#SkepticalTuesdays: On Mandating Vaccinations | Vol. 2 / No. 33.1

Mandated. Photo: Flickr user El Alvi, CC BY 2.0
Mandated. Photo: Flickr user El Alvi, CC BY 2.0

In this week’s #SkepticalTuesday post, I respond to an article over at Wired on why parents should oppose California’s attempt to get rid of the “personal beliefs exemption” to vaccination.

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In a recent article, Wired senior editor Sarah Fallon argues that SB 277 — a piece of legislation set to eliminate personal, “beliefs based” exemptions to vaccinations in California — “is legislation every parent… should oppose.” There’s only one problem: she doesn’t offer a single coherent argument against it.

I really like Wired. I do. But sometimes you just have to wonder.

She starts with the accusations of “opponents” who “have called it draconian and unnecessary.” For this she cites an assessment of kindergarten vaccination rates that shows rates went up from 2014 to 2015, from 90.2% to 90.4%. That’s a good number, but when the Herd Immunity Threshold for measles is 92-95% it’s not enough. And here’s the thing about trying to achieve herd immunity through vaccinations: vaccinations don’t always work, and even when they do, they don’t offer 100% protection. That means that the effective number of vaccinated people is actually lower than 90.4%, which was already too low to provide herd immunity for that disease.

The other arguments she has against it are flimsy at best. She starts with an argument that the numbers might not be as low as all that, because we might not be following up with “conditional entrants” as well as we could be, but since she provides no evidence to suggest that’s the case, or even that it might be enough of a case to affect the vaccination rates significantly, I’m going to suggest we make policy based on the data we have and move on.

Next there’s an argument about not being able to sue vaccine manufacturers the way you can sue seatbelt manufacturers if something goes wrong, which seems to be a bizarre way of saying she isn’t convinced that there’s enough pressure on vaccine manufacturers to ensure the quality and safety of their product. As she puts it, it makes vaccines “a mandatory drug for which the manufacturer bears no liability” and “means Merck, or other vaccine makers, don’t have an incentive to study the safety and side effects of these drugs to the same extent as almost anything else it sells.”

This is an argument for a lot of things, but it’s not one against mandatory vaccination. Why not? Because in order to keep our society safe, vaccines for things like measles are already mandatory, at least, if you have any moral compunctions. What’s more, if 9 out of 10 people already take these vaccines, and vaccine makers don’t have the incentives to make their products safe, this is a huge problem, regardless of SB 277.

But of course, they do have incentives to make them safe, which is why there’s a massive series of regulatory and experimental hurdles. Fallon argues, based on this study, that the current regulatory approval setup isn’t rigorous enough, but if so that’s something that needs to change, as I said before, regardless of SB 277. If vaccines aren’t safe, not being able to sue their manufacturers is a sideshow, and maintaining a personal beliefs exemption is just allowing for extra victim-blaming if something does go wrong. If you do want to guarantee the safety of vaccines more than the governmental agencies currently responsible already do, there are better ways to do it than the threat of a lawsuit. Legislative ones might be a good start.

She also seems to be using the “you get more flies with honey” argument at one point, suggesting that vaccination against nine illnesses over the course of six or seven years (something like fifteen or sixteen shots, many of which can be given simultaneously) is so onerous that it’s going to damage the parents’ relationship with their doctor, which could otherwise be used to plead and cajole recalcitrant parents into at least getting some of the vaccinations. But trying to convince people doesn’t work. Neither does shaming them into it. So then if we accept that some people just aren’t going to vaccinate their kids, and accept that we want to keep as many people’s children safe as possible, SB 277 is where we end up.

Under SB 277, if you don’t get your children properly vaccinated you can’t send them to public or private schools in California. This doesn’t count, of course, children who medically can’t have the vaccinations — they’re the people we’re trying to protect by getting everyone else vaccinated. It hasn’t been a problem in the states where there is no personal or religious exemption — they just have high rates of vaccination. So you can still exempt your kids from vaccination, but you have to home-school them and keep them away from everyone else’s children if you do. This seems perfectly reasonable to me, and I haven’t yet seen any argument against it — Fallon’s article included.

So, while I agree with Fallon’s assessment that we should find a way to hold drug companies to tighter standards, I can’t see any reason not to pass SB 277, and quite a few reasons to do so.

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Richard Ford Burley is a doctoral candidate in English at Boston College, where he’s writing about remix culture and the processes that generate texts in the Middle Ages and on the internet. In his spare time he writes about science and skepticism here at This Week In Tomorrow.