Episode 139: Shots or Not? The Ethical Tug-of-War Between Parental Rights and Community Health

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Welcome to another episode of K12 Education Untangled. My name is Dr. Kim J. Fields, former corporate manager turned education researcher and advocate, and I'm the host of this podcast. I got into this space after dealing with some frustrating interactions with school educators and administrators, as well as experiencing the microaggressions that I faced as an African American mom raising my two kids who were in the public school system. I really wanted to understand how teachers were trained and what the research provided about the challenges of the public education system. Once I gained the information and the insights that I needed, I was then equipped to be able to successfully support my children in their educational progress. This battle tested experience is what I provide as action steps for you to take. It's like enjoying a bowl of educational research with a sprinkling of Mother Wisdom on top. If you're looking to find out more about current information and issues in the public education that could affect you and your children and the action steps that you can take to give your children the advantages they need, then you're in the right place. Thanks for tuning in today. I know that staying informed about K12 public education trends and topics is important to you, so keep listening. Give me 30 minutes and I'll untangle the latest trends, issues and topics pertaining to this constantly evolving K12 public education environment. In this episode, I'll be discussing mandatory health mandates of K12 public schools and the role of parental consent. You know that your children need to be vaccinated before they start school, and as they continue in school they per state regulations and school district requirements. But where do these health mandates end and parental rights begin? This can be both tricky and controversial. Some say that parents have a societal obligation to vaccinate their children, while others say that parental rights matter over all else. I discuss the crucial debate over consent in childhood vaccinations for school aged children while considering parental rights and ethics. In this episode, let's untangle this Childhood vaccinations are required for entry into kindergarten. Recent concerns about childhood vaccinations such as measles, mumps and Bella or or MMR vaccine have led to reduced vaccine intake and increased probability of disease outbreaks. The 14th Amendment's guarantee of liberty protects parental rights. The family circle is where concerns about privacy and personal liberty are at their highest in most circumstances, parents are their children's best advocate and parental rights are are all about protecting your children. In those cases where parents make decisions that harm their children, the legal system can step in to protect the child. Some have argued that when parents do not vaccinate their children, they're working against the interest of the child and this could justify legal interventions. In a few cases, courts have ordered medical treatment over pro parental opposition when there is a clear risk of imminent harm, but this is generally not the case regarding vaccinations. When Merck created and rolled out the MMR combination vaccine in 1971, measles cases in the United States plummeted by more than 99% and resulted in its subsequent elimination in 2000. The Centers for Disease Control and Prevention recommends that having a 95% or higher immunization coverage with a 2 dose MMR series be given at 12 to 15 months and at 4 to 6 years of age for children in this country. Outbreaks of measles continue to occur in this country and around the world. As of February of this year, there were 800 cases of measles in 24 states, including 597 cases in Texas. Texas accounts for about three out of four reported infections. Keep in mind that although you may hear about a rise in measles cases across the country, the numbers being reported are Nothing compared with 27,000 cases reported in 1990 and the over 400,000 cases reported in 1963 before the measles vaccine was created. The 2015 Disneyland outbreak of measles in the United States, which amounted to about 73 cases, unequivocally brought to light what had been brewing below the surface for a while a slow but steady decline in vaccination rates resulting in a rising number of outbreaks. This can be traced back to an increasing public questioning of vaccines by an emerging anti vaccination movement. In the face of diminishing vaccination rates, some researchers positivity that childhood vaccinations should not be seen as part of the domain of parental choice, but instead as a non negotiable legal obligation. They indicate that the government should not permit parents to put their children at avoidable risk of death and suffering. These researchers also postulate that the government should guard the common good of herd immunity to protect vulnerable persons. Here's a real example about the significant concerns surrounding parental rights and health mandates. The North Carolina Supreme Court ruled that a mother and her son can proceed with a lawsuit against the public school System and the Doctors Group for administering a COVID 19 vaccine to the boy without consent. Here's the backstory. In August of 2021, during the height of the COVID 19 pandemic at a North Carolina high school in Guilford County, a 14 year old student named Tanner Smith attended a testing and vaccination clinic at his high school to be tested for COVID 19 because of an outbreak among the schools football team. Guess what happened? Tanner expressed his refusal and although he lacked parental consent, he was vaccinated against his wishes. This action was supposedly taken after clinic staff failed to reach his mother and they decided to proceed with the vaccination anyway. This case underscores the delicate balance between public health mandates and individual rights, especially when those rights concern minors. It prompts a conversation that we can have about protecting public health while also respecting individual rights and parental consent. Parental decision making is necessary for contracting medical interventions that require personal relations, risk benefit evaluation, and for overseeing matters of education. In the 19th century, exemptions from obligatory vaccination were granted for religious and conscientious reasons. Then and today, religion and moral values play marginal roles in vaccine hesitancy and denialism. Rather, the key values invoked by vaccine hesitants and denialists are liberty and pluralism. Neither is compatible with limiting adolescents choice. Because vaccination doesn't require assessment of personal medical risk and because it doesn't need to occur within the sphere of the doctor patient relationship, the risk involved is within the range of daily activities and adolescents have the right to free access to vaccinations without legal requirements of parental involvement. There's presumption that vaccination of adolescents might involve a conflict between parental authority and public health. Free access to vaccination is compatible with the law and ethics of adolescence. Evolving on autonomy in relation to health care, there's currently a drop in vaccination coverage against measles, mumps, and rubella, which may lead to reduced herd immunity and large scale outbreaks of serious diseases. Measles outbreaks, for instance, are likely to result in some children's death and long term disability in others. Parental concern about vaccines appears to be the main cause of the drop. The current MMR controversy gained strength after suggestions of a possible link between the MMR vaccine and inflammatory bowel disease and perhaps autism received wide media coverage. Parental concerns continued despite subsequent studies showing no link between MMR and autism or inflammatory bowel disease. This is not the first time parents have become concerned about vaccines. A recent U.S. study suggested that 15% of adults believe vaccines are unnecessary to prevent disease and that 61% believe that childhood vaccinations are at least somewhat unsafe. Parental concerns are not the only factors affecting vaccine uptake. As with other types of health care, the poor are less likely to vaccinate. The direct and indirect costs of assessing health care and poor access to health care are important factors. In the case of the MMR vaccine, however, it is well off parents who have more concerns and lower uptake. The role of the healthcare professional is in relation to vaccine uptake has also received attention. It's claimed that in 78 to 97% of cases where children attend the clinic and do not receive appropriate vaccinations. This is due to failure by professionals either through lack of information, ambivalence toward the vaccine, or fear of litigation following any adverse event. However, these figures are based on routine vaccinations and may not apply where a vaccine has attracted controversy. Just as parental concern is not the only factor in vaccine uptake, there is not a perfect match between parental concern and vaccination uptake. If parental concerns are raised, they can lead to a major reduction in vaccination rates. As a parent, you can refuse recommended medical treatment for your children and the courts will typically respond with deference, particularly when your objections are based on religious beliefs. The state can require parents to have their children vaccinated against communicable diseases, but many states are reluctant to challenge parents who refuse to do so. Worth noting, the law sometimes limits parental authority over older children. For example, teenagers may be able to review some treatments such as psychiatric hospitalizations, over their parents objections. Older minors may also have access to treatments such as family planning services without their parents consent. Parental Rights and parental power is not absolute. Under its police power, the state can sometimes override the rights of to promote social welfare, for example, when the state requires that you can be vaccinated. Also, the government tends to defer less to parental rights of low income parents. The legal system deals very differently with most families whose parental rights are strongly protected and low income families whose parental rights may receive little consideration. There's been a decline in childhood vaccination rates which has been exacerbated by the convergence of anti vaccine sentiment and parental rights advocacy, thus presenting a multifaceted challenge to public health. In the United States, for example, measles cases in 2024 surpassed the 2023 totals. National vaccination coverage for incoming kindergartners dropped from 95% in 2019 and 2020 to 93% in the 2022-2023 school year. Although exception rates in 41 states increased, these Trends, coupled with growing support for parental choice to altogether skip vaccines among certain demographic groups, underscores the complexity of the current public health landscape. While parental rights are highly valued and generally respected, there are circumstances where public health considerations may require a higher threshold for intervention. This approach ensures that while the authority of parents is respected, it's also balanced with the need to protect public health and the welfare of all children, especially those who are most at risk for complications from vaccine preventable diseases. In the policy arena, vaccine requirements can limit parental rights due to the public health risk posed by unimmunized children, so policymakers strive to balance public safety with respect to parental authority. They do this by allowing for religious or personal exemption options for vaccination requirements and allowing for temporary exclusion of unvaccinated children from certain activities during high risk periods such as disease outbreaks. The Supreme Court has historically recognized the authority of states to require compulsory vaccination laws to to protect public health. The debate over vaccination requirements and parental rights involves ethical considerations such as autonomy, beneficence, which obligates individuals and the state to act in ways that benefit others and prevent harm, and justice. Requiring vaccinations is morally justified when the risk of harm to the public is significant and the measures taken are proportionate to prevention at home, thereby ensuring the benefits to the collective good decisively outweigh the cost to individual autonomy. The resurgence of vaccine preventable diseases such as measles is a stark reminder of the importance of vaccination as a public health tool as well, well as the need for a balanced approach that respects parental rights while prioritizing community well being. The goal is to foster a future where public health thrives on both collective responsibility and sound decision making developed through comprehensive educational programs. And just so you know, there are no federal mandates associated with immunization consent. The guidelines around this issue are left to the state and local governments. All US States require that children become vaccinated in order to attend public schools, and some states provide exceptions based on religious, moral or philosophical beliefs. But only two states, Mississippi and West Virginia, allowed for medical exemptions. Worth noting is that the state is not obligated to mandate vaccination as many provide non medical exemptions to parents who do not wish to vaccinate their children. There are a number of factors to consider when looking at the ethical consequences of non vaccination. These factors generally fall into three categories the cost of disease outbreak, community safety and rights of the child. An outbreak can occur with three or more infected persons. These public health emergencies can snowball from being an intimate situation to an epidemic and eventually a pandemic situation. The cost of curtailing an outbreak due to non vaccination has a direct monetary cost and can increase the incidence of preventable diseases. Community safety involves providing safety for the community as a whole, irrespective of unvaccinated members. Would members of the community be unnecessarily exposed to a preventable disease? Many people believe that children have certain rights, but do vaccinations infringe upon the right of a child? Is a decision to not vaccinate a child in the best interest of the child, considering the possibility that the child could die if he or she is infected by a vaccine preventable disease? Have you had a chance to check.

Out my interactive expert on my website? There are some great conversations and questions going on there. You can check it out ationthrougheducation.com askmenything. Again, check out the questions and conversations happening there ation com askmenything.

Several court rulings have established that religious exemptions from vaccination does not allow the endangered of others, including the public's health and the health of the child. The right to practice religion freely doesn't include the liberty to expose the community or the child to communicable diseases. In these cases, the state may have paternalistic interest in protecting the children over their parents objections. Now let's move from listening to this discussion to applying it, because the main goal of this podcast is to inform you and mobilize you to take action. So what can you do about this? Here are the action steps you can take regarding this topic. The controversial topic of mandatory health updates and requirements and parental rights covers a wide range of topics including measles vaccine, COVID 19 vaccine, HPV vaccines, et cetera. The area that seems most controversial has to do with the vaccinations that are required for entry into public school, namely MMR vaccines and COVID 19 vaccine, among others. Your rights as a parent includes following the guidelines opting out of vaccinations for your children. The question to consider is whether your rights as a parent infringe on the community's rights to not be exposed to infectious disease. A lot of the articles that I read as research for this topic indicated that when parents are presented with science based messaging from doctors, the benefits of vaccinations are more readily accepted. I find that interesting because even doctors debate on the efficacy of combination vaccines like the MMR vaccine. No doubt many children have been harmed by vaccines as documented in the Vaccine Injury reporting database. Vaccine hesitancy, defined as delaying subsequent doses of vaccines or refusing vaccines on schedule, is fueled by vaccine mistrust. Some researchers consider vaccine hesitancy as a public health threat that undermines historical achievements and thwarts years of progress in the fight against infectious diseases. Vaccine hesitancy is marked by low parental vaccine trust, poor vaccination uptake, and high non medical exemptions. It also seems to be driven by social environmental factors such as the Internet, family and friends that shape parental perceptions and decisions on immunization. Overall, I believe that childhood vaccinations have benefits that exceed exceed their costs. My siblings and I were vaccinated as children and my children were vaccinated as well. At the same time, I can understand a parent choosing not to vaccinate their children because of philosophical or religious reasons. It's a controversial topic, one that evaluates the safety of the community versus parental rights. Both sides have valid perspectives. Homeschooling may seem like a viable option, but remember that part of most homeschooling experiences is incorporating cultural and community activities into the curriculum. This means that your child will be out in society, so the ethical dilemma of the individual rights versus community rights still exists. Ultimately, the decision to vaccinate or not vaccinate your children is up to you. Here are this episode's takeaways. There are no federal mandates associated with immunization consent. The guidelines around this issue are left to the state and local governments. All US States require the children become vaccinated in order to attend public schools, and some states provide exemptions based on religious, moral, or philosophical beliefs. But only two states, Mississippi and West Virginia, allow for medical exemptions. Worth noting is that the state is not obligated to mandate vaccinations, as many provide non medical exemptions to parents who don't wish to vaccinate their children. The debate over vaccination requirements and parental rights involves ethical considerations such as autonomy, beneficence, which obligates individuals and the state to act in ways that benefit others and prevent harm, and justice. Requiring vaccinations is morally justified when the risk of harm to the public is significant and the measures taken are proportionate to prevention at home, thereby ensuring the benefits to the collective good decisively outweigh the cost to individual autonomy. Parental concerns are not the only factors affecting vaccine uptake. As with other types of health care, the poor are less likely to vaccinate. The direct and indirect costs of accessing health care and poor access to health care are important factors. In the case of the MMR vaccine however, it is well off parents who have more concerns and lower vaccination uptake. There are a number of factors to consider when looking at the ethical consequences of non vaccination. These factors generally fall into three cost of the disease outbreak, community safety, and rights of the child. An outbreak can actually occur with three or more infected persons. These public health emergencies can snowball from being an intimate situation to an epidemic and eventually a pandemic situation. The cost of curtailing an outbreak due to non vaccination has a direct monetary cost and can increase the incidence of preventable diseases. Community safety involves providing safety for the community as a whole, irrespective of unvaccinated members. What are your thoughts about mandatory health requirements and parental rights? Let me know what you're thinking about this topic by leaving me a text comment. Comment on my podcast website k12educationuntangled.buzzsprout.com if you enjoyed this episode, why not listen to another episode from my library? It could take as little as 10 minutes of your day. And remember, new episodes come out every Tuesday. Thanks for listening today. I hope you'll come back for more K12 educational discussions with even more exciting topics to untangle. Until next time, aim to learn something new every day.

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