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Since the polio virus affects the nervous system, some children who contract the disease become paralyzed and may even lose breathing ability (WHO: Poliomyelitis).In the early to mid 20th century, some children with polio had to use an iron lung, a machine to pump air into their lungs, to breathe (Figure 1).A pediatrician enters Examination Room B, ready for a routine check-up with a two-month-old infant.He greets the mother, and begins to discuss the next step in infant care: receiving the required vaccinations.Both diphtheria and pertussis can cause severe breathing complications in children (CDC Diphtheria).Over 206,000 people were reported to have diphtheria in 1921, and there were 150,000-260,000 cases of pertussis per year (CDC 2007).Scientists hope that "through vaccination, children develop immunity without suffering from the actual diseases that vaccines prevent" (CDC, How Vaccines Prevent Diseases 2009).States often require that children receive vaccinations against particularly dangerous diseases, such as polio, varicella (chicken pox), diphtheria/tetanus/pertussis (DTP), Haemophilus influenza B (Hib), and measles/mumps/rubella (MMR) (Goodman 2007: 266). S., unvaccinated children may suffer severe consequences, such as being prevented from attending schools, camps, sports, and other organized group activities (Park 2008).

For instance, recent studies report that there are currently 97.56% fewer pertussis cases in the United States, than would be expected without mass immunization, due to compulsory vaccination programs (Health and Human Services).In 1809, Massachusetts passed a law that "granted city boards of health the authority to require vaccination 'when necessary for public health or safety'" (Mariner 2005: 582).When the state required all residents to receive a smallpox vaccine in 1902, 46-year-old Henning Jacobson declined the vaccine, claiming that he had suffered "bad reactions to earlier vaccines" (Mariner 2005: 582).Moreover, as the CDC argues, "[those] same germs exist today, but babies are now protected by vaccines, [and so] we do not see these diseases as often" (CDC, How Vaccines Prevent Disease 2009).For these reasons, supporters of mandatory vaccinations argue that immunizations in the United States have been very effective.After noting the large impact of vaccinations on American public health, philanthropists such as Bill and Melinda Gates have begun funding vaccine research and distribution to improve the quality of health in third world countries (Gates Foundation).