Vindicating the Vaccine: Injecting Strength into Mandatory School Vaccination Requirements to Safeguard the Public Health

INTRODUCTIONSometime between December 17 and 20, 2014, a patient zero entered Disneyland Park in Anaheim, California and brought with her an unlikely guest: measles. 1 By early 2015, this extremely contagious and vaccine-preventable disease ("VPD") had spread to a reported 100 confirmed cases across California and into Colorado, Utah, Oregon, Washington, Nebraska, and Arizona. 2 In response, health officials in Orange County, California-a region with high rates of parents who opt out of vaccinating their children-ordered about two dozen high school students without proof of immunization to stay home after learning that an infected student had come to school following the school's winter break. 3Vigorous vaccination practices largely eradicated measles in the western hemisphere in the 1990s, but many of those infected via this Disneyland outbreak were unvaccinated. 4 A study by researchers at MIT, Boston Children's Hospital, and Harvard Medical School indicated that substandard vaccination rates likely caused the rapid spread of the outbreak. 5It is not surprising that the disease found a foothold in the parts of California where vaccination levels for schoolchildren are markedly low, a reflection of an "anti-vaccination" movement that has developed in isolated but notable pockets across the nation. 6 The "anti-vaccinationists" object to childhood inoculation on various grounds, but most commonly for religious or philosophical reasons, or because of beliefs that vaccines are unsafe. 7 But as the movement gains traction and more and more parents refuse to vaccinate their children, the risks of a public health crisis, as evidenced by the Disneyland measles outbreak, grow increasingly real. 8Currently, all states have mandatory vaccination laws that require children to document proof of inoculation upon entering school. 9 Most states, however, also provide for religious and in some cases philosophical exemptions to these compulsory vaccination requirements. 10 In recent years, parents have increasingly taken advantage of these exemptions.11 This has led to a growing number of schoolchildren who go unvaccinated, putting themselves and other children at risk of illness. 12In light of the danger posed by the resurgence of VP Ds, this Note argues that lawmakers have a responsibility to either strengthen or refashion the mandatory vaccination laws in this country to ensure public health and quell the threat of these serious but preventable diseases. 13 Part I of this Note gives a brief history of mandatory vaccination law in the United States and outlines the typical arguments for and against the practice of vaccination. 14 Part II discusses the relevant judicial decisions and constitutional issues that have shaped modern mandatory vaccination requirements and the medical, religious, and philosophical exemptions thereto. 15 Finally, Part III argues that there is a legislative duty to strengthen mandatory vaccination requirements and apply greater scrutiny in order to limit exemptions to inoculation. 16 This Note proposes three methods by which legislatures can achieve this outcome: eliminate philosophical exemptions, tighten existing religious exemptions by revising them to more closely reflect model state statutes, or alternatively, assign an independent organization or agency to draft a uniform vaccination mandate for adoption by the states. 17I. A HISTORY OF MANDATORY VACCINATION LAW AND POLICY IN THE UNITED STATESThis P art provides background on policy surrounding vaccination laws in this country. 18 Section A discusses the first attempts at legislative regulation of vaccinations. 19 Section B examines the U.S. Supreme Court's landmark decision on vaccinations in Jacobson v. Massachusetts. 20 Section C considers contemporary arguments in favor of and against mandatory vaccination requirements.21A. Shot Law: Early Legislati ve Control Over the Implementation of Vaccine Requirements and Ini tial BacklashLocal, and then state, authorities were the first to take charge of vaccination practice in the United States. …