Monday, March 12, 2012

PF - Vaccination Topic - General Information



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Resolved: State mandated administration of childhood vaccinations is justified.


Clarifying Meanings
State mandated administration, simply means that a function is obligatory by order of the state and in this case the function is the administration of childhood vaccinations.  Administration can have several interpretations but I don't think it matters all that much.  Administration is the act of administering and to administer can mean, to employ or bring into use and it can mean to manage one's affairs.  In either case, there is really little to be gained from getting tricky with definitions.  We are talking about governments requiring compulsory immunization and that is really the core of the debate.  A secondary issue may or may not revolve around how the vaccinations are performed.  The phrase, childhood vaccinations can also carry several definitions, neither of which is particularly significant, in my opinion.  Given that a vaccination is an inoculation against disease, we could say childhood vaccinations are those given to people of childhood age or we could broaden that to say they are the class of inoculations which should be administered to children regardless of whether they were or not.  The only difference is, under the second definition one can claim that adults who missed the childhood vaccinations should also be forced to receive them. Regardless, I think it is a secondary issue at best.  The major debate will center around whether or not states are justified in mandating such actions as a general principle.  The details of administration are not that important.

Time-frame and Scope
It is worthy to note, the resolution does not provide any information about particular kinds of targeted diseases except perhaps those most commonly described as childhood diseases, and it does not provide any kind of time-frame.  This means the mandated program could be permanent or a specific campaign aimed to a particular public health emergency and goes away when the emergency has ended.  The fact, the resolution does specify "childhood" vaccinations does seem to suggest, the debate should be limited in scope.  In the U.S. for example, childhood vaccinations are generally limited to Varicella (chickenpox); DTP (diphtheria, tetanus,pertussis); IPV (inactive polio vaccine); MMR (mumps, measles, rubella), Hib (a form of influenza) and several others.

The Rationale for Immunization
So why mandate childhood vaccinations?  Anyone who researches this topic will be overwhelmed with information and statistics supporting the use of childhood vaccinations and advocating compulsory administration.  Clearly, the disease rate is reduced in states and countries which require vaccinations. In the United States, the Federal Government does not mandate immunization but the 50 individual states do mainly as a condition for admittance into public schools. (see: http://www.cdc.gov/vaccines/vac-gen/laws/state-reqs.htm

Exceptions are made for children who may be allergic or have compromised immune systems or for parents who cite certain religious or philosophical objections.  In those areas of the country where there are a high number of exemptions, the disease rate increases accordingly. Some of these diseases are highly virulent, meaning they spread quickly and easily to others and each is particularly devastating to the health of the victims.  Without modern medical attention, some of these diseases have a high probability of permanently injuring or killing the victims.  In some cases, the diseases (measles for example) can be much more harmful to adults than children.  Because children are grouped closely together is school settings, infections tend to race quickly through the local population, hence the requirement for vaccination prior to entering school. The other thing to consider is the cost of dealing with these diseases.  There is a financial impact in terms of drain on the health-case system, lost time, lost productivity, etc.

The Argument Against Mandating
Well perhaps there are several important arguments against mandating vaccinations.  The most important centers around the issue of personal freedom.  People tend to feel very suspicious when the state claims the right to inject something into one's body or the bodies of one's children.  This can be viewed as an invasion of privacy and infringement of personal autonomy and the right to choose what one allows into their body.  Does the Government always have one's best interests in mind?  Look at Project MKULTRA or look at this article detailing a U.S Government sponsored experiment in Guatemala: 
http://abcnews.go.com/Health/guatemala-syphilis-experiments-shock-us-drug-trials-exploit/story?id=14414902#.T14kXUj-jZU

The most reasonable argument against mandated programs is common sense.  It can be claimed that most well-informed and caring parents will choose childhood vaccinations to protect their children because they are known to be effective and what parent would not want to protect their children?.  In fact, in most other countries around the world, vaccinations are NOT mandated by the state.  People are free to choose and most will opt for the protection of immunization. Of course, many European countries have government sponsored health-care so the cost of receiving childhood immunizations is not an issue.

Herd Immunity and a Dash Of Controversy
Herd immunity is based on the idea that some non-immunized members of a population will be protected from disease if a sufficient percentage of the remaining population is immunized.  This was observed and studied in cattle populations in which farmers were able to protect their herds from disease even when some number fewer than 100% were immunized.  The level of inoculation in which herd immunity becomes effective is typically cited at around 80-90%.  During the 2009 LD season when this topic was debated, herd immunity arguments where very popular when coupled with the argument that most people would opt for voluntary immunization. This USA Today article may be of interest: 
http://www.usatoday.com/news/health/2010-01-06-childhoodvaccines06_CV_N.htm

And now for the controversy.  In 2009, there were a rash of rumors and some evidence linking MMR vaccine with autism in children.  The claim was MMR vaccination caused autism in certain children and so the vaccination was thought unsafe.  This led to fear among many parents that perhaps the government mandated vaccines required more study and many parents refused to have the vaccine administered to their children.  At that time, debaters countered the argument with a trove of CDC and health industry studies which claimed the evidence linking autism to childhood vaccinations was flawed or non-existent and even if there was a link, the benefits of immunization far outweigh the risks.  So I will leave you with this article dated from one year ago: 
http://www.cbsnews.com/8301-31727_162-20049118-10391695.html

In the next part, I will discuss the Pro and Con strategies and present some evidence for both sides.
<Click here for part 3>







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