Matt;157348:
[I said:
Vaccination has been lauded as an important public health measure but it requires at least 80% of people, ideally more than 90% of people, be vaccinated before a whole population is protected. Some groups in Australia are opposed to vaccination, often referred to as conscientious objectors.
Overseas, in the UK, there have been calls to make vaccination compulsory for children in public schools. What is your opinion on this issue and what are your reasons?[/I]
Well, vaccination is - infact - compulsory in Australian in Australian schools (and I believe in accredited childcare), atleast in the sense that parents need to show proof of vaccination or exemption (for medical reasons, or for the reason of conscientous objection), and a centrelink payment (which may be called the maternity immunisation allowance?) is made to parents of 18 month olds and 4 year olds who either have their vaccinations up to date or have exempt stuatus.
In Australia, the penatly for non-vaccination WITHOUT exempt status (having a gp or maybe an NP in some areas complete an exemption form) is several hundred dollars which the parent would otherwise be entitled to, and this amounts to a fincial penalty, I think. Irrespective of the reason for non vaccination, non-vaccinated children may be excluded from school if there is an outbreak, which has costs of time and lost work hours and so forth for the parents, although i'm not sure how often this occurs in practice.
SO vaccination in AUstralia is something-close-to cumpolsory, vaccination in not only free, but there is a financial incentive to do it. In my experience, opportunistic vaccination and education seem to be offered routinely for non-vaccinated children who appear in health chilics and hospitals for other reasons. There is a significant deterent to not vaccinating, which is the inability to sent your child to school, which is illegal and has its own sanctions. SO non-exampt non-vaccination is only a step away from being illegal, in that sense. Essentially the situation is that it is compulsory to either vaccinate your child, or to attend a clinic/dr and discuss the issue with a health proffessional.
But the broader issue is wider. I am vaccinated, and my children are vaccinatecd. Putting aside conspiracty theories, there is a very small degree of risk involved in vaccination. I do think that the risks posed to both individuals and society from vaccination-preventable diseases are high (if the vaccination rate falls below a certain level). Infact, if vaccination levels are high in the community, if everyone else was vaccinated, I would avoid all risk by avoiding vaccination...but that only works in game theory, and assumes I am not responsible to the society in which I live. Vaccination asks individuals to assume a very small level of personnal risk to prevent a much greater risk to ourselves and others (if no-one was willing to be vaccinated).
By contrast, very few people who remember the polio epidemic don't support vaccination. But most people have no direct experience of polio, or measles or whooping cough as dangerous epidemics. If we know much about these things at all it's likley to be through isolated experience, or indirectly.
There is good reason to fear these epidemics, and there is good evidence that vaccination prevents them, and that if global vaccination is not promoted and pursued, there is a grave personal and public health risk. For which reasons, vaccination should be near-compulsory, certainly, as close to compulsory as we can make it without dramaticaly infringing on the rights of citizens, which is an approach which seems to have been effective in Australia.
As to conscientous objectors
...at the moment they are dealt with by being required to see a doctor and get an exemption certificate....if they do this, they are then able to recieve the centrelink benefit for immunisation, and start school. I am not sure that the former is a good idea, ethically, but as I suspect there would be legislative issues if it was stopped. WHat this system is doing is requiring conscientous objectors talk to a doctor about their decision. This system hopes to provide opportunities to pursuade parents who are mildly against vaccination to think otherwise, and perhaps aadress their concenrs. It is a burden on doctors, I think, but the reality is that doctors should hope to have some influence over peoples health-realted behavior.
I think, personally, that conscientous objection to vaccination is a poor choice, demonstrates terrible critical thinking skills and is broadly speaking, unethical. But the opportunity may exist, in the non-adverorial conditions of routine health care screening, to pursuade people otherwise. SOme people who are ostensibly conscientous objectors may have been mis-informed, may not understand the issue, may not realise that one can die of measles etc...They might, in short, be pursuadable.
There will, however, be a small number of people who cannot be pursueded. We need not consider them selfish muddle-headed game-theorists. It is very likely that they truly believe that vaccination is bad or dangerous. They may very well know someone whos child was diagnosed with autism after a vaccination (this is likely given that there are 4 or 5 vaccinations until 18 months, and autism is generally first diagnoses after a vaccination), or they may know a child who was allergic to a vaccination. These are errors of reasoning. It may be that - for example - they have lost a child to stillbirth, be overprotective and will brook no risk towards this one. In any case, the requirement that some health proffessional talk with them about vaccination with them is a good one, however flawed, and an undersrtanding of their reasoning may provide the opportunity to pursuade them otherwise - every effort should go into ensureing that GPs and ECH nurses are equipted to have these conversations.
However, the idea of compulsory vaccination in the sense of being mandatory and state enforced is abhorent to the ideals of democratic freedom, and the values of our society, and likely to cause both personal misery and civil unhappiness.
The present situation, of providing a strong incentive to vaccinate, endevouring to identify opportunities for opportunistic vaccination, and requiring some form of official exemption for conscientous objectors seems to me to be the option in the best interst of the public.
I do feel that global vaccination is a worthwhile cause, and the correct one, and I think that conscientous objection is misguided. HOwever, I think that there would need ot be extraordinary circumstances before there would be any worth in mandatorily imposing the will of the government - however well intended - on indiviuals agaist their liberty.
