Choices regarding vaccines must be clarified

Dear Editor:
ARE YOU ASKING THE RIGHT QUESTION? It is unfortunate that an article regarding an opportunity to protect individuals and communities from vaccine-preventable diseases got sidetracked and ended with a poll question that skews the issue: “Do you think parents should be able to choose which vaccinations their children receive?”
Yes, there is an issue of choice – but the choices/options must be correctly identified and fairly presented so that their implications/potential consequences can be evaluated and considered in making the decision. To poll readers regarding whether or not parents should have free personal choice of what vaccines their children receive misses the point, as it fails to correctly identify the choice and the social context.
In this poll, the “choice” refers to parental choice regarding what, if any, vaccines their child will receive. It is presented as a personal choice with consequences for just that child. The question basically asks about “free choice” – yes or no. Since “freedom” is what this country has been founded on, it’s almost unpatriotic to not choose “choice”! It’s a rather loaded question with a predictable outcome.
But, by their very nature, vaccines have consequences extending well beyond the individual. Protecting a high number of individuals within a community also collectively protects through herd immunity those members who cannot be immunized due to age, medical condition, or religious belief. In this society, if everyone were to opt for egocentric “free choice,” there would be unhealthy and downright deadly consequences. (Consider the trends in those areas which have relaxed mandates for certain basic vaccines. The current pertussis outbreak in California is a case in point.) Asking a question focusing on “vaccine choice” ignores the reality that, although vaccines are given to individuals, what’s at stake is really the public’s exposure to vaccine-preventable disease.
If the choice is more correctly identified as disease vs. no disease, rather than vaccine vs. no vaccine, the response may be different. Asking “Do you think parents should be able to choose to allow their children and, by extension, their community to be vulnerable to vaccine-preventable diseases?” redirects the conversation.
It is vaccine-preventable disease that should be the focus. Vaccine-preventable diseases are still a threat to public health. We should be clear about what we are really choosing.

Leslie Leonard
A public health nurse and president of Greater Passaic Valley Public Health Nurses’ Association

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