Should Canada mandate the vaccination of schoolchildren?

Posted By Jessica Walsh – Jan. 28, 2014

Vaccines have been saving lives since the late 18th century. Thanks to vaccines, smallpox has been eradicated and diseases like polio and measles may soon be eliminated.  

Vaccines stimulate the production of antibodies to provide immunity against diseases through the injection of weakened or killed infectious organisms. They also create herd immunity: when enough people in a community are immune to a disease due to vaccination or prior illness, the disease cannot easily spread. With herd immunity, even unvaccinated individuals may be protected given the lower possibility of disease transmission.

Vaccination in Canada

Despite these benefits, Canada, as a country, does not have a general vaccination policy. The federal government seems reluctant to enter into the debate, preferring to leave vaccination as a matter of provincial health jurisdiction. The Canadian Public Health Agency highly recommends that parents vaccinate their children against preventable diseases. However, only three Canadian provinces mandate children to be vaccinated before entering the school system.

Ontario and New Brunswick require vaccination against diphtheria, tetanus, polio, measles, mumps, and rubella, while Manitoba demands vaccination against measles. In each of these provinces, legislation allows parents to receive exemptions from vaccination on medical, religious or ethical grounds.  In the case of a disease outbreak, an unvaccinated child may be quarantined or asked to stay home.

If an exemption is not granted, parents may face fines as a consequence for not vaccinating their children. For example, in Ontario, parents can be penalized with a fine of up to $1000 for failure to vaccinate. Children may also be suspended from school in Ontario for up to 20 days for failing to produce their immunization record. In 2013, about 900 high school students in Ottawa were suspended for not providing proof of immunization or special exemption.

The Global Perspective

Vaccination policies vary internationally. All American states require children to be vaccinated before entering school. There are exemptions available on religious, medical and ethical grounds, which vary depending on the state. Some countries, like Australia, provide financial compensation to parents for vaccinating their children. Slovenia has an extremely stringent vaccination policy with exemptions only available for medical reasons.

The Debate Over Compulsory Vaccination

The debate over compulsory vaccination hinges on the competing interests of public safety versus personal liberty. Some vaccine opponents simply view the mandatory injection of a foreign substance into their bodies as an unacceptable infringement on their personal liberty by the state. Other opponents regrettably cling to a discredited 1998 study that mistakenly linked the Measles, Mumps and Rubella vaccine to autism in children to promulgate the view that vaccines are unsafe.

Yet vaccine supporters, such as the Canadian Public Health Association, argue that vaccines are among the safest tools of modern medicine and that side effects are rare. The World Health Organization has even produced a myth-busting webpage to counter misinformed opinions on vaccination.

Still, there is a difference between deciding to vaccinate oneself or one’s children and deciding to mandate vaccination for all children of a province. According to the Canadian Medical Association Journal’s Erin Walkinshaw, there is little interest in Canada to implement a strict mandatory vaccination policy. If more legislated policies like Ontario’s were adopted, it seems critical that there be wide room for exemptions to still provide parents with a degree of choice. As well, some Canadian health officials do not believe there is much to be gained by introducing more mandatory vaccination schemes since most children in Canada already get immunized.

However, compulsory vaccination schemes for schoolchildren should not be ruled out for other provinces. At a time when countries like the UK have seen decreasing vaccination rates and the return of diseases like measles, government legislation of vaccinations could be an important step by provinces to manage public health risks. At the very least, the provinces must continue to educate the Canadian public about the safety and importance of vaccines to counter growing misinformation.

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