons, there are religious or personal beliefs exemptions. These mandates are clearly in place for a reason. Vaccines are admittedly not 100% effective, but some chance is better than none even if the immunity is not long lasting. Nonmedical exemptions allow the threat of disease to linger and the elimination of these exemptions is the only way for the continued protection from potentially fatal diseases.

Those that obtain medical exemptions have monitored and approved conditions preventing them from being vaccinated with the rest of the community. They rely on ‘herd immunity’ which is defined by The National Institute of Allergy and Infectious Diseases as a form of immunity that occurs when the vaccination of a significant portion of a population provides a measure of protection for individuals who have not developed immunity (“Community” par. 2). This theory holds true as long as 95% of the community remains vaccinated. However, it does not account for the coming and going of people within the population. With the all the means of travel available today, it would be very easy to re-infect a population due to an individual from a country that still is endemic with a disease. That’s not even considering an accidental exposure in a lab or the potential threat of bioterrorism; however rare, the possibility is there.

For those opting out of vaccination due to religious or personal beliefs, they’re also relying on ‘herd immunity’ but are doing so with greater cost to the theory’s stability. The laws on nonmedical exemptions vary greatly for each state; some states have strict regulations only providing exemptions to those with recognized religious faiths, while some have no regulations effectively making it easier to obtain the exemption than the vaccines. As more exemptions are obtained, this effectiveness wanes. Melinda Wharton, Acting Director for the National Center for Immunization and Respiratory Diseases explains that this increase in exemptions is partially due to the focus on adverse reactions linked to vaccines containing thimerosal, a preservative containing mercury. Although research done by the CDC has shown no evidence linking thimerosal to reactions, it has since been removed from most vaccines (35). Adverse reactions are a possible complication for any vaccine, but the chance is infinitely small and worth the risk for the benefits received.

Some may even argue eliminating exemptions would infringe on the rights of an individual. I can see how this would be true. No one should be forced into medical treatment if they don’t wish to receive it. However, when it comes to public safety, it becomes another issue. Breakouts of epidemics are best controlled by these mandates by preventing the likelihood of the event happening altogether. The first mandated immunization law for Smallpox was established in 1809. This law was only first questioned in 1905 by Henning Jacobsen of Cambridge Massachusetts by his refusal of the vaccine. His case was defeated, however, when the U.S. Supreme Court “affirmed the right of the states to require vaccination as a legitimate use of their police powers and . . . the protection of the health of the public supersedes certain individual interests” (Salmon et al. 439). This case had set the stage for all future vaccine laws and none have been defeated since.

Modern medicine has made incredible leaps and bounds in the understanding and prevention of potentially fatal diseases. With increased awareness and compliance, people are aiding in the eradication of these diseases. Personal exemptions allow this threat to linger dangerously and have been made easier to obtain than the vaccines themselves. Since there is no federal mandate, all states should have consistent regulations mandating vaccines with personal exemptions being discontinued and only legitimate medical exceptions allowed.

Works Cited

“Community Immunity.” Vaccines.gov. The National Institute of Allergy and Infectious Diseases, 27 Nov. 2013. Web. 22 Apr. 2014.

Salmon, Daniel A., et al. “Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future.” Lancet 04 Feb. 2006: 436+. Academic Search Complete. Web. 18 Feb. 2014.

“Vaccines ProCon.org.” ProCon.org. 5 Feb. 2014. Web. 18 Feb. 2014.

Wharton, Melinda. “Childhood Immunization: Exemptions And Vaccine Safety.” Journal Of Law, Medicine & Ethics 33.4 (2005): 34-37. Academic Search Complete. Web. 10 Feb. 2014.

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6 thoughts on “Should All U.S. States Eliminate Nonmedical Vaccine Exemptions?

  1. Jaime,
    The details in your introduction painted a vivid picture in my mind about visiting the doctor’s office. As much as I dread that yearly visit, you brought it back to life! I remember reading one of your rough drafts, and your paper has really improved since then. Specific details and facts better piece your blog together. It was a very good blog, and I enjoyed reading your view. Your art at the top of your blog also tied in very will with your side. Good job!

  2. I really enjoyed your introduction! It was as though I was right back in the doctor’s office all over again. I thought you had some great facts and the resources you used really added to your paper. I agreed with your view on the topic and enjoyed reading it!

  3. I love your visual rhetoric! Your description of the doctor visit really captured me as well. This is such a tricky topic. My major is Biology so my “belief” is in science, but I have to admit I kind of understand the opposing argument as well. I would have liked to hear an example of the “religious or personal belief” exemption even if you only used it to weaken their argument and make yours stronger. I really appreciate how you referenced how we can travel so easily nowadays. It really is a scary thought of how swiftly a microorganism can bring us to our knees. I agree %100 with your stance. I think it is in the best interest of human kind to do whatever we can to avoid these epidemics. Great topic.

  4. I really liked your introduction,I was in the doctors office yesterday and the way you described the environment was spot on. It made me feel like I was back in the doctors office just reading it. The examples you used throughout your paper really helped you prove your point that vaccines should be mandated. Also your use of statistics and quotes really helped support your argument and made for a really informative blog.

  5. Hi Jamie, Very blunt visual that i think was great for the topic. I felt compelled to read more after seeing the visual. I think it is crazy people will not vaccinate their kids although it is proven that it helps in the long run. I don’t know if laws should be in place to have kids vaccinated but it should definitely be encouraged. It is crazy that vaccinations save 33,000 people a year. Very interesting topic and i really liked reading your blog.

  6. Great introduction, it really made me think of my last trip to the doctors and its surroundings. I had no idea how big of an impact vaccines actually had. Some vaccines are even becoming a a sort of spray to put up a persons nose, so that can be one less shot. I didn’t know that the law required the vaccines, I just knew i always had to get them every few years.

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