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Childhood immunization should be mandatory in Australia

Introduction

It is always a priceless moment for a couple to have a neonate for the first time. This

moment is always a moment of joy with a tinge of nervousness following the needs of their

child. Childhood immunization is one of the crucial steps in the life of the infant that needs to be

taken with the weight that it deserves (Rigby et al., 2020). Childhood immunization has been

proven to have many benefits in the life of all those who take it seriously. Making the process

mandatory against the will of those who are against it will insubordinate their autonomy thus the

need for proper advice to all parents regarding the subject.

Making childhood immunization is quite a debatable topic yet it is worth it as it is one of

the major plans laid down by the World Health Organization in ensuring the safety of humanity,

depicting the principle of beneficence (Rigby et al., 2020). Australia is not an exception in this

campaign that champions childhood immunization in its population. The main benefit of

immunizing infants is that it reduces infant mortality and infant morbidity (Rigby et al., 2020).

With early immunization, infants are shielded from all forms of serious and preventable illnesses

like tetanus, mumps, measles, diphtheria, and many others.

The Ethical Dilemma Surrounding Mandatory Immunization

Immunization among children requires a balance between parental autonomy in

immunizing their children and the benefits following mandatory immunization. The ethics

surrounding mandatory vaccination also affects public domains involved professionals involved

in decision-making (Rus & Groselj, 2021). In Australia, although childhood immunization is

widely acknowledged and recognized as a significant achievement in health care, some portion

of the population does not fully agree with the benefits. For instance, in countries with well-

established vaccination programs as Australia, disease incidences have plummeted and hence

some people do not see/believe the need for having a vaccination program (Giubilini, 2021).

Some people believe that vaccination is unnecessary and that it's only a program aimed at

controlling the population.

Various opinions exist concerning vaccination, with some people being against its

mandatoriness, while other people do not appreciate the state's involvement in the program

(Giubilini, 2021). Hence, vaccine reluctance and vaccine hesitancy has become more popular,

with the emergence of certain groups against vaccines and vaccination, popularly known as

"anti-vaxxers". These groups have become more popular with the recent advancement of social

media platforms and increased interaction among people from all parts of the world (Rus &

Groselj, 2021). An increase in vaccine hesitancy increases the proportion of the population

susceptible to certain infections necessitating mandatory immunization.

Reasons for early childhood immunization

Infants are usually born when their immune system is still underdeveloped. For this

reason, they are at risk of contracting all forms of infections both viral, bacterial, and fungal

(Sheahan et al., 2021). In utero, they are always protected by the mother’s robust immune

response in the fetoplacental unit that scavenges for all forms of pathogens and clears them

before they may cross into the fetus (Sheahan et al., 2021). At birth, infants become vulnerable to

all sorts of infections as they possess a weak immune system with weak cellular and humoral

immune system.
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The cellular arm of the system is weak since infants have never been exposed to any

pathogen in utero thus, they possess no memory of dealing with any type of disease-causing

organism when they are exposed (Sheahan et al., 2021). The humoral arm is present with a few

immunoglobulin molecules that cross the placenta to the fetal side. IgG and IgA are the common

immunoglobulins that the infant possesses that help in combating common infections (Sheahan

et al., 2021). These two immunoglobulins are not enough in keeping the immune from many

existing pathogens.

Regarding the innate arm of the immune system in infants, it’s poorly developed with no

ability to combat any pathogen, even those with the lowest virulence can easily cause a serious

infection (Lindstrand et al., 2021). At birth, neonates are only covered in vernix caseosa, a

protective and insulative cover that is later wiped off. The skin of infants is still weak and not

strong enough to shield them from the entry of virulent microorganisms (Lindstrand et al., 2021).

In their respiratory system, the cilia are not yet developed, this puts them at risk of inhaled

organisms that possess the ability to cause serious systemic infections. This is the main reason

why upper respiratory infections are commonest in this population.

There is only one simple measure that can be taken to alleviate all these threats to

children’s lives and it is through early childhood immunization (Lindstrand et al., 2021). These

measures taken to prevent adverse events associated with immunization are aimed at maintaining

the principle of nonmaleficence. Immunizations have been proven to have reduced the infant

mortality rate by over 50% globally. This is because conditions that paused a great threat to

humanity have been wiped out near extinction by early vaccinations (Lindstrand et al., 2021).

New advances in technology and healthcare are continuously promoting the creation of safe,

effective vaccines to manage early childhood serious diseases. For instance, polio was the most
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feared disease worldwide with the highest mortality and morbidity rates (Lindstrand et al., 2021).

It was to cause serious disabilities through paralysis but through immunization programs, this

disease has been contained with few cases being reported even in developing countries.

Another major reason to consider making immunizations mandatory is that they are all

safe and effective (Milet et al., 2018). The process of developing a vaccine takes time and it goes

through various trials before it gets authenticated to be used in humans. This indicates how the

healthcare system invests so much in the entire process, with the single aim of reducing the

disease burden in society and this calls for all citizens to be compliant for the success of this

process (Milet et al., 2018). Serious adverse events following immunization are very rare,

indicating high beneficence conferred to the infant. This includes anaphylactic reactions

following the administration of certain vaccines (Milet et al., 2018). This event is not always the

effect of the vaccine but the molecules used in the creation of the active component of the

vaccine. For instance, a flu vaccine has a component of egg lecithin, and when given to an infant

who has a known allergy, the incidence of reacting to the vaccine is pretty high (Milet et al.,

2018). However, taking a proper history regarding infants’ allergies before administering the

vaccine has proven to be of great importance in preventing such occurrences. In most cases,

vaccines are issued by well-trained medical personnel who are well-acquainted with resuscitation

skills (Milet et al., 2018). This proves an entire point that the disease prevention benefits of early

childhood immunization outweigh the possible effects in all infants.

Immunizations are also crucial in the young population because they serve to protect

others that we care about (Olaniyan et al., 2021). Getting vaccinated does not only benefit the

infant who receives it but also serves a greater good to shield against disease transmission among

children when they interact (Olaniyan et al., 2021). Immunizing over 80% of the infants confers
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herd immunity to the entire infant population, whereby the transmission rate of the disease is

brought down to zero with no new infections in the entire population (Olaniyan et al., 2021).

This serves to protect the vulnerable population who may be reactive to vaccines thus missing

out on most of them. Protecting others is itself a form of beneficence to society at large. By fully

immunizing all the infants who have no allergies to certain vaccines and a robust immune

system, the most vulnerable ones get protected passively from serious infections.

Childhood immunizations have been proven to save most of the family’s time and

resources. Most vaccine-prevented diseases have been documented to be the leading cause of

lifelong disabilities and major health complications (Olaniyan et al., 2021). When vaccinations

are missed out, some infants may suffer the inevitable consequences of having to pay so heavily

to maintain their children in special institutions caring for children with disabilities (Olaniyan et

al., 2021). Most of the guardian’s time is also spent off duty while caring for their children who

have disabilities and this generally reduces the productivity of the family. Employing trained

caregivers to look after infants with disabilities is also way too expensive compared to getting

early immunization (Olaniyan et al., 2021). To avoid these unnecessary costs, parents need to

follow up on their children’s immunization program to ensure that they receive their vaccinations

on a good time.

Early childhood immunization also protects future generations from debilitating

conditions (Boyle et al., 2020). For instance, the WHO organization’s move to vaccinate the

entire global population against smallpox by creating the smallpox vaccine and availing it to all

populations served a greater good in eliminating the disease (Boyle et al., 2020). This has

protected the present generations from getting the smallpox vaccine since the disease was wiped

out long ago (Boyle et al., 2020). Vaccinating infants against German measles has also been
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proven to prevent the vertical transmission of this disease vertically in utero from mother to fetus

when the vaccinated gets a reproductive age (Boyle et al., 2020). This move is feasible

economically in lowering the disease burden as most infants are born normally with no profound

congenital anomalies. If the program of immunizing infants is made mandatory, it’s clear that the

future of Australia will be brighter with less disease burden on the economy and a healthy

working population.

Conclusion

In summary, the process of childhood immunization has been proven to have greater

benefits to the entire nation with minimal risks that can be easily mitigated. With proper

upholding of the client’s autonomy and beneficence, immunizations can be offered to all infants

at risk. The main benefits range from a reduction in the infant mortality rate, decreased infant

morbidity rate, and good health amongst this population. A healthy population is crucial to the

economy of Australia as there will be enough workforce and bright minds to implement and

input our economic policies. This type of immunity is achieved when more than two-thirds of the

population gets vaccinated thus the transmission rate is lowered in the entire population.
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References

Boyle, J., Berman, L., Nowak, G. J., Iachan, R., Middleton, D., & Deng, Y. (2020). An

assessment of parents’ childhood immunization beliefs, intentions, and behaviors using a

smartphone panel. Vaccine, 38(10), 2416-2423.

https://doi.org/10.1016/j.vaccine.2020.01.032

Carpia no, R. M., Polonijo, A. N., Gilbert, N., Cantin, L., & Dubé, E. (2019). Socioeconomic

status differences in parental immunization attitudes and child immunization in Canada:

Findings from the 2013 Childhood National Immunization Coverage Survey

(CNICS). Preventive medicine, 123, 278-287.

https://doi.org/10.52206/jsmc.2018.8.2.%25p

Feldstein, L. R., Sutton, R., Jalloh, M. F., Parmley, L., Lahuerta, M., Akinjeji, A., ... & Wallace,

A. S. (2020). Access, demand, and utilization of childhood immunization services: A

cross-sectional household survey in Western Area Urban district, Sierra Leone,

2019. Journal of global health, 10(1), 010420. https://stacks.cdc.gov/view/cdc/90844

Giubilini, A. (2021). Vaccination ethics. British Medical Bulletin, 137(1), 4-12.

https://doi.org/10.1093/bmb/ldaa036

Lindstrand, A., Cherian, T., Chang-Blanc, D., Feikin, D., & O’Brien, K. L. (2021). The world of

immunization: achievements, challenges, and strategic vision for the next decade. The

Journal of infectious diseases, 224(Supplement_4), S452-S467.

https://doi.org/10.1093/infdis/jiab284

MacDonald, N. E., Harmon, S., Dube, E., Steenbeek, A., Crowcroft, N., Opel, D. J., ... & Butler,

R. (2018). Mandatory infant & childhood immunization: Rationales, issues, and

knowledge gaps. Vaccine, 36(39), 5811-5818.

https://doi.org/10.1016/j.vaccine.2018.08.042

Milet, B., Chuo, J., Nilan, K., Warren, K., McKenna, K., Carroll, J. M., ... & Zhang, H. (2018).

Increasing immunization rates in infants with severe chronic lung disease: a quality

improvement initiative. Hospital Pediatrics, 8(11), 693-698.

https://doi.org/10.1542/hpeds.2018-0046

Olaniyan, A., Isiguzo, C., & Hawk, M. (2021). The Socioecological Model as a framework for

exploring factors influencing childhood immunization uptake in Lagos state,

Nigeria. BMC Public Health, 21(1), 1-10. https://doi.org/10.1186/s12889-021-10922-6

Olaniyan, A., Isiguzo, C., & Hawk, M. (2021). The Socioecological Model as a framework for

exploring factors influencing childhood immunization uptake in Lagos state,

Nigeria. BMC Public Health, 21(1), 1-10. https://doi.org/10.1186/s12889-021-10922-6

Rigby, M. J., Chronaki, C. E., Deshpande, S. S., Altorjai, P., Brenner, M., & Blair, M. E. (2020).

European Union initiatives in child immunization—the need for child centricity, e-health,

and holistic delivery. European Journal of Public Health, 30(3), 468-

https://doi.org/10.1093/eurpub/ckz199

Rus, M., & Groselj, U. (2021). Ethics of vaccination in childhood—A framework based on the

four principles of biomedical ethics. Vaccines, 9(2), 113.

https://doi.org/10.3390/vaccines9020113

Schiavo, R., Basu Roy, U., Faroul, L., & Solodunova, G. (2020). Grounding evaluation design in

the socio-ecological model of health: a logic framework for the assessment of a national
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routine immunization communication initiative in Kyrgyzstan. Global health

promotion, 27(4), 59-68. https://doi.org/10.1177/1757975920914550

Sheahan, K. L., Orgill-Meyer, J., Speizer, I. S., Curtis, S., Paul, J., Weinberger, M., & Bennett,

A. V. (2021). Development of integration indexes to determine the extent of family

planning and child immunization services integration in health facilities in urban areas of

Nigeria. Reproductive Health, 18(1), 1-16. https://doi.org/10.1186/s12889-021-10922-6

Wemakor, A., Helegbe, G. K., Abdul-Mumin, A., Amedoe, S., Zoku, J. A., & Dufie, A. I.

(2018). Prevalence and factors associated with incomplete immunization of children (12–

23 months) in Kwabre East District, Ashanti Region, Ghana. Archives of Public

Health, 76(1), 1-9. https://doi.org/10.1186/s13690-018-0315-z