Has vaccination become a partisan issue?

I’m not entirely sure how much valence this has, but the anti-vax sympathies on the American right reminds me of Ayn Rand’s bitter refusal to quit smoking, solely on the grounds that if the American government and social movements were trying to make people quit, then she was by God going to keep doing it.

She eventually contracted lung cancer (shock) and died of heart disease.

It needn’t be said out loud, but if you really need evidence that the anti-vaccination movement is not symmetrical about the left-right axis, just look at the list of Democratic politicians who are hemming and hawing about whether vaccines are safe and effective against disease. There are none, at least no prominent ones. (RFK Jr. is probably the biggest name, he’s never served in office, and his name is of course not famous because of his own accomplishments.) Just watch: GOP presidential hopefuls will start prefacing their remarks on this question “Well, I’m not a doctor…” just as frequently as they answer climate change questions by disclaiming being a scientist.

Many apparently-political issues are in fact mental-health ones.

I daresay people have already seen this:
http://robertmoorejr.tumblr.com/post/110101466091/im-an-anti-braker

I post it not just because it’s great, but b/c (to step from brakes to belts) I’m old enough to remember when seatbelts were made legally compulsory for drivers in the UK. There was a libertarian storm in a teacup then, threatening to turn ‘the right to choose not to wear a belt’ into a political rallying cry. It petered out, I’d guess because the advantages in wearing a belt so massively and patently outweigh the advantages (if there are any: I can’t think …) of not wearing a belt. Vaccination is similar. Denying climate change looks like a no-cost performance, because the issues are huge and, you can kid yourself, far away. Not vaccinating your kids is small-scale and very close to home. That you oppose the nanny state with fervour doesn’t mean that you’re happy with the prospect of your own kid getting measles.

“and Democrats pushing a pro-vaccine, pro-science line.”

That would be a positive change, at least, from only a few years ago. As your footnotes indicate you’re aware. That it would still be a change, you seem less aware of.

Ok, let’s be clear about something: Vaccines work, science. People should be forced to be vaccinated? NOT science. It’s that is/ought gulf you likely covered very early in philosophy… Science is about “is”, not “ought”. In fact, give scientists too much say over “ought”, and they have a disturbing tendency to stop being scientists.

And Paul is pushing a pro-vaccine, pro-science, pro-freedom line.

It’s one of those philosophical divides between the left and the right, I guess. We’re not as enthusiastic about this notion that being convinced you know which choice is best entitles you to impose it on somebody, as your side is.

Ze and Brett are right–the politically more astute Republicans are now saying that vaccination is a good idea, but do not endorse mandatory vaccination. This way, they can pretend to support both Science and Liberty.

I’m just going to recycle recent comments on another vaccination thread starting around here. In short, it was quite reasonable to be concerned about thiomersal as opposed to vaccination, and this concern was reflected in the official decision to remove it from vaccines. Statements like “The Huffington Post used to be full of leftish anti-vaxers” (and now they’re not) may be in part a rhetorical change, but they may also reflect people catching up on changes in scientific knowledge and regulation.

It would be catastrophic if this did become a partisan divide, and as such I think it doesn’t help for people on the left to use dubious arguments on the assumption that people concerned about vaccination can’t see that they’re dubious. See here.

Brett Bellmore @ 8:

It seems very neat and nice to say that science is about “is” and politics is about “should,” and that works for the vaccine argument as long as you define it as being about individuals or even individual families: I can decide whether I should be vaccinated.

But there is another aspect to vaccines that involves “is” and “should” and blurs that nice individualistic line: herd immunity. Once you know the probability that people will contract a disease like measles from a carrier and a few other relevant variables, you can calculate an “is”, namely the percentage of the population that must be vaccinated to prevent the spread of that disease. Measles is highly contagious before any symptoms appear, so its percentage for herd immunity is well over 90%.

So if enough people decide to free ride on others’ decisions to vaccinate, then that benefit goes away. There are some people who can’t be vaccinated – very young babies, those with compromised immune systems, and so on, and one might think that they “should” be in the priority for that less than 10% who go unvaccinated, rather than those who call whim “freedom.”

I suppose you can call that a political judgment, whether to have herd immunity or not. If you do, you are giving the free riders something like ten times the voting power of those in favor of herd immunity.

I thought the whole point of vaccination is that it needs to be mandatory (with a few rational, specific, individual exceptions no doubt). It’s a public health issue. One of the fault lines is that conservatives do not accept the concept of public good at all–it’s like public schools, public libraries, the post office. Conservatives dream of a world where it’s all individual rights, and if that means no public health, fine–they think they can survive because they’ll be the rich ones. Senator Tillis carried the ball on this when he talked of the freedom not to wash one’s hands even when one is serving food to others.

For someone expounding the virtues of empiricism you sure seem reticent to use it yourself. Could it perhaps be because the data doesn’t fit your narrative?

Look at any survey concerning vaccines, you’ll find the same thing: there are nutters across the spectrum. Sure, there’s slightly more of them in the middle and on the right but the differences are a few percentage points. It’s nowhere near a partisan issue.

Add me to the chorus of people who think it’s unhelpful to characterize Christie and Paul’s comments as representative as an ‘anti-science’ perspective.

You don’t have to be a science denialist to think that we need not mandate all vaccines, and that parents ought to have some discretion. In particular, I think we can reject a principle according to which the law should compel parents to maximally promote public health through their children’s vaccinations.

It shouldn’t be controversial to say that parents may make choices for their children that fail to produce the best all-things-considered outcomes. Few people object to parents who drive their kids to school, even though everyone would be safer if they walked. (And I don’t imagine that many people think it should be illegal to drive children to school.) Of course, this doesn’t mean that parents may do anything they want. In the case of driving, parents have to put their children in car seats and they need to obey speed limits and traffic laws.

I think we can say something similar about vaccine choices. There should be limits on parental discretion: Parents should have a political obligation to vaccinate against diseases that place their children and others at significant risk of serious harms. For example, there should be no parental discretion when it comes to vaccines against polio and measles. But the risks and harms of some other diseases – like chicken pox – are not nearly as high. When it comes to these vaccines, Chris Christie may be right that parents should get to make a choice.

I’ll leave it to Americans to try to interpret the bizarre politics of their country. But it’s evident that the vaccine “debate” is a painfully clear and unambiguous example of the continuing conflict between individual rights and collective benefits, whose centre has moved steadily towards the former and away from the latter, in tandem with the widespread adoption of neoliberal economic and social policies by most mainstream political parties. Without that movement, arguably, there wouldn’t be a “debate” at all.
It’s interesting that the Left has not developed a genuinely anti-vaccination discourse of its own. In addition to traditional wariness about the good intentions of the state, and the commercial ambitions of drug companies, it seems to me there are at least two arguments which could be used by the modern Left against vaccination and I’ll set them out very briefly as thought experiments.
First, the Left has moved away from pragmatic, consequentialist arguments, about improving the lives of ordinary people, to normative arguments about things that Should be Done or things That Are Right, and the indefinite extension of various concepts of human rights under all circumstances. An evaluation of potential consequences, by this thesis, is not just an inferior kind of argument, it’s not an argument which is allowed into the debate at all, because consequences don’t count. An example would be the intervention in Libya, which was “right”, and whose consequences are thus irrelevant. Another would be current pressure in France to enable couples (including homosexual couples) to pay women in Africa to bear children for them. The idea was withdrawn from a draft law last year after much protest, but its proponents continue to argue that every couple has an absolute human right to have children, and that considerations of the practical effects, on the child or on society, are simply irrelevant. So for vaccination, it’s easy to argue that everyone has an absolute and exclusive right to control over their own body, and, that, since children are not capable of making informed decisions at the time they are vaccinated, vaccination should not take place and the state (or even parents) should not seek to control the bodies of children. Clearly, the discourse of unlimited abortion rights is available for (mis?)use here.
The second is the move away from consideration of the collective interests of society, towards the separate (and often conflicting) demands and analyses of identity groups. Someone could reasonably point out that the vast majority of those who recommend vaccinations are white and male. There is, indeed, an immense online literature about medicine itself as a “patriarchal” system, in which male ideas are exclusively represented, and where women doctors are unconsciously programmed into masculine ways of thinking. So it could be argued that women doctors and experts who advocate vaccination have simply been brainwashed by a patriarchal system. Obviously, such an assertion could never be disproved.
So far as I can see, neither of these arguments has been made, and one must hope they won’t be. But why? As Adam Roberts above says (and I remember the seat-belt “freedom” argument as well) it hits close to home. If we intervene in Syria, none of those killed will be close to me. If we allow homosexual couples more parental freedom, then any negative social consequences are for others to worry about. But if my children get measles because your children are not vaccinated, then that affects me very much. Nonetheless, if that’s the psychological explanation, it obviously won’t do as a logical one. If the collective good should take priority over the infinite extension of human rights here, then why not elsewhere? If the male patriarchy-dominated medical system is right about vaccination, could it conceivably be right about other issues? If not, in either case, why not?
I may be optimistic, but I hope that this issue is the beginning of the recovery by the Left of its old virtues of solidarity and social responsibility, and, indeed, to more emphasis on such things across the political spectrum as a whole.

This is a completely made up controversy. Exemptions exist because of concern for civil liberties, the only state that has no exemption is Mississippi and this is not because it is super progressive but because it is a place that doesn’t tolerate the sort of people who don’t vaccinate, religious dissenters or crunchy granola people. This is why the block of states with the highest vaccination rates are in the South, it is why Utah has a very high vaccination rate and Colorado doesn’t. It is why Oregon with a decent statewide vaccination rate does worst in places like Eugene and Bend, and why Idaho with a truly terrible rate has its problem areas in the parts of the state that you can get liquor easily and social life isn’t governed by which Mormon ward you attend.

And all of this is about considerably less than 10% of the population, in most places it is about 5%. If Mississippi makes it impossible to get an exemption and Texas isn’t much better the Republican Party isn’t going to endorse it. Southern Baptists like vaccinations as do Roman Catholics. You can call them anti science but two centuries after Jenner debates about them are even less about “Science” than internal combustion engines.

Not everything is a partisan divide.

– error – Hobby was Secretary of Health not a Senator.

I know, never read the comments, but the comments on that Reason article are some full-bore bizarro world crazy.

About that is/ought gap, Brett. Like many other things you might learn in philosophy 101, that’s simple, clear and quite wrong. As Dennett says, empirical facts are the only thing one could possibly hope to derive normative claims from.

There’s measles, but there’s also hep-b. Should that vaccine be mandatory? I was sure my wife was not an IV drug user and not having sex with one. Only one in a million has a severe allergic reaction. Good odds, right? But another way to look at is that 100 people have had severe allergic reactions so far, and some of them were babies not really at risk for hep-b.

Polio is contracted mostly from drinking water with infected feces in it. There is no heard immunity issue. There hasn’t been a “wild” case in the US for decades. Should the polio vaccine be mandatory? Forever?

Should the whole recommended schedule be mandatory?

Neil 02.08.15 at 3:59 pm @ 30:
‘… As Dennett says, empirical facts are the only thing one could possibly hope to derive normative claims from.’

Maybe. But what will we decide is an empirical fact, and which empirical facts will we hold to be significant? Messages from the gods may be part of my empeiria, but you may have other gods. In any case, intuitions, aesthetics, learned traditions, and moral judgements are substantial, indeed, dominant parts of almost everybody’s experience. The material world does not interpret itself without them.

Bruce, could you clarify whether in your last paragraph you’re objecting to my phrasing of “they don’t like it when people on the other side tell them they’re wrong”? Because it sounds to me like–regarding your last paragraph–we are saying much the same thing. And I can’t tell whether you have a point to make. or whether you’re making a scholarly kind of general statement of analysis.

Cheryl Rofer in #14: “Measles is highly contagious before any symptoms appear ..”

Before today I used to think that the distinction between infectious and contagious followed the Latin: contagious means transmission by touching, infectious means or includes transmission by droplets in the air. Apparently this is not (or no longer) the trade usage. Contagious is now the only term useful for the public, as it covers human-to-human transmission by any means. Infectioushas become a pure term of degree, for the numbers of the beastie needed for transmission. So we annoyingly now have to distinguish between touch-contagious like Ebola and air-contagious like the flu, and of course measles.

bianca steele @ 35

I am certainly agreeing “they don’t like it when people on the other side make them feel wrong.”

If I demur to anything in your comment @ 19, it is to the condescension, which I thought Anarcissie @ 13 had deliberately put aside, but which you added back. Adding it back, though, did make your punch line that much more effective, so I quoted it.

My point was that partisan political identity — as constituted in the current American mode — ties an issue (any issue, really) into personal self-esteem in a way that doesn’t improve the intellectual quality of the argument. The argument becomes a matter of making me feel good about being pro-science (or anti-racist or whatever) and “them” feel bad about being wrong. It becomes tribalism. And, I think making any issue into one of partisan political identity can make it that much harder to recognize and manage substantive conflicts of interest, and — most relevant — hold elites accountable.

The POAB thing strikes me as a natural development in any highly-specialized society. Everyone has their own little corner of the economy where they’re an authority, where they get to be the priest. The problem is that extreme specialization also means that we’re very tiny cogs in a very big machine; as wannabe priests, we all find this limitation on our authority deeply dissatisfying, and wish we had slightly bigger parishes to manage.

Meant to add – And democratic politics is the space in which our urge to expand our priestly purview plays out. This is certainly problematic, but is it not, in at least some sense, preferable to a world in which an actual specialized priesthood claims that its priestliness gives it authority over all spheres of life, whether they know anything about those spheres or not?

Have you ever actually read Martin Luther’s polemical writing? Because it seems to me he would fit right in, in any of the internet’s darker comment threads: ranting, scatological, etc.

I think this is a situation where classic liberalism does not help, and is indeed actively harmful, because here, there is a right answer and a wrong answer. A civilised discussion between reasonable people would probably lead to a conclusion that, whilst vaccination is highly desirable, it’s wrong to make people do things against their will, so it should not be compulsory. And then you get thousands of illnesses and hundreds of deaths.
This is linked to the issue of defence to authority, since, on this occasion, the only authorities worth taking seriously, as I mentioned before, are actually right. But can you have a general distrust of authority (which, it is true can be misused) combined with exceptions for particular cases?
As it happens, I was talking to a health professional today, who said that there are now the beginnings of a whooping cough epidemic in parts of London – not poor areas, but areas inhabited largely by upper-middle class professionals. These people are often of broadly “liberal” views, and are exercising their independent judgement in what they see as their children’s interests, as well as defending their principles. Many educated middle-class women are refusing to be vaccinated while pregnant. So how do you “persuade” an upper-middle class couple (a lawyer and a banker, say) to accept vaccination?

To expand a little: as far as I can tell, religious arguments against trust in authority are often based in assumptions about alternative sources of revelation. The skeptic may question how different these are from authority, whether they’re not simply authority under a different guise (except in their extreme forms, with something like Rousseau on the one side, and a religiously acceptable authority like the Vatican on the other), but the answer is that they’re really not. But that just pushes the question “which authority?” off to a question about “which non-authorities get to have a voice, and which are excluded because of non-goodness?”

And “these non-authorities don’t get to have a voice, because they don’t obey these authorities, but it’s not about authority at all,” is, well, paradoxical.

bianca @44: Of course all historical analogies can be pushed too far. Modern liberalism isn’t Lutheranism, nor is it the Catholic Church. I think confusion possibly arises when a person tries to empty out the empirical component so as to view the purported ideological clash in purely formal terms.

Arguing about “disagreement” or “dissent” in the abstract is kind of a second-order dispute; but it’s the weight that we accord to the first-order disputes that lends the second-order dispute urgency. What gave the theological battles of the Reformation era their force wasn’t just the formal existence of disagreement over the Eucharist or whatever; it was that people really believed that it mattered, and that if you got it wrong you were going to hell. Today the disputes are, instead, over the validity of conclusions in natural science, and their connection to matters of life and death is often seen as attenuated – except, of course, in cases like abortion or vaccination where the moral implications are unavoidable.

The really fucking frightening thing about Brett Bellmore’s comments on this thread is that they provide evidence for JQ’s thesis. As Rich and others have noted, this is likely to be catastrophic.

@8:

“People should be forced to vaccinate” really means “people should not be allowed to be walking bio-weapons”.

Vaccination has the valence it does because the rules in question involve the most intimate of responsibilities: the care by parents of children. Prescribing and enforcing rules “inside” the family feels even more invasive of privacy, of private discretion than rules affecting the conduct of a business.

The truth of the science is complex and nuanced and not always the kind of moral slam-dunk required for making it a dispute shaped around partisan political identity and conceits. Vaccination does involve complex trade-offs and risks, and as medicine has advanced, the risks and trade-offs have been finer and more subtle. It’s a control problem, and as is typical of control problems, there’s no stable equilibrium solution in the economic sense, short of completely eradicating the disease and ceasing vaccination. As we’ve pushed back the frontier, the balance of risk has changed, as was discussed on previous threads.

Politically, it seems to me, that we need to be holding elites accountable, not either confirming the authority of expertise blindly or criticizing from superstition.

“So how do you “persuade” an upper-middle class couple (a lawyer and a banker, say) to accept vaccination?”

You won’t persuade them, but you also won’t force them. What’s likely to happen is that rich people will pay bribes to get certificates without actually vaccinating their children.

Which is, basically, a less attractive alternate of bribing poor people for vaccinating their children.

I’m not exactly sure who this The Left is that Brett is always talking about. Didn’t Norbizness retire?

dn @ 56:

I just watched The Hundred Foot Journey the other night. A cute little romantic movie, it has at its core the mythic archetype for your priestly authority over a tiny domain. The hero of the movie is a young man from India, who comes to aspire to become a chef de cuisine in France.

On another recent thread — the epic bureaucrat — there was some desultory discussion of Hannah Arendt’s The Human Condition, a frustrating (to me) book in which she tried to get at the phenomenology of life, work and political achievement in our modern, disenchanted, bureaucratized world. The movie hero follows a course that illustrates what she may have been trying to express: he labors with his family to create a restaurant, working as a cook. He studies the rules of French cuisine, mastering “the basics” of the five sauces, learns to distinguish poisonous toadstools from delightful mushrooms and so on. He has by grace and the instructive nurturance of his deceased mother, a discerning palette and nose. Finally, he rises in confidence to the level at which he breaks the rules and begins to make his own rules: he alters a two hundred year old recipe, replying to his mentor’s challenge: “Perhaps, two hundred years is enough.” We see him in triumph in Paris, the star chef of an establishment high above the Pompidou, where the motto is: innovation, innovation, innovation. He’s making the new thing — something Arendt celebrated as praxis, the lost political and heroic art of the Greeks in pursuit of arete and gusto. (I’m sure I’m fracturing all of that terribly — god forbid Corey should ask for textual support from Arendt! I did watch the movie, though.)

My point, here, is to affirm that, yes, there’s a mythic ideal of the innovator, whose good taste and discernment leads to a kind of breakthrough to the realization of new values, from the phenomenological miracle of expecting the unexpected. Steve Jobs at Apple. The fictional chef from The Hundred Foot Journey. Napoleon on horseback at Jena, as Hegel saw him.

Most of us, most of the time, don’t experience that. As the head baker, we apply the frosting, and no one much cares — neither our customers nor our apprentices. At best, we find ourselves featured on http://www.cakewrecks.com/ because, like Billy Joel said, You’re not the only one who’s made mistakes; But they’re the only things that you can truly call your own

What we experience is resentment and failure. And, sometimes, some things much, much worse. Like being a protective, responsible parent, who makes a well-intended choice for a child — a gamble, as most choices are — and it all goes terribly wrong. That’s the praxis of the every day, the tragedy of life. And, it is political.

As the head baker, we apply the frosting, and no one much cares — neither our customers nor our apprentices. … What we experience is resentment and failure.

Where I live there are many small artisan bakeries with quasi-heroic status. They make exceptional goods and their customers deeply appreciate it, paying well above the typical price for similar mass-produced products.

Obviously we can’t all be Olympian Artisan Bakers, but I’ll say the following from personal experience. No matter how mundane your job is, if you look for opportunities treat people with honor and respect you will be rewarded, most of the time, with a feeling of having done something worthwhile.

What is the percentage of those who are vaccinate who will now come down with these viruses, thanks to the loss of the herd immunity? Are we all at risk of these viruses – or is the risk more heavily born by those who choose not to vaccinate?

The real and significant issue with vaccination is NOT political – and I doubt that it is really even “anti-science” (I’ll bet you’ll find anti-vaxxers who believe in evolution and global warming.) The big issue is that there is a significant portion of the public (about 10% or so) who absolutely do NOT buy what the CDC and the medical establishment are selling with regard to vaccines. If vaccines are so safe, so valuable, so without harm, why is this? Are anti-vaxxers really just stupid, ignorant anti-science nitwits? That kind of attack does nothing to address the underlying issue in this debate – the lack of trust in the health care establishment.

Some people I know who are anti-vaxxers are dealing with autism in the family. Some people I know who delayed the schedule saw a scary adverse reaction to an early vaccination. Are they really just “anti-science”? There is absolutely NO problems with injecting a 2 month old baby with multiple viruses?

I realize there are tons of studies to disprove a link to autism and vaccines – but what constitutes the control group? Do we have enough unvaccinated children to disprove a link? How is this proved? WHY is autism on the rise? And by autism, I mean more than just “on the spectrum” – I mean incidence of severe autism, which is a serious public health issue today. Anyone know the answers to these questions?

What’s ignored right now is that vaccines themselves – fantastic though they are (my children are fully immunized!!) – are not without problems – when you bring your child to be vaccinated, you leave the office with a stack of papers filled with “adverse reactions” to be on the watch for. When they talked about the safety of ethyl-mercury (once in all children’s vaccines, now limited to flu shots and adult vaccines), the language was not reassuring – a key difference is that ethyl-mercury has a shorter half-life than methyl mercury and is only in the body for 1.5 weeks before it is flushed out. Add up all the shots a baby gets in that first year – that’s a lot of weeks of exposure for infants with immature immune systems… and probably a reason why the CDC removed it from children’s vaccines.

Also, the CDC paid out nearly $3 billion to families to compensate for vaccine injury last year – it is commonly believed that many injuries don’t even get reported. And yet, anyone with any doubt of any kind about the safety of vaccines is branded as a lunatic and an “anti-science” anti-vaxxer. Whether vaccination is a political issue, the result of ignorant anti-science idiots, it is clear that the “attack mode” is not working… perhaps an American outbreak of polio will provide the cure for this fear? (Are there really people refusing to immunize their children for polio?! I find that a terrifying concept.)

I suspect that vaccines, as such, may be a surrogate for something else. It’s not a religious question (except possibly in the US) and it’s not a question of contrasting authorities, because no authority I’m aware of is really against vaccines. It’s not even really a symptom of a general crisis of authority, although as I said earlier, the two are linked. It’s primarily about the exaltation of the subjective experiences and emotions of the individual, and their right to have these treated as seriously as any objective process of evaluation. So I “doubt” the effectiveness and safety of vaccines, I “fear” what might happen to my child, I am “suspicious” of the medical establishment, I “feel” that my child is a victim because he/she became ill reasonably soon after receiving an injection. I demand, and in this age I usually get, acknowledgement the validity of my concerns. Ironically, in spite of the discrediting of the autism link, one can say that this kind of behavior by parents has autistic elements to it. I want my subjective fears acknowledged: I don’t care what happens to your children. The last point, to repeat what I said earlier, seems to me the most problematic. How do you deal with someone who says “even if what you say is true, I’m not getting my child vaccinated. What duty do I have to your children?”

“Ironically, in spite of the discrediting of the autism link, one can say that this kind of behavior by parents has autistic elements to it.”

I think that Collin Street will tell you that the use of autism as a metaphor for any behavior that one don’t like is, itself, an indicator of autism. Maybe you should have yourself checked out and treated.

One of my children is a high-functioning autistic child, and I “fear” for what will happen to him once people like you thoroughly change the term from a medical one into an insult.

@Rich Pulasky. Tut tut. It wasn’t intended as an insult, but as a metaphor, rather like blindness or deafness are routinely used, and in this case I think it’s rather precise.

@67 – the risk is obviously much higher for those without immunizations, but those include newborns prior to immunizations and people with medical reasons not to immunize (such as Leukemia patients). The Disney Measles outbreak, for example, did include a fair number of infants under 12 months, i.e pre-MMR immunization. Those are the people who rely _only_ on herd immunity.
As for the rest — every one of the arguments you bring forward has been amply addressed at any given level of detail from the simple, non-technical summary to the Cochrane Meta Review. The sad state of affairs is that we simply have no idea how to convince people (who aren’t convinced) to vaccinate their children
http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365
Interestingly, the more drastic messages actually makes it worse, though.

Rich says above we shouldn’t give people a lable like anti-vaxxers, but is that necessarily true? Do we have any evidence that a label with a strongly negative connotations actually builds rather than prevents group cohesion? (e.g. it strikes me that calling homophobes, well, homophobes has been relatively effective).

Bruce Wilder @ 36

” Identity politics is a symptom of the low ebb of social affiliation, but it is also a deliberate product of a concentration of wealth and power: a means of manipulating a largely atomized and passive population.”

I don’t buy this. There can be progress on different fronts. MLK, Malcom X and Mandela pushed for progress on the racial front. The whites were/are engaging in identity politics and the freedom fighters were fighting for universalism. Same with women and the vote, gay marriage, etc.

Vaccines could be a stand in for socialized medicine or for the priorities of the medical industry. It’s interesting how some on the left see Obamacare as either progress or a giveaway.

What’s interesting to me is how a general distrust in the authority of government and institutions can be a good thing, something that begin in earnest after Vietnam.

It also can lead to more atomized society. If you don’t trust the government which is a product of democratic participation to work for your interests, then what? Just go it alone? Tend your garden?

I also think of Marx’s words on capitalism: “all that is solid melts into air” as everything is reduced to the cash nexus. The elites running institutions owe no real allegiance to society as whole. The institutions are to be used. And so they are no longer trusted, nor is authority.

I think this is indicative partly of the human difficulty with understanding probability. Most of us want the simplicity of binary logic. So we want a vaccine to be effective one hundred percent of the time, and to have exactly zero risk of a side effect. Yet, reality comes on a sliding scale, but our primitive emotional processing has little regard for probabilities, and lots of regard for the emotional salience of imagined potential outcomes. So for many parents the tiny risk of negative consequences can be blown up into a huge emotional burden.

Likewise at the communal/political level. No non-medical exemptions isn’t a desirable policy, unless it is the only thing that can push herd immunity over the epidemiologic threshold. Its been noted elsewhere that true religious (vax) objectors are small enough in number not to constitute an important threat. But, how do you exclude those who claim that their ungrounded (or wildly) overblown fear in fact stem from religious convection. We risk imposing on both types the same regulatory sanctions.

I’m not convinced that the cultural conditions for vax versus anti-vax aren’t changing substantially. Until the media attention to the latest measles epidemic, the downsides of allowing vaccination rates to decline, just wasn’t on the mental radar outside of public health circuits. Now those who resist vaccination face potential social consequences. Maybe their kids will be socially shunned as potential Typhoid Tami and Timothies. Maybe the risk of possible social isolation will tip the balance towards compliance without the need for draconian regulation?

Main Street Muse: “If vaccines are so safe, so valuable, so without harm, why is this? Are anti-vaxxers really just stupid, ignorant anti-science nitwits? That kind of attack does nothing to address the underlying issue in this debate – the lack of trust in the health care establishment. ”

Because a lot of people lie, and lie repeatedly, and pass on those lies. And the ‘liberal media’ happily puts an Playmate vs a scientist, as a debate which makes Stalinist show trials look fair.

Saying “we need to hold elites accountable” is a truism. To avoid the trap of confirming the authority of expertise blindly, people need to develop a modicum of expertise themselves, at least enough to tell good research from bad. But that’s just the problem, isn’t it? If anti-vaccination views are really on the rise, it would seem that we are failing at this.

According to polling data, the answer to the question posed in the title of the post is “no”. Though I guess it’s possible that might change in future:

http://www.culturalcognition.net/blog/2015/2/5/what-does-christie-know-that-the-rest-of-us-dont-my-guess-is.html

“Anti-science ibertarians in Australia and the UK are strongly pro-speeding”

Is ibertarian a typo or a weird derivative of Iberian? If the latter, shouldn’t the speeders be Spanish and Portuguese?

It has clearly become a partisan issue. Several republican politicians, presidential hopefuls among them, have made public statements expressing nuances on the topic.

A topic which requires no nuance; vaccinations are an example unqualified success in science driven policy. But a republican candidate for president must make it clear that they are aware of all the controversies, and that whatever their own position, they will not be quick to apply the power of the state against those who might, quite reasonably in the opinion of the candidate, disagree.

I haven’t yet seen a democratic hopeful do that particular dance. Have I missed one?

Quote all the polls you want, and cite all the liberal Huff post anti-vaxers you like. . . a mainstream republican candidate MUST at least nod to the loonies on this question if they hope to win the nomination.

Layman @ 90 “Most people are stupid, anti-science nitwits with respect to any experiment they can’t conduct themselves. They believe in electricity, because their lights work, but the don’t believe in sub-atomic particles in any meaningful sense of the word ‘believe’. They simply bow to authority, and they want to select the authority they credit.

You go on to pose a number of other question which, it seems to me, are poorly disguised, soft anti-vaxer claims. Use the google.”

This is exactly the problem – anyone – ANYONE – who questions vaccines is stupid. I, too, recommend Google. The issue is more complex than you know. CDC paid out $3 billion to families with vaccine injuries last year – and again, claims filed are supposedly a small percentage of people who feel they or a family member has been injured by vaccines. The argument that vaccines are without harm is simply not true.

And 90% of American children ARE fully vaccinated. SKY IS FALLING….

MSM: “CDC paid out $3 billion to families with vaccine injuries last year”

False. From here:

Since the first National Vaccine Injury Compensation (VICP) claims were filed in 1989, 3,941 compensation awards have been made. More than $2.8 billion in compensation awards has been paid to petitioners and more than $121.6 million has been paid to cover attorneys’ fees and other legal costs.

Note that this is over the life of the program, since 1989. Not “last year”.

MSM: “The argument that vaccines are without harm is simply not true.”

Misleading. Literally no one that I know of makes the argument that vaccines are without harm. On the contrary, vaccines are known to very rarely cause injury. But the risk of injury is, as far as we know, outweighed by the increased risk of injury from getting the disease that the vaccine is designed to protect against that you undergo if you aren’t vaccinated.

Main Street Muse: Total compensation paid out for vaccine-related injuries is $2.8 billion dollars for all claims since 1989. That covers 3,941 awards. See:http://www.hrsa.gov/vaccinecompensation/data.html

It’s worth noting that anyone can report a vaccine-related adverse event to the CDC without needing any proof of causation. As for under-reporting of vaccine problems, we enter into the realm of pure speculation.

Most adverse reactions to vaccines are minor; swelling at injection site, brief fever, transitory pain at the injection site. For those of us old enough to have seen people in iron lungs or scarred by smallpox these are pretty small potatoes.

Rich @ 95 – yes you are right – I misread it late the other night.

MSM – Going off Dr. Hilarius’ numbers, the CDC since 1989 has paid out just under 4,000 individual awards in 25 years – just under 160 per year – while many, many more than 4 million get MMR shots each year. That’s settlements for vaccine injuries – I see zero evidence in this thread of any actual deaths from vaccines, and no indication of how serious these reported injuries were (and Dr. Hilarius says they don’t even need proof of causation – am I reading this right?).

And we’re supposed to take your measles numbers as proof of something other than “vaccines have saved 400-500 lives and a great deal of additional suffering every year”? Forgive me for my harshness, but I really don’t understand what you’re trying to convince us of here.

“Dr. Hilarius says they don’t even need proof of causation – am I reading this right?”

The program was purposefully set up to cover more than the likely actual injuries from vaccines. The court has more relaxed standards of evidence and burden of proof than typically are used.

And yes, by comparison, the 1 in 10,000 chance of dying of measles and 1 in 1,000 chance of having a serious brain injury are relatively huge risks. Having 2% of the population infected with measles each year when the U.S. didn’t have vaccines happened because almost everyone got measles (and then got immunity to measles).

Here’s a good medicine related example: The 1980s AIDS epidemic in the United States was in large measure the result of the gay liberation of the 1970s unleashing gay male promiscuity. The science is obvious on this topic, but stating this plainly will lead to much outrage.

RFK Jr. is regularly granted private meetings with top Democratic congresspeople and their staff as well as HHS and other public health agencies. As far as I know, few if any prominent Democrats have called out him by name for his dangerous, uninformed nonsense. It’s only a partisan issue in that the right-leaning anti-vax crowd seems to be more motivated by profiting off of rather than spreading idiotic paranoia.

I think the scientific and moral questions about this have quickly reached their expected end. Yes, the risks of not vaccinating vastly outweigh the risks of vaccinating; yes, people who define freedom as causing significant negative externalities for others really don’t have a leg to stand on in any common system, whether conservative, liberal, libertarian, or leftist. Even the question of whether viewing the issue as partisan would be harmful when it isn’t has, in my opinion, pretty much been answered by Dan Kahan unless someone cites other science that indicates differently.

Which brings me to this article by Fredrik deBoer. I think that he said the most sensible things about the recent Chait / call-out topic. I pretty much agree with the analysis that the right thing to do about this doesn’t really matter: the U.S. is already committed to a culture-war treatment.

A couple of things.

1. Going back to JQ’s post: A fair number of commenters have objected, citing polls and such, that the anti-vax sentiment or vax-skepticism or whatever doesn’t break on clear partisan lines. But of course, everyone concedes this. (I guess there was one commenter who held otherwise.) But JQ’s clear point was that there are good indications that this is changing and that vax-skepticism, say, is likely to become a partisan issue. And I’m not really seeing any counter to this at all. And this isn’t about point-scoring. It’s that the possibility is so utterly, devastatingly sad—and especially I suppose to someone from my background, growing up around widespread polio, etc.—that I’m really at a loss for words.

2. I was reading this recently, and I haven’t read the book, but I think Biss had an article in Harper’s a while back that covered some of this (unless it was someone else taking a very similar line), and while I didn’t quite agree with all of it (from what I remember), I thought there was a lot of very good stuff in it (and with apologies to commenters I like and respect, stuff that seems a lot more relevant than whatever Luther did or didn’t do a few centuries ago).

Why don’t we frame it another way?

What could be done to keep this from becoming a partisan issue? Are there methods of approaching the problem that are more or less likely to turn it into partisan issue? How would we go about engaging people who have worries about vaccination without politicizing them?

So far it seems as if most of the comments are suggest demonizing them as the best way to keep it from becoming partisan, and speak as if them becoming partisan is almost inevitable like gravity.

We are seeing something that is on the cusp of becoming a stupid partisan issue. The question is how do we keep it from crossing the line?

I’m not really sure I’m advocating anything in particular. I vaguely sort-of think that social pressure regarding vaccination is likely to work amazingly well with respect to middle and upper class woo-woo types (who at the moment seem to be much more of a problem than serious religious objectors). Saying that their kids can’t go to orchestra camp should hit home just fine.

I vaguely sort of suspect that Rich is onto something about denying a pithy label for people who don’t understand the statistics behind relative risk of bad stuff and vaccines.

I guess I don’t have a good feel for why certain things become highly politicized and why others don’t. Some things seem to fester for a long time and then suddenly gain political valence for reasons that I don’t understand. Silly objections to vaccines and woo-woo wories about GMOs strike me as two areas that have been simmering just under serious political valence for a while. Why and when they break out isn’t clear to me. But having been a member of out groups at different times in my life (the harshest one being that I was gay in a fundamentalist Christian upbringing) suggests to me that demonizing often doesn’t bring change in the way the people doing the demonizing want.

You can intimidate people into silence, but you can’t make them feel ashamed unless they share at least some common moral framework with you. Shame cultures exist because people understand there are rules and recognise when they have broken them. But there are no common rules here. Genuine religious opponents of vaccination (and there will be few in most societies) believe they are bound by heavenly rules, not earthly ones, and the libertarian, the plain selfish and the politically-committed aren’t reachable by such arguments anyway. So how do you shame somebody who doesn’t feel shame?
Oh, and don’t forget the 95% of the world’s population that lives outside the US. Culture Wars issues are quickly imported into Europe, and I shudder to think what happens if this example gets before the European Court of Human Rights, for example.

“The 1980s AIDS epidemic in the United States was in large measure the result of the gay liberation of the 1970s unleashing gay male promiscuity. The science is obvious on this topic, but stating this plainly will lead to much outrage.”

“Fuck off back to your racist shithole, Sailer.”

Ah, the party of science. You can just smell the rational response to evidence.

He’s right, you know. Even today, knowing how nasty AIDS is, and how to prevent it’s transmission, over half of new AIDS cases are male homosexuals, even though they’re a tiny fraction of the population. AIDS transmission among the straight population is almost entirely due to transmission from homosexuals, because AIDS doesn’t transmit efficiently enough between straights who are taking even the slightest precautions.

In an entirely straight population, there would have been no AIDS epidemic, and if homosexuals were taking proper precautions, the epidemic would have extinguished itself by now. It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity. They are the infectious reservoir that keeps the epidemic going.

That’s science, even if you don’t want to hear it.

See, that’s the problem with branding Democrats as “the party of science”. Science, not having a political agenda, isn’t always going to produce results that a particular party likes. And Democrats are not shy about viciously attacking, yes, science, if it tells you something you don’t want to hear.

Oh, sorry, I was unaware that there were no homosexuals in Africa. My bad, how did I overlook that?

Here are the elected offices RFK Jr. has held:

It’s not up to “us” to decide whether it becomes a partisan issue (unless “our” solution is to take on anti-vaccine or anti science views on the left too). It’s up to the Republicans which factions to give more power within their party and which to give less.

If Republicans decide to hand over all their power to the crazy faction in their party, Democrats and the left can’t change that by cooperating with them and wishing for the benefits of cooperation to all go to the non-crazies.

If there’s anyone who’s responsible for making the issue partisan, I’m going to suggest it’s Jenny McCarthy. She could have prevented the whole thing by labeling herself differently.

The way you shame parents is getting the kids to do it.

A big part of the success of anti-smoking campaigns in the 80s-90s was marketing to kids how unhealthy smoking is and them encouraging their parents to stop.

Kids are far more sensitive to difference and likely to react to them. When a kid goes home and tells his mom that everyone is treating him like a “germ” because has hasn’t been vaccinated the parent can do two things – go to the doctor and get them vaccinated or go to the school which will say “well, gee, it was your choice afterall.” They probably aren’t going to try explaining to their kid the nuanced view of why they chose not to vaccinate and make the kid eat it.

I’m not a big fan of using kids as pawns, but maybe the responsible adults owe it to the children of less responsible parents to help bring them the facts (like was done with smoking).

“But JQ’s clear point was that there are good indications that this is changing and that vax-skepticism, say, is likely to become a partisan issue. And I’m not really seeing any counter to this at all. And this isn’t about point-scoring. ”

It is a real issue, for real parents. Labeling them stupid, ignorant, or republican, doesn’t seem to move the ball forward, so I don’t engage in that. And while calling someone a republican shuts them up pretty quickly on this board, I know some of the people on this board, and I know that there is a lot of vax-skepticism that cuts deeper than the republican anti-science narrative that is being thrown around this thread.

Consider the current schedule of vaccines – what is the right number/right schedule? There is a movement of parents looking to slowdown or change the “standard” program of vaccine schedules. Before you call these people republicans, ask yourself why the US vaccine schedule is different than most of Europe’s (no republicans there)? Is Europe anti-vaxx? Some European countries have more, some less. But these decisions are not entirely driven by science. Asking questions and having PARENTS make decisions is not a bad thing IMHO.

Trader Joe: “When a kid goes home and tells his mom that everyone is treating him like a “germ” because has hasn’t been vaccinated the parent can do two things – go to the doctor and get them vaccinated or go to the school which will say “well, gee, it was your choice after all.””

I think that there is some point at which that 1 in 10,000 chance of death, 1 in 1,000 chance of brain injury starts to look acceptable compared to some of the alternatives. Maybe the point at which we start to suggest turning our societies into SF dystopias is one of them. “Foster, You’re Dead!” was not supposed to be a manual of political engagement.

I think that Trader Joe is just getting carried away with this comment rather than really supporting it, but re-read #70, #72, #74 above. There’s really not much more to say about this before John Holbo comes in and starts asking why people just start insulting people for no reason again.

AIDS transmission among the straight population is almost entirely due to transmission from homosexuals, because AIDS doesn’t transmit efficiently enough between straights who are taking even the slightest precautions. In an entirely straight population, there would have been no AIDS epidemic, and if homosexuals were taking proper precautions, the epidemic would have extinguished itself by now. It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity.

Absolutely, incontrovertibly true scientific statements (no less!) should be easy to back-up with multiple, sound, credible scientific references, presumably from primary sources. Would you care to provide any?

That’s science, even if you don’t want to hear it.

Oh, I do want to hear it. Please show me where.

@134
Yes, my comment was meant to be purposefully over the top.

The point, however, is that parents don’t necessarily see this as a political or scientific or even logical issue – they see it as an “I want to protect my kid issue.”

Maybe they’ve researched, maybe that haven’t. Mamma bear don’t always care about facts (see McCarthy, Jenny), they care about baby bear. The only way you reach them is to convince them that the ramifications of non-vaccination are greater than vaccination….1 in 10,000 chances don’t mean much to people. If there’s something more day to day, it will be weighed in their calculus of what to do.

That’s where public service adverts on everything from kids shows to daytime TV about smoking, drug use, drunk driving, drinking milk or even, yes, vaccination, might reinforce some awareness that the alternative isn’t a safe no-risk choice.

Trader Joe, there’s a huge difference between “smoking isn’t cool” and “you’re not cool if your parents smoke”. An adolescent can choose whether or not they start smoking. They don’t choose whether or not they get vaccinated. (I suppose it’s theoretically possible that kids, shamed by a media campaign, could sneak off to get vaccinated without their parents’ permission.)

I’m surprised nobody yet mentioned the HPV vaccine (H
PV causes, or contributes to, cervical cancer) story. If I remember correctly, when the vaccine became available, one of the first to enthusiastically endorse it was Texas governor Perry. He faced a lot of backlash from conservative moralizers who fumed about promoting promiscuity. But the backlash was also from parents rightfully concerned that their children were being used as guinea pigs for a medical intervention of very dubious benefit and effectiveness. As of now, nobody thinks this particular vaccination should be mandatory. It’s one of many health-care related decisions that people have to make for themselves or in this case, their children, hopefully guided by reliable information and trustworthy health care professionals.

The tone of the vaccination discourse is exasperating. On the one hand, it is inexcusable for the mass media to give so much space to fringe “experts” making unwarranted claims about the supposed dangers of vaccination; that fearmongering unfortunately is mirrored by some on the other side. On the other hand one must not ignore the fact that vaccination is a medical intervention. For good reasons, medical ethics dictates that medical interventions cannot be forced on a patient against their will. This prohibition is not to be taken lightly. It is by no means on the same level as seatbelt or smoking laws. (And for that reason, many countries, including Germany, do not mandate any vaccinations for humans).

Is there a partisan divide on vaccinations? It seems unlikely given that the vast majority of Americans support vaccination (although perhaps not every single kind of vaccination). It is really a tiny minority that doesn’t, although they appear somewhat concentrated geographically (note that Mississippi is the model state with almost 100% MMR vaccination rates). If Republicans manage to make hay by framing their side as defending individual autonomy against government overreach, that would be a huge failure of messaging on our part (but also, again, this wouldn’t be possible without media collusion). We should be on the side of both autonomy and responsibility.

TM: “I’m surprised nobody yet mentioned the HPV vaccine (HPV causes, or contributes to, cervical cancer) story.”

I’ve mentioned upthread that a lot of these controversies are driven by economic decisions by corporations, and that turning them into morality plays between sets of people is leaving out a lot of the process.

I’ll quote from Dan Kahan at length:

These conditions were all an artifact of decisions Merck self-consciously made about how to pursue regulatory approval and subsequent marketing of Gardasil. It sought approval of the vaccine for girls and young women only in order to invoke “fast track” consideration by the FDA. It thereafter funded—orchestrated, in a manner that shielded its own involvement—the campaign to promote adoption of mandatory vaccination programs across the states. To try to “counterspin” the predictable political opposition to the vaccine, it hired an inept sock puppet—“Oops!”—whose feebly scripted performance itself enriched the cultural resources available to those seeking to block the vaccine.

Had Merck not sought fast-track approval and pushed aggressively for quick adoption of mandatory vaccination programs, the FDA would have approved the vaccine for males and females just a few years later, insurance companies plus nongovernmental providers would have furnished mechanisms for universal vaccination sufficient to fill in any gaps in stated mandates, which would have been enacted or not by state public health administrators largely removed from politics. Religious groups—which actually did not oppose FDA approval of the HPV vaccine but only the proposal to mandate it—wouldn’t have had much motivation or basis for opposing such a regime.

[…]

But it wouldn’t have been good for Merck. For by then, GlaxoSmithKline’s alternative vaccine would have been ready for agency approval, too, and could have competed free of the disadvantage of what Merck hoped would be a nationwide set of contracts to supply Gardasil to state school systems.

“Genuine religious opponents of vaccination (and there will be few in most societies) believe they are bound by heavenly rules, not earthly ones, and the libertarian, the plain selfish and the politically-committed aren’t reachable by such arguments anyway.”

Genuine religious opponents of vaccination aren’t the problem here. The problem appears to be parents who are listening to woo-woo buzz about vaccinations in their social circles–especially in liberal circles of California. A few posts down Kieran has some thumbnail research confirming that here. Framing this as a religious objection issue (at least from a traditional right/Baptist/Catholic/Protestant angle) is missing the reality entirely. The traditionalist religions in the US don’t seem to have a problem with vaccinations. In fact they seem to vaccinate at higher rates even than the general population. Pigeon-holing this into a classic right-wing-religion lens is starting off looking at the wrong thing entirely.

I’m not sure what it IS. But it isn’t what you’re saying.

“As of now, nobody thinks this particular vaccination should be mandatory.”

I think it should be.

Ok I stand corrected. But you are aware, are you, that at best 70% of HPV infections are prevented by the vaccines?

“Ok I stand corrected. But you are aware, are you, that at best 70% of HPV infections are prevented by the vaccines?”

Indeed. Still think it should be part of the basic vaccination package and should be paid for by the government.

Based on facebook posts from some liberal friends, it already is, though not in the sense John thinks it will. More in the sense John demonstrates: A basis for self-congragulatory sneering, however ill based it might be in reality.

But self-congragulatory sneering isn’t about reality, it’s about feeling good because you think worse of somebody else. Works just fine even if it isn’t reality based.

If the percentage of Republicans supporting the benefits of Vaccination is below 50% at the end of the time frame I pay. Other wise you pay.

Why 50%? Based on the California school data and other studies linked in these discussions, I don’t think that vaccination has yet become a partisan issue. But it could manifest as a partisan issue even if both Republican and Democrat vaccination support doesn’t go below 50%.

As an example, according to this 2012 poll Americans love solar power. 84% of Republicans support using more solar power. 63% of Republicans even think the government should provide solar incentives like tax credits. Support is even higher among Democrats and independents. Surely opposition to solar power is not going to take on partisan characteristics when it enjoys majority support in every major political group.

But in reality solar power opposition does have partisan characteristics. Majorities of Republican and Democrat voters support solar, and you can find large numbers of D and R politicians who support solar, but opposition is concentrated in the Republican camp. That’s where you will find legislatures and governors looking to roll back renewable energy tax credits and Renewable Portfolio Standards, also where you will find mouthpieces like the Heartland Institute praising coal and panning solar. An issue can be supported across the D and R camps but still have its opposition concentrated in one camp or the other, even if the opposition doesn’t reach 50% or greater. Solar power is fortunately popular enough that it seems unlikely to become a tribal marker that some people want to reject just because opposing tribes like it. Vaccination will probably — I hope — stay the same way.

@Bianca: The “socialism” point is that eg herd immunity is a property of the herd, of the sociality, and not of individuals. Trying to frame the social issue in terms of individual self-interest is a category error. “What do I owe other people’s kids” is the wrong question … you have no parental duty towards random children (beyond a broad duty to public safety). The correct question is “How much am I obliged to sacrifice myself and my family in favor of social goals?” How much do I have to ask other peoples’ permission? Follow the somewhat arbitrary guidelines because smart/powerful/many people say so. Whereas democracy is about one man, one vote according to each individually determined self-interest. A society is something more than a bunch of people doing their own thing, the global world is a big container ship with loads of its own proper inertia. Right now the political situation is such that we are not encouraged to sacrifice for social goals except for sending our boys and girls overseas to kill terrorists and thereby defend America. (Although paradoxically, the first duty of a cop is to go home to his family). You might view insurgent identity politics as attempts to nucleate meaningful societies of “brown rice people” (see in comments above). Hope this clarifies.

dn @ 86: Saying “we need to hold elites accountable” is a truism. To avoid the trap of confirming the authority of expertise blindly, people need to develop a modicum of expertise themselves, at least enough to tell good research from bad. But that’s just the problem, isn’t it? If anti-vaccination views are really on the rise, it would seem that we are failing at this.

Anarcissie @ 131: Liberal constitutions were supposed to contain mechanisms which restrict authority and thus legitimate that which remained, but few non-elite people today believe they have any significant part in the conduct of government and state, and I think they are right. Thus, no authority is legitimated.

Rich Puchalsky @ 144: . . . a lot of these controversies are driven by economic decisions by corporations, and that turning them into morality plays between sets of people is leaving out a lot of the process. RP linked to Dan Kahan’s narrative analysis concerning Merck’s Gardisil campaign, its attempts at political manipulation and its political fallout.

If I thought that that base problem was simply that people didn’t understand the scientific rationale for vaccination, didn’t understand the statistics or the balance of risk, then my view of the politics would be more straightforward and optimistic. I would see that the most likely to forego vaccination have been among the highly educated, and I would think that recent events, highlighting the consequences, would be a salutary corrective. People would pay attention to the news, and re-think. Problem solved.

I think the base problem is a breakdown of governance. That Republican politicos Paul and Christie chose to rhetorically step in the dog poo reinforces my sense that the base problem is the breakdown of governance. I don’t think it is helpful in getting at how the breakdown of governance is implicated to call their views “anti-science”, as if the logical alternative to be taken up by any partisan alternative (aka Democrats) is “pro-science”.

As the OP points out, Paul and Christie vocalized resentments of “people [who] want to be free to do as they please, even when there’s an obvious risk to others”. CNN got a lot of attention with an interview with an nutty Arizona cardiologist, who campaigns strenuously against vaccines. This was the widely reproduced money quote:

“It’s a very unfortunate thing that people die but unfortunately, people die, and I’m not going to put my child at risk to save another child. I’m not going to sacrifice the well-being of my child. My child is pure. It’s not my responsibility to be protecting their child.”

This is a political problem of solidarity, not a political problem of expertise or authority, per se. There’s an intersection, sure. But, confusing the two masks rather than reveals the problem of governance. Committing the partisan centre-left (aka U.S. Democrats) to “pro-science” rather than pro-solidarity mistakes the problem.

The OP may be right that a latent cleavage point has been revealed, but if a partisan divide follows, it is symptomatic, I think, of how politics has been converted from a means of popular governance into a irrelevant distraction, an unpopular entertainment.

Of course it’s in the cards. The ideology is based on – and insists on – personal autonomy, individual rights, and competing interests – and then, suddenly, an appeal for solidarity? Get real.

uh, promised link: http://www.npr.org/blogs/13.7/2015/02/09/384877284/psychological-biases-play-a-part-in-vaccination-decisions

Fewer than 1% of American children receive no vaccines, suggesting that the search for Grand Ideological Causes here is unlikely to have much basis in empirical fact, and is much more likely to be an indulgent exercise in blaming all of society’s ills on opposing political ideologies.

Like nearly everyone, anti-vaxxers draw on a wide range of inconsistent beliefs that cut across political ideologies, including anti-authoritarianism, distrust of corporations, distrust of scientific research, the idea that “natural” is good, and the idea that parents are uniquely well positioned to make decisions on behalf of their children. Anyone interested in anti-vaxxer psychology should note how common and popular these beliefs are in different contexts. The fact is that ideology is of limited value in determining behavior, although it does serve the social functions of bonding people together and creating out-groups.

“The ideology is based on – and insists on – personal autonomy, individual rights, and competing interests – and then, suddenly, an appeal for solidarity? Get real.”

If you seriously believe that personal autonomy, individual rights, and solidarity are mutually incompatible values (or “ideologies” if you wish), then you are (1) demonstrably wrong, and (2) as a matter of political tactics, committing a disastrous mistake.

TM,

That dude’s been trolling this blog for a decade—and yes, really trolling. ‘Ze Kraggash’ is at least his fifth handle. Just saying that I wouldn’t expect anything very constructive out of him (or from engaging with him).

Films like “Contagion” are very good. Also, measures to strengthen providers’ communications skills. Finally, I read a suggestion someplace that simply making exemptions more difficult to get (more paperwork, requiring quizzes to make sure parents understand the issues, and the like) could also be effective in reducing the exemption rate without recourse to draconian or punitive methods or crude financial incentives unworthy of a democracy.

Bruce Wilder: “This is a political problem of solidarity, not a political problem of expertise or authority, per se. There’s an intersection, sure. But, confusing the two masks rather than reveals the problem of governance. Committing the partisan centre-left (aka U.S. Democrats) to “pro-science” rather than pro-solidarity mistakes the problem.”

I sort of agree, but I don’t see how the center-left could commit itself to solidarity even if prominent elements of it wanted to. National solidarity is right-wing, class solidarity is a trainwreck (for reasons that I’m not going to go into yet again), and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime: all of our culture wars really come from the end of legal racism, and the well is thoroughly poisoned. All of the people insisting that people concerned about vaccination are “anti-vaxxers”, and that anti-vaxxers are naturally right-wing, are hunting for solidarity, and it just makes things worse.

Sebastian H@144

“What could be done to keep this from becoming a partisan issue?”

Um, resurrect US anti-fascist media regulation?

One of the major media strategies of the radical right is to convert rational debate to incoherent fights. So I suppose this is ultimately in the hands of Roger Ailes at Fox News.

It also would help if we adequately funded the federal bureaucracy.

The evidence that vaccination is “going the same way” as climate change and gun control is rather slim at this point, almost seeming to amount to wishful thinking. RFK Jr. and the Huffington Post have actively peddled large amounts of anti-vaccine nonsense over the years, did anyone get excited about the prospect of them turning vaccination into an ideological issue?

The function of ideology is not to answer the question “Should I care about other people or should I follow my heart’s desire?” — no one answers that question the same way in all contexts — the function of ideology is to identify who a good worthy member of my tribe and who is bad unworthy member of the out-group. Conservatives also sit around and bemoan how liberals have selfishly ripped out the fabric of society (religion, gender roles, sexual revolution, distrust of prosperous corporations, racial hierarchies) in the name of individualistic self-interest. It’s just an unhelpful framing.

” It’s just an unhelpful framing.”

Hmm. It looks to me as though it’s becoming a helpful framing. If the anti-vaxxers can be packed off to the right, then that’s one more issue where we’re right and they’re wrong. I’d like to see my fellow lefties less sympathetic to alternative medicine, though, and perhaps this is a first step in persuading people who think that stupidity is, well, stupid. (I think it hilarious that three-quarters of the herbal remedies on the shelves of US stores don’t actually contain the herbs they claim to contain. I wonder if the Japanese do any better? Here, various “kanpo” (Chinese herbal remedies) snake-oil products are widely advertised, and apparently health insurance covers some amount of acupuncture and the like. There’s been a recent study* finding that expensive placebos work better than cheap placebos (which makes sense, since the point is to persuade the patient that the placebo works, although neither works as well as the real drug), and given the cost of OTC medicines in general here, it seems the Japanese are aware of this effect.))

*: http://theincidentaleconomist.com/wordpress/the-placebo-effect-is-crazy/

By the way, while the anti-vaxxers are silly, it’s not all bad to insist that we keep a careful eye on exactly what the NNH (number needed to harm) is for current vaccination technologies, and think about how we can do even better. My annual flu shot leaves my arm quite sore for a week. That’s very much worth one less bout of influenza every 3 or 4 years (assuming worst case of only 25 to 33% effectiveness), especially since I use public transportation almost daily. Again, in a worst case world this is really quite fine, but even better would be nice.

anarcisse
“It is curious that, in this case, authoritarianism is assigned to the ‘Left’ and resistance to authority to the ‘Right’.”

I’m not sure that left and right are all that useful at the best of times. The key point here is whether you believe externalities imply collective responses or not. The left tends to be for such as belief.

” National solidarity is right-wing, class solidarity is a trainwreck […], and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime”

Class and cultural solidarity have nothing to do with it. Vaccinations is a national project where you are required to sacrifice something (your child, in the minds of some) for the nation. This sentiment can be right-wing or it can be left-wing, but most certainly it ain’t liberal. It’s not just collectivist; considering what’s at stake (to some), it’s radically collectivist, totalitarian.

“Vaccinating your child will reduce their risk of serious illness even if they do it alone, but if it is collectively done then it reduces the risk even more (eventually even to the extent that the risk virtually disappears – see smallpox and polio).”

Now, that’s a framing that suggests voluntary vaccinations. It’s in your interests to protect your child, and if a large enough number of people decide to do it, you get a huge extra benefit – so much the better. But isn’t this what’s considered “anti-vax”?

This is the typical right wing spin. I want my privileges (to impose externalities on everyone else and to free ride on them) to receive special protection.

If it’s voluntary and no one wants to make it mandatory, then what’s all this brouhaha?

Peter T:

Before One said “Kenya”, there was Zero, and Zero said Kenya first. And that’s how the whole thing got rolling. Wasn’t a Republican who invented this particular meme.

Mmm, no, it was based on racism looking for something to latch onto. Just like the claims that he’s Muslim because he went to a school in Indonesia that was attended by Muslims, and where Islam was a topic.

I went to school in Singapore, there were probably Muslims at my school, and Islam was a topic in some of the classes I attended to. I’m pretty sure I’m still Jewish.

Ze Kraggish
“If it’s voluntary and no one wants to make it mandatory, then what’s all this brouhaha?”

I’ll try reprise some things
(From the OP)
“or, more precisely, policies that impose costs on parents who don’t vaccinate their kids, may become a partisan issue, ”

Me @195
“but vaccinations ARE voluntary. People get fined for not vaccinated or banned from certain institutions, but that is a pigouvian tax. People don’t get thrown in jail for not vaccinating.”
Me @196
“This is the typical right wing spin. I want my privileges (to impose externalities on everyone else and to free ride on them) to receive special protection.”

Is all clear now?

Reason 204. The OP says that “Christie and Paul took a lot of flak from other Republicans”, and then in the next para: “The outline of the debate can be seen in the ferocious response to Reason magazine’s endorsement of mandatory vaccination.”

I take it you’re against mandatory vaccinations?

The US and also the states have mandatory vaccination policies. Even if nobody goes to jail for not vaccinating, mandatory is mandatory and it’s not helpful to pretend otherwise. It’s also not helpful to conflate mandatory (like measles) with non-mandatory (like flu or HPV) vaccinations. Re Ze 192, I know I shouldn’t bite but… a policy that requires anybody to “sacrifice their child for the common good” would be monstrous and no liberal or progressive advocates such a thing. Are you posing as a parody of a stalinist to generate talking points for the right or what?

Ze Kraggash: “Class and cultural solidarity have nothing to do with it. Vaccinations is a national project where you are required to sacrifice something (your child, in the minds of some) for the nation. This sentiment can be right-wing or it can be left-wing, but most certainly it ain’t liberal. It’s not just collectivist; considering what’s at stake (to some), it’s radically collectivist, totalitarian.”

I’ll try answering you one more time, though if your reply is as foolish as the last time I tried answered you, I’ll go back to ignoring you again. No, vaccination is not a national project. Some diseases have been eliminated from the world entirely. How do you think this was done? Through vaccination in one country? Measles is one of the diseases that can be globally eradicated, which would be possible by spending a mere $8 billion by 2020.

I have to agree with Popeye @ 205. I’m seeing sentiments like these:

David J. Littleboy: “It looks to me as though it’s becoming a helpful framing. If the anti-vaxxers can be packed off to the right, then that’s one more issue where we’re right and they’re wrong.”

If concern about vaccinations was taken up as a tribalist right-wing issue in the way that global warming has been, that would be a public health catastrophe. You’re valuing scoring political points over people’s lives.

And I disagree with all of the comments about how a one-sided culture war is possible and how this up to powerful people on the right-wing side and not anything that the left contributes to. The whole “Obama is Kenyan / Muslim” (birther) thing is obviously not an isolated question about where he was born or his religious affiliation, it’s an expression of American racism, something with the highest stakes on both sides. Maybe we can avoid giving this the reinforcement it needs, maybe we can’t, but there are no actual stakes for the left here (unlike feminism, resistance to homophobia, and so on) and deciding to try to gleefully reinforce this is making an attempt in the wrong direction.

“No, vaccination is not a national project. Some diseases have been eliminated from the world entirely.”

My point was that vaccination is not class- or culture-related. But yes, it is a national project. Diseases are eliminated from the world by coordinated national projects. This is how WHO operates.

“You’re valuing scoring political points over people’s lives.”

No, I’m not. The anti-vaxxers are going to be crushed. I just want to score some political points along the way, both stomping on righties, and working to clean up our own act..

“My point was that vaccination is not class- or culture-related. But yes, it is a national project. Diseases are eliminated from the world by coordinated national projects. This is how WHO operates.”

Well, I’ll reply to that. WHO necessarily has to operate closely with nations, because it’s part of the United Nations and because nations are the de facto authorities over most areas in the world. But it works with non-state actors as well, and what it says under “About WHO” is “In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats.”

More broadly, I was talking about solidarity. Solidarity necessarily implies that one feels connected to some kind of group, in implicit separation or opposition to some other kind of group or groups opposed or distinct. World health is a world concern and doesn’t really make sense as a national concern.

“So people (including me) are now playing semantic games about “mandatory” and “voluntary”.”

Look, where I grew up, they would show up in the middle of a school day and vaccinate everybody. You couldn’t say no, the best you could do is to try to hide under a desk or something. That’s what I call ‘mandatory’. And I’m not saying mandatory is good or bad, right or wrong – that depends on the situation; obviously if you’re anticipating some deadly epidemic, then mandatory might very well be the way to go. Or if you value public health well above personal autonomy. And that’s the controversy, as I understand it. Declaring some minor disagreement about small fees and inconveniences a “partisan divide” doesn’t make for an interesting discussion.

“Look, where I grew up, they would show up in the middle of a school day and vaccinate everybody. You couldn’t say no”

Of course children don’t get to say no. But parents do. Could you please stop that BS.

TM: “Of course children don’t get to say no. But parents do. Could you please stop that BS.”

He apparently didn’t grow up in the U.S. Probably parents couldn’t actually say no, wherever it was. Yes, “vaccination is totalitarian!” is annoying. But don’t get baited into making counterstatements that are actually, provably false.

One of the things that I often talk about within the U.S. is what is called eliminationism — treating people like a disease. It’s common on the right. Someone could conceivably say “Ah ha, you too talk about mobilizing everyone to wipe out this ‘disease’: that’s totalitarian.” But treating a literal disease like a disease really doesn’t suffer from the same problems.

Rich, medical ethics is unambiguous: any medical intervention, with narrow exceptions (mostly concerning patients in a state where they are unable to give consent), requires informed consent of the patient or legal guardian. That definitely applies to vaccinations, mandatory or not. I don’t tolerate anybody blurring these lines.

RP @ 178: . . . I don’t see how the center-left could commit itself to solidarity even if prominent elements of it wanted to. National solidarity is right-wing, class solidarity is a trainwreck . . . , and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime: . . . racism, and the well is thoroughly poisoned.

And, I do not see how the centre-left can achieve even a transitory political power, while conceding to the demagogues and dominators of the right, leadership of all of the mass of followers.

Politics, as a variant of morality, is founded not in philosophy, but on the primitives of social psychology. Raising politics from animal emotion to the level of analytic philosophy was an Enlightenment project that I very much endorse: that project, which founded the social sciences and partially displaced religion in attempts to improve society and ethics, is the core of liberal and social democratic politics and the general left point of view that we can deliberately govern ourselves in a shared, common or public interest.

The superstructure of political philosophy and allied social science has not displaced the emotional foundations and political attitudes still count, political arguments are still more hypnotic trance induction than Aristotelian syllogism, more slogan than logic. At best, bringing the human capacity for deliberation and analysis into the political realm enables cooperation on the basis of an enlightened self-interest that favors the resolution of conflict on a basis that enhances mutual benefit from cooperation. It doesn’t eliminate the potential interest of some in taking advantage of others, whether in the domination by an exploitive elite or in the oppression of an out-group by an in-group.

Nationalism, which you condemn as right-wing, was a liberal invention. The liberal campaign for institutions of bourgeois democracy was built around motivating national solidarity behind ideals of liberty, equality and fraternity, and claims of a People’s right to national self-determination and self-governance. And, it continued to be employed in the liberal and social democratic campaign for the technocratic social welfare state, in competition, it should be noted, with fascist demagoguery — a competition lost in some countries with catastrophic results.

I refer to history, because I think people tend to lose their perspective without it, lose their sense that political coalitions and movements are contingent on ephemeral circumstances, rotating in a kaleidoscope of changing patterns.

On another thread, some are marvelling that Jim Crow might be polemically tacked on as a caboose to the Republican campaign train in long-ago 1944, when FDR still claimed the Solid South (and would win benighted Mississippi’s 9 electoral votes, backed with 93.5% of the popular vote.) Democrats would ask the Senate’s Republican majority in 1947 not to seat Mississippi’s Bilbo, elected in 1946. It was a messy time. They’re all messy times.

Nationalism is tainted with fascism, class consciousness is a train wreck (especially with the passing of Fordist mass-production), cultural solidarity is prone to racism, etc. because 1.) the primitives of political psychology are primitive and 2.) the alignments are embedded in political struggle (hello!) for power.

The other day Atrios pointed to an article about how Hilary Clinton had 200 advisers struggling to find a way to make populist appeals that address the increasing hardships of economic inequality without insulting or alienating the rich, who are the engineers and beneficiaries of said inequality. So it goes.

Brett Bellmore,
Thank you for providing a source. However, this source is not even close to back-up the claims you made that “the epidemic would have extinguished itself by now [were it not for male homosexuality]” and that “It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity” (and in fact the source does not come even close to making such statements).

I am not an epidemiologist (and I would venture you are not one either) but I am a mathematician and I can easily construct an abstract contagion model such that a fragment of the population has a much higher incidence rate than the rest of the population and yet the epidemic would by no mean whither out were this fragment to disappear (all is needed is that the two fragments are separated and that they have has different contagion property one for the other; two properties which are not completely unlikely for the AIDS epidemics with respect to male homosexuality, as you yourself note, by the way). Nothing in the source you give presents evidence that the AIDS epidemics does not conform to this abstract model.

Do you have further evidence that it doesn’t? If not, I suggest you treat the adverbs absolutely and incontrovertibly with slightly more skepticism. Because, you know, skepticism and demanding evidence is not exhibiting ideological blind spots. Rather the contrary, in fact.

Once upon a time the Left had a libertarian streak.

I just wonder if there’s actually an opportunity here. A number of people, me included, think that the Left will never regain any meaningful degree of power until it re-learns the vocabulary and habits of thought of solidarity and community. (It will be easier in some countries than others, of course.) Vaccination protects children irrespective of the ethnicity, skin color, gender or sexual orientation of their parents. Indeed, it even protects children largely irrespective of things like the wealth or education of their parents as well. If there was ever a case to be made in favor of collective action, and against the indefinite extension of personal autonomy, then this must be it. Here’s an open goal to kick into at a distance of five paces. Can a fragmented Left manage to combine enough to do it?

David 02.11.15 at 9:45 am @ 234:
‘… A number of people, me included, think that the Left will never regain any meaningful degree of power until it re-learns the vocabulary and habits of thought of solidarity and community. … If there was ever a case to be made in favor of collective action, and against the indefinite extension of personal autonomy, then this must be it.’

Will that be ‘the Left’, though? There is a politics of solidarity and community under authority which has been quite successful at times in the past, but it usually isn’t assigned to the Left.

@237. Yes, of course there are other types of solidarity and community which are not of the Left, and many of them have authoritarian overtones. But I was thinking of mass political parties, trades unions, public utilities run not for profit, but also more spontaneous, community-based systems of cooperation, as well as things like public libraries and free medical care which are coming under attack and need to be defended. In reality, people in most countries today are fed up with liberal ideology, and have no particular desire to run their entire lives as just autonomous economic and social actors. They prefer (so would I, frankly) the sense of being embedded in a community with shared interests and values, and a shared support mechanism. This is a function that the Left used to help perform, but which in many countries now no longer happens. In France, for example, the old Communist Party had offices everywhere and a huge network of volunteers who among other things helped people with problems in their daily lives and created and supported community organizations. That’s all gone now, and you wouldn’t catch the modern Left in France even going into the areas where communities need help most. And guess who is? The National Front of course. “At least they care about our problems” say ordinary people.

“Solidarity”? Wasn’t that the Polish trade union that successfully fought communism?

I think communists only have use for solidarity where they don’t rule.

Also I would still love to hear some thoughts re 217.

Vorwärts und nicht vergessen,
worin unsere Stärke besteht!
Beim Hungern und beim Essen,
vorwärts und nie vergessen:
die Solidarität!

http://de.wikipedia.org/wiki/Solidarit%C3%A4tslied

“The slogan of Food Not Bombs, an American invention, is ‘Solidarity Not Charity’.”
That’s great. My point, if I really need to spell it out, is that the idea of solidarity is close to completely absent from American mainstream discourse.

Sorry. Too much liberté undermines fraternité (which is not the same as solidarité). Sigh.

Brett, you don’t think people cheat?

The Raven 02.12.15 at 4:32 am @ 249:
‘In my very first comment on this: “Viruses and bacteria don’t care about our individuality; they just know we taste good.” It’s the same with climate change. I don’t believe in arguing with thermometers—they don’t budge—or micro-organisms—they don’t listen.’

You’re not arguing with microorganisms or thermometers. You’re arguing with other human beings about a particularly intimate matter, the interior of their own bodies. Or, rather, you’re not going to argue with them, you’re just going to use force. Well, at least it’s obvious why the issue has become overtly politicized.

And—never forget—this is not a remotely personal decision. Measles is one of the most contagious of viruses. That is why a few cases have led to an epidemic. It is possible we will see many more cases. The disease is most dangerous to the very young, the very old, and the already ill.

This is not a false threat, designed to stampede people into doing unreasonable things. The danger is real and prevention is easy and low-risk.

(My wife, a sometime health care professional who is checking my facts, is sitting in the other chair, spitting mad.)

“the whole spectrum of liberals-libertarians ”

The idea that liberals and libertarians are on the same side of just about anything is completely nuts: libertarianism is about denying that individuals have any responsibilities to society, and liberalism is about building a society based on our mutual responsibilities. Complete opposites.

But you know that and are just trolling, right?

“But you know that and are just trolling, right?”

If it’s still not clear: no I don’t. I am well aware of the self-righteous streak in American liberalism (that you’re demonstrating here); its unwillingness to acknowledge its shortcoming and limitation, and so on. But that just means that you and I are unable to communicate, not that I’m trolling.

I think libertarianism is neither a diseased form of liberalism, or a natural development of it. Libertarianism, essentially, IS liberalism. And what calls itself “liberalism” today is just a sort of Fabian socialism that successfully appropriated the word early in the last century, in a massive PR coup.

Something like what’s going on with originalism today, where the living constitutionalists are in the process of appropriating the term, and soon actual originalists will have to find a new name for themselves to avoid confusing people.

Movements often attempt to take the name of their opponents, when their opponents have a much better reputation. Like all those communist dictatorships that called themselves “democratic republics”. That’s what happened with liberalism early in the last century.

At least in the US.

> That vaccines may be compulsory makes them the exception, not the rule.

Trying to turn a continuum into a dichotomy and then focussing on the dichotomy is unwise, I think.

[things before labels.]

OTOH, we don’t charge people who walk through a mall sneezing with a crime, either. Short of being under some sort of explicit quarantine order, or deliberately going out of your way to infect somebody with a deadly illness, it doesn’t legally get treated as aggression.

David #263
Many extreme right-wing and lefty types (choose to?) misunderstand what you so perfectly expressed. Vaccination isn’t contrary to rugged individualism nor to the well-being of the collective.

Small pox and polio are distant memories or forgotten by most of us. They haven’t been forgotten in Mississippi, West Virginia or Africa though.

I read a chapter of a book from the CDC, Vaccination Mandates: The Public Health Imperative and Individual Rights [PDF] that said government imposed inoculation was constitutionally allowed under Parens Patriae, see p. 273. I’m a statistician, not a lawyer, so I can’t be certain.

David J. Littleboy: “If you want to go to a movie theater, eat in a public restaurant, go to school or college, get your shots.”

Fredrik deBoer, in his blog post on this that I otherwise thought was pretty good, also said something like this — that if you don’t get vaccinated, you basically shouldn’t be allowed outside. And it’s ridiculous and draconian, much like the people who wanted everyone who’d travelled to Africa during the Ebola scare to be quarantined. No actual public health person is going to recommend that; no politician is going to implement that; people who seriously want that (as opposed to just getting rhetorically carried away) are worse than the anti-vaxxers.

Rhetoric is getting out of hand around here. A hundred cases of a disease that is harmless in the vast majority of cases don’t make an “epidemic”. This fearmongering is just dumb.

It is absolutely not harmless. At best, it’s the source of a significant amount of suffering for the patient; at worst it’s fatal. Not to mention that infected people are themselves disease vectors and potential breeding grounds for mutated variants of the disease.

The fact that we’re having this conversation is a testament to how effective vaccination has been: people are alive today (myself included!) who have no memory of any life-threatening infectious diseases, so they think vaccination is no big deal. It actually is a very big deal, and a very serious public health issue. People who don’t understand this basic fact don’t deserve to have a voice in the conversation.

TM: What is harmless? You said, “It is (now, in developed countries) harmless in the vast majority of cases.”

What is “it”: Vaccination? Or polio/ smallpox/ measles/ mumps/ diptheria/ pertussis etc.?

I think one of the fundamental principles of liberalism is the idea of equal rights — significant, inalienable, normally indefeasible rights, rights being defined areas of freedom of situation and conduct. Your little suburban yard in the polity, one might say. These rights are held by many to be of extreme importance. One of them, a right of privacy, is so important that it was not written in the Constitution but simply assumed, and was eventually discovered in the interior of women’s bodies, so that the government was prohibited from either preventing or compelling abortion and contraception, even though the lives of other individuals might be at stake. So crossing the line, or rather penetrating the surface of the human skin against the will of its owner, is not a question to be taken lightly. It is certainly a violation of what are widely held to be natural or God-given rights, and the political question is at what point a communal threat defeats this very important right of physical privacy, and how we determine that point. It does not seem like an issue to be treated contemptuously, nor one in which opposition is to be dismissed out of hand simply because one happens to have superior power at the moment.

Remember, you will not always have superior power, and you will not always be right.

“Look, all this high-minded business about natural rights and privacy and so on is great, but there’s also the danger that you’re going to float off into the clouds of theory without really facing the concrete issue in front of you.”

All right, then look at the concrete recommendations of trained public health experts, epidemiologists, and so on. Exactly zero of them are recommending what is effectively quarantine for people who don’t get vaccinated. Some of them probably recommend making the personal exemption forms less easy to claim.

I’m reasonably confident that vaccinations were a requirement of public schools when I was a child. That seems now not to be the case. Isn’t the solution here to restore that requirement? Anti-vaxers can send their kids to private schools, or home school them, while everyone else can benefit from the reduction of risk by sending their kids to public schools where everyone is vaccinated. An imperfect solution, I know, but one which strikes a balance between personal freedom and the public welfare.

“Remember, you will not always have superior power, and you will not always be right.”

Is this a quote from Wolf Hall?

Laymen 276: Vaccinations – certain vaccinations – are still a requirement in US public schools, but there are exceptions, and the exact conditions vary by state.

Oh look, a real actual thing that happened in 2015!

Sorry, pregnant woman! Sorry, immunosuppressed cancer patient! Sorry, months-old-infant who isn’t old enough to be vaccinated! Sucks to be all of you, whose health and ability to use public transit is potentially compromised by imaginary fears of autism and chemicals and government jackboots. Remember, nothing says “personal liberty” like being able to infect your fellow humans in shared public spaces.

If you have unprotected sex and have aids it can be a crime; if you don’t get vaccinated, get a potentially deadly virus and then go around in public with it…
I’m just thinking there should at least be a big degree of civil liability in it.

“I’m just thinking there should at least be a big degree of civil liability in it.”

Exactly. The amount of harm one can cause by not getting your kids vaccinated is large. The civil liability should be proportional to the amount of harm. Ergo, no public school, movies, public transportation for libertarians (and their kids) who think getting vaccinated is a personal choice, since they can’t possible carry enough insurance to compensate everyone who might be hurt by their stupidity.

Also, (re: @276) if you are running a private school, there’s no way you can let unvaccinated kids in: that’d open you up to horrific lawsuits (to say nothing of your moral responsibilities to the other children in your care), so there’s really no place to send unvaccinated kids. Interesting libertarian catch 22 here: presumably libertarians don’t like the government telling private schools how to run their business, so the right of private schools to refuse admission to unvaccinated libertarian kids is the sort of thing that libertarians will defend to the death. Oops.

tm@267: “Rhetoric is getting out of hand around here. A hundred cases of a disease that is harmless in the vast majority of cases don’t make an “epidemic”. This fearmongering is just dumb.”

It is, technically, an epidemic. If it makes you feel better, call it an “outbreak.” I don’t think it’s peaked yet, either; two infected people have ridden commuter trains, and that probably means a fair number of additional cases.

The rate of complications from measles is quite high. They are most serious in children under age 5 and adults over age 20. The CDC notes the following rates of complications: “Diarrhea – 8% reported. Otitis media [middle ear infection, can lead to hearing loss] – 7% reported. Pneumonia [the most common cause of death from measles in young children] – 6% reported. Encephalitis [this often leads to permanent brain damage or death] – 0.1% reported. Seizures – 0.6-0.7% reported. Death – 0.2% reported”

Eye infections, sometimes leading to blindness, are also possible, but seem to have been left off the list.

>Other than some narrowly defined medical exceptions, why should any public school grant exceptions?

Because the headroom exists.

It’s an allocation problem: there are a limited number of spaces available. Previously, demand for exemptions was low and could be easilly met — we didn’t need a formal allocation process because there was no shortfall — but increased demand has left the old “whoever asks for one can have it” unworkable/unsuitable.

Since we have the headroom there’s no reason not to allocate it if we can. I mean, christian scientists have pretty solidly-established religious objections to vaccination. I don’t like christian science, but if we’re not going to ban it outright then we have to tolerate it to the degree that we can tolerate it, and it turns out that, yes, we can tolerate christian science vaccination exemptions, by-and-large.

But not them and the modern anti-vaxers simultaneously. We have to establish some sort of allocation protocol; it’s a commons situation, and those are only solvable by regulation in some format. Libertarians would no doubt argue for auction, or tradeable exemption-certificate fractions; I’d suggest an external merits assessment, which does involve comparing competing religious claims [but strikes me as better than the alternatives]. Simply vastly increasing the paperwork for non-medical exemptions would actually work ~reasonably~ well; allocation by willingness to commit time rather than money would help overcome the equity problems you’d have with a libertarian-style market allocation.

End of the day, if we can do something that makes people happy and doesn’t make anybody unhappy we should; I think pareto efficiency is a fucked-up measure but it works here. We can grant some exemptions and therefore we should.

The Raven @287:
Beyond that, I don’t see how to practically deal with a large unvaccinated (minority). Do day care centers start requiring proof of vaccination? Do pediatricians and obstetricians forbid unvaccinated people from entering their offices? What happens if someone lies about that, and a child or an expectant mother gets severely ill because of it? Is the unvaccinated person liable? Do we have to bring back quarantine laws?

I can’t see how any day care center could accept a child without a vaccination certificate. It’d leave them open to nasty lawsuits.

Pediatricians is a harder question. Some think they are morally required to not turn away unvaccinated kids, some think that their other patients shouldn’t be exposed so they should turn them away.

If someone lies, they are liable to both criminal and civil lawsuits.

I don’t think quarantining will be necessary. Just vaccination certificates and the right to turn away unvaccinated children will do fine. And no exemptions other than medical exemptions. (I suppose there’s an argument for religious exemptions, but that means defining what is a religion, and the state shouldn’t be in that game, so no religious exemptions. Religion is your private relation with your god; the state shouldn’t speak to that.)

@286

“Also, (re: @276) if you are running a private school, there’s no way you can let unvaccinated kids in: that’d open you up to horrific lawsuits (to say nothing of your moral responsibilities to the other children in your care), so there’s really no place to send unvaccinated kids. ”

Yet private schools currently honor personal exemptions and permit unvaccinated kids. Undoubtedly some private schools offer that as a feature, since there’s a market for it.