Opt-out vaccination in school and daycare: Reconciling parental authority and obligations

Bioethics. 2024 Nov;38(9):816-822. doi: 10.1111/bioe.13344. Epub 2024 Aug 19.

Abstract

An increasing vaccine hesitancy among parents, which has resulted in insufficient rates of immunization, provides reason to reconsider childhood vaccination practices. Studies suggest that parents' decision-making process concerning whether to vaccinate their child is highly influenced by cognitive biases. These biases can be utilized to increase vaccination uptake via changes in the choice context. This article considers childhood vaccination programmes, which involve children being vaccinated in school or daycare unless their parents actively 'opt out'. We suggest that such programmes reconcile parents' decisional authority and vaccination duties. First, opt-out childhood vaccination based in schools or daycare centres are not disrespectful of parental authority. Second, the programme aligns the default setting with a moral obligation to vaccinate one's child that most parents have.

Keywords: childhood vaccination; easy rescue; nudging; opt‐out; parental authority; school‐based vaccination.

MeSH terms

  • Child
  • Child Day Care Centers*
  • Decision Making*
  • Humans
  • Immunization Programs / ethics
  • Moral Obligations
  • Parents* / psychology
  • Schools*
  • Vaccination Hesitancy*
  • Vaccination* / ethics