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.
When those who steadfastly believe in the ideal of a free society (i.e. no state) try to convince their brainwashed brethren to imagine a world free of institutionalized violence they are invariably assailed not with counter-arguments but rather with emotionalism or questions. “But without the state, how would X be accomplished?” This typical smug response betrays the interlocutor’s belief in the false choice promoted by the state, namely, that without the state it is not possible to accomplish X, Y, or Z. But a question is not an argument. A question proves nothing other than the questioner’s inability to understand the argument. A lack of understanding does not invalidate an argument any more than understanding it proves its validity. There is no more telling example of this truth than the obvious invalidity of the rejoinder “but who will pick the cotton?” from those that opposed the end of slavery. Apropos the similarity between statism and slavery: this method of argumentation, assaulting your opponent with questions believed to have no answer, is the most common tact against those proposing the end of statism. Without the state: who will build the roads? Who will teach the children? Who will stop the criminals? Who will stop the Ebola outbreaks?
It is this last point that I’d like to address since (a) the first three are absurdly easy to refute and (b) even some libertarians have a hard time answering this one. Let me begin by stating the guiding principle behind any of these thought experiments: if apparently the only way to accomplish something is by initiating violence against a fellow human being then you’re either not very imaginative or it is something that truly should not be done. Incentives and persuasion always trump coercion and violence. So, without further ado, how does one stop the spread of highly infectious diseases in a free society? To find the answer we need look no further than what the state does, albeit rather poorly, today. The answer lies within the principal of private property and the absolute control and discretion of private property owners over the use of their property. The state takes on the presumptive role of being the property owner of all within its borders. Under this presumption of ownership it then exercises its putative rights as property owner, namely control of ingress and egress and movement in that property. The irony of such state control is that the state actually has an incentive to do a poor job when it comes to control of infectious disease. Why is that? Because crises are the perennial excuse for expansion of state power, power that when the crises is over, is never relinquished. That is not to say those in power deliberately try to make it worse, but merely that failure of the state in its stated goals always results in the people rewarding it with more, not less, power.
Within a free society that had full private property rights the property owner (hospital) carries liability insurance and that insurance requires it do everything in its power to not release infected people. If an infected person wanted to leave anyway, they could, but only to the extent surrounding property owners permitted it. In other words, they wouldn’t get very far owing to highly secure fences and private roads. A private road owner would have a mutual contract with the hospital (for their own insurance reasons) to not permit sick individuals to leave without a clean bill of health. Because the state shields hospitals from this type of liability and the state owns all the roads and the state itself has no liability many people like this fall through the cracks today. In a private system there are many more people involved (insurance, hospital, road company, surrounding property owners) and this ensures a more granular level of control that minimizes “crack fall through”.
What we have today is a total structural problem in how society is organized. This is why there is no simple “what liberty says we should do” answer when we consider how we should handle quarantines within the current system. It is insufficient to say “we must respect the right of the individual who is infected” while ignoring the systemic problem of monopolistic state ownership that both crowds out competitors that would do a better job and that eliminates liability for its own mistakes.
There is an all too common form of argumentation today. I call it argumentum ad forgetum. In this argument the proponent has lost site of all perspective on the origins of benefits gifted to them. They have forgotten the path others employed to bring them where they now stand. And so ignoring the path’s utility, they seek to destroy it. Burning bridges, as it were. While this 20/20 hind-blindness afflicts many today, nowhere is it more prevalent than among the anti-vaccination crowd. The increasing quantity and magnitude of outbreaks of formerly vanquished diseases (measles, whooping cough, polio) is a chilling reminder of the aphorism, “those that fail to learn from history are doomed to repeat it.”
The modern anti-vaccination movement had its genesis in a fraudulent study (since retracted) that claimed a link between the MMR vaccine and autism. Once that study was thoroughly debunked and discredited, the anti-vaccination front changed tactics. They employed FUD (fear, uncertainty, doubt). Scary sounding vaccine ingredients are plastered on anti-vaccination websites in order to bolster fear and uncertainty. Complex names are “bad” by mere virtue of sounding scary. Side effects are presented absent the context of concentration. Concentration matters: even water will kill if you drink too much. In point of fact, those scary sounding ingredients are no more harmful than common processed food ingredients we eat everyday. Even when childhood vaccines contained thimerosal (ethyl-mercury) (they no longer do since 2001 due to autism hysteria) the amounts were so low that one could arguably receive a higher dose of mercury from a tuna sandwich than from a vaccine. The third prong (doubt) of their attack is to obliquely cite statistics that imply rates of disease were declining dramatically before vaccine use. For example, it is often cited that measles in the US declined by 96% before its vaccine was implemented in 1963. But push a little deeper – what they either omit or pass over quickly is that it was rates of death from measles that declined by that amount, not rates of the disease itself. This of course makes sense in light of improvements in childhood nutrition in the early 20th century. All things being equal, a weak, malnourished child is more likely to die from a disease then is a hardy, well-nourished child. To suggest that because death rates declined without vaccines we therefore don’t need vaccines is foolish. There are a many other debilitating effects (brain damage, deafness, paralysis) of these diseases that will have a profound impact on a child’s life.
Helping the immune system combat and prevent disease involves the use of many tools: sanitation, nutrition and vaccination. None of these alone is 100% effective. Even when all three are combined there is no guarantee of 100% effectiveness in all individuals. Herd immunity (augmented through vaccination) helps ameliorate that issue by reducing the overall probability of infection in a given individual. But, if more and more of the herd is not vaccinated then the probability that any one individual will be exposed increases, putting at risk both the voluntarily and involuntarily unvaccinated (as well as the vaccinated who unluckily fall into the minority of vaccine insensitive individuals). In this respect, forgoing vaccinations that put others at risk of death or permanent debilitation is selfish. Although selfishness should never be illegal, it will always be socially shunned.
So does this mean we should blindly follow the state and accept whatever elixir they wish to inject into our children or us? Certainly not. Be skeptical, ask questions and seek answers from those with expertise and a positive reputation (not self-anointed internet gurus). Weigh the benefits and risks. Just because some vaccines might not seem worth the risks doesn’t necessarily mean you should reject all vaccines. Likewise, just because some vaccines are worth the risks, doesn’t mean all vaccines are necessarily warranted. But most of all, don’t jump to conclusions and remember that correlation is not causation.