Abstract
Mandatory vaccination provides the needed motivation and incentive for many to receive their necessary vaccinations. Such positive outcomes cannot occur with only voluntary programs, but passing laws which make it mandatory for students and health workers has been proven to increase rates, and it provides an example that is likely to be followed by others. When more people receive their needed vaccination, herd immunity is more likely, and when herd immunity rates are reached the community can remain healthy in the face of preventable diseases. It is possible to reduce the suffering of very sick children, elderly persons and workers by preventing the incidence of communicable illness through mandatory vaccination. For the simple reason that it is possible to do so and thereby avoid tragedy, mandatory vaccination should be supported by lawmakers, enforced by healthcare providers and institutions such as schools and put into practice by households.
Why would such situations be allowed to occur, when there is a simple solution? For the simple reason that it is possible to do so and thereby avoid tragedy, mandatory vaccination should be supported by lawmakers, enforced by healthcare providers and institutions such as schools and put into practice by households. This would have the potential to prevent hundreds of thousands of deaths every year, on a national scale. Anything less predicts terrible outcomes, as there are known rates of mortality, injury and illness when communicable disease takes a toll on communities. It is possible to reduce the suffering of very sick children, elderly persons, and workers by preventing the incidence of communicable illness through mandatory vaccination.
Herd immunity describes how an entire population can benefit when most of the people in a community have received vaccinations against common communicable illness. This opportunity can be missed due to the problem of reaching the minimum level of vaccinations needed for herd immunity due to the phenomena where, when immunization levels reach a certain point, voluntary immunizations are resisted by many (Van Panhuis et al., 2013). This occurs despite the success of vaccines historically in stemming disease, death and injuries. The first mandatory requirement for vaccination against smallpox was in Massachusetts in 1809, an example which was followed by other states leading to a dramatic decline in incidence by1840 (Omer et al., 2009). Unfortunately smallpox returned by 1870 due a decrease in enforcement of the law (Omer et al., 2009).These events provide a clear historical reason for implementing mandatory vaccination to support efforts in reducing the incidence of preventable disease (Omer et al., 2009).
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In order to maximize the potential preventative power of the immunization it is necessary to find ways to raise the immunization rates and mandatory immunization holds the potential to do that (Van Panhuis et al., 2013). Lawmakers play a part in ensuring that herd immunity is present and preventing unnecessary sickness and mortality in communities by passing laws supporting the mandatory vaccination of school children and healthcare workers. In order to reach the higher rates of immunization to prevent outbreaks of disease one cannot count on voluntary immunization. It does not result in high enough rates to ensure herd immunity, and when herd immunity is not sufficient vaccination programs do not achieve their goals and outbreaks of disease occur (Averhoff et al., 2004). Two areas where mandatory vaccination can easily be supported by lawmakers are in public schools and health care settings. In these cases the institutions themselves would be the agents of enforcement, and students and workers without appropriate vaccinations would be sent home until they have complied.
There are great risks when children in school are not vaccinated. When children go without vaccination this allows for a point of entry for disease into the community and population which can undermine the objectives of vaccination programs. In order to meet the objectives of vaccination for school aged children, mandatory requirements are necessary to ensure compliance and herd immunity (Averhoff et al., 2004).In this case, the passage of a law requiring immunization for school entry has the effect of greatly increasing compliance rates, as schools ensure that the laws are not breached through checks at school entry every year (Averhoff et al., 2004).
Health care workers have a special position as they are constantly interacting with the sick and vulnerable. Low vaccination rates pose a health risk for health care workers and for their patients. The influenza virus in particular is a cause for concern, and the result of unvaccinated healthcare workers has included patient mortality and increased costs of healthcare (Stewart & Cox, 2013). Voluntary vaccination programs have not worked to reduce the incidence of the flu in health care workers and it is a continued cause for concern in relation to patient health (Stewart & Cox, 2013). Many jurisdictions have, through mandatory requirements, achieved success with vaccination results that are nearly one hundred percent, thereby saving lives and the health of the vulnerable (Wicker & Marckmann, 2014).
Mandatory vaccination works, by providing the necessary incentives to specific populations. Saving lives and ensuring good health can be this easy. Ensuring that outbreaks do not occur begins with increasing vaccination rates, and this can be achieved by laws making it mandatory for children in schools and health care workers to receive their annual vaccinations. As a result, not only does this population benefit, but also patients, households and the community will benefit from a low incidence of influenza and other preventable diseases (Wicker & Marckmann, 2014). With the examples of schools and health settings, employers might also pass policies that make it mandatory for their workers to become immunized. This further increases herd immunity while ensuring that there are fewer sick days and lost productivity in the workforce. There is a clear business case for mandatory vaccinations in the workplace, particularly in those positions that interact with the public.
Mandatory vaccination provides the needed motivation and incentive for many to receive their necessary vaccinations. Such positive outcomes cannot occur with only voluntary programs, but passing laws which make it mandatory for students and health workers has been proven to increase rates, and it provides an example that is likely to be followed by others. When more people receive their needed vaccination, herd immunity is more likely, and when herd immunity rates are reached the community can remain healthy in the face of preventable diseases.
- Averhoff, F., Linton, L., Peddecord, K. M., Edwards, C., Wang, W., & Fishbein, D. (2004). A middle school immunization law rapidly and substantially increases immunization coverage among adolescents. American journal of public health, 94(6), 978-984.
- Omer, S. B., Salmon, D. A., Orenstein, W. A., deHart, M. P., & Halsey, N. (2009). Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. New England Journal of Medicine, 360(19), 1981-1988.
- Stewart, A. M., & Cox, M. A. (2013). State law and influenza vaccination of health care personnel. Vaccine, 31(5), 827-832.
- Van Panhuis, W. G., Grefenstette, J., Jung, S. Y., Chok, N. S., Cross, A., Eng, H., … & Burke, D. S. (2013). Contagious diseases in the United States from 1888 to the present. The New England journal of medicine, 369(22), 2152.
- Wicker, S., & Marckmann, G. (2014). Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe?. Vaccine, 32(38), 4844-4848.
