Health & Wellness response to the increasing prevalence and incidence of illness and death caused by disease such as measles, small pox, polio and other vaccine preventable diseases. As a result of this mandatory intervention (often referred to as one of the top public health achievements of all time), many of us have been fortunate enough to enjoy life and liberty blissfully unaware of many of these diseases (this is, of course, until recently). When establishing the vaccine requirements, legislators (informed by physicians, researchers, and other learned experts) weighed the benefits of vaccination against the risk of going without. In doing so, they reasonably deduced that for individuals with health issues contraindicated by vaccines, the risks of taking the vaccine outweighed its benefits. As a result, all states have a medical exemption and, understandably so; the rationale for medical exemptions are proven, documented, and not based on the choice of the individual. And, then there are those who are exempt for religious reasons. Some religions prohibit certain activities (including medical interventions) and engaging in these activities would prevent them from faithful practice of their religion. I can understand this as well. Once again, the rationale for religious exemptions are documented, and not based on the choice of the individual (outside of their 1st amendment right to practice said religion). What I haven’t quite wrapped my head around is the philosophical exemption
(and, I’ll readily admit, my public health training prevents me from doing so). Parents who seek philosophical exemptions do so for a variety of reasons: vaccines cause autism; vaccinepreventable diseases no longer exist; natural immunity is better, etc. In order to obtain a religious or philosophical exemption, all a parent must do is complete a form (such this one or this one) by checking a box and write a brief comment or explanation regarding the religious belief or strong moral ethical conviction which conflicts with the vaccination requirement. Pretty easy, right? Yep, it is. And, discussions on parent boards about immunization exemptions in Pennsylvania, coupled with the data on the number of religious and philosophical exemptions, confirm this fact. First of all, we know that the link between autism and vaccines has long since been debunked and its chief purveyor, Dr. Andrew Wakefield, discredited, so I won’t get into that here. Also, vaccine-preventable diseases do exist, as evidenced by the recent resurgence of measles from the Disney outbreak, the mumps in the National Hockey League, and let us not forget the prevalence of these diseases in other countries (... thanks to modern travel, a vaccine-preventable disease is just a plane ride and unimmunized person away!). But, I digress. Regardless of the reason parents choose to not vaccinate, the overarching rationale is that their individual beliefs and liberty trump the need to adhere to mandatory laws designed to protect the public’s health. And, as a result, the common good that has been realized through the childhood vaccination requirement is being compromised by the ease with which the “philosophical exemption” is obtained. Believe it or not, individuals seeking philosophical exemptions from mandatory vaccinations have been around since the beginning of the 20th century, as noted in a famous public health case that made its way to the Supreme Court of the United States (SCOTUS): Jacobson v. Massachusetts. In this case, the City of Cambridge, Massachusetts, under the authority of state law, required its citizens to
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BCMS-PA.org Bucks County
Physician