COMMENTARY

YOUR Fault if Your Unvaccinated Child Makes Someone Sick

Arthur L. Caplan, PhD

Disclosures

October 15, 2013

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I'm Art Caplan from the Division of Medical Ethics at the NYU Langone Medical Center in New York City. Are you doing enough to make sure that your patients and their kids are getting vaccinated? Sometimes we leave this for the pediatrician to worry about, but I think that every doctor who sees patients should make it a part of taking the history to ask if they are up to date on vaccinations. Have they gotten their boosters? What are they doing with their kids?

All over the United States, we are tragically seeing the recurrence of diseases that weren't here 20 years ago. Whooping cough, mumps, and measles are all on the rebound because people don't vaccinate their kids or they don't get the booster shots that they need to grant immunity to themselves. There was a recent outbreak in Texas in a small church, and these outbreaks are pretty typical. It's not that most people don't vaccinate, but you get pockets of people who aren't doing it. In this case, a particular church didn't believe much in Western medicine. Someone went to Africa and got exposed to measles. Then they came back and they paid a visit to a neonatal nursery, infecting the babies, who, you may remember, can't get vaccinated until they are at least a couple of months old. They don't have enough immunity. The place is quarantined and the parents in the neonatal nursery are freaking out, wondering if the kids are going to die of measles or if they are going to get side effects and other medical problems.

A couple of lessons emerge from this measles situation. We are seeing outbreaks all over the United States and all over the world because pockets of people are not getting vaccinated. First, we have to make it an important mission in medicine to urge people to get their vaccinations. If they are not in your office, then it has to be brought up at church. If it's not at church, it has to be brought up at school. Vaccination works best when it is something that everybody does. That's where we get our group or herd immunity. More protection comes from more people getting involved. Doctors and nurses really have to advocate hard for this.

If you suspect that someone hasn't been vaccinated or you hear about it, then it's important to tell that person, "You have responsibilities." You wouldn't send your kids to daycare if they have symptoms of a cold or illness. You shouldn't be visiting a neonatal unit if you haven't gotten yourself or your kids vaccinated. It's one thing to make a decision not to vaccinate. I'm not sure I would change that. I still think people have the right to make that decision. I don't think it's a smart thing to do, but they have the right. However, they are responsible for the consequences. They need to understand that if they make somebody sick or they kill a child because they gave them a disease that was preventable, it is on them. It is even possible that they could get sued for the harm and damage that they caused as a result of irresponsible behavior after choosing not to vaccinate.

I don't think that's too tough. I think that it is the responsible and right thing to do to tell people to get vaccinated, not just for yourself but for your neighbor and for others. If you choose not to do that, remember that you are responsible. You have to take precautions so that you don't hurt others.

I'm Art Caplan from NYU. Thanks for watching.

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