Immunization of 5 to 11 year olds against COVID-19 well underway: White House Announcement this week an estimated 10% of children in that age group received their first dose.
California has become the first state to announce that it will add the vaccine to its list of required shots for all school children. And a handful of counties in 14 states are making similar moves, starting with mandates for student-athletes participating in sports.
Because almost every child goes to school, the vaccine’s duties are only effective against diseases such as smallpox, polio, whooping cough, and, most recently, chickenpox. But school mandates also always bring resistance – and that has been taken to new heights in the 21st century.
“Vaccines have been controversial since the first vaccine was developed against smallpox,” said Elena Conis, a historian of medicine at the University of California, Berkeley. “And vaccinations are becoming increasingly controversial as states begin to mandate vaccinations.”
It’s a spiral tour of the past, present, and future of vaccine missions, with some surprises along the way.
1. The first immunization missions for schools date back over 200 years
In 1818, the King of Wittenberg, in east-central Germany, issued what appeared to be the first school vaccination requirement, for smallpox. The king decreed: “No man shall be admitted to any school, college, or charitable establishment; be obliged to be apprenticed in any trade; or hold any public office, who unvaccinated.” In 1827, Boston became the first US city to do the same. As the country became more urban in the late 19th century, the need for vaccines increased and the mortality rate from smallpox plummeted.
2. The first vaccine missions gave rise to the first anti-vaccination people.
In 1882, the Anti-vaccination League of America hold its first meeting in New York. Among the false assertions made by speakers at the meeting was the idea that smallpox was spread by dirt, not germs. Just as they do today, the anti-vaccinationists of the 19th century proclaimed skepticism of science, faith in religion, and fervor for individual liberty. They have shared cause with a host of other outside-mainstream groups, such as moderation advocates, vegetarians, homeopaths, phrenologists, and palm readers. They advocate unfounded vaccination alternatives, like homeopathic remedies; and false claims, such as vaccines cause eczema.
Conis points out that there were real cases of vaccine-related injuries in the 19th century that contributed to the suspicions: “The vaccination is done in a number of different ways, sometimes from livestock. , especially cows, and is sometimes done by a procedure called “arm-to-arm”, where one person’s blisters from a vaccination are used to immunize the next. “And both of these methods can sometimes transmit other infections, like tetanus and syphilis.”
3. The Supreme Court upheld school vaccine regulations a century ago.
Important U.S. Supreme Court ruling on school vaccination mandate came in 1922 case Zucht sues King. “The court has been very clear: This is not a violation of liberties,” said James Hodge, a law professor at Arizona State University and a member of the Public Health Law Network. “This is not a constitutional issue. States and localities can impose immunization requirements on schools, cyclically. And as a result, we’ve already seen clearly over 80 years later the schools have done exactly that through state law.” Hodge has tracked legal challenges to the COVID vaccine mandates.
4. The polio vaccine was not used for many years after its introduction in 1955.
“When the polio vaccine was first approved, a lot of people came to give it to themselves, their children,” says Conis. “And it’s been several years before states are even considering mandates that require that vaccine for children.”
5. Since 1979, Mississippi has prohibited individual religious and belief exemptions from school immunization mandates, and the state has highest childhood immunization rates United States
West Virginia, too, has only allowed medical exemptions since it passed the first statewide mandatory immunization law in 1905. California, Connecticut, Maine and New York followed suit in the 2010s, the kind. dropped non-medical exemptions in response to measles outbreaks followed by an increase in vaccine refusals.
6. In 1980, 28,000 New York City students were expelled from school after not being vaccinated against measles.
It’s one thing to put state law in the vaccination requirements book; it’s another matter for schools to enforce them. In 1977, during a measles outbreak in Los Angeles, it was estimated that only two-thirds of the nation’s lower-income children were actually vaccinated against the disease. The last resort is to keep children out of school, as New York City has done. Throughout the second half of the 20th century, outbreaks resulted in successive crackdowns on the one hand and public vaccination campaigns on the other.
7. The World Health Organization named “vaccine hesitancy” as one of the 10 most notable threats to global health – back in 2019.
While opposition to vaccine mandates is as old as the missions themselves, scholars agree that the 21st-century movement is different. That’s partly due to the ease of spreading misinformation on social media. Dorit Reiss, a professor at the University of California’s Hastings College of Law, argues in part that is also due to the emotional weight of the opposition.
“Parents of children with autism have become embroiled in the anti-vaccination movement,” says Reiss. The anti-vaccination movement has advocated for them, offering them an explanation for how their child has become autistic, says Reiss. like, offering cures – fake cures, but cures,” Reiss said. “It has created a very strong core group who believe passionately that it is a vaccine [that caused their children’s autism], and the movement is more organized, more institutionalized. “
8. Adding new vaccines to the school mandatory list has proven difficult in the 21st century.
All 50 states now require students to be vaccinated against polio, smallpox, MMR (measles, mumps, and rubella), Tdap (tetanus, diphtheria, pertussis), and chickenpox. Varicella (chickenpox) is the newest disease, making the list in the early 2000s, according to Immunization Action Coalition.
But only a few states require rota, flu, or HPV vaccines for schools. Because of its association with sexual activity, the HPV vaccine has been particularly controversial. “One of the last vaccines that we try to give children is the HPV vaccine,” says Elena Conis at Berkeley. “It’s not going very well. And we’re in a much more polarizing moment in terms of vaccinations now than we were then.”
9. In terms of history, especially recent history, many public health experts and vaccine historians say it’s not yet time to mandate COVID vaccines in schools.
Dr Stella Safo said: ‘I would say over the next three to six months, encouraging a self-directed push for people to get their child vaccinated is probably what will keep it from being so ‘troublesome” . founder of Just Equity for Health, a New York City-based healthcare company focused on providing equitable care. “And then I think, just like we required you to get the chickenpox vaccine before you could go to school, I think COVID will eventually be added to that portfolio.”
“My view remains that the missions are premature,” says Reiss. “But I want to be clear… I’m making my proposal from the ivory tower a little bit, and those on the ground might have a very different perspective.”
“I don’t think that would be the right time to [mandate the COVID vaccine at a state level], especially if we look at the context of the entire pandemic,” Dr. Thomas Dobbs, Mississippi State Health Officer. “Patients trust their own doctors more than anyone else, and especially where we’re right in the middle of a pandemic, that’s the best place for that conversation.”
