Resolved: The US should make vaccines mandatory
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After 1 vote and with 3 points ahead, the winner is...
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Resolved: That the US should make vaccines mandatory
Vaccinations: A biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe, its toxins or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as foreign, destroy it, and "remember" it, so that the immune system can more easily recognize and destroy any of these microorganisms that it later encounters.
For more info on vaccines see here http://www.who.int/topics/vaccines/en/
Mandatory: required by law or rules; compulsory.
Ought: indicates moral desirability
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8. The BOP is evenly shared
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R1. Pro's Case; Con's Case
R2. Pro generic Rebuttal; Con generic Rebuttal
R3. Pro generic Rebuttal; Con generic Rebuttal
R4. Pro generic Rebuttal and Summary; Con generic Rebuttal and Summary
== Additional Information ==
The vaccines schedule and vaccines that this debate is refering to are the vaccines recommended by the CDC. (see here https://www.cdc.gov/vaccines/vpd/vaccines-age.html). Obviously those who are medically unable to receive vaccines will be exempt.
Efficacious vaccines not only protect the immunized, but can also reduce disease among unimmunized individuals in the community through “indirect effects” or “herd protection”. Hib vaccine coverage of less than 70% in the Gambia was sufficient to eliminate Hib disease, with similar findings seen in Navajopopulations.29,30 Another example of herd protection is a measles outbreak among preschool-age children in the USA in which the attack rate decreased faster than coverage increased.31 Herd protection may also be conferred by vaccines against diarrhoeal diseases, as has been demonstrated for oral cholera vaccines.32“Herd protection” of the unvaccinated occurs when a sufficient proportion of the group is immune.33 The decline of disease incidence is greater than the proportion of individuals immunized because vaccination reduces the spread of an infectious agent by reducing the amount and/or duration of pathogen shedding by vaccinees,34retarding transmission. Herd protection as observed with OPV involves the additional mechanism of “contact immunization” – vaccine viruses infect more individuals than those administered vaccine.10
A Colorado study last year showed that children of parents who refuse vaccinations against whooping cough are 23 times more likely to develop the disease than children who get the shots. Moreover, those in the anti-vaccine movement who insist that their actions do not risk harm to anyone other than their own unvaccinated children ought to take a closer look at those five California deaths to pertussis.All five were infants younger than 3 months, too young to be fully vaccinated themselves, but terribly vulnerable to a highly contagious disease passed around by unvaccinated children.Let's be very clear about this: Parents who skip vaccines for their own children are endangering the health and lives of other kids. And none of their justifications for such a selfish, short-sighted act stand up to scrutiny. Some parents pretend that their children don't need to be vaccinated because their friends and classmates have been vaccinated, claiming that this "herd immunity" will protect them all.
The ease with which non-medical exemptions can typically be obtained has raised concerns among many that the benefits of widespread immunization are being compromised. Because of the nature of medical exemptions, unvaccinated persons in a community with only medical exemptions would be expected to be few and dispersed. Herd immunity can be attained, and protection is ensured for both the vaccinated majority and the unvaccinated few. Broadly granted philosophical and religious exemptions make herd immunity more difficult to attain and increase the risk to the community. This risk is exacerbated by the fact that many of those who apply for such exemptions “will cluster together in one geographic area.” This cluster effect tends to increase the likelihood of serious outbreaks:Recent studies have shown that clusters of exemptors, who are significantly more susceptible to contracting vaccine preventable illnesses, pose an increased risk of spread of diseases not only to their unimmunized peers, but also to the surrounding, largely vaccinated population.
When evaluating data from VAERS, it is important to note that for any reported event, no cause-and-effect relationship has been established. Reports of all possible associations between vaccines and adverse events (possible side effects) are filed in VAERS. Therefore, VAERS collects data on any adverse event following vaccination, be it coincidental or truly caused by a vaccine. The report of an adverse event to VAERS is not documentation that a vaccine caused the event."
---A report to VAERS generally does not prove that the identified vaccine(s) caused the adverse event described. It only confirms that the reported event occurred sometime after vaccine was given. No proof that the event was caused by the vaccine is required in order for VAERS to accept the report. VAERS accepts all reports without judging whether the event was caused by the vaccine.
That leaves two options. One, Pro’s case has no enforcement. That leaves his case without any solvency; since issuing a mandate means absolutely nothing if no one has any incentive to adhere to it. Two, Pro’s mandate is enforced, at minimum, via fines and jail time. The poor would be fined for their inability to cover the costs of vaccinating, and then be jailed for not paying the fine. Pro is also turning every vaccine skeptic into federal criminals who will wield their imprisonment for civil disobedience. Parents are already being pushed away from the public school system and into protests due to far less daunting mandates. This will lead to wide-scale protests, overburdening the court and prison system for as long as the federal government continues to prosecute them, and additional sentences every time they missed their boosters or yearly flu shot. Pro’s case also doesn’t address shortages, like those seen with the flu vaccine year after year. With only the medical exemption left, anyone who gets to their flu shot too late would be prosecuted.
But let’s get into Pro’s arguments.
- In 2014 there were 2791 cases of hepatitis B resulting in over 500 deaths.
- In the same year there were 10,000 cases of chicken pox resulting in 4 deaths.
"We know that Washington state is a state with one of the highest percentages of religious and philosophical exemptions for vaccines in the country," he said. "It seems a reasonable conclusion that this death occurred because of inadequate immunization levels, but more epidemiological investigation will have to take place to find out."
Pro pretends to be acting on moral obligation but targets an inaction that by itself causes no harm to others.
On my case:
Loss of Freedom/Backlash
Pro concedes the inherent loss of freedom and drops all its impacts. Pro is forcing individuals who have strong fears of vaccination to receive said vaccinations, effectively invalidating their religious freedom. At minimum, this applies to 9% of the US population. That’s over 29 million people, all of whom are being told that their freedom of religion cannot be applied to their own bodies or those of their family. That population is far larger than all the epidemics Pro has cited, and the damage far deeper than any of these short-term illnesses is likely to cause.
Pro also drops consent. Everyone who gets vaccinated because of this mandate does so without consent. 16% of the population either thinks vaccines are safe or is unsure of their safety. That’s over 52 million people, all of whom lose their right to consent. Nothing destroys trust in the medical system so thoroughly than having basic decisions about your own body taken away. Pro also drops the story of Caryn Tabor where a vaccine was causing harm to a child and refused medical exemption. If not vaccinating is always child abuse, as Pro claims, then what would he call situations like this where vaccinating is causing clear and ignored harms? If anything, subjecting a child to this is far more abusive.
Taken together, this means that a huge swath of the population will justly feel that their rights have been violated. Pro concedes the points I made under backlash, and if harm to self, children and others is what makes something immoral, then the impacts of this point far outweigh any harm Pro ascribes to any lack of vaccination. The small protests that currently occur for local mandates will become massive, country-wide efforts, some of which may turn violent as many of these people believe the vaccines being forced on them are actively damaging them and their families. Those tens of millions of people will flee from their doctors, failing to seek treatment for a variety of diseases and increasing their spread. That includes diseases that aren’t vaccine preventable but are treatable, which Pro’s case does nothing to ameliorate. Those that do submit are far more likely to sue their providers, increasing the cost of care for everyone and decreasing access to that care as a result. Each illness will do more harm in Pro’s world, and many will spread far more easily.
Pro drops the first link on this point, which provides clinically-established incidence numbers for every vaccine that he is mandating, and therefore establishes that a portion of the population that is directly being harmed by vaccination. This means that many of the patients who seek lawsuits for damages will have convincing cases, costing the government and medical institutions tremendously in malpractice lawsuits. This supercharges my backlash impacts.
On Pro’s case:
Putting others at risk
Even with everyone taking every vaccine, diseases will still spread by bad behaviors. Pro is continuing to allow directly dangerous behaviors, revealing his willingness to allow people to put each other at risk. Clearly, he recognizes that some liberties matter more than doing everything possible to prevent disease outbreaks, so when he tells you that safety outweighs freedom when it comes to disease spread, he’s more than willing to cherry-pick applications of that principle.
Before this round, Pro never said that that only applied to a specific group (i.e. children going to school); all he said was that everyone must be vaccinated, with only a medical exemption available. Now, he wants to apply his case only to public school kids, automatically granting exemptions to others. He’s also providing a financial incentive to vaccinate. He never even suggested these planks before, and it is grossly unfair for Pro to be able to alter his case so late in this debate. Pro is trying to shift out of my arguments by presenting what is basically a brand-new case because he made a bad choice not clarifying in R1. I should also note that, in the rules, Pro states that both of our cases are confined to the opening round. Clarifying his case later is against the structure Pro himself established. Voters, hold Pro to his opening case and take a stand against this abuse.
If you buy that this tactic is abusive, extend both arguments: the pervasive damage to the doctor-patient relationship that will push many away from the health care system completely, as well as the massive jailing and court costs, both of which compound the backlash harms. Even if you’re considering Pro’s new case, it’s still subject to much the same backlash in the form of widespread protests and distrust of medical professionals.
Pro concedes this point, failing to challenge any of the costs I cited. Pro ignores the fact that that $2,194 figure only applies to child vaccines for families with insurance, so that number does not include what insurance covers, and will continue to increase rapidly as companies raise their prices due to the requirement to purchase them. Note that Pro’s case provides absolutely no recourse for people who cannot afford these costs (the financial incentive he talks about covers less than 1/17th of the lowest possible cost), so that means poor patients will have to pay for vaccination in place of necessities like food and housing. Pro admits that there is no recourse in status quo or in his case, and everyone is paying these costs, whereas comparatively few are seeking treatment of vaccinable diseases. Even if the overall cost is higher now, the government can afford those costs. The poor cannot.
However, make no mistake: costs are higher with Pro’s plan. Without secure housing and continuous access to food, the poor will suffer greater burdens of disease from exposure and malnutirion, costs the government will pay through ER visits. Also, the numerous costs of lawsuits and imprisonments, plus the costs of increasing vaccine production ($600 million per new facility ), will ensure that costs rise.
Herd Immunity/Disease Burden/Vaccine Effectiveness
Pro drops that the threshold for herd immunity for almost every disease Pro is vaccinating against is already met without any mandate. Pro also drops that states with mandates have similar rates of vaccination to many that don’t. Both points vastly undercut his solvency, since they suggest that a) people can and do voluntarily seek vaccinations, b) they do so in large enough numbers to obtain herd immunity to most diseases, and c) mandates do not necessarily result in substantial alterations to those numbers. Chickenpox exemplifies this, as even low levels of vaccination appear to impart herd immunity. Pro’s new plan further limits the effectiveness of his vaccinations, as parents may forge vaccination certificates, it makes home schooled kids and those attending private schools completely exempt, and provides no means to track boosters and adult vaccinations. All of this allows for the same pockets of the population to avoid vaccination, perpetuating the very problems he aims to solve.
Even if none of this factors in, Pro concedes that we cannot reach herd immunity with diseases that require above 90% vaccination rates. What diseases are these? Pertussis (whooping cough) and measles, the two diseases for which Pro keeps citing numbers. Without herd immunity, these outbreaks continue in Pro’s world, regardless of how effective the mandate is. Even Hepatitis B, the other disease Pro cites this round, appears to require 98% immunity to see effective protection. This makes Pro’s harms with these diseases non-unique – outbreaks continue in his world and those with weak immune systems remain vulnerable.
And I agree. I do, however, think there's an argument to be made about these restrictions being overly onerous. Protecting third parties from harm is not the overriding principle in all cases, since there are many actions or inactions that we largely agree should be allowed to persist despite the harms they cause to others. Whether that's true of vaccination is an open question, I'm just saying that the line isn't clearly drawn.
I'm not contesting the value of freedom in general, though. I'm just saying there are legitimate restrictions on the right to choice to protect third parties from harm.
Perhaps not the best way to explain it, but I meant to reemphasize the difference between the link story and the impact. Explaining why the loss of these freedoms is important requires linking it to some solid impacts, which I've always found somewhat difficult. I don't think it's hard to explain why certain freedoms should exist or why the government taking those liberties away steps on some toes, but that doesn't really get down into the nitty-gritty of why their loss is very damaging. The problem, as I see it, is that you either keep it nebulous and focus on why freedoms are important, or you peel away from the issue of freedoms and focus on reactions to their loss. I'm not really a fan of either approach, and I can't do the first one well at all.
"It’s much more about examining why this matters than it is about explaining why these freedoms should exist." I don't understand what this means.
That’s usually the response I bring, but it has limitations. The other side can just say that the same argument can be used to justify much vaster and more debilitating restrictions. If it’s justified to prevent individuals from harming others by potentially acquiring a given illness or set of illnesses, then you could use that same point to force people to wear masks, take antibiotics, sneeze into their elbows and generally stay home from work when they get sick. All of those would arguably have a much larger effect on disease burdens than mandatory immunizations, but we recognize that we cannot reasonably police such actions in everyday life, and it’s not just because of backlash. There’s an inherent value to our basic freedoms, particularly when they come at the cost of certain securities. Countries have built the backbone of their constitutions on recognizing that policing the actions of the people needs to be substantially limited based on certain criteria. We might disagree about what those criteria are and about how well they apply to these cases, but I don’t think we can disagree that there are many freedoms that should not be abridged just because there’s a security benefit that could result, no matter how substantial it might be. Admittedly, I think I’m doing a bad job of explaining why these freedoms matter, and particularly if we’re speaking outside of the context of a given country’s Constitution and history, these impacts may always be largely based on how different populations view the issue, but I don’t think the link is what’s at issue on this point. It’s much more about examining why this matters than it is about explaining why these freedoms should exist.
"Admittedly, the argument is somewhat difficult to counter, especially if you're going full bore and requiring everyone who can to get vaccinated."
Honestly, I didn't find the liberty argument compelling one bit. The really simple response seems to be the harm principle: it's completely okay to restrict liberty to prevent third party harm. If liberty were absolute, there's no argument against legalizing murder or assault. Clearly, we restrict liberty to protect public health all the time. I dunno if it's just me, but I thought it was a really weak argument.
I'd say my main problem with your case is that you didn't go hard enough. I get that there's a strong incentive to roll with a case that causes the least possible harm to liberty (I'll come back to that), but I feel like you either need to go full bore and argue that vaccinations need to be the main priority or else you just don't gain enough solvency. Despite what I said in this debate, I think the case can be made that we can either reach herd immunity with many of these diseases or get so close to herd immunity as to not matter. Trumping up the importance of essentially eradicating these diseases within the US is a lot stronger than stating that we're getting some minor improvements to childhood vaccination rates. The main barrier to making that kind of argument is the generally low level of harm caused by these diseases individually, and I think the main way to get around that is by talking about trends and the potential for much higher death tolls and other harms. But to do that in enough detail, you really need to focus on a specific vaccine or set of vaccines rather than hitting them all at once. Doing that made your case sound overly generalized, and the impacts didn't sound as solid. You really need those points to counter issues of side-effects, which are honestly not that huge given the potential scope of the problem with diseases like measles and pertussis (incidentally, I find that MMR and TDaP are the easiest to argue for on debates like this), particularly as they apply to the immunocompromised.
When it comes to tackling my case, I think the first thing you have to do is nip the liberty argument in the bud. Admittedly, the argument is somewhat difficult to counter, especially if you're going full bore and requiring everyone who can to get vaccinated, but I think I've come up with an effective response by simply stating that it's impossible to quantify, especially compared with a quantifiable loss of life and quality of life. I think also clarifying from the outset what makes an instance where loss of liberty is acceptable and why is important. You kind of did that later with the comparison to drunk driving, but I feel like the link was tenuous. I’ve gone with traffic laws, the allowance of drug tests, and taxation in general, all of which reflect a shared responsibility that overrides personal liberties for the common good. All of this does a pretty good job at least introducing doubt into the liberty argument, and provides a basis for supporting a policy that may seem severe and a huge step beyond what’s been done before. All of this is also somewhat necessary to counter the backlash point, because a lot of the liberty argument is building up an important link story: that the negative response is justified and righteous. Challenging that underlying assumption knocks at the backlash point by allowing you to say that these are just a bunch of people who are too self-interested to see the basic facts of how they’re harming others, and that their threats of retaliation are no better than retaliating against any supposedly oppressive laws that are there for a basic public good. Admittedly, there’s the medical aspect to it, but I’ve found that that’s easy enough to get around by just fining anyone who is actively afraid of or otherwise unwilling to get vaccinated. Fines go to medical subsidies and therefore improve access to medical care. Sure, there will still be some backlash, but this doesn’t force anyone to get vaccinated just because they see their doctor.
Lastly, on the lack of a case, your best bet would have been to present something in R1, but lacking that, I think there were some available outs in R2 and R3, though all of them would have required that you stick by generally making vaccination mandatory. You could have argued that the same system currently used in schools (i.e. doctors notes) could be used by the government to monitor vaccinations, and that updates on vaccinations would be required at the usual times (e.g. tetanus after 10 years). That would have knocked out my point about enforcement, as the only thing remaining would have been which agency would be in charge, which really doesn’t have any weight to it. You could have argued that the fine I mentioned above was obvious enough that it should have been assumed, meaning that dissenters won’t get jailed to nearly the extent I’m suggesting, and those that do get imprisoned for failing to pay the fine deserve it for willingly putting others at great risk. That just leaves the “who pays?” argument, and I think you could have argued that there are enough governmental and non-governmental organizations that would step up to help with this, particularly as it’s such a huge public good, which means most of the poor would be covered through subsidies from one source or another. It would have been better to simply state that the government was covering everything from the outset, but that requires it be stated in R1.
Realized I never offered this, but as I said, I’m actually solidly for your side in this resolution, and I’d be happy to discuss what you could have improved, both in your case and your responses.
Me to! I'd hate to see a good debate go tied
I'm so glad that this got voted on.
Sorry I couldn't vote.
Thanks a lot for the vote and the feedback! I had a plan for how to capitalize on the liberty impacts, though honestly, I still struggle with weighing more philosophical arguments like these.
OMG. So many spelling errors. Gonna delete and fix and repost.
Thanks for the vote and feedback!!
Is the resolution for childhood vaccines only? It's worded broadly and would seem to encompass adult vaccines as well (e.g. annual flu vaccine).
If vaccines should be mandatory, what should the punishment for not having one be?
I'm okay with some vaccines, but not ones that contain unborn baby parts.
If that helps you, I would accept that. I would completely understand.
If you want we can make this a 3 round debate and just waive the fourth round
You have my condolences. I'm very sorry to hear about that. I wish you the best in your time of mourning.
My grandfather passed away this evening. I will try to get my arguments in on time.
please wait till sunday to post response if you can
It is certainly difficult at first, though I have to admit, those are the most rewarding instances. With a few exceptions, I've garnered the most from trying to understand the other side on topics that I feel very strongly about. I learn quite a bit from the experience. Strange thing, though, is that I can usually find a solid repository of arguments for that side. Most of the sites I've looked at on the topic have made pretty awful arguments, so I had to mostly derive my own.
I respect that. It can be difficult playing devil’s advocate especially when you’re passionate about the topic
Agreed. I think this is a fascinating debate. I'm actually taking devil's advocate for this one because I'm solidly on the "Pro" side of this debate, but I do feel there's a lot of good ground to cover on my side.
great topic! sounds like parents' rights vs the best interests of children. look forward to the arguments
Will post after work. Thanks
You can post your argument any time.