Should Anti-Vaxers Be Shamed or Persuaded?

The backlash to a measles outbreak—and a case against politicizing it

As the measles outbreak spreads to 18 states, anger against the anti-vaccine movement and individual parents who opt against immunizing their children is everywhere. National commentators and voices on social media alike have declared that they are selfish people with blood on their hands. "Anti-vaccine parents are turning their children into little walking time bombs," says Alex Berezow, founding editor of RealClearScience and a member of USA Today's Board of Contributors. "They ought to be charged for endangering their children and others."

This backlash is understandable and parts of it are overdue.

The ignorance and poor judgment of anti-vaccine parents put their own children and the general public at significantly increased risk of sometimes deadly diseases. Anger is a reasonable response, and efforts should certainly be made to persuade all parents to vaccinate their kids save in rare cases of medical exceptions.

But I part with the commentators who assume that insulting, shaming, and threatening anti-vaccination parents is the best course, especially when they extend their logic to politicians. For example, Chris Christie is getting flak for "pandering" to anti-vaccination parents. He said, "We vaccinate ours kids, and so, you know that’s the best expression I can give you of my opinion. You know it’s much more important what you think as a parent than what you think as a public official. That’s what we do. But I understand that parents need to have some measure of choice in things as well, so that’s the balance the government has to decide."

Those remarks could be improved upon. Indeed, Christie's office released a clarifying statement after his original comments came under criticism. But isn't Christie's approach more likely to persuade anti-vaccine parents than likening their kids to bombs? Let's emulate the New Jersey governor. If I could address any anti-vaccine parents reading this article: Like you, I looked into the scientific evidence with an open mind. When I regard conventional wisdom or the ruling establishment to be wrong, I'm always eager to publicly dissent. In this case, I came to the same conclusion as my own hyper-cautious mother: Not only would I definitely vaccinate my own kid if I had one—the case is so strong that, were standard vaccinations more expensive, I'd spend 20 percent of my income to get my kids their shots. That's how high my confidence is in their safety and importance. And if you're surprised by this measles outbreak, you underestimated the costs of your choice, which you'd be smart to reverse as soon as possible.

Testimony from people who actually have kids is, of course, going to be more credible. (See Roald Dahl's story about his daughter for a particularly affecting testimony.) I'd urge parents with the impulse to shame and insult to try that approach instead, not just because it strikes me as more likely to persuade the typical anti-vaccine parent, but due to the conviction that while anti-vaxer ignorance has caused great damage, the vast majority are not, in fact, especially selfish people, and characterizing them as such just feeds into their mistaken belief system. Put another way, the parents I know who vaccinated their children, mine included, were not acting selflessly or sacrificially to protect the herd. They were appropriately confident that vaccinating their kids would significantly increase rather than reduce their chances of surviving and thriving in this world.

Well-informed selfish people get vaccinated!

Like Chris Mooney, I worry about this issue getting politicized. As he notes, there is presently no partisan divide on the subject. "If at some point, vaccinations get framed around issues of individual choice and freedom vs. government mandates—as they did in the 'Christie vs. Obama' narrative—and this in turn starts to map onto right-left differences ... then watch out," he writes. "People could start getting political signals that they ought to align their views on vaccines—or, even worse, their vaccination behaviors—with the views of the party they vote for."

As a disincentive to this sort of thinking, folks on the right and left would do well to reflect on the fact that the ideology of anti-vaxers doesn't map neatly onto the left or right, with the former willing to use state coercion and the latter opposing it.

For example, consider some of the standard language used to talk about abortion. If you're a progressive who believes in both a constitutionally guaranteed right to privacy and a moral right to autonomy over one's body, do you also believe that choices about vaccinations ought to be between patients and doctors, and that the state has no right to intrude on such a sensitive matter?

If you're a conservative who believes that the community has a role in safeguarding innocent babies, even when that infringes on a parent's choices and bodily autonomy, do you also believe vaccinations can be compelled by the state?

I don't mean to suggest that the abortion and vaccination debates map onto one another perfectly—only to illustrate that legally compelling vaccinations would be both consistent with and in tension with other positions taken by both the left and right. Personally, I can think of hypothetical situations where I'd support compelled vaccination and others where I'd staunchly oppose them, based not only on specific facts about the world, a given disease, and the vaccine against it, but also on the question of whether such a law would really improve public health outcomes.

When it comes to measles, my tentative thought is that the best way forward is to downplay the polarizing debate about coercion, wherever one stands on it, and to focus on the reality that ought to make it unnecessary: the strength of the case for vaccinating one's kids, as demonstrated by the scientific merits of the matter as well as the behavior of every pro-vaccination elite with kids of their own. As a doctor, Rand Paul especially should walk back his imprudent comments on CNBC. While he's perfectly welcome to maintain that parents shouldn't be legally obligated to vaccinate, he ought to focus on explaining why, as a trained medical professional, he opted to vaccinate his own children, or so I gather from the fact that he declared that he believes the shots to be "a good thing."
Anti-vaxers should not be pandered to but neither should they be callously abused. Neither of those approaches achieves what ought to be the end goal here: persuading enough people to get vaccinated that measles once again disappears.