It is illegal to yell “Fire!” in a crowded theater because it places the individuals surrounding you at risk of harm. Why then can someone demand that people not vaccinate their children when this puts not only their children, but others at risk as well?
The First Amendment to the United States Constitution prohibits the making of any law which impedes the free exercise of religion, speech, press and assembly. These are some of the most fundamental rights afforded by the Constitution and are a part of what has defined the United States for more than 200 years.
However, on rare occasions it becomes necessary to place restrictions on the extent of the freedoms protected by the First Amendment. These restrictions include prohibiting the use of speech to incite imminent lawless action, false statements of fact, obscenity, child pornography and other limitations that lawmakers have felt necessary to impose. An example of a restriction on personal freedom would be the prohibition on a protesting speaker from urging the crowd to start a riot or attack a person, because this could put lives at risk and cause harm to society.
Claims about the negative implications of vaccinations are not only common, but are tolerated by society. Although tides are turning for the better, anti-vaccination supporters are still given airtime by news organizations to promote false claims. What is even more concerning is that parents can easily have their child excluded from vaccination in some states by saying it is against their personal or religious beliefs. No complicated process, no forms to fill out.
The reason vaccinations can be avoided is that anti-vaccination supporters are hiding behind the First Amendment, thus ensuring the government cannot force vaccinations upon them. This would be acceptable if parents’ decisions affected only themselves and their children, but that is not the case. Every time a parent unnecessarily avoids having their child vaccinated, it creates another potential vector for a deadly disease. This increases the risk for everyone in society. There are more than 500,000 people in the United States who cannot be vaccinated for legitimate reasons, which include patients undergoing chemotherapy, immunosuppressive therapy and those who are immunocompromised. These numbers do not even include infants and the elderly whose immune systems have reduced function and are also at increased risk.
A recent illustration of the problem was written about in The New York Times. The article focused on a six-year-old boy who was diagnosed with leukemia four years ago. He has since been on chemotherapy. His disease and treatment leave him especially vulnerable and unable to be vaccinated. His elementary school in California has an unvaccinated rate of around seven percent, which is higher than the state average. His father asked the school district to forbid unvaccinated children from attending the school so his son could attend. The school refused to do so. The county health office also denied the request, stating there is a balance between personal freedom and the spread of communicable diseases. It is clear the balance is out of whack.
The government regularly enacts laws which regulate our private lives, yet the government is noticeably absent in regard to the vaccination debate. For example, the Affordable Care Act, which was signed into law in 2010, requires every American to have health insurance coverage. Also, with the recent Ebola outbreak, the government had no problem restricting and monitoring travel to affected areas. Last year, more people in the United States died from measles, pertussis and influenza than Ebola. The same result will almost certainly occur in 2015. Measles, pertussis and influenza all have vaccines available. If full compliance were to be achieved, lives would undoubtedly be saved.
In medical school, it is commonly taught that to increase vaccination rates, it is important to take time to properly explain their importance of vaccinations to patients. Of course, this should continue to be done. With the national rate of unvaccinated kindergarteners being higher than five percent for 2-dose MMR, DTaP and varicella, more drastic action should be taken. Restricting the use of personal and religious exemptions to avoid outbreaks of preventable diseases is a viable solution. Religious and personal freedom should not go unchecked if it means putting other people’s lives at risk. If speech and other personal freedoms can be limited in other situations for the benefit of society, why not limit those same exemptions to vaccinations?
Contributing Writer
Cooper Medical School of Rowan University
Daniel Ricketti is a Class of 2018 medical student at Cooper Medical School of Rowan University. He is passionate about evidence based medicine and helping the impoverished gain access to better medical care. When he is not doing anything medical school related he can be found playing with his dog and watching sports.