Are childhood vaccines mandatory?
Are parents forced to vaccinate their children? Are vaccines mandatory in the U.S.? This is a question that worries many parents, and it is a claim that is made very confidently by many in the anti-vaccine crowd, and it appears the answer is yes, and no. The CDC has a recommended immunization schedule that most pediatricians follow. That schedule is not mandatory and many parents work with their pediatricians to come up aith alternate schedules, even though they may be going against their pediatrician’s advice when they choose to do that.
Nevertheless, we don’t live in isolation in a mountain top; we live in a society which has rules to protect the whole, and vaccines are no exception. Most states require children to be up to date with their vaccination schedule in order to attend day care centers or public schools (I am not sure how private schools handle this, so for the sake of the argument let us assume they follow the same guidelines as public ones). Those same states, on the other hand, provide opportunities for parents to exempt their children from the vaccination requirements. In this entry we will review the legal requirements, and what exemptions are available to parents when it comes to vaccinating their children.
The best sources of information in regards to this issue that I have been able to find are reports prepared for the U.S. Congress by the Congressional Research Service, CRS, a think tank that provides reports to members of Congress on a variety of topics relevant to current political events, whose mission statement reads as such:
CRS is committed to supporting an informed national legislature — by developing creative approaches to policy analysis, anticipating legislative needs and responding to specific requests from legislators in a timely manner. With a rigorous adherence to our key values, CRS provides analysis that is authoritative, confidential, objective and nonpartisan.
The CRS prepared reports titled “Mandatory Vaccinations: Precedent and Current Laws” which seem to have been compiled by different attorneys at different points in time. For example I found this one, dated 10/26/09 by Kathleen S. Swendiman; this one from Angie A. Welborn last updated on 01-18-05. A couple of earlier versions of Swendiman’s report can also be found at the opencrs website. Keep in mind that these are reports compiled by attorneys and were provided to the U.S. Congress, as such I consider the information in here to be of the highest quality. So what do these reports say about mandatory vaccinations?
Latest Report- October 26, 2009 by Kathleen S. Swendiman, Legislative Attorney
The thing to keep in mind when discussing the laws regarding mandatory vaccinations, is that this is mainly a state law issue, as opposed to a federal law issue. With very limited exceptions, “the preservation of the public health has been the primary responsibility of state and local governments“. Also, “current federal regulations do not include any mandatory vaccination program” (Summary).
States on the other hand do have laws in place mandating that children attending day care centers or schools are up to date with their vaccine schedule. The CDC has a nice page with information on mandatory vaccinations by vaccine, by state. Pick a vaccine, pick a level of schooling and you get a table with state-by-state information about the mandatory requirements for the specific vaccine.
If you want to dig more deeply, you will have to research the statute of your state to learn everything on mandatory vaccinations & exemptions. I will not do a state by state analysis, instead I will defer to the Swendiman 10/26/09 report. Here is a synopsis of the main points the report makes:
- The preservation of the public health is the primary responsibility of state and local governments, not the federal one.
- State/local governments have the power to institute measures such as quarantine, isolation or enact mandatory vaccine laws.
- U.S. courts have rejected the constitutional concerns raised by petitioners to mandatory vaccine laws (Jacobson v. Massachusetts)
- Every state and the District of Columbia has a law requiring children entering school to provide documentation that they have met the state immunization requirements.
- Many states provide exemptions for medical, religious, or philosophical reasons (exemptions vary from state to state).
- All states allow medical exemptions for those whose immune systems are compromised, who are allergic to vaccines, are ill at the time of vaccination, or have other medical contraindications to vaccines.
- Nearly all states grant exemptions for persons who oppose vaccines for religious reasons. For example, all states, with the exception of Mississippi and West Virginia, provide for religious exemptions.
- Exemptions based on philosophical or moral convictions are less common but are provided by 20 states.
- Many states require health workers to be vaccinated; exemptions for medical, religious and philosophical reasons are available to them as well (they vary by state) but not for all diseases.
- Many states have laws providing for mandatory vaccinations during a public health emergency or outbreak of communicable disease, especially ones with high morbidity or mortality rates. Exemptions for medical, religious or philosophical reasons are still available, however a person who refuses to vaccinate during the emergency may be quarantined.
- At the federal level, no mandatory vaccination programs are specifically authorized, nor do there appear to be any regulations regarding the implementation of a mandatory vaccination program at the federal level during a public health emergency.
So, the answer to the question: are childhood vaccinations mandatory is: Yes and No. Yes, since most states require that children attending day care centers or schools provide documentation proving that they are up-to-date with their childhood immunization schedule, and no because those same states allow many exemptions for medical, religious and philosophical reasons. You may think that’s bad, but consider that in the other hand, child car seat laws are mandatory and do not, to the best of my knowledge, offer any exemptions for any reasons. Thus, to the best of my knowledge, vaccination laws are more relaxed than car seat laws, and car accidents are not contagious. You can judge for yourself if this is a good or bad thing, but the facts remain as described above.