About every 18 months the issue of vaccinations (or, more specifically, the issue of not having your children vaccinated) becomes especially newsworthy. In January 2013, following the hospitalisation of an unvaccinated seven-year-old with tetanus, I suggested that not vaccinating your children was "considered a badge of honour in some circles", that it has "become something of a status symbol in some quarters".
Three years ago, in the wake of non-vaccinated children being banned from a west Auckland school in order to contain the spread of measles, the selfishness of non-vaccinators was discussed: "The more people who vaccinate the more we collectively benefit yet it's an accepted principle that the entire population won't be able to receive a vaccination. The only thing is that it's child cancer patients and other people with compromised immune systems that we're happy to excuse - not the offspring of amateur researchers who've trawled the internet for dubious reasons to buck the system."
In recent weeks there was a measles outbreak in Hawke's Bay - with "two confirmed and five suspected cases" - and 84 measles cases were confirmed in Hamilton where sporting, social and cultural events were cancelled or postponed to try to contain the spread.
Such news inspired at least one talkback radio host to wonder whether vaccinations should be made compulsory. His reasoning was that if the unvaccinated children are impinging on the rights of others and having a negative impact on the wider community - and if some parents refuse to voluntarily act like responsible citizens - then perhaps childhood vaccinations should become required rather than optional.
Yet while it's easy to focus on those who deliberately shun vaccination (they are vocal, form groups, share misinformation and seem to relish their nonconformist status), it seems the more significant group of non-vaccinators is largely flying under the radar. A reader of an earlier piece commented that: "The vast majority of non-vaccinators are not making an informed decision ... in fact they are not making a decision. These families might not be aware that they can vaccinate ... might be worried about cost, might not have a family doctor or other such issue."
It's a view supported by Immunisation Advisory Centre Director, Dr Nikki Turner, who said that "the anti-vaccination lobby is not necessarily the major problem" when she appeared on Breakfast where it was reported that of the "close to 100" cases in Waikato's measles outbreak, only four had been immunised. Those people who are unaware of the existence of immunisation programmes or those who don't have ready access to health professionals or those who don't realise that vaccinations are administered free of charge are likely to outnumber those who deliberately choose to not vaccinate.
Dr Turner considers immunisation a "social responsibility" - which brings us back to the question of whether it should be made compulsory. Given recent events, it's a logical suggestion yet it's difficult to see how such a move would pick up those people who are simply unaware that vaccinations are freely available. It would also be a body blow to the freedom to make our own personal health choices. On that basis, making vaccinations compulsory is probably a step too far. However if proof of up-to-date vaccinations was made a requirement of children gaining admittance to primary school, it might help spur some hitherto reluctant vaccinators into action. And that would surely have a positive impact on the health of our nation.
Should vaccinations be made compulsory? Should proof of vaccinations be required upon enrollment at school?