Emily Long

8 April 2015
CAS138T
Persuasive Essay
Movement Towards Immunity
In the last month of 2014, flocks of vacationers traveled to Disneyland to celebrate the
holidays. While families enjoyed their time at the happiest place in the world, a virus was
maliciously spreading through the air. The measles, which is declared eliminated from the United
States, was silently threatening the visitors. After reports were released announcing the spread of
measles beginning at Disneyland, many vacationers could have a sense of ease knowing they
received the measles vaccines. However, one family lived with unsettled fear because their
daughter was not vaccinated, and could not be vaccinated. Rylee is a leukemia patient, who was
enjoying a break from her chemotherapy with her family at carefree Disneyland (Smith,
Patricia). After her parents learned about the outbreak, they worried everyday Rylees weakened
immune system would be compromised by the measles.
Fortunately, Rylee did not have to face the taunting battle with the measles, but due to the
nature of the measles, many were not as fortunate. The virus spread, and 178 cases nationwide
have been reported (Measles Cases and Outbreaks). Measles is very contagious, and can be
transmitted by simply sneezing or coughing. The virus can linger for two hours, infecting nine
out of ten people exposed, who are not immune via vaccination (Smith, Patricia). The origin of
this outbreak was an amusement park, during the busiest time of the year, allowing for the virus
to create a battleground amongst travelers to carry back to their homes.
Measles outbreaks are now rare in the United States, but outbreaks, such as the one at
Disneyland, have been documented in areas with high rates of unvaccinated children
(Introduction to Should Vaccinations By Mandatory?). In order to prevent future outbreaks,

every school-aged child without medical exemptions will receive the measles vaccines, to protect
themselves, as well as, the people around them who cannot endure the vaccination for
physiological reasons.
Despite the risk associated with the unvaccinated population, an antivaccination
movement is spreading across the United States. This movement roots from a medical journal
published in 1998, mentioning a possible link between the measles-mumps-rubella (MMR)
vaccine and autism (Smith, Patricia). Medical Research Council and the UK Committee for the
Safety of Medicines refuted this journal because there is no evidence of a link between autism
and the MMR vaccine. The research paper had a strong selection basis of only 12 children,
which manipulated the results (Edwards, Carolyn). To assure the safety of vaccines, the U.S.
Food & Drug Administration (FDA) conducts approximately 15 years of researchers and
dedicates millions of dollars into researching the vaccines to ensure safety for the children
receiving immunization (Vaccine Safety). Although the current scientific evidence shows no
connection with autism and carefully researches drugs before use in clinical settings, fear still
lingers among parents today when it is time to take their child to the doctors office to receive the
shots required to attend school.
Members of the anitvaccination movement and numerous others view vaccination as a
personal decision, but refusing vaccination may put many others who cant receive vaccinations
for medical reasons at risk. Cancer patients, like young Rylee, citizens with vaccine allergies and
immune system disorders physically cannot receive vaccinations. Their only way to gain
immunity from diseases is through herd immunity- the idea that if the community is immunized
against a virus, the members of the community are protected against the virus because the chance
of an outbreak is slim (Community Immunity). Therefore, refusing to receive vaccinations not

only directly jeopardizes the child in question, but also endangers the children who do not have a
choice.
In order to create herd immunity for those with medical exemptions, and decrease the
number of outbreaks throughout the United States, legislation should be implemented in all states
stating all school children must obtain two doses of the MMR vaccine. The only exception to this
law is medical exemptions signed by a physician and approved by the local health officer. All
vaccination requirements will be assessed annually through the school and its nursing staff.
Every state has requirements for children to be vaccinated before attending school, but
medical, religious, and philosophical exemptions are currently given, depending on the
individual states policy. All fifty states allow medical exemptions. Forty-eight states, excluding
Mississippi and West Virginia allow religious exemptions, and seventeen states allow
philosophical exemptions (NVIC). With the freedom to exempt for religious and philosophical
reasons, many anitvaccinaiton parents are using the route to avoid what they believe is putting
their child at risk. Along with the anitvaccination movement, the number of religious and
philosophical exemptions have risen exponentially. Elimination of religious and philosophical
exemptions would prevent this caveat.
According to the policy proposed, only medical exemptions should be approved.
However, 48 states currently allow religious exemptions. These exemptions based on spiritual
beliefs can lead to unvaccinated communities. When a religious group exempts from vaccination,
they put themselves and the unvaccinated around them at danger for a rapid outbreak. The virus
spreads quickly among those that are unvaccinated, causing an outbreak in religious
communities. An example is a 2013 measles outbreak. A Jewish Orthodox community in
Brooklyn, New York was exempt from vaccination for religious reasons. Fifty-eight cases of the

measles were identified in Brooklyn, all of which were in the Jewish Orthodox community
(Notes from the Field). Other cases similar to the Jewish Orthodox outbreak have been reported,
highlighting the negative effects of concentrated cases of religious exemptions.
With every able child receiving the vaccine the chance of an outbreak significantly
decreases. In 1989 an outbreak of measles spread through school children. The Advisory
Committee on Immunization, the American Academy of Pediatrics, and the American Academy
of Family Physicians implemented the widespread recommendation that all children should
receive a second dose of MMR vaccine, which led to a decline in cases of the measles (Measles
History). This recommendation was widely accepted. Many school children received a second
dose of the MMR vaccine. The second dose boosts immunity higher than a single dose alone.
With this trend in vaccination, the measles was declared eliminated in the United States in 2000.
The vaccine program increasing the number of measles vaccinations proved to be
successful. However, between 2004-2008 an upward trend began as more and more patients
claimed vaccination exemptions for personal beliefs, such as religious and philosophical beliefs.
This trend correlated with an increase in measles outbreaks. Between 2001 and 2008, a total of
285 United States residents filed cases of the measles (Fiebelkorn, Amy Parker, et al). All of
these cases are classified as preventable measles, meaning they were medically able to receive
immunity through vaccination, but chose not to do so. The connection between unvaccinated
individuals and measles cases proves to be significant, and endangers the nations measles free
status.
Due to the high correlation between personal exemptions and measles outbreaks, West
Virginia and Mississippi currently execute the proposed policy, only allowing medical
exemptions. Other states do not currently implement this policy because it would infringe on the

First Amendment right to exercise religious beliefs. West Virginia and Mississippi overrode the
religious and philosophical exemptions based on a compelling state interest from a statewide
epidemic. The 1905 Supreme Court case Jacobson v. Massachusetts proclaimed that religious
and philosophical rights can be denied, if it is the best interest of the state. The 1905 Supreme
Court case focused on the governments right to protect public health vs. the protection of
personal freedoms (Mariner, Wendy). School vaccinations are not considered as a personal rights
issue because herd immunity is in the best interest of the entire community in virus protection.
The execution of the policy has proven to be effective in reducing the risk of measles
outbreaks. West Virginia has a vaccination rate of 97% among school children ages 5 to 18, and
has not had a measles outbreak in over two decades (Nuzum, Lydia). There has not been a
reported case of the measles in Mississippi since 1992, and the vaccination rate is 99.7% among
school children (National Measles Outbreaks Cause Concern). If implemented in every state in
the U.S., similar results will show a strengthened nationwide immunity.
In West Virginia, Mississippi, and several other states a letter from a licensed physician is
required for medical exemption. A medical doctor must write a letter describing the medical
reason the child cannot receive the required vaccination. Reasons can include chemotherapy,
allergies, and other treatments or diseases resulting in a comprised immune system. The letter
must indicate the length of time, whether a brief treatment or a lifelong disease, that the child
cannot receive the vaccination. Then, the letter is sent to the local health officer for approval.
Letters and approval are important to insure all able school children are vaccinated. Also, in case
of a measles report the student with an approved exemption can be notified to stay home until the
case has cleared (National Measles Outbreaks Cause Concern).

In order to insure compliance, vaccination data collected annually in West Virginia is sent
to the Centers for Disease Control and Prevention Services. All private and public schools
administer a survey regarding the vaccinations of school age children each academic year. This
data is then sent to the Centers for Disease Control and Prevention Services (CDC). Systematic
data collection closely watches the rates of immunization, and shows which students need to be
vaccinated. Processes through educational systems will insure all parents adhere to the
vaccination policies.
To create a feasible solution, West Virginia and Mississippi provide vaccinations to all
children whose families cannot afford them through the Vaccines for Children (VFC) program.
Any child younger than 19, who is uninsured, underinsured, an American Indian, or an Alaska
Native, is eligible for the funding (Vaccines for Children Program). In West Virginia, all health
departments statewide accept the VFC program. In Mississippi, Public Health, Federally
Qualified Health Center, and Community/Rural Heath Center administer vaccines to the children
in the VFC program. Therefore, all children have access to the mandatory vaccinations. To
successfully administer the policy presented, all states would implement a VFC program to allow
all socioeconomic families to receive immunity, and aid in the immunity of others, creating a
safer learning environment.
In the future the minuscule fees of vaccination will replace the substantial bills for
treatment of measles. As shown in a Shot at Lifes Value of Vaccination, the effects of increasing
the use of vaccination worldwide brings billions of dollars in benefits. The economics of
vaccinations is broken into two parts, economic yield of vaccinations and the billions of dollars
in treatment cost savings. In total, vaccinations are projected to create $151 billion dollars

worldwide by 2020 (OBrien, Kate). The implementation of the policy to require vaccinations
without the options of religious and philosophical exemptions will result in economic benefits.
Eliminating the exemptions before a statewide epidemic is proactive, and can save lives
and billions of dollars in treatment savings. The rapid spread of the measles virus in schools and
throughout the nation can be combated by immunization via vaccination requirements at an early
age. About one million children die from the measles virus each year, according to Canada
Research Chair Eric Fombonne (Krakow, Eve). With the elimination of religious and
philosophical exemptions, herd immunity will be developed, and ultimately reduce the chance of
a measles outbreaks in the United States.

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