Skillman 1

Emilee Skillman
Padgett
English 102
15 November 2016
The Delay Behind the Choice:
Making Vaccinating Children Mandatory
Childhood vaccinations are one of the biggest controversies being brought to attention
today. The biggest issue with this topic is that people are worried with the potential side effects
that they choose not to have their child vaccinated. When a child is not vaccinated, they pose a
threat to their family and others they encounter. With all of this in mind, a big question to ask is
whether it should be mandatory that children receive vaccinations? Most schools have the rule
that a child must be vaccinated to attend school. They have put this rule into place with good
intentions of course, to prevent students from spreading diseases to others. However, there are
exemptions that people can say applies to them which are usually medical, religious, or personal
beliefs exemptions. Each state has different state laws that say what is and what is not considered
a valid excuse for not vaccinating their children. Despite the hesitancy of parents, to ensure the
safety of children as well as those around them, it is important to have vaccinations mandatory
for all children.
Vaccinations have been around for a very long time, with the original purpose of
preventing diseases that an individual could contract. James Lobos article explains, The
smallpox pandemic fueled the vaccination movement, and historians trace the first stabs at
inoculation in America to as early as 1721 (Lobo, p.264). People who saw firsthand the
devastating effects of the smallpox disease developed an urge to prevent it from harming anyone

Commented [LD1]: Very clear

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else. Lobos article goes into detail on how the vaccination movement came to be and how it
continues to influence people. Lobos article explains how the smallpox disease would hit the
young children and infants first, which then led to schools enforcing a mandatory vaccination
law (Lobo p.264). However, there of course were the issue of people who did not believe that the
vaccinations were all that effective. These advocates did not see the point of them if no one could
for sure say it was the vaccines that were preventing these diseases. As these disagreements
continued, by the 1800s, challengers brought judicial action against mandatory vaccination
requirements, and arguments debating the merits of such requirements continue to the present
day (Lobo p.265-266). Given this background on the issue it is important to note how long this
has been an issue in our country and how there has always been people for mandatory
vaccinations and those who are against it.
One thing that has remained constant since the 1800s in the vaccination argument is the
main influencer are the parents. Parents ultimately control their childrens health options, which
is how it should be. However, with something as serious as vaccines, it is necessary to have a
higher power become involved. One example of a higher power that can influence a parents
decision to vaccinate their child is a school. Many schools today require their students receive
certain vaccines before enrolling in school. However, most statesalso provide for religious
and in some case, philosophical exemptions to these compulsory vaccination requirements. In
recent years, parents have increasingly taken advantage of these exemptions (Lobo p. 263).
Parents choosing not to give their children the required vaccines before entering schools is
creating a problem. Christine Parkins article included a story about how a group of unvaccinated
children contracted a disease and spread it to their classmates and then eventually spread to
become an epidemic. Parkins states, Seventy-three of those exposed were unvaccinated

Commented [LD2]: Love the back ground info definitely

give context for the argument to those who dont think or
know anything about it

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children, including twenty-five children whose parents opted out of vaccinating them and fortyeight children who were too young to [have been] vaccinated (Parkins p. 439). This is a scary
statistic that brings into the light how important it is that children are vaccinated. Parkins article

Commented [LD3]: I like this in that it can play off of

ethos, pathos, and logos all at once by providing a real-life
example

also focuses on a potential solution to this issue; taxing parents that choose to not have their child
vaccinated. She talks about how many parents begin to use the religious exemption as an excuse
and how it is more cost effective to get vaccinated, rather than paying potential medical bills
after you contract the disease. Parkins believes, In order to counteract the negative externality
that arises from the refusal to vaccinate ones child, states should impose a tax on parents who do
not vaccinate their children and use the funds generated by the tax to pay treatment costs of
patients who contract vaccine-preventable illnesses (Parkins p. 441). This could be a helpful

Commented [LD4]: Its nice that you also propose a

solution

incentive for parents who are hesitant on getting their child vaccinated.
Parents hesitancy on giving their children vaccines is becoming more and more common
every day. Melissa Gilkey was interested to know more about why parents are so hesitant to give
their children something that can prevent them from being sick. She conducted a survey asking
parents to explain their hesitancy. When the author concluded based on their findings, they
discovered that, In addition to vaccine refusal, we found that vaccination confidence was
consistently associated with measures of vaccine delay and vaccination status (Gilkey p. 3).
This shows that although many parents are straight up saying no to vaccinating their children,
there are some parents that are just delaying their decision. This could be more many reasons
such as conducting research on their own. This related to an article written by Heidi Larson
which states, Vaccine-hesitant individuals have been defined as a heterogeneous group in the
middle of a continuum ranging from total acceptors to complete refusers (Larson). This
continuum that Larson describes is a real issue when it comes to arguing whether vaccines

Commented [LD5]: What are those? I see its touched on

right after but maybe elaborate a little more clearly

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should be mandatory for children to receive. There will be some parents that are for this and
parents that feel strongly against it. However, along with the higher powers discussed earlier,
another higher power would be Pediatricians. Kenneth Alexanders article is composed of
statements given by other experts in pediatric infectious disease. The article states that
sometimes when parents refuse to vaccinate their child, their pediatrician will refuse to continue
to see them. A comment from Alexander and a colleague, Thomas Lacy, about this statement
says that some Pediatricians that have patients that refuse vaccines breach both physician
family trust and patient safety that merits a severance of the relationship with the family
(Alexander p.3). Alexander specifically comments and says, In practices who choose to exclude
unvaccinated families, parents are generally given a period of time to get their child's
immunizations up to date, after which time they are advised to seek alternative care (Alexander
p.3). This is a surprising, but truthful statement. This is important to note because it shows how

Commented [LD6]: This who section is an eye catching

argument

the doctors that are refusing to give patient care, must be strong advocates for giving children
their needed vaccinations. This also connects to what was previously said about how creating
serious incentives, such as doctors refusing to treat children, could get parents to realize the
importance of vaccinating their children.
The parents that are for vaccinating their children and believe it should be mandatory
thankfully are much of the population. These parents understand the risks of not vaccinating their
children. Eileen Wang does a great job in her article Everybody Just Wants to Do What's Best for
Their Child: Understanding How Pro-Vaccine Parents Can Support a Culture of Vaccine
Hesitancy, of informing vaccine hesitant parents about all the reasons parents are for giving
vaccines to children. Wang created a survey targeted at parents that fell in the upper-middle class
range living in Philadelphia. Interviewee 5 was asked to explain their thoughts in response to

Commented [LD7]: Where did you get that assumption

from?

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overwhelming and conflicting information. They said, I think in terms of deciding whether or
not to vaccinate, it is important to gather information, but sort of, more important than getting the
information is to understand the source of the information and you know, its a medical decision.
Its not an emotional decision. So, you need to make a decision thats based in science and
medical fact, not in, you know, what you are feeling or what other people are feeling (Wang
6706). This person being interviewed makes a great point about how vaccinating children is not
an emotional decision. It should be a medical decision, where you know that by giving your child
this vaccine they will be protected from contracting the disease as well as potentially spreading it
to those around.
With the amount of threats that children who are not vaccinated pose, it should be
mandatory that children receive vaccines. Hesitancy among parents is extremely common, as
well as using religious reasons as an excuse to be exempted from receiving a vaccine. Making
vaccines required for all children to have is not something that will be harmful to them, it is
simply put in place in the hopes to ensure the safety of others. It could also be beneficial to the
vaccination industry if stronger incentives were created to get more parents on board with getting
their child vaccinated. Hesitancy is not just simply saying no, but it could also be holding out on
the decision to get their child vaccinated. Yes, every parent has their own right to choose what
medication their child receives, however with something as serious as vaccines, making them
mandatory would create a safer environment to live in.

Dont forget about charts

Commented [LD8]: A major argument that has been

going on in all areas of life for decades

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Alexander, Kenneth, et al. "Should Pediatric Practices Have Policies to Not Care For Children
With Vaccine-Hesitant Parents?." Pediatrics 138.4 (2016): 1-6. Academic Search
Complete. Web. 19 Oct. 2016.
This article is very interesting as it brings a whole other response to hesitant parents that
refuse to give their children vaccines. The article describes that some pediatric offices
refuse to give care to children with parents that are not pro-vaccination. These offices
however usually give warnings to their patients before they announce they will no longer
be providing them with care. Others however, continue to provide care and continue to
try to convince parents that the benefits of immunizations far outweigh the risks
(Alexander). This would tie in to the whether it should be mandatory since if it is not
mandatory, some doctor offices can decline giving care. This is a credible source as it is a
peer-reviewed article and brings a lot of information to my paper.

Gilkey, Melissa B., et al. "Vaccination Confidence And Parental Refusal/Delay Of Early
Childhood Vaccines." Plos ONE 11.7 (2016): 1-12. Academic Search Complete. Web. 19
Oct. 2016.
This article is again a survey conducted for finding out why parents are hesitant to give
their children vaccines and what percentage of parents are hesitant versus the percentage
that are not. The authors calculated the average scores for the Benefits, Harms, and Trust
factors based off the information the parents surveyed gave them. When the author
concluded based on their findings, they discovered that, In addition to vaccine refusal,
we found that vaccination confidence was consistently associated with measures of

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vaccine delay and vaccination status (Gilkey). This shows that parents are not solely
denying vaccines altogether, but that some are just choosing to delay giving their children
vaccines which is entirely different. This article is helpful as well as credible to my paper
because it is a scholarly article and has real hard evidence from surveys given to parents.

Larson, Heidi J., Caitlin Jarrett, Elisabeth Eckersberger, David M.D. Smith, and Pauline
Paterson. "Understanding Vaccine Hesitancy around Vaccines and Vaccination from a
Global Perspective. A Systematic Review of Published Literature from 2007-2012"
Academic Search Complete: Elsiever, 2 Mar. 2014. Web. 19 Oct. 2016.
These authors piece reflects on peoples hesitancy to be vaccinated and take it to a
global scale. The article states, Vaccine-hesitant individuals have been defined as a
heterogeneous group in the middle of a continuum ranging from total acceptors to
complete refusers (Larson). This article goes in to further detail on this range of people
that are accepting to refusing. It explains the motive for their research as well as their
findings on the matter. The authors also included peer-reviewed studies in this article if
they focused on children under the age of seven receiving vaccinations. This piece is
going to hopefully bring a lot of insight into my paper on why people are so hesitant on
vaccinating their children.

Lobo, James. "Vindicating the Vaccine: Injecting Strength into Mandatory School Vaccination
Requirements to Safeguard the Public Health." Boston College Law Review 57.1 (2016):
261-96. Academic Search Complete. Web. 18 Oct. 2016.

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James Lobos article does a great job of telling the history behind mandatory children
vaccines in schools. Lobo explains, In 1827, Boston became the first city to require
schoolchildren to give evidence of vaccination upon enrolling at school and the article
then explains that many other states followed this rule in later years (Lobo 264-265).
After this was put in to place, a group of people who were against these mandatory
vaccines created the anti-vaccination movement that became popular around the country.
I feel that this is important to include in my paper because it gives a better understanding
of when this issue started. This article is basically a history lesson, but will give the
reader of my paper a greater understanding of why this has been an issue for so long.

Parkins, Christine. "Protecting the Herd: A Public Health, Economics, and Legal Argument for
Taxing Parents Who Opt-out of Mandatory Childhood Vaccinations." Southern
California Interdisciplinary Law Journal 21.2 (2012): 437-90. Academic Search
Complete. Web. 18 Oct. 2016.
Parkins article focuses on the issues that arise from not vaccinating children at a young
age. When parents choose to ignore issues such as spreading the disease their child could
potentially contract, they are putting their child and others at risk. I feel that this is
beneficial to my research because it shows how people who choose not to get vaccinated
at a young age can still affect people when they get older. It also poses a solution to the
problem: taxing parents that are not pro-vaccination. Parkins says that the more parents
that are choosing to not vaccinate their child are putting the entire communitys health
at risk, but their actions are also raising health care costs, since preventing illness through
vaccination is substantially more cost-effective than treating the illnesses. (Parkins 440).

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Per her introduction in her journal article, Parkins is a former student at the University of
Southern California where she has discussed this topic with many of her professors and
has had numerous credible colleagues read over and critique her work.

Wang, Eileen, Yelena Baras, and Alison M. Buttenheim. "Everybody Just Wants to Do What's
Best for Their Child: Understanding How Pro-Vaccine Parents Can Support a Culture of
Vaccine Hesitancy." Vaccine 33.48 (2015): 6703-6709. Academic Search Complete.
Web. 19 Oct. 2016.
This article favors the viewpoint of parents that are pro-vaccines. They conducted
surveys with parents that fell in the upper-middle class range living in Philadelphia. The
article has excerpts that contain quotes from parents and how they go and decide whether
to give their child vaccinations. This piece, although it focuses on the opinions of only
parents that are for vaccinating their children, will be important for my paper as it brings
lots of information as to why these people support it. This study also contains quotes
from the parents who were interviewed on why they think some parents choose to be
against it. One interviewee says, I wrote down crazy people on my list because theres
just some people who are so strongly opposed to vaccination and I dont understand it
(Wang 6707). Another interviewee that defends parents that choose to be against
vaccinating their children says, You know I dont think theyre crazy I would
consider it more maybe passionate or strong willed theyre taking a stand that, in a
minority against a majority. They dont make these decisions lightly (Wang 6707).
These quotes add a lot of character to the article as they show how strongly these parents
feel about either agreeing to vaccinate their children or do not agree. This will be

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beneficial to my paper as it is from parents who are pro-vaccines, but also understand
why some parents are not for vaccines.