From: Heather White
Date: November 17, 2:00PM
Re: Mandatory Vaccination
There are not many public health issues where views are as extremely polarized as those concerning vaccines. Four populations are targeted for vaccine mandates, children who go to public school, healthcare employees, immigrants, and our military. Exemptions to vaccine mandates fall into three basic categories, medical, religious, and personal or philosophical. Through the course of this paper I will discuss each of these target populations, and the ethical philosophies that drive, and oppose these policies.
In 1983 children were required to have 10 total injections of the polio, MMR, and DTP vaccines prior to entering the public school system by age 4 (CDC, 1983). In theory these mandates are to protect the children, and the greater good of society from disease. This very utilitarian approach had some drawbacks. The policy created debilitating injury in some children. Parents of the vaccine injured sued the pharmaceutical industry and won huge claims from these vaccine adverse events. Vaccine manufacturers then went to the U.S. government and threatened to stop production of vaccines in light of the settlements. This ruffled the feathers of the utilitarian policy makers whose only goal is to presumably maintain the health of the greatest majority. This gave way to the legislation of The 1986 National Childhood Vaccine Injury Act. In this Act the pharmaceutical company gained its freedom from liability if their product causes harm because our government outlined vaccines as “unavoidably unsafe” (HRSA, 1986). Thus began a tax collection from the sale of every vaccine to be placed in a compensation fund for the injured, thereby the product consumers are now liable for product failures.
The U.S. government created a list of “table injuries” where claimants’ had no-fault protection if the suspected injury fell within the timeframe guidelines (HRSA, n.d.). There are some very serious adverse events listed within that table like death, and encephalopathy (swelling of the brain). Another factor we must consider before we try and understand the different mindsets is the surveillance system that is in place for picking up vaccine adverse events. We only have one system, and it is considered a passive reporting system with many methodological limitations. According to a peer-review study on the vaccine adverse event reporting system (VAERS), “The study of vaccine safety is complicated by underreporting, erroneous reporting, frequent multiple exposures and multiple outcomes” (Singleton, 1999). There are over 400,000 vaccine adverse events that are documented in the VAERS (NVIC, 2012). The utilitarian ideologues claim none of these events can be medically associated with vaccines. Based upon these findings this surveillance system is inadequate, and impossible in determining vaccine risk, but it is the system of choice by our health authority.
With the foundation of the policy framed I think we can have a clearer understanding of the dueling ethical philosophies. The utilitarian argument is vaccines are the greatest accomplishment in science, and medicine of this century. They prevent infectious disease epidemics, which in the 1900s where the scourge of U.S. citizenry. They claim that vaccines have been thoroughly tested and proven safe, and effective. Some argue that if you refuse to vaccinate you are a poor member of society, and a parasite of herd immunity. A utilitarian approach is to maintain the highest vaccine compliance to insure the highest disease protection for the greatest majority even while understanding that some will die because of this policy. There is an extremist faction within this utilitarian group, and unfortunately their goals are infringing on parental rights and informed consent. The utilitarian’s main focus is a policy that protects the greatest good. They will lie, conceal, show no mercy for the populations who are harmed, and ignore violations they create in the process. The only goal is to protect the policy at all cost and force the public into compliance at every turn. On MSNBC Dr. Nancy Snyderman sums up the philosophy well by saying, “Just get your damn vaccine” (Snyderman, 2009). Don’t question the policy; don’t exempt from the procedure just do it for the greater good of humanity.
There are several ethical philosophies that argue against this policy. There are two exemptions that protect the rights of these populations religious, and philosophical. The religious ethical ideologues oppose the ingredient MRC-5, which are cells from aborted fetuses. The vaccines that contain those ingredients are chickenpox (varicella), rubella (German measles), hepatitis A, and shingles (CDC, personal communication, September 30, 2009). These Christians also quote the Bible, which states parents are entrusted with the care and welfare of the child (1 Timothy 5:8 King James Version). That would remove the power of this policy from our health authority. Many other religious groups oppose other specific ingredients that are injected through vaccines like cells from cows, monkeys, chickens, and pigs (Evangelista, 2004). Some religious groups like the Amish, and the Mennonite forgo all advanced medical care of the 20th Century.
The philosophical ideology that opposes vaccination can encompass many ethical groups. Their argument is vaccines are not proven safe, or effective. They feel the U.S. health authority overemphasizes the benefit, and trivialized the adverse events. These ideologues point to the known corruption of the pharmaceutical industry, and question the legislation that allows manufactures to produce, conduct the safety analysis, market, and promote products they will never have liability for if they fail. Philosophical ethicists disagree with the growing list of mandated vaccines for school-aged children and point out the lack of safety data that exists with these simultaneous injections. Today a child can have 38 injections of 15 vaccines before reaching school age (CDC, 2012.). This “bloat” as they call it is a cause for concern. Dr. Paul Offit an outspoken utilitarian and a defender of vaccines once said, “an infant could handle up to 100,000 vaccines at one time…safely” (Offit, 2006). Philosophical ideologues would say this is a ridiculous statement that is meant to spin the science, and trivialize the topic. A utilitarian routinely points to the pediatric population to prove vaccine safety by outlining how immune they are to infectious disease. A philosophical exempter would argue that this is a one-dimensional approach in establishing public health. They would point to increases in infant mortality, and childhood chronic disease like asthma, IDDM, and autism to name a few (NCHS, 2009). It is also proved through evidence-based medicine that;
“90% of the decline of infectious disease mortality among US children occurred before 1940, when few antibiotics or vaccines were available” (Guryer et al, 2000).
The philosophical ethicists feel that utilitarians cannot make risk assessments regarding vaccine safety because injuries are not actively tracked by VAERS. And how many times have we heard from these utilitarians that there is only one study that linked vaccines with autism, and it was debunked. This has to be the biggest lie of them all. There are dozens of studies that link vaccines, and their ingredients to a myriad of negative neurological, and immunological outcomes (Validation, 2012). The arguments continue back and forth without end in site because the ethical beliefs are so opposing.
Our public health authority that maintains a utilitarian mindset is trying everything they can to steamroll this policy down the throats of the American public. There are those who are actively trying to pull the legal exemptions, and waivers from religious, and philosophical ideologies. The American Academy of Pediatrics, and Dr. Paul Offit issued a joint news release urging the end of these exemptions stating “the delicate balance between individual freedoms and societal good” (News Release, 2010). Also, the Pediatric Infectious Disease Society (PIDS) stated, “Parents should not be allowed to exempt their children from vaccinations” (Rain, 2011). In Massachusetts they passed a law that children can be removed from their homes and forcibly vaccinated against the parents wishes (FoxNews, 2009). This year California passed a bill AB2109 that allows health care providers to vaccinate 12 year olds without the parent’s knowledge or consent at public school institutions, or medical facilities (AB 2109, 2012). In West Virginia where they do not allow religious, or philosophical exemptions a policy was implemented to drop students who where not compliant with vaccine booster protocols’ (Horst, 2012). In Maryland the government threatened parents with jail, or bring their children to the courthouse to have them vaccinated with up to 17 vaccines at the same time. This got the attention of the Association of American Physicians and Surgeons who immediately issued a press release.
“This campaign of intimidation to brutally enforce blanket vaccine mandates by government agencies and the school district gives no consideration for the rights of the parents or the individual medical condition of the child” (Serkes, 2007).
The utilitarian camp justifies the trampling of civil liberties and parental rights because of their presumed greater good outcomes. The philosophical, and religious groups claim the government does not know what is best for the children of this Country the parents do. With this growing controversy, and incoming science that has damaged the vaccine policy non-medical vaccine exemptions are on the rise (Hawthorne, 2012). I am certain that these utilitarians who care little of personal civil liberties, or parental rights will implement more vaccine roundups in the future if op-outs continue to climb. Already pediatric offices around the Country are firing children from their practices because of vaccine refusals, yet another bulling tactic to force compliance (Patt, 2012).
There has been a growing demand to enforce tougher penalties against healthcare workers who refuse the yearly flu vaccine. Medscape contributor and head of the Division of Medical Ethics at New York City Medical Center, Art Caplan PhD sums up the utilitarian philosophy nicely.
“Ethically, your first obligation is to do no harm. If you are there to do no harm and that is your primary obligation, then you cannot put your personal choice or your personal reluctance to get that shot above doing harm. And you are likely to do harm to others if you do not get that shot” (Caplan, 2012).
This pressure from the U.S. health authority has been met with opposition from the opposing philosophical, and religious ideologies. This year healthcare professionals have flooded the comment section of the HHS pleading for their right to choose. Their comments are filled with science, and philosophy that contradicts this encroaching policy vaccinate or be fired (HHS, 2012). The utilitarians are ignoring their opinions, and their jobs are in jeopardy. Colorado has implemented a 100% vaccine compliance rate for all medical staff. If the staff does not comply they “will be suspended and then fired” (Denver CBS4, 2012). This appears to be a growing trend at medical facilities, and is already established in Philadelphia, Washington, and New York. Some healthcare workers are fighting back. In 2009 across the state of New York nurses protested the vaccine mandate. “Frank Mannino, a 50 year old registered nurse, said the state regulation violates his personal freedom and civil rights” (Nurses Forum Staff, 2009). The Washington State Nurses Association filed a lawsuit over the vaccine mandate (KOMO Staff, 2009). I suspect this policy will be fully implemented across the U.S. in the near future. Eventhough the flu vaccine has little effectiveness, and known serious adverse events the utilitarians are not concerned who is harmed by the policy.
According to the CDC immigrants who make their way to the U.S. are required to have a medical exam, and be injected with up to 14 vaccines on the same day (CDC, n.d.). However, this requirement can be waived for objections based on religious, and moral convictions. This requires form I-601, Application for Waiver of Ground of Inadmissibility, which has a $545.00 application fee, and an affidavit that must be customized for each applicant (U.S. Dpt of Homeland Security, n.d.). There are very few immigrants who can afford, or have the knowledge that can protect their ethical objections against the utilitarian ideology of mandatory vaccination. An immigrant Somali community in Minneapolis is speaking out against this protocol. Dr. Stacene Maroushek a pediatrician is seeing a disproportional increase in autism in this small population. Anne Harrington the special education coordinator for the Minneapolis district had this to say,
“They’re given more [vaccines] then we get, and sometimes they’re doubled up,” Harrington said. “Then their children are given immunizations. In Somalia, their generations have not received these immunizations, and then suddenly they’re getting just a wallop of them in the moms and then in the babies. That’s certainly a concern that’s been expressed to me by the Somali population” (Gorman, 2008).
In a 2010 Congressional hearing regarding autism, and environmental health research, Dr. Linda Birnbaum the director of the National Institute of Environmental Health Sciences overseeing autism research made statements that they would appropriate funding that would look into the Somali anomaly, and verify if the autism rates were indeed disproportional than what we see in the rest of the Country (Senate Committee Environment and Public Works, 2010). This important preliminary research has yet to be conducted.
The U.S. Military’s vaccine protocol is equal to the CDC’s civilian recommendations, plus additional vaccines like Typhoid, Yellow Fever, and Anthrax (U.S. Army Medical Dept, N.D.). The utilitarian philosophy believes that these service men, and women who live in close quarters, and travel around the world should be fully vaccinated. The traveling families of these servicemen have to be vaccinated in the same manner. They are not offered an exemption. Their only recourse is to find another employer or face military punishment. According to a press release Private First Class Leif Hamre who refused the Anthrax vaccine had this to say,
“The tactics they have used to coerce me into taking the shot are unregulated, unscrupulous and downright un-American…. They tried to turn my platoon against me in various ways. Along with the more common tactics like intimidation and threats (including the possibility of a forceful inoculation). I can only imagine what will come as I continue with this” (Weisberg, 2007).
There is a new population of soldiers that are refusing these vaccines based on their personal, or philosophical ethics. This is creating a challenge for the recruiting offices around the United States (Churchill, 2000).
This presentation has barely scratched the service regarding vaccines and the polarizing ethical ideologies. Utilitarian ethicists use fear, and intimidation to drive a policy that they know will harm some but in their opinion will benefit most. The American Medical Association (AMA) recently proposed the use of mandates for vaccine clinical trials to compensate for the lack of volunteer participation.
“If progression of promising vaccines from the lab to the clinic is to remain unaffected and financial inducement is an ethically unacceptable solution to the recruitment shortage, other strategies need to be considered. Compulsory involvement in vaccine studies is one alternative solution that is not as outlandish as it might seem on first consideration. Many societies already mandate that citizens undertake activities for the good of society; in several European countries registration for organ-donation has switched from ‘opt-in’ (the current U.S. system) to ‘opt-out’ systems, and most societies expect citizens to undertake jury service when called upon” (AMA, 2012).
Based on the AMA’s statements we could all be mandated to participate in experimental vaccine clinical trials in the future. The United States Constitution protects the personal freedoms of all Americans but those measures seem to be narrowing when it comes to vaccine mandates. These four populations are under immense pressure to submit to the CDC’s recommended vaccination protocol. The utilitarian vaccine policy makers are under pressure by vaccine refusals, and damning scientific evidence that contradicts their policy. In 1984 the Department of Health and Human Services along with the Food and Drug Administration ruled,
“…any possible doubts, whether or not well founded, about the safety of the vaccine cannot be allowed to exist in view of the need to assure that the vaccine will continue to be used to the maximum extent consistent with the nation’s public health objectives” (HHS, 1984).
This statement by our health authority clearly indicates they are biased, and driven by a utilitarian philosophy. Based on my research I have arrived at the inevitable conclusion that vaccination has grown into an organized criminal enterprise dressed up as disease prevention by means of junk science. I also believe that this medical procedure once stemmed from good intentions, but like the over prescription of antibiotics vaccination protocols have overreached their usefulness into the area of harm. After reading all the peer-review that substantiates the pervasive injuries caused by this policy I am left harboring these terrible opinions toward the U.S. health authority. Margaret Mead a cultural anthropologist, writer, and speaker once said, “Never doubt that a small group of thoughtful committed citizens can change the world; indeed it is the only thing that ever has.” I am somewhat hopeful that these opposing philosophical groups will one-day balance the acts of these utilitarians. The parents have the right to carefully consider any medical procedure that has the potential to cause harm not a utilitarian government. The system we have established is violating civil liberties, and denying culpability all under the mantra of the betterment of society. There has been a cost to this policy, which strikes a blow to the U.S. government morality. Even the minority has the right to liberty and security of person, regardless of the supposed public good involved.
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