February 5, 2015


The appalling, incoherent selfishness of Chris Christie's vaccine 'choice' (Ryan Cooper, February 3, 2015, The Week)

Christie is utterly mistaken on the science. But his comments exemplify a typically American selfishness, one that in this case is not just morally odious, but incoherent.

It's true that an individual case of measles is a lot less threatening than one of Ebola, for which Christie -- again acting against the best advice of medical scientists -- last year briefly enacted a forcible quarantine for health-care workers who had treated Ebola in Africa. By this reasoning, it is worth curtailing individual liberty for very deadly diseases, but not so with less dangerous ones.

But just because a disease is not as bad as Ebola does not mean it isn't still worth eradicating. Furthermore, the measles vaccine is extremely safe for healthy people: though there is a tiny risk, as there is with every activity, it is far smaller than getting measles itself. Only the very young, and those with compromised immune systems or allergies, have an actual reason to avoid it.

And make no mistake, measles is still a very serious illness. A quarter-million people worldwide got it last year, mostly children in the developing world; more than half died (though that death rate can be reduced to about 1 to 2 out of 1,000 with modern medicine). Long-term complications can include deafness, pneumonia, encephalitis, and a degenerative nerve disease. It's also incredibly contagious, "probably the most contagious infectious disease known to mankind," as a CDC specialist told NPR. Back in the pre-vaccine days, each person who caught it infected 17 new ones -- as opposed to less than two for Ebola.

More broadly, this entire argumentative frame misses the greatest benefit of vaccines: herd immunity. A population vaccinated to a high enough level becomes largely impervious to the disease by sheer statistics, and that protects the vulnerable ones who can't be vaccinated, or those whose vaccines didn't take root. Vaccines are not just about preventing personal illness, but stopping them from spreading. Done systematically enough, it can eradicate diseases completely. The elimination of smallpox, which killed something like 300 million people in the 20th century alone, ranks high on the list of human accomplishments.

That is why this is as much a moral issue as a scientific one. The appalling selfishness inherent in the idea of "vaccine choice" was starkly illustrated in a recent CNN story. After the measles outbreak at Disneyland, CNN talked to a family whose 10-month-old baby had contracted the disease. They're terrified he'll pass it on to their 3-year-old daughter, who has leukemia and can't get the vaccine -- but might be killed by the disease. Here's the response of a refusenik parent:

CNN asked Wolfson if he could live with himself if his unvaccinated child got another child gravely ill. "I could live with myself easily," he said. "It's an unfortunate thing that people die, but people die. I'm not going to put my child at risk to save another child." [CNN]

In other words, it's okay to cause the death of another child if your kid wants to go to Disneyland. And that's leaving aside the risk to Wolfson's own kids, who are put at risk by his atrocious parenting.

Posted by at February 5, 2015 6:24 PM

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