Running head: THE IMPORTANCE OF VACCINATING CHILDREN

The Importance of Vaccinating Children

Classical Argument
Sarah Abel
LDS Business College

ENG 201 Section 02

Brother Gagon
December 15, 2015

THE IMPORTANCE OF VACCINATING CHILDREN

Abstract
This paper outlines the importance of childhood vaccinations by comparing historical parallels
and analyzing research published in peer-reviewed journals. Through this analysis, the paper
identifies the benefits of vaccinations. The costs, few of which are present, are also identified.
The consequences that can follow the choice to abstain from vaccinating are addressed. Public
education for caregivers in regards to the decision to vaccinate the child in their care is
recommended, as misinformation contributes to the fear and confusion felt by parents. This
education includes statistics of national vaccine coverage, exemptions, outbreaks, the importance
of immunity, and the lack of correlation between vaccinations and autism. The ethical aspects of
vaccination are explored; as parents have the moral responsibility to choose what they believe is
best for their child (Krantz, Sachs, & Nilstun, 2004). The presence of side effects and
contraindications is particularly addressed, as this is the fear that is most commonly cited by
parents.
Keywords: vaccinations, children, side effects, immunity, public health

THE IMPORTANCE OF VACCINATING CHILDREN

The Importance of Vaccinating Children

For thousands of years, smallpox was an unstoppable killer. For those who contracted it,
flu-like symptoms quickly progressed to painful, pus-filled lesions covering the entire body,
which could eventually lead to death (Smallpox- Symptoms, 2014). For those who survived, the
open sores left deep scars which horribly disfigured them. Additionally, the aftermath of
smallpox often caused blindness. The horror of smallpox affected everyone, even those who
were held in the highest respect. George Washington, a survivor of smallpox, ordered his troops
to be mandatorily exposed to the infection in order to protect them from the disease (Hajj
Hussein et al., 2015)
Then, Edward Jenner took on the task of proving a hypothesis right, eventually leading to
a breakthrough. When Jenner first proposed his thesis regarding smallpox vaccination in the
summer of 1798 (Bennett, 2008), it is doubtful he could have imagined the effects his research
would have on modern science and society 217 years later. Because of his discovery, naturally
occurring smallpox was eliminated by 1980 (Smallpox- Definition, 2014). The eradication of
smallpox an incurable and most often fatal disease - has saved the lives of millions of people.
Prevention is the only treatment available (Smallpox- Definition, 2014), and vaccinations must
be used. Jenners research provided the option of prevention. The demographic most affected by
the discovery and utilization of vaccinations, both past and present, is children. Therefore, it is
crucial that childhood vaccinations are required in order to prevent the loss of lives that
originally spurred vaccine creation.
One might wonder if Jenner would be surprised with the current argument and attitudes
that surround the efficacy of vaccines. Currently, there are two sides to this issue: those who
support vaccinations, and those who do not. When discussing vaccines, it is important to take

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into account the benefits versus the costs. Benefits include a) increased safety for children and
adults, b) protection against outbreaks, and c) the promotion of immunity, both herd and
vaccine-induced (Fine, Eames, & Heymann, 2011; What Would Happen If We Stopped
Vaccinations, 2014). Additionally, the consequences that would follow the discontinuation of
vaccinations should be emphasized, as mortality rates could increase.
There are few costs associated with vaccinations, as the primary risk is side effects. Mild
side effects are common, but serious risks are extremely rare. The opposition of vaccinations is
primarily supported by misinformation, most commonly the fear of frequent fatal side effects. By
disproving some of the myths surrounding vaccines, common ground is more likely to be
established.
There are parallels present, both in 1798 and in 2015, regarding societys reluctance to
acknowledge the benefits of vaccination. One parallel is the importance of parental involvement.
When vaccinations were first introduced, acceptance and widespread use was dependent on
mothers, as they were typically the caregivers making the decision to vaccinate (Bennett, 2008).
Today, mothers are often at the forefront of either side of the choice to vaccinate. A mothers
presence is significant. It is also important to note the prominent role that women had in the
successful establishment of widespread vaccinations. After the release of Jenners research,
aristocratic women promoted the widespread use of vaccination, collectively vaccinating over
30,000 children by the end of 1805 (Bennett, 2008).
Another historical parallel is the opposition to vaccination. Not everyone was a supporter
of Jenners work, as many attempted to discredit him. According to the research of Michael
Bennett, There was a vociferous campaign against the new practice by a small minority of
medical men, and there was a series of well-publicized vaccination failures, or at least what

THE IMPORTANCE OF VACCINATING CHILDREN

appeared to be vaccination failures (Bennett, 2008). While it is to be expected that a new

practice or discovery might be rejected by people in that specific time period, it is interesting that
this type of campaign described still exists today. Whether it is through misinformation or
fraudulent research, the modern tactics used to discourage parents from vaccinating their
children mirror the very same tactics attempted by those that opposed Jenners research over 200
years ago.
In Jenners time, there was no method to determine the exact number of vaccinations
taking place. This made the process of establishing widespread vaccine coverage difficult, as
there was no way to know the amount that had been distributed and received. Today, there is a
system is in place to monitor vaccine coverage. According to the Center of Disease Controls
(CDC) Morbidity and Mortality Weekly Report (MMWR), To monitor state and national
vaccination coverage and exemption levels among children attending kindergarten, CDC
analyzes school vaccination data collected by federally funded state, local, and territorial
immunization programs (Seither et al., 2015).
However, while the CDC may monitor coverage, they do not set immunization
requirements, as that is left up to the state (Immunization Requirements for Child Care and
School, 2015). Because of this, state decisions reflect their demographics, which provide another
reason to collect vaccination data. This data is also used to pinpoint areas with low vaccination
rates, as these areas are at a higher risk for outbreaks (What Would Happen If We Stopped
Vaccinations, 2014). This data found that 32 states and DC did not report meeting the Healthy
People 2020 target of [greater than or equal to] 95% coverage with 2 MMR doses (Seither et al.,
2015). By not reaching this target, potential risks could arise.

THE IMPORTANCE OF VACCINATING CHILDREN

According to the MMWR, new state laws have been reviewed by the CDC's Public Health
Law Program and are subject to change (Seither et al., 2015). Currently, these laws have focused
on exemptions. Earlier this year, California and Vermont removed philosophic exemptions, while
California additionally removed religious exemptions and homeschooling vaccination
requirements (Seither et al., 2015). Because of these changes, different exemptions are now
being claimed, with an increase of medical exemptions being cited (Seither et al., 2015). It is
apparent that however the laws change, so will the reactions of those who avoid vaccinations.
As mentioned earlier, misinformation has been present since the introduction of
vaccinations, and is largely responsible for the amount of fear and confusion felt by parents and
caregivers when deciding to vaccinate their children. Some of the most common misconceptions
are a) vaccines cause the illness that the vaccine prevents, b) not vaccinating only affects the
parents child, c) autism is vaccine-induced, and d) a fear of frequent serious side effects. While
some of these beliefs have merit, education is one of the best ways to fight against the spread of
fear-based misinformation.
To better address these fears, one must first understand the importance of vaccinating.
One reason to immunize is to create the presence of herd immunity, which protects those who
cannot be immunized by decreasing their risk of infection (Fine, Eames, & Heymann, 2011). The
demographic of those who are unable to receive immunizations depends on the vaccination.
Some of the most common medical exemptions for childhood vaccines are severe
immunodeficiency, pregnancy, or a serious allergic reaction following a prior dose (Chart of
Contraindications and Precautions to Commonly Used Vaccines, 2014).
There are two types of immunity; active and passive. Active immunity results from
exposure to the disease, which creates antibodies. Antibodies make immunity possible, as they

THE IMPORTANCE OF VACCINATING CHILDREN

are disease-specific (Immunity Types, 2014). This happens through either natural immunity,
which is triggered by an actual infection, or vaccine-induced immunity, caused by an
introduction to the diseases weakened form (Immunity Types, 2014). Passive immunity happens
when a person is given antibodies to a disease instead of independently producing antibodies
(Immunity Types, 2014).
Vaccinations protect against outbreaks, as they reduce the spread of preventable diseases.
Many diseases have declined in number due to vaccination, such as diphtheria, rubella, and
measles. However, only smallpox has been completely eradicated (What Would Happen If We
Stopped Vaccinations, 2014). For this reason, vaccinating cannot be stopped just because some
of these diseases are no longer in circulation. Outbreaks are more likely to happen in areas with
low vaccination rates because of the absence of herd immunity (What Would Happen If We
Stopped Vaccinations, 2014). A few contagious, unvaccinated people can be the catalyst to an
outbreak when there are not enough vaccinated people to protect those who are not or cannot be
vaccinated. This is why only one person is not affected by choosing not to vaccinate is such a
damaging belief.
Stopping vaccinations can have terrible consequences. Mass vaccinations in Japan were
implemented in the 1960s in order to control influenza and decrease the mortality rate. In 1987,
parents were allowed by legislature to refuse influenza vaccinations and doubts surrounding the
vaccines effectiveness caused the discontinuation of the program in 1994 (Suqaya & Takeuchi,
2005). After mass vaccinations were stopped, the influenza mortality rate increased. According
to a study conducted by Norio Suqaya and Yoshinao Takeuchi concerning this phenomenon, the
discontinuation of mass vaccination of schoolchildren probably led to the increase in influenzaassociated deaths among young children in the 1990s (Suqaya & Takeuchi, 2005).

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Fear surrounding the impact a vaccination may have on a child should be addressed. The
impact of not vaccinating school-age children is significant. First, a non-immunized student
spreads the infection to both children and teachers, as all are susceptible. Second, a nonimmunized child will miss large amounts of school if they become sick and their recovery time
could be longer. Third, the child may not be able to enroll until vaccinated, thus their education
will suffer because of delayed enrollment.
The effectiveness of vaccinations is most dependent on the individual actually receiving
it. According to the MMWR, most immunization programs reported high vaccination coverage
and low levels of exemptions among kindergartners (Seither et al., 2015). However, as
previously mentioned, exemptions are still commonly cited. This is evidenced by the changing
state laws in California and Vermont, as well as the patterns emerging considering medical
exemptions over religious and philosophical exemptions.
In a concurrent session, involving several different speakers, exemptions and vaccine
safety were discussed. Melinda Wharton expanded on these different types of exemptions. All
states offer medical exemptions to immunizations for medical contraindications to vaccination.
48 states allow religious exemptions and 18 states allow philosophical exemptions (Wharton,
Hogan, & Segal-Freeman, 2005). These exemptions are requested for various reasons, but some
of the most common are a lack of fear for rare diseases, and unfamiliarity with some of the
diseases children are now required to be vaccinated for (Wharton et al., 2005).
The decision of necessity is given to the parents. The problem with exemptions is that
they are not always necessary. Depending on state vaccination requirements, one way some
parents avoid exemptions is to homeschool their children (Seither et al., 2015). While California
may have removed vaccination requirements for homeschooling, it is still important for children

THE IMPORTANCE OF VACCINATING CHILDREN

who are homeschooled to have the opportunity for immunization. The best way to provide
immunization would be the requirement of vaccinations in order to homeschool, an example set
by North Carolina (Khalili & Caplan, 2007). However, this decision is ultimately left up to the
state, as evidenced by California.
There are ethical concerns in regards to vaccinations. One area in question is parental
rights. In a Swedish study concerning the ethics surrounding vaccinations, researchers
acknowledged that parents have the right to choose for their children, as that is their moral
responsibility (Krantz, Sachs, & Nilstun, 2004). However, from a legal standpoint, before
making decisions for their children, parents should also be given the opportunity for informed
consent after consultation with a medical professional.
Another ethical aspect is religious exemptions, which are broadly defined and vary by
state. Four states require an organized, recognized, or established religion, 14 states require
genuinely and sincerely held religious beliefs, 28 states and Washington D.C. merely require
an affidavit or form stating opposition to vaccination based on religious grounds (Wharton et
al., 2005). These requirements are so varied that it is difficult to pinpoint a universal definition,
however, the overall allowance of religious exemptions negates an ethical issue.
In review, the importance of vaccination cannot be ignored because they a) promote herd
immunity, b) protect those who cannot be vaccinated and c) lower mortality rates. Additionally,
harmful consequences follow when mass vaccinations are ceased.
There are parents who still refuse to vaccinate their children. Swedish researchers
Dannetun, Tegnell, Hermansson, and Giesecke conducted a study to find out why. After
gathering data from 173 interviews, they found that the most common reasons were fear of side

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effects, wanting the child to mature, and a belief that natural immunity is better than vaccineinduced (Dannetun, Tegnell, Hermansson, & Giesecke, 2005).
These fears also create discord between parents who refuse vaccinations and the
pediatricians who treat their children. In a study conducted in Israel by Maayan-Metzger,
Kedem-Friedrich, Ben-Namer-Basseches, and Kuint, 376 pediatricians were surveyed to gain an
understanding of their attitudes toward parents who refused to vaccinate their infants. While
there was an overwhelming agreement on the importance of vaccinations, the researchers found
that a pattern had emerged in the form of two opposing values. On one hand, a large majority of
pediatricians disagreed with the justification of incorrect evidence as the basis for refusal, but on
the other, the pediatricians acknowledged the parents right to refuse (Maayan-Metzger, KedemFriedrich, Ben-Namer-Basseches, & Kuint, 2013).
As previously mentioned, misconceptions contribute to the refusal of vaccinations. While
misinformation is passed through society by the use of many different routes, including face to
face conversations, the biggest contributor to this communication breakdown is the Internet. The
Internet is a useful source for information and the technology available today has advanced
societys methods of education. However, it can also contribute to the spread of mass panic and
fear on a global scale. This is because many people who receive their news from social media
websites, such as Facebook or Twitter, do not always check the sources that these stories
originate from.
Since information on the Internet is not always reliable, it would be fair to assume that
parents and caregivers who are deciding on vaccinations may stumble upon information that is
not credible. A study conducted by Selim ncel and Mge Alvur used Google to simulate a
scenario that a parent may experience when gathering information on vaccinations. The question

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that they used for their search was, Should I make my child vaccinated against influenza
(ncel & Alvur 2013). Next, they judged the success of their experiment by the information that
resulted from their search. The right answer they were looking for was the recommendation of
yearly vaccinations for all children (ncel & Alvur 2013).
Through their Google search, ncel and Alvur found that out of 112 websites, the
information was correct in 32, incorrect in 24, and irrelevant in 56 (ncel & Alvur 2013).
Through this data, they concluded that the Internet should not be a substitute for professional
medical care, and that Internet-provided public health information should be checked for
accuracy, completeness, and consistency (ncel & Alvur 2013).
One misconception that has continued to spread, partially through the Internet, is the
belief that vaccinations cause autism. This is false. Autism Spectrum Disorder (ASD) does not
have a specific cause tied to it, as researchers are still trying to achieve an adequate
understanding of its causes. Still, there are some risk factors that researchers agree on. According
to M. Rutter, the best-established risk factor for ASD is genetic liability (Rutter, 2005).
However, while its origins are yet to be specified, there is no evidence connecting the measles,
mumps, and rubella (MMR) vaccine with ASD (Gerber, & Offit, 2009).
The belief that vaccines cause autism was created by a paper published by Andrew
Wakefield and his colleagues on February 28, 1998. Wakefield, a gastroenterologist, published a
study conducted on 8 children, which tried to link a correlation between the MMR vaccine and
autism. His study claimed that within a month after receiving the MMR vaccine, symptoms of
autism had appeared (Gerber, & Offit, 2009). There were many holes in Wakefields research,
however, as it was discovered that there was no control groups, the study was not double-blind,

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autism predated any intestinal symptoms, and, among other reasons, intestinal symptoms are not
consistent with MMR vaccine viruses (Gerber, & Offit, 2009).
While Wakefields study has been continuously disproved as fraudulent, it is still believed
by millions of people. According to a study conducted by Gerber and Offit in order to find
correlations between ASD and the MMR vaccine, twenty epidemiologic studies have shown
that thimerosal nor the MMR vaccine causes autismthe large size of the studied populations
has afforded a level of statistical power sufficient to detect even rare associations (Gerber, &
Offit, 2009).
While the belief that ASD is caused by the MMR vaccine has been disproved, the larger
reason cited for not immunizing, the fear of side effects, is the reason that does carry some
weight. It is true that rare side effects from vaccinations can occur. According to an article
published in the journal Pediatric Dermatology, Rarely, a secondary localized soft tissue
infection can develop due to introduction of microorganisms through the skin. (Beveridge et al.,
2012) Common side effects are redness or soreness near the injection site.
Serious allergic reactions to vaccinations are also a cause for concern. However, the
frequency of such allergic reactions is very rare. For most vaccinations, it is difficult to tell
whether side effects are directly caused by the vaccine. One specific example of
indistinguishable correlations would be the MMR vaccine (Possible Side-effects from Vaccines,
2015). It is critical to distribute correct information to parents and caregivers that harbor this fear.
In conclusion, since Jenners discovery, society has been given an important tool to
protect each other. Vaccinations are necessary for preventing the spread of infectious and deadly
diseases. While it is true that our current environment is free of many illnesses that have
previously plagued society, this has only been possible by vaccines. The refusal to vaccinate

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harms everyone, not just the individuals who personally make that choice. Herd immunity is
created when most of the population is vaccinated. The frequency of people choosing to forego
vaccines increases the risk of outbreaks.
The goal of disease prevention depends greatly on childhood vaccinations. The choice to
vaccinate children is primarily given to their caregivers. Educating parents and guardians of the
importance of vaccinating their children by disproving the misconceptions that have spread over
the years will help them to make an informed decision. This also applies to the choice of
exemptions. While medical exemptions in some cases are warranted, unnecessary exemptions
could impact society negatively the more frequently they are chosen. This is why childhood
vaccinations should be enforced. If vaccination does not happen, then it will be impossible to
reverse the harmful consequences that will follow.

References

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Beveridge, M. G., Polcari, I. C., Burns, J. L., Adler, A., Hendrickson, B., & Stein, S. L. (2012).
Local vaccine site reactions and contact allergy to aluminum. Pediatric Dermatology,
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