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State Guidelines for Mandatory Childhood Vaccination Policy

State Guidelines for Mandatory Childhood Vaccination Policy

In recent news, an outbreak of measles at a Texas mega-church famous for preaching against vaccines has sparked new concern about vaccination rates. In fact, with more than 21 cases of measles linked to the church, health officials consider the outbreak a potential threat to public health and safety (Aleccia, 2013). The case highlights the fact that a minimum number of people in any population need to be vaccinated to provide "herd immunity" to keep disease in check for those without vaccination or whose immunity has waned. As such, an updated state policy for mandatory childhood vaccination for major diseases is well worth formulating and articulating.

Foremost, the updated mandatory state vaccine policy is applicable to all children who participate in any type of public or private school campus-based activities. Specifically, the mandatory policy holds that all such children "are required to have age-appropriate vaccines with proper documentation on file at the school" (Florida Department of Health, 2013). As a basis for the immunization guidelines, the Centers for Disease Control and Prevention (CDC) schedule of immunizations is the most reliable medical publication for vaccines. In fact, the CDC standards reflect the fact that medical science is advancing each and every year. Therefore, the CDC immunization guidelines and schedule are adjusted and modified annually according to the latest scientific and medical data and research findings. With these facts in mind, the proposed state guidelines, herein, reflect the recommended immunization schedule of the CDC (2013) Advisory Committee on Immunization Practices (ACIP).

For infants (birth to 18 months), the following vaccinations/immunizations are recommended. For Hepatitis B (Hep B), the first dose should be at birth, the second dose should be administered between 1 and 2 months, and the third dose should be administered between 6 and 18 months (CDC, 2013). Potentially life threatening diseases for infants like pneumococcal conjugate (PCV13) should be administered in a regiment of five separate doses. The first dose should be at two months, the second dose should be at three months, the third dose should be at 3 months, the fourth dose should be administered between 15 and 18 months; and finally, the fifth dose should be administered at 4 to 6 years (CDC, 2013). Serious and highly controllable diseases like the measles, mumps, and rubella should all be administered with the first dose between 12 and 15 months and the second dose anywhere between 4 to 6 years (CDC, 2013). For other diseases - including rotavirus (RV); diptheria, tetanus, and accellular pertussis (DT&P), varicella (VAR); human papillomavirus (HPV2: females only; HPV4: males and females); and meningococcal (Hib-MenCy) - state guidelines should adhere strictly to the CDC schedule (see CDC Immunization Schedule at: http://www.cdc.gov/mmwr/preview/mmwrhtml/su6201a2.htm).

In providing a basic ethical rationale for the proposed mandatory childhood vaccination guidelines, it must be fundamentally recognized that imposing vaccination requirements on all children (with some limited exceptions) brings into light potential conflicts between constitutional and civil rights. The US Constitution, for example, ensures basic and fundamental freedoms with respect to religion and beliefs. At the same time, however, assurance of public health and safety is understood as one of the most basic of all civil rights. In weighing a conflict of values and rights that arises in a case like the Texas mega-church measles outbreak, the utilitarian principle of the greatest good for society must carry greater philosophical, ethical, and moral weight than rights to religious or philosophical freedom. It is unfair and unjust, in other words, for the belief system of a minority population to pose a threat the health, safety, and welfare of society as a whole. The best interests and good of society is, thereby, the guiding ethical and moral principle of the vaccination and immunization exceptions as identified in the subsequent section.

With respect possible exemptions, most states already have a reasonable format that can be adopted with some slight modifications and adjustments. As of July 2012, in fact, all 50 states allow vaccination exemptions for medical reasons; 48 states allow exemptions for religious reasons; and 19 states allow exemptions for philosophical reasons (National Network for Immunization Information-NNii, 2012). As a basic rationale for medical exemptions, a number of medical conditions may render certain immunizations too risky for the recipient. For instance, a child may have an allergic susceptibility to some types of vaccines. In other cases, a child's immune system may be intolerant of a vaccine due to conditions like cancer, AIDS, or other (National Network for Immunization Information-NNii, 2012). As a matter of policy, medical exemptions should, therefore, be attentive to any such cases. However, approval of exemptions should be strictly handled and determined by a qualified physician.



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