Opinion | Morgan Liddick: Civil liberties, measles and vaccinations
On Your Right
The brink of a measles pandemic is a useful place to consider an essential problem of our republic: the proper balance between the public interest and individual rights. This is an old question; concern about threats to our liberties was one of the chief reasons the Founders designed the central government to be balky, slow and cumbersome, hedged about with impediments and opposed by the power of constituent states. From the Alien and Sedition Acts of 1798 to the regulatory nightmare that is the EPA and the partisan hackery of the IRS, there have been ample proofs that their concern was justified.
But in every contest between the individual and the state, should the former prevail? No. Since the 1799 Logan Act, private U.S. citizens have been constrained from engaging in diplomacy, a power reserved for the federal government. Similarly, citizens cannot wage war privately, nor can they coin money. But what of more personal matters like public health?
Some measures have been positive. Crude oil is no longer sold as an over-the-counter medicine, Coca-Cola no longer contains cocaine and sickness related to processed meat is now newsworthy, not a fact of daily life. Other aspects have been less helpful: regulation of small-scale food producers, obsessive nannyism over “healthy eating” and, in general, treating citizens as though they cannot be trusted to make good decisions about their personal lives. Then there’s vaccination against disease — and here’s where it gets complicated.
If one persistently undercooks chicken, there will eventually be consequences, but the one who feels them most will be the one who disregards warnings — and perhaps, his dinner guests. But the impact of not inoculating children can be broader and potentially deadlier, as the current measles breakout illustrates.
Measles, caused by the morbillivirus, is one of the most contagious diseases on the planet. It is spread by coughing, direct contact with or even close proximity to an infected person, who is often asymptomatic for the first few days. The virus is persistent: It can survive in the air or on surfaces for hours before infecting a new host. This makes it easy to catch: Before inoculation began in the United States, we saw between 2 million and 4 million cases a year. And it is deadly: In 1980, there were 2.6 million deaths worldwide. By 1990, this had been reduced to 545,000, largely through inoculation; in 2013, only 96,000 people died and it was seen as having been eradicated in the U.S.
Measles returned to the U.S. because we became lax and credulous. Policy makers decided that since the risk was small it was useful to cater to the vocal minority among us who, frightened by sensational, unscientific reports about widespread side effects of vaccines, refused to inoculate their children. We are now seeing the first results of this; worse is still to come.
Colorado has the dubious distinction of being one of the most easygoing states regarding childhood inoculations. Thanks to politicians like Congressional District 5’s Doug Lamborn, parents may avoid vaccinating children simply by citing “moral or philosophical objections” to the process. This approach may be popular with extremists on the left and right, but it helps no one, not even children.
Immunization protects even the non-inoculated against the target disease through what is called the “herd effect.” When more than 90 percent of a population is vaccinated, viruses have difficulty spreading; people who cannot be vaccinated because of allergies or weakened immune systems still enjoy a degree of protection. But when it’s easy to opt out, as in Colorado, immunizations quickly decline and the most vulnerable immediately become the preferred targets of deadly microbes while the unvaccinated still enjoy the protection of the herd. This is free-riding in its purest form, sometimes with deadly consequences.
When the unvaccinated use public facilities — schools, libraries, the public square or private businesses where groups congregate — risks multiply. When a disease threatens outbreak, as measles presently does, the danger increases substantially.
This is not a call for forced immunizations. The specter of government compelling citizens to undergo medical procedures against their will is odious. But there are consequences to every decision in life, and so should there be with refusal to immunize. When contagion looms, there is no rational argument for unfettered access to public facilities, particularly our petri-dish public schools. The non-immunized should instead remain home, in the interest of public health. This has proven effective in the past and doubtless would again.
Those so constrained would have time to consider questions of individual responsibility, public good and natural consequences. They might even review the evidence that vaccines do not have many serious side effects. A good place to start would be the New England Journal of Medicine, available at http://www.nejm.org/doi/full/10.1056/NEJMoa021134.
Morgan Liddick writes a weekly column for the Summit Daily News.
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