title: Free-riding, fairness and the rights of minority groups in exemption from mandatory childhood vaccination.
abstract: The authority of government to require participation in mandatory childhood vaccination programs may not target specific groups for either participation or exemption on a discriminatory basis. This poses difficulties when allowing religious or philosophical exemptions to mandatory vaccination, because certain groups are more likely to appeal for exemption. Avoiding loss of herd immunity, then, may require either discrimination against these groups by disallowing an exemption option that is available to others, or by denying the good of an exemption option to the entire population because of the action of certain groups. To avoid this unacceptable choice, steps must be taken now to more stringently enforce exemption requirements.
authors.affiliation: Center for the Study of Bioethics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. tmay@mcw.edu
authors.forename: Thomas
authors.initials: T
authors.lastname: May
authors.forename: Ross D
authors.initials: RD
authors.lastname: Silverman
mesh_terms: D019983:Guideline Adherence; D006801:Humans; D032521:Immunity, Herd; D037141:Mandatory Programs / Q000706:statistics & numerical data*; D032541:Mass Vaccination / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D011634:Public Health; D012068:Religion and Medicine; D014481:United States