Baby getting a measles vaccination

Vaccination: who decides?

Personal choice and public safety may clash – read through the evidence and decide what you think

For certain diseases, there are established thresholds or targets for vaccine coverage, above which herd immunity protects the whole population from epidemics. With measles, for example, 95 per cent of a population must be immune to maintain herd immunity.

Some parents decide not to get their children vaccinated. This could be because they are worried about potential side-effects or because vaccinating conflicts with their religious beliefs. These children remain protected as long as coverage doesn’t fall below the critical threshold for herd immunity. However, if there is an outbreak, unvaccinated children will be susceptible and will help the disease to spread. And some children cannot be vaccinated, either because they are too young or because they have an illness that makes vaccination unsafe. These children are also put at risk if herd immunity is compromised.

In the UK, parents decide whether their child is vaccinated or not. In New York State, children must have the required vaccinations before starting school. There are limited exemptions for parents with religious objections. A recent legal case focused on a school that would not allow unvaccinated children to attend during a measles outbreak, in order to prevent the disease from spreading.

Pros of making childhood vaccination compulsory

  • Greater coverage makes outbreaks less likely.
  • Children are protected from outcomes of decisions that they were not able to make themselves.

Cons of making vaccination compulsory

  • Very rare allergic reactions and other side-effects due to immunisations.
  • Conflicts with religious beliefs and parents’ rights to make health decisions about their own children.


  1. Is there a moral and social obligation to vaccinate in order to protect the wider community?
  2. Should parents be legally obliged to have their children vaccinated against MMR (measles, mumps and rubella)?
  3. What should be done if parents disagree over the vaccination of their child(ren)?

Lead image:

Baby getting a measles vaccination in Ethiopia’s Merawi province.



Further reading

Downloadable resources

About this resource

This resource was first published in ‘Immune System’ in January 2015.

Ecology and environment, Immunology, Medicine, Health, infection and disease
Immune System
Education levels:
16–19, Continuing professional development