Is there any good reason not to mandate national vaccination?

So let’s just clarify three premises right off the bat:

  1. Vaccines are overwhelmingly safe and effective.
  2. Antivaccine sentiment is leading to an increase in infectious diseases.
  3. Lowered vaccination rates lead to more disease vectors, which is a risk for others beyond those who choose not to vaccinate - in other words, in choosing not to vaccinate, you’re not just a danger to yourself and your own children, you are a danger to those around you.
    I don’t think there’s any rational arguing with 1 or 2. The conclusion to be drawn from this is that it would be legitimate for the government to mandate vaccination against infectious diseases, and potentially to make it a crime to withhold vaccines from your children or go significantly off-schedule. My question is, is there any good reason not to? Measles was effectively eradicated in the USA for a few years back around the turn of the century; now it’s making a comeback. I think it would not only be sensible to mandate the vaccination of everyone, but that it would be irresponsible not to. Thoughts?

No.

Make it a requirement of attending public schools.

And private schools.

And of being in public areas.

I don’t think that’s good enough, personally. I mean, sure, there you indisputably have justification - this is public property under the government’s control and you do not get to put others at risk and still be here - but there are plenty of other places where unvaccinated people interact with society at large. Don’t get me wrong, getting rid of those absurd exemptions would be a great first step, but why not go further?

It is in many if not most districts. A waiver is not particularly hard to get in this, the second McCarthy era, but the requirement is widespread to universal AFAIK.

A national mandate would be yet another example of gummint oppression, yadda yadda, bitch bitch, grumble grumble. But no, there’s absolutely no reason not to consider one, just as there is no reason for parents to fail to vax their kids.

Yes, there are some rare health and allergy issues. Emphasis on rare.

You run the risk of some parents never taking their kids to the doctor and getting no medical care at all.

Some parents will simply forge the immunization records to get their kids into school, others will homeschool.

I’m leery of mandatory anything in healthcare, for the precedent it sets. Sure, I support universal vaccination, but slippery slope is slippery what about mandatory statins for those with high cholesterol? Imprisonment during infectious disease outbreaks? Mandatory sterilization of people who are too poor to be parents? Mandatory abortions for teens? Once you start putting the government between people and their doctors, I get nervous.
I prefer education and education and more education. Persuasion, not force.

Make it a requirement for a subscription to Mother Jones.

More seriously, as much as I am for vaccination I’m concerned that a government mandate will push the crazies even crazier. I don’t know the solution. Maybe we can send Jeff Gillooly to bust up Jenny McCarthy’s knee.

The 1958 thalidomide scandal comes to mind. Vaccines, medications, drugs are overwhelmingly safe and effective. Except when they aren’t.

A monarchy could force every citizen to ingest anything it believes is in the best interest of the King/Queen.

Remove or reduce the tax credits for having children unless you submit up-to-date vaccination information with your return for each such dependent. People will still be free to allow their craziness to put their and others’ children’s health at risk (because this is, for some reason, important), but they will have a direct financial incentive to comply with sanity.

(Actually, I think the tax code should be significantly simplified and shouldn’t normally be used for this type of social influence. But if we’re going to do all the other hodge-podge of stuff we do with taxes, why not add this to the pile?)

How? They already believe that the government is conspiring to hide the harm behind vaccines to protect big pharma’s profits. What are they gonna do, double down on their belief? Big deal, they’re already about as likely to accept actual evidence as a member of the Westboro Baptist Church.

They do that already. And honestly, I think the best solution is to simply take their kids. They’re being medically neglectful in a manner which can kill their children. That sounds harsh, I know, but so is the return of Measles.

What about it? It’s a totally flawed comparison. We don’t mandate vaccination because vaccines are good for you. We do it because:

  1. We’re talking about children, not adults, and parents have a responsibility to make rational medical decisions for their children. Parents who choose not to vaccinate aren’t doing that.
  2. Failing to vaccinate puts others at risk - not just you, not just you and your children, but everyone around you.
    It’s got nothing to do with individual health. There’s no slippery slope that leads to any of these things.

Believe me, I do too. It’s just that at some points, education is too damn slow, and people are too damn stupid, and the result is people getting sick and dying. It’s virtually impossible to reason with a conspiracy theorist. How would you propose we go about educating them?

That is an absolutely terrible analogy. Or do you want to claim Thalidomide had anywhere near the safety testing that modern vaccines have had?

Not sure what this has to do with anything.

Thalidomide did little damage in the USA because of government testing. Frances Oldham Kelsey, MD, held the line for the FDA, despite serious drug company pressure. She refused to approve the drug. Eventually, news from Europe indicated she was right…

Of course, now we’re told to fear the government & “streamline” testing to help the drug companies push newer & more profitable drugs. The vaccines have been well tested. Besides, they aren’t big money makers like drugs for the obese & the impotent…

As measles and whooping cough outbreaks become more common, I get less and less nervous about this.

I’m ok with it as long as there’s an independent medical body determining which vaccines go on the schedule.

If there’s not, we get things like Rick Perry doing his lobbyist buddy a solid by mandating the HPV vaccine. Not that it was unsafe, but I’d rather have medical professionals making those decisions and not Governor Goodhair.

Do they? No, I haven’t read evidence of that. They homeschool for other reasons, but as long as we allow exemptions, there’s no motivation for actual forgery or homeschooling to avoid vaccination. Doctor avoidance is a small problem right now, but again, mostly for larger reasons, not vaccination alone. And so at least now we know who isn’t vaccinated. That’s a step towards refining our education and vaccination efforts to address those people. But make things truly, criminally mandated, and those people will be much harder to track down.

Nice to choose the one of several examples. I added the others for the “think of the children factor,” though, and tried to pull some from each side of the political divide for a reason. People said fetal personhood laws would only apply to homicides, too, and now they’re being pulled out for miscarriages. That’s how slippery slope works…someone uses the thing you agree with to justify the thing you don’t agree with, and you’re screwed.

I think we need to change the tenor of the education. Since the largest group of non-vaccinating parents is not granola crunching hippies or alt med fanatics, but is college educated professional women, I think we need to ramp up the selfish quotient. Emphasize the time off work and sleepless nights it takes to deal with a child with measles. Point out that a 2 week hospitalization during a big project is going to fuck over the parent’s chance for a promotion. The numbers of measles deaths is just too small too shock people of privilege who think that their money and social standing and best doctors in the country will keep their exceptional snowflakes safe even if they get measles. So hit em where it really hurts: their careers and beauty sleep.

There is no question that vaccinations have done wonderful things. That does not mean that every single vaccination that comes out of a public company needs to be forcibly administered to every single person in the country. Have we really reached the point where anyone who questions the safety and effectiveness of a new vaccine needs to be labeled an anti-vax nut-job and forced to comply?

I questioned the purpose of the Hep-B vaccine when it hit the market and they wanted to give it to my 3 year old. That is my job as a parent. The pediatrician had zero information other than “it’s recommended”, so I opted out. Later, it became a requirement to enter school, so we got it then. They happened to have a little more info available then too, rather the the ‘shut up and do it’ attitude I got before.

People haven’t been specific about which vaccinations should be mandatory, but I don’t think that’s what anyone is proposing.

I’m referring to the main vaccine schedule, and any other such well-examined vaccines that are examined.

Of course, you presumably didn’t get your information from Age Of Autism or the like…

Well, I’m not a big fan of homeschooling either, for a number of reasons…

Fair point.

Yes, and it doesn’t make it less silly when they do if the justification is meaningless. Again, the reason for mandatory vaccination outlined in the OP does not get us to anywhere beyond perhaps imprisonment during outbreaks, which I would read as a form of quarantine.

And then they turn around and see, “Oh look, autism does that way way worse”.

To be an anti-vaxxer is to be burdened with several misapprehensions, including, but not limited to:

[ul]
[li]The belief that mommy always knows best, regardless of how dirt stupid mommy happens to be (cf: Jenny McCarthy).[/li][li]That the devil you know (measles) is always better than the devil you don’t (autism), even when it isn’t.[/li][li]That anything big and organised (government, Pharma, etc…) always operates with the worst possible intentions, to the point that they think nothing of poisoning kids for profit.[/li][li]That anything “natural” is, by definition, better than anything artificial, even when it isn’t (cf: cancer, tuberculosis, Poison Ivy etc…)[/li][li]The Dunning-Kruger effect.[/li][/ul]

That’s a pretty powerful list of thinking traps and irrational biases to overcome, even when debating a person who holds only a couple of them. A common acceptance of point 3, above, makes them particularly difficult to convince. You can show them a thousand studies clearly proving that vaccines don’t cause autism, but since they’re all run by mainstream scientists (a.k.a. - hapless tools of “Big Pharma”), you might as well show them a card trick.

All this is complicated further by the fact that (a) most anti-vaxxers genuinely do love their kids, and (b) most anti-vaxxers (indeed, most people generally) are absolutely terrible at accurately calculating risk, especially when dealing with something over which they have no control. For instance, why are so many people scared of flying but not driving, even though driving is far more dangerous? Well, I think it’s mostly down to the fact that a driver is easily able to maintain an illusion of control. It is an illusion, of course, because it doesn’t really matter how good a driver you are if you’re surrounded by bad drivers, but that doesn’t matter. The illusion of control is a powerful one. By contrast, when you’re in a plane, you have absolutely zero control, and if something goes badly wrong you’re pretty much fucked. Aviation authorities can cite safety statistics until the heat death of the universe, but to someone whose real fear stems from a lack of control, they’re just a bunch of hollow, empty numbers.

The same is true for anti-vaccinationists. When faced with the threat of a measles epidemic, such a person can reassure themselves by using anti-bacterial wipes in the kitchen, or making sure little Jimmy always washes his hands, or whatever. But what can you do to minimise the threat that your kids MMR jab will give them autism? Absolutely nothing. The anti-vaxxer has already decided that vaccines DO cause autism (point 5, above) and they’ve already decided that everyone in authority who says otherwise has been compromised (point 3), and they approach the question burdened by a vast overestimation of the virtues of “mommy wisdom” (point 1), so they’re pretty well entrenched in their ignorance. Throw both a genuine love for their children and a pathological fear of being out of control into the mix, and you’ve got someone who is pretty well impervious to reason.

What I’m trying to say is that the outlook for conquering anti-vax quackery is pretty bleak. There have been anti-vaxxers for as long as there have been vaccines, and the internet has only made the problem worse and it will likely continue to do so. I fear we just have to live with that. Education is of limited value when most of the people you’re trying to educate have already decided that the educators have an ulterior motive.

Given all this, you might expect me to be in favour of mandatory vaccination. If these people’s lazy thinking renders them more or less incapable of making easy, responsible medical decisions for their kids, surely the sensible thing to do is just override them. However, I think that’s a terrible mistake, and here’s why: Vaccinations are not 100% safe. They’re 99.9999 (add as many 9’s as you like) percent safe, but not 100% safe. This is hardly a point against vaccines, of course, because nothing in real medicine is 100% safe. Anaesthesia isn’t 100% safe, aspirin isn’t 100% safe, cough syrup isn’t 100% safe. But these things aren’t the subject of any controversy. Ridiculous as it is, vaccines just are hugely controversial. And sadly, I fear that a great many people, perhaps even the majority, are susceptible to the fallacies that make anti-vaxxers so intractable, it’s just that, for most people, this susceptibility is counterbalanced by an appropriate respect for the expertise of doctors. Make vaccination mandatory, and the publicity engine that drives the anti-vax movement will ensure that each legitimate vaccine injury (and, of course, everything that even looks like it might be a vaccine injury) will become a cause célèbre for the movement. This will result in a further erosion of respect for authority among the general public. The net result? More anti-vaxxers.

Of course you might well say “The anti-vax movement are trying their best to do that right now”, and you’d be right. However, their bullshit arguments and scaremongering will be far more persuasive, and more palatable to the general public, if the government mandates vaccination, for one simple reason: People really, really don’t like having other people telling them how to raise their kids, especially when it comes to medical decisions. This goes double when the person telling them what to do is Uncle Sam. In a nation where “Do you trust your government?” is a de facto campaign slogan for one of the two main political parties, it seems likely that mandatory vaccination will make the old anti-vax canard that the government is in Pharma’s pocket far more persuasive. Every vaccine injury that makes the papers (and the increased controversy alone would guarantee they made the papers) would erode the trust that many people - people who might otherwise be content to choose to vaccinate - have in their doctors and legislators. Net result, as I said, more anti-vaxxers.

TLDR version: I think it will all backfire and make the problem worse.