November/December NFL Topic Overview

by Jessica Huseman

Resolved: Public health concerns justify compulsory immunization.

Background and Framework

Compulsory immunization has been hotly debated since 1806 - the year a regulation mandating the smallpox vaccination was passed. Since then, most developed countries have required immunization of preventable diseases to some degree. Today, for example, most countries require some degree of polio, small pox and measles vaccination.[i]

Compulsory immunization has proven to be an effective method of disease prevention, so negatives should not argue that vaccines are ineffective. This is why states and countries continue to require immunizations. Alternatively, negatives can argue that such requirements shrink the autonomy of the individual. 

This particular topic contains a few ambiguities that need to be addressed. First, consider the difference between the terms "justified" and "just." When an action is justified, there is reasonable ground for doing it. For instance, it is justified that someone be excused of a crime due to mental insanity. However, this justified act may not be viewed as just by all parties involved. Just is rooted in principles of justice. In other words, to be just, something must be fair or equitable. And while the "reasonable ground" for doing something might fall under those categories, it doesn't always have to.

Second, "public health concerns" is a nebulous phrase. What qualifies as a "public health concern?" Is it an emergency situation, or just a general worry? Arguably, the state should be worried about our health at all times. So, does this mean that the resolution argues that compulsory vaccinations are always justified? Or should the definition of "public health concerns" be narrowed? That is up for you to decide in your debate round. However, it might be advantageous to narrow the debate to a more specific definition of "public health concern," like the threat of a pandemic. Clearly, "public health concern" was thrown into the resolution for a reason, so it should change something about the way that you debate. If you choose to say that the government is always concerned, arguably you are debating the status quo. All words in a resolution matter and it is up to you to figure out how.         

Affirmative

First, the affirmative can argue that compulsory immunization is a necessary precaution that should be taken to stem the devastation a biological weapons attack might cause. In the early 2000s, the Anthrax scare was at its peak. There was talk of compulsory immunization against Anthrax that eventually died away, but consider what would have happened if Anthrax had been more than a contained problem. Many more would have been harmed or killed, and compulsory immunization potentially would have saved thousands of lives.

Affirmatives can argue that governments should be prepared to respond to effectively to a biological weapons attack. Governments have previously justified extensive searches, the tapping of telephone wires, and warrantless arrests in the name of national security, so why not compulsory immunizations? Compulsory immunization is arguably less invasive than the aforementioned items, and is historically effective. The affirmative can argue that because one of the government's duties is to keep its citizens safe, compulsory immunization would empower the government to meet that responsibility. 

To make this argument persuasive, affirmative debaters must establish that biological weapons are a viable threat. And according to David W. Siegrist, Research Fellow at the Potomac Institute for Policy Studies, they are. He says, "Among weapons of mass destruction, biological weapons are more destructive than chemical weapons, including nerve gas. In certain circumstances, biological weapons can be as devastating as nuclear ones-a few kilograms of anthrax can kill as many people as a Hiroshima-size nuclear weapon." [ii]

Second, affirmatives can argue that pandemics often strike without warning; and lack of warning translates into a shortage of vaccination supplies. Vaccines are not typically stocked at pandemic levels. Accordingly, the limited vaccines would be rationed and some citizens will be barred from receiving them. The affirmative can argue that compulsory immunizations can preempt the shortage.

A flu outbreak is a perfect example.  According to Medical News Today, "A new predictive model shows that vaccinating infants with 7 valent pneumococcal conjugate vaccine (PCV7) - the current recommendation - not only saves lives and money during a normal flu season by preventing related bacterial infections; it also would prevent more than 357,000 deaths during an influenza pandemic, while saving $7 billion in costs." The affirmative can argue that if flu vaccination was mandatory an outbreak would be less severe. [iii]

Third, people who refuse vaccines for religious, moral, or philosophical reasons are likely to associate with each other. This cluster of vulnerable people creates a huge health concern because it allows illness to spread quickly. Thus, imposing mandatory vaccination would eliminate this problem, reducing the risk to the general population.

Fourth, many people are cheap and won't get immunized even if they can afford it. This sounds like a silly argument, but it is the same reason that the state of Texas mandates that all drivers have car insurance. People want to avoid costs so they simply go without, regardless of the risk. But, in the case of immunizations (and driving without insurance), you put not only yourself at risk, but everyone else as well.

Fifth, many people are afraid of immunizing themselves and their children because of myths and exaggerations that they hear about the dangers of vaccines. As the affirmative you should be prepared to defend the safety of vaccines and argue that these myths are unfounded and have not been substantiated.

Negative

First, negatives can argue that compulsory immunization alters the availability of vaccines. If immunization is compulsory, the government would have to kick in free or heavily discounted vaccines for those that cannot afford them. Since the government would be buying vaccines on a massive scale, the entire vaccination market would become distorted.

Matt Baumann notes in "What's Behind the Vaccine Shortages" that government buying of vaccines "gives the federal government tremendous leverage, or market power, allowing it to demand and receive below-market prices from manufacturers.  The federal government can often negotiate a discount of 25 percent to 65 percent off the average wholesale price of a vaccine." He goes on to note:

"Manufacturers are going to direct capital to those products whose markets provide the most stability and highest profit margins.  Vaccines account for only 2 percent of pharmaceutical revenues. Thus, if profit margins continue to decline, it is highly likely that pharmaceutical manufacturers will continue to replace vaccine production with more profitable drug production." [iv]

On a more philosophical level, the negative can argue that compulsory immunization increases biopower and the ability for the government to manipulate the population. French philosopher Michel Foucault coined the term "biopower" to refer to a government's regulation of its people through "an explosion of numerous and diverse techniques for achieving the subjugations of bodies and the control of populations." Biopower is literally the control of an entire population through the manipulation of their bodies; clearly vaccines would fall into this category.[v]

While Foucault does not discuss whether or not biopower is inherently good or bad, many scholars suggest the latter. The majority argue that the manipulation of citizens through their bodies is a slippery slope that will justify more horrendous things down the road. Anne Stoler, Professor of Anthropology at the New School states that, "It is as managers of life that so many regimes have been able to wage so many wars, causing so many to be killed, at stake is the biological existence of a population."[vi]

The negative can also argue that immunizations pose health risks, and should therefore not be compulsory. Andrew Wakefield's report first suggested a link between the Measles, Mumps and Rubella (MMR) vaccine and autism in 1998.  As a result, many parents decided not to vaccinate their children. The United States federal government started the Vaccine Adverse Event Reporting System (VAERS) in 1998 to track negative responses to vaccines, and thousands of negative reactions are reported each year. In 2008 alone, there were 30,009. [vii]

Negatives can also argue that parents should be able to choose what happens to their children.  Making vaccines mandatory takes this choice away from parents. Since vaccinations do incur some risk, regardless of how small, parents ought to be able to make the decision whether or not to expose their children to that risk. Parental consent is required in essentially every medical situation for children under the age of 18 and negatives can argue that it should be required for vaccinations too.

The negative can also make the argument that requiring vaccinations crushes religious and cultural dissent. Some more conservative sects of Christianity believe that since vaccines are created with harsh chemicals, it would be defiling to your body to put them into your bloodstream. They believe that this is in direct opposition to God's will that we keep our bodies free of impurities. There is also a passage in the Bible that warns against mixing the blood of humans with the blood of animals, and since many vaccines are gestated in animals, this seems to contradict that particular teaching.

More specific objections to vaccines include those vaccines which are intended to prevent against diseases that are typically spread through sexual contact. The HPV vaccine is intended to prevent cervical cancer resulting from the sexually transmitted "human papillomavirus." In 2007, Rick Perry, the governor of Texas, attempted to add the HPV vaccine to the list of required vaccines for school children. He received a harsh backlash from the religious community, which eventually won the fight. [viii]

The negative could also offer a counterplan. The negative can easily argue that the government would not be justified in blanket mandating immunizations, and that more private organizations should instead require immunization for participation. This would provide the same benefits as the affirmative (albeit on a slightly smaller scale), while still respecting the right of private citizens to decline becoming immunized.

Universities, workplaces, private schools, and insurance providers could easily require proof of immunization before allowing people to participate. This would provide a safety net for their members, while also increasing the number of people that are vaccinated in the general public.

Arguments up to this point have focused on the harm of vaccines, but the negative could just as easily say that government involvement with vaccinations is bad because it would result in the overregulation of vaccines, which would lead to less effective vaccinations. Baumann states "In 1999, the FDA mandated the removal of thimerosal, a potentially toxic, mercury-based preservative used in vaccines. Despite warnings by the American Academy of Pediatrics and the U.S. Public Health Service that the danger posed by thimerosal was vastly outweighed by the danger of not vaccinating, the FDA proceeded to implement the requirement anyway.  This action resulted in a 25 percent reduction in the already fragile supply of some childhood vaccinations like DTaP (diphtheria, tetanus and pertussis)." This unnecessary overregulation could become commonplace if the United States made immunization compulsory.

[i] Salmon et al. "Compulsory vaccination and conscientious or philosophical exemptions: past, present, and future," The Lancet, Vol 367. February 2006. 

[ii] Siegrist, David W. "The Threat of Biological Attack: Why Concern Now?" Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/EID/vol5no4/siegrist.htm

[iii] "Numerous Deaths Could Be Prevented And Costs Reduced By Pneumococcal Vaccine During Flu Pandemic." Medical News Today, October 2008. http://www.medicalnewstoday.com/articles/127329.php

[iv] Baumann, Matt. "What's Behind Vaccine Shortages?" National Center for Policy Analysis, April 2009. http://www.ncpa.org/pub/ba655

[v] Foucault, M.  "History of Sexuality vol. 1: An Introduction."  trans. R. Hurley. 1978.

[vi] Anne Stohler, Professor of Anthropology, University of Michigan, Race and the education of desire : Foucault's History of sexuality and the colonial order of things, 1995, p. 81-82

[vii] "Yearly Summary of the VAERS Database." National Vaccine Information Center. http://www.medalerts.org/vaersdb/stats.html

[viii] Elliot, Janet. "Reluctant governor yields on HPV shots," Houston Chronicle. May 9, 2007. http://www.chron.com/disp/story.mpl/metropolitan/4787541.html