After washing your hands, vaccination is probably the simplest and best medical advance in human history. But in spite of overwhelming evidence of its efficacy at preventing death and disease, irrational fearmongering is persuading people to skip shots for themselves and their children, and we’re now paying the price.
In the U.S., 2014 was the worst year for measles in more than a decade, due to an outbreak in an Ohio Amish community spread by a missionary returning from overseas. And 2015 will likely be even worse, as an epidemic that began at Disneyland in Anaheim, California has now spread to 14 states.
The good news is that the days of massive pandemics aren’t likely to return. Overall vaccination levels in the U.S. are still very high. But there are pockets of vulnerability, communities where anti-vaccine ideology has taken hold. If an infected person travels to one of these enclaves, they can touch off a furious outbreak. And of course, infants and the immunocompromised can still fall sick and die when there are cracks in the wall of herd immunity.
I often castigate religious conservatives for their anti-scientific views, but vaccine phobia is a popular delusion that’s truly bipartisan. There are conservative religious communities, like the Amish or Eagle Mountain Megachurch in Texas, that have seen disease outbreaks because they believe in faith healing and reject science; but there are also plenty of vaccine refusers in liberal, crunchy-granola communities where obsession with “natural” lifestyle shades into New Age pseudoscience and knee-jerk distrust of modern medicine.
That said, there’s one dissymmetry worth noting: at least with the current outbreak, Democratic politicians and officeholders have mostly taken the side of science, while Republican leaders have fed the fear. Barack Obama and Hillary Clinton have both made strong, unequivocal statements urging people to get vaccinated, while New Jersey Governor Chris Christie and Senator Rand Paul, both likely Republican presidential candidates, have publicly pandered to anti-vaxers. When creationist Tea Partier Ben Carson is your party’s voice of reason, you know things have gotten bad.Since Christie’s waffling is especially hypocritical, I want to highlight it. Infamously, he forced a health worker returning from West Africa into quarantine against her will for fear of the Ebola virus, even though she showed no symptoms. Compare that over-the-top paranoia with his dismissive shrug at measles – which killed almost 150,000 people worldwide in 2013 alone, far more than Ebola ever has or will. (This offers grim context for the hair-raising irresponsibility of parents who throw “measles parties” for their children.)
Still, as heartless as it sounds, I think that vaccine refusal is self-limiting. The anti-vax movement is becoming, and will become, a victim of its own success: the more people they persuade to forego vaccination, the more these long-banished diseases will return, and as people remember how terrible they are, vaccination will soon become a more attractive choice (and vaccination refusal will rapidly cease to be condoned).
That said, there’s no reason to sit back and wait for nature to take its course. In far too many states, it’s ridiculously easy to opt out of vaccination, often just by claiming a “personal belief exemption”. I think personal choice and liberty should be respected as much as possible, even when people make bad choices, but that shouldn’t stretch to endangering others by exposing them to infectious disease. I’m of the opinion that we should eliminate all exemptions to vaccination mandates, except the ones that are granted by a doctor for strictly medical reasons. I don’t say this too often, but in this case Mississippi and West Virginia have led the way. California is also doing the right thing with a bill to curtail non-medical exemptions. If there’s anything that’s properly the realm of government, it’s protecting public health – and if more states want to fulfill that duty, they should stop coddling this dangerous irrationality and pass vaccine laws based on science.