Kindon Model

              2) Vaccines are Inherently Risky; Mandatory Vaccination Violates Human Rights and Medical Ethics

Links: 1) http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-08-tighter-limitations-immunization-opt-outs.page

           2) http://www.naturalnews.com/050112_mandatory_vaccination_human_rights_medical_ethics.html

Why Selected: Vaccinations have been a hot topic of debate in these past few years, with more parents fearing lifelong effects vaccines may have on their children. The Centers for Disease Control (CDC) recommends getting 28 doses of 10 vaccines for kids aged zero to six (ProCon, 2016), which for many people seems excessive and is therefore leading to higher rates of individuals not following guidelines. Although there are no federal laws mandating vaccines, many pro-vaccination associations are fighting for tighter restrictions on exemptions. This is becoming an increasingly important topic, especially since there has been a rise in incidences of vaccine preventable diseases such as measles, mumps, polio, rubella, and whooping cough (Brady, 2015) over the past couple of years.

Problem Stream: How can we create a unified mandate to combat further outbreaks of vaccine preventable diseases?

                           1) In recent years, there has been a correlation between an increase in incidences of common diseases (that were once almost eradicated) and the anti-vaccine movement. The American Medical Association (AMA) has taken notice of this, especially after the recent measles outbreak at Disneyland (which affected 147 United States individuals), and became increasingly concerned that only two states bar non-medical exemptions for immunizations based on personal beliefs (Mills, 2015). 

                           2) With the recent push to mandate immunizations, backlash from anti-vaccine advocates was inevitable. Larry Cook, founder and director of the Stop Mandatory Vaccination Project, stressed the fact that the unvaccinated are not threats, pointing out that those affected in the Disneyland measles outbreak were both vaccinated and unvaccinated individuals (Huff, 2015). He states, "Forcing us to be vaccinated against our will is an absolute personal sovereignty in every possible way and is nothing short of medical tyranny and a path to enslavement".

Preferred Solution: 1) AMA created a new policy that recommended states having an established decision mechanism that involves qualified public health physicians to determine which vaccines will be mandatory for admission to schools and other public venues, and that states should only grant exemptions to these mandated vaccines for medical reasons (Mills, 2015). This policy also extends to include physicians and other health care professionals, especially since highly transmissible diseases pose significant risks for immunocompromised patients and the health care workforce. 

                               2)  Cook recommended contacting legislators and demanding that they vote NO on any bills that create mandates on vaccinations and instead supports "doing nothing" and continuing to allow for the rejection of vaccines for whatever individuals deem appropriate (Huff, 2015). He further recommends educating "yourself, friends, family members, and coworkers on the dangers of vaccines". 

Alternative Solutions: An article by Makia Freeman (2015) advocates for making health care providers sign a form that states they are aware of the ingredients, safety, risks, etc. of vaccinations before injecting their patients rather than making vaccinations mandatory. This suggests that in return providers will take full legal liability and will stop unethically "forcing" patients to accept a vaccination. On the other hand, it could be proposed that patients sign a form stating they understand the risks of NOT receiving vaccinations. Although most likely unethical, fines could be set if patients do not receive vaccines. 

Political Stream: 1) Many are in support of the AMA's policy. For instance, on June 30, 2015 Governor Brown signed the policy that states personal and religious belief exemptions for vaccinations will not be allowed in the state of California (National Vaccine Information Center, 2016). The American Academy of Pediatrics recommends a mandate for the flu vaccine for all children, as do many hospitals for their health care workers. A poll conducted by Ipsos for Reuters found that 78 percent of Americans believe all children should be vaccinated, 70 percent believe schools should be able to suspend unvaccinated students during outbreaks of contagious disease, and 65 percent think schools should be able to refuse enrollment to unvaccinated children (Wofford, 2015).

                           2) Donald Trump, the Republican presidential candidate, is an anti-vaccine advocate that is against mandated vaccinations. He has made claims such as "a child went to have a vaccine, got very, very sick, and now is autistic" (Ferris, 2015). There are several other anti-vaccine groups, such as The Vaccine Resistance Movement, Vaccination Liberation Group, and Parents Against Mandatory Vaccinations, that are creating petitions against vaccination regulations, stating they cause more harm than good. There is even a film that highlights the risks of vaccines called Vaxxed. This film was directed by Andrew Wakefield, an academic gastroenterologist, and attempts to reveal a coverup of the MMR vaccine connection to autism by the CDC (Goldstein, 2016). 

Kingdon Model "In Action": Vaccinations have been a topic of debate for quite some time now, especially now that anti-vacciners are on the rise. With an increase in disease outbreaks, such as the measles outbreak at Disneyland, The American Medical Association has proposed a policy that would mandate immunizations and prevent exemptions due to "personal or religious" purposes. However, several anti-vacciners (such as Larry Cook) argue that this is not only unnecessary, but also strips patient autonomy. Suggestions have been made by both sides, yet a conclusion still has not been set. Many members of the political party (i.e. Donald Trump) have commented on vaccinations and whether or not they are important and the topic frequently comes up in debates. This has definitely become a nation-wide issue, and several states are starting to take action FOR mandating immunizations. The Kingdon Model is certainly addressed through all aspects, and will continue to include more background information as the topic progresses.

Personal Opinion: After reading both sides and researching the topic, I believe the American Medical Association provides a more convincing argument. The fact of the matter is that preventable diseases are on the rise, especially in children. These vaccinations have been proven to work, and even though a subset of individuals have been affected negatively, I am still not convinced this is causation but rather correlation.

References:

Brady, M. P. "Reemergence of 5 Vaccine-Preventable Diseases." Medscape. WebMD LLC, 14 May 2015. Web. 11 June 2016. <http://reference.medscape.com/features/slideshow/vaccines-preventable-diseases>.

"California State Vaccine Requirements." National Vaccine Information Center (NVIC). N.p., 23 May 2016. Web. 11 June 2016. <http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/california.aspx>.

Culp-Ressler, T. "Vaccines Have Almost Totally Eliminated These 13 Infectious Diseases In The U.S." ThinkProgress RSS. Center For American Progress Action Fund, 22 Feb. 2013. Web. 11 June 2016. <http://thinkprogress.org/health/2013/02/22/1622871/vaccines-impact-infographic/>.

Ferros, S. "Trump Links Vaccines to Autism 'epidemic'." The Hill. Capitol Hill Publishing Corp., 16 Sept. 2015. Web. 11 June 2016. <http://thehill.com/policy/healthcare/253980-trump-links-vaccines-to-autism-epidemic>.

Freeman, M. "A Handy Solution to Every Pending Mandatory Vaccination Program." The Freedom Articles. N.p., 2016. Web. 11 June 2016. <http://freedom-articles.toolsforfreedom.com/solution-to-pending-mandatory-vaccination/>.

Goldstein, M. "Why the Documentary Vaxxed Is so Controversial and Important to Support." VacTruth.com. N.p., 2016. Web. 11 June 2016. <http://vactruth.com/2016/04/27/the-truth-about-vaxxed/>.

Huff, E. A. "Vaccines Are Inherently Risky; Mandatory Vaccination Violates Human Rights and Medical Ethics." NaturalNews. Natural News Network, 18 June 2015. Web. 11 June 2016. <http://www.naturalnews.com/050112_mandatory_vaccination_human_rights_medical_ethics.html>.

Mills, R. J. "AMA Supports Tighter Limitations on Immunization Opt Outs." AMA News Room. American Medical Association, 8 June 2015. Web. 11 June 2016. <http://www.ama-assn.org/ama/pub/news/news/2015/2015-06-08-tighter-limitations-immunization-opt-outs.page>.

"Should Any Vaccines Be Required for Children?" ProCon.org Headlines. N.p., 04 Apr. 2016. Web. 11 June 2016. <http://vaccines.procon.org/>.

Wofford, T. "New Poll: Americans Want Mandatory Vaccines." Newsweek. NewsweekLLC, 24 Feb. 2015. Web. 11 June 2016. <http://www.newsweek.com/americans-want-mandatory-vaccines-new-poll-finds-309186>.