The PLEA: Legal Immunity

For as long as there have been vaccines, there have been people who have questions about or are outrightly critical of vaccines. Doctors sometimes call these people vaccine hesitant. In popular culture, they are often called anti-vaxxers. People with vaccine hesitancy exist across society. Their reasons for being hesitant are diverse.

The anti-vaccine movement emerged alongside the smallpox vaccine. At the time, medical science had determined that the smallpox vaccine worked. However, medical science did not yet understand how germs caused diseases. This lack of knowledge meant that vaccinations were risky, and performed with unsterilised equipment. Catching a disease from vaccination was a very real possibility.

Because of the risks, people were not wrong to ask questions. That said, smallpox was painful, disfiguring, and often lethal. Most people weighed the risks against the benefits, and determined that vaccination was the best course forward.

Smallpox went into decline, due almost entirely to vaccinations. Yet, opposition to vaccines grew. At first blush, this seems illogical: a vaccine subduing a disease is proof that it works. However, the decline of smallpox meant that few people experienced its horrors first-hand. With the public memory of smallpox fading, space was created for people to capture the public imagination with vaccine risks. And capture it, they did. By the late 1800s, anti-vaccination leagues were popping up everywhere, pitting many citizens against the medical community.

The concerns of the anti-vaccination leagues of this era were not all unwarranted, and the freedom we have in a liberal democracy to offer constructive criticism often works to make things better. Critics continued to worry about catching diseases from vaccination. To that they tacked on questions about vaccine ingredients. Some religious people joined in, concerned about body purity. People opposed to animal experimentation added to the chorus. And some civil liberties advocates jumped on board, criticising laws of the day that made vaccines mandatory.

The issues raised by early anti-vaccination movements were never fully settled. Public opinion was instead won over by results: as the 20th century proceeded, diseases ranging from polio to rabies were safely tamed, thanks in no small part to vaccines.

Nonetheless, history echoes. With so many diseases subdued over the 20th century, space has again been created to capture the public imagination with vaccine risks. Today, many people are declining vaccines. The result? More and more disease outbreaks. The trend led the World Health Organisation to declare anti-vaccination movements one of 2019’s top-ten threats to health.

No single personality trait or fact explains why people embrace vaccine hesitancy. Just as a member of a small orthodox religious community may be hesitant because they accept the authority of their faith leaders, a member of a small “hippy” town may be hesitant because they reject the authority of government and large pharmaceutical corporations. And just as a member of a minority community may be hesitant due to a history of unethical, racist medical experiments, a member of an affluent white community may be hesitant because of advice from a fee-based alternative medicine practitioner. Vaccine hesitancy is a complex mix.

Canada’s laws recognise the complexity associated with vaccine hesitancy. They attempt to balance the need for public health with the desire of some individuals to refuse vaccines. How the law balances these conflicting interests will be discussed on pages 10 and 11.