The State of Immunization: Understanding Law, Policy, and Resistance

Although the introduction of vaccines has been an enormous public health boon to many diseases, including the major childhood diseases, the possible eradication of these diseases has been compromised by the increasing number of parents and guardians who choose not to vaccinate their children. These decisions are enabled by legislation in most states that was enacted under Congressional pressure. While a few states, like California, have moved to make exemptions from routine vaccination requirements more difficult, most states still require deference to parental decisions based on religion or, more amorphously, on “philosophical” objections.

This presentation will discuss the recent history of exemptions, the clustering of disease in communities with high rates of vaccine refusal, and suggestions for changing the dialogue. Among the suggestions raised will be: increased public awareness of the Vaccine Injury Compensation Program; purposely separating discussion of vaccinations that protect against STDs; and agitating for legislation that achieves a compromise by requiring more of parents who wish to opt out of vaccinating their children. The possibility of imposing civil liability on parents whose children infect other children will also be discussed.

John Culhane is the H. Albert Young Fellow in Constitutional Law, and Co-Director of the Family Health Law & Policy Institute at Delaware Law School (Widener University). From 1999 through 2009, he was a Lecturer at the Yale University School of Public Health. He has written widely on a host of topics, including the injuries caused by social risks, and compensation for victims of mass disasters, including Hurricane Katrina, the terrorist attacks on 9/11, and child sexual abuse. He is editor and an author of Reconsidering Law and Policy Debates: A Public Health Perspective (Cambridge 2011). His work has appeared in numerous law journals, and he has been featured on National Public Radio, the Washington Post on-line, and has been published by the New York Times, Politico, Dissent, and Slate (where he is a contributing writer), among many others.

The Innovative Discoveries Series, sponsored by the Delaware Clinical & Translational Science ACCEL program and the Christiana Care Value Institute, features informal presentations on topics relevant to current research and healthcare practice, led by knowledgeable and experienced presenters. There are offerings for researchers, healthcare providers, and community members of varying levels of experience.

These free talks are held Fridays at noon at Christiana Hospital but can be viewed from your home or office computer. Earn CMEs by participating in-person or online. Lunch is served and all are welcome to attend.

To see the full calendar of events, visit the Value Institute Events page or the ACCEL website, or subscribe to the ID Series mailing list.

Contact Sarahfaye Dolman at with any questions.


  • John G. Culhane, JD