Should child vaccinations for preventable diseases be made mandatory?
A parent or guardian faces 18 years of decision making about a wide range of issues on behalf of their child. Many of those decisions can have broad ramifications and since accurate assessment of risk is challenging for the vast majority of people we need a framework to support our decision making. We rely on experts gathering, analysing and presenting the conclusions from vast amounts of data to provide guidance on topics ranging from education to nutrition. But, how do we decide who is an expert and how do we react to the variety of ways guidance is proposed or imposed? For example, why does the law in the UK mandate your child must wear a seatbelt but only recommends they must be vaccinated?
The World Health Organisation recommends at least 95% of people be vaccinated in order to provide herd immunity for those who are medically unable to receive the vaccination or for whom it is ineffective. The challenge most countries face is reaching the magic 95% level when parents are understandably concerned about potential side effects of vaccinations at an individual level whilst also finding it hard to picture the real consequences of not vaccinating - having (luckily) never really seen what a case of measles or diphtheria looks like.
Many countries impose vaccinations, primarily by restricting access to education for unvaccinated children. This is not the case in the UK where reticence to vaccinate in some groups has led to outbreaks of preventable diseases over recent years. So,the question now for UK public health policy is whether it should be led by the carrot or the stick. Undoubtedly education of those reluctant to vaccinate should be the gold standard but if this continues to not be fully effective then it could be time for a stronger approach.