The Role That Vaccines Play In The Health Of Children

by Ralph Scharnau
Published with permission

States require hundreds of thousands of their residents—mostly infants, toddlers, and schoolchildren—to be vaccinated against numerous diseases. Actually, mandatory childhood immunizations have been a hallmark of American society since the 19th century. Now on the airways and social media, in personal and family conversations daily news coverage of the national COVID pandemic seems ubiquitous.

Childhood immunization rates have a long history in the United States as well as such European countries as France and Italy. Mandated vaccinations for polio, diphtheria, and tetanus rank as the most common. Now a wider range of vaccinations include shots for influenza, measles, mumps, rubella, pertussis, pneumonia, and chickenpox.

The vast majority of children are vaccinated. But no guarantee exists against disease transmission, particularly when school age children congregate close to one another in schools and daycare centers. The recent delta variant of the coronavirus sparked outbreaks and upset plans for a smooth transition to the school process. Some school immunization experts predict that vaccine mandates will become more common.

All 50 states mandate vaccination as a condition of school entry. Despite this requirement, exemptions occur and vary from state to state. A nationally enforced mandatory vaccination program will reduce local outbreaks, morbidity, and mortality associated with vaccine-preventable diseases.

All states also allow vaccination exemptions for medical reasons. And California, Mississippi, and West Virginia go a step further by granting religious or philosophical exemptions for those with sincerely held beliefs that prohibit immunizations. Today 29 states and D.C. have a religious and philosophical exemption law. These laws allow parents to claim an exemption based on their personal, moral, or other beliefs.

According to a recent POLITICO-Harvard poll, a majority of Americans now support a requirement that public school students aged 12 or older be vaccinated against Covid-19 before they can attend classes in person. The survey also shows lingering divisions along partisan, racial, and ethnic lines.

Nearly 75% of Democrats favor a vaccine mandate for the students while 59% of Republicans are opposed with just over half of independents against the mandates. Support for mandates was higher in communities of color than among white folks with blacks at 63%, Hispanics at 59%, and whites at 51%.

Making COVID-19 vaccination mandatory for children draws widespread support among health care professionals across a spectrum from general physicians to specialized immunologists. It will not be possible to achieve full protection against COVID-19 at the population level unless most adolescents and children are vaccinated. However, factors such as vaccine hesitancy and mistaken beliefs about COVID-19 risks may pose to children make this a challenging goal.

In the United States advocates and opponents of vaccination have clashed over compulsory vaccination and whether vaccines are safe and effective. There are also barriers to vaccines created by misinformation. Some social media sites claim that vaccines cause autism, a notion refuted by large-scale studies. Long standing studies, moreover, show that childhood immunization protects children from diseases that ravaged populations fifty years ago.

Other factors such as race and class also come into play. Kids may not get shots if their parents can’t get off work. Other factors like child care, missing work, evening hours, and getting transportation may also be important. Sometimes racist and sexist messages aimed at teens contribute another barrier to vaccination.

Upholding the efficacy of vaccination for the health of children while protecting the openness to the need for exceptions remains a delicate balancing challenge. Perhaps the most we can expect is a respectful discussion without rancor.

Ralph Scharnau
November 3, 2021

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