Thursday, October 18, 2007

Religion, Philosophy, and Vaccinations

Who would have thought that parents would contrive religious "convictions" to exempt their kids from vaccinations?

When one considers the medical advances with the most dramatic impacts on health, it is hard not to rank childhood vaccines and their mandatory use among the top. The resulting decline of life-threatening infections in the developed world has truly been a public health miracle.

Unfortunately many parents refuse to vaccinate their kids because some "experts" and the inevitable lawyers that give them voice have convinced many people that it is dangerous to do so. Their assertions are largely derived from junk science. The use of virtually every modern vaccine has been excoriated by these people despite an near absolute lack of supporting data.

Large studies, for example, have failed to document a link between vaccinations and autism (see here and here) yet still, many parents are terrified enough to opt out of them.

Such refusals are not without consequences. Great Britain had a vaccine scare in the late 1970's that caused pertussis vaccination rates to fall precipitously. This triggered the worst pertussis epidemic they'd had since the 1950's. Many children died.

The reason that vaccinations are made compulsory is that they not only protect the children taking the vaccine but by reducing the pool of susceptible individuals, they even protect unvaccinated children from getting infected. When enough people are vaccinated, the "critical mass" required to sustain an epidemic can't be achieved (a phenomenon referred to as herd immunity).

That said, virtually all states allow parents to opt out based on purely medical reasons i.e. allergic reactions to previous vaccinations. But in modern society, there is also a substantial aversion to forcing citizens to take medications particularly those for whom to do so would violate their basic religious principles. For this reason, most states allow religious exemptions, undoubtedly to avoid running afoul of the first amendment's freedom of religion clause.

Some states, though not all, allow similar exemptions for purely philosophical reasons (read: reasons based on junk science). Therefore, as the above article reports, many parents are lying about their religious convictions and the state is de facto designating them criminals.

To me, this is unfair. If we're going to allow parents to refuse the vaccines for their children for any nonmedical reason, it shouldn't matter why they refuse. Patient autonomy is patient autonomy.

There is no way to get into a person's mind to know why they want the things they want. To allow the state to evaluate religious vs. philosophical beliefs seems like governmental over-reaching to me and it brings Big Brother a little too close for comfort. The article does suggest that no one has actually been charged with lying but this doesn't mean that these distinctions between philosophical and religious motives are justifiable.

Parents should either be allowed to refrain from the vaccinations for nonmedical reasons or not. If we decide that the decision can be left up to the citizenry then it shouldn't be up to the state to decide if the belief system from which the decision arose is appropriate or not.

I understand that there is precedent for requiring the law to reach into people's minds. For example, prosecutors must frequently prove "intent" since it is a critical element of many crimes for example. However this seems qualitatively different from what we're discussing here.

There will always be conflict between the needs of the state and the rights of the individual. Having to prove to the state where my motivation for wanting something comes from is simply too obtrusive for my taste.

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Blogger Angelo said...

I'm just wondering: Why aren't the major (at least) religious organizations being involved in this matter? Their active suasive participation can dissipate a large amount of mis-information or, at least, pull the rug many yards away from under the tactic of using religious belief as a "reason" for refusing children's vaccination.

The Catholic Church and virtually all (if not really all) protestant churches, I know, have nothing against vaccination. It is a non-controversial topic to them, Indeed, they have rites/rituals that can be seen as treading parallel lines to vaccination! Nor is there anything in Islam, and other eastern religions that proscribes such human effort as would promote the health of people.

Some parents would, even so, still refused, but they will do so clearly on their own personal behest. Of course, their decision should be respected--unless doing so places in clear and imminent danger the health of their community.

Peel away their layers of rationalizations, until there is left nothing and they will have to admit they have been misled by misconstrued information. And then, clarified and assuaged, at their own volition, they will ask that their children be vaccinated!

October 19, 2007 1:32 AM  

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