This post reviews Donya Khalili and Arthur Caplan, “Off the Grid: Vaccinations Among Homeschooled Children” in Journal of Law, Medicine, and Ethics 35, no. 3 (Fall 2007): 471-477.
Khalili, a University of Pennsylvania law student, and Caplan, director of Penn’s Center for Bioethics, argue here that the large number of unvaccinated homeschooled children in the United States poses a public health threat that must be met.
The authors begin by summarizing some historic Supreme Court decisions that, while establishing a parent’s right to keep children out of public schools (Meyer v. Nebraska and Pierce v. Society of Sisters), nevertheless set limits on parental autonomy and allow government to require things like vaccinations (Prince v. Massachusetts). They note that State laws require private schools to ensure their students are vaccinated as well, though religious exemptions are often permitted. Indeed, among Amish and Christian Science children recent decades have seen outbreaks of Polio, Measles, and Rubella due to their religious objection to vaccination. Most private schools, however, comply.
When it comes to homeschooling, however, regulations vary wildly. In states like Texas where homeschoolers are not even required to register, there is no way to ensure that children are immunized. Even states with registration requirements, such as Illinois, often have no follow-up mechanism to ensure that children really are vaccinated. A better practice would be to follow the lead of North Carolina, which requires the same vaccination policy for homeschoolers as it does for all other children.
This lack of oversight would not be a problem if homeschooling parents sought out vaccinations voluntarily. But homeschoolers tend to be a pretty skeptical lot when it comes to government programs for children. Khalili and Caplan summarize several reasons homeschooling parents tend to be against vaccination: religious reasons, hesitancy about causing their children pain, skepticism about their efficacy, worries about possible side effects (such as “the myth that autism is caused by vaccinations”), and fear of having to register their children with state vaccination registries.
Most worrisome to Khalili and Caplan is the willingness among homeschoolers to trust that the vaccinations of other people’s children will be enough to protect their own. They seem not to know or care that in failing to vaccinate their own children they put others at risk. Such parents are placing “family interests ahead of civic responsibilty.”
What strategies might be employed to help ensure that homeschooled children are vaccinated? Khalili and Caplan propose that homeschoolers be kept to the same standard of vaccination that all other children must meet. Homeschooled parents should be required to submit the same paperwork as public and private schooled children. They note that parents with religious objections can still seek a religious exemption, but they speculate that this will not be a majority of homeschoolers. Requiring the paperwork to avoid being charged with truancy would motivate homeschooling parents who have no religious objection to get their kids to the doctor for their shots.
But Khalili and Caplan recognize the power of homeschool lobby groups and worry that an effort to impose even so minimal a requirement on homeschoolers as the filling out of a vaccination form might reap a political whirlwind. Given this political reality, a more feasible plan of action might be to require that homeschoolers wishing to take advantage of programs sponsored by public schools (sports teams, spelling bees, library services, etc.) must show proof of immunization before doing so. This “back-door requirement” wouldn’t catch all homeschoolers, but at least it’s something.
I have two comments to make about this paper. First, given its prediction of dire consequences for public health following from failure of homeschooled children to be vaccinated, I’d like at least a little evidence that homeschooled children aren’t being vaccinated. There is no data presented here that suggests that homeschooled children are or are not getting vaccine shots. Hypothetically, it makes sense that parents with a strong animus against government regulation and distrust of medical expertise would opt out of vaccination programs, but it’s just speculation. What we need are a few studies of samples of homeschooling families’ rate of vaccination. Such studies would not be hard to do. A researcher could simply go to a few support group meetings and ask the mothers and fathers present if they vaccinate their children. I have no idea what would be found. Would there be variation by region? By religious commitment? By pedagogical orientation? We need to know more about this before we move to predictions of public health crises and calls for increased regulation of homeschooling.
Second, this paper provides one example of a larger issue that I think the homeschooling movement needs to consider more carefully. As I have noted in previous posts, there is a powerful undercurrent of libertarianism among homeschoolers of all religious and political orientations. This article’s title “off the grid” accurately summarizes an instinct that goes deep in homeschooling history and psychology. But the vast majority of homeschoolers are not off the grid. They rely on all sorts of government programs: sewer and water treatment, roads and bridges, fire and police, insect reduction programs, government-regulated savings and loans, and of course broader things like national defense, international diplomacy, oversight of the economy, social security, and much more. National vaccination programs are just one of a host of government initiatives created to ensure the public good. Just as conservatives have long feared a “creeping socialism” when new government enterprises have been proposed, one might suggest that among homeschoolers we have seen a “creeping libertarianism” as the rejection of one government agency (the public schools) has gradually led to an instinct to react against all government, mingled perhaps with a naivete about just how deeply dependent on government we all are for so many of our daily needs (clean air and water, safe food, consumer protection, etc.). In my book on the history of homeschoolingI note the irony that anti-government suburbia, the base of so much of the homeschooling movement, was in fact built and sustained by government. That irony is with us still, given the reality that, as my last post described, Reagan Republicans have only made government bigger despite their anti-statist rhetoric.
By associating vaccination policy with this broader web of government I do not mean to suggest that it is good policy. I’m no medical professional so I cannot speak to the efficacy or utility of various vaccines. As a parent of four young children I have watched with some concern as the number of vaccines required has risen with every successive child. Public policy on this matter is certainly a work in progress. Perhaps future medical science will deem some vaccines unnecessary or even harmful, I don’t know. But what I do know is that homeschoolers do themselves and others a disservice when they remove their voices from this important public discussion in an quixotic effort to go off the grid. But given the lack of evidence in this article, it is by no means clear that homeschoolers are in fact off the grid on this issue. Perhaps some enterprising researcher will help us find out what homeschoolers really think and do about vaccination.