Refusing To Vaccinate Should Come With A Social Cost

Refusing to vaccinate your children isn't a crime. Nor should it be – except perhaps in the most extraordinary of circumstances.

But when parents refuse to vaccinate their kids for wholly preventable childhood diseases such as whooping cough, polio and measles, they're not only potentially risking their own children's lives but also the lives of others.

And although parents have the right to make a wide array of choices for their kids, choices that have public health consequences should also have certain social consequences.

The case against vaccination is weak and hardly worth discussing. Yes, I am being dismissive. There are no serious, peer-reviewed studies that support a link between vaccination and autism, only anecdotes. And the various conspiracy theories surrounding vaccines are patently absurd.

There will always be exceptions. Some people have congenital illnesses or immune deficiencies that make vaccination dangerous, if not deadly. Not every vaccine is 100 percent effective. Some people have bad reactions to vaccines – much as some people have bad reactions to aspirin, bee stings and sunlight. Generally speaking, though, vaccines are safe, and they work.

If some people absolutely insist on not vaccinating themselves or their children, then at the very least, businesses should have the right to discriminate on the basis of vaccination. No shoes, no shirt, no vaccinations, no service. In fact, businesses already have that right. They simply haven't exercised it.

Think about the Disneyland measles outbreak in December. Patient zero probably brought the disease to the Happiest Place on Earth from the Philippines, according to public health officials. Measles is highly contagious, affecting 90 percent of those who come into close proximity with an infected patient. So chances are a few other people would have become ill no matter what.

But at least 34 of those Disneyland cases were unvaccinated. Six were infants too young to be inoculated. The rest were either older kids or adults who should have known better. Those people came in contact with hundreds of other people, many of whom were also unvaccinated and placed into quarantine. Now the California Department of Public Health confirms 99 measles cases and counting.

Disneyland has an interest in protecting its guests from infectious disease. Although it might not be desirable or even logistically possible for every business to demand their customers prove they've been properly vaccinated, a few theme parks, sports venues and airlines would be enough to make the point.

What might happen as a result? Many customers would be furious. Vaccinated people would recoil at the inconvenience – and resent the reason for it. Unvaccinated people would cry out against the injustice of it all. They might even demand special protection under the laws. Those demands should be rejected.

“Unvaccinated” is not a protected class covered by state and federal civil rights laws. People are born a certain race or sex.

People should be free to choose not to vaccinate. But just because the choice is legal doesn't mean we have to respect it.

Now let's suppose this scheme doesn't have the desired effect of pressuring more people into vaccinating their children. Maybe it backfires on Disney and others, and cuts into their bottom lines. Then what?

Then government has a role to play, even if it's a limited one.

Fact is, we've had mandatory vaccination laws in the United States since the early 19th century. The U.S. Supreme Court in 1905 upheld a Massachusetts law mandating that residents be vaccinated for smallpox in the midst of a major outbreak.

“There are manifold restraints to which every person is necessarily subject for the common good,” Justice John Marshall Harlan wrote in the court's decision in Jacobson v. Massachusetts, which rejected a Cambridge man's argument that vaccination couldn't be imposed on healthy citizens just because they might contract a disease.

I'd venture to say many Americans today would have a problem with some of Harlan's reasoning. I certainly do. But here again, the government doesn't have to forcibly inject people or toss them in jail to ensure public safety. Legislators could merely make certain public benefits contingent on vaccinations, an argument made eloquently this week by Bloomberg columnist Megan McCardle.

You don't want to vaccinate your kids? Fine. Then you don't receive the child tax credit. Or you don't get a federal student loan.

If that sounds coercive, it is. But as Harlan wrote, “Society based on the rule that each one is a law unto himself would soon be confronted with disorder and anarchy.” Individual liberty is sacred – but not so sacred as to risk the lives and liberty of everyone else.

This piece originally appeared in The Sacramento Bee

This piece originally appeared in The Sacramento Bee