Florida surgeon general wrong to end vaccine mandates, doctor argues

Taking a vaccine may be a matter of personal choice when it comes to protecting an individual against a virus or bacteria, but it is also a matter of community protection, especially when the vaccine is highly effective at stopping spread and there are immunocompromised people around who can’t take the vaccine. They need our help to protect them by providing fewer hosts for the virus. 

In the case of measles, mumps, and rubella, we are talking about viruses with the potential to make a child very sick, but the vaccine, which creates a wall of protection after two doses, uses a live attenuated (weakened) virus which cannot be taken by an immunocompromised child. This is because he or she doesn’t have the immune protection needed to stop the live virus in the vaccine from potentially causing the disease.

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The surgeon general of the state of Florida is wrong when he vows to end vaccine mandates in the state based on the notion that they should be a matter of personal choice. Yes, the child or their parent has a right to choose not to be vaccinated, but the school has the right to exclude that child from attending based on the definition of what constitutes a safe environment. Everyone agrees that no one has the right to bring a knife to school. At the same time, a school needs to be able provide protection for children who are unable to take a vaccine because of their underlying medical conditions. How would Florida health officials feel if there were a measles outbreak at the school because other children or their parents vote against taking the vaccine?

This case is clear cut, because the MMR vaccine has been proven safe and effective at preventing spread, whereas measles is so contagious that almost every unvaccinated child who is exposed to it will get sick and approximately one out of seven of them will end up in the hospital.  

The concept of community protection is more debatable when the vaccine doesn’t prevent spread, as with the flu or COVID vaccines, but keep in mind that vaccines which decrease severity also decrease rates of hospitalization. In fact the flu vaccine has been shown to significantly decrease the risk of urgent care visits, hospitalizations, and death.

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Many medical centers, including my own, are justified in imposing flu vaccine mandates among health care workers, because the last thing we want to do is to unknowingly spread flu from one patient to the next. The flu vaccine decreases the chance of this happening.

Community protection is also why, as I have written elsewhere, President Trump deserves the Nobel Peace prize for Operation Warp Speed, an unprecedented public/private partnership that brought a largely vulnerable population a layer of crucial protection in just nine months, saving millions of lives around the world. And though the COVID virus continued to mutate, rendering the MRNA vaccines less effective at preventing spread, it continues to be effective at decreasing severity, which again leads to fewer hospitalizations and fewer deaths, especially in vulnerable populations with pre-existing conditions and especially in the first few months after vaccination.

Unfortunately, vaccines have been caught up in a political battle and displaced from their real purpose as one of our greatest public health tools of prevention. I am all for continued scrutiny of data, continued study, and full transparency. I am also for the debate over which vaccines should be mandated and which shouldn’t, with the reasons for and against clearly spelled out. It is clear that the COVID vaccines were mandated for far too long, for too many groups, where in the latter stages of the pandemic the government ended up infringing on civil liberties without demonstrating sufficient community protection. But that is not the same thing as saying that they shouldn’t be widely available or used.

As a practicing physician, I perform a risk/benefit analysis before I recommend a vaccine to anyone, and it is crucial that a patient’s fears and concerns and their vaccine history are part of the conversation that follows. But as I remind all my patients, the purpose of vaccination is twofold; personal as well as community protection. Politics should never play a role in this decision.

DR. MARC SIEGEL