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Emilee Skillman
Padgett
English 102
22 November 2016
The Delay Behind the Choice to make 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,
so instead 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 are beginning to 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
else. Lobos article goes into detail on how the vaccination movement came to be and how it

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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. The line graph shown on the next page is created
from data from the California Department of Public Health, which shows how immunization
rates in public schools have increased. This numbers on this graph represent the percentage of
students that are fully vaccinated to their public schools standards. California isn't the only state
that is making sure their students are up to date on vaccines. Other states like Wisconisn, are also
releasing data that proves they are invested in maintaining a high level of students that are
vaccinated. The bar graph below shows the percentages of students in Wisconsin public schools

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that are up-to-date on all required vaccines. 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

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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
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
incentive for parents who are hesitant on getting their child vaccinated. The entire purpose of a
tax would be to put a price on not giving children something can prevent them from getting sick.
Parkins also talks about how this said tax would only be enforced on specific infectious diseases
currently recommended by the CDC, and the tax will only be in place until the child turns 18.
This would be a great solution in having more parents see the benefits as opposed to the risks
associated with vaccinating their children.
Parents hesitancy on giving their children vaccines is becoming increasingly 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,

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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
should be mandatory for children to receive. There will be some parents that are for this and
parents that feel strongly against it. However, there are always incentives that are used to get the
parent to comply with vaccinating their children. 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. This could potentially create many issues for parents and doctors. Doctors that are
refusing to give patients treatment run the risk of losing the patient all together. A comment from
Alexander and a colleague, Thomas Lacy, about this statement says that some Pediatricians that
have patients that refuse vaccines breach both physicianfamily 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 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

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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
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 and if needed school systems and pediatricians should
be given the power to regulate. Hesitancy among parents is extremely common, as well as using
religious reasons as an excuse to be exempted from receiving a vaccine. I personally think that
these exemptions people are using are just excuses to not have their child vaccinated because

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they are worried of the potential side-effects. Many have heard of the fear parents have about
their child contracting autism from receiving vaccines at a young age. This is definitely a
concern, but there is also a larger concern for the possibility to infect others around if someone is
not vaccinated at all. 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.

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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.
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.
Krule, Miriam. "Why Is There a Religious Exemption for Vaccines? Do Any Religions Really
Object?" Slate Magazine. N.p., 2015. Web. 05 Dec. 2016.
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.
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.
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.
"Smallpox." Smallpox - Communicable Disease Control and Prevention, San Francisco
Department of Public Health. N.p., n.d. Web. 05 Dec. 2016.
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

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Vaccine Hesitancy." Vaccine 33.48 (2015): 6703-6709. Academic Search Complete.
Web. 19 Oct. 2016.