Doctors call for mandatory vaccinations
Leaders of the country’s largest doctors group are calling for mandatory vaccinations for children amid concerns growing numbers of “vaccine hesitant” parents are spurning the shots.
The Canadian Medical Association’s board of directors has endorsed a resolution calling on all provinces and territories to require proof children registering for daycare or school have received up-to-date immunizations, unless there is a medical reason they cannot be inoculated.
Currently, only Ontario and New Brunswick have laws mandating children receive the full schedule of recommended shots, although exemptions are allowed on medical and non-medical grounds — including children whose parents are religiously or philosophically opposed to the needles.
Under Ontario’s Immunization of School Pupils Act, children who don’ t have proof of immunization, or a valid exemption, can be suspended from school.
The doctors’ resolution, which will go before the CMA’s general council meeting in August for voting, is silent on the issue of nonmedical exemptions.
But recent measles outbreaks in the U.S. have spurred some American legislators to make it harder for parents to shun vaccinations, while a leading ethicist says that parents who choose not to vaccinate should be held legally liable if their child infects another child who then gets sick or dies.
The issue of “vaccine refusers” has come under intense focus following recent measles outbreaks in parts of Canada, including an outbreak in B.C. linked to a Dutch Reform congregation whose pastor has said vaccines interfere with God’s will. A measles outbreak that began at a Disneyland theme park in Orange County, California, last year eventually spread to at least half a dozen other states, sickening more than 150 people.
In Canada, immunization rates for key diseases are below target in many regions, according to a recent C.D. Howe Institute report. If coverage continues to slide, “more vulnerable populations, such as children, the elderly and people with medical conditions that may prevent them from being immunized will be put at risk,” the report warned.
CMA president Dr. Chris Simpson worries a demographic of parents is relying on an “alternate set of facts,” rejecting vaccines out of misplaced fears and deep suspicions of science and Big Pharma.
In addition to calling for proof of vaccination, the CMA board endorsed a multi-year plan to increase immunization rates. Simpson said requiring parents to provide proof of their child’s immunization against designated diseases alone isn’t sufficient, noting that even Ontario, with its mandated model, misses national targets.
“The big thing for us is going to be on the vaccine hesitant,” Simpson said. “We can say until we’re blue in the face that immunization programs have saved more lives than any other health intervention … (that) doesn’t reassure people when they’re hearing other people that they trust, and particularly (celebrities), who are saying otherwise,” Simpson said.
He said parents have forgot- ten the benefits of vaccines, and the days when “there was a kid with polio in every neighbourhood at any given time.” Measles is more than a “nuisance” disease, he added. In rare cases, it can kill.
Vaccine rates in some pockets of the country, Simpson said, are dropping below those necessary for herd immunity, meaning the number of children needed to be vaccinated to stop the spread of a virus.
Despite his frustrations, Simpson said it’s important to “move away from the blameand-shame approach and toward, ‘how can we give you (parents) the information and the reassurance you need?’”
Simpson said the CMA board has no position, for or against, religious or conscientious objection. “The decision of the board was simply to be silent on that for now,” he said. “It may come up — and I expect it will come up — for discussion at general council.”
However, “The intent and the spirit from the board was that this isn’t for us to comment on.”
California’s Senate last month passed a controversial bill striking the “personal beliefs” exemption from vaccination requirements, while last week Vermont’s governor signed into law a bill preventing parents from opting out of vaccinations on philosophical grounds.
Arthur Caplan, director of ethics at the New York University Langone Medical Center, said that parents have a duty not only to protect their own child, but other vulnerable children in the classroom who can’t be vaccinated because of a medical condition.
On the issue of conscientious choice, “the question becomes, should we allow parents to make ill-informed poor choices that put other people at risk?”
Parents may be free to choose not to vaccinate, he said. “But if their child infects or harms another child, they still may be liable if that child gets sick or dies.”
“You certainly might be free to choose not to do various things,” Caplan said. “That doesn’t release you from your responsibility to others if you hurt them.”