Parents ask Themselves, to Vaccinate or to not Vaccinate?

Parents ask Themselves, to Vaccinate or to not Vaccinate?

14 November 2022

University of Mary
Parents ask Themselves, to Vaccinate or to not Vaccinate?

Abstract

Currently, the United States have a mandatory vaccination policy for children who are

entering the school system. But, through this there are also exemptions to a mandatory vaccination

policy. Through this, you can be exempt through religious exemption, physiological exemption, or

medical exemption. There is no right or wrong answer through this question. The pro side to

mandating is explaining how it will cause herd immunity in the community and hopefully eradicate

disease. The con side to mandating vaccines explains that it is impounding on freedom, and

religious beliefs. The side of a medical exemption is based on the con side of the ethical dilemma

but is directly based on a medical issue on why they cannot receive the vaccine. The conclusion of

if the ethical dilemma of if a mandatory vaccination policy for children entering a school system is

that it will continue to be an ongoing discussion through states, schools, and parents.

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

Parents ask Themselves, to Vaccinate or to not Vaccinate?

To vaccinate or to not vaccinate my child, parents are asking themselves this question.

This is a difficult ethical dilemma of trying to do what is best for your child, listening to society,

and listening to medical advice, parents do not know what the best choice is anymore. They ask

themselves, “do I vaccinate my child or not?”, “should vaccine mandates be put in place?”, “how

can my child stay safe?”, “does it align with my religious beliefs?”. Currently, the generation that

are having children never went through a deadly virus that had no vaccine. COVID-19 was a deadly

virus, but our technology and science are very advanced to be able to produce a vaccine in a timely

manner. The ethical dilemma haunts parents, even once their child grows older. There are many

societal norms, religious factors, and science that will go into choosing the path for that family. So,

is vaccine mandate for children the right way to go?

This ethical dilemma does not solely belong in the sciences like many bring up. There are

many religious opinions, safety, and effectiveness opinions that come into light for this issue. How

a vaccine affects one child, might not affect another child the same - vaccines can be safe and

effective but not 100%. Therefore, it does not solely belong in the sciences. The community must

take the time and look at what information they will want to believe and follow. The vaccine itself

could cause any number of related issues, but you will never fully know if it was the vaccine that

caused the problem. The vaccine becomes the part to blame because of the correlation to the

timeline of events (Malone & Hinman, 2003).

There is no easy answer to this problem. The main picture is that parents want to protect

their children. Some see it in the manner of the vaccine is protection, and some see it as no vaccine

is the protection (Navin PhD, Wasserman PhD, Ahmad BS, & Bies MPH, 2019). This ethical

dilemma is immensely focused on opinions because it could be the right answer for one family and

not for the other. According to the CDC, “Four common childhood vaccines—DTaP, MMR, polio,

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

and varicella—are required for children to enroll in kindergarten in almost every state. Many states

require the meningococcal (meningitis) vaccine for entry into later grades, often at 7th grade.

Alaska is one of several states that require hepatitis A and hepatitis B vaccines for entry into

kindergarten. For entry into later grades, Rhode Island requires the human papillomavirus (HPV)

vaccine, according to the following schedule” (Center for State, Tribal, Local, and Territorial

Support. Centers for Disease Control and Prevention, 2022).

The above medications are required, but there are many reasons that could have the child be

exempt from vaccination. The mandates for exemption are different for each state. The mandates

are a way to make everyone happy by, 1. having mandated vaccines for disease prevention and 2.

have an out for parent’s children who have medical problems, or religious beliefs. The various

reasons include, “permits medical exemptions only, permits medical and religious exemptions,

permits medical, religious, and philosophical exemptions, requires parental acknowledgment during

the exemption application process that exempted students can be excluded from school during

outbreaks, establishes that exemptions might not be recognized in the event of an outbreak, requires

notarization of documents in the exemption application process, requires parental education on

vaccinations in the exemption application process, and addresses the duration of medical

exemptions (e.g., temporary or permanent)”(Center for State, Tribal, Local, and Territorial Support.

Centers for Disease Control and Prevention, 2022).

The type of ethical dilemma is conflicting rights. This is because some believe that you

should choose what is going into your body or not or into my child’s body. It is believed that it

should not be mandatory because of this. The United States of America is a free country and by

mandating a vaccine it is going against rights and freedoms.

The CDC, States, and parents are the main authorities involved in the authority of making

decisions. The CDC, center for disease control, is the “nation’s leading science-based, data-driven,

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

service organization that protects the public’s health” (Centers for Disease Control and Prevention,

2022). Each State has the right to make laws based for their community. They decide if they require

certain vaccines for when children attend school and/or the children can be exempt from the

vaccination. The States cannot force parents into any decision, but they can put out the information

to help the parents understand why vaccination is important. The parents have the right to choose

about their children if they are going to be vaccinated or not. If not, they must have a reason on why

they will not be vaccinating the child because of certain laws.

The 14th amendment makes it so the United States government cannot make vaccines

mandatory. The 14th amendment states, “no state shall make or enforce any law abridging the

privileges or immunities of citizens of the United States or deprive any person of life, liberty, or

property without due process of the law.” Through this the United States government can indirectly

enforce vaccination for children by making it mandatory for schools to have mandatory

vaccinations. The states use the school system to track the vaccinated and unvaccinated. The

legislation enacted that, “…vaccines are mandatory in places where children are in close quarters

such as private schools and day cares” (Macarthur, 27).

The first course of action that could be taken is mandatory vaccine for all between the ages

of 0 and 18 years of age. (Refer to appendix A for charts of vaccines). There would be a way to

have health related exemption to the mandatory but no other religious exemption or personal belief.

With this, it would be going against the 14th amendment. This mandatory action would have to be

brought to each state through an election to vote ‘YES or NO’ to determine if it would pass for the

state or not. This would put the communities in the correct direction to eradicate virus, but it would

put the government into more control which a lot of Americans would not want. Some Americans

believe that voting yes to mandatory vaccines is decreasing the number of freedoms we as

Americans have.

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

A different course of action that could be taken is continuing the action that we have now.

Religious, philosophical, and medical exemptions would be continued to be accepted. Many parents

have been concerned of how the vaccines affect their children. Religious exemptions mean that it,

“permits people, churches, non-profit organizations, and sometimes corporations to seek

exemptions from state laws that burden their religious beliefs” (Movement Advancement Project

(MAP), n.d.). Philosophical exemptions include fear and control. The fear is related to them are so

wonderful, but they also undergo years of testing. The fear is the unknown of if it will work or not.

The fear of why the rate of autism in children have been raised immensely since vaccines have

come to light (Spaeder, 2016). Some people do not want to take the chance or be controlled by the

government (Vaccine Update for Healthcare Providers, 2015). The medical exemptions are related

to children who cannot get vaccines due to their current health issues. The vaccines are not

indicated in this case because it would cause more harm to the child. Through this course of action

there are potential consequences which would affect the rate of transmission to children. They are in

daycares and schools that have children in a condensed area where transmission of viruses are

transmitted like wildfire.

Through the ethical framework utilitarianism through the ethical principal justice, they are a

safe and effective intervention to benefit the whole community with minor burdens of rare side

effects (Sween, MD, MPH, Ekeoduru, MD, & Mann, MD, DBe, 2022). Through ethical

justification, “since control of infectious diseases is a public interest, herd immunity should be

recognized as a common good. On the one hand, it means a form of solidarity with vulnerable

members of our society; it helps to protect those, who are too young or too old to be vaccinated,

unable to benefit from vaccination or have medical contraindications. On the other hand, it allows

so called “free riders” to enjoy benefits of herd immunity without bearing any costs of vaccination”

(Rus, 2021).

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

Deontology is another ethical framework that could be focused on for this ethical dilemma.

Deontology would be associated with vaccine mandates for children by doing what is right for their

children regardless of the consequences. This framework is specific to the values of the parents

because what they regard as what is right could be different than what another thinks what is right.

Through the Catholic church many parents are concerned about how vaccines are developed

through morally questionable means. In this way they are concerned about using cell lines derived

through aborted fetuses. The Catholic members are most concerned of the MMR vaccine which are

developed from WI-38 and MRC-5. These are both made from aborted fetuses. Through getting this

vaccine it is viewed as consenting to evil (Spaeder, 2016). The Catholic standpoint is, “Examining

the Catholic teaching on the individual’s responsibility to the common good shows that, in the

absence of medical contraindications, each person has a duty to receive currently recommended

vaccinations” (Spaeder, 2016).

Beneficence is seen as on the healthcare provider has a fundamental mission to apply a

treatment to the patient’s best interest. In the rising numbers of certain illnesses, it would be in the

best interest to bring up to the patients the need for certain vaccines (Rus, 2021). For unborn babies,

if the mother is Rh- it is very important to administer rho-gam to the patient IM during the

pregnancy and SQ after giving birth. The healthcare provider has a mission to take care of that

patient regarding all information.

Nonmaleficence is an ethical principle to the healthcare provider because we have a duty to

do no harm. Vaccines are minimally invasive and a very safe procedure, but everything is not 100%

safe. There is minimal risk to the patient receiving a vaccine (rash, pain and swelling at the injection

site, mild fever, rash, or syncope.) There are incorrect associations between the MMR and autism

which have since been proven incorrect by reliable data (Rus, 2021).

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

Provision two and three through the American Nurses Association Code of Ethics for Nurses

are the two provisions for nursing that directly align with the ethical dilemma at hand. Provision

two states that, “The nurse’s primary commitment is to the patient, whether an individual, family,

group, community, or population” (American Nurses Association, 2015). This outlines that the

nurse has the best interest of the patient at hand. She/he is required to outline all the benefits/risks of

the vaccine and how it can affect the person, family, group, community, and population. Provision

three states that, “The nurse promotes, advocates for, and protects the rights, health, and safety of

the patient.” As a nurse, their job is to advocate for their patient, especially for the patients that are

children and do not make their own medical choices. The nurse is there to advocate for that child on

why or why not the vaccine is the correct way to go in that instance (American Nurses Association,

2015). The American Nurses Association (ANA) does have a statement out on the manner of

mandatory vaccinations. The position statement is,

“Effective protection of the public health mandates that all individuals receive

immunizations against vaccine-preventable diseases according to the best and most current

evidence outlined by the Centers for Disease Control and Prevention (CDC) and the

Advisory Committee on Immunization Practices (ACIP)” (Nursing Practice & Work

Environment Department and LT. Steven G. Pochop, Jr. ANA member, 2020).

Through the statement provided by the ANA, the nursing facility should be promoting vaccines to

each parent that brings their child in. When the child is born the parent should be given a copy of

immunizations needed with the schedule of at what age the child should be receiving this. We

should be following up and contacting the parents to continue to encourage vaccines. Nurses should

do education for the community on benefits of the vaccines and free clinics to immunize the

children.

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

To vaccinate or to not vaccinate. Parents think through this question every time another

vaccine or time for a vaccine comes up. Through the American Nurses Association, CDC, and the

Catholic church, vaccination of children should be mandatory, and it is. It has exceptions, religious,

philosophical, and medical exemptions. But each of these entities bring to light the importance of

vaccination and how it will decrease or eradicate a disease. Children are the most susceptible to

illness because of the proximity in schools and daycares. Parents do not want to vaccinate because

of the freedom of choice, and for the possibility of extensive illness/injuries from the vaccine that is

given. The way the government puts a hold on mandating vaccination is putting hold on the people,

not giving the parents a choice. Parents believe that children must get infections because how will

their immune system learn to fight off diseases (Wolfson, DO, 2015). Through each side of the

ethical dilemma of if children should be vaccinated or not, which is correct? Should it be

mandatory, or should it be a choice?

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

Appendix A

Yellow: Range of recommended ages for all children

(National Center for Immunization and Respiratory Diseases, 2022)

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

References

American Nurses Association. (2015). Code of ethics for nurses. American Nurses Publishing.

Center for State, Tribal, Local, and Territorial Support. Centers for Disease Control and Prevention.

(2022). State School Immunization Requirements and Vaccine Exemption Laws. In Public

Health Law.

Centers for Disease Control and Prevention. (2022, April 29). Mission, Role and Pledge. Retrieved

from Centers for Disease Control and Prevention:

https://www.cdc.gov/about/organization/mission.htm

MACARTHUR, S. (27, March 2021). CAN VACCINES BE MANDATED BY LAW? Retrieved from

MPHonline: https://www.mphonline.org/mandatory-vaccinations/

Malone, K. M., & Hinman, A. R. (2003). Vaccination Mandates: The Public Health Imperative and

Individual Rights . In Law in Public Health Practice (pp. p. 262-284). New York: Oxford

University Press.

Movement Advancement Project (MAP). (n.d.). RELIGIOUS EXEMPTIONS. Retrieved from

Movement Advancement Project (MAP): https://www.lgbtmap.org/policy-and-issue-

analysis/religious-exemptions

National Center for Immunization and Respiratory Diseases. (2022, Februray 1). For You and Your

Family. Retrieved from Centers for Disease Control and Prevention:

https://www.cdc.gov/vaccines/schedules/parents/index.html

Navin PhD, M. C., Wasserman PhD, J. A., Ahmad BS, M., & Bies MPH, S. (2019). Vaccine

Education, Reasons for Refusal, and Vaccination Behavior. In American Journal of

Preventive Medicine (pp. 359-367). Elsevier Inc.

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Parents ask Themselves, to Vaccinate or to not Vaccinate?

Nursing Practice & Work Environment Department and LT. Steven G. Pochop, Jr. ANA member.

(2020). Immunizations Position Statement. American Nurses Association.

Rus, M. &. (2021, February 2). Ethics of Vaccination in Childhood—A Framework Based on the

Four Principles of Biomedical Ethic. Retrieved from

http://dx.doi.org/10.3390/vaccines9020113

Spaeder, M. G. (2016). The Moral Obligation to Vaccinate. In The National Catholic Bioethics

Quarterly (pp. 245-250). Philadelphia: The National Catholic Bioethics Center.

Sween, MD, MPH, L., Ekeoduru, MD, R., & Mann, MD, DBe, D. (2022, February). Ethics and

Pitfalls of Vaccine Mandates. Retrieved from ASA Monitor:

https://pubs.asahq.org/monitor/article/86/2/24/118298/Ethics-and-Pitfalls-of-Vaccine-

Mandates

Vaccine Update for Healthcare Providers. (2015, March 25). News & Views: Philosophical and

Personal Belief Exemptions From Vaccines. Retrieved from Children's Hospital of

Philadelphia: https://www.chop.edu/news/philosophical-and-personal-belief-exemptions-

vaccines

Wolfson, DO, J. (2015, Jan. 29). Should Any Vaccines Be Required for Children? Retrieved from

PRO & CON QUOTES: https://vaccines.procon.org/should-any-vaccines-be-required-for-

children-pro-con-quotes/

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