Hanging over everything is the tradeoff between getting more people vaccinated and shutting out those who aren’t vaccinated. Douglas Diekema, the director of education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children’s Hospital, noted that anytime a government institutes a school-based mandate, they’re balancing two public goods: preventing disease and getting kids educated. “I think you need a good reason … to take that benefit away from people who won’t get vaccinated,” he said.
COVID-19 vaccination requirements are bound to run into similar priority struggles. We, as a society, want more people vaccinated — we also want people to be employed and be able to go to college. And unlike the diseases that childhood vaccines have strongly curtailed, COVID-19 is an active pandemic. The choice isn’t just about “prevention” versus “access to societal services.” You have to factor in the health and lives of other people too.
Not everyone will make the same choices about how to balance access with safety. States have significantly different requirements about how many vaccinations are required to go to school, and whether they’re really required. Some vaccines are required for school entry in every state — measles, polio, diphtheria — because they have extremely high efficacy rates and are related to diseases that spread through normal daily contact with other kids in schools. But only six states — plus New York City — require flu vaccines, which have lower efficacy. Only three states require vaccination for human papilloma virus — a disease that’s spread by sexual contact, and which has been heavily politicized by groups that framed it as giving preteens and teenagers adult approval to go have sex.
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