The Forced Vaccine Debate: Both Sides Presented

Image Credit: CDC

Image Credit: CDC

The Foundation for Economic Education published two opposing opinions on the vaccine debate. The authors were asked, “Are mandatory vaccines compatible with liberty?” Both responses are republished below.

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Mandatory Vaccinations Are Incompatible with Liberty

By Robert P. Murphy

Mandatory vaccinations are a gross violation of liberty. On some government policy issues — including mandatory quarantines, airport checkpoints, and NSA email scanning — there is at least a coherent allegation of a trade-off between individual freedom and public safety. But when it comes to mandatory vaccinations, there is little scope for plausible debate.

Mandatory vaccinations involve a supreme violation of liberty, where agents of the state inject substances into someone’s body against his or her will. On the other side of the ledger, even in principle, mandatory vaccinations do not offer much benefit in enhanced public welfare, relative to a free society. When we throw in the realistic worries of government incompetence and malfeasance, the case against mandatory vaccinations is overwhelming.

Before making my case, I will explain in basic terms how different groups are likely to treat the proposition, according to major conceptions of the state’s proper role. I do this in order to show that, even if we’re being charitable to the most inclusive conceptions of liberty as a principle, mandatory vaccinations are still not justifiable.

First, among those who hew strictly to a nonaggression principle and a stateless society, mandatory vaccinations are, of course, a nonstarter. Whether they identify themselves as “strict libertarians,” “voluntaryists,” or “anarchocapitalists,” this group would obviously never condone the state’s forcing someone to be vaccinated, because most believe the state is illegitimate.

Second, for minarchists, the proper role for the state is that of a “night watchman,” a minimal government that only protects the individual from domestic criminals and foreign threats. In a minarchist framework, it is only legitimate for the state to take action against someone who is violating (or threatening to violate) the rights of another. A person’s failure to become vaccinated is hardly by itself a violation of someone else’s rights. Flipping it around, it would sound odd to say you have the right to live in a society where everyone else has had measles shots.

Third, and most interesting, let’s consider a broader notion of liberty, which balances a presumption of individual autonomy against the public welfare. In this approach, there’s not a blanket prohibition on the state restricting the liberties of individuals — even when they haven’t yet hurt anybody else — so long as such restrictions impose little harm on the recipients and possibly prevent a vast amount of damage. This is the only conception of the state for which the mandatory vaccination debate is possible.

Let’s be charitable and assume this more expansive definition, under which, for example, even self-described libertarians might not object to stiff penalties for drunk driving or prohibitions on citizens building atomic bombs in their basements. How does mandatory vaccination fare in this framework, where we’re not arguing in terms of qualitative principles but instead performing a quantitative cost-benefit test?

Even here, the case for mandatory vaccinations is weak. First of all, the only realistic scenario where the issue would even be relevant is where the vast majority of the public thinks it would be a good idea if everyone got vaccinated, but (for whatever reason) a small minority strongly disagreed. This is obvious: if the medical case for a vaccine were so dubious that, say, half the public didn’t think it made sense to administer it, then there would hardly be an issue of the government clamoring to inject half the population against their will.

Now, let’s push our analysis further. We’re dealing with a scenario in which the vast majority of the public thinks it would be a good idea for all of the public to become vaccinated. In that environment, if vaccines are voluntary, then we can be confident that just about all of these enthusiasts would go ahead and become vaccinated. In other words, any “free riding” would only take place at the margin, if most of the population had gotten the vaccine and thus an outbreak of the relevant disease was unlikely.

This is a crucial point, and it shows why the case for mandatory vaccines is so much weaker than, for example, the case for mandatory restrictions on carbon dioxide emissions or mandatory contributions to the national military. When a person gets vaccinated, the primary beneficiary is himself. And this benefit is all the greater the lower the rate of vaccination in the population at large. In other words, among a population of people who all believe that a vaccine is effective, the individual cost-benefit analysis of taking the vaccine will only yield a temptation of “free riding” once a sufficient fraction of the population has become vaccinated, thus ensuring “herd immunity.”

Unlike other examples of huge (alleged) trade-offs between individual and public benefits, with vaccinations there is no threat of a mass outbreak in a free society. With vaccines, we have the happy outcome that when someone chooses to vaccinate him or herself, so long as the vaccine is effective, then that person is largely shielded from the consequences of others’ decisions regarding vaccination.

However, the proponents of mandatory vaccinations say that this analysis is too glib. There are people who can’t undergo certain vaccinations because of medical conditions, including young people (babies) who are not yet old enough to receive certain shots. It is to protect these vulnerable pockets of the population that some want the state to force vaccinations on those who are too ignorant or too selfish to recognize their duty of living in a community.

Notice the irony and how weak the mandatory vaccination case has become. We are no longer being told that vaccines are “safe,” and that anyone who fears medical complications is a conspiracy theorist trusting Jenny McCarthy over guys in white lab coats. On the contrary, THE CDC WARNS CERTAIN GROUPS not to take popular vaccines because of the health risks. This is no longer a matter of principle — of the people on the side of science being pro-vaccine, while the tinfoil-hatters are anti-vaccine. Instead it’s a disagreement over which people should be taking the vaccine and which people should not take it because the dangers are too great.

Regarding children, social conflict can be resolved through the fuller application of private property rights. If all schools, hospitals, and daycare centers were privately operated and had the legal right to exclude whichever clients they wished, then the owners could decide on vaccination policies. Any parents who were horrified at the idea of little Jimmy playing with an unvaccinated kid could choose Jimmy’s school accordingly.

We have seen that even assuming the best of government officials, it is difficult to state an argument in favor of mandatory vaccinations. Yet, the debate tilts even more when we recall that throughout history, government officials have made horrible decisions in the name of public welfare, either through incompetence or ulterior motives. It should be obvious that no fan of liberty can support injecting substances into an innocent person’s body against his or her will.

Mandatory Vaccinations Can Be Compatible with Liberty

By Randal John Meyer

We can take comfort that modern science can handle infectious diseases. Questionable studies such as reports linking vaccinations to autism have been DEBUNKED. Despite the EMPIRICALLY DEMONSTRABLE efficacy of vaccines, some people have decided to forego vaccinations for themselves or for children under their custody. Accordingly, libertarians have been forced to examine their own tenets to evaluate whether compulsory vaccinations are compatible with the principles of individual freedom.

I believe they are.

A major pitfall for libertarians examining this question is the consideration of whether mandatory vaccinations are too paternalistic. But because vaccinations prevent harm to others with incidental paternalistic effects, I argue that they are justified. Because certain deadly diseases are communicable from human-to-human contact, transmission can be prevented by using medically safe vaccines.

Vaccines do not always and in every case protect individuals who receive them. Bacteria and viruses can mutate, preventing vaccines from conquering them. And, over time, a particular vaccine can become less effective. But when given to a large enough population and updated periodically to counter mutations, vaccines act like a computer firewall, protecting the entire population. And if a significant enough portion of the population chooses not to be vaccinated, then the whole population becomes more susceptible to an outbreak. Immunization of a critical proportion of the population in this manner is called “herd immunity.” Though it may seem paradoxical, it becomes important to ensure that the vast majority of people get immunized to prevent harm.

Libertarian philosophy holds that it is justifiable to prevent unauthorized harm of one individual against another. Accordingly, even libertarians who have adopted principles such as the nonaggression axiom or the harm principle can see that vaccination is a means of preventing harm. Moreover, even libertarians who follow a strict Rothbardian nonaggression principle consider the prospect of AGGRESSION to be indistinguishable from actual aggression. And this is reasonable: preventing imminent harm is as good as stopping present harm.

University of Arizona professor Joel Feinberg has ARGUED that “it is always a good reason in support of legislation that it would probably be effective in preventing (eliminating or reducing) harm to persons other than the actor and there is probably no other means that is equally effective at no greater cost to other values.”

John Stuart Mill famously notes in On Liberty that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.”

The questions of whether the nonimmunized members of a population pose a risk to others — as well as the effectiveness of vaccinations in preventing that harm — turn on facts. To address such questions, let’s take a look at the disease that has lead to most of this recent controversy: measles.

If one imagines a community with an immunity rate of 96–99 percent for measles due to vaccination (and most states fall below this rate), it is statistically unlikely that there will be an outbreak of measles in this population due to herd immunity. When only 95 percent of the population is vaccinated, an outbreak is possible. When the percentage vaccinated falls below 90 percent, the rate of infection per 10,000 children more than DOUBLES. If the rate falls low enough, we can expect pandemics. “Before mass vaccination was introduced, measles used to follow a cyclic pattern, with [epidemics occurring each] period of about 2 years in Europe and North America,” according to RESEARCH by V.A.A. Jansen and N. Stollenwerk.

From 1840 through 1990, measles killed nearly 200 MILLION people globally. But from 2000 through 2012, measles deaths decreased by 78 percent after the UN SPONSORED IMMUNIZATION. During this period, 68 percent of the populations of member countries were immunized to herd immunity levels. In the United States, the vaccination rate among infants was 91 PERCENT, considerably below the 96–99 PERCENT needed for herd immunity to be maintained. In fact, in some enclaves, such as the ORANGE COUNTY SCHOOL DISTRICT, the immunization rate dropped to 50–60 percent among kindergarteners. This failure to vaccinate, at least in part due to the existence of the state philosophical exemption from vaccination, allowed the measles outbreak to occur in 2015 in more than a dozen states.

No individual has the right to expose other individuals to that risk.

Alternatively, there is parallel argument from the libertarian principles regarding common defense. According to David Boaz in his updated book, THE LIBERTARIAN MIND, “most libertarians” believe that “governments should exist … [to provide] national defense against external threats.” The entire human race is at war with microbes, such as viruses, and has undergone massive assaults. Examples include the bubonic plague, smallpox, and polio. Each day, an individual’s immune system destroys numerous potential pathogens. Liberty-restraint principles allow for collectivization of defense efforts against equally deadly foes: our immune systems are not alone in this. Vaccines are instruments of that ongoing war.

People should not be compelled to be vaccinated for noncommunicable diseases, of course, but we don’t want any of these serious pathogens to reemerge. Measles, mumps, rubella, and pertussis cases are all on the rise in the United States. Polio has returned in more than 10 countries; the World Health Organization believes it constitutes a global health emergency. Childhood vaccines save nearly $40 billion in DIRECT AND INDIRECT COSTS, in addition to numerous lives.

It is important to note, as well, that compulsory vaccination can accomplish herd immunity by means short of forced procedures. On one level, the CIVIL LAW could be used to hold nonvaccinated adults and the parents of nonvaccinated children financially liable with punitive damages for their role in any public health emergency. Exclusion from various types of public space or activities could be justified, yet enforcement would be difficult, if not impossible, particularly in urban areas. On a more restrictive level, the state could use the criminal law to impose fines on parents or declare that such action constitutes child neglect. Regardless, more extreme measures for noncompliant adults would only be appropriate if more restrictive means could not achieve herd immunity thresholds.

Thus, it can be argued that vaccination policy approaching infringement on individual and parental choice does not pose an issue per se with mainstream libertarian thought, given the narrowness of the means of vaccination (how little it imposes on the recipient’s liberty) and the degree of relatively certain harm to others that is thereby prevented.

The harm of nonvaccination for serious communicable diseases poses a significant enough risk for others to become infected that it justifies such small impositions on personal liberty. A policy of voluntary vaccination, or the granting of philosophical exceptions to the general vaccination requirement, causes much more potential harm than requiring people to get a vaccination does.