Robert Ragotte is a PhD student and Rhodes scholar in the Nuffield Department of Medicine at the University of Oxford, where he studies malaria vaccines.
I used to think that vaccinations should not be mandatory. I held a vague notion that mandatory vaccination would be a form of “biopower," as Michel Foucault described this kind of state subjugation and control of people and populations – and that decisions about health should be left to the individual.
This was bolstered by my impression that no one, when presented with the compelling efficacy and safety data for vaccination, would opt out of these life-saving interventions. People would seek it out for themselves.
I was optimistic people would be swayed by the vast swaths of data showing vaccines work and they are safe. After all, we have enormous studies, some of more than a million children, demonstrating safety. I was untroubled by the preaching of Jenny McCarthy, as I assumed people would ultimately turn to their doctors, their governments and their universities for the final word, all of whom have spent decades and millions of dollars proving time and time again that vaccines work.
But there is currently a measles outbreak in British Columbia, joining current outbreaks in Washington State and the Philippines – the latter of which has killed more than 130 people. It comes on the heels of outbreaks in California and New York and after news that measles cases in Europe tripled last year.
This is not a small local phenomenon. Declining vaccine coverage is an urgent public-health threat that is not limited to diehard “anti-vaxxers." Vaccine hesitancy – wherein parents pick and choose vaccines for their kids – is perhaps a more important factor. And while a new Angus Reid poll has found that 83 per cent of Canadians would vaccinate their children “without reservation," 20 per cent of people with children under the age of 12 say the decision to vaccinate should be left to the parent. More concerning still is that 29 per cent say that the science on vaccinations isn’t quite clear.
It leaves me wondering where we, as scientists, went wrong. I thought that as a vaccine researcher, my job was to help develop tools that would better equip us to combat the scourge of infectious disease. I did not think it was my place to take a public position on this topic to convince you that no, getting measles is not fun; yes, you should get vaccinated; and no, it will not give you autism.
I study vaccines for a living. I am not part of a global vaccine conspiracy, nor are my colleagues at the University of Oxford. We are people who recognize that vaccination is a medical miracle that has saved millions of lives. Vaccination has meant that you probably do not know what an iron lung is, let alone ever visited someone in one.
It has meant that you have not had friends or family killed by smallpox, paralyzed by polio, or who have suffered a miscarriage because of rubella.
It has meant that, until now, you never knew the symptoms of measles.
The term “vaccine hesitancy” implies that these attitudes are rooted in a sense of caution. Unequivocally, there is nothing cautious about eschewing vaccination. That is misguided. It is reckless and it is irresponsible. The risks associated with standard vaccination are negligible. The risks associated with measles, mumps, rubella, polio, diphtheria, tetanus, pertussis, and many others are not.
It is time that we give more serious thought to mandatory vaccination across the country, while ending religious and conscience exemptions in Ontario and New Brunswick. This is not a question of personal belief or personal risk. Forgoing vaccination puts others at risk who are unable to receive vaccinations due to allergies or immunodeficiencies.
This is not only about you. This is about all of us.
Herd immunity, the term used to describe the protection conferred on the whole population when most are vaccinated, requires that everyone who is able to be vaccinated does so. It is herd immunity that protects those who are unable to get vaccinated, but will not work if overall vaccine coverage continues to decline. Vaccination, like paying taxes, is a civic duty; it is part of the social contract. Opting out for personal beliefs should not be an option.
Mandatory vaccination is a pragmatic solution to a growing problem. For millennia, death by common infectious disease was an inescapable fate for many. We are fortunate to live in a time and place where this is not the case – and it is our collective responsibility to preserve this.