No More Vaccine Exemptions for Children

CAS 138T Persuasive Essay Victoria Spadafora Audience Statement: My persuasive essay is directed at both the state and local governments as well as parents of young children. I push for the governments to make mandatory vaccination laws and for the parents to abide by and understand the need for such laws to protect the health of their children and society. Introduction We all tense up as that needle approaches our arm, preparing for that familiar yet harmless pinch that we somehow still fear. The discomfort and anxiety that is often associated with getting vaccinated is a small sacrifice to make to reap its larger benefits. Unfortunately, some people disagree, associating this minor sting with an even more harmful consequence. This grander fear is a dangerous one, one that could lead our country to being more susceptible to diseases new and old. Yes, we may have fought off and eradicated many epidemics, but without vaccinations, there is always the chance and probability that these monsters will rise again. We need to foresee this possibility in order to diminish its opportunities of becoming a reality. The best way to do this is by starting at a young age. State and local governments are currently deemed the protectors of public health. Every state has a law that requires a child to be vaccinated before they can enter a public or private school (Welborn). Many different kinds of exemptions exist to allow the avoidance of receiving a vaccine. These allowed exemptions vary amongst the states, with some states being more lenient than others. State and local governments should take the initiative to make childhood vaccinations mandatory by removing all religious and philosophical exemptions present in their respective states. This is an important action for these governments to take because it will improve each individuals personal health, provide safety for the community, and allow for the protection of the country in the future.

Personal Health Mandatory vaccinations for school children were first introduced in 1855 in Massachusetts when only the small pox vaccine was in existence (Vaccination Exemptions). Since then, vaccinations have been mandatory for children before they are permitted entry into a school. Vaccines are important for a childs personal health because of childrens susceptibility to diseases due to their less developed immune systems. Vaccines help to strengthen a childs immune systems defenses by training it to produce antibodies that fight a certain virus or bacteria (Williams 8). This can be done because a vaccine consists of either a completely dead or heavily weakened form of the microbe that we want to produce a defense against (Williams 8). These microorganisms contained in the vaccine are so weak that they are unable to cause illness, but the body still reacts to them in the same way as it would to the full-on disease. In this way the body practices defending itself from the virus and prepares itself to react more quickly and effectively if exposed in the future (Williams 8). Medical research and vaccine production has come a long way since the first mandatory small pox vaccine. After the initial implementation of vaccine requirements, the only exemption that was considered valid was that of medical related issues where someones immune system or other factors would not allow them to be vaccinated. In recent years, the addition of religious opposition and philosophical beliefs against such vaccines has increased the amount of exemption requests. Some of the philosophical beliefs proposed in opposition to vaccinations include a mistrust of the pharmaceutical companies that provide them and a fear that the vaccine will actually cause more harm than good (Ciolli 1). A more recent concern that has risen regarding vaccines is one that indicates that vaccines could be linked to autism (Concerns about Autism). In essence, people are concerned that increased appearances of autism are related to more prominent vaccine usage. An ingredient called thimerosal was of upmost concern in the linkage between vaccines and autism. In 2001, the Center for Disease Control itself conducted an experiment to test this suspicion. The ingredient in question was taken out

of every childhood vaccine or decreased to very miniscule amounts (Concerns about Autism). Next, data was analyzed that compared the vaccine use with autism frequency to see if anything had changed after this alteration. The CDCs review did not find any correlation between the two factors (Concerns about Autism). An additional review completed by the Institute of Medicine (IOM) produced a further conclusion that the evidence went as far as to favor the opposite of the initial fear. Rather than showing a trend supporting a cause and effect relationship between vaccine use and autism, they believed to have seen evidence that would reject this relationship all together (Concerns about Autism). After these concerns surfaced, the IOM decided to go further and test the wide range of adverse side effects of vaccines. It reported on eight different vaccines in August of 2011. These included vaccines provided for both children and adults. The conclusion stated that the vaccines were in no way dangerous because the occurrence of adverse side effects after injection proved to be very rare (Concerns about Autism). A final piece of proof that vaccines and those who administer them are trustworthy, safe, and effective is seen in how these vaccines are made and evaluated. Vaccine safety is tested initially using animals and later through a cycle of many human trials. The Food and Drug Administration (FDA) then conducts more of its own tests following this process while also inspecting the manufacturing protocols and facilities of the vaccines creator (Williams 20). Every vaccine lot must have a few samples tested even after being licensed so that the FDA can truly be assured the vaccine is pure and potent. After the manufacturer has tested each lot, the FDA once again performs its own lot tests (Williams 21). After passing through all of these checkpoints, a vaccine can finally be released. This is a thorough process meant to catch anything that could possibly be deemed harmful about the vaccine. As mentioned above, there are no doubt possibilities that a side effect can occur from a vaccine, but this is rare. When being evaluated, the vaccine is used in clinical trials involving thousands of people, so any common side effect would be evident. This would indicate diminished safety of the vaccine and action could be taken. Rare side effects do not occur in such trials and therefore are not documented as consequences of the

given vaccine. Their disparity in such trials indicates that these effects would occur so minimally in children that they would be at more risk of being affected by the disease than the vaccine itself. (Williams 22-23). Community Safety Traffic laws, paying taxes, and even drug tests are annoyances that everyone participates in for the betterment of the community they live in. Drug tests may be seen as an invasion of privacy and paying taxes is detrimental to anyones income. Despite these downsides that could be seen as violations of ones personal choice, we are required to obey them, and we do. In such cases, avoidance of participating in these actions even comes with a punishment. These are small sacrifices made for the betterment of society and represent situations where the idea of the subversion of individual choice to public good is set into action (Feemster). For this act of subversion that violates our rights to be justified, it must meet a certain criteria. The action that is being encouraged must be both safe and effective. On top of this, the risk involved with exempting oneself from participating in such action must outweigh the risk of involving oneself in the action (Feemster). Kristen A Feemster, a pediatric infectious disease physician, assures that vaccines do meet this criteria despite what the media may portray. Unfortunately, the spread of media sourced information has created a hesitance towards vaccination which has been labeled as the vaccine confidence gap, something that we should fight hard to eliminate (Feemster). While the Center for Disease Control agrees that any serious injury from a vaccine is one too many, it assures that a child is much more likely to be injured by the disease than the vaccine, and for this reason they believe that the benefits of vaccines far outweigh the risks (Williams 9). Despite the assurance that vaccines are safe and necessary, forty-eight states have allowed religious exemptions and fourteen have also allowed philosophical opposition to qualify for exemption (Ciolli 2). In states with all three exemptions (including the imperative medical exemption), personal belief exemptions have become the most commonly used (Vaccination Exemptions). This is most likely

because almost anything goes. Whether the person fears a harmful effect of the vaccine or would rather refer to natural immunization, they all qualify. Some states such as Washington require that these people speak with a health provider to give them more information on vaccines in hopes of educating them and changing their opinion. In states like these, exemption rates are only six percent, but they are still increasing (Vaccine Exemptions). The frequency of philosophical exemption requests have been increasing over time. From 1991 to 2004, these requests increased from 0.99 percent to 2.45 percent and they continue to rise today (Vaccine Exemptions). By vaccinating large portions of the population, our goal is to create something called herd immunity. This kind of immunity prevents a disease from gaining a foothold within a community. In this way, the large percentage of immunized people serve as a protective barrier that keeps the disease from spreading to those who are too young to be immunized or who have compromised immune systems (Ciolli 2). Each disease requires a varying percentage of people to be immunized to qualify for herd immunity, but all require percentages that lie above 90 percent (Ciolli 2). Our ability to achieve this goal is jeopardized more as we become more flexible with the exemptions we allow. Already, a large portion of people cannot receive immunizations because of their medical conditions, and these are the people we need to protect by getting vaccinated. As the addition of other exemptions and the number of people requesting these exemptions increases, we slip closer towards putting ourselves, the medically unable, and our whole community in danger of disease (Ciolli 2). Proof of this is contained in religious hot spots. Christian Science, Amish, and Menonite communities have been known to host the outbreaks of preventable diseases due to their opposition to vaccinations (Ciolli 1). They have formed smaller communities within our larger one, and these communities are unable to achieve the herd immunity we desire. Rather than the majority getting vaccinated as needed to form the protective barrier, more are in opposition putting themselves and the whole community in danger. Dangerous diseases that we have already fought off using vaccines such as

measles, rubella, and polio resurface. The costs of the outbreak of a preventable diseases are immense both monetarily and more importantly in regards to human life (Ciolli 1). Future Protection There is a strong chance that a large part of the indifference towards vaccinations is due to the success of vaccinations themselves. Now this seems a little bit contradictory, but think about it. Because of the effectiveness of vaccines, diseases such as measles and polio no longer appear to be a threat to us as a country. We dont see this issue as an immediate harm to us or our community so it appears to be something that we can just surpass and remove from our thoughts. While some of these past deadly diseases appear as if they are completely gone or even severely diminished, the bacteria and viruses causing these diseases still do exist and could harm those who arent vaccinated (Merino). A great example is that of polio. It has officially been eradicated in the Western Hemisphere, European region, and West Pacific region (Merino). While this is indeed a large portion of the world, it still exists and it still poses a threat to those not vaccinated. Especially with our ability to quickly travel across the world, the spread of such a disease is quite possible and is made easier when people make themselves susceptible. Polio was the cause of acute paralysis in 20,000 American victims before a vaccine was produced (Merino). We can quantify the success of the polio vaccine as worldwide 350,000 people fell victim in 1988, only 2,000 in 2006, and now only four countries remain endemic. This means that polio is restricted and almost native in these countries (Merino). But the countries that fit this final four include India, Afghanistan, Pakistan, and Nigeria. Afghanistan houses many of our fighting soldiers determined to return one day to their family and capable of bringing back a disease. India is a place that is frequently traveled to by Americans, so we are in no way safe from exposure to this disease. We can continue to look upon the past to predict what a future without vaccinated people would be like. It is stated in one article that before the measles vaccine became available nearly everyone got measles and 450 measles associated deaths were reported each year (Merino). It is

considered one of the most infectious diseases in the world and we are by no means protected from its return. In past years, cases of measles in the U.S. were caused by either foreign visitors or U.S. citizens who had traveled abroad. Even scarier is that if someone who is not immune to measles from the vaccine comes in contact with it, they have a 90 percent chance of contracting the disease (Merino). Analyzing statistics on the deaths per year from measles of third world country citizens enables us to get a glimpse of what the removal of vaccinations could do. If no measles vaccines were provided, over 2.7 million people would die from measles each year. Currently, vaccines have reduced measles outbreaks by 99 percent but all these efforts could be reversed if too many exemptions follow (Merino). Finally, why is our future in the children? Because they are those among us who are the most susceptible proven by the fact that some diseases are only able to injure the immune system of a child. An example of this is Hibs meningitis. Before the vaccine, one in every 200 U.S. children under five years of age got a Hibs disease, including a span of time where HIbs killed six hundred children per year (Merino). The vaccine was introduced in 1987, improving these incidents by 98 percent, and creating a four year period where less than ten cases were reported each year (Merino). Just like the diseases listed above, the predicted outcome of ending vaccinations would be a return to pre-vaccination conditions. While not everyone currently seeks to be exempt from the vaccinations, the requests continue to climb, and soon enough our ability to create herd immunity will be eliminated. This will be just the beginning of a downward spiral towards renewed susceptibility to diseases that should instead be easily prevented. Conclusion Vaccines have allowed us to triumph against deadly monsters such as polio, measles, rubella and more, but they remain looming in the dark waiting to rear their ugly heads once again. For years we have remained strong, keeping vaccination rates high, and leaving exemption to a mere few. Whatever the reason, whether it be laziness, mistrust of authority, or other growing trends in our society today,

our exemption request rates are vastly increasing. People are relying on religious beliefs and more heavily on the philosophical or personal belief plea to rid them of the burden of receiving their mandatory vaccinations. While these diseases have been long suppressed and their threat seems dim and distant, this is far from the case. Our gradual reduction in the amount of U.S. citizens who are taking the initiative to get vaccinated is leading to the reduction in our immune ability as individuals and as a community. If we want to continue our fight against such deadly but preventable diseases, we need to take action now. State and local governments must eliminate both religious and philosophical exemptions given to our citizens in attempts to avoid vaccinations. This is the only way that we can ensure the continuance of our personal health, the safety of our community as a whole, and the promise of a healthy world in the future, three benefits that vaccines can guarantee.