Public Health Ethics on Childhood Vaccination

Vaccination is unquestionably recognized as a major public health achievement of the current century, however, there is no consensus among the general population about its efficacy. In most Western countries, like the U.S., vaccines have become “a toss-up debate” as successes experienced in the past with vaccines eradicating several diseases such as smallpox, polio, and so on have been forgotten. The WHO recently included vaccine hesitancy in the top ten of global public health threats both in advanced and developing countries. Many now question the safety and necessity for vaccinations, and therefore, reject immunization of their children. In the U.S., some immunization policies have changed by shifting them from a voluntary to a mandatory system, or by making it difficult (mandatory program) for parents to be exempt from participation. School children without a complete vaccination record can no longer be enrolled in public schools, and some private organizations have made vaccination a requirement to remain employed by their companies. In this commentary, we suggest ways in which we can close the gaps between applying a framework for ethical analysis of childhood vaccination based on the four biomedical ethics (autonomy, nonmaleficence, beneficence, and justice) and individual beliefs (cultural, religious).