How Do You Solve a Problem Like Vaccination?

Short side-trip to a different Health Care topic: Flu vaccinations. Seems like a bland and relatively benign topic, except that there are as usual in our free democratic society any number of special interest groups that can transform the mundane into the political issue du jour. And we can probably find some connective tissue between this issue and Health Care system costs, and even a few useless strands linked to our Congressional leadership.

What is the issue? The seminal issue of vaccinations in the U.S. is the efficacy of vaccines for disease prevention versus the risk that vaccines might cause to individuals. Entangled with the risk issue is the “violation of individual rights” red flag that evokes the “no government has the right to force me to __”, in this case: inject a substance into my body.

I am going to first address the rights violation position. Absolutely correct, we all know that the Government doesn’t have the authority or right to impose upon citizens anything to which the individual citizen objects. Well, almost anyway. And therein lies the rub. Our Constitution not only provides a explicit declaration of some of our rights, its reserves all rights not enumerated to the United States government to the States and/or the people. But it does grant and define to the Government a variety of powers that it can impose upon the citizenry. In fact the very concept of a society, and particularly a democratic constitutional society and government, must be built upon the mutual agreement and acceptance of its citizens that they are individually obligated to accept the rules and constraints of their governmental contract. In our case, we are all required to honor the terms and conditions of the Constitution. The only recourse to an individual is to declare and renounce their allegiance to that social contract and leave the jurisdiction of the society. This renouncement voids all rights and claims the individual has within the borders of the nation. Rejection of the social contract is a rejection of everything and leaves the individual with absolutely nothing, with the exception of their own being. No lands, no titles, no property of any kind is owed to the individual by the citizens of the society. You must accept and acknowledge the authority and validity of the Constitution to be able to evoke its power to convey and protect the rights guaranteed by the Constitution.

So the real question about vaccinations is: Does the Government have the power defined in the Constitution to compel individuals to be vaccinated? The answer here is that there are conditions and situations under which the Government can and has imposed medical treatments upon individuals.

Happily for Americans, our Government has been generally cautious about dictating and mandating a medical procedure where the risk of doing otherwise would be highly dangerous to the public at large. Instead, the Government typically relies on an advocacy approach and on public awareness campaigns to encourage and convince the populace to voluntarily avail their selves of treatment.

So let us not be distracted by the emotional joy that we all relish in shouting our defiance of the Government under the banner of individual rights. If it is determined that vaccinations are a necessary action to protect the public from a ‘clear and present danger’ then we can disagree and complain, we can choose to refuse; but we cannot expect to win in a legal test. We could elect politicians that well change the law and provide a restraint upon the Government from being able to compel us in this area. But then we also have to accept the consequences of that act. Consequences which I suspect most of us would not anticipate; and more humorously would be absolutely livid about, and would be insisting that the Government should have prevent us from allowing to happen.

So getting back to the seminal issue: Is the value of vaccinations to the populace as a whole sufficient to outweigh the rights of individuals to accept the risk of contracting the disease (and consequentially exposing and increasing that risk to others in the population)? And now we have identified the true conflict. It is not that the Government has the right to force you to be vaccinated to protect you. It is the that the Government has the obligation under our Constitution to protect me from you. If your decision did not expose me or other members of my family to any risk then the Government would be under no obligation to protect the other members of the society. But where you create an unreasonable risk then you must abide by our social contract, just as I must be responsible for not causing an unacceptable risk to you. Controlling the spread of dangerous diseases is a one of those circumstances for which the Government is empowered by our social and legal system to impose public treatments.

Now in the specific case of the H1N1 / Swine flu, the risk appears to be higher for certain groups in the general population that others. So not everyone is at an equal level of risk, and thus it’s even more difficult to come to the conclusion that the Government should compel everyone to be vaccinated. However, there are also sub-groups in the population that various Governmental entities would have sufficient justification in mandating compulsory vaccination. Health care providers/workers would be an excellent example; but they are not alone in this class. Other sub-groups would include, but not be limited to: military personnel, critical governmental entity employees like the police (probably not Congress, nothing bad would happen if they were infected or incapacitated), educators, and perhaps students.

Now if you disagree, if you think the Government has not right to compel anyone, then I would like to come to an agreement on what you are responsible for if we collectively in our democratic wisdom decide to go along with this view. And that can be for tomorrow.