Doubling down on mandatory vaccinations
Earlier this week I tried to explain why, from a risk management and public health position, saying ““I believe that vaccinations are good, but shouldn’t be mandatory” will result in having a vulnerable populace:
Past all of the immediate threats, however, is the issue of risk management and culture.
People in the workplace have a tendency to gravitate toward the path of least resistance without strong signaling from both management and regulators. This is pretty much universally true with all organizations, and it is why a construction company with no safety meetings will average far, far more frequent and more severe worker injuries than companies with regular safety meetings. It isn’t that workers learn anything new at these meetings; in fact, they almost never do. It’s just that knowing that safety is important to the boss and OSHA leads to employees deciding that it’s important to them as well, and this leads to fewer accidents. The same would absolutely be true of the government telling restaurants that worker hygiene wasn’t a big enough public health issue for anyone to make washing their hands after wiping the butts mandatory.
Cultural signaling also applies to vaccinations. “I believe that vaccinations are good but shouldn’t be mandatory” communicates something far different than what needs to be communicated. Indeed, intentionally or not what it really communicates is this:
“Vaccinations are good, but not getting them is okay too.”
As it turns out, Oregon is a state that chooses to communicate such a message to its populace.
Oregon has a mandatory vaccination requirement to attend public school. And like all things mandated by the government — be it selective service, age of consent or filing taxes — the system is set up to make exceptions under certain circumstances. The way Oregon choose to communicate the “mandatory” part is definitely squishy, with far more of an emphasis put on the “exception” than the “mandatory.” Indeed, in an attempt to play the “I believe that vaccinations are good, but shouldn’t be mandatory” and placate all sides of the fence, Oregon law provides for a “personal belief” exclusion, where a parent is simply required to state (with signature) that they do not believe that immunization is the best choice for their child. The thought at the time, of course, was that you only needed 90-ish% of the population in order for immunization programs to be effective. If the state simply chose to lead with the message of “you don’t have to get one of you don’t want,” surely that 10% buffer would be enough to keep everyone safe, right?
Not so much.
Largely because of what the state chooses to signal when talking about the importance of immunization, Oregon has the highest vaccination exemption rate in the United States. The rate of non-vaccinated children in some Oregon schools is currently as high as — and I am not making this up — 70%. As a result, measles cases have been on the rise in Oregon over the past half decade.
There currently is a bill being proposed in Oregon that would tighten my state’s mandatory immunization requirements for public schools: Exceptions would continue to be made for medical and religious reasons, and there would be a requirement that children already in elementary school would need to be immunized prior to being allowed into junior high school.
Of course, even in such a system as the one proposed other exceptions will inevitably be made, and some other people will simply fall through the bureaucratic cracks. Again, this is the way of government mandates. But as less than 2% of Oregonians have medical conditions which would make vaccination too risky, it should be easy to stay within the 90+% requirement.
Oh, and by the way — if you’re wondering which religions actually forbid inoculations and vaccines, here is the comprehensive list:
Aaaaaand, that’s basically it.
[Picture: Oregon welcome sign, via Wikipedia]