Vaccination Is Not About Parental Rights
The vaccine conflict escalates as vaccine advocates pursue legal avenues to minimize nonmedical exemptions, while the opposed fervently cite their rights to make decisions on behalf of their kids as parents a la “My child, my choice!” “medical freedom” or the appropriation of “informed consent,” under the banners of those who have financial and political incentives to create this dissent. Despite the pith of the latter’s rallying cries, all of them are fallacious and miss the point.
Discourse regarding the ethics of mandatory vaccination policies overemphasizes bodily autonomy. At the most basic level, biomedical ethics can be distilled to four core principles: (1) autonomy (right of individuals with capacity to make choices regarding their care), (2) beneficence (duty to ensure the best interests of their patients), (3) nonmaleficence (do no harm), and (4) justice (equitable distribution of health resources). Inarguably, upholding these values is essential. However, even considering the issue at this rudimentary level, already there is a problem: those opposed are ignoring the apparent conflict between autonomy with beneficence and non-maleficence, as though the primacy of autonomy should be a forgone conclusion.
The problem with “my child, my choice,” is its implication of absolute parental authority and even ownership of one’s child, but children are not chattel- they have inalienable rights, including the right to life, and the right to have their best interests be a primary consideration in all matters pertaining to them. At the same time, minors are generally not considered to have the socio-cognitive maturity to have decision-making capacity. This necessarily means that informed consent does not exist in pediatric care, as this only applies when one makes care decisions for oneself, but is present in the form of “informed permission” on the part of the parents.
With the guidance of clinicians, parents act as surrogate decision-makers on behalf of their children, but the ethical obligations of all parties lie in the assurance of the best interests of the child. The evidence is so overwhelming for vaccine safety and efficacy that it is in the best interest of the child to be vaccinated in all cases except true medical exemption. Thus, in focusing on parental rights, the anti-vax lobby has waved a huge red herring to push their “entitlements” ahead of their children’s best interests.
The majority of vaccines are given at too young an age for there to be any discussion of the procedure with the child, and thus vaccines cannot be consented to by children. At the same time, a child does not consent to have exponentially elevated risk for the contraction of diseases that may be fatal or whose sequelae may be life-limiting. There is no circumstance in which the vaccine is more dangerous than the disease (except perhaps the case of anaphylactic reactions to a vaccine ingredient, and hence individuals to whom this applies are deservedly granted medical exemptions). Thus, per the best interest standard, and Article 6 of the UN Convention on the Rights of the Child there is a single clear choice: vaccinate the child according to the schedule. It is thoroughly tested and demonstrated in a scientifically rigorous way to be the safest and most effective way to ensure protection from vaccine-preventable disease.
When parents inappropriately advocate to withhold vaccines from children, they act directly against their ethical obligations to minimize the harms their children will face. How much longer can we abide advocacy that is directly at odds with the needs of the child? We as a society need to send a stricter message to the anti-vaccine movement and its actors: it’s always been about the children, it isn’t about you, and for you to appropriate this issue to make it about your rights is narcissism at its worst. Vaccinate your child according to the schedule because it is the moral thing to do. Doing less necessarily means you are shirking your parental responsibilities. There is no justification for consciously forgoing your child’s protection against measles, mumps, rubella, hepatitis B, hepatitis A, meningococcal, diphtheria, tetanus, pertussis, influenza, Haemophilus influenzae type B (Hib), HPV, pneumococcal, rotavirus, varicella (chickenpox and shingles), or polio.
It’s okay to be nervous or to have questions- that’s what your pediatrician or family physician is for. Direct those questions to them or your local public health department. What isn’t okay is to allow those anxieties to deprive your child of necessary protection, for themselves, and for everyone.
Some excellent resources in addition to the aforementioned healthcare professionals include:
https://vaxopedia.org/
https://www.cdc.gov/vaccines/parents/index.html
https://www.chop.edu/centers-programs/vaccine-education-center
https://www.immunizeusa.org/parents/
I also want to extend my sincerest gratitude to Rachel Alter whose excellent and instructive edits made the article you see before you much more palatable in both tone and diction.