State Mandated Vaccination
State Mandated Vaccination
The state plays a major role in influencing the vaccination of children and health promotion decisions. The diseases covered under the state-mandated vaccination include influenza Hepatitis A, Hepatitis, B, Hib, HPV, Influenza, Rotavirus Varicella, and Polio among others (Stratton et al., 2012). Notably, in the United States, the main objective of state-mandated vaccination is to increase the rates of vaccination coverage among school children (Hendrix et al., 2016). Immunization policies are applicable to the children attending both the private and the public schools. Many of the state laws have provisions, which describe and enforce the school vaccination needs and exemptions. The focus of this study is to discuss the ethical issues, the public health goals, ethical dimensions, and public health actions in state-mandated vaccinations.
Ethical Issue, Public Health Goals, Risks Ethical Conflicts, Competing Moral Claims
The Office of Disease Prevention and Health Promotion states that the goal of the state-mandated vaccinations is to increase vaccination rates and further reduce the preventable infectious diseases. The program helps to increase the level of life expectancy as the level of child survival is boosted. State immunization programs are essential in the prevention of the vaccine-preventable diseases (Hendrix et al., 2016). It is notable that influenza, tuberculosis and Viral hepatitis are among the global health problems that lead to high mortality rate among children. In the US, the value of vaccination extends to saving around 33, 000 lives and prevents approximately 14 million cases of new infectious diseases (Hendrix et al., 2016). According to Hendrix et al. (2016), “immunization in the US has helped in reducing direct health costs by 9.9 billion dollars and indirect health costs by 33.4 billion dollars.”
Although the immunization has fostered health promotion programs while reducing disease transmission, state-mandated immunization presents underlying ethical issues (Hendrix et al., 2016). There is moral distress on the compulsory vaccination, which leads to ethical conflicts. It is important to note that childhood immunization should involve the balance between the autonomy of the parents and benefits to public health. There are formulated vaccine ethics which are conceptualized as the intersection between the public health policy and the clinical ethics. Several ethical implications concern the vaccine-related ethics. The perspective of the parents on the immunizations is highly valuable and influences the decision on ethics (Stratton et al., 2012). The ethical considerations that can be factored in include the social responsibility of how the choices on the immunization can affect them.
Varying cultural beliefs among the parents influence their vaccination decisions. Some of the beliefs that attribute to the rejection of the vaccines may be natural or unnatural (Stratton et al., 2012). In the US, it is exclaimed that democracy and freedom of choice are epic. However, the state-mandated vaccines are considered to be among significant liabilities that inhibit freedom of choice for parents and their children (Stratton et al., 2012).
Ethical Dimensions of Public Health Options
According to the Acute Humanitarian Crises, there are complex ethical dilemmas especially for the policymakers in the setting of the adequate and inadequate health care services (Hendrix et al., 2016). The ethical dimensions of state-mandated immunization assume different dimensions, which include the mitigation of spread of the infectious diseases in the society. Infectious disease outbreaks in the society can lead to humanitarian crises, which are avoidable through vaccination.
It is important to consider several factors before the state government mandate vaccination. Foremost, states should consider the potential burden of the disease in the local, national or global capacity. Secondly, vaccine-related risks is another aspects that state governments should consider because some of the vaccines have significant side effects on children (Moodley et al., 2013). Thirdly, states should also consider the desirability of the prevention of the disease as opposed to the treatment of the health condition. Furthermore, the duration of protection conferred is also a relatively important consideration (Hendrix et al., 2016). Lastly, the state should also consider the logical feasibility of the vaccination would play a major role in influencing the decision on the vaccines.
In some instances, vaccines may be the only desirable option for treating and protecting children from various infectious diseases. Such diseases include meningococcal meningitis and measles. Despite the effectiveness of vaccines in preventing infectious diseases, it is essential for the policymakers to ensure ethical considerations mentioned above. As a result, the rate of acceptability among parents will significantly increase.
The federal government, WHO and other health organization impact the decision on the ethical issues surrounding the state-mandated vaccinations (Moodley et al., 2013). Based on a framework where the nation is facing an infectious diseases crisis, the key factors to consider include the epidemiological risk of the disease among other factors. The ethical dimensions that ought to be integrated before the validation of the state-mandated are as follows.
Beneficence and Human Rights
The international community and the federal government are considered to have a collective duty to ensure prevention of the infectious diseases in the society through immunization (Moodley et al., 2013). Hence, WHO and other health organisations view vaccines as beneficial to children. Henceforth, immunization is a human right for all children in the US based on the state-mandated vaccination programs.
Based on this consideration, all the decisions should be founded on seeking a balance between doing good while reducing vaccine related-risks. It is important to note that the vaccines play a major role in preventing diseases although they could also cause social harm in the society (Moodley et al., 2013). The side effects of the some vaccines are examples of adverse effects that raise ethical issues in state-mandated vaccination programs.
Other ethical considerations include the distributive justice system which requires the use of the fair allocation of the vaccination to all vulnerable people without discrimination (Moodley et al., 2013). It is vital to ensure equity in the distribution of the vaccination so that the problem of the spread of the disease can be managed. Based on the state-mandated vaccinations, it is mandatory for all children in the US to undergo particular vaccination.
Public Health Actions
Integrating public health action to address the ethical dilemmas and issues related to state-mandated vaccines is critical. By developing an ambient approach, public health practitioners can integrate the problem of ethics with the cultural and ethnic beliefs of diverse people in the society. The approach includes the inclusion of both pharmaceutical and the non-pharmaceutical vaccines (Moodley et al., 2013). The non-pharmaceutical approaches help to ensure that the ethnic consideration and beliefs are factored. Thus, the freedom of choice is improved through the increase of a variety of options.
In the society, it is essential to ensure that the distribution of the vaccines is effective to avoid the dilemma of leaving some population at risk. It is important to establish an effective strategy to ensure effective allocation and equitable distribution of vaccines to help improve the quality of life and further protect people from infectious disease (Hendrix et al., 2016). State governments should also offer an educative session to emphasize the value of vaccination as it helps to increase the rate acceptance among parents in the US. Thus, involving parents in the development of an action plan is fundamental in reducing ethical issues surrounding state-mandated vaccines.
1. Hendrix, K. S., Sturm, L. A., Zimet, G. D., & Meslin, E. M. (2016). Ethics and Childhood Vaccination Policy in the United States. American Journal of Public Health, 106(2), 273–278. http://doi.org/10.2105/AJPH.2015.302952
2. Moodley, K., Hardie, K., Selgelid, M. J., Waldman, R. J., Strebel, P., Rees, H., & Durrheim, D. N. (2013). Ethical considerations for vaccination programmes in acute humanitarian emergencies. Bulletin of the World Health Organization, 91(4), 290–297. http://doi.org/10.2471/BLT.12.113480
3. Stratton, K. R., Wilson, C. B., McCormick, M. C., Institute of Medicine (U.S.)., & Institute of Medicine (U.S.). (2012). Immunization safety review: Multiple immunizations and immune dysfunction. Washington, D.C: National Academy Press.