Should vaccinations be compulsory?

Health secretary Matt Hancock recently announced that he wouldn’t rule out making childhood vaccinations mandatory, though he hoped it wouldn’t come to that. Speaking on Radio 4’s Today programme, he said: “Failure to vaccinate when there isn’t a good reason is wrong. These people who campaign against vaccinations are campaigning against science.”

Mr Hancock made these comments after a report in The Times stated that nearly 40,000 parents in the UK had signed up to an online group that urges people not to immunise their children against potentially fatal diseases. It seems the anti-vaxxers are gaining traction, and that many are reluctant to immunise their children due to fears that the vaccinations could do more harm than good.

The health minister was reported by The Times as saying that vaccines are “good for you, good for your children, and good for your neighbour” and that “those who have promoted the anti-vaccination myth are morally reprehensible, deeply irresponsible and have blood on their hands”.

According to Unicef, more than half a million children in the UK were not vaccinated against measles between 2010 and 2017. And while the World Health Organization (WHO) declared the UK free of measles in 2017, small outbreaks were reported in 2018, and a sharp rise in cases was recorded across Greater Manchester in March 2019.

So should immunisation against diseases like measles be compulsory or a matter of choice?

Yes, vaccinations should be compulsory

According to Paul Offit, chief of infectious diseases at the Children’s Hospital of Philadelphia and University of Pennsylvania School of Medicine, compulsory vaccination is a necessary measure. He argued in The BMJ that “measles causes pneumonia and brain damage, mumps causes deafness and sterility, rubella causes severe birth defects, pertussis causes suffocation, and human papillomavirus (HPV) causes cervical, oropharyngeal, and anal cancers” and points out that vaccines “stand on a mountain of scientific evidence”.

Mr Offit claims that fake news is driving the anti-vaxxing movement and that parents are making “bad decisions based on bad information”. He believes that children have died needlessly because parents have chosen alternative treatments over those that are tried and tested, and that failure to vaccinate children not only affects the family in question, but any other children they come into contact with.

“Is it a parent’s right to make decisions that affect the health of others?” he asks. “Someday we may live in a world that doesn’t scare parents into making bad health decisions. Until then, vaccine mandates are the best way to ensure protection from illnesses that have caused so much needless suffering and death.”

No, vaccinations shouldn’t be compulsory

Director of immunisation at the Department of Health in London, David M Salisbury gives the other side of the argument. He points out that forcing people to vaccinate has proved counterproductive and divisive in the past, with many parents resenting state interference. He also notes that forced immunisation would potentially be ineffective, as the peak age for measles cases between 1998 and 2010 was under five, meaning that compulsory vaccination for school entry would come too late.

Mr Salisbury claims that while “hostile reporting, polarised views, and credibility given to ill-informed opinions after claims of a link between autism and the measles, mumps, and rubella (MMR) vaccine in the late 1990s” caused a 10% decline in national immunisation coverage, compulsory MMR vaccination was never considered.

“It would probably have made matters much worse,” he writes. While he does not dispute the fact that vaccinations are vital, he believes that there is little evidence that compulsory immunisation has raised and sustained immunisation coverage. “Compulsion would be unenforceable, unnecessary, and its use would probably do more harm than good,” he concludes.