By David M Salisbury, UK director of immunisation
BMJ 2012; Published 15 May 2012
Paul Offit (doi:10.1136/bmj.e2434) believes that mandatory vaccination is needed to protect vulnerable people from infection, but David Salisbury argues that there are more workable ways to ensure high uptake
Mandatory vaccination in the UK was attempted first in the 19th century. The legislation was ineffective, discriminated in favour of those able to use the exemptions, and was divisive; it fostered substantial anti-vaccine sentiment and was counterproductive. Attempts to impose compulsion today would undoubtedly be challenged in terms of autonomy, inappropriate intrusion of the state, availability of choice, and parental rights and responsibilities. Bolstered by access to information, its unacceptability to the public would be likely to have the same consequences.
Two questions need to be answered: do we need mandatory vaccination and are there examples of it being beneficial?
Compulsion is unnecessary
I presume that the purpose of mandatory vaccination is to raise coverage. If coverage is sufficiently high, compulsion is not needed. If coverage were not adequately high, other interventions are more likely to be successful than compulsion.
Vaccination Choice is a Human Right by the Refusers