Law, Ethics, and Public Health in the Vaccination Debates: Politics of the Measles Outbreak

JAMA Online, February 2015

3 Pages Posted: 15 Feb 2015

See all articles by Lawrence O. Gostin

Lawrence O. Gostin

Georgetown University - Law Center - O'Neill Institute for National and Global Health Law

Date Written: February 12, 2015

Abstract

The measles outbreak of early 2015 is symptomatic of a larger societal problem –the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” in which parents choose not to vaccinate their children, relying on the fact that other parents will vaccinate their children, thus providing community immunity. However, the net result of many individual decisions not to vaccinate is the collapse of herd immunity and thus an upsurge in preventable disease and death.

The failure to vaccinate puts others at risk, thus violating an important ethical principle. However, punishing individual parents could entrench political opposition to vaccine policy. The most ethical and effective solution is for state legislatures to tighten vaccination laws, making it more difficult to obtain non-medical exemptions.

Keywords: measles, vaccination laws, childhood vaccinations

JEL Classification: K00, K30, K39

Suggested Citation

Gostin, Lawrence O., Law, Ethics, and Public Health in the Vaccination Debates: Politics of the Measles Outbreak (February 12, 2015). JAMA Online, February 2015, Available at SSRN: https://ssrn.com/abstract=2564724

Lawrence O. Gostin (Contact Author)

Georgetown University - Law Center - O'Neill Institute for National and Global Health Law ( email )

600 New Jersey Avenue, NW
Washington, DC 20001
United States
202-662-9038 (Phone)
202-662-9055 (Fax)

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