Compulsory Vaccination Of Children: Challenges And Benefits

The success story of mandatory immunization against polio

Discuss about the Compulsory Vaccination of Children.

Massive campaigns have been mounted against polio around the world over for years (Chaturvedi et al., 2009). The efforts have necessitated a commendable decline in polio cases to a tune of 98%; from a suspected 3,500 cases annually a decade ago, only 37 cases were reported last year. However, there are still pockets of polio cases being reported annually in some countries such as Pakistan (Obregón et al., 2016). 1 in every 200 cases of polio results in irreversible paralysis. About 5-10% of those paralyzed die when their breathing muscles become immobilized. Immunization of children against most diseases is largely voluntary with the exception of a few including polio (Mangrio, Alam & Shaikh, 2008). The success story of mandatory immunization against polio is full of fascinating twists and turns. Mandatory immunization enjoys the support of proponents; it also draws most of its critiques of society and religion (Jegede, 2007). This essay explores the hurdles mandatory vaccination of children against polio has undergone in Pakistan.

Pakistan is a war-torn nation. Its economy is struggling at best. Like its neighbors, most of its nationals live in abject poverty (Khan & Qazi, 2013). Preventable communicable diseases are common in the population living below a dollar per day. According to the WHO (2015), there is a need for a strong political will to make sure that millions of Pakistan children get immunized. Statistics reveal that a little over three million Pakistan children do no complete their immunization schedule annually, rendering them susceptible to life-threatening preventable diseases.  Pakistan’s immunization coverage varies across the nation with some regions scoring poorly; less that 50% of the children being fully immunized against deadly diseases such as tetanus, measles, and polio are some districts (WHO, 2015).

A high-level mission from the WHO and UNICEF expressed concerns that the Pakistan Government was not moving with the required speed to implement immunization recommendations. The mission further pledged support for the immunization program. According to these experts, it is a tragedy when children perish of preventable diseases. Millions of lives of children across Pakistan are put at risk each day due to limited access vaccines.

The eradication of smallpox is ascribed to mandatory vaccination around the globe. Under the recommendation of the WHO and the CDC, most governments legislated in dealing with outbreaks in the areas of their jurisdiction (Khowaja, Khan, Nizam, Omer & Zaidi, 2012). The Pakistan government should permit its local governments to make decisions with regards to rolling out polio vaccination drives in the areas of their jurisdiction. Such drives can target all vulnerable individuals, in this case, children. However, exceptions must be made for those who are likely to demonstrate against such programs. Until such a time when all populations at risk have been vaccinated against, mandatory vaccination should be the way to in Pakistan. This is a cost effective and friendly approach to preventing polio and similar communicable diseases. Additionally, it should be part of the general public health policy.

The need for a strong political will to make sure that millions of Pakistan children get immunized

Ordinarily, vaccination programs are achieved through the combined efforts of state entities that mostly develop and recommend vaccines (Cole & Swendiman, 2015). This is made possible with the support of legislatures and local boards of health. It is not fully precise to term it “mandatory vaccination” because the Pakistan government cannot criminally punish parents and guardians for not bringing their children to the hospital for vaccination or compulsorily subject children to vaccination. As an alternative, the government can archetypally permit school enrolment when parents provide proof of vaccination polio (Nishtar, 2010). However, the government should monitor the situation carefully because mischievous parents can opt for homeschooling in case they which to bypass the vaccination requirements.  In addition, the Pakistan authorities must be aware and ready to grant vaccination exemptions under religious and philosophical intentions. In addition, exemptions must also be made for those who cannot be vaccinated for medical reasons (Swendiman, 2011; Warraich, 2009).

The link between enrollment in schools and vaccination policies need to be made clear. Pakistan health officials tasked with protecting the public with from the dangers of polio need to realize that mass vaccination is a sure way of attaining sufficient levels of population immunity enough to contain possible outbreaks even with the existence of pockets of unvaccinated children among the population. This is supported the principle of herd immunity. Vaccination by itself is incapable of yielding 100% immunity against a disease. In some instances, vaccinated individuals still contract diseases (Closser, 2010). Nonetheless, because of herd immunity is an adequate number of people in a population are vaccinated; the whole population ceases to be vulnerable to the disease. In this light, mass vaccination not only needs to be regarded as an individual medical choice but also as an undertaking to secure the health of the entire population.

Following the popularity of public schooling, many governments opted to condition school attendance to small pox vaccination. Towards the end of the last half of the last century, many governments had embraced this practice. The same can be done for polio. The Pakistan government can limit school enrollment to children who have been vaccinated against polio not unless sufficient medical proof has been provided to direct otherwise. Adopting this policy is reasonable when we take into account the heightened risk of communicable diseases in limited resource settings such as Pakistan. By mandating the vaccination during school enrollment, the authorities would be making sure that the youngest population vaccinated initially becomes the oldest in society (Mushtaq et al., 2010; Khan et al, 2015).  

The concept of herd immunity and the potential benefits of mandatory vaccination

Vaccination programs have faced challenges in both the legal and social fronts for decades. Some of the critiques have cited personal liberties and possible reduced efficacy of the vaccines. In the early 19^th C, courts characteristically advocated for the adoption of mandatory vaccination packages and the allocation of power to local authorities. More notably, to rip the potential of mandatory vaccination policy, educating the public on the importance of such rulings (Modlin, 2010; Mushtaq et al., 2010; Khan et al., 2015).

It has been argued that prevention of future epidemics lies with making use of current technology. In a similar manner the advances in agriculture have saved more lives that those claimed by wars, governments are faced with the dilemma of whether to make it mandatory for their people to be compulsorily vaccinated. It is not deniable that there is a few side effects vaccination. It is also not deniable that vaccinations may be contradicting the religious and the philosophical wishes of certain people.  They should be still mandatory considering that the benefits outweigh the setbacks. The public gets to be protected, the side effects are minimal, and future epidemics are averted (Mushtaq et al., 2010; Khan et al., 2015).

Vaccinations augment public health and create a society where members are treated equally and given a chance to live a healthy life. Despite the argument side effects, no significant studies have been conducted to proof that they occur. In a study conducted in Britain, only 28 cases of 10 million vaccinations against swine flu reported side effects. Well, people die a day in the day for innumerable reasons. However, people tend to be on high alert when the deaths occur around the time of immunizations. It is at this time that people throw around speculations that are not founded on science and therefore misleading the public. As such, the severe effects claimed to emanate from vaccinations may be difficult to be proven because many other factors can cause such reactions. Deciding against immunizing children entails taking a much bigger risk. If such children come in contact with polio-infected children, the potential of contracting polio is significantly high. In the economic front, immunized people hardly miss school or work because they hardly fall sick; thereby helping the society to grow socially and economically (Kazi, Khalid & Kazi, 2014).  

As it has been shown by some of the world greatest philosophers, vaccines protect the right to live. On grounds social contract, it is possible for people to surrender some of their freedoms to state authorities to allow for the protection fundamental interests. Polio vaccination ought to be one of such times. While mandatory vaccination may ignore one religious or philosophical view or desire, the protection of the right to life should be supreme. Individuals tasked with polio vaccination in Pakistan need to make the critiques aware that the sanctity of life is supreme over other wants and views. One has to be alive to demand basic human rights and express views and desire of religion and philosophical inclinations. In addition, the desire not to be vaccinated harms both the individual and others who have not been vaccinated but have a desire to be vaccinated. Someone may be too lazy to go out to hospitals and health centers for vaccination. Such people, if not forced to go for vaccination, they can spread the disease to others. If it is left up to them, they will never go for it, as such, a slight push to undergo mandatory vaccination is in their best interest and the society (O’Reilly et al., 012).
History has proven that vaccination is the surest way of preventing epidemics in the future. The modern world is free of epidemics of past diseases such as smallpox. This is because governments made it mandatory for their citizens to undergo the exercise. The same can be replicated for polio vaccination in Pakistan.  In the early 1980s, an outbreak of H1N1 was reported. However, vaccination was not made mandatory. This is has necessitated the worldwide pandemic of H1N1 reported in the world today. Through mandated vaccination, possible mutations of polio can be averted. The H1N1 influenza virus has been reported to have mutated causing a more severe version of the disease. Time vaccinations can avoid such mutations.

The challenges of implementing mandatory vaccination policy in Pakistan

Those who claim that vaccines cause disease need to remember that vaccines are continually monitored for safety. They also need to remember that like any other medication, some minor side effects are to be expected. Some of the possible side effects expected include sore arm momentarily after vaccination. Occasionally, some few people get sick after vaccination. However, the sickness is normally a weaker for of the disease that normally lasts for a shorter period of time.  In most times, the weaker version of the disease does not need medication. It disappears on its own.

Diseases are continually being spread. However, because of mandated vaccinations, we will continue to enjoy the protection against diseases. The Pakistan children need not be left behind. Despite the few polio vaccination setbacks, the future generations need the protection. It should be mandatory. Current technology can be deployed in making sure that the vaccines are availed in the remotest parts of Pakistan (Murakami et al.., 2014).

In May this year, Ministers of Health from 194 states congregated to endorse new recommendations on ways of strengthening vaccinations programs in order to meet GVAP goals. It is regrettable that Pakistan is among the few countries that were not invited despite being invited. Pakistan missed out on an opportunity to interact with countries on the means the country can use to strengthen the governance and leadership of their immunization programs in addition to monitoring and surveying to avert polio outbreaks. The conference called on countries to strengthen and expand the vaccination services beyond infancy and mobilize domestic resources as well as for countries to work with others to meet GVAP goals. Health Ministers from the 194 countries also asked WHO Secretariat to continue offering support for countries lagging behind to ensure regional balancing in vaccine uptake and that each country works towards meeting its goals (Shah et al., 2011).

Recommendations of scaling up of advocacy programs have been made in the past. According to the experts in the field of disease prevention and vaccination, improved understanding of the value of vaccination is likely to improve the uptake of the services; all geared towards meeting GVAP goals. Constant monitoring and reporting are necessary. In the Health Minsters’ meeting, countries were asked to report back on an annual basis made towards the realization of GVAP goals and targets. Such comparisons are critical for any country wishing to benchmark its progress, or lack thereof, towards having a polio-free nation. Pakistan, though not represented in the meeting needs to join others, reports its progress towards meeting GVAP goals with a particular focus on polio (Lenzer, 2011).

The link between enrollment in schools and vaccination policies

Vaccination of health children with the intent of safeguarding the individual child and the community, in general, should be central to all vaccination programs. This entails subjecting the child to a theoretical risk exposure to disease immunized against; whether live, attenuated or killed. Times are gone when people question the decisions of their governments or physicians. However, those times are long behind us. People are becoming more and more aware of medical procedures (Owais et al., 2011). New treatment recommendations regard patients as partners in the decisions made. This is integral to ensuring that the patients take charge of their treatment plans.

Well, underage individuals may not be in a position to make sound decisions. In such instances, parents are tasked with the responsibility of making the decisions of behalf of their children. It is always advisable for physicians to pay cognizance for parental autonomy in making medical decisions not unless the minor is at the highest risk of not receiving the vaccines (Kazi, Khalid & Kazi, 2014).

Debates have been doing rounds on whether it is justifiable to scare the public with statements that make them aware that not vaccinating their children endangers the society. In this case, stubborn parents can be stripped of the right to decide for the child. Such decisions can be made by the government of physicians through legislation. But again, it is important to evaluate on who stands to gain the most from a child’s vaccination. There are many stakeholders with vested interests (Kazi, Khalid & Kazi, 2014). The community gets a disease free health population from which it draws it workforce. The pharmaceutical companies will get a ready market for their products while the individual child gets to live a normal healthy life; which is instrumental in meetings personal goals at every stage of life. All these groups need awareness with regards to the improvements that have been made of vaccines since Edward Jenner’s initial administration of vaccines in the late 17^th century.  Jenner’s vaccines had thimerosal and mercury that were responsible for the undesirable side effects reported back then. In early 1900, four children died while twenty people developed severe abscesses and sixty reported systemic infections following receipt of staphylococcus aureus vaccines. Since then, remarkable improvements have been made with regards to vaccine delivery. One of the improvements that have been effected includes having lower levels of mercury in vaccines to a tune of 187.5 and below. Presently, vaccines meant for children do not contain thimerosal and mercury with the exception of the influenza vaccine. Besides, numerous trials of the polio vaccine have been conducted, and it has been proven to be safe.

Many people are against vaccinations because they believe that they are harmful and contain many different ingredients that hurt them

Critiques of mandatory vaccination of children against polio

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