- Mandatory vaccination campaigns are a concern for many parents, even as the likelihood of a COVID-19 shot increases and many countries look towards such a shot to return to normal.
- Vaccine hesitancy remains an issue. In Colombia, the parents of 700 children say an HPV vaccine caused serious side-effects and sued both the manufacturer and the government to prevent mandatory vaccinations.
- Anti-vaxxers point to concerns about the ingredients included in some vaccines and say their individual and paternal rights are infringed by mandatory vaccinations.
- Ultimately, public health considerations may outweigh individual choice.
COLOMBIA. When 700 children in the Caribbean town of Carmen de Bolivar, Colombia, started displaying health issues in 2014, their parents were quick to suspect a vaccine against human papillomavirus (HPV) as the cause.
As of 2013, 45 countries had included the HPV vaccines in their national immunization schemes including Colombia. Another four planned to introduce it. Most countries in the Americas, Western Europe, Australia and Japan (basically most of the rich countries in the world) require children get the vaccine.
This requirement did not sit well with parents in Carmen de Bolivar, who took their case to court, with little success.
“Health officers went to the schools to warn teenagers that if they didn’t get the shot, they were going to fail the academic year,” Mercurio (not his real name), a father of two girls and an anti-vaxxer activist, told Anticentric. (Read more about Mercurio here: Antivaxxers: Vaccine hesitancy rears its head around the world as agencies work to reach everyone)
These same parents are among the many concerned that a COVID-19 vaccine, when one is developed, could also become mandatory. They want to have a choice.
There are more than 100 programs underway to develop a vaccine for Covid-19, a vaccine that many see as key for a return to some kind of normalcy but a question for many is whether a vaccine, once it becomes available, will be mandatory.
A question of choice
Dr. Harry Brunal, a self-declared anti-vaxxer in Colombia, believes pharmaceutical companies have spent years lobbying and pushing for expanded mandatory vaccination campaigns.
Speaking to Anticentric, he pointed to the Nuremberg Code, drafted in 1947, as requiring voluntary consent for medical experimentation. The code was developed after the trials of Nazi doctors following World War II and has become the seminal text on medical ethics. It later inspired the International Covenant on Civil and Political Rights adopted by the General Assembly of the United Nations (UN) in 1966.
Brunal believes mandatory vaccination campaigns and programs bypass this requirement for free consent. Courts have not agreed but Brunal and many others say such vaccinations required by law are a direct infringement on personal and parental rights.
Carmen de Bolivar and aluminum
There are multiple ways for governments to ensure their populations take certain vaccines, as it became clear in Carmen de Bolivar.
About 700 teenagers who received the HPV vaccine Gardasil in 2014 reported a number of symptoms and adverse events including fainting, seizures, paresthesias and tachycardia.
Merck Sharp & Dohme (MSD), the U.S. manufacturer of Gardasil, was sued as part of a class action that is currently moving though the Colombian courts. The lawsuit was the first in a series of similar actions not only against MSD but also against mandatory vaccination laws in Colombia. Similar lawsuits have been filed in many countries.
The Carmen de Bolivar case opened the floodgates of debate in Colombia and much of the region about mandatory vaccination. The case could ultimately determine the future of vaccination schemes across Latin America, including against COVID-19.
The issue is contentious and the courts have been often unsure about how to deal with it or how to weigh personal choice against societal health. For example, Colombia’s constitutional court did not make a ruling in a 2015 lawsuit against mandatory vaccination for HPV. A decision in a different lawsuit by the same court two years later did not prohibit the administration of Gardasil nor did it adopt the claims of the Carmen de Bolivar patients and their relatives, who argued that their injuries and side-effects were a consequence of aluminum hydroxyphosphate, a component of the HPV vaccine.
The court noted that “the HPV vaccine does indeed contain a small amount of amorphous aluminum hydroxyphosphate x 225 mcg, however, from the tests and reports collected at the review site, it cannot be concluded that the vaccine is the efficient cause of the aluminum poisoning because this metal is present in multiple environments,” the court said.
For people that are hesitant about vaccines, the issue is often with specific ingredients rather than with the vaccine as a whole. Ingredients like aluminum derivatives have triggered intense debates over the past decade, even in the scientific community.
“Aluminum is an experimentally demonstrated neurotoxin and the most commonly used vaccine adjuvant,” Lucija Tomljenovic and Christopher A. Shaw, then researchers at the University of British Columbia in Canada, wrote in a paper published by Current Medicinal Chemistry and the journal Vaccine in 2011.
The researchers suggested that the “notion that aluminum in vaccines is safe appears to be widely accepted” but note that “(e)xperimental research, however, clearly shows that aluminum adjuvants have a potential to induce serious immunological disorders.”They suggested these ingredients could affect immune systems, lead to long-term brain inflammation and neurological complications. However, Tomljenovic’s and Shaw’s research was retracted and both publications pulled the papers because, according to the CBC, one of the authors claims figures published in the study were deliberately altered before publication. The retractions did not stop vaccine hesitant people from quoting the research.
The mandatory concern in Latin America
Still, most jurisdictions in Latin America have mandatory vaccination schemes that are widely seen as necessary to the elimination of diseases like polio or chicken pox. For many in the region, the concern is avoiding mandatory vaccinations that could jeopardize their parental rights.
“The parents’ refusal to allow their child to be vaccinated enables the state to provide compulsory vaccination with the proper information and dignified treatment, both of the child and of their family circle, considering the risk of not vaccinating the minor, both for him and for the rest of the community in general,” Palabras del Derecho, a legal news portal in Argentina noted recently.
In Colombia, there are similar concerns.
“In theses cases, you would have to find a good lawyer to make your fundamental rights prevail,” said Brunal. “This is something that we will need to do more frequently, because this [vaccine business] is a business that produces USD30 billion per year. It is the goose that lays the golden eggs,” he said.
In Colombia, children have to get a complete set of vaccines outlined in the country’s vaccination scheme. The law makes it clear that families are responsible for making sure children get the vaccines while authorities can verify that children get their shots by, for example, requiring schools to ask for proof of vaccination before enrolling children.
“Nowadays there is pressure from schools, which are pressed by the secretaries of education, or by the health departments in countries where vaccines are a requirement for admission,” Antifragil (not his real name), another anti-vaxxer and also a father of two girls, told Anticentric. Both Mercurio and Antifragil chose not to use their real names out of legal concerns.
“Also pediatricians ask in many cases for the vaccination schemes to be fulfilled, to attend the children, so that generates great pressure,” he explained.
The COVID-19 pandemic has raised new worries. If, or when, a vaccine for the virus becomes available it is very likely that it will become part of mandatory vaccination schemes for minors but may also be required for adults.
Ultimately, however, public health may win out over concerns about individual choice. There is no shortage of evidence that vaccines have helped stomp out diseases and big swaths of the global population are waiting for a COVID-19 vaccine with the expectation that it will make it possible for life to return to normal.
Alan Dershowitz, emeritus professor at Harvard Law School, has already suggested that such a vaccine could become mandatory for adults in the U.S.
“If you refuse to be vaccinated, the state has the power to literally take you to a doctor’s office and plunge a needle into your arm,” Dershowitz told Jason Goodman in Crowdsourced Truth. “You have no constitutional right to endanger the public and spread the disease, even if you disagree. You have no right not to be vaccinated.”