The Vaccine Wars: What Can Be Learned from California’s Experiences with Mandatory Immunisation of School Children?

Abstract

The almost universal administration of childhood immunisations has been associated with logarithmic drops in the incidence of a number of diseases in the United States and worldwide. In the United States, mandatory school immunisation laws have in particular been instrumental in achieving the high levels of coverage needed to sustain herd immunity. However, concerns about vaccine safety led to the passing of the National Childhood Vaccine Injury Act of 1986, which uses a no-fault system compensation system for people found to be injured by certain vaccines. The measles vaccine is highly effective, and outbreaks of measles are usually the consequence of failure to vaccinate. A high-profile outbreak of measles at a southern California amusement park in 2014 led the state of California to further restrict the ability of children to attend school if they are not immunized because of their family’s beliefs. Immunisation requirements are but one of many legal mandates designed for public health protection, from mandatory fluoridation of drinking water to quarantine and isolation for communicable diseases. We conclude that school immunisation requirements help governments fulfil their duty to protect and promote public health.