WMN: t3_3eai2b_t1_ctd31lp

[TITLE]

CMV: There is nothing wrong with requiring (medically-appropriate) vaccination for children to attend public schools

[facing_the_fallout]

Recently I've heard a lot about mandatory vaccination schemes in public schools. I don't see any problem with them. I've heard a few counterarguments, but they seem unsatisfying to me, for example: 1. My child, my choice. Well, yes. And this is the closest one to a valid argument, IMO. But of course we put limits on what parents are allowed to do and choose for their children; you can't deprive your child of food or education (in the US) and be allowed to keep your child, so clearly it is NOT all your choice. While refusing vaccines is nowhere near on that level, not EVERY possible choice is equally acceptable, because your child is a person, not a piece of property. If the child had the capacity to refuse, I might be swayed, but unfortunately young babies can't understand vaccines on any reasonable level. And, more importantly, it IS still your choice under school vaccination schemes; you can choose to homeschool your child, or send them to private schools that don't care. Those choices aren't available to everyone and that's unfortunate (for far more important reasons than this), but...that's our current system anyway. Being rich gets you all kinds of benefits. I don't think this is different from being able to buy better medical care, better schools, better food, private tutors, and worlds more for your child if you have the resources (I do support basic income, which would alleviate this issue, but that's neither here nor there as we haven't got it). Public schools are a governmental service, and there are rules about who can and cannot use them. I think it is fine to say only vaccinated (or medically exempt) people can use them. 2. Not everyone can get vaccinated. That's why doctors are able to issue waivers for those not medically right for vaccination. This already happens and should continue. 3. Vaccines are dangerous. Not as dangerous as rampant infection. Honestly this is its own debate...But suffice it to say you are going to need some pretty major evidence to possibly CMV. I don't think it exists, but I won't rule it out. I don't really want to talk about vaccine efficacy as it has been done to death, but I guess if there's some truly amazing evidence... 4. Everyone is entitled to an education. They still are. Any unvaccinated child either needs to attend a non-public education option, be homeschooled or eschooled, provide a medical certificate that says they shouldn't be vaccinated, or get the shots. I don't necessarily have a strong view on the best way to handle noncompliance, and don't know enough about policy to say what would be most effective and just. Maybe fines for the parents? The same punishment as parents who refuse to send their kids to school or teach them at home for other reasons? I would not support removing the child from the home or incarcerating the parents, or any other severe punishment. What would change my view: evidence that such a policy would have clear public health risks, would unavoidably keep children from getting an education, or would have some other major negative effect on society. I also am open to the idea that it is fundamentally unjust, though it doesn't seem that way to me right now. Edit: My post focuses mainly on why I think mandatory vaccination isn't bad, but it occurred to me that it might be helpful to say why I think it's good. Mainly, I think it's good because it protects those who cannot be vaccinated and the minority of children for whom the vaccine was ineffective or wore off sooner than it "should have" based on medical guidelines. Children should be safe at school, and I think this promotes safety in a significant way--since children can die of preventable illness. Edit2: If vaccines are prohibitively expensive and can't be obtained for free, this system is pretty shit for poor families. In my area you can get free vaccines in certain conditions, which are very lenient. If this isn't true everywhere in the US (and it almost certainly isn't), it should be before vaccines are made mandatory. Edit3: Going to bed now, will respond to new posts tomorrow. If it blows up, I might not get to everyone, but I will try to address any new points that are brought to the table.

[spencer4991]

As much as I hate defending the anti-vaccine crowd, I think the problem with mandatory vaccination for public school is that school is also compulsory. Ever since No Child Left Behind, education has been mandatory for all children until 16 or 18 (can't remember). Now the same people who demandon't children be sent to school also demand that in order to go to school, they must be vaccinated. Now, now you might say, that's only for public schools, what about private schools and home/eschooling? There's a problem with that too. Roughly 40% of children in the US live in single parent home, which rules out the prospect of homeschooling and eschooling becomes unviable because it's illegal to leave your kids alone at home. You also have a large percentage of the population who can't afford or don't have access to private schools. The amount of overlap here has the potential to be very high, especially in poor neighborhoods. So, now we have a segment of the population for whom public school is the only option. What are the odds that some of these people do not want their kids vaccinated, for whatever reason (ignorance usually, but that's not the point)? Pretty high. So now the question becomes, are we willing to fine and or imprison parents because they don't want their kid to get a vaccine and therefore won't send them to school? Personally, that is not something I'm willing to do, so I'm against mandatory vaccination in order to go to school.

[Not_Pictured]

For the truly poor is very much is a government mandate that the state can inject a foreign substance into your children, or else. You can claim this foreign substance is GOOD (I believe it is), but holy shit. If you get to inject my kid, I get to inject your kid. You better hope you stay in power!

[jlot]

I don't have a problem with public schools mandating vaccines in theory. My kids are homeschooled. (Which is NOT just an option for rich people...) I do vaccinate, but on a limited and delayed schedule, and I want to maintain the right to decide what gets injected into my children. My problem is that some regulation usually leads to MORE regulation, and public opinion is against anti-vaxers in a big way. So, it feels like a short step between mandating public school kids and mandating ALL kids.

[facing_the_fallout]

I feel like this is a slippery slope argument, but maybe I'm not understanding your point. Can you elaborate, or show how this is different from a fallacious slippery slope argument? Right now I'm hearing "if we mandate vaccines for one purpose, we will mandate it generally," which to me seems far from certain. So many people choose not to vaccinate now (even if they are a small group, percentage-wise).

[jlot]

Slippery slope arguments may be difficult to support, but in cases of liberty, I think they can be relevant. Give up some freedoms for the sake of the greater good (like 9/11 and the Patriot Act) and it can be not only difficult to regain that ground, but as we get comfortable with the new reality, we become increasingly willing to open doors to greater intrusions on our privacy. Your CMV was that it is okay to require vaccinations for public school attendance, and the reality is that it is [already mandatory to vaccinate your children in all 50 states](http://www.cdc.gov/phlp/docs/school-vaccinations.pdf) to send them to school. Most states include private schools (which does impact many homeschoolers), and some states include homeschooling families as well. And there are already increasing pushes to go after the "clusters" of unvaccinated children that pose a "public health risk" - which are often kids outside the public school system. Whenever there is an outbreak of some sort, regardless of the reason, public opinion turns against families that choose alternatives to the CDC's recommendations, and public opinion affects public policy. In my state (TN) I am required to provide a "religious exemption" form for my alternative schedule, which I hate, as my objections have nothing to do with religious considerations. I choose an alternative and delayed schedule based on a combination of the CDC's guidelines, my doctor's perspective and independent research. The CDC recommends more than 20 shots (some of which combine multiple vaccines) within the first 12 months of an infants life. I question EACH and EVERY vaccine because I question everything in life. I don't take pills my doctor suggests simply because they suggest it. I do my own research, evaluate health and lifestyle changes and seek a second opinion if warranted. Why would I do less for my fragile newborn? Vaccines CAN be dangerous. Most of them cause mild side effects, and the serious side effects are extremely rare, but in some cases you are having your perfectly healthy child injected with something that can cause [permanent brain damage](http://www.cdc.gov/vaccines/vac-gen/side-effects.htm). They can contain additives like [aluminum, formaldehyde, and thimerosal](http://www.cdc.gov/vaccines/vac-gen/additives.htm). They are made by some of the same drug companies we are skeptical of in other situations, who [might not always be perfectly honest with us](http://www.forbes.com/sites/gerganakoleva/2012/06/27/merck-whistleblower-suit-a-boon-to-anti-vaccination-advocates-though-it-stresses-importance-of-vaccines/), and sometimes vaccines have to be recalled - such as the cases of the rotavirus vaccine that has had to be recalled for causing [intussusception - a rare type of bowel obstruction that occurs when the bowel folds in on itself](http://www.cdc.gov/vaccines/vpd-vac/rotavirus/vac-rotashield-historical.htm). Admittedly, there is paranoia from un-vax crowd, but we are in a climate of hostility towards anyone who questions the standard. Not everyone who does so hangs on every word Jenny McCarthy says and believes every anti-vax blog post out there. Many of us are just good parents who are very intentional about the decisions we make for our children, and would like to continue to have that right. To sum up my opinion again, I do wish public schools weren't the little breeding grounds of illness that they are, and I think you should have some assurance when you send your kids in that there is some herd immunity going on for really serious diseases. But I choose to keep my kids home, and limit their interaction with the outside world (at least for a few years) and I would like to maintain the right to challenge what gets put into their tiny bodies.

[bayernownz1995]

So I do think this policy I justified, but I don't think it's a good mechanism for mandatory vaccination. The people who insist on not vaccinating their children do so because they think it would be harmful for their child, and some of them probably hold this belief strong enough so that they would not enroll their children in school. Are anti-vaxxers really the people you want homeschooling children? The comparison here is, with mandatory vaccinations, hundreds of kids have their lives ruined by leaving school each year. Without them, maybe once every decade, less than a hundred kids will get sick for a few weeks. But the problem is also worse than that, because this also plays into a lot of anti-vaxxer rhetoric. A lot of it relies on exploiting people's fears of the government. Mandatory vaccines only make that seem worse. Additionally, it makes these people even less trusting of the government, meaning that they are more likely to shut themselves of from outside streams of information. So it forces many anti-vaxxers into even more of an echo chamber. One of the must successful ways to spread information is to have anti-vaxxers have a friend or a neighbor who can discuss these things with them. The easiest way to prevent that from happening is by forcing them further away from the rest of society.

[facing_the_fallout]

[STA-CITE]>So it forces many anti-vaxxers into even more of an echo chamber. One of the must successful ways to spread information is to have anti-vaxxers have a friend or a neighbor who can discuss these things with them. [END-CITE]This is an outcome I hadn't thought of. I'll award a ∆ for a partial view change. This could cause more people to choose to isolate themselves socially or geographically around vaccine-belief lines, which is just bad for everyone in the long run. I still think in the short term it is appropriate to mandate vaccination, but I hadn't thought how it could affect perceptions over time.

[DeltaBot]

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[whattodo-whattodo]

The problem with your argument is that it creates cracks in a system which punish the child for the parent's decisions. It's fine in theory. The parents either cave and vaccine their kid or the kid goes to private school. But in reality, most people can't afford private school. Also unlike public schools, private schools don't have an obligation to their community. So they can just turn kids down. Also - while I think the parents are dead wrong - they feel that they are saving the kid's life. They probably won't cave on issues that *they feel* will endanger their child. The end result is that parents who don't want to vaccinate their kids *still don't*. Most kids will wind up getting just enough home schooling to be above the law. Or more realistically just enough to not warrant the removal of the child by protective services. So now you have a kid who *could have had a chance at life* but because of their parent's decisions, partnered by a system set up to fail them, a part of a generation of children who won't have the most basic skills possible.

[facing_the_fallout]

The problem with not vaccinating is the same; children are punished for their parents' decisions, and also other children's parents' decisions (when vaccinated children get infected, which does happen sometimes). Unvaccinated kids may choose to receive vaccinations in adulthood...but realistically if you've made it to adulthood, you're probably gonna be okay anyway, so that's really beside the point. It's a trade-off. Either some children receive less education, or some children die. It's a small group either way, admittedly. Most children who aren't vaccinated don't end up dying of polio. And most children, in the US, are vaccinated. But I care most about those kids--and the kids who would otherwise sit next to them at school--not dying. That has to be first. [STA-CITE]>Also - while I think the parents are dead wrong - they feel that they are saving the kid's life. They probably won't cave on issues that they feel will endanger their child. [END-CITE]Some parents won't. I think better education and public awareness are key here, and they'd probably be a necessity to get policies like these off the ground, politically. Some parents will never change their minds about vaccines, sure. Has anyone done a study of how many reluctant parents do choose to vaccinate when they are pressured by the child's school district? Given how much laws do change behavior in general, I tend to suspect that at least some parents would (or would send their kids to private schools). But if there were empirical evidence indicating that mandatory vaccination does not increase vaccination rates (in areas with comparatively low rates already--clearly you can't increase 100%), that would CMV. My preliminary search did not return anything directly answering that question.

[whattodo-whattodo]

[STA-CITE]> The problem with not vaccinating is the same; children are punished for their parents' decisions, and also other children's parents' decisions (when vaccinated children get infected, which does happen sometimes). [END-CITE]It's not actually the same. The kid who does not have a vaccine and could not get a proper education will be in a subclass of untouchables comparable to the lepers in India. [STA-CITE]> But if there were empirical evidence indicating that mandatory vaccination does not increase vaccination rates (in areas with comparatively low rates already--clearly you can't increase 100%), that would CMV. [END-CITE]I don't disagree on this point. In fact I think creating a law would send the *majority* to get vaccinated and a minority to private school. The problem is that the remainder is pretty large. [STA-CITE]> It's a small group either way, admittedly [END-CITE]Based on this site [~1K people die per year from preventable diseases](http://www.antivaccinebodycount.com/Anti-Vaccine_Body_Count/Home.html). Let's assume (best case) that they are all in public school. Separately, we have [50 Million kids in public school](http://nces.ed.gov/fastfacts/display.asp?id=372). The CDC aims to maintain a 95% vaccination rate, and let's assume (best case) they met their goal. So our problem is ~2.5 Million students. From there, let's knock off (best case) 10% who can go to private school and again (absurdly optimistic best case) 60% vaccination as a result of the new law. So with every value swayed **heavily** in favor of your argument, we only throw **750,000** kids onto the street. Admittedly it is small relative to the population but it is 750x the size of the yearly death toll. It's not even remotely an option for anyone who creates public policy. Not to mention that these kids (accumulating yearly) will drain welfare, unemployment and every other service because we never gave them a shot at education.

[facing_the_fallout]

[STA-CITE]>The kid who does not have a vaccine and could not get a proper education will be in a subclass of untouchables comparable to the lepers in India. [END-CITE]And the kid who dies of a vaccine preventable illness is dead. More to the point, this seems a bit absurd when you consider that most people who refuse to vaccine because it is "dangerous" are rich white educated people. They aren't dealing with generations of horrific oppression, and most of them CAN afford private education or eschool. [STA-CITE]>So if absolutely everything goes according to plan, we only throw 750,000 kids onto the street. [END-CITE]Bullshit. Throw them onto the street? Why? Nowhere in my CMV did I say that was an appropriate way to handle this. And no way can only 10% of rich white kids afford private school. You also forgot to account for those who switch to homeschooling and provide a perfectly acceptable education. Sadly, it's not hard to beat America's schools. Oh, and what about the fact that public school children are already pushed to be vaccinated? Surely that would cause self-selection, reducing the number of public school kids who currently are not vaccinated. Those who don't like it may have already jumped ship to private/homeschool. Parents can't just not educate their kids. Some already want to, and we don't let them. My understanding is that the consequences for this vary by state and area, but we certainly won't stand by and say "ah what can you do, crazies gonna cray." I refuse to believe that the only, or best, solution is to allow that to happen. I don't claim to know the very best way to ensure compliance. I don't make policy. But for starters, you can increase public awareness and therefore social pressure to vaccinate. You can monitor homeschooling (and the state already should). You can make it easier to get vaccinated. And many other things that better-educated people than me would know to do. We won't have millions of rich white kids inexplicably languishing without education; it just isn't going to happen.

[whattodo-whattodo]

[STA-CITE]> when you consider that most people who refuse to vaccine because it is "dangerous" are rich white educated people. They aren't dealing with generations of horrific oppression, and most of them CAN afford private education or eschool. [END-CITE]Just a reminder that the math behind the example was exclusively about public schools. You're saying that the parents of these 50M public school kids are mostly rich? Can you site a reference? [STA-CITE]> Throw them onto the street? Why? Nowhere in my CMV did I say that was an appropriate way to handle this. [END-CITE]That's not what I guess you *intend* will happen. But again, assuming the numbers above are right, that is the remainder. It's far too large of a number for child protective services to monitor on top of their workload. So these kids *now* can't go to school. Where do you think they will go? [STA-CITE]> And no way can only 10% of rich white kids afford private school. [END-CITE]Again, the math was just for the 50M public school students already. I'm saying that 10% of that (or 5M new students) will go to private school who were not previously enrolled. It's a ridiculous overestimate in favor of your argument [considering that only 10% of students currently go to private school.](http://www.huffingtonpost.com/jack-jennings/proportion-of-us-students_b_2950948.html) [STA-CITE]> You also forgot to account for those who switch to homeschooling and provide a perfectly acceptable education. [END-CITE][30% - 60% of kids](http://datacenter.kidscount.org/data/tables/107-children-in-single-parent-families-by#detailed/1/any/false/36,868,867,133,38/10,168,9,12,1,13,185/432,431) (divided by race) live in single parent households. Not even factoring in households where both parents *need* to work, that means that most kids won't be able to get any sort of homeschooling. [STA-CITE]> Oh, and what about the fact that public school children are already pushed to be vaccinated? Surely that would cause self-selection, reducing the number of public school kids who currently are not vaccinated. Those who don't like it may have already jumped ship to private/homeschool. [END-CITE]How does the existence of anti vaxxers in private school affect your CMV on public school requirements? Also, just a reminder that only 10% of all students are in private schools. So even if there were self selection on an absolute scale, it would only vary the end number of 750K by - at a maximum - 10%. At this point I get how strongly you feel about it but the math is not on your side. If you can provide any hard evidence that supports your ideas or refute mine, great. *I would love* to be wrong about this.

[facing_the_fallout]

Okay, clearly this is never going to go anywhere. I do not believe for a minute that we are going to be throwing kids to the streets. School districts have adopted mandatory vaccination and that hasn't happened. Whole countries have adopted it and that hasn't happened. Nowhere on earth has this catastrophic outcome happened. I can sit here and quibble numbers with you as we try to work out amateur stats, but that's not the point and I wish I hadn't even gone there in the first place. The numbers don't matter when it's not going to happen. I agree that more kids may well have their quality of education somewhat reduced than lives will be saved, because it's a pretty small number of kids dying per year (at least, right now). But 1) that's apples to oranges. Death is worse than shitty education. 2) Nowhere else that's implemented mandatory vaccines has had this level of devastating outcome you predict. It's not going to be some mass exodus of hundreds of thousands to die in the streets. That doesn't happen. If someplace has had that outcome, I'll CMV. But as it stands, predicting that hundreds of thousands of kids will completely miss their education--I just don't buy it. We don't let parents do that. That doesn't happen anywhere mandatory vaccines happen, and I don't believe it'll happen here. Why is the US so different from anywhere else that has mandatory vaccination (including parts of the US itself)? Surely not every child was vaccinated in those places before it was implemented either, otherwise why bother?

[whattodo-whattodo]

[STA-CITE]> I do not believe for a minute that we are going to be throwing kids to the streets. [END-CITE]It's simple. If the vaccination is mandatory they can't go to school. I'm not the one making this up. It's your argument. Rather than backpeddling, just tell me. Where do they go? [STA-CITE]> I can sit here and quibble numbers with you as we try to work out amateur stats, but that's not the point [END-CITE]Actually facts and logical deduction are the cornerstones of CMV. That's exactly the point. [STA-CITE]> But 1) that's apples to oranges. Death is worse than shitty education. [END-CITE]Death is worse. That's why you deal with anti vaxxers differently from the way you proposed. They still need to be dealt with, but in another way. [STA-CITE]> 2) Nowhere else that's implemented mandatory vaccines has had this level of devastating outcome you predict. [END-CITE]No problem. I broke it down at every step and cited references for everything I could find. If you disagree with something, just say it. But it's poor form to quit when you're not getting your way. [STA-CITE]> It's not going to be some mass exodus of hundreds of thousands to die in the streets. That doesn't happen [END-CITE]Of course it wouldn't happen. No one would pass a law like this in the US for exactly this reason. That's why I posted to change your view. It's incredibly poor as public policy. This CMV attempts to show you the fallout from that decision.

[z3r0shade]

[STA-CITE]> If the vaccination is mandatory they can't go to school. I'm not the one making this up. It's your argument. [END-CITE]Nearly every state requires kids under a certain age to be schooled. Thus either they are being homeschooled (by someone meeting state requirements), they are in private school, or they got the vaccinations and went to public school. They would not be allowed to not be schooled.

[whattodo-whattodo]

I understand the concept *in theory*. My post was to elaborate how it breaks down in practice. As mentioned in my post above (with references) most households do not have the resources to homeschool. Further, the US government does not have the resources or the desire to remove 750K kids from their homes. My point is that a law like this would never pass (A) because it sets *lots* of families up for failure and (B) because we just don't have the resources to enforce the policy. A law without repercussions if broken is nothing more than a suggestion. The only way anyone could think that this *might* work is if you assume that everyone will just cave under the pressure. If that were true then no one would break laws ever and we wouldn't have prisons. But that's just not a realistic way to view our legal system.

[z3r0shade]

[STA-CITE]> My point is that a law like this would never pass [END-CITE]http://www.cdc.gov/vaccines/imz-managers/laws/state-reqs.html Most states already have a law like this in place. The problem is the number of loop holes that exist for people to get out of vaccinating their children. The idea would be to close the loop holes, but the laws mandating vaccination for public school already exist. [STA-CITE]> because we just don't have the resources to enforce the policy. [END-CITE]Sure we do. You must present proof of vaccination in order to enter public school....just like right now you must do so or provide a statement that fits one of hte exemptions. [STA-CITE]> Further, the US government does not have the resources or the desire to remove 750K kids from their homes. [END-CITE]Where are you getting that parents of 750K children would simply let their kids go without being schooled rather than either homeschool, get them vaccinated or send to public school? Sure, I saw your numbers and you have an estimation of 750K children that would be from parents not wanting to vaccinate them but I don't see how that translates to all or even a significant number of them simply deciding that their kids won't go to school at all. Nearly all of those kids will either get their vaccinations and go to public school, or they will be homeschooled or go to private school. And personally, I'd prefer it if we also made mandatory vaccinations a requirement for private schools too.

[[missing]]

[speedyjohn]

[STA-CITE]>It's a trade-off. Either some children receive less education, or some children die [END-CITE]Except it's not an even trade. You know that if you require vaccination, most children with anti-vaxxer parents will get a shit education. If you don't require vaccination, a very very (very very very very) small number or children will become seriously ill who wouldn't have. We're talking minuscule numbers here. Even sitting next to an unvaccinated child, the odds of a vaccinated child contracting a life-threatening disease is incredibly low. Maybe they'll get sick and miss some school, but very few will die. This is going to sound incredibly callous, but in terms of cost to society, forcing unvaccinated children out of school is almost certainly more detrimental.

[facing_the_fallout]

It isn't an even trade in terms of numbers; you're right. However, the goal ISN'T to force kids out of education. Some kids will be and that sucks, but the goal is to get them vaccinated and in school, or at least, educated in private schools so they aren't presenting the same dangers to public schools. And depending on implementation, you can affect how many kids end up in different situations (homeschooled/privately educated/vaccinated). You can couple it with awareness campaigns to increase social pressure to vaccinate. You can make it easier to get vaccinated (such as by having school clinics for free). You can demand some basic accountability in homeschool education, which, honestly, ought to happen anyway. I'm sure there are many other things that I don't know about, because I'm not a public policy maker. But the fact that you COULD just not do any of those things and let kids fall out of school doesn't mean that's a good idea. I support measures to promote vaccination and continued enrollment in appropriate schooling. Plus, the parents who choose not to vaccinate because they believe it's dangerous tend to be rich educated white people, many of whom can afford private school. Them, I'm not too worried about.

[speedyjohn]

[STA-CITE]>the goal ISN'T to force kids out of education [END-CITE]It may not be the goal, but it's a major forseeable consequence. [STA-CITE]>the goal is to get them vaccinated and in school, or at least, educated in private schools so they aren't presenting the same dangers to public schools. [END-CITE]As argued in the top comment, the vast majority of anti-vaxxers would end up home schooling their children, even if there are technically other options. [STA-CITE]>You can couple it with awareness campaigns to increase social pressure to vaccinate. [END-CITE]Or you could just do this on its own. [STA-CITE]>You can demand some basic accountability in homeschool education, which, honestly, ought to happen anyway. [END-CITE]Yes, this is something we should change. But right now, that doesn't seem likely. Besides, this is moving the goalposts a bit. Sure, if you get rid of all the reasons not to do something it's a fine idea. [STA-CITE]>But the fact that you COULD just not do any of those things and let kids fall out of school doesn't mean that's a good idea. [END-CITE]So is your view "vaccination should be mandatory for public school enrollment?" Or is it "vaccination should be mandatory for public school enrollment, provided there is also widespread reform in our education system"? [STA-CITE]>the parents who choose not to vaccinate because they believe it's dangerous tend to be rich educated white people, many of whom can afford private school [END-CITE]Source? In my experience, "rich educated" people tend to know that vaccines don't cause autism. It's the *uneducated* people we need to worry about. And there aren't a ton of rich uneducated people out there.

[facing_the_fallout]

[STA-CITE]>As argued in the top comment, the vast majority of anti-vaxxers would end up home schooling their children, even if there are technically other options. [END-CITE]Source? I don't believe this. [STA-CITE]>Yes, this is something we should change. But right now, that doesn't seem likely. Besides, this is moving the goalposts a bit. Sure, if you get rid of all the reasons not to do something it's a fine idea. [END-CITE]I disagree. It seems like it should be obvious that someone should follow up on those kids who suddenly left school due to this law. If it wasn't, then you have my apologies. This isn't a sweeping reform, this is a basic consequence of implementing a policy like this. This isn't "CMV: the worst possible way to mandate vaccines is a good idea." It's "CMV: a reasonably well-thought-out way to mandate vaccines is a good idea." Obviously the worst possible way is bad! [STA-CITE]>So is your view "vaccination should be mandatory for public school enrollment?" Or is it "vaccination should be mandatory for public school enrollment, provided there is also widespread reform in our education system"? [END-CITE]Vaccination should be mandatory for public school enrollment, and efforts should be made to provide vaccinations and vaccine education to those who refuse to vaccinate. No need for reforming schools. [STA-CITE]>Source? [END-CITE]http://sociology.about.com/od/Current-Events-in-Sociological-Context/fl/Everything-You-Need-to-Know-About-Anti-Vaxxers.htm

[z3r0shade]

[STA-CITE]> This is going to sound incredibly callous, but in terms of cost to society, forcing unvaccinated children out of school is almost certainly more detrimental. [END-CITE]I would disagree. A non-zero number of people who would not have vaccinated their children will do so as a result of it being mandatory. (For example parents who are on the fence or not quite anti-vax). Which means that mandatory vaccination will decrease, by some amount, the number of unvaccinated children. As a result of unvaccinated children we are seeing a resurgence of diseases that we haven't for decades such as measles. Thus it is much more detrimental to allow unvaccinated children in public school.

[OakTable]

What if you lose the medical records? Should your kid have to go through every single vaccination *again?* Shit happens. People move and things get lost, doctors retire/move away. Sometimes it's easier to just get a religious/personal belief exemption than trying to re-obtain the paperwork, if you even can. And if your kid has already had their shots, it would just be ridiculous to have them get stuck a dozen times all over again just to "prove" something to some "going through the motions" bureaucrat. There's no medical reason for it at that point.

[collegemathchef]

As a teacher, I agree with you. However, in my school law class, we discussed this issue at length and so I'll try to 'change your view' on one part regarding religion. As other have noted, school is mandatory in the United States. (Ever since the Supreme Court case *Society of Sisters* in 1925) Sure, there are exemptions such as private tutoring or private school, but these are not feasible for all people. Without any doubt, there are people who, due to circumstance, can only attend public school and are mandated to do so by Federal law. Now, courts have certainly tried to balance the liberty of the parents/student and the greater good in cases regarding education. One Constitutional issue that gets particular scrutiny is that relating to religion in First Amendment. First, there is the establishment clause, which basically says government cannot establish any sort of religion. Second, there is the free exercise clause which basically says government cannot prevent persons from freely practicing their religion. Now, we look at the issue at hand. Some religions expressly prohibit vaccination, and forcing them to get a vaccination would almost certainly been seen as a violation of the free exercise clause. Therefore, I wish to change your view on just this point: Medical AND Religious exemptions must be considered, or else this idea (similar to Jerry Brown's new law in California) will be struck down by courts on First Amendment grounds.

[facing_the_fallout]

[STA-CITE]>Medical AND Religious exemptions must be considered, or else this idea (similar to Jerry Brown's new law in California) will be struck down by courts on First Amendment grounds. [END-CITE]∆ You have me here. On the one hand, I don't feel strongly about the liberty/religious freedom argument in this area, which is why I didn't bring it up. But you're right; other people DO care about that, a lot, and without taking that into consideration such a policy would be unconstitutional and immediately struck down before any benefits could be reaped.

[DeltaBot]

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[Tullamore_Who]

Disclosure: I'm all for mandatory vaccinations *in general.* That being said, this is a tough subject to debate on Reddit because anyone defending the anti-vaccination crowd will be downvoted to the depths of Hades. I'd ask you to elaborate on your definition of "medically-appropriate" as this will be essential for further discussion. Playing devil's advocate, can you imagine certain rich or ethnically non-diverse communities asking their Board of Education (or equivalent) to add certain vaccinations to intentionally exclude students of a less-than-desired population (e.g., migrant non-English-speaking communities without knowledge and/or access to specialized hospitals)? You've many points worth discussing but with ANY policy, fines are the *worst* option because they disproportionately harm the poor. A $500 fine for a Jenny McCarthy suburban mom is nothing. $500 for the restaurant cleaner can literally obliterate their barely surviving status and move them to homelessness. Even % of income based penalties are unfair. 5% for Sepp Blatter does not hurt. 5% for the street sweeper does. Again, I'm all for vaccination. But curious to see your thoughts on the above.

[facing_the_fallout]

[STA-CITE]>I'd ask you to elaborate on your definition of "medically-appropriate" as this will be essential for further discussion. [END-CITE]If the doctor will give a certificate for it, you don't have to get the shot. I think it is okay for there to be some extra leniency here, because the intent is not to provide subpar medical care to those already suffering. [STA-CITE]>Playing devil's advocate, can you imagine certain rich or ethnically non-diverse communities asking their Board of Education (or equivalent) to add certain vaccinations to intentionally exclude students of a less-than-desired population (e.g., migrant non-English-speaking communities without knowledge and/or access to specialized hospitals)? [END-CITE]I can. However, my understanding is that it is mainly better-off, white parents who oppose vaccinations on moral grounds (edit: [and at least one source agrees this might be so](http://sociology.about.com/od/Current-Events-in-Sociological-Context/fl/Everything-You-Need-to-Know-About-Anti-Vaxxers.htm)). Not always, but disproportionately. As a result, I think this would be difficult for a board to pull off without alienating other privileged groups. Also, I think vaccines would probably need to be free (or ludicrously low-cost, say, a couple of dollars) for mandatory vaccines to be fair to everyone. I should have said so in my OP, and that's my fault for forgetting that caveat. In my area you can get free vaccines, but I'd bet my life it's not true everywhere in the US. [STA-CITE]>You've many points worth discussing but with ANY policy, fines are the worst option because they disproportionately harm the poor. A $500 fine for a Jenny McCarthy suburban mom is nothing. $500 for the restaurant cleaner can literally obliterate their barely surviving status and move them to homelessness. Even % of income based penalties are unfair. 5% for Sepp Blatter does not hurt. 5% for the street sweeper does. [END-CITE]I actually agree that fines are very problematic, and a poor solution to the issue of noncompliance. I just don't have a better idea. I'm not sure a suggestion of a better system of compliance would count as C'ing MV, since I don't have a firm plan to begin with. But if there were a really good way to handle it, I'd be all ears.

[Tullamore_Who]

I think you might have misunderstand my first point (and in fairness, that means I didn't convey it clearly)... We currently have a generally accepted list of vaccinations for newborns/toddlers/kids. As devil's advocate, was proposing a random community choosing to expand this list to intentionally exclude an undesired demographic. Getting a doctor to sign off on an exemption for a migrant worker (think of: people w/ limited English picking veggies in the field) is not as easy as it sounds. In fact, it can be terrifying. -- You're right that it's generally the privileged that are opposing vaccinations. All I can say is that with so many policy mishaps in the past, society fails when it addresses the short-term without realizing the long-term implications (as in, imagine the first paragraph happening 5 years hence). --- I would take vaccination costs further. If they are *mandatory* for access to a public system (education), they need to be free. Feel that you won't disagree on this one but just throwing it out there. --- Will add that this discussion excites an entirely different debate re: illegal immigrants. In the future, can't you imagine privileged communities using the vaccination debate to force the non-documented workers to expose themselves to public scrutiny? **This CMV is not about illegal immigration** (left to another CMV) so I bring it up only as a very plausible example of how mandatory vax-policy can be used for non-community-health reasons. --- Yeah, enforcement is a very difficult issue so appreciate your honesty. Again, I'm personally for vaccinations in public schools (for FREE). Fines always suck for the poor. But using the bad case scenarios highlighted above... how would barring migrant workers' kids from attending school help society (beyond the community health benefits)? Homeschooling and e-schooling is ONLY viable for middle-class or above families. This is something so many people fail to realize (when it comes to many education-related topics). Thoughts?

[facing_the_fallout]

[STA-CITE]>Getting a doctor to sign off on an exemption for a migrant worker (think of: people w/ limited English picking veggies in the field) is not as easy as it sounds. In fact, it can be terrifying. [END-CITE]You're not wrong, and that's absolute shit. But that's a symptom of a larger problem; the fact that we have such terrible healthcare provisions for the poor, and translation ranges from okay to horrendous. Immunocompromised children of poor migrants are pretty fucked, but I think it's way more likely that it will be because they aren't getting medical care in the first place than that they are forced into vaccines. After all, if they're lucky enough that someone has diagnosed them as being immunocompromised, the doctors should all know that YOU DON'T VACCINATE THEM. Surely there are some terrible doctors...but as someone studying to work in health professions, it would be incredibly rare for a pediatrician or immunologist to not know that you don't do that. TL;DR yes those kids are screwed, but not because they're getting vaccines. They're screwed because no one is going to notice or treat their health problems to begin with, so their parents wouldn't even know to try to avoid vaccines. [STA-CITE]>I'm personally for vaccinations in public schools (for FREE) [END-CITE]I agree, and it's the most straightforward system I can come up with off the top of my head that would work here. Free shots that the school nursing staff can administer. Otherwise, you have issues like how do poor parents find time and transport to the clinic, etc. Other systems could work too, though, such as having special clinics, home health visitors (I understand this is common practice in many countries, including the UK), or offering vaccination at some other public service station. [STA-CITE]>In the future, can't you imagine privileged communities using the vaccination debate to force the non-documented workers to expose themselves to public scrutiny? [END-CITE]Sure, it could happen. The problem is that these types of objections don't seem grounded in current reality. Future reality? It's possible. I don't have a crystal ball. But many, many laws are like that, and the best we can do is solve these problems when they come up. Personally, it seems that the laws that require providing proof of residence would do a much better job of fucking over the poor and undocumented that vaccination laws, and for a whole lot less benefit. Dunno if it's everywhere, but to attend my public US high school, I had to bring in proof of residence every year.