With presidential primary season looming, New Jersey Gov. Chris Christie is finally voicing his opinion on national issues. And out of the gate, he's stirring up controversy. Monday morning, Christie said that while he believes vaccination is a public good, parents should have a degree of choice in the matter. The Washington Post quoted him saying, "Not every vaccine is created equal, and not every disease type is as great a public health threat as others." These comments come just a day after President Obama urged all parents to "get your kids vaccinated," in light of the recent measles outbreak in California.
Christie's office did clarify his position. "There is no question kids should be vaccinated," a statement read. But his thoughts on policy are vague. He calls for "a measure of choice," and "balance" over which vaccines the government should mandate. Yes, it would be probably be weird public policy if the U.S. government took a totalitarian approach: barging into homes with nurses and syringes. There are some legitimate reasons not to vaccinate a child. Allergic reactions can happen. There are tricky vaccination decisions to make for children born with HIV. But for the vast, vast majority of children, vaccines are safe, and they should stay to the prescribed schedule.
If Christie is advocating for the parental right to choose vaccinations Ã la carte (it isn't clear if he is) based on how effective the vaccines are and how dangerous the diseases are, his thinking is curious. Look no further than the mumps and the flu.
The mumps vaccine—included in the MMR shot that also inoculates for measles and rubella—is not that great. Depending on how many doses a person gets, the mumps vaccine is about 80 to 90 percent effective. Meaning that out of 100 people with the shot, about 20 still might be able to get the mumps.
But more people with the vaccine means fewer opportunities for those 20 people to become infected. It's called herd immunity: Having more people in a community with the mumps vaccine makes every individual's dose of the vaccine, in effect, stronger. For mumps, doctors say between 88 and 92 percent of people in a group need to have the vaccine to keep the disease from spreading.
And consider the flu, a disease that most healthy kids can ride out just fine. It's really important for children to get the flu shot. Because kids are gross. Children most readily pass the flu on to others, including the elderly, who often don't ride out the disease just fine. The journal Vaccine finds that the optimal way to mitigate a flu season is to prioritize kids.
So yes, Governor, not all vaccines are created equal. And neither are diseases. But whether those facts should factor into a vaccination decision ... well, it's a lot more complicated than that.
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