Vaccine Refusal and the Risks of Vaccine-Preventable Diseases

Abstract

Omer et al. (May 7 issue)¹ skirt the crucial question: Does a developed, educated democracy such as that in the United States still need compulsory vaccination laws to achieve target compliance rates of 90 to 95%? It was the legislation for compulsory smallpox vaccination that led to the conscientious objector laws in the United States and the United Kingdom. Jacobson may have lost the 1905 Supreme Court case² against the Commonwealth of Massachusetts, but the court concluded that the state government could not pass laws in order to protect an individual person but could do so to protect the public. The U.K. compulsory smallpox vaccination laws of 1853³ led to riots, demonstrations, the circulation of tracts, and vaccine refusal, leading the Royal Commission to amend the laws with a conscientious objector clause in 1898 and culminating in the end of compulsory vaccination in 1946. Most member states of the European Union, especially the Scandinavian countries, achieve high levels of compliance with the use of information, education, persuasion, and subtle coercion — but not compulsion. The European Academy of Paediatrics is campaigning to make access to immunization a stated right of children. Surely compulsory immunization is anticonstitutional with respect to parental autonomy?