Should there be a penalty for not vaccinating yourself or your kids?

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I'm a firm believer in vaccinations. I know I've told the story on here before about my friend whose kid couldn't be vaccinated: he caught whooping cough and died.

Now some are proposing penalties for failure to vaccinate:

Quote:

What does society do when one person's behavior puts the greater community at risk? We make them stop. We pass laws, or impose economic rules or find some other way to discourage individual behaviors that threaten the greater common good. You don't get to drive drunk. You don't get to smoke in public places. You don't even get to leave your house if you catch some particularly infectious disease.

The evidence is overwhelming that declining vaccination rates are contributing to outbreaks of disease. Take just one example, measles. The World Health Organization reports outbreaks in countries where vaccination rates have gone down, including France (7,000 cases so far this year, more than in all of 2010), Belgium, Germany, Romania, Serbia, Spain, Macedonia and Turkey. There have already been 334 measles cases in England and Wales this year, compared with 33 all of last year. The U.S. has seen 118 cases as of mid-May, compared with 56 cases a year from 2001 to 2008.

Small numbers, you say? True, but consider their cost (beyond the suffering of the patients), as illustrated in this case published this year by the Oxford Journals. When a woman from Switzerland who had not been vaccinated for measles visited Tucson in 2008 and became symptomatic, she went to a local hospital for medical attention. This initiated a chain of events that over the next three months led to at least 14 people, including seven kids, getting measles. Seven of the victims caught the disease while visiting healthcare facilities. Four people had to be hospitalized. The outbreak cost two local hospitals a total of nearly $800,000, and the state and local health departments tens of thousands more, to track down the cases, quarantine and treat the sick and notify the thousands of people who might have been exposed.

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There are many potential solutions, each fraught with pros and cons and details that require careful thought and open democratic discussion.

• Perhaps it should be harder to opt out of vaccination. (Twenty-one states allow parents to decline vaccination of their children simply for "philosophical" reasons; 48 allow a religious exemption, but few demand documentation from parents to support claims that their faith precludes vaccination.)

• Perhaps there should be higher healthcare and insurance costs for unvaccinated people, or "healthy behavior" discounts for people who do get vaccinated, paid for from what society saves by avoiding the spread of disease.

• There could be restrictions on the community and social activities in which unvaccinated people can participate, like lengthy school trips for kids,etc.

Read all about it: http://www.latimes.com/news/opinion/commentary/la-oe-ropeik-vaccines-20110718,0,4240440.story

On the "Step away from the candy" thread there was a lot of discussion about government interference in people's lives. I'm wondering what people think about this kind of interference.

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Type: Question • Score: 14 • Views: 9,148 • Replies: 128

@boomerang,

For the parents? Yes! For the kids? Indirectly by withholding them from schools if they need their vaccines.

Children who don't have their vaccinations could lead to school wide epidemics if their numbers reach a tipping point.

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@tsarstepan,

I think most kids are vaccinated so I don't think there will be major epidemics what worries me is the kids that can't be vaccinated for whatever health reasons. I think we owe it to them to vaccinate those we can.

Those numbers in the article were pretty scary. I know there was a big anti-vaccine thing for a while but I thought that was over and I assumed those kids had since received their shots.

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@boomerang,

It depends on whether or not the kids have any kind of serious allergic reaction to the vaccinations.

As a kid, I had a serious reaction to the polio vaccine and passed out in the parking lot as we were exiting the medical center. I was always told to only receive the polio vaccine using the sugar cube method.

As an adult, several times I've had a stronger than mild but not severe reaction to flu vaccines. So much so, that I refused to get them for many years because I felt I always ended up with a worse case of flu immediately after getting the injection.

After moving in with BBB two years ago, I gave in and got a flu shot since I was going out in the public a lot to do errands and didn't want to bring anything home to BBB. BBB and the pharmacist/nurse both insisted there wasn't any live viruses in the vaccines and it was all in my head. I got the injection and a few minutes later, I started feeling dizzy, sweaty and had a rapid pulse. They made me sit there for half an hour to make sure the reaction subsided. Turns out, I'm allergic to an ingredient used in the vaccines. We suspect it is tamiflu but no one knows for sure.

As far as I know, I've had all the vaccines for the common child hood diseases such as chicken pox, measles, mumps, etc., and didn't have any reaction to those. I've also had the diseases themselves and have built up immunity that way.

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@boomerang,

boomerang wrote:

On the "Step away from the candy" thread there was a lot of discussion about government interference in people's lives. I'm wondering what people think about this kind of interference.

In my capacity as an armchair economist, I'm all for effluent taxes on air pollution. Sneezing harmful bacteria into the air other people breathe is analogous to emitting harmful chemicals into it. So why not tax non-vaccinators or---probably an easier sell---subsidize those who vaccinate themselves and their children?

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@Thomas,

In most states, the failure to complete mandated childhood vaccinations is grounds for dismissal from public schools and proof that they have been completed is usually required. There are always fringe groups who resist - sometimes successfully. The reasonable course of action is to avoid relentless enforcement of such a law in that the beneficial effect of vaccinations is largely accomplished if a great majority of the population has been vaccinated. Perfection is not necessary.

I believe the public health argument trumps individual discretion in this matter, but also believe that restraint is warranted for things like childhood obesity.

"Good intentions" are often used to rationalize tyrannical government. The (self-appointed) Vanguard of the Working class in Russia presumably had the best of intentions, when it overthrew the regime in October 1917. When Lenin started the "Elimination of the Irreconcilables" a few years later, I'm sure he had the best of proletarian revolutionary intentions, but it was murderous tyranny nonetheless.

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@georgeob1,

I'm not advocating that non-vaccinators be eliminated as irreconcilable, only that they be taxed. People would be free to get vaccinated---or not to get vaccinated and pay the tax. There is plenty of room between Leninist Russia and applying no pressure at all.

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Last year, there was an outbreak of pertussis in our schools in San Diego - mainly caused by children of undocumented workers who had no vaccinations to speak of. Coming September, every child needs to submit proof of a recent pertussis booster vaccination before entering any So Cal schools.

Jane had that done a few weeks ago and now she got a second vaccine
for chicken pox. Apparently the first one she got at age 5 was not enough,
nowadays a second immunization is required.

Hell yes, the parents should be held liable if they neglect to immunize their children. They jeopardize not only their own health but all the children around them as well.

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@Thomas,

Our constitution doesn't allow one to be singled out for taxation just for not doing something. The enumerated powers of the Federal government were established precisely to prevent the gradual expansion of areas in which the government could "apply pressure" to compel behavior.

People have a right to do and say stupid, sometimes offensive things. Our law permits the limitation of this right only for issues involving compelling public interest. The boundary is often hard to find and rationalize, but I believe there should be a substantial burden of proof of public harm in such cases.

Moreover, I believe an essential feature of most totalitarian governments is to treat people as interchangable 'bricks', when in fact we are more like randomly shaped rocks. That is what freedom is all about. Progressives often tend to see us as interchangable bricks too. That's why I oppose them.

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@georgeob1,

georgeob1 wrote:

Our constitution doesn't allow one to be singled out for taxation just for not doing something.

That remains to be seen. So far, the federal courts have split 50:50 on this in the various Obamacare cases. We'll have to wait for the Supreme Court for a final decision. In any event, your objection is easily remedied in either of two ways:

subsidize the vaccinators instead of taxing the non-vaccinators, or
have the states collect the non-vaccination tax. States, unlike the US government, are not bound by the 10th Amendment.

Why does every little pragmatic policy discussion have to turn into a freedom-vs.-totalitarianism discussion these days? I'm getting weary of this ideological overkill.

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Vaccinating a certain percentage of kids is important to society. Respecting and accommodating diverse religious and cultural beliefs is also important. The science is that there is a certain percentage of vaccination where a group gets a herd immunity. Vaccinating any more kids doesn't do much good.

So the balance is simple. You do just enough to reach that level starting with the least intrusive measures.

You start with a well-done public education campaign combined with making vaccinations as accessible as possible (obviously free and available at schools, clinics etc). I suspect that this on its own is sufficient to reach the scientifically based level of vaccination. This means that religion-bashing will not be necessary (a fact that will disappoint some people).

There is an urge in society to enforce conformity and to beat anyone over the head who dares to stray from the norm. I think is a bad thing that should be avoided.

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@maxdancona,

Well there is diverse religious and cultural beliefs and then there is the scientifically flawed dogmatic belief that vaccines ABSOLUTELY is the cause of autism.

That is the greatest reason these days for a parent not to get their child vaccinated. This population will be the one to break the preventative cycle of the herd immunity.

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@boomerang,

I think this is up there with the fat kids - it could be considered abuse to not vaccinate your children.

And an added item to this - is the safety to our overall society. Do you want your child sitting next to another child that hasn't been vaccinated? This is even more far reaching than simple obese child which the impact is on one child - this impacts all society.

Since religion is no longer a factor if you do not get your kid proper medical attention, then vaccination should not be a factor either.

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@boomerang,

So my kid and your kid takes whatever small risks there are in a vaccination and Fred's kid over there doesn't because of his philosphy?

Just plain old wrong.

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@Linkat,

What? Wait... I believe ALL kids should be vaccinated. Philosophy and religion be damned. I think the only kids (and adults) who shouldn't have to get vaccinations are the ones with a legitimate medical reason not to get them.

This is one area where I welcome government intrusion.

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@boomerang,

Sorry - I didn't necessarily mean to direct it at your - more responding to the question.

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Oops, it looks like I have stepped into another group think. I never seem to fare very well with everyone in lockstep. I don't know why I do this to myself.

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@boomerang,

Quote:

This is one area where I welcome government intrusion.

I am with you here, the collective has the right to take reasonable steps to prevent pandemics, and getting a shot that has almost no risk is reasonable. The cost of refusing should be not allowing entry into state supported schools, and a $5K tax to cover future health care and pandemic control costs.

And lets remember that I am a guy who thinks that government should be massively shrunk.

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That seems a little ridiculous. If the goal is to protect kids how can answer be keep them from going to school?

As long as the number is small, scientifically there is no damage to letting families opt out. In this case, punishing kids and families serves no purpose other than to force conformity and to prove a point.

It is very difficult for me to stomach that there is such a mob mentality toward punishing non-compliance when public education is effective without the cost.

Assuming we can launch a public education program and provide enough access to exceed the necessary vaccination rate, what's the point of attacking and families?

Any punishment brought down on families and kids has an obvious cost. If you keep kids out of school, they will suffer.

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@maxdancona,

My friend's kid died from an easily preventable disease.

He couldn't be vaccinated because he was born with a genetic abnormality that left him with a weakened immune system.

Other kids, mostly infants, die from preventable diseases.

It doesn't make sense to me to say that that is okay or that people who think it's not okay are acting like a mob.

If you keep vaccinated kids out of school it might allow others to attend.

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Should there be a penalty for not vaccinating yourself or your kids?

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