Consent and public health are rarely mentioned in the same breath. It is believed that public health programmes are well thought out, anyway. . So when the Tamil Nadu health department says it could make the measles-rubella vaccine mandatory for children below 15 years, it is disturbing. The statement is a fallout of the misgivings some parents had regarding the vaccine, despite it being administered in schools as part of a State-run initiative. Mistrust of a public health programme is worrying. The vaccination programme ran into complications as teachers sought parental consent. Were the parents worried that the programme was influenced by the interests of a vaccine company? Or were there other fears?

The Government needs to explain why this or any vaccine is necessary. And indeed the prevalence of the disease required the Government to ensure uniform vaccination coverage in the interest of public health. But steam-rolling consent stifles individual freedom. A backlash here could derail genuine public health initiatives. A greater vaccinated population ensures herd immunity and that has been illustrated by India’s success with polio. A sustained campaign, highly advertised and supported with feet on the street has put India on the polio-free map. But with vaccines for illnesses ranging from a flu to cervical cancer, there is the very real concern of turning our children into “pin cushions”.

Rooting out rubella, paediatricians explain, is part of a global commitment, not a programme in isolation. But does the combination vaccine interfere with the larger immunity of society? Clearly, this is a scientific decision that must be taken by experts not compromised by commercial interests. And that reasoned decision needs to be communicated for a public health programme to be successful.

Deputy Editor

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