Free Market Vaccination

The recent outbreak of measles cases in the US in the last few weeks has brought into stark relief the result of what happens when one forgoes vaccination. The measles vaccine was introduced in the mid 1960’s when cases averaged around 400,000 per year. It quickly dropped to nearly zero and remained there until 2014 when it shot up to over 600 cases.  The anti-vaccine movement is having an effect, and it is not a good one. I would like to believe that the anti-vaccine folk do understand and accept the principle behind vaccine enhanced immunization (which has been convincingly demonstrated since the days of Edward Jenner) but rather that they want that which has never been and never will be: absolute 100% elimination of all risk. Nothing in life is 100% risk free. Vaccines are not perfect and they do have side effects for some. But those side effects pale in comparison to potential outcome of the disease itself (death).

The anti-vaccine movement is right in one respect but for the wrong reason. The anecdotal cases they cite are likely correct at face value. But this does not prove all vaccines are bad. It merely proves some people are allergic to some things (duh). The problem is not the vaccines but the humans it is administered to: we are all different. In nearly any metric one might choose to measure, populations can be plotted into a bell-shaped curve where the bulk are in the middle “normal” range and a small percentage occupy the “tail” portions (e.g. really fast and really slow). For most there are no issues, no side effects and they work great. But under one tail there are those that have an allergic response while under the other tail the vaccine does nothing at all to enhance their immunity.

One area where the anti-vaccine movement is correct for the right reason is the one of government mandate. The part of Chris Christie’s opinion on vaccination that was omitted allows us to see how the true statist thinks, “parents need to have some measure of choice in things as well, so that’s the balance that the government has to decide.” Yes, government is the true owner of our children and it up to them to decide what is best. Shudder.

It’s not that parents shouldn’t vaccinate their children, they should. Rather the government should not force parents to do so because it precludes any ability for the individual to ignore bad choices by those in charge. Government interference in the vaccine market distorts it and leads to outcomes more deleterious than we would see in a free system. For example it is often cited that the mere existence of the “National Vaccine Injury Compensation Program” established by the government is proof enough that vaccines are not safe. Not really, however it is evidence of how government mandates can incentivize a less safe outcome. It is a classic case of moral hazard. If the government orders the entire nation to buy your product you are happy because of the increased sales but you are sad because the government sets price ceilings on what can be charged. You know your product will have population dependent differential outcomes that can result in lawsuits and the low prices won’t support defending such suits. So the government steps and “immunizes” you from all suits as long as you pay a premium into this Compensation Program fund. Now you have less incentive to devote resources into figuring out why certain people may react negatively to a particular vaccine or how to predict that outcome so it can be avoided. Why bother, the government has protected you from all liability?

The solution to this whole “should the government force parents to immunize their children” debate is so obvious the only reason it has not been implemented is there must be some sort of obscure law forbidding it. Insurance companies should require certain immunizations as a condition of continuing health insurance coverage (and by “should” I don’t mean in the “pass a law mandating it” sense). Since the insurance companies have an incentive in their customers not being injured by a vaccine (as opposed to the government which has no such incentive) you can bet that parents would be more willing to accept scientific evidence of safety from the insurance companies.

If you don’t want to get your children vaccinated then switch to another insurance carrier that either does not require it or that requires fewer vaccines or with a different schedule. Or simply opt to not have health insurance. Oh, right, you can’t do that anymore because of government.

Voluntary choices would help foster a marketplace of alternatives. Yes, vaccination is a sound principle and has been highly effective. But that fact does not necessarily rule out the possibility that an alternative vaccination schedule would also not work equally as well.