iStock_000011003532LargeVaccinations or rather, the lack thereof – has been a hot topic in the news lately. The media is reporting increased outbreaks of communicable diseases with the finger pointed at those individuals who choose to not vaccinate out of a fear, amongst others, that vaccinations cause autism.

Studies conducted in the scientific community have largely discredited any association between vaccinations and autism.  Most recently, a March 2013 study published in the Journal of Pediatrics concluded that there is no causal relationship between vaccines administered in the first two years of life and autism.

So with this in mind, can anyone be legally forced to vaccinate? In Nebraska, school age children attending private or public school are required to be immunized for Diptheria, Tetanus, Pertussis, Polio, Measles, Mumps, Rubella, Hepatitis B, and Varicella (Chicken Pox). Nebraska hospital employees are required to be vaccinated for various diseases including Influenza and Hepatitis B.

Currently, all 50 states, including Nebraska, require certain vaccinations for children entering public and private schools. All states except for Mississippi and West Virginia permit religious exemptions for vaccinations and twenty states allow exemptions for philosophical reasons.  Nebraska does not include an exemption for philosophical reasons but allows exemption for medical reasons or religious beliefs.  As a result of recent outbreaks of previously controlled diseases, many have urged for religious and philosophical exemptions to be eliminated or severely limited in scope.  (There may be constitutional issues with limiting such exemptions.  I will leave this discussion for another day).

There is no federal legislation requiring vaccinations. When necessary, the federal government uses quarantine and isolation to halt the spread of communicable diseases.

Dr. Kristen Feemster, a pediatric infectious disease physician at the Children’s Hospital of Philadelphia writes in a New York Times Op-Ed that it is the “scientific and public health community’s responsibility to … ensure the health of the communities in which they live.” In order to close the “vaccine confidence gap” she encourages the public health community to provide accurate and clear information on vaccinations:

“We are fortunate to live in an era when we rarely see many vaccine-preventable diseases — the risk of these diseases seems minimal while the perceived risk of vaccination becomes larger. This is compounded by the proliferation of misinformation, readily available from the news media and other sources. This has resulted in what many describe as the ‘vaccine confidence gap.’ There is no doubt that this gap needs to be addressed. It is the responsibility of the scientific and public health community to ensure that vaccines are safe. It is that community’s responsibility to listen to concerns and provide accurate and clear information.”

I think Dr. Feemster’s message is spot on – the public health of our communities continues to be at risk unless the “vaccine confidence gap” is bridged.