09/23/2025
The essay below was originally written in 2018 by a high school student in our practice, in response to a debate with an unvaccinated peer who was advocating for vaccine choice. In light of the most recent measles outbreak in Texas—and the ongoing, fierce dispute over whether parents should have the right to opt out of vaccinating their children—we believe this piece remains strikingly relevant. It offers not only a compelling defense of mandatory vaccination but also a timely reminder of the consequences of forgetting our public health history
AN ARGUMENT FOR MANDATORY VACCINATIONS IN U.S.
Did you hear the good news? Measles was declared eliminated in the United States in 2000—the very year I was born—thanks to the widespread use of the safe and effective MMR vaccine. Now, here’s the bad news: measles is back.
Over the past few decades, a growing number of parents have chosen to skip not only the measles vaccine but often all childhood immunizations. While vaccination is a personal right, it is also a collective responsibility. The more people in a community who are vaccinated, the healthier and safer that community becomes.
Vaccines are a triumph of democracy—born from public dialogue, scientific consensus, and collective action. They are among the greatest achievements in modern medicine, responsible for the eradication of smallpox and the near-elimination of diseases like polio, diphtheria, and measles. They have saved countless lives.
Yet vaccines have become victims of their own success. Many younger parents have never witnessed the pain, suffering, and death these diseases once caused. As a result, they question the need for vaccines and assert their right to choose. But the freedom to make personal decisions about one’s child ends where it puts others at risk. One parent’s choice not to vaccinate affects every other child in their community.
As the renowned playwright George Bernard Shaw once said, “Liberty means responsibility. That is why most men dread it.” In public health, that responsibility means protecting not just our own children—but everyone’s.
A History We Seem Eager to Forget
Opposition to vaccines isn't new—it predates even the first vaccine. Inoculation against smallpox saved countless lives, despite early skepticism. Benjamin Franklin, a strong advocate for public health, supported smallpox inoculation as early as the 1730s. In fact, he lost his own son to the disease—a tragedy that left him with lifelong regret. In his autobiography, Franklin wrote:
“I long regretted bitterly, and still regret that I had not given it to him by inoculation… therefore, the safer should be chosen.”
George Washington, too, recognized the power of immunization, mandating smallpox inoculations for the Continental Army—a pivotal decision that helped secure American independence. Later, Edward Jenner’s development of the smallpox vaccine marked a turning point in medicine. So impressed was President Thomas Jefferson by Jenner’s discovery that he declared vaccination a top national priority.
These founding leaders understood what many today have forgotten: that public health depends not only on individual action, but on collective will.
The Cycle of Forgetting
By the time the polio and measles vaccines were developed, smallpox was nearly eradicated—and, in the minds of many, forgotten. A generation of parents raised without fear of these diseases began to question the need for vaccines. Fears over “toxins” and “unnatural chemicals” began to eclipse historical memory. Some stopped vaccinating entirely. Others delayed, not realizing that vaccines draw their strength not only from the individual dose, but from herd immunity—the collective wall that keeps infectious disease at bay.
Few people know that beloved children’s author Roald Dahl — who wrote Charlie and the Chocolate Factory — lost his seven-year-old daughter, Olivia, to measles in 1962, just one year before the vaccine was introduced. In a public letter in 1988, he urged other parents: (...) There is today something that parents can do to make sure that this sort of tragedy does not happen to a child of theirs. (...) Today a good and safe vaccine is available to every family, and all you have to do is ask your doctor to administer it. (...) In America, where measles immunization is compulsory, measles—like smallpox—has been virtually wiped out. Here in Britain, because so many parents refuse, either out of obstinacy or ignorance or fear, to allow their children to be immunised, we still have a hundred thousand cases of measles every year.”
Ironically, Dahl held up America as a model for his countrymen, urging them to follow the U.S.'s lead on vaccination. Yet nearly thirty years later, it would be America that needed the same wake-up call.
A Warning from Disneyland
In December 2014, an international visitor brought more than joy to California’s Disneyland—measles had returned. With vaccination rates as low as 50% in some communities, the virus spread quickly. More than 150 people fell ill—many unvaccinated by choice, others too young to be vaccinated. The outbreak spread to six states, as well as Canada and Mexico. Quarantines were issued, panic ensued—and thankfully, no one died.
At the time, California allowed “personal belief” exemptions. In some affluent, health-conscious communities, families chose to forgo vaccines, trusting that diet, lifestyle, and natural immunity would be enough to protect their children. While these families made choices based on their beliefs, their decisions unintentionally relied on the protection provided by those around them who were vaccinated. But when vaccination rates drop too low, it’s not just individual families at risk—entire communities become vulnerable.
The Disneyland outbreak jolted the country back into awareness. Pro-vaccine parents found their voices again. The conversation around mandatory vaccination, exemptions, and public responsibility returned to the national stage.
Measles Is a Plane Ride Away
Before the vaccine, measles infected four million Americans every year and killed 500—mostly children. Thanks to immunization, those numbers dropped to fewer than 200 cases annually, nearly all imported by unvaccinated travelers. But in many parts of the world, the disease is far from gone. Every day, 300 children still die of measles globally. Many of their parents walk for hours just to access a vaccine—something some Americans now reject.
Measles is one of the most contagious viruses on Earth. Ninety percent of unvaccinated people exposed will become infected—even hours after the contagious person has left the room. That’s why herd immunity is critical. To stop transmission, at least 95% of a community must be vaccinated. This protects infants, the immunocompromised, and the small percentage of people for whom vaccines don’t work.
Measles is not always mild. It can cause pneumonia, blindness, hearing loss, brain damage, and death. Survivors may need years of therapy. Some die years later from SSPE (Subacute Sclerosing Panencephalitis), a fatal neurological disease. All this is preventable with a widely available vaccine that carries a serious side effect risk of just one in a million.
As Roald Dahl once wrote:
“I should think there would be more chance of your child choking to death on a chocolate bar than of becoming seriously ill from a measles immunisation… It really is almost a crime to allow your child to go unimmunised.”
Freedom with Responsibility
No vaccine is perfect, but the benefits overwhelmingly outweigh the risks. The MMR vaccine, though relentlessly scrutinized, has been proven safe in countless studies. It does not cause autism. And yet, 18 U.S. states still allow parents to claim “personal belief” exemptions, jeopardizing public health in the name of individual freedom.
But public health laws are not new. We already have laws mandating seatbelts and car seats. We outlaw drunk driving. We require helmets. We ban smoking in public places. We regulate food safety, drinking water, and sanitation. Why? Because some risks to society outweigh individual freedoms.
The choice not to vaccinate is not just a private one—it endangers those around you. It’s the difference between protecting your own child and putting someone else’s in harm’s way.
Therefore, what happens when well-meaning decisions to protect a child unintentionally put them—or others—at risk?
What if an unvaccinated child falls seriously ill or dies from a preventable disease? Or what if they pass it on to a vulnerable peer? Is that merely misfortune—or something more, given that vaccination could have prevented it?
Public health is a shared burden and a shared right. And rights, by definition, come with responsibilities. Children—all children—have the right to a safe future. Our democracy must not allow them to become collateral damage in the name of personal liberty.
After the Disneyland outbreak, California joined Mississippi and West Virginia in removing personal and religious exemptions. It was a major step forward—not a complete solution, but a meaningful one. A victory for science. A victory for public safety. A victory for every family who wants to visit “the happiest place on Earth” without fearing a brush with measles.
Vaccines are not just a scientific achievement—they are a moral imperative. In a society that values life, equality, and shared responsibility, mandatory vaccination should not be a debate. It should be the standard.
