The Moral and Ethical Sides of Vaccines and Vaccinations

Key Takeaways:

• Be a leader in sharing how getting vaccinated protects you, your family and those around you
• It is better to prevent disease than to treat it
• Research from the Centers for Disease Control and Prevention, working with the American Academy of Pediatrics, provides evidence of vaccine safety

Do you remember those childhood vaccinations you received prior to each school year?  They were responsible for near elimination of some childhood illnesses like polio, measles (rubella), mumps, diphtheria and whooping cough. Younger readers may not even recognize these illnesses or the fact that hundreds died prior to their controlled existence by the use of vaccines. Although these illnesses have not be eradicated, their presence is controlled.

Consider the devastation caused by these illnesses — 15,000 Americans died from diphtheria in 1921, but from 2004-2014 only two cases have been seen; prior to vaccines almost everyone had measles and many died. Nearly 12.5 million people died from rubella between 1964 and 1965, yet from 2012 to 2018 only 15 cases were seen. [i] Vaccinations protect not only you, but the people around you. Individual, community  and national leadership is necessary to provide education, understanding and support to encourage dialogue and participation in health promotion and disease prevention programs that support a healthy environment.

Individuals have disavowed the use of vaccines since the 19^th century, suggesting distrust in the process and some consider mandatory vaccinations an impingement upon their liberty and freedom of choice.  The fury about vaccines diminished after a 1905 Supreme Court decision to support state’s rights in enforcing mandatory vaccinations after a Massachusetts smallpox outbreak. The outrage came back into vogue with a 1997 British article espousing that the MMR (measles, mumps, and rubella) vaccine was linked to autism — a claim that was retracted by the authors, but sadly the damage had been done and appeared to be irreparable. [ii]

Further dissention related to vaccination refusal was noted when remarks were made that vaccines contained dangerous additives such as mercury, antifreeze, antibiotics and other chemicals and were a ploy by big pharma to increase sales.[iii] The National Childhood Vaccine Injury Act of 1986 was disseminated to support a special court program for claims of vaccine injury that provides for individual damages but limits manufacturer liability[iv]. This legislation continues to be debated with a notable 2018 opinion by Justice Antonin Scalia supporting the legislative power to preempt design defect claims against manufacturers.

We are seeing a surge in illnesses that were once considered to be controlled. The World Health Organization reported that, in 2017, measles caused nearly 110,000 deaths stating that one of every 10 children contracting measles will die from the illness or its complications. The United States experienced an outbreak of 1,172 cases of measles from January 1 to August 1, 2019 — the greatest number reported since 1992.

There are rises in other preventable diseases — severely affecting vulnerable populations including infants, children and older adults. We are, again, seeing spikes in pertussis (whooping cough), where more than 104,119 cases appeared between 2014 and 2018 and continue into 2019. Human papillomavirus (HPV), while not generally referred to as an outbreak, has become common as one in four people will contract it during their lifetime — and it is preventable through vaccination!

Although there is no existing cure for cancer, we now have the ability to prevent some cancers including cervical, vaginal, vulvar, penile and oral that are caused by certain high risk strains of HPV. More than 33,000 cancers are caused by HPV each year in the United States ^v. Resurgence of illnesses we once thought under control as well as preventable cancer are threatening the health and lives of our families.

Where we go and how we continue to enforce a proactive ecosystem supporting health is up to us — as leaders.  We are all leaders in some sense. We are household leaders, community leaders, academic and professional leaders. Our human responsibility is to support the greater good through leadership, education and support.

As leaders, we must support a system that understands individual fears while supporting a nurturing environment where vaccine education is provided to encourage adoption to protect ourselves, our families and our communities. Government control may not be the answer to vaccines, but public health is important to us all and our decisions matter.

[i] Centers for Disease Control and Prevention (https://www.cdc.gov/vaccines/vac-gen/whatifstop.htm)

[ii] Novak, S (2018). The Long History of America's Anti-Vaccination Movement. Discover, Dec.

[iii] Smith T. C. (2017). Vaccine Rejection and Hesitancy: A Review and Call to Action. Open forum infectious diseases, 4(3), ofx146. doi:10.1093/ofid/ofx146

[iv] Blake, V (2012) The National Childhood Vaccine Injury Act and the Supreme Court’s Interpretation. AMA Journal of Ethics Virtual Mentor:14(1):31-34. doi: 10.1001/virtualmentor.2012.14.1.hlaw1-1201.

1. Centers for Disease Control and Prevention (https://www.cdc.gov/vaccines/vpd/hpv/index.html)