Should Vaccination Be Mandatory?

“We need myths that will identify the individual not with his local group but with the planet.” ~ Joseph Campbell, The Power of Myth

The debate about vaccination is not a new controversy. Unfortunately, the fact that I still see so many articles, posts on social media, etc. on reasons to vaccinate just goes to show how we seem to be losing ground in our vaccination efforts. One needs to look no further than our current culture around issues like sexual harassment, women’s reproductive rights, gender discrimination and racial disparities, to know we seem to be regressing in many facets where progress was once made.

Many years ago, when I was doing a long-term locum in a family practice, a patient told me that she didn’t plan to vaccinate her infant child. Until then, I naïvely assumed that given the benefits of vaccination, parents would “do the right thing” and get their children immunized the minute they could. I think we all know that this is not the case, and over time, various celebrity quackery endorsements and other non-reputable sources have led some of the public astray.

A conversation with our kids at dinner the other night prompted me further to dissect this topic. Our 18-year-old son, who is in first year sciences at university, said he had watched a short documentary on polio (out of curiosity, not a school requirement) and found it to be quite fascinating. Our 15-year-old daughter was quite intrigued, as she never heard of polio. Imagine the contrast to just 70 years ago when it was an epidemic.

Needless to say, both of them were relieved to know that they had been vaccinated against it. It is amazing to think that something that used to have such a significant impact on our world, is now an interesting historical topic. We then discussed the fact that we are starting to see a resurgence of some of these preventable diseases such as pertussis, measles and mumps due to some parents choosing to not vaccinate their children.

In a recent New York Times article, All Children Should Have to Get the Flu Shot, they discuss the idea of mandatory flu vaccination, which I think ends up being a difficult subject to tackle given its yearly requirement and overall lower effectiveness. It would seem easier to mandate something on a fixed schedule, similar to the childhood immunization schedule, which could be implemented as part of education admission requirements.

This year, influenza has reached pandemic levels and has led to devastating consequences across North America, so this is definitely a pressing issue. Despite the fact that the flu vaccine was not a good match with the circulating strains this year, the argument was that it would still provide some herd immunity and result in fewer deaths and hospitalizations.

Social media has become a platform for many physicians and other advocates to try to dispel some of the myths around the anti-vaxers’ propaganda. This is a perfect example of leveraging social media for the greater good and allowing health professionals to directly engage with the public about such important public health issues.

So, should vaccination be mandatory?

Back to my example of the patient I referred to above, I said the only thing I knew to say – “ultimately, it’s your decision, but if your child were to contract a preventable disease, can you live with the consequence?” I think the difficulty comes with putting ‘mandatory’ in front of anything. It tends to build a level of resistance and causes people to be more defensive – arguably, just human nature.

Like it or not, we all have the choice at this point in time. I think the best thing we can do is to continue to dispel the myths around vaccinations and emphasize the importance of them for not only our children, but for global health as a whole.

Additional Resources

The New York Times (January 18, 2018) – The Flu Outbreak Has Peaked but Still Has Weeks to Go

The Globe and Mail (October 23, 2017) – Stopping the Spread of Anti-Vax Myths: There’s No Quick Fix