Mandatory Vaccinations in Israel

Two days ago I wrote about the legality of mandating medical treatment against the patient's or guardian's will. That post led me to some material on mandatory vaccination laws.

The mandatory vaccination movement seems to have begun in England in 1853 when the government required every child to be vaccinated or the parents would have to pay a fine of £1. There was a strong public backlash (partly due to the fines) and a committee was formed to re-investigate the matter and the fine was repealed. In 2004, the British Medical Association announced that vaccination policies should be based purely on voluntary participation. For a book on this topic see Bodily Matters: The Anti-Vaccination Movement in England, 1853–1907 (Radical Perspectives) by Nadja Durbach.

In the U.S., mandatory vaccination laws have been upheld by the Supreme Court since 1905 in the case of Jacobson V. Massachusetts. All fifty states now require some vaccinations as a condition of public school enrollment. Only two states make an exception for people whose religion prevents them receiving the vaccinations (West Virgnia and Mississippi.) The rationale for mandatory inoculations is that if enough of the population is immune to a certain disease it provides "herd immunity" to the population making it difficult for an epidemic to spread thus protecting those who are not vaccinated, e.g. those with medical conditions that prevent them from being vaccinated. When not enough people are vaccinated it can lead to the deaths of some and a large cost to the healthcare system. One author proposes imposing a special tax on those who choose not to have their children vaccinated. See Religious & Philosophical Exemptions to Mandatory School Vaccinations: Who Should Bear the Costs to Society? by Anthony Ciolli available here; but cf. here where the author discounts the whole notion of "herd immunity." And see the Note entitled Toward a Twenty-First-Century Jacobson V. Massachusetts where the author urges an update to vaccination law and points out a distinction between "medically necessary" and "practically necessary" vaccines:

Those vaccines classified as “medically necessary” would be those that are the only known viable defenses against diseases taking hold in a community. “Practically necessary” vaccines are those to which there are alternatives, but which alternatives are, in practice, not used by a significant number of people.

In Israel, the Basic Law of Human Dignity and Liberty reads:

2. There shall be no violation of the life, body or dignity of any person as such.

7(a) All persons have the right to privacy and to intimacy. (b) There shall be no entry into the private premises of a person who has not consented thereto.

These sections suggest that a mandatory vaccination law would be illegal. But Section 4 says that "All persons are entitled to protection of their life, body and dignity." Thus, if some people are in danger because others won't get vaccinated then the former are not receiving the protection of their lives to which they are entitled. Sometimes the right to autonomy of the individual must take a back seat to the health of society as a whole. The Health Ordinance of 1940, allows for compulsory vaccinations if the Health Minister declares a health emergency. By inference, absent a health emergency, vaccinations may not be compelled.

For more discussion of vaccination policy see the website Vaccination News. For a post from the Economist about the vaccination efforts in Afghanistan and the CIA's covert DNA gathering operation see here. For an article in Hebrew regarding mandatory swine flu vaccine for preventive care physicians see here.