Vindicating the Vaccine: Injecting Strength into Mandatory School Vaccination Requirements to Safeguard the Public Health
Vindicating the Vaccine: Injecting Strength into Mandator y School Vaccination Requirements to Safeguard the Public Health
James Lobo 0 1 2
0 Boston College Law School
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2 James Lobo, Vindicating the Vaccine: Injecting Strength into Mandatory School Vaccination Requirements to Safeguard the Public Health , 57 B.C.L. Rev. 261, 2016
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1 See Rong-Gong Lin II, Measles Outbreak Spreading Beyond Disneyland Visitors, L.A. TIMES
(Jan. 17, 2015),
http://www.latimes.com/local/orangecounty/la-me-0118-measles-outbreak-20150118story.html#page=1 [http://perma.cc/F52E-5PG5]. The identity of patient zero is yet unknown, but the
first patient to be referred to the California Department of Public Health was an 11-year-old
unvaccinated child who had visited one of the Disney theme parks during the exposure period. See Jennifer
Zipprich et al., Measles Outbreak—California, December 2014-February 2015, CTRS FOR DISEASE
CONTROL & PREVENTION MORBIDITY AND MORTALITY WKLY. R. (Feb. 20, 2015), http://www.cdc.
gov/mmwr/preview/mmwrhtml/mm6406a5.htm?s_cid=mm6406a5_w [http://perma.cc/86FM-6NDR].
Arizona.2 In response, health officials in Orange County, California—a region
with high rates of parents who opt out of vaccinating their children—ordered
about two dozen high school students without proof of immunization to stay
home after learning that an infected student had come to school following the
school’s winter break.3
Vigorous vaccination practices largely eradicated measles in the western
hemisphere in the 1990s, but many of those infected via this Disneyland
outbreak were unvaccinated.4 A study by researchers at MIT, Boston Children’s
Hospital, and Harvard Medical School indicated that substandard vaccination
rates likely caused the rapid spread of the outbreak.5
It is not surprising that the disease found a foothold in the parts of
California where vaccination levels for schoolchildren are markedly low, a
reflection of an “anti-vaccination” movement that has developed in isolated but
notable pockets across the nation.6 The “anti-vaccinationists” object to childhood
inoculation on various grounds, but most commonly for religious or
philosophical reasons, or because of beliefs that vaccines are unsafe.7 But as the
movement gains traction and more and more parents refuse to vaccinate their
children, the risks of a public health crisis, as evidenced by the Disneyland
measles outbreak, grow increasingly real.8
2 See Rong-Gong Lin II et al., As Disneyland Measles Outbreak Spreads, O.C. Bars Students
Lacking Proof of Shots, L.A. TIMES (Jan. 20, 2015),
http://www.latimes.com/local/orangecounty/lame-measles-huntington-beach-20150121-story.html#page=1 [http://perma.cc/CJ8R-3C6W]; see also
Measles Cases and Outbreaks, CTRS. FOR DISEASE CONTROL & PREVENTION, http://www.cdc.gov/
measles/cases-outbreaks.html [http://perma.cc/YQ5F-HLLU] (showing a map of the states and the
number of people affected by the Disneyland outbreak).
3 See Lin et al., supra note 2.
4 See Lin, supra note 1; Zipprich et al., supra note 1 (providing statistics on vaccination rates of
patients involved in the Disneyland outbreak). Measles presents as a rash but can spread surreptitiously
for up to four days before any symptoms appear. See Bill Briggs, Measles Outbreak Spreads in
California, Other States, NBC NEWS (Jan. 19, 2015),
http://www.nbcnews.com/health/health-news/measlesoutbreak-spreads-california-other-states-n289091 [http://perma.cc/3T8U-KLTM].
5 See Maimuna Majumder et al., Research Letter, Substandard Vaccination Compliance and the
2015 Measles Outbreak, 169 J. AM. MED. ASS’N PEDIATRICS 494, 494 (2015) (showing that
immunization rates that fell far below the required threshold contributed to the outbreak’s spread).
6 See Lin, supra note 1; see also Press Release, Kaiser Permanente, Study Identifies Geographic
Clusters of Underimmunization in Northern California (Jan. 18, 2015), http://share.kaiserpermanente.
org/article/study-identifies-geographic-clusters-of-underimmunization-in-northern-california/ [http://
perma.cc/7WA8-RJML] (using electronic medical records and spatial analysis software to document
hot spots of underimmunization and vaccine refusal among the company’s members).
7 See Steve P. Calandrillo, Vanishing Vaccinations: Why Are So Many Americans Opting Out of
Vaccinating Their Children?, 37 U. MICH. J.L. REFORM 353, 388 (2004) (documenting the common
religious and philosophical objections to vaccinations and highlighting (...truncated)