Cooper: Personal choice or public good or both?

“You’re the first person to ask me directly,” she answered, “most people skirt around it.” I had just asked her if she and her husband had their children vaccinated.

“You’re the first person to ask me directly,” she answered, “most people skirt around it.” I had just asked her if she and her husband had their children vaccinated.

I was pretty sure they didn’t and I wanted to hear from someone whom I knew loved their children as much as any human being could.

I knew she would tell me the considerations that led them to their decision and she did not fail me. Family history and knowledge of immunity were among their reasons not to vaccinate their children.

This mom knew about the risk of contracting the diseases and went on to make the point that they also believe it is their responsibility as parents to build their children’s immune system through a healthy diet and activity.

They knew too that their children are protected by the fact most children are vaccinated but that they must be vigilant during outbreaks for the sakes of their own and other children.

I, who started my nursing career in public health, am swayed by deeply caring parents who make a deliberate calculation based on science and risk. Despite my strong value in the importance of primary prevention, I learned once again that there is always another side and one in which public policy has to allow for exceptions.

These parents checked the “personal choice/reasons” box on the school vaccination exemption form. In fact fully 90 percent of the 343 exemptions reported throughout Sequim schools (public and private) were for personal reasons. Eight percent were for medical reasons and 2 percent were for religious reasons.

The problem I see is that the system as designed leaves little room for education and does not expect parental accountability. The question needs to be asked, “Would the public good be better served if we had parents justify their decision with more than a checkmark?”

A stake in public good

Most parents have their children vaccinated even though neither they nor their parents lived through the time of smallpox, measles, mumps, chicken pox and polio. Although, they may know people who are in their 70s and 80s who are suffering post-polio syndrome and can no longer stand on their feet.

These parents have accepted the professional advice of the Centers for Disease Control and Prevention (CDC), the scientific community, their pediatrician and the schools. For others like the parents I introduced in the opening of this column, they have done their due diligence and come up with a different conclusion with no less a sense of responsibility.

The irresponsible parent is the one who finds it more convenient to refuse for the allowable “personal reasons” than to do the research or have their children vaccinated. In other words, they are as thoughtless and careless about the public good as they are about their children.

Government – keep your hands off my children!

I am not swayed by parents who hear the recommendations of CDC and shout, “Next the government will tell you what you have to feed your child!” I am even less swayed by the politician who states unequivocally “ … parents own children. The government doesn’t own children.”

I thought we had put the concept of owning children to bed along with owning wives a while back. I would much rather think about parents having responsibility for their children rather than thinking about what it would mean to “own” your children like you own your car.

If you are a child, you just have to hope that you are in a family who treats you like an expensive sports car with vast potential to go places and not a piece of junk to be entered into demolition derbies.

Those that don’t have their children vaccinated because they don’t want the government telling them what to do are either irrationally fearful of government or have decided that they have no responsibility for the public good which includes their children.

In context of all the other issues that parents have or cause, failure to vaccinate may be the least of our problems. But vaccinations do seem to be the area we can use to debate the responsibility of parents, the individual and the government to the public good.

Failure to adequately fund public health and child safety

I was professionally born into public health and the understanding that there was a clear role for the detection and prevention of communicable disease whether it was tuberculosis, polio, sexually transmitted disease or a new contagion like Ebola.

Public health funding on federal and state levels has been steadily declining. We are not funding public health enough to effectively deal with modern day threats to the public good. For example, we can see that obesity is endemic if not epidemic in our children and can forecast with certainty the increased incidence of diabetes in earlier ages than ever before. The cost to society in productivity lost and health care will be enormous.

In addition to lack of funding, elected leaders fail to see the need to apply epidemiological or said another way the scientific study of conditions that affect public health such as drug addiction and early child abuse. A significant study called ACE (Adverse Childhood Experience) demonstrated that later life health problems are predictable for victims of early abuse. We seem to lack the will or public policy to ensure support to the family unit and more critically protect children in abusive or neglectful situations.

Some of our reluctance has to do with what we respect as the sanctity and sacred privacy of the family unit. A more cynical view has to do with those that believe people shouldn’t need or don’t deserve support and help.

Regardless the reasons, we’re not talking about it. We seem to have a see no evil, hear no evil and speak no evil attitude toward irresponsible “owners” of children.

We have yet another opportunity to talk about the lines between individual rights and responsibilities and the public good – it’s our responsibility to our children and their future. Isn’t it?


Bertha D. Cooper is retired from a 40-plus year career as a health care administrator focusing on the delivery system as a whole. She still does occasional consulting. She is a featured columnist at the Sequim Gazette. Reach her at