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The Largest Public Health Success in History and How we Could Lose it

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Immunization has been knighted as the largest public health success in history; yet our children are still at risk. Many families are choosing to not vaccinate their children. This choice is putting everyone’s children in danger. I believe that immunizing your child should be mandatory. According to the National Library of Medicine National Institute of Health (NLM, NIH)

Vaccination has made the greatest contribution to global health of any human intervention apart from the introduction of clean water and sanitation. The development of vaccination as a public health tool is attributed to Edward Jenner and his experiments with cowpox in 1796 (Greenwood, 2014).

The World Health Organization (WHO) says, “Immunization is the process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease” (The World Health Organization, 2018). In this essay I will attempt to explain why it must be mandatory to vaccinate our children.

Immunization is an easy and effective way to protect your child from dangerous diseases. By immunizing your child, not only do you give them the best start to a healthy life, but you help protect the other community members by minimizing the spread of disease. Sadly, some children cannot be vaccinated because of allergies or a compromised immune system. We also need to consider the babies that are still to young to begin receiving their vaccinations, until they reach the needed age, they are at risk for contracting disease. By having your own children immunized, you help protect these individuals, as well as your child.

Immunization protects against many childhood diseases considered dangerous. “These include: Whooping cough (pertussis), measles, German measles (rubella), meningococcal C, pneumococcal disease, chickenpox (varicella), tetanus, mumps, polio, diphtheria, rotavirus and hepatitis” (Medline Plus, 2017). Each of these diseases cause serious health problems and can sometimes prove fatal. Thankfully, through high immunization rates in the community, these diseases can be prevented and eventually stopped.

When you vaccinate a child against a disease, you trick the immune system by mimicking a naturally accruing infection. This teaches the immune system. The body cannot tell that the vaccine virus is a compromised version, and it consumes the virus as if it were dangerous. It then creates antibodies to fight the disease, quickly getting rid of the virus. What remains is a group of cells designed to fight against future infection from the virus it was introduced to. Should your child encounter the disease in the real world, their immune system is able to respond efficiently, not allowing the disease to develop or greatly reducing its severity. As medical science advances, it’s possible for people to be protected from a growing number of diseases. Some diseases which once maimed or killed many children have been eliminated entirely. For example, smallpox immunizations are no longer required because the disease simply does not exist anymore thanks to vaccination. The possibilities could be endless if we made it mandatory to vaccinate children. We could eradicate so many diseases.

Other diseases are very close to being eradicated, like polio. Polio was once considered one of America’s most feared diseases, but thanks to vaccination, the United States has been declared polio-free since 1979. “However, the virus has been brought into the country by travelers with polio. The last time this happened was in 1993. It takes only one traveler with polio to bring the disease into the United States” (Center of Disease Control and Prevention, 2017). Polio was once a disease feared worldwide, striking suddenly and paralyzing mainly children for life. The WHO says,

The Global Polio Eradication Initiative, the largest private-public partnership for health, which has reduced polio by 99%. Polio now survives only among the world’s poorest and most marginalized communities, where it stalks the most vulnerable children. The Initiative’s goal is to reach every last child with polio vaccine and ensure a polio-free world for future generations (World Health Organization, 2017).

Think of all the other diseases we could eradicate if immunizing our children was mandatory.

One reason why a parent would choose not to vaccinate their children is because they think that the vaccine has dangerous ingredients. Vaccines go through vigorous tests to make sure they are safe before they are put on the market. The Center for Disease Control (CDC) states,

Prior to federal licensing, vaccines, like other pharmaceutical products, undergo extensive safety evaluations in the laboratory, in animals and in human clinical trials. The vaccines undergo testing for purity and potency. The Food and Drug Administration (FDA) licensure occurs only after the vaccine has met rigorous standards of efficacy and safety, and when the potential benefits in preventing disease clearly outweigh any risks. Manufacturers must submit samples of each vaccine lot and results of their own tests for potency and purity. Only after the FDA approves them can they be released for public use (Center for Disease Control, 2015).

This shows that the vaccines are safe. Safety should not be a reason why we should not make it mandatory to vaccinate our children,

Some people claim that vaccines cause autism. This makes them fearful to vaccinate their children. Even well-known celebrities, like Jenny McCarthy, started a campaign to try and scare people from vaccinating their children by claiming that it will give them autism. According to WebMD,

The debate began in 1998 when British researchers published a paper stating that the measles-mumps-rubella (MMR) vaccine caused autism. The study looked at only 12 children, but it received a lot of publicity. At the same time, there was a rapid increase in the number of kids diagnosed with the condition. The paper’s findings led other doctors to do their own research into the link between the MMR vaccine and autism. At least 12 follow-up studies were done. None found any evidence the vaccine caused autism. An investigation into the 1998 study also uncovered a number of problems with how it was conducted. The journal that published it eventually retracted it. That meant the publication no longer stood by the results (WebMD, 2018).

Soon the focus shifted to a vaccine additive called thimerosal. There was also no evidence it caused autism, but people were still scared.

A year after the British study, fears about a possible vaccine-autism link shifted from MMR to a substance used in some children’s vaccines. It was called thimerosal, and it contained mercury. That’s a metal that’s harmful to the brain and kidneys at high levels. Doctors used thimerosal to prevent the growth of bacteria and fungi in vaccines. There was no evidence that the small amount used in the medicines caused harm. Still, it was taken out of most children’s vaccines by 2001 at the urging of the American Academy of Pediatrics and the U.S. Public Health Service (WebMD, 2018).

After thimerosal was removed from most vaccines, autism rates did not drop. Rather, they continued to rise. The science shows that the ingredients in vaccines are not dangerous and do not cause autism. In my opinion this is not a strong enough excuse to not vaccinate your child. It should simply be mandatory.

Like any drugs, vaccinations do come with a risk of side effects. Generally, these are minor reactions such as soreness where the shot was given or a low fever. Most effects do not last long and cause very little discomfort. In fact, a low fever or small reaction can be a good thing, as it shows that the vaccine is strengthening the immune system. More serious side effects are very rare; however, they do happen. Often, this is caused by an allergic reaction. While this can seem scary to a new parent, the benefits still far outweigh the risks of an allergic reaction. If your child were to catch one of the many preventable diseases because they were not vaccinated pain, discomfort, side effects, risks and even death are far worse than the possibility of a reaction from a vaccine. It has been proven that these vaccines are safe. Therefore, it should be mandatory to immunize your children. It is for their own safety.

There are no federal laws about immunizing your children. Laws and requirements vary from state to state. State laws establish vaccination requirements for school aged children. Currently Ohio regulations state,

No pupil, at the time of initial entry or at the beginning of each school year, to an elementary or high school for which the state board of education prescribes minimum standards pursuant to division (D) of section 3301.07 of the Revised Code, shall be permitted to remain in school for more than fourteen days unless the pupil presents written evidence satisfactory to the person in charge of admission, that the pupil has been immunized by a method of immunization approved by the department of health pursuant to section 3701.13 of the Revised Code against mumps, poliomyelitis, diphtheria, pertussis, tetanus, rubeola, and rubella or is in the process of being immunized (Ohio Department of Health, 2015).

However, there is a loop hole. According to The National Vaccine Information Center (NVIC)

A pupil who presents a written statement of the pupil’s parent or guardian in which the parent or guardian declines to have the pupil immunized for reasons of conscience, including religious convictions, is not required to be immunized. Medical exemptions are also allowed (National Vaccine Information Center, 2018).

This loop hole in the system essentially makes it so that any parent could obtain the proper paper work to so that their child does not have to comply with the current policy. From a public health stand point this could be very dangerous. We need to make it mandatory that all children get immunized.

Children can and are dying from these preventable diseases. This is needless death, suffering, and risk that could clearly be prevented if everyone would vaccinate their children. According to the Children’s Hospital of Philadelphia,

Each year, about 85 percent of the world’s children receive vaccines that protect them against tuberculosis, polio, diphtheria, tetanus, pertussis, and measles. These vaccines save about 2.5 million lives, and the hepatitis B vaccine, although not as widely used, saves about 600,000 lives. Despite this success, more than 3 million people die from vaccine-preventable diseases each year. Approximately 1.5 million of these deaths are in children less than 5 years old. Of the top 10 causes of death in those less than 5 years old, several are infectious, meaning they can be transmitted from one person to another (Children’s Hospital of Philadelphia, 2018).

Some of these preventable deaths are right here in the United States. Tragically most of these deaths are unvaccinated children. The rates of which have been rising as our society becomes complacent and the rates of vaccination drop. Many of these diseases were once under control due to vaccination. As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or put off getting their vaccines, and start outbreaks. This rise was predicted and could have been prevented. Parents have been listening to anti-vaccine propaganda that scares them away from protecting their children with vaccination. The fact that these diseases are almost forgotten, and people are becoming complacent is a testament that vaccines work and are necessary. Because some people are making the poor, uneducated decision to not vaccinate, we need to make it mandatory to protect our society.

There are so many excuses parents use as to why they do not want to vaccinate their children. The vaccine will harm my child, there are dangerous ingredients, that their decision does not harm other children, that the infant immunization schedule is dangerous to the infant’s immune system or that spacing out immunizations is not harmful. Some of these arguments I have previously covered. Others can be easily debunked with a little research. An infant’s first set of vaccines include at least 6 shots. This does seem like a lot, however, there is no credible scientific evidence that vaccines are able to “overload” babies’ immune systems. An infant’s immune system is prepared to handle the vaccines. It is immature, but it handles many viruses and bacteria daily. Delaying the infant’s vaccine just means that there will be a larger window of risk for the unimmunized child to get sick. The idea that a parent’s decision to not vaccinate will not harm anyone else is ridiculous. A vaccinated child would not become ill from the preventable disease; however, if a child that was not vaccinated becomes ill, he will infect many others beyond just his non-vaccinated classmates. He could infect babies who have not received their immunizations. He could infect the small amount of children whose vaccines did not work, as well as those who are immune compromised and were not able to receive immunizations, or those who were allergic. He could infect the elderly whose vaccine’s effectiveness might have worn off. According to (The Institute of Medicine, 2013)” Where kids aren’t vaccinated, more people get sick. In 2011, the states with lenient policies about immunization exemptions had 90 percent more whooping cough cases than stricter states”. This shows that any gains made can be lost if parents stop immunizing their children, or if teens and adults don’t get necessary booster immunizations. Ignorance should not be an excuse when public health is at risk. With a little bit of education about the effectiveness of vaccines and what could happen if we stop, I feel like we could get most people to agree on making immunizing your children mandatory.

Some statics worth sharing to help strengthen my argument are, according to The United Nations International Children’s Emergency Fund (UNICEF),

Two hundred years after the discovery of vaccine by the English physician Edward Jenner, immunization can be credited with saving approximately 9 million lives a year worldwide. A further 16 million deaths a year could be prevented if effective vaccines were deployed against all potentially vaccine-preventable diseases. So far only one disease, smallpox, has been eradicated by vaccines, saving approximately 5 million lives annually. Polio could be next. Over 80% of the world’s children are now being immunized against the polio virus, and the annual number of cases has been cut from 400,000 in 1980 to 90,000 in the mid-1990s. If the year 2020 goal of eradicating polio is achieved, the United States will be able to save the $270 million a year that is currently spent on polio vaccination. The savings for Western European countries will amount to about $200 million a year. Measles, currently killing 1.1 million children a year, is another possible candidate for eradication. Once high levels of routine immunization have been achieved, national immunization days, followed by close monitoring and ‘blitzing’ of any outbreaks, can eliminate the disease. In all, vaccines have brought seven major human diseases under some degree of control – smallpox, diphtheria, tetanus, yellow fever, whooping cough, polio, and measles (UNICEF, 1996).

Imagine the success we could have in eradicating the six diseases listed if mandatory vaccination was enforced. We can’t lose all the progress we have made thus far.

Like my Father used to tell me, “your rights end where mine begins”. At the time my Father was referring to having to listen to my teenage choice in music; but this mind set can absolutely be used in the context of this paper. If your choice to not immunize your child puts myself, my children, or my family at risk then you should not have that choice. The excuse of, “I am not hurting anyone” is not true. It is not definite that you will harm someone, but it is probable. If an intoxicated driver got behind the wheel, and said that he is only harming himself, it would only damage his vehicle or injure himself, you would know that was not true. It is not definite that he would cause an accident; but it is probable. He might make it home just fine. On the other hand, he could cause a terrible accident, kill entire families, damage vehicles or another person’s property. Therefore, legally he doesn’t have that choice. The law has taken that choice away from him for the interest of public safety. This is not any different than taking that choice away from the public and making it mandatory to vaccinate your children. This is in the best interest of public health. Science has come so far with the development of vaccines. If we succumb to the false propaganda, fearmongering techniques, and do not seek out the facts, we could lose all the progress we have made so far. Imagine living is a world where you are so afraid of disease that you can’t even take your child to the community pool; for fear of contracting a deadly disease. We must stand up and take notice of what is happening and what could happen and stop being so complacent; because the world we live in seems safe. Making immunization mandatory will ensure the public health of our citizens. It is just a little pain now for a great gain tomorrow. We must protect our children.

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