Stop AB499 STD Vaccines for Minor Children without Parental Consent “Why is AB499 So Dangerous? Even though you may make a conscientious informed decision to decline a vaccination for your child for a sexually transmitted disease like the controversial HPV Vaccine, AB499 permits a minor child 12 years old and older to consent to any vaccine for a sexually transmitted disease without parental knowledge or consent.”
An Act To Prohibit Mandatory Immunizations Maine “Two legislative bills regarding vaccinations deserve passage. LD 694, sponsored by Rep. Andrea Boland, D-Sanford, requires disclosure of the ingredients of vaccinations prior to immunizing those under 18. It also provides parents with the option of refusing immunization for their children.”…”LD 941, sponsored by Sen. Douglas Thomas, R-Somerset, prohibits mandatory immunizations.”
August 18, 2015 – Racial and Ethnic Disparities in Vaccination Coverage Among Adult Populations in the U.S. “For the three vaccines in this report that are included in Healthy People 2020 (influenza, pneumococcal, and shingles), vaccination coverage in all race and ethnic groups was well below the respective target levels of 70% for influenza vaccination among adults aged ≥18 years, 60% for pneumococcal vaccination among adults aged 18–64 years with high-risk conditions, 90% for pneumococcal vaccination among adults aged ≥65 years, and 30% for shingles vaccination among adults aged ≥60 years.” Comment: One of the reasons for mandates.
August 7, 2015 – Addressing Parental Vaccine Concerns: Engagement, Balance, and Timing (full text) “The increasing prevalence of parental vaccine concerns and the pressure it places on doctors are clearly pressing public health issues. Medical providers, policy makers, and researchers are all trying to figure out how to influence parental immunization attitudes and behaviors. It’s becoming apparent that we likely need better doctor–patient communication strategies, public health messaging campaigns, reliable web-based resources for parents, and stronger mandatory immunization laws. Recently, there have been vigorous discussions centered around strengthening state-level school immunization mandates. For example, in California, a bill (SB277) that eliminates personal belief exemptions to vaccination faced strident, vocal opposition as it progressed through the state legislature. Although the bill was recently signed into law, political obstacles may be insurmountable in other states. For the other strategies to boost vaccine acceptance, we need interventions designed to test whether or not the strategies assist parents in the decision-making process for vaccination.
August 2015 – Making mandatory vaccination truly compulsory: well intentioned but ill conceived (free registration) “These legislators are well intentioned. They see more parents worried about the safety of vaccines and that more parents are delaying and refusing vaccines through non-medical exemptions. As legislators, they are looking for a direct legislative fix by proposing to eliminate non-medical exemptions altogether. Unfortunately, despite the good intentions, this approach is imprudent. The problem of vaccine hesitancy is far more complex than can be addressed with a simple ban on non-medical exemptions.”…”Despite a remarkable safety record, vaccines are not perfect and many parental safety concerns have remained unaddressed. Effective methods to address vaccine hesitancy at the level of the provider, community, and nation are scarce. Trust in the pharmaceutical companies that make vaccines and the governments that purchase and promote them are at an all-time low. A more draconian approach could result in more harm than good, and might even backfire by driving hesitant parents to accept antivaccination arguments.”
May 21, 2015 – Nudges or mandates? The ethics of mandatory flu vaccination“The article suggests that a successful strategy for policy-makers and others hoping to increase vaccination rates is to design a “choice architecture” that influences behavior of healthcare professionals without foreclosing other options. Nudges incentivize vaccinations and help better align vaccination intentions with near-term actions.”
April 16, 2015 – Social Distancing and the Unvaccinated “Efforts to control vaccine-preventable illnesses force society to face a number of difficult challenges, many of which transcend the issue of scientific effectiveness. Social distancing measures raise ethical issues central to society’s commitment to freedom and social justice. Even when they are effective, social distancing measures can have adverse consequences for economic and civil liberties. At the same time, increased public knowledge of the existence of such measures may lead more vaccine-questioning parents to choose to follow vaccination recommendations. Though social distancing may represent a key public health measure, such infringement of individual rights should be minimized and undertaken only when necessary to protect the public’s health.”
March 24, 2015 – Social Distancing and the Unvaccinated (full text) “Efforts to control vaccine-preventable illnesses force society to face a number of difficult challenges, many of which transcend the issue of scientific effectiveness. Social distancing measures raise ethical issues central to society’s commitment to freedom and social justice. Even when they are effective, social distancing measures can have adverse consequences for economic and civil liberties. At the same time, increased public knowledge of the existence of such measures may lead more vaccine-questioning parents to choose to follow vaccination recommendations. Though social distancing may represent a key public health measure, such infringement of individual rights should be minimized and undertaken only when necessary to protect the public’s health.”
August 27, 2014 – Professional and ethical responsibilities of health-care workers in regard to vaccinations (first page pdf)
- Voluntary vaccination programs have not achieved acceptable rates.
- Legally mandated vaccination is required.
- Governmental policies are crucial to mandate vaccination.
August 27, 2014 – Vaccination policies for healthcare workers in Europe “In order to achieve higher vaccination coverage against VPDs stronger recommendations are needed. The issue of mandatory vaccination should be considered for diseases that can be transmitted to susceptible patients (influenza, measles, mumps, rubella, hepatitis B, pertussis, varicella). The acceptance of vaccinations and of mandatory vaccinations by HCWs is a challenge and appears to be VPD-specific.”
August 20, 2014 – Healthcare workers under a mandated H1N1 vaccination policy with employment termination penalty: A survey to assess employee perception “96% felt that the mandating hospital should be liable should a significant adverse effect occur from receiving the vaccine. While the mandate helped to increase HCW influenza vaccination rates dramatically, the strict consequence of employment termination created negative feelings of coercion. Adopting a policy that includes a declination option with mandatory masking during influenza season might be a more widely acceptable and still adequate approach.
August 20, 2014 – Vaccination perceptions of school employees in a rural school district “Suboptimal vaccination rates of school employees may negatively affect the health and well-being of individuals in the school environment. School employees report a variety of beliefs regarding the influenza and MMR vaccines. While over half of school employees support mandatory vaccination policies for adults working in the school environment, those opposing such a policy report concerns regarding violation of personal choice. Public health officials and school administrators should coordinate efforts to increase vaccination rates among adults in the school environment.”
July 31, 2014 – Frequency and erroneous usage of temporary medical exemptions and knowledge of immunization guidelines among some Miami-Dade County Florida providers “In order to eliminate the improper use of TMEs, long-term efforts are needed to provide immunization-related educational materials and trainings to the medical community regarding vaccinations. These findings also suggest a need for enhanced explanation in multiple languages on the current Florida Immunization Certificate. Due to enhanced surveillance and education, the number of TMEs for kindergarten and seventh grade students was reduced by 12% and 4.9%, respectively, during the 2011 and 2012 school year.”
May 17, 2014 – Mandatory polio vaccination for travellers: protecting global public health “On May 5, 2014, WHO issued strong recommendations that Pakistan, Syria, and Cameroon should ensure that their residents and long-term visitors have up-to-date vaccination against polio before they travel internationally”
May 1, 2014 – Childhood Influenza Vaccination Mandates: The Importance of Research-Based Evidence in Public Health Policy Decision-making (pdf) Finally, this article will use New Jersey as a case study, looking at its 2008 Childhood Influenza Vaccination mandate, the reasoning behind it, and its effects. By examining the vaccination rates of New Jersey children from 2004-2012, specifically what effect New Jersey’s addition of the seasonal influenza vaccine to its mandatory vaccination list has had on influenza related hospitalization levels in the 65+ age group, this paper will look at whether or not New Jersey’s decision to enact legislation making yearly influenza vaccinations mandatory for children has exhibited positive movement towards the legislation’s Stated public policy goal of perpetuating herd immunity.”…”The ACIP has a mandate to advocate for health promotion behaviors, including routine immunizations. However, the progressive move towards a universal influenza vaccination recommendation was made because it was believed by the ACIP decision-making board to be in the best interest of the population, even in the absence of strong scientific data to support the claim.”
May 2014 – Preventive vaccinations for medical personnel “In Germany there are no longer laws for mandatory vaccinations, either for the general public or for medical personnel. Vaccinations are now merely “officially recommended”
February 12, 2014 – Legislative Challenges to School Immunization Mandates, 2009-2012 “Eighteen states introduced 1 or more exemption-related bills. Among 36 bills introduced, 15 contained no administrative requirements, 7 had 1 or 2 administrative requirements, and the remaining 14 contained between 3 and 5 administrative requirements. Of 20 states with a current PBE, 5 saw a bill introduced to restrict exemptions and 1 saw a bill introduced to expand exemptions. Among the 30 states without a PBE, none saw a bill introduced to restrict exemptions and 13 saw a bill introduced to expand exemptions. Of the 36 bills introduced, 5 were categorized as restricting exemptions and 31 as expanding exemptions. None of the bills categorized as expanding exemptions were passed. Three of the 5 bills categorized as restricting exemptions were passed (Washington, California, and Vermont). “Exemptions to school immunization requirements continue to be an issue for discussion and debate in many state legislatures,” the authors write.”
January 8, 2014 – Mandatory seasonal influenza vaccination of health care workers: a way forward to improving influenza vaccination rates “Voluntary strategies of increasing access, offers of free vaccines, education, and highly visible publicity campaigns have had limited success. In the US, more innovative ideas have been proposed to complement these steps. We discuss such strategies including mandatory influenza vaccination and its possible implementation.”
October 10, 2013 – Vaccination of health care workers against influenza: Is it time to think about a mandatory policy in Europe? “We conclude: Given the available evidence concerning the benefits, burdens and risks of HCWs influenza vaccination and the limited effectiveness of voluntary policies, it is time to consider mandatory vaccination policies for HCWs in Europe.”
February 7, 2013 – Ethical considerations for vaccination programmes in acute humanitarian emergencies “Obtaining valid consent from individuals before a medical intervention is an obligation under the principle of respect for the autonomy of persons. In non-emergency circumstances, the consent process needs to be thorough and takes time. During emergencies, it has to be modified. If time permits, information on the risks and benefits of vaccination should be communicated to target populations in sufficient depth to allow individuals to make informed decisions, while bearing in mind that many will lack a basic understanding of germ theory and immunology. During emergencies, vaccination often takes place while people are too desperate for food and other basic necessities to recognize its importance. Furthermore, in some developing countries people defer to decision-makers at the expense of individual autonomy.
January 2013 – Attitudes toward mandatory occupational vaccinations and vaccination coverage against vaccine-preventable diseases of health care workers in primary health care centers “Despite the fact that two-thirds of HCWs working in primary health care centers in Greece support mandatory vaccination for HCWs, completed vaccination rates against vaccine-preventable diseases are suboptimal.”
September 13, 2012 – Mandatory flu vaccine for healthcare workers? (free registration) (video) “This is the best kept secret in Healthcare. I too got GBS about 3 weeks after vaccination! Very scary. Guess who had to pay all the medical bills – not my employer. I disagree with flu vaccines being “mandatory” for ALL heathcare workers – Yes “encouraged” but not “mandated”.
June 19, 2012 – Attitudes toward mandatory occupational vaccinations and vaccination coverage against vaccine-preventable diseases of health care workers in primary health care centers “A total of 2,055 of 5,639 HCWs (36.4% response rate) from 152 primary health care centers participated. The self-reported completed vaccination rates were 23.3% against measles, 23.3% against mumps, 29.8% against rubella, 3% against varicella, 5.8% against hepatitis A, 55.7% against hepatitis B, and 47.3% against tetanus-diphtheria; corresponding susceptibility rates were 17%, 25%, 18.6%, 16.7%, 87.5%, 35%, and 52.6%. Mandatory vaccinations were supported by 65.1% of 1,807 respondents, with wide differences by disease. Multiple logistic regression analysis revealed higher rates of acceptance of mandatory vaccination in physicians compared with other HCW categories.”
November 21, 2011 – Increases in vaccination coverage of healthcare personnel following institutional requirements for influenza vaccination: A national survey of US hospitals “Hospitals that are unable to improve suboptimal influenza vaccination coverage through multi-faceted, voluntary vaccination campaigns may consider institutional requirements for influenza vaccination. Rapid and measurable increases in vaccination coverage followed institutional requirements at hospitals of varying demographic characteristics.”
November 5, 2011 – Mandating influenza vaccination in health-care workers “RB has received financial support from CSL, Sanofi, GSK, Roche, Novartis, and Wyeth/Pfizer to do research and present at scientific meetings. Any funding received is directed to an NCIRS research account at the Children’s Hospital at Westmead and is not personally accepted by RB. JL is an investigator in a study receiving part funding from Sanofi. The other authors declare that they have no conflicts of interest.”
October 21, 2011 – Impact Of Implementatoin Of Mandatory Influenza Vaccination Of Health Care Workers At A Tertiary Care Center: A Step in The Right Direction
October 21, 2011 – Sociodemographic Correlates of Seasonal Influenza Vaccination among Health Care Workers at A Large Academic Healthcare System
October 21, 2011 – An 11th hour mandatory influenza healthcare worker vaccination vs mask policy
October 6, 2011 – Seasonal influenza vaccination predicts pandemic H1N1 vaccination uptake among healthcare workers in three countries
September 15, 2011 – Immunize.org State mandates on immunization and vaccine-preventable diseases
September 2011 – Student immunity requirements of health professional schools: vaccination and other means of fulfillment-United States, 2008.
September 2011 – Examining Future Adolescent HPV Vaccine Uptake With and Without a School Mandate (full text)
September 2011 – Effectiveness of state-level vaccination mandates: Evidence from the varicella vaccine.
September 2011 – Exploring the Presentation of News Information About the HPV Vaccine: A Content Analysis of a Representative Sample of U.S. Newspaper Articles. “Together, our findings suggest that U.S. newspaper coverage lacked detailed information about both HPV and the HPV vaccine in spite of federal approval of the vaccine, legal mandates for the vaccine, and a widespread information campaign. Implications for public health are discussed.”
August 2011 – The human papillomavirus (HPV) vaccine and cervical cancer: uptake and next steps.
“The epidemiology of HPV, the mechanisms of action, protocols for vaccine immunization, rates of uptake, and barriers to vaccination at the policy, provider, and patient levels are reviewed. Various intervention techniques are described, and policy-level programs, such as legislation supporting mandates, subsidized public education, and cost-reduction initiatives, are also explored.”
July 25, 2011 – A compelling editorial on mandatory vaccines for health care workers
July 25, 2011 – Exploring The Politics Of Mandatory HPV Vaccinations – Whose Children Are These?
June 30, 2011 – Vaccinations and Your Rights in the U.S. Alan Phillips, JD
June 3, 2011 – Vaccination Coverage Among Children in Kindergarten — United States, 2009–10 School Year Morbidity and Mortality Weekly Report (MMWR)
June 2011 – [Does patient safety justify mandatory vaccinations?]. “Contrary to the widespread concern that a vaccination requirement would cause resistance, our data support that mandatory vaccinations (at least for HCWs who care for immunocompromised patients) might be widely accepted.”
June 2011 – “Do We Really Need Hepatitis B on the Second Day of Life?” Vaccination Mandates and Shifting Representations of Hepatitis B (full text)
May 20, 2011 – Healthcare Workers Choose Flu Shots Over Masks (free registration)
April 29, 2011 – Court upholds vaccine human rights: No more mandatory polio vaccines
April 12, 2011 – Missouri Dem joins health care repeal effort “If Congress can force activity under the Commerce Clause,” he said, “then it could force individuals to receive vaccinations or annual checkups, undergo mammogram or prostate exams or maintain a specific body mass.”
April 8, 2011 – History Of Compulsory Vaccination “Compulsory vaccination for some diseases is still extant in some countries like Italy, France, Greece, Portugal and Belgium; in other countries, like the United Kingdom and Finland, vaccinations are voluntary but the state pursues a policy of active promotion. In 2007, the Veneto Region of Italy government approved a law allowing the experimentation of the abolition of mandatory vaccination.
April 2011 – Development of a survey to identify vaccine-hesitant parents: the parent attitudes about childhood vaccines survey.
February 24, 2011 – Mandatory Vaccinations: Precedent and Current Laws (pdf)
February 23, 2011 – Battle Brewing Over Mandatory Meningitis Vaccine
February 22, 2011 – Public Health Concerns Justify Compulsory Immunization Immunization by vaccine saves thousands of lives. The benefits are much greater if everyone is vaccinated than if not, therefore it is essential that as many people as possible are vaccinated. There should be as few obstacles as possible to such a program in order to save as many lives as possible. Some might argue that, on the other hand, why should the government be able to force someone to have a needle stuck into them? They might also say that if they wish to take the risk of not having the vaccine, that is their choice. However, it not only effects them but the people around them. So, this essentially boils down to personal liberty vs. the good of the entire society.
February 9, 2011 – Opinion: Vaccinations – Let parents make the choice By Charlotte Vandervalk Assembly Woman Representing Distric 39 New Jersey.
February 1, 2011 – Maternal characteristics that predict a preference for mandatory adolescent HPV vaccination.
November 1, 2010 – Mandatory Immunization’s Growing Appeal Many U.S. health care providers already require employees to accept vaccinations. Henry Ford Health System requires measles, mumps, rubella, and tuberculosis vaccinations, with no opt-outs allowed.
October 2010 – Should doctors fire young patients if their parents refuse to vaccinate them?
September-October – Evaluation of a legislatively mandated influenza vaccination program for adults in Rhode Island, USA.
August 19, 2010 – HPV Vaccination Mandates — Lawmaking amid Political and Scientific Controversy (full text)
August 2010 – Use of multimedia as an educational tool to improve human papillomavirus vaccine acceptability–a pilot study.
April 2010 – Alfred Russel Wallace and the Antivaccination Movement in Victorian England (full text) “I also briefly analyze the similarities and differences between the Victorian and contemporary vaccination debates. It has recently been argued that comparative historical analysis can play a major role in public health policy. In contemporary vaccination controversies, history is frequently used as a source of arguments, but the historical argument often is not based on up-to-date historical understanding. The polarizing controversies surrounding vaccination have never completely gone away, and the nearly unbroken tradition of debate apparently entices participants to reuse old arguments without making certain that their context is still valid. Vaccination involves national and international politics and the deeply personal sphere of child care. It is thus probably inevitable that culturally influenced ideas of bodily integrity and health from time to time are at odds with so-called vaccination technocracies.
March-April 2010 – Using an H1N1 vaccination drive-through to introduce healthcare students and their faculty to disaster medicine.
March-April 2010 – Establish the habit: influenza vaccination for health care personnel.
March 20, 2010 – Taking the Final Step: Implementation of a Mandatory Flu Shot Program Within a Healthcare System “Exemption from vaccination was allowed for egg allergy, history of either Guillian-Barré or a post-flu shot anaphylaxis. A formal exemption process began as a written appeal to an internal review board which determined exemption. For the non-exempt, the choice to not be vaccinated resulted in termination. Rehire is conditional, based on the intent to comply with influenza vaccination in the future. …Over 99.99% of approximately 3800 employees received a seasonal flu shot. No serious side effects occurred among those receiving vaccine. Of those employees who applied for exemption but were denied, 4 chose to terminate employement; however, one of these, a physician, chose retirement rather than immunization. Consequences for unvaccinated, non-employees were not explored this initial year.”
March 20, 2010 – Mandatory Seasonal Influenza Vaccination “Vaccination of healthcare workers (HCW) has been shown to reduce absenteeism, infection among staff, patients and visitors, and to result in financial savings for the hospital.¹ In the 2006-2008 fall vaccination seasons, University Hospital in Cincinnati achieved voluntary immunization rates ranging from 35- 51%. In late August 2009, the decision was made by administration and the hospital’s Medical Executive Committee to make seasonal flu vaccine mandatory for all employees and medical staff.”
March 20, 2010 – From 51 to 99.8% – Mandatory Seasonal Influenza Vaccination – Fifth Decennial International Conference on Healthcare-Associated Infections (abstract) – “A dedicated flu shot clinic was opened daily, and a “shot brigade” took vaccine to locations around the hospital. A general publicity and educational campaign occurred by email and by posters. A program to review and approve exemptionsfor medical reasons was created. Negotiations with each of three unions were held according to terms of their respective contracts. A deadline of October 20th was set after which time staff who had not received vaccine or an approved exemption would be declared unfit for duty and taken off work schedules.”
March 2010 – Physician attitudes towards influenza immunization and vaccine mandates.
February 15, 2010 – Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice (full text) “Medical or religious exemptions could be requested. Predetermined medical contraindications include hypersensitivity to eggs, prior hypersensitivity reaction to influenza vaccine, and history of Guillan-Barré syndrome. Medical exemption requests were reviewed by occupational health nurses and their medical directors. Employees who were neither vaccinated nor exempted by 15 December 2008 were not scheduled for work. Employees still not vaccinated or exempt by 15 January 2009 were terminated.”
February 15, 2010 – Mandate to Protect Patients from Health Care-Associated Influenza (full text) “The list now includes some of the largest and most prestigious organizations in the United States, including Hospital Corporation of America, Johns Hopkins Health System, University of Iowa Hospitals, Hospital of the University of Pennsylvania, Children’s Hospital of Philadelphia, and the Department of Defense [11].. Mandatory vaccination has also generated vigorous debate and opposition, including legal challenges [12]. This year, the New York state health commissioner issued a regulation requiring influenza vaccination for all health care workers. Justice Thomas J. McNamara of the New York Supreme Court issued a temporary restraining order until 3 lawsuits can be heard and the legal issues tested in court [13].
December 2009 – A successful mandatory influenza vaccination campaign using an innovative electronic tracking system. “By February 12, 2009, all 2,754 identified patient‐care employees either were vaccinated or formally declined vaccination. Among those, 2,424 (88%) were vaccinated either at the NIH or elsewhere, 36 (1.3%) reported medical contraindications, and 294 (10.7%) declined vaccination for other reasons. Among the 294 employees without medical contraindications who declined, the most frequent reason given for declination was concern about side effects. Conclusions. Implementation of a novel vaccination tracking process and a hospital policy requiring influenza vaccination or declination yielded dramatic improvement in healthcare worker vaccination rates and likely will result in increased patient safety in our hospital.”
November 19, 2009 – Mandatory Vaccination of Health Care Workers (full text) “Many health care workers believe that the mandate violates fundamental individual rights and public health policy, and some have filed court actions. In response, one judge ordered a delay in implementing the regulation, and New York’s governor, David Paterson, suspended the requirement so that the limited supply of H1N1 vaccine currently available can be distributed to the populations most at risk for serious illness and death.”
Summer 2008 – Assessing Mandatory HPV Vaccination: Who Should Call the Shots?
September 2008 – Mandatory School Vaccinations: The Role of Tort Law (full text) “Although most scholars have recommended that state governments close the “legal loophole” of religious and philosophical exemptions, this nation’s political landscape makes outright eliminating these exemptions highly unrealistic. Tort law, however, may allow state governments to retain religious, philosophical, and other exemptions to mandatory vaccinations, while still providing both a deterrent against religious exemptions of convenience and a mechanism for compensating victims.
June 1, 2008 – A Proposed Ethical Framework for Vaccine Mandates: Competing Values and the Case of HPV (pdf) “This work was developed in conjunction with the Center for Vaccines Ethics and Policy, a program of the Center for Bioethics at the University of Pennsylvania, The Wistar Institute Vaccine Center, and the Vaccine Education Center of Children’s Hospital of Philadelphia”
Fall 2007 – Off the Grid: Vaccinations Among Homeschooled Children
February 2006 – Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future.
July 1, 2004 – Children Who Have Received No Vaccines: Who Are They and Where Do They Live? (full text)
March 7, 2003 – Vaccination Coverage Among Children Enrolled in Head Start Programs, Licensed Child Care Facilities, and Entering School — United States, 2000–01 School Year Morbidity and Mortality Weekly Report (MMWR)
Fall 2002 – Childhood immunization: laws that work.
August 24, 2002 – Anti-vaccinationists past and present – Box A: Anti-vaccination arguments, past and present – Box B: Anti-vaccination movements past and present
December 27, 2000 – Individual and Community Risks of Measles and Pertussis Associated With Personal Exemptions to Immunization (full text)
October 29, 1999 – The immunization system in the United States – the role of school immunization laws.