The outbreak of measles recently has stirred a debate in this country over whether parents should be forced to vaccinate their children for measles and other diseases, or whether they should have the freedom to refuse to have their children vaccinated for various reasons, such as religion or concern about harmful side effects. The debate is an amalgam of distrust of science and libertarian aversion to big government mandating decisions that should be the prerogative of the individual.
The fact that there was an article linking vaccines to autism that has since been debunked, but which caused many parents to unnecessarily decide not to vaccinate their children, has led a lot of people to oppose this junk science with the assertion that vaccines are absolutely safe. According to the CDC, however, any vaccine can cause side effects, most of which are minor, but a few of which result in serious harm or death. This includes the vaccine for measles and related diseases. The risk is exceedingly small, but it exists nevertheless.
In a world where a given disease is lurking, always threatening to break out into an epidemic, any risk associated with the corresponding vaccine is vastly outweighed by the benefit of not contracting the disease. But as the disease begins to disappear and become rare, some people reason that the risk of contracting the disease is lower than the risk of experiencing serious side effects from the vaccine, thereby making it prudent for them to not get their children vaccinated. But as more and more parents make this decision, the disease then has the opportunity of reappearing, and the pendulum of reward/risk calculation swings back in the other direction.
The libertarian principle that people should be free to make their own choices must be limited where negative externalities occur, where one’s personal decision has the potential to harm others. By not having one’s children vaccinated, one not only puts one’s own children at risk, but also others who have not been vaccinated, including some who are unable to avail themselves of the vaccine for some reason. For this reason, the state is justified in mandating vaccines for children.
So far, so good. What has puzzled me in all this discussion about whether parents should be forced to vaccinate their children is that the discussion is limited to children. In one way, this makes sense. Children should be vaccinated as early as possible. By the time people have grown to be adults, most have already received the vaccines. But what about those who have not? Though adults who have not been vaccinated for measles are encouraged to get their shots, yet no one, to my knowledge, is advocating that such shots be mandatory. Hospitals may insist that their workers be vaccinated for all sorts of diseases, but there seems to be no one advocating the mandatory vaccination of adults in general.
Just as children are not allowed to attend school in some states if they have not been vaccinated, so too could a law be passed not allowing people to be employed if they refuse to get their shots, inasmuch as they endanger their coworkers. Without proof of vaccination or exemption from a doctor, their paychecks could be withheld. Regarding adults, this would especially apply to the flu shot. The CDC estimates that over the last forty years, deaths in the United States from influenza have ranged from 3,000 to 49,000 per year, somewhat more than any potential deaths from the measles outbreak now being experienced, just to put things in perspective. In other words, enough people die from influenza to justify state-mandated flu shots for adults.
What I am getting at here is a kind of hypocrisy regarding vaccinations. While many people have expressed outrage that parents are not getting their children vaccinated for diseases like the measles, there is no corresponding outrage that adults often decide not to get vaccinated themselves. And while many states mandate that children get vaccinations, no state has a corresponding mandate for adult vaccinations, except in special circumstances, such as health-care workers. Because, to my knowledge, mandatory vaccinations for adults are not being advocated, I can only guess what the public’s attitude would be about such a law. I will venture to guess, however, that some of the people who believe parents should be forced to vaccinate their children would balk at the prospect of a law mandating vaccines for adults.
Let me put a face on this hypocrisy. Behold the case of Dr. Ezekiel Emanuel. Today on Morning Joe, Dr. Emanuel was arguing in favor of parents getting their children vaccinated. And he ended the segment by saying that what really concerns him is the low rate of vaccination for influenza, which could be disastrous if there is a pandemic. However, in an article for The Atlantic last September, he said he wanted to die at the age of 75. And toward that end, he announced that when he reaches the age of 75, he intends to quit getting a flu shot. Presumably he would take umbrage at the idea of the government forcing him to get a flu shot at that age, even if in so doing, he would be reducing the chance of infecting others around him. Pandemic or no pandemic, his desire to die at 75 is more important than the desire of others to live.