Forced Vaccination vs Vaccine Choice

Vaccine Basics

Talk to your pediatrician if you have any questions about your child's vaccines.
Talk to your pediatrician if you have any questions about your child's vaccines.. Photo by Getty Images

Forced Vaccination

Listening to some parents online, you would think that doctors are going to start holding down babies and force them to get vaccinated to follow the CDC immunization schedule.

Is there any truth to that?

Of course not.

Have kids ever been forced to get vaccinations?

Not routinely, but there have been a few cases of health officials getting court orders to get kids vaccinated and protected, especially during outbreaks of a vaccine preventable disease.

In 1991, for example, a judge ruled that parents of unvaccinated children who were members of the Faith Tabernacle Congregation in Pennsylvania had to get a measles vaccine. As a measles outbreak spread through Faith Tabernacle, an associated church, and the rest of the city, there were at least 486 cases of measles in the church, mostly among children, and 6 deaths.

In addition to being unvaccinated, these children didn't get any medical care, as their families instead relied on prayer. Finally, after the order was appealed all the way to the state Supreme Court, only nine children got vaccinated.

Vaccine Mandates

Instead of any kind of forced vaccination plan, we do have vaccine mandates. And although some people equate vaccinate mandates with forced vaccination, they are certainly not the same thing.

Most of today's vaccinate mandates are simply requirements to get certain vaccines to attend school and daycare.

Some employers are also starting to institute some vaccine mandates as a requirement for employees to keep their job.

In all of these situations, vaccines are mandated to protect children and adults from vaccine-preventable diseases. This includes protecting those who are too young to be vaccinated and who can't be vaccinated because they have medical exemptions.

Forced Vaccination vs Vaccine Choice

Do vaccine mandates take away a person's choice about getting vaccinated?

Of course not.

Again. We are not talking about forced vaccination.

For example, if you work in a hospital that requires a yearly flu vaccine, you can decide to work somewhere else. Sure, you no longer simply have the choice between getting vaccinated or leaving yourself unprotected and continuing to work at the same job, but you can still decide to skip the vaccine and look for another job.

The same is true with vaccine mandates for kids to attend school or daycare. If you choose to skip one or more vaccines for a non-medical reason, then even if you are in a state that doesn't allow religious or philosophical vaccine exemptions, you won't be forced to get vaccinated. While it may not be an option you are happy with, homeschooling is usually an option for those who don't want to vaccinate their kids.

That is your vaccine choice.

Public education is a benefit of those who comply with vaccine mandates and compulsory vaccination laws.

Informed Consent

One of the newer arguments among those who oppose vaccines, especially through vaccine mandates, is that getting these vaccines takes away a person's informed consent.

Although some of these parents may be taking a libertarian argument against mandated vaccines, many are just turning it into yet another anti-vaccine talking point.

Can you make informed consent to something that is mandated?

Of course you can. Just as you can choose not to do it. Again, these are mandates with a choice.

While not generally defined by state vaccine laws or even the federal National Childhood Vaccine Injury Act of 1986, "vaccination generally would be covered under laws that more generally address consent for health care."

What is informed consent?

According to Black's Law Dictionary, informed consent allows "patients to voluntarily consent to medical interventions by reasonably balancing the probable risks against the probable benefits."

The American Academy of Pediatrics has long recommended that pediatricians obtain informed consent from parents, and when possible, assent from their patients.

Although they aren't specifically meant to be informed consent documents, the Vaccine Information Statements that parents receive before their children are vaccinated, which cover the risks and benefits of each vaccine, are thought to provide sufficient information to adequately inform parents.

They include information about:

Each vaccine information statement also includes information about the Vaccine Adverse Event Reporting System (VAERS) and the National Vaccine Injury Compensation Program (NVICP).

Vaccine Choice vs Misinformation

Interestingly, those who choose to delay or skip vaccines because of this talk about informed consent or other antivaccine misinformation are actually the ones least likely to be making a choice based on informed consent.

They are typically making a risk/benefit assessment using missing or misleading information, often provided by one-sided articles and discussions in anti-vaccine websites and forums.

For example, I was recently banned from posting on the immunization education website of Bob Sears. And although they state that they are "dedicated to providing balanced and objective information regarding immunizations and infectious diseases in order to equip consumers to make educated decisions in partnership with a health care provider," they admitted that "people already get your side of the information so we do not need relay that again- we are providing the other side of the information so they have access to all of it."

Keep in mind that this type of censorship on anti-vaccine websites is the norm.

That's not informed consent.

As part of the informed consent for delaying or skipping vaccines or following a non-standard, parent-selected, delayed protection vaccine schedules, vaccine-friendly pediatricians and groups also have an obligation to discuss:

Instead, they typically focus on all possible risks (not likely or probable or even rare risks), most of which are unlikely and have even been shown to not be associated with vaccines.

Again, that's not informed consent, especially when most of these sites routinely censor and ban anyone who disagrees with what they are saying.

If a health care provider makes statements associating vaccines with SIDS, shaken baby syndrome, or peanut allergies, etc., or starts talking about homeopathic vaccines, they aren't providing informed consent about vaccines.

But don't they need to give the "other side" of the vaccine injury story? Isn't that real informed consent, getting ALL of the information?

Not when the "other side" has been disproven and relies on conspiracy theories to keep it going. In addition to overstating the risks of vaccines, they go all the way from the false ideas that vaccines don't really work and that many vaccine-preventable diseases went away because of better hygiene alone to conspiracy theories about Big Pharma.

Parents aren't making a real choice about vaccines when they rely this kind of misinformation.

Making you afraid of thimerosal, aluminum, formaldehyde, human DNA, and every other vaccine ingredient, both real and imagined, simply pushes parents into the decision to skip or delay vaccines. It also pushes an omission bias - not acting (skipping vaccines) vs acting (getting vaccinated).

Don't let your vaccine choices be influenced by anti-vaccine misinformation.

Get Educated. Get Vaccinated. Stop the Outbreaks.


American Academy of Pediatrics Committee on Bioethics. Informed Consent, Parental Permission, and Assent in Pediatric Practice. Pediatrics. Feb 1995, 95 (2) 314-317.

Ciolli, Anthony, JD, MBE. Mandatory School Vaccinations: The Role of Tort Law. Yale J Biol Med. 2008 Sep; 81(3): 129–137.

Gust, Deborah A. Parents With Doubts About Vaccines: Which Vaccines and Reasons Why. Pediatrics. October 2008, VOLUME 122 / ISSUE 4

English, Abigail. Legal Basis of Consent for Health Care and Vaccination for Adolescents. January 2008, VOLUME 121 / ISSUE Supplement 1

Malone, Kevin M. Vaccination Mandates: The Public Health Imperative and Individual Rights.

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