A recent New Jersey Health Council ruling has gotten me thinking about the role schools play in their student’s medical decisions. Many of the requirements schools place on students seem reasonable. Vaccination against infectious disease and sports physicals make sense. They aren’t enjoyable by any means, but the reasoning behind such treatments appears sound.

But should school systems be able to force students and their parents to consider and have treatments that may not be in their best interest? Two years ago, Texas Governor, Rick Perry signed into law a requirement that all girls entering the 6th grade receive the Gardasil shots¹. Despite the fact that this was signed into law just after Merck ramped up their lobbying efforts, my larger concern is not for the democratic process, but rather the health of girls who were subjected by law to a medication that had not been on the market long. Gardasil has been found able to prevent the spread of HPV, the Human Papillomavirus, which is a cause of cervical cancer. While I am for ending cancer, I do understand the variety of moral and ethical dilemmas caused by administering shots to teenagers in order to protect them from a sex related infection. Certainly those in favor of the administering the medication to teens cite that some estimates state that 3 out of 4 may woman may be infected with HPV and will therefor have a greater risk of cervical cancer, however the deaths of two European girls (1 in England and another in Germany) attributed to Gardasil should have many rethinking requirement policies. (Information about the European deaths can be found here.)

Every medical treatment has risks. This includes the simple and routine. Even the flu shot carries with risks with it. The Center for Disease Control (www.cdc.gov) states that the flu shot can cause:

• Soreness, redness, or swelling where the shot was given
• Fever (low grade)
• Aches

This doesn’t sound too bad considering that the flu can and will be if caught far worse. If the flu shot is a choice than the recipient is entering into the possibilities of these side effects by choice, but what if they are required? Do you want to be told that you have to get a shot that may cause aches and a fever?

What about the flu mist? The flu mist can cause:

in children

• runny nose
• wheezing
• headache
• vomiting
• muscle aches
• fever

In adult

• runny nose
• headache
• sore throat
• cough

Vomiting? Wheezing? As a choice it may seem reasonable, but if mandatory?

The CDC also lists a number of situations that should not be vaccinated without consulting a physician. These people may not be able to be vaccinated at all. But what if school attendance depended upon being vaccinated? What does one do then? What if a kid isn’t really sick, but can’t go to school because they haven’t been vaccinated because they “have a severe allergy to chicken eggs” or
have “developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine”? True, those with GBS have larger issues until the syndrome is treated, but if the ability to attend school depends on having a shot that a person cannot have doesn’t that infringe on his or her rights to an education? At what point does the interests of public health outweigh the rights of the individual? I hope the Public Health Council of New Jersey took these issues into consideration when mandating that flu shots were mandatory for all preschoolers. (Read more about it here.)

JY

¹I am under the understanding that the Gardasil treatment is a series of 3 shots.