Removing parental exceptions to mandatory vaccination: Is it the best way?

The World Health Organization (WHO) has named “vaccine hesitancy” – being reluctant or refusing to vaccinate despite the availability of vaccines – as one of the top threats to global health.

But is removing parental exceptions to mandatory vaccination the best way to achieve the results health experts desire or does it increase opposition to it? Lawmakers in New Brunswick are asking themselves that question now before the final vote for Bill 11.

In Fredericton, about 150 people gathered in front of the Legislature on June 9 and again on June 16 to protest Bill 11 which would tighten the rules on vaccination of schoolchildren and children in daycare. Bill 11 would remove the ability of parents to use religious or conscientious objection as a reason for not having their children vaccinated.

“We don’t want our rights taken away,” protester Liz Kramer told the NB Media Co-op on June 9. Kramer, who describes herself as a “concerned mother,” is considering homeschooling her child if the Bill passes, rather than leave him in the public school system where he would be subject to vaccination.

Kramer and others interviewed by the NB Media Co-op frame the protest as being primarily about civil liberty and only secondarily about vaccination. “This is about your rights and your freedom to do what you want with your body,” says Kramer. “It’s time to stand up for your rights whether you believe in vaccination or not.”

Currently only two provinces – New Brunswick and Ontario – require a child to have proof of vaccination to enter the public school system. In New Brunswick, the list of vaccines children must take is not stipulated in legislation but is determined by the Chief Medical Officer on an ongoing basis.

In both New Brunswick and Ontario, children can be exempted from vaccination on the advice of a medical practitioner, or by parental objection for reasons of conscience or religious belief.

Bill 11, introduced by Minister of Education and Early Childhood Development Dominic Cardy in November, would keep the medical exemption but get rid of the parental one.

As the protesters gathered on the lawn on June 9, chanting and holding signs with messages such as “Our Rights, Our Freedom”, “Our Bodies, Our Choice”, and “Stop Bill 11”, inside the Legislative building the Bill was being reviewed by committee.

Via a wireless feed and a small speaker set up by the protesters one could hear Minister Cardy inside the House: “Unfortunately, we are seeing the growth of an organized anti-vaccination movement, and that is the reason why this legislation is before us.”

Nicole Lynn, one of the protest organizers, said similar protests had been held on May 5 and May 26. When asked if any organizations were behind the protest she responded: “This has been purely grassroots…. I became involved last summer when my daughter was 2; it came onto my radar then, when Bill 39 was presented, and it’s really taken off since April of this year. Since the beginning it’s been purely citizen-led.”

Lynn said people had come to the protest from “all across New Brunswick… from Moncton, from Saint John, from Bathurst.”

Bill 11 is a revised version of another vaccination bill, Bill 39, which was introduced by Cardy in the spring of 2019 but did not get to a vote. The main difference is that a Constitutional notwithstanding clause was added to Bill 11, which would exempt the bill from parts of the Charter of Rights and Freedoms and from section 6 of the Human Rights Act. That clause was removed in Legislative committee debate on June 16.

In New Brunswick, opposition to Bill 11 appears to be led by women.

The crowd at the June 9 protest was overwhelmingly female, with an estimated six women for every man. This appeared to be particularly true among those who were most involved in the organising. Organiser Lynn said “I think it speaks to the burden of women, of mothers, and that we are the caretakers essentially, in a lot of ways, of our families; and so you see that reflected here.”

Cardy has repeatedly disparaged opponents of the Bill, saying, for instance, that they “subscribe to a vague, weird Trumpian ideal of how the world works,” and that they have “nothing but conspiracies and medieval fantasies to base their arguments on.”

However discussion with the protesters outside the Legislative Assembly in Fredericton revealed that their political views defy easy left/right categorization. Some express conservative views on race and gender, and one used the word “socialism” as a pejorative; but at the same time an anti-capitalist, anti-corporation critique is present, as is a strong environmental sensibility among some of the protesters.

Liz Kramer, who is the mother of a ten year old, said it was during her pregnancy that she began having doubts about vaccines: “I am over 40, so I was thinking that vaccines were a normal part of life-saving medical care, but when I started reading about this hepatitis B vaccine while I was pregnant, and I was going to be expected to give my newborn not one but three shots before six months for a disease that there was no risk of contracting, I started to really question.”

According to federal government estimates, only 1.3% of children in the Atlantic provinces have no history of vaccination by two years of age, while the national figure is 2.3%. Minister Cardy has said that 1.6% of the province’s school population has a vaccine exemption, but he doesn’t know what proportion of that is medical and what is parental. He says vaccines don’t work in 3% of cases, so about 5% of the school population is unprotected.

The proportion of a population that needs to be immune in order for “herd immunity” to exist — in other words, for the reproduction rate of the disease to be less than 1 so that it decays exponentially and disappears — varies from one disease to another. For example, measles and pertussis are highly contagious and therefore require 92-95% of the population to be immune before they die out. But for many other diseases the herd immunity threshold is lower, ranging from 83-86% for diphtheria and rubella, down to 33-44% for influenza.

Controversy over mandatory vaccination is almost as old as vaccination itself. According to a recent, pro-vaccination paper by Alvin Nelson El Amin and others in Public Health Review, the first compulsory vaccination laws, or “mandates”, were passed in Italy in 1806, France in 1810, and Sweden in 1816. They precipitated vigorous ethical debate, and considerable opposition among parents of the targeted children.

In the United Kingdom, the history begins with a compulsory smallpox vaccination law in 1853, to which fines for noncompliance were added during the subsequent two decades. Steadily increasing opposition led to a Royal Commission in 1889, which seven years later decided that a “conscientious objection” should be permitted for parents opposed to vaccination of their children.

The compulsory vaccination law was repealed entirely in 1946 and, according to the El Amin paper, mandates have not been used in the UK since.

In New Brunswick, the question of mandatory vaccination will come up again in a different context, and also across the country and around the world, when the COVID-19 vaccine is developed. Already experts are saying that in Canada, the COVID-19 vaccine is unlikely to be mandatory, as doing so creates a host of complex problems.

Norm Knight is a reporter with the NB Media Co-op.