Vaccines: when should we legislate? Open Access

Beeler, Jennifer (2015)

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Vaccination has proven to be an effective method of controlling and preventing the spread of many infectious diseases. Due to routine immunization in the United States, mortality rates due to diphtheria, pertussis, tetanus, and mumps have been reduced by 99%, and compulsory vaccination laws have resulted in near record high vaccination coverage among school-age children. Compulsory vaccination laws have been in effect since the 19th century, and have been generally well accepted. However, vaccine mandates have also been met with ardent opposition from various groups, including certain religious factions. Some religious groups believe that mandatory vaccination laws violate their religious freedom, while others argue that compulsory vaccination infringes upon their personal autonomy. Furthermore, some have expressed concern over the possible, but unlikely, risks associated with vaccination, and the number of vaccines that children receive. All states, with the exception of West Virginia and Mississippi, permit religious exemptions, allowing followers of certain religious beliefs to opt-out of vaccination laws. Additionally, 20 states allow for philosophical or personal belief exemptions. In order to maintain high vaccination coverage and prevent infectious disease outbreaks, state legislators must propose dynamic legislation restricting, but not eliminating nonmedical (i.e. religious and philosophical) exemptions. Ultimately, by broadening administrative requirements for nonmedical exemptions, policy makers will tip the "balance of convenience" in favor of vaccination, making vaccination the default option.

Table of Contents

Abstract. 8

Literature Review. 9

Introduction. 9

History of Compulsory Vaccination Laws. 9

School Entry Vaccination Requirements. 11

School Entry Exemption Policies. 12

Claiming Nonmedical Exemptions. 13

Nonmedical Exemptions: Necessary or Dangerous?. 14

Vaccine-Related Legislation. 16

Rational Administrative Requirements. 17

Effective Health Communication. 18

Financial Incentives and Penalties. 18

Policy Implementation. 21

Conclusion. 21

Public Health Implications. 23

References. 26

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