1.02- Balancing Individual and Community Claims

Biomedical Technology II

Exploring Vaccines

Introduce students to key ethical tension: balancing respect for individual choices with the need to protect the community.

When is it acceptable to compel someone to do something in the name of public health, or to object to participating in a public health measure?

ACTIVITY: Setting Vaccinations Policies-What is the Ethical Question?

• Get Kids Vaccinated or Else

• Do you agree with the Maryland county’s officials, that parents who refuse to have their children vaccinated should be jailed

• What are the ethical questions? Under what circumstances, if any, should a state grant exemptions to its school vaccination policy?

Ask Yourself…..

What kind of information do you need to answer the ethical question?

Gathering the Facts-Vaccines

• Get into groups of 3 for discussion

• You will record your own individual answers on your worksheet

• Spend 10 minutes at each station

• Record the main points for “What are the Relevant Facts?”

Station 1 Debrief-Vaccine Preventable Diseases

• The risks of getting particular diseases vary.

• The risk of suffering harm when one has the disease varies. (For example, How likely are you to have a negative outcome?)

• The magnitude of harm caused by the disease also varies. (For example, What is the worst thing that could happen to you?)

• Childhood diseases were once common in the United States, but they are largely unknown today because of widespread vaccination.

Station 2 Debriefing-Vaccine Risks

The risk of harm from vaccines is extremely low. In fact, it is much lower than the risk of harm

from getting a disease.

Station 3 Debriefing-The Measles Graph

• Vaccines are largely responsible for reducing how many people get childhood diseases such as measles.

• Sometimes outbreaks occur because vaccinated individuals haven’t developed an appropriate immune response (“vaccine failure”) or because people have not been vaccinated for a variety of reasons.

Station 4 Debriefing-Exemptions, and review the difference between exemptions and opting out

• An “exemption” provides permission not to act as a policy requires.

• The term “opting out” means choosing to go against the policy. You can legally opt out if you have a legal exemption

DAY 2

COMMUNITY IMMUNITY

ACTIVITY: Simulating Community Immunity

• Goal is to model an important scientific concept related to immunization-community immunity—and highlight some of the ethical considerations that mandatory vaccination raises.

Ground Rules for Activity

• Students are “infectious” for one “day” only.

• When they are infectious, they infect two other students.

• The index (first) case will tag two individuals sitting nearby, who will then become sick.

• Anyone who is infected gets sick and remains sick.

• In each day that follows, anyone who is newly sick (has just been tagged) tags two additional people.

• Vaccinated students cannot tag anyone.

Activity (continues)

Each student a copy of Master 2.8, and note the “0%”(vaccinated) column for Round 1

• Everyone gets a red and a green card

• Green means they’re healthy

• Red means they’re infected and sick.

ROUND 1

Everyone is susceptible to the disease.

ROUND 2

Some individuals will be immune

65 percent of the students are vaccinated

Let’s Discuss What Happened

Activity: Discussing the Simulation

Define a working definition of the concept of community immunity

When a critical percentage of a population is immune to a particular transmissible disease

(in this case, through vaccination), the disease can no longer circulate in the community

What happened to susceptible people ?

• Round 1

• Round 2

Percentage of Community That Must Be Vaccinated for Community Immunity to Work

Disease Community Immunity Threshold

Diphtheria 85%

Measles 83-94%

Mumps 75-86%

Pertussis 94%

Polio 80-86%

Rubella 85%

Smallpox 85%

Take out Master 2.7

• Add a sentence about community immunity in “relevant facts” section

• Add potential stakeholders

RECAP

HOMEWORK ASSIGNMENT

• Complete Community Immunity Reflection

– You will need your data from Master 2.8 sheet

DAY 3

Vaccines, Ethics, and Social Policy

Homework Review

• Share your definition of community immunity and how the data from the simulation illustrated the concept

FAIRNESS

• Examine the ethical consideration of fairness

• Review what fairness means

Story Time with Ms. K

How fair is it for someone to benefit from theprotective effect of community immunity if he or she has chosen not to assume any risks of vaccination?

• Record the main ideas under “Fairness” on Master 2.7

Master 2.11: Opting Out of aVaccine—Variables to Consider

Let’s review the five variables and the smallpox example

Are some reasons for wanting to opt out of a vaccine more acceptable than others?

• Read the scenarios on Master 2.11 which represents some common reasons for opting out of a vaccine

IMPORTANT …..

Because of the success of worldwide vaccination programs, smallpox no longer

occurs naturally

Other Considerations

• Think about this and add them to Master 2.7

– Example: the responsibility to the community

ACTIVITY: Discussing Ethical Considerations- Respect for Persons

Fairness Respect

Master 2.7- Respect for Persons

Under what circumstances and to what extent should we respect an individual’s choice not to be vaccinated?

Pair Up

• Master 2.12: Vaccination Policies Contrasted

• Examples of approaches to vaccination policies that differ in the emphasis on respect for persons

Where would you place it and why

State Force

State requires vaccination with

some permissible exemptions

Let Individuals Decide

What Do You Think?

• How much of a role should the state play in deciding whether people should be vaccinated?

• How coercive or forceful should the state be in implementing a vaccination policy?