On Individual Liberty and Vaccinations — Troy Senik

 

Here in Nashville for a couple of weeks — the closest thing I have to therapy — I’ve been perusing the local press, partially as a means of playing one of my favorite games: “Spot the Contrast with California.”

It takes only one item to underscore the difference. The big economic fight right now in Tennessee — a state that already has no general income tax and is in the process of phasing out its estate tax— is whether the Hall Tax, a levy on income from stocks and bonds, is also destined for repeal. We’re not in Los Angeles anymore, Toto.

My survey, however, also brought me to this item — one that the two states have in common. From The Tennessean:

With preventable diseases such as measles staging a resurgence, a leading Nashville physician says it’s time for Tennessee and other states to stop allowing parents to opt out of vaccinating their children.

Exemptions for personal or religious beliefs put children at risk who have legitimate medical reasons for not getting vaccines, said Dr. Bill Schaffner, an infectious diseases professor at Vanderbilt University.

Forty-eight states, including Tennessee, have passed laws allowing parents to opt out of mandatory school vaccinations. About 2 percent of Tennessee children do not receive their required shots because parents cite religious or medical reasons, according to the state health department.

Infectious disease experts worry about that percentage rising, as it has in states such as California, where the rate of parents citing personal belief exemptions rose 50 percent in three years.

… Any action to remove exemptions for mandated school vaccinations in Tennessee would face certain opposition from organizations such as Vaccination Liberation. Kelly Riggs, a spokeswoman for the organization in Knoxville, said the opt-out law in Tennessee should be expanded, not restricted. She wants the state to add philosophical objections to the religious and medical reasons for refusing mandated vaccinations to attend public schools.

“We don’t want the state or any government to tell us what we need to do with our child or body,” Riggs said.

I don’t have any truck with the anti-vaccine crowd, who, in a just world, would receive the kind of “anti-science” scorn reserved for climate change skeptics (the anti-vaxxers, after all, actually hurt people). I’m also libertarian enough, however, that I don’t begrudge people their stupid decisions provided that they — and they only — are the ones who bear the costs.

That’s not the case here, of course. In fact, what makes this issue so interesting from a philosophical point of view is that it includes the two great spike strips of pure libertarianism: children and negative externalities. Both of those factors would lead me to be inclined towards narrowing the exemptions (thought, at two percent, I’m not sure the issue is pervasive enough to justify a response yet).

 I’ve got to be honest — I don’t feel great about coming to that conclusion. I’m almost always on the side of those making the religious liberty argument. I was with them on the contraception mandate. I was with them on the fight in Arizona. And here … well, the right to leave your child gratuitously exposed to illness just feels like a bridge too far.

What say you, Ricochet? If you were a state legislator and this issue came before you, what approach would you take?

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  1. Valiuth Member
    Valiuth
    @Valiuth

    Frankly I don’t see why public schools can’t just make vaccination a precondition of attendance. The school is responsible for the safety of the children under its care, and as schools provide a perfect ground for disease transmission they should be able make vaccination a precondition for attendance. Call it a measure to minimize liability exposure. Then I would just make public education optional. So if you don’t want to vaccinate your kid you can send them to a school that doesn’t care. Everything beyond that is irrelevant to me.

    • #1
  2. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    As Valiuth said, this issue is more about public schooling than it is vaccines.

    Certainly, private schools would be well within their rights to require that students attending be vaccinated against whatever horribles they believe would put their student body at risk.

    • #2
  3. Herbert Woodbery Member
    Herbert Woodbery
    @Herbert

    It’s a very interesting dilemma, what is probably best for your individual child, has negative consequences for society as a whole.   I heard recently that the pro circumcision crowd is making the same argument,  ie the societal benefit of a circumcised population outweighs the negative costs of circumcising the individual child.

    • #3
  4. Nick Stuart Inactive
    Nick Stuart
    @NickStuart

    If I were a state legislator I’d find something constructive to do with my time. 

    Valiuth pointed out make public school attendance contingent on vaccination. Here in the People’s Republic of Illinois, it already is. That will test out the sincerity of the religious conviction (if they’re willing to homeschool their kids, let ’em).

    We homeschooled our kids, but had them vaccinated. One of my earliest childhood memories was getting the polio vaccine probably the day it was available because my sister had polio. 

    You can’t cure stupid, and if people are so stupid they won’t get their children vaccinated, there really isn’t that much to be done about it.

    • #4
  5. Pseudodionysius Inactive
    Pseudodionysius
    @Pseudodionysius

    If I were a state legislator I’d want to know what’s going on with vaccines derived from aborted fetuses.

    • #5
  6. Whiskey Sam Inactive
    Whiskey Sam
    @WhiskeySam

    Midget Faded Rattlesnake:As Valiuth said, this issue is more about public schooling than it is vaccines.Certainly, private schools would be well within their rights to require that students attending be vaccinated against whatever horribles they believe would put their student body at risk.

     I attended a private college, and you did have to have your immunizations up-to-date to attend so the idea is not unheard of for private institutions.

    • #6
  7. Sabrdance Member
    Sabrdance
    @Sabrdance

    I’m in favor of mandatory immunizations with 2 conditions:

    1.) the vaccine has to be for actual herd immunity.  DPTS is fine, those are airborne or touch communicable.  While I’m persuaded that, on balance, the HPV vaccine is worth the cost for the individual, I’m not persuaded of its public health benefit, and so am reluctant to mandate it.

    2.) A religious (I could be persuaded to go philosophical, too) exemption.  We can get the benefit of herd immunity without vaccinating everyone -obviously, since some people can’t be vaccinated for medical reasons.  There is no need to hassle Christian Scientists about this.  They are a vanishingly small minority and not endangering anyone.

     

    Now, provided 1 was kept to the absolute minimum -no rent seeking by Merck to get their newfangled vaccines mandated -I could be persuaded to revisit 2 if it began to seriously threaten herd immunity.  I don’t know that 2% is that threat.  Call me at 5%.

    But I really don’t want to remove the religious exemption so that Merck can line its pockets and a couple obnoxious legislators can feel good about themselves.

    • #7
  8. Mike H Inactive
    Mike H
    @MikeH

    Sabrdance:But I really don’t want to remove the religious exemption so that Merck can line its pockets and a couple obnoxious legislators can feel good about themselves.

     It’s that last 2% that causes Merck to line their pockets? I doubt they would care.

    • #8
  9. jedichris25@hotmail.com Member
    jedichris25@hotmail.com
    @ChrisB

    Anti-vaxxers are only about 2% of the population and you only need ~ 80% vaccination for effective herd immunity, so why are they even being questioned?

    Several of my siblings have had severe reactions to  immunizations. One nearly had an arm amputated . . . twice. Both times the doctors in the ER insisted that the reaction was caused by a bee sting that happened to be in the exact same location that the the immunization was injected less than 24 hours before. They refused to report it to the Vaccine Adverse Event Reporting System because there “wasn’t any evidence that it was connected to the immunization.”

    My brother had his MMR and within days contracted all three in rapid succession.

    My dad nearly died of pneumonia after receiving a flu shot.

    So, would I be “gratuitously exposing my (hypothetical) child to illness” by not having him immunized? What if he loses an arm, or dies, from the shot? I already know from personal experience and discussions with numerous workers in the medical field that problems with immunizations are under-reported and dismissed as being caused by unrelated things,  because no one wants to deal with the paperwork and government scrutiny.

    I’d oppose mandatory immunization.

    • #9
  10. Sabrdance Member
    Sabrdance
    @Sabrdance

    Mike H:

    Sabrdance:But I really don’t want to remove the religious exemption so that Merck can line its pockets and a couple obnoxious legislators can feel good about themselves.

    It’s that last 2% that causes Merck to line their pockets? I doubt they would care.

     No, getting an unnecessary vaccine mandated to 100% of the population is Merck lining their pockets, which they tried to do with Gardasil.  That by itself is objectionable.  Simultaneously coercing 2% of the country who have objections to it is just the cherry on top of the obscenity.  Either would be worth blocking, but I could live with a little rent seeking and no religious coercion, or a little coercion but no rent seeking.  The combination of both, though, is worth making a fuss over.  We’re no longer coercing people for the public good, but allowing one faction of the people dragooning the government to coerce the other for no better reason than they want money-and that’s wrong whether its 1 person or 300 million people.

    • #10
  11. Fake John Galt Coolidge
    Fake John Galt
    @FakeJohnJaneGalt

    Not with you on this one.  If  the sanctity of an individuals blood is not their own then how can you make an argument that anything else is?  Is there a risk? Sure.  But freedom is about taking the risks.  You want to pollute the integrity of my blood with chemicals of the states choice?  Then come and get it and you better be willing to shed some of your own in the process.

    • #11
  12. Midget Faded Rattlesnake Member
    Midget Faded Rattlesnake
    @Midge

    Whiskey Sam:

    Midget Faded Rattlesnake:As Valiuth said, this issue is more about public schooling than it is vaccines.Certainly, private schools would be well within their rights to require that students attending be vaccinated against whatever horribles they believe would put their student body at risk.

    I attended a private college, and you did have to have your immunizations up-to-date to attend so the idea is not unheard of for private institutions.

     Ditto. That’s where I got the idea.

    • #12
  13. Valiuth Member
    Valiuth
    @Valiuth

    Fake John Galt:Not with you on this one. If the sanctity of an individuals blood is not their own then how can you make an argument that anything else is? Is there a risk? Sure. But freedom is about taking the risks. You want to pollute the integrity of my blood with chemicals of the states choice? Then come and get it and you better be willing to shed some of your own in the process.

     I agree that we should not force any medical action on anyone, but I think you can make vaccination a pretty condition to public education. This is a strict quid pro quo with the public. You want your kid to go to public school they get vaccinated. No pressure no coercion, no different from demanding that you get your kids paper and pencils for them to use, or school appropriate clothes.

    • #13
  14. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    Chris B:Anti-vaxxers are only about 2% of the population and you only need ~ 80% vaccination for effective herd immunity, so why are they even being questioned?

    The challenge is that the 2% isn’t constant.  In some communities it is as high as 8% which leads to outbreaks of disease.  I’m uncomfortable with making it mandatory thought.  

    While newer vaccines (e.g., Gardasil) may have a higher profit margin, under the Clinton administration, regulations were put into place to promote vaccines in lower income communities by regulating cost.  That, not surprisingly, led to shortages.  

    Here in the DC area, pediatric practices are refusing to accept patients who do not plan to vaccinate or haven’t.  I like that adjustment best.  Families still make their own decisions, and work with a provider who respects their decision.  No regulations needed. 

    • #14
  15. Kozak Member
    Kozak
    @Kozak

    Valiuth:

    Fake John Galt:Not with you on this one. If the sanctity of an individuals blood is not their own then how can you make an argument that anything else is? Is there a risk? Sure. But freedom is about taking the risks. You want to pollute the integrity of my blood with chemicals of the states choice? Then come and get it and you better be willing to shed some of your own in the process.

    I agree that we should not force any medical action on anyone, but I think you can make vaccination a pretty condition to public education. This is a strict quid pro quo with the public. You want your kid to go to public school they get vaccinated. No pressure no coercion, no different from demanding that you get your kids paper and pencils for them to use, or school appropriate clothes.

     Do I still have to pay my taxes to support said public school?  Or can I use that money to provide an alternate education for my children?

    • #15
  16. jedichris25@hotmail.com Member
    jedichris25@hotmail.com
    @ChrisB

    Here in the DC area, pediatric practices are refusing to accept patients who do not plan to vaccinate or haven’t.

    So the solution to low vaccination rates is to deny medical care to children who haven’t been vaccinated? How is that reasonable?

    My point was that there are legitimate reasons quite beyond the religious for not getting vaccinated. My entire family has a history of extremely poor results from vaccinations in general. They have proven both ineffective and harmful.

    I’m not actually anti-vaccine, but the pro-vaccine crowd seems intent on ignoring situations when vaccines are counter-indicated. They have a one size fits all mentality that has probably ruined a lot of lives.

    • #16
  17. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Chris B:

    Here in the DC area, pediatric practices are refusing to accept patients who do not plan to vaccinate or haven’t.

    So the solution to low vaccination rates is to deny medical care to children who haven’t been vaccinated? How is that reasonable?My point was that there are legitimate reasons quite beyond the religious for not getting vaccinated. My entire family has a history of extremely poor results from vaccinations in general. They have proven both ineffective and harmful.I’m not actually anti-vaccine, but the pro-vaccine crowd seems intent on ignoring situations when vaccines are counter-indicated. They have a one size fits all mentality that has probably ruined a lot of lives.

     I should be allowed to refuse to treat someone that does not follow my recommendations. I think that is perfectly reasonable.

    • #17
  18. user_525137 Inactive
    user_525137
    @AdrianaHarris

    When I was in school we had to have our vaccinations up to date before attending. It wasn’t because the government was trying to control us; it was a matter of public health. Not vaccinating children against potentially lethal childhood diseases is tantamount to neglect. I don’t understand the religious argument against something that didn’t exist at the time of the argument.

    • #18
  19. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    I think that how we pay for public school is its own issue.

    I know that even though they are treated, my kids are at risk of disease if they are exposed to other kids with them. I would rather not have my kids exposed to these illnesses.

    Children used to die often of childhood diseases. Now they do not. I don’t want that to come back.

    • #19
  20. user_1938 Inactive
    user_1938
    @AaronMiller

    Bryan G. Stephens:

    I should be allowed to refuse to treat someone that does not follow my recommendations. I think that is perfectly reasonable.

     You should be allowed to refuse to treat someone period. Refusal to help someone in need might be wrong or even despicable at times, but doctors should not be slaves of society. The nature of one’s abilities should not determine one’s freedoms.

    As for vaccinations, should all types of vaccinations be considered equally under these laws? Do strains of other diseases vary as widely as flus?

    • #20
  21. user_3130 Member
    user_3130
    @RobertELee

    I was forced to get the anthrax vaccinations and had a bad, life changing, reaction.  I sat in a staff meeting where a doctor wanted an Airman court-martialed because he almost died from the first shots and couldn’t receive more shots.  Yes there are people out there like that.  The commander asked the doctor if he were insane after that statement and refused his demand. 

    So, while I’m pro vaccine I believe in the right to objecting to and refusing vaccination for oneself or one’s children.  I understand there are consequences for not vaccinating for oneself and others.  I don’t see an easy answer.  I will refuse, where possible, any vaccination now that I don’t trust or have reason to believe will harm me.  Any legislation involving vaccinations should take the decision to refuse vaccination into account.

    • #21
  22. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Robert E. Lee:I was forced to get the anthrax vaccinations and had a bad, life changing, reaction. I sat in a staff meeting where a doctor wanted an Airman court-martialed because he almost died from the first shots and couldn’t receive more shots. Yes there are people out there like that. The commander asked the doctor if he were insane after that statement and refused his demand.So, while I’m pro vaccine I believe in the right to objecting to and refusing vaccination for oneself or one’s children. I understand there are consequences for not vaccinating for oneself and others. I don’t see an easy answer. I will refuse, where possible, any vaccination now that I don’t trust or have reason to believe will harm me. Any legislation involving vaccinations should take the decision to refuse vaccination into account.

     Well now, wait a moment. If a airman or soldier cannot take the vaccinations, maybe they should leave the service. I don’t think court-martialed, but discharged for medical reasons. That seems to make some sense to me.

    And we can tell military that it is part of signing up. If you are unwilling to take them, then don’t sign up for service. Hospitals make it mandatory to get flu shots and other vaccinations. The Armed Forces should be no different.

    • #22
  23. user_3130 Member
    user_3130
    @RobertELee

    Sure an person’s career go down the tubes because they can’t take the vaccine?  I had 19+ years in and was told to take the vaccine or be discharge with no pension or severance pay.  The vaccine lots I was given later turned out to be those contaminated with squalene. 

    As for the argument “you knew what you were in for when  you signed up,” ask any first year Soldier, Sailor, Airman or Marine if they knew everything that was required of them before they signed up.

    Did you know that the US is not a signatory to the  Nuremberg Code?  That the very principles we used as justification to execute people are not followed here?  That executive order 13139 allows the testing of “investigational new drugs” on military members without their knowledge or consent?  That wasn’t in any recruiting speech I ever heard.

    • #23
  24. Pseudodionysius Inactive
    Pseudodionysius
    @Pseudodionysius

    What would Sheryl Attkinsson do?

    How hard, for example, should it have been for the press to notice the views of Dr. Bernadine Healy, the former head of the National Institute of Health, the former head of the American Red Cross, and the former Chair of the White House Cabinet Group on Biotechnology, one of several White House positions she held in service to three U.S. presidents.Dr. Healy criticized the public health establishment for being “too quick to dismiss [vaccine concerns] as irrational…The more you delve into it, if you look at the basic science, if you look at the research that’s been done in animals, if you also look at some of these individual cases, and if you look at the evidence… what you come away with is that the question [of vaccine safety] has not been answered.”Dr. Healy’s views would have been particularly easy to find because they were actually aired by one of America’s leading journalists, Sharyl Attkisson of CBS News, in one of the rare instances in which the mainstream press fairly presented a skeptic’s perspective on the vaccine issue.

    • #24
  25. Devereaux Inactive
    Devereaux
    @Devereaux

    Bryan G. Stephens:

    Robert E. Lee:I was forced to get the anthrax vaccinations and had a bad, life changing, reaction. I sat in a staff meeting where a doctor wanted an Airman court-martialed because he almost died from the first shots and couldn’t receive more shots. Yes there are people out there like that. The commander asked the doctor if he were insane after that statement and refused his demand.So, while I’m pro vaccine I believe in the right to objecting to and refusing vaccination for oneself or one’s children. I understand there are consequences for not vaccinating for oneself and others. I don’t see an easy answer. I will refuse, where possible, any vaccination now that I don’t trust or have reason to believe will harm me. Any legislation involving vaccinations should take the decision to refuse vaccination into account.

    Well now, wait a moment. If a airman or soldier cannot take the vaccinations, maybe they should leave the service. I don’t think court-martialed, but discharged for medical reasons. That seems to make some sense to me.And we can tell military that it is part of signing up. If you are unwilling to take them, then don’t sign up for service. Hospitals make it mandatory to get flu shots and other vaccinations. The Armed Forces should be no different.

     I don’t think your statement stands up by itself, without modifiers. This airman apparently had a large reaction to the vaccine. That could have been from either a carrier component, OR he could already be immune, causing a large reaction. Neither should be disqualifying.

    I am personally in favour of vaccines. I believe that they have destroyed so many bugs that were the scourge of mankind. Resistant H.flu is one case in point; another would be small pox. Still, the thread starts talking about civilians, and I believe that those that don’t want vaccination, for them or their children, ought not be forced to get it. I would also claim that were they to suffer any consequences of such lack of vaccination, no malpractice can be claimed.

    • #25
  26. Pilli Inactive
    Pilli
    @Pilli

    Bryan G. Stephens:

    Chris B:

    I should be allowed to refuse to treat someone that does not follow my recommendations. I think that is perfectly reasonable.

     Two points:

    1)  The SCOTUS just refused to hear the case of the NM baker that is required to provide her services to people with whom she has religious issues.  So your argument that you should be allowed to refuse treatment is on very thin ice.

    2)  If the availability of medical care were such that you could change doctors easily, then you would have an argument.  However, it is not easy to change doctors in many places and is getting very much more difficult because—Obama.

    While I agree that doctors should not be made slaves of the state, that ship is leaving port as we speak.

    • #26
  27. user_3130 Member
    user_3130
    @RobertELee

    Devereaux:

    “Still, the thread starts talking about civilians, and I believe that those that don’t want vaccination, for them or their children, ought not be forced to get it. I would also claim that were they to suffer any consequences of such lack of vaccination, no malpractice can be claimed.”

    I agree with this wholeheartedly.

     

    • #27
  28. PsychLynne Inactive
    PsychLynne
    @PsychLynne

    I think the argument here shows why it’s so important the medical care not be carried out in a cookbook – regulatory heavy way.  Given family history, allergic reactions, there are plenty of reasons people have concerns.  However, we are also quite insulated from the devastation of the pre-vaccine world.  It’s a tension between the two.  

    Also, when I mentioned docs not having non-vaccinated patients in there practice, that isn’t the sum total of all medical care available, it’s just a choice individual practices make.

    • #28
  29. user_1030767 Inactive
    user_1030767
    @TheQuestion

    The anti-Vax people appear to believe that all vaccines are bad (if I’m understanding them correctly).  That makes no sense to me, but it is true that each individual vaccine involves a cost/benefit analysis (potential harm to the patient, etc.), so I think a law mandating vaccination would probably not be a good idea.  Allowing individual physicians, hospitals, and local authorities to make their own policies regarding vaccination requirements would probably lead to sensible use of vaccines.

    I think there are few or no situations where a physician should be required by the state to follow a particular method of treatment.  If a physician can’t be trusted to make those decisions on his own, he shouldn’t be practicing medicine.

    • #29
  30. Troy Senik, Ed. Member
    Troy Senik, Ed.
    @TroySenik

    Chris B:

    My point was that there are legitimate reasons quite beyond the religious for not getting vaccinated. My entire family has a history of extremely poor results from vaccinations in general. They have proven both ineffective and harmful.

    This is a completely legitimate point and I would hope that any reasonable construction of the medical exemptions that are allowed for vaccination would include sensitivity to cases like the ones you’re describing. 

    • #30
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