Vaccines

I’m in Week 9 of my third quarter of nursing school. Next quarter I start what I considered more “nursey” courses, and I was pretty pissed about having to take Microbiology again. I took it many moons ago for my Biology degree (which is why I had to retake it. The credit was too old). But in all honesty, Micro with a nursing focus is totally different and way more interesting. We have weekly online discussions and this week we were asked:

• Should people be allowed to decide whether to vaccinate themselves or their children? Why or why not?
• Should people who decide against vaccinations pay higher insurance premiums? Why or why not?
• If a person were to refuse vaccinations, and therefore transmit a deadly disease to a susceptible person such as a young infant, should the unvaccinated person be criminally prosecuted? Why or why not?

I am a student and I am not a health professional. The following is only an opinionated response to a microbiology assignment. If you have opinions regarding the above questions or the statements below, feel free to share them, respectfully and thoughtfully, in the comments.

I believe that vaccines provide a tremendous benefit to society, and personally, I believe everyone who can be vaccinated should be. Measles was almost entirely eradicated in the United States. It was a thing of the past – something that I swore over in Oregon Trail if my wagon mates didn’t die from poisonous berries first. Then, in 2014, there were 667 cases of measles. In 2018, there were 372 cases. It is barely March of 2019 and the CDC has already reported 206 cases. The majority of people who got measles were unvaccinated, and many were in areas with poor vaccination coverage (Centers for Disease Control and Prevention, 2019).

While America is built on democracy and free choice, I believe there is a point at which a line needs to be drawn. It isn’t about just protecting yourself. It is about protecting everyone in the community. Herd immunity occurs because there are a limited number of susceptible individuals in a community, so the associated disease cannot spread effectively (Parker et al., 2016). That being said, I believe that vaccinations for highly contagious diseases, such as measles and whooping cough, should be required for the general public. In order to honor the right of free choice, I believe some vaccinations can still be up to the individual or parent. Diseases like Hepatitis B are spread through blood or sexual contact (Schillie et al., 2018). While I believe in getting a Hepatitis B vaccine, I don’t think it’s something to force on someone who isn’t working in a healthcare setting. I think that educating people, especially parents, would be more effective than coercion.

If you smoke cigarettes, you are knowingly and willingly putting your health at risk as well as others’ health in the form of secondhand smoke. You will pay higher insurance premiums (Pesko et al., 2018). If this logic were applied to people who have been educated about the benefits and risks of vaccinating and choose not to vaccinate, then these individuals should also pay higher insurance premiums. Enough evidence exists that few would argue that cigarette smoking isn’t unhealthy. Enough evidence also exists proving the connection between vaccinations and fewer outbreaks of infectious disease.

While I think it is unethical to put others at risk – those with compromised immune systems or those still too young to be vaccinated (Parker et al., 2016) – I don’t know that I would support criminal prosecution for the transmittance of an infectious disease. Scientists have gotten very good at identifying the source of an outbreak; however, people get other people sick all the time. I believe measures should be taken to punish those who refuse to vaccinate against select diseases, such as fines, higher premiums, or even social conditions. Maybe unvaccinated travelers need to be quarantined, or simply not allowed to travel abroad until they have been vaccinated. There are too many loopholes (e.g., religious exemptions) to make a blanket case of criminally charging someone. I’m really not sure about this one. I feel strongly that people have a moral, and sometimes legal, obligation to vaccinate if they can, and I think that healthcare providers need to be delicate but persistent in patient education about vaccinations (Zagaja, 2018).

Divers Alert Network recommends getting a comprehensive vaccine recommendation from your health care provider, and also to consider your dive travel destinations. Some of the common immunizations recommended on the DAN website include cholera, diphtheria, influenza, MMR (measles, mumps, rubella), meningococcal meningitis, polio, typhoid, and yellow fever. Visit https://www.diversalertnetwork.org for more information.

References

Centers for Disease Control and Prevention. 2019. Measles Cases and Outbreaks. Measles (Rubeola). Retrieved from https://www.cdc.gov/measles/cases-outbreaks.html

Parker, N., Schneegurt, M., Thi Tu, A., Forster, B. M., Lister, P., Allen, S., Franklund, C. (2016). Microbiology. OpenStax at Rice University. Retrieved fromhttps://openstax.org/details/books/microbiology

Schillie, S., Vellozzi, C., Reingold, A., Harris, A., Haber, P., Ward, J. W., & Nelson, N. P. (2018). Prevention of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices. MMWR Recommendations and Reports, 67(1), 1.

Pesko, M. F., Bains, J., Maclean, C., & Cook, B. L. (2018). Nearly Half Of Small Employers Using Tobacco Surcharges Do Not Provide Tobacco Cessation Wellness Programs. Health Affairs, 37(3), 473-481.

Zagaja, A., Patryn, R., Pawlikowski, J., & Sak, J. (2018). Informed Consent in Obligatory Vaccinations?. Medical science monitor: international medical journal of experimental and clinical research, 24, 8506.