COMMENTARY

A Child's Right to Be Vaccinated

Paul A. Offit, MD

Disclosures

January 11, 2016

Editorial Collaboration

Medscape &

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Hi. My name is Paul Offit. I'm talking to you today from the Vaccine Education Center here at the Children's Hospital of Philadelphia.

Most of you know that the state of California eliminated its philosophical exemption to vaccines. Therefore, the only exemptions in California are medical exemptions. Why did they do that? The reason is that southern California, specifically Disneyland, served as the epicenter for a massive measles epidemic—one that spread across the United States, involving about 25 states and affecting about 158 people, mostly children. The epidemic also extended northward into two Canadian provinces, where it affected hundreds more people. What happened in California was, they asked the question, "Is it your right to catch and transmit a potentially fatal infection?"

They decided in California that the answer was no. This is the third state that now has only medical exemptions to vaccines. The other two states are Mississippi and West Virginia. The roots of this are in Mississippi, in a case that occurred in the late 1970s called Brown v. Stone. The question that came up in Mississippi was, "Is it your right not to be vaccinated?" and the decision was made that only medical exemptions made sense. It was a 14th Amendment argument—specifically, the second clause of the 14th Amendment—which states that all citizens of the United States should have equal protection under the law. Even if your parents have ill-founded beliefs about vaccine safety, that doesn't mean that children shouldn't be protected. Essentially it became a civil rights issue.

If you go to these rallies in California or Vermont or Michigan, you often hear parents say, "It's about my rights. It's my parental right to raise my child as I see fit." But what about children's rights? Who represents them? In this country, for example, if you are an African American and you feel that you are being treated badly, there are places you can go and people who will represent you. If you are Jewish and you feel that you are being defamed, there are groups you can go to who will defend you. But if you are a child, it's assumed that your parents represent your best interests, and that's not always true. When it's not true, as in this case where parents have a false belief that vaccines cause autism and they don't want to vaccinate their children, who do those children go to?

The answer is, they go to the state. That's what happened, frankly, in California, which basically used a child's rights issue as the central focus of how they made that change. A little boy who had leukemia would go out to those meetings and say, "What about me? Don't I have rights, too? I can't be vaccinated. I depend on those around me to be vaccinated." In the end, in many ways, this is a child's rights issue. It is a civil rights issue with a child, and it's a right that is protected by the 14th Amendment.

Thank you for your attention.

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