Vaccinations and Children Case

Vaccine Controversy

Christina Heissenbuttel

Saint Martin’s University

Ethical Issues in Health Care

NUR 370

Louise Kaplan, PhD, ARNP, FNP-BC, FAANP

Vaccine Controversy

Increasing popular vaccination resistance has provoked controversy amongst parents who decide against vaccinating their children. The argument over the safety, efficacy, and morality of required vaccinations long stem from contrary beliefs that include defending individual’s autonomy verses safe guarding the welfare of our public health’s standards. The medical dilemma pointed out here discusses the following two points. How unvaccinated children decrease individual and community immunity and increase the risk of vaccine preventable diseases to individuals who are unable to protect themselves from disease. And, how parents in Washington State are able to legally exercise their right to exempt their child by means of, philosophical, or personal beliefs. The ethical dilemma at stake is how to respect the autonomy of parents who choose not to vaccinate their children verses the beneficence of the community which ought to be protected from harm.

The parents are at the center of the dilemma because they are ultimately responsible to decide whether or not their children will be immunized. The stake holders however, include the medical providers, nurses, and the community (add why). Medical professionals such as physicians, are committed to the welfare of the individual patient as well as the health of the public, with this commitment comes an ethical responsibility to help prevent infectious disease by taking appropriate and established measures (Routine Universal Immunization of Physicians for Vaccine-Preventable Disease, 2015).  Nurses have a strong stake and are obligated to help promote wellness by advocating vaccines for children and to help eliminate any barriers conceived against vaccines. (ANA Immunize, 2015). All medical professionals are obligated as noted in the Code of ethics for providers^[a] to inform and protect the communities of vaccine-preventative disease by means of informing parents of the Center of Disease and Center of Prevention (CDC) recommendations.

The general public, the community is a stakeholder that is placed at increased risk when weakness in immunity begins to spre^[b]ad as a result of unvaccinated individuals. The population most at risk are children who are too young to receive vaccines, individuals who have been vaccinated (vaccines are not 100% effective and or may weaken over time leaving a person non-immune, and the population where vaccination is deemed contraindicated because of medical reasons (CDC, 2015^[c][d]).

In order to make an informed decision, parents need current evidence based information regarding the benefits and risks of immunizations. A parent might be intimidated by CDC information such as learning of the potential moderate, and severe risk factors related to certain immunizations. Also, parents may have been exposed to stories and personal accounts through family, friends, and media about a child who was allegedly hurt by a vaccine through an adverse reaction, with speculations of children developing autism or other neurological disabilities. Such information may hinder a parent’s decision, and discredit the value in the personal and community benefit of immunity protection. Parents thus need to be aware of the benefits of vaccines.

On the other hand parents need to be informed of the potential risk of their child contracting a preventable disease such as recent statistics of preventable outbreaks here in the U.S. including Washington State. Parents should be aware the measles was declared exempt in the year 2000 (no cases reported for one year in the U.S.) compared to the 644 cases of measles reported in the year 2014 from 27 different states. Another important statistic: January 1 through March 2015, 178 cases of measles have been reported with records indicating the majority of these cases were not immuniz^[e][f]ed. Access to data within an individual/parents’ state may help a parent to learn about the significance of vaccines from a different. The Washington State Department of Health School Data for the years 2006-2007 have reported rates of exemption from vaccination for non-medical reasons for the following counties: Thurston County 7.7%, Jefferson County 14.9 %. In April-May 2008 WA State had a reported 19 cases of measles, 17 of the 19 cases where not immunized, one person was vaccinated, and one infected person was an infant, two where younger than two years of age, and the rest were of school year age (Omer, Salmon, Orenstein, deHart, & Halsey, 2009). Such statistics may change a parents’ perspective and leave them with a better understanding the potential beneficence of vaccin^[g][h]es

As an example of beneficence to the general public, Washington State Law requires all children to be vaccinated against 11 vaccine-preventable diseases prior to entering a Washington school or daycare center including the measles.  However, the state law also allows for philosophical and personal exemptions as declared in the RCW 28A.210.090. This bill entitles full or partial exemption from immunizations for personal beliefs once signed by a parent or legal guardian (WA Legislature, 2015)^[i]. This law protects the population who may not agree or accept current medical preventative measures; whose ideological beliefs may not support vaccination. The recommended requirements infringe upon individual autonomy, and liberty (Ethical Issues and Vaccines - History of Vaccines, 2015).