There’s a complex interplay between the items listed in this article’s title that I think deserves examination. Everywhere we read about vaccines, we’re inundated with a whiplash-inducing ‘debate’ over whether or not they are somehow linked to autism, but it’s fairly clear that by employing the scientific method we can dismiss this particular concern. But there are plenty of other controversies associated with the phenomenon of vaccines, even though vaccines are easily one of humanity’s most impressive and world-changing inventions ever.
But this post isn’t so much about vaccines as it is about the interplay between something so demonstrably beneficial, like vaccines, and the underlying social compact which makes our great Western society work. Discrimination is one facet of our society which interacts with a phenomenon like vaccines (or, perhaps more specifically, the anti-vaccine movement), but discrimination could be used in a positive way–so long as that discrimination occurs at the local level and not at the federal level. Before you flip your lid, allow me the opportunity to explain.
Discrimination is generally a bad thing in that it cuts off potential paths to people. Paths like education, health care, workforce participation, and even retail access are considered fundamental ‘rights’ in our society, and that’s a good thing when discrimination is based on factors outside of a person’s control, such as ethnicity, religion, sex, phenotypic expressions like skin/hair/eye color, etc..
But what about discrimination that isn’t based on factors outside of a person’s control? What about discrimination based on factors directly under a person’s control? Is our aversion to discrimination still as valid in these latter situations as it is in the former? The answer is clearly ‘no.’
Our judicial systems in the West always address intentionality of a given act when prescribing the ‘correct’ punishment for a crime, which means that the degree to which a given action was ‘chosen’ by the perpetrator influences just how severe the punishment should be. We all agree this should be the case in the vast majority of circumstances; choice, intentionality, premeditation, or other expressions of what we collectively refer to as ‘free will’ or ‘agency’ are, at the most fundamental level, the primary causative factors which we, as a society, can address and hope to modify. If someone accidentally slides their car into someone, killing them, as a society we’re pretty lenient in terms of dishing out punishment. But if someone plans the exact same event out, and commits the act knowing full well that they’re going to kill someone with their car, we generally lock that person away for a long, long time. In the justice system, the cost of a person’s actions is less concerning to society than the cost of that person’s choices. As cognitive neuroscientists and author Sam Harris reiterates ad nauseam, and with good reason: “Intentions matter.”
So why don’t we turn this social force against a phenomenon like anti-vaxxers? I argue that it’s because there is insufficient freedom at the local levels of society, and too much power at the top of the bureaucracy (in the USA, this would be the Federal Government’s myriad tentacle-like branches). Think about it simply: if a school administrator for your local public school district had the power to discriminate against students based on their lack of vaccination (or even based on their having received vaccines!), all schools would be populated by the children of people who largely agree on that particular issue–or at least it would be populated by the children of people who’d been exposed to the arguments surrounding vaccinations, which would make them eminently better-informed on the subject than the average parent is today.
If we permitted school administrators to wield this measure of discriminatory authority, the results (whatever they may be!) would be apparent to all onlookers. Either the pro-vaxxers would be proven right (this is easily the most likely outcome) and their kids would present with markedly superior outcomes than the anti-vaxxers or, far less probably but still within the realm of possibility, the anti-vaxxers would begin to demonstrate superior outcomes.
Honestly, which way it goes is less relevant than the confidence the rest of us has in our understanding of the subject going forward. I’d bet everything I own that the pro-vaxxers win that debate, but I’m not arrogant enough to think it’s impossible that I’m wrong. Some people are, certainly, but I’m not among them.
Ok, so that’s how we could put some pressure onto the anti-vaxxers. But what if they homeschool their kids? This mechanism wouldn’t address homeschoolers, right? Right, it wouldn’t; so why not permit insurance companies, or state medical programs, to discriminate based on vaccine status? Surely the linkage between vaccination and the contraction of disease is well-enough-established that we could boil it down to simple cost/benefit ratios in this corner of the conversation. Why not just charge people who weren’t vaccinated a higher insurance premium commensurate with the associated medical costs resulting from not being vaccinated? We already do this with cigarettes and alcohol, to varying degrees and with varying stated reasons, but we do collect taxes for behaviors which have associated downstream costs with the purpose of offsetting those costs at the point of purchase.
If anti-vaxxers’ insurance rates tripled compared to everyone else, they’d have no choice but to modify their interaction with either vaccines or health insurance. This is indisputable. What is reasonably disputable is whether or not we should be engaging in discrimination to modify the behaviors of people who haven’t committed crimes. That’s a perfectly reasonable argument and, obviously, the argument has leaned heavily in favor of the ‘no’ crowd on this one.
And I’m not even arguing that people who make choices the majority disagrees with (by employing dubious reasoning, leaning on bad data, or for any other of a million reasons) need to be censured. I’m actually arguing the reverse, because this entire position I’ve developed is predicated on the Federal Government never being in a position to discriminate in this fashion. Ideally, the States would be the ultimate arbiters of something like how anti-vaxxers’ impact on their constituents is addressed. If a State permitted discrimination at the public school enrollment process, based on a child’s vaccination status, then only some of the schools in that state would exercise such discriminatory powers. And some States would disallow such discrimination, preferring to take a different approach to the phenomenon of anti-vaxxers’ and the damage (real or perceived) that they cause their fellow citizens.
But what would happen, without fail, is that we would get massive data sets with excellent variability–and that would let us examine the issue with significantly greater clarity than we presently enjoy.
I live in the Philippines, where vaccines are not universally adopted, and I can scarcely take a car ride without seeing an adult who was clearly afflicted with polio. A year doesn’t go by without someone my wife knows losing a child in their family to a disease like measles. And even though I live among walking examples of the risks associated with not taking vaccines, I’m not arrogant enough to declare that My Way Is RIght and anyone who doesn’t follow it is a fool. I want there to be overwhelming piles of data for people to peruse, and I want us to preserve the records of that data so that once we conduct an experiment we don’t have to conduct it again.
But mostly, I want people to be free. Free to make choices that differ from those made by everyone else, and even (or especially!) free to make mistakes. I want people to be free not to engage in behaviors that will benefit them, just like I want them to be free to engage in those behaviors.
And seriously, I’m not really arguing for discrimination against anti-vaxxers. That’s not the point of this post; I’m simply pointing out that the whole reason the anti-vaxxers are allowed to make the rest of us shoulder the burdens of their choices is because the ‘pro-vaxxers’ don’t discriminate against the choices of the anti-vaxxers. Usually, when it comes to discrimination, I agree that’s a good thing. On this issue, I’m genuinely uncertain.
At some point, the consequences of a person’s choices have to be brought to bear against that person. And yes, the consequences of a parent’s choice vis-a-vis vaccines are most directly visited upon their unvaccinated children. That makes me sad. But in the end, we have to cultivate a respect for critical thinking, empiricism, and reason. Sometimes the only way to cultivate such respect is by going at people in their pocketbooks, but more usually it just ends up morphing into yet another terrible misapplication of state force.
TL;DR version: anti-vaxxers exist because we endorse their existence. That’s a feature, not a glitch, of our hyper-tolerant society. And in the final analysis, that’s probably a good thing. But when people’s choices are disconnected from the consequences of those choices, the rationality quotient of their choices can be expected to decrease. I’d like to connect the choice not to vaccinate with the consequences of that choice, in such a way that permits people to make said choice without shunting the associated costs onto people who didn’t–and never would–make the same choice.
Mostly this was a thought exercise, and I apologize if I rambled a little too hard in the middle. Hope you enjoyed it; back to writing for now!