Italy Attempts to Control Infectious Disease Outbreaks by Implementing Mandatory Vaccinations

The anti-vaccination movement has had an effect on the incidence of infectious disease outbreaks in cities and countries around the world. Once nearly eradicated diseases like measles and mumps have started to once again infect people in unprecedented numbers, partly because of some parents’ refusal to vaccinate their children.

In response to a recent outbreak of measles in Italy which has so far affected 1,500 people, the Italian government has made it illegal for parents to prevent their children from receiving 12 essential vaccines. Parents of preschool and school-aged children will now have to show proof of vaccination when their children enroll in school.

These types of regulations already exist in other countries – including the US – where vaccination has become a controversial issue in the past 20 years. But critics of the law in the US say it’s too easy for parents to claim conscientious objection to the rule to avoid having to vaccinate their children.

The Italian law aims to combat this; parents who refuse to allow their children to receive the 12 vaccines covered by the rule will be fined between €500 and €7,500. If the fine is paid, the children will be allowed to enroll in school however the hope is that the fines will be enough to persuade parents to vaccinate their children.

“I would argue that these measures are ethically justified, and other countries should follow Italy’s lead,” wrote Dr. Alberto Giubilini, a postdoctoral research fellow at the University of Oxford, in an article published on The Conversation UK. “Most parents, even if they are opposed to vaccines, will have no choice but to vaccinate their children.”

Despite the wide availability of the measles vaccine, the infectious disease remains one of the leading causes of death in children, according to the World Health Organization. Still, the WHO estimates that worldwide vaccination programs implemented since the year 2000 have reduced the number of measles-related deaths by 79 percent.

The importance of widespread vaccination lies in the concept of ‘herd immunity.’ Infectious diseases have the least chance of spreading in a population so long as around 95 percent of individuals in that group have been vaccinated against the pathogen. For years, generations of people in the US were regularly vaccinated and those that could not be vaccinated due to serious health concerns, such as allergies to vaccine ingredients, benefited from this herd immunity.

While some may question the ethics of implementing a law that requires people to get vaccinated, Giubilini defends the Italian government by explaining why the needs of the many truly do outweigh the needs of the few. Since infectious disease outbreaks are a public health concern, he argues that an individual’s liberty and ability to choose whether to vaccinate their children should be overruled.

“Most people would think that, in many cases, it is acceptable to quarantine or isolate people in order to protect the community from infectious diseases,” wrote Giubilini. “Similarly, the risk of future outbreaks of infectious diseases that pose a risk to the life or the health of other people is a sufficiently strong reason to limit parents’ freedom of choice regarding whether or not to vaccinate their children.”

Currently, all 50 states in the US have laws requiring children to receive vaccines to prevent infectious diseases including pertussis, polio and measles. However, 47 states allow parents to opt-out of mandatory vaccination because of religious reasons, and 17 states allow exemptions on philosophical grounds.