Vaccination Policy - Compulsory Vaccination

Compulsory Vaccination

In an attempt to eliminate the risk of outbreaks of some diseases, at various times several governments and other institutions have instituted policies requiring vaccination for all people. For example, an 1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply. In the United States, the Supreme Court ruled in the 1905 case Jacobson v. Massachusetts that the state could require individuals to be vaccinated for the common good. Common contemporary U.S. vaccination policies require that children receive common vaccinations before entering school. A few other countries also have some compulsory vaccinations. Compulsory vaccination is believed to have greatly reduced the rates of some infectious diseases.

Beginning with early vaccination in the nineteenth century, these policies led to resistance from a variety of groups, collectively called anti-vaccinationists, who objected on ethical, political, medical safety, religious, and other grounds. Common objections are that compulsory vaccination represents excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe. Many modern vaccination policies allow exemptions for people who have compromised immune systems, allergies to the components used in vaccinations or strongly held objections.

In 1904 in the city of Rio de Janeiro, Brazil, following an urban renewal program that displaced many poor, a government program of mandatory smallpox vaccination triggered the so-called Vaccine Revolt, several days of rioting with considerable property damage and a number of deaths.

Having compulsory vaccinations is connected with difficult policy issues where health authorities try to balance health of society and individual liberty:

"Vaccination is unique among de facto mandatory requirements in the modern era, requiring individuals to accept the injection of a medicine or medicinal agent into their bodies, and it has provoked a spirited opposition. This opposition began with the first vaccinations, has not ceased, and probably never will. From this realisation arises a difficult issue: how should the mainstream medical authorities approach the anti-vaccination movement? A passive reaction could be construed as endangering the health of society, whereas a heavy handed approach can threaten the values of individual liberty and freedom of expression that we cherish."

Reviews of scientific evidence for different types of vaccination policies have found strong evidence for the effectiveness of standing orders, which allow healthcare workers without prescription authority (such as nurses) to administer vaccines in defined circumstances; sufficient evidence for the effectiveness of requiring vaccinations before attending child care and school; and insufficient evidence to assess the effectiveness of requiring vaccinations as a condition for hospital and other healthcare jobs.