DDP Newsletter March 2012, Volume XXX, No. 2.
Like clean water and clean air, a low incidence of infectious disease is a very good thing. But removing smaller and smaller traces of pollution, or the last cases of measles, becomes increasingly difficult and costly. Zealotry is a problem in and of itself. And at some point, efforts become counterproductive. “Clean” technology such as wind turbines may lead to more net pollution. What if more vaccines produce more net sickness?
Doctors may be hesitant even to ask this question. And families can be punished for failure to vaccinate. In Australia, for example, children must be fully immunized to receive the Child Care Benefit or the Child Care Rebate. In July, the Family Tax Benefit end-of–year supplement will also be tied to full immunization, which will soon include meningococcal C, pneumococcal, and chickenpox vaccines (ABC News [Australia] 12/5/11). In the U.S., such punitive actions are uncommon although children may be excluded from school or from many physicians’ offices.
The leading edge of compulsion is for annual influenza vaccination of health care workers (see November 2011 issue), even those who do not participate in patient care. The rhetorical temperature is rising; refusal is being portrayed as antisocial behavior.
“Newborn babies, the elderly, and the immunocompromised have a powerful interest in not being killed by those caring for them and in having a healthy workforce available to treat them,” writes bioethicist Arthur Caplan (Lancet 7/23/11, http://tinyurl.com/88jzze5). Moreover, he writes, “by not vaccinating themselves, health-care workers feed vaccine fears, reinforce anti-vaccine sentiment, and set a dismally poor example for the public.”