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Should Vaccinations Be Mandatory?, edited by Noel Merino. 117 pgs. Farmington Hills, MI : Greenhaven, 2010. 978-0-7377-4691-4.

Vaccination, the injection of pathogenic cells into a healthy individual to induce immunity, was long held as one of the marvels of medical science. Polio, smallpox and diphtheria have been essentially erradicated; Pasteur and Salk lionized as champions of public health; and even once-common childhood diseases like chickenpox and measles have been greatly minimized. Nonetheless, concerns have emerged from a small but vocal group questioning whether possible adverse reactions justify the series of 15 or 16 (depending on gender) generally recommended vaccines.

This volume in Greenhaven’s At Issue series addresses the arguments of the increasing number of people who challenge conventional wisdom and forgo compulsory vaccinations for their own children. Vaccine is, as the volume posits, only commercial product for individuals mandated by law. While all 50 states have mandatory vaccination laws, the process for exemption for medical, religious, or even philosophical reasons varies widely from state-to-state, with some states dictating stringent requirements while others aren’t so rigorous. Some skeptics see childhood diseases as a natural stage of developing a robust immune system and refuse vaccination on those grounds, while others are concerned about side effects. Parents who refuse vaccinations for their children are actually relying on the "herd immunity" of other vaccinated children, and that "herd immunity" has recently broken down in some affluent communities. The book cites the occurrence of whooping cough in Boulder, Colorado, as an example of parents opting against vaccination and unwittingly contributing to a modern epidemic.

One article indicts a handful of vocal celebrity parents for persistence of the accounts in the popular press warning that thimerosol, a preservative in the Measles-Mumps-Rubella (MMR) vaccine, can trigger autism disorders. But given the mandate for MMR vaccination in the United States, the initial U.K. study suggesting the link was not immediately refutable using an American population. Another article recounts the Danish study that used videotapes of early childhood behavior -- commonly known as the "Home Movie Study" — to demonstrate that signs of autism disorders were present in children prior to vaccination.

Other objections discussed center around the manufacture of the vaccines. Because chicken pox and MMR vaccines are derived from fetal tissue, many choose to forgo vaccinations on religious grounds. The book is even-handed in its evaluation of the benefits and risks of the process, as well as the external factors that lead to widespread adoption of innoculation against a particular disease. For example, it was the loss of parental productivity (computed to be one work day per affected child) that influenced recommendations for chicken pox vaccination.

In addition to thorough coverage of the claims about autism and the MMR vaccine, the volume also treats a topic of considerable recent interest. That’s the role of a newly available vaccine against Human Papilloma Virus (HPV), which causes cervical cancer. Five of the 13 articles in the volume are devoted to the HPV debate. Since HPV is transmitted through sexual activity, some critics argue you cannot force parents to inoculate their children against what is a sexually transmitted disease. Though most individuals contract HPV decades before developing what is now an often-preventable cancer, it was the recommendation that pre-pubescent girls receive vaccination that raised hackles for those who felt universal vaccination encourages promiscuity.

The volume traces vaccination back to 200 B.C. in both India and China. Articles are taken from publications ranging from the U.S. Department of Health and Human Services literature on childhood vaccination to alternative health and Libertarian publications. Recommended for school and public libraries.