Is There a Moral Right to Nonmedical Vaccine Exemption?

2016 ◽  
Vol 42 (2-3) ◽  
pp. 598-620 ◽  
Author(s):  
Isha Ann Emhoff ◽  
Ellen Fugate ◽  
Nir Eyal
Keyword(s):  
United States ◽  
At Risk ◽  
Herd Immunity ◽  
The United States ◽  
The State ◽  
Moral Claim ◽  
Single Source ◽  
Vaccination Rates ◽  
Measles Outbreak ◽  
Vaccine Exemption

A recent measles outbreak in the United States was linked to a single source, yet it spanned eighteen jurisdictions and infected 121 people. Forty-seven states currently allow legal exemption from vaccination on religious grounds, eighteen of which also allow it on philosophical grounds. Recent research usually accepts a fundamental right to vaccine exemption and primarily seeks ways to protect herd immunity while also respecting that right, for example, by keeping the exemption available yet harder to procure or by imposing torts for infection-related injury. We argue that when herd immunity is at risk, any moral claim to exemption from vaccination on conscientious, philosophical, or religious grounds is overridden.Our argument rests on an analogy to a series of situations in which a person puts others at risk through philosophically or religiously motivated choices. In these situations, intuitively, there is no claim-right to compromise the safety of others. Similarly, we propose, there is no claim-right to refuse vaccination, regardless of one's conscience, when refusal is sufficiently likely to seriously affect herd immunity and the safety of others. We also address several counterarguments. The lack of a claim-right to exemption when herd immunity is at risk does not mean, however, that it is always prudent for the state to force vaccination, or even that forcing vaccinations must be legal. Alternatives to forced vaccination may prove wiser and more conducive to high vaccination rates.

scholarly journals Demographics, perceptions, and socioeconomic factors affecting influenza vaccination among adults in the United States

PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e5171 ◽  
Author(s):  
Kaja M. Abbas ◽  
Gloria J. Kang ◽  
Daniel Chen ◽  
Stephen R. Werre ◽  
Achla Marathe
Keyword(s):  
United States ◽  
Health Insurance ◽  
Influenza Vaccination ◽  
Vaccine Efficacy ◽  
Herd Immunity ◽  
The United States ◽  
Vaccine Cost ◽  
Factors Affecting ◽  
Vaccination Rates ◽  
Healthy People 2020

Objective The study objective is to analyze influenza vaccination status by demographic factors, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance status, and barriers to influenza vaccination among adults 18 years and older in the United States. Background Influenza vaccination coverage among adults 18 years and older was 41% during 2010–2011 and has increased and plateaued at 43% during 2016–2017. This is below the target of 70% influenza vaccination coverage among adults, which is an objective of the Healthy People 2020 initiative. Methods We conducted a survey of a nationally representative sample of adults 18 years and older in the United States on factors affecting influenza vaccination. We conducted bivariate analysis using Rao-Scott chi-square test and multivariate analysis using weighted multinomial logistic regression of this survey data to determine the effect of demographics, perceived vaccine efficacy, social influence, herd immunity, vaccine cost, health insurance, and barriers associated with influenza vaccination uptake among adults in the United States. Results Influenza vaccination rates are relatively high among adults in older age groups (73.3% among 75 + year old), adults with education levels of bachelor’s degree or higher (45.1%), non-Hispanic Whites (41.8%), adults with higher incomes (52.8% among adults with income of over $150,000), partnered adults (43.2%), non-working adults (46.2%), and adults with internet access (39.9%). Influenza vaccine is taken every year by 76% of adults who perceive that the vaccine is very effective, 64.2% of adults who are socially influenced by others, and 41.8% of adults with health insurance, while 72.3% of adults without health insurance never get vaccinated. Facilitators for adults getting vaccinated every year in comparison to only some years include older age, perception of high vaccine effectiveness, higher income and no out-of-pocket payments. Barriers for adults never getting vaccinated in comparison to only some years include lack of health insurance, disliking of shots, perception of low vaccine effectiveness, low perception of risk for influenza infection, and perception of risky side effects. Conclusion Influenza vaccination rates among adults in the United States can be improved towards the Healthy People 2020 target of 70% by increasing awareness of the safety, efficacy and need for influenza vaccination, leveraging the practices and principles of commercial and social marketing to improve vaccine trust, confidence and acceptance, and lowering out-of-pocket expenses and covering influenza vaccination costs through health insurance.

scholarly journals Studying Public Perception about Vaccination: A Sentiment Analysis of Tweets

2020 ◽  
Vol 17 (10) ◽  
pp. 3464 ◽  
Author(s):  
Viju Raghupathi ◽  
Jie Ren ◽  
Wullianallur Raghupathi
Keyword(s):  
United States ◽  
Sentiment Analysis ◽  
Public Perception ◽  
Ebola Virus ◽  
Herd Immunity ◽  
The United States ◽  
The Public ◽  
Time Period ◽  
Document Frequency ◽  
Measles Outbreak

Text analysis has been used by scholars to research attitudes toward vaccination and is particularly timely due to the rise of medical misinformation via social media. This study uses a sample of 9581 vaccine-related tweets in the period 1 January 2019 to 5 April 2019. The time period is of the essence because during this time, a measles outbreak was prevalent throughout the United States and a public debate was raging. Sentiment analysis is applied to the sample, clustering the data into topics using the term frequency–inverse document frequency (TF-IDF) technique. The analyses suggest that most (about 77%) of the tweets focused on the search for new/better vaccines for diseases such as the Ebola virus, human papillomavirus (HPV), and the flu. Of the remainder, about half concerned the recent measles outbreak in the United States, and about half were part of ongoing debates between supporters and opponents of vaccination against measles in particular. While these numbers currently suggest a relatively small role for vaccine misinformation, the concept of herd immunity puts that role in context. Nevertheless, going forward, health experts should consider the potential for the increasing spread of falsehoods that may get firmly entrenched in the public mind.

scholarly journals The landscape of childhood vaccine exemptions in the United States

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Casey M. Zipfel ◽  
Romain Garnier ◽  
Madeline C. Kuney ◽  
Shweta Bansal
Keyword(s):  
United States ◽  
Temporal Trends ◽  
Herd Immunity ◽  
Public Health Intervention ◽  
The United States ◽  
Vaccine Uptake ◽  
Childhood Diseases ◽  
Childhood Vaccine ◽  
Spatio Temporal ◽  
Vaccine Exemption

AbstractOnce-eliminated vaccine-preventable childhood diseases, such as measles, are resurging across the United States. Understanding the spatio-temporal trends in vaccine exemptions is crucial to targeting public health intervention to increase vaccine uptake and anticipating vulnerable populations as cases surge. However, prior available data on childhood disease vaccination is either at too rough a spatial scale for this spatially-heterogeneous issue, or is only available for small geographic regions, making general conclusions infeasible. Here, we have collated school vaccine exemption data across the United States and provide it at the county-level for all years included. We demonstrate the fine-scale spatial heterogeneity in vaccine exemption levels, and show that many counties may fall below the herd immunity threshold. We also show that vaccine exemptions increase over time in most states, and non-medical exemptions are highly prevalent where allowed. Our dataset also highlights the need for greater data sharing and standardized reporting across the United States.

scholarly journals A Review of Traditional Vaccine-Preventable Diseases and the Potential Impact on the Otolaryngologist

2017 ◽  
Vol 22 (03) ◽  
pp. 317-329 ◽  
Author(s):  
Christopher Greenlee ◽  
Stephen Newton
Keyword(s):  
United States ◽  
Treatment Guidelines ◽  
Disease Incidence ◽  
The United States ◽  
World Health ◽  
Vaccine Preventable Diseases ◽  
Vaccination Rates ◽  
Current State ◽  
The World ◽  
Vaccine Exemption

Introduction A majority of otolaryngologists have not had direct experience with many vaccine-preventable diseases since the creation of national vaccination programs. Despite the elimination of endemic transmission of some of these diseases in the United States, outbreaks can occur anywhere and still pose a threat to public health around the world. Recent outbreaks and changing trends in exemption rates indicate that it is important for physicians to maintain a working knowledge of how these diseases present and of the recommended treatment guidelines. Objectives This review will evaluate the current state of vaccination rates, vaccine exemption rates and disease incidence in the United States and in the world. It will also examine the clinical presentation and treatment recommendations of these diseases. Data Synthesis United States estimated vaccination rates, vaccine exemption rates and vaccine-preventable disease incidences were obtained from data compiled by the Centers for Disease Control and Prevention. World vaccination rates and disease incidences were obtained from the World Health Organization databases, which compile official figures reported by member states. A PubMed literature review provided information on the current state of vaccination exemptions and outbreaks in the United States. Conclusion Vaccination and vaccine exemption rates continue to put the United States and many areas of the world at risk for outbreaks of vaccine-preventable diseases. Clinical guidelines should be reviewed in the event of a local outbreak.

scholarly journals The landscape of childhood vaccine exemptions in the United States

2020 ◽  
Author(s):  
Casey M Zipfel ◽  
Romain Garnier ◽  
Madeline Kuney ◽  
Shweta Bansal
Keyword(s):  
United States ◽  
Temporal Trends ◽  
Herd Immunity ◽  
Public Health Intervention ◽  
The United States ◽  
Vaccine Uptake ◽  
Childhood Diseases ◽  
Childhood Vaccine ◽  
Spatio Temporal ◽  
Vaccine Exemption

Once-eliminated vaccine-preventable childhood diseases, such as measles, are resurging across the United States. Understanding the spatio-temporal trends in vaccine exemptions is crucial to targeting public health intervention to increase vaccine uptake and anticipating vulnerable populations as cases surge. However, prior available data on childhood disease vaccination is either on too rough a spatial scale for this spatially-heterogeneous issue, or is only available for small geographic regions, making general conclusions infeasible. Here, we have collated school vaccine exemption data across the United States and provide it at the county-level for all years available. We demonstrate the fine-scale spatial heterogeneity in vaccine exemption levels, and show that many counties may fall below the herd immunity threshold. We also show that vaccine exemptions increase over time in most states, and non-medical exemptions are highly prevalent where allowed. Our dataset also highlights the need for greater data sharing and standardized reporting across the United States.

scholarly journals Fine-scale spatial clustering of measles nonvaccination that increases outbreak potential is obscured by aggregated reporting data

2020 ◽  
Vol 117 (45) ◽  
pp. 28506-28514
Author(s):  
Nina B. Masters ◽  
Marisa C. Eisenberg ◽  
Paul L. Delamater ◽  
Matthew Kay ◽  
Matthew L. Boulton ◽  
...  
Keyword(s):  
Infectious Disease ◽  
United States ◽  
Spatial Clustering ◽  
Spatial Scales ◽  
The United States ◽  
The State ◽  
World Health ◽  
Local Immunity ◽  
Vaccination Rates ◽  
The Impact

The United States experienced historically high numbers of measles cases in 2019, despite achieving national measles vaccination rates above the World Health Organization recommendation of 95% coverage with two doses. Since the COVID-19 pandemic began, resulting in suspension of many clinical preventive services, pediatric vaccination rates in the United States have fallen precipitously, dramatically increasing risk of measles resurgence. Previous research has shown that measles outbreaks in high-coverage contexts are driven by spatial clustering of nonvaccination, which decreases local immunity below the herd immunity threshold. However, little is known about how to best conduct surveillance and target interventions to detect and address these high-risk areas, and most vaccination data are reported at the state-level—a resolution too coarse to detect community-level clustering of nonvaccination characteristic of recent outbreaks. In this paper, we perform a series of computational experiments to assess the impact of clustered nonvaccination on outbreak potential and magnitude of bias in predicting disease risk posed by measuring vaccination rates at coarse spatial scales. We find that, when nonvaccination is locally clustered, reporting aggregate data at the state- or county-level can result in substantial underestimates of outbreak risk. The COVID-19 pandemic has shone a bright light on the weaknesses in US infectious disease surveillance and a broader gap in our understanding of how to best use detailed spatial data to interrupt and control infectious disease transmission. Our research clearly outlines that finer-scale vaccination data should be collected to prevent a return to endemic measles transmission in the United States.

Is This the Care We Need?: An Examination of Childcare Policy in Pennsylvania

Commonwealth ◽  
2017 ◽  
Vol 19 (2) ◽  
Author(s):  
Jennie Sweet-Cushman ◽  
Ashley Harden
Keyword(s):  
United States ◽  
Child Care ◽  
Current System ◽  
The United States ◽  
The State ◽  
Federal State ◽  
Women And Politics ◽  
Richard Nixon ◽  
State And Local ◽  
Childcare Policy

For many families across Pennsylvania, child care is an ever-present concern. Since the 1970s, when Richard Nixon vetoed a national childcare program, child care has received little time in the policy spotlight. Instead, funding for child care in the United States now comes from a mixture of federal, state, and local programs that do not help all families. This article explores childcare options available to families in the state of Pennsylvania and highlights gaps in the current system. Specifically, we examine the state of child care available to families in the Commonwealth in terms of quality, accessibility, flexibility, and affordability. We also incorporate survey data from a nonrepresentative sample of registered Pennsylvania voters conducted by the Pennsylvania Center for Women and Politics. As these results support the need for improvements in the current childcare system, we discuss recommendations for the future.

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