Vaccination Is a Moral Good, Not a Political Football

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Hello. I am Art Caplan, at the New York University Langone Medical Center, Division of Medical Ethics, in New York City.

Should politicians weigh in on vaccination? From what I have seen in their efforts to shape the debate about measles, probably not.

Sadly, vaccination rates in some areas of the country have been dropping—in some communities to as low as 50% for the full series of childhood vaccines.^[1] You need to have much higher vaccination rates, 90% to 92%, to achieve herd immunity, which you need to achieve widespread protection. The measles vaccine, for example, is not perfect. Roughly 4% or 5% of people do not respond to it; thus, if you have a pocket of people who do not vaccinate, they are putting the entire community at risk for an epidemic.

We have seen this beginning in the United States, with cases breaking out all over the country and crossing into Mexico, all from a case that began at Disneyland. Thus, lack of vaccination, undervaccination, and poor vaccination rates can truly put the population at risk.

Physicians also need to understand that people who have had a bone marrow transplant, an organ transplant, those who have an immune system disease, and newborns up to age 1 year are especially vulnerable to diseases like measles, mumps, or whooping cough because they lack immunity and we cannot vaccinate them effectively.

From my point of view, vaccination is a moral good because it protects children from something they cannot protect themselves from, and it is a moral good because it protects the community. The weak and vulnerable members of our community are protected when everyone vaccinates.

Making This Political Serves No Purpose

A number of politicians have weighed in and said that they do not see it that way. They favor liberty and choice. Rand Paul, Chris Christie, and a number of candidates who are running for President have said either "I am not sure about mandating vaccines" or "I am not sure that the right to decide whether to vaccinate their children should be taken away from parents."

To me, this is like saying that a parent should have the right to decide whether or not they want to use a car seat, or a parent who owns a gun should have the right to decide whether they want to put it out on the table when the neighborhood kids come over.

I mean, come on. We have vaccinations that can prevent death, hospitalization, and a lot of suffering. In my opinion, this should not be a matter of choice. I believe vaccinations should be a requirement. I would argue that we ought to ensure, through school and daycare mandates, that kids get their vaccinations. When they are proven effective, the argument against them is hard to understand.

Perhaps we should allow some exemptions for health reasons, but religious or philosophical objections, when you put others at risk, do not make any sense to me. Politicians who say otherwise should be thinking harder about which priorities they believe in: the public good or individual rights. When it comes to diseases that are vaccine preventable, I believe the community ought to trump the individual.

I am Art Caplan, at the Division of Medical Ethics at the NYU Langone Medical Center. Thanks for watching.

Cite this: Vaccination Is a Moral Good, Not a Political Football - Medscape - Mar 24, 2015.

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