Compulsory vaccinations: Where do we draw the line?

[Ms. Toad]

99. Thank you - that is the kind of discussion we should be having

without all of the screaming and name calling.

Generally mandatory (with exceptions for religious reasons, or in consultation with the child's physician)
MMR
DTaP
IPV (polio)
Hib, Hep A, and possibly RV for children in state licensed day care - but not generally as a prerequisite for children entering kindergarten if they have not previously been in child care. Mandatory vaccination on entry to kindergarten is because it is the easiest point to catch unvaccinated children - even though the high risk/transmission period for these three diseases ends before kindergarten). That said, the state licensed day care criteria is a similar easy-to-catch criteria. It is more age appropriate, but unlicensed home child care for multiple children is also risky. Other than drawing the easy line - I'm not sure where to draw the line. Certainly children like my child who was never cared for by anyone other than her parents (or with any other child) until she was 18 months old, and never in a group setting until she was out of diapers, should be excluded from the vaccination requirement. She missed it being a kindergarten entry requirement by one year - had she been a year younger we would have been required to vaccinate her for HiB, even though she was at least 2 years past the age of risk (Toddlers who are in group childcare are the at risk and/or high rate of transmission population.) RV is "possibly" because it is highly transmissible through fecal-oral transmission - obviously a high risk for children in day care - but the vaccine is not a very effective vaccine. So even if everyone is vaccinated it would be less likely to create herd immunity.

All vaccines should be available as separate components, without additional cost, for parents who want to spread the immunizations out.

All other vaccinations should be recommended, perhaps even with mandatory risk counseling, but not mandatory vaccinations.

Smallpox is no longer even recommended in this country, BTW