As of February, there were 50 confirmed measles cases in Washington, one of 19 states that allow vaccine exemptions for “philosophical and personal” reasons. Of those confirmed cases, 34 occurred in children under the age of ten, the vast majority of whom were not vaccinated. The upshot is that kids are getting sick because parents have placed personal liberty — their legally protected right to make irresponsible medical decisions — over community safety. But that’s what happens when a country or a culture operates on the mistaken premise that raising children is purely the individual pursuit of parents.
The ongoing measles outbreak in Washington was caused by parents attempting to prioritize the wellbeing of their children over the wellbeing of their communities. Clark County, at the epicenter of the outbreak, only saw 78 percent of 6 to 18-year-olds receive the age-appropriate MMR vaccine dose of two shots. Of those who opted out only 1.2 percent had done so for legitimate medical reasons. Nearly 7 percent, on the other hand, had opted out for personal or religious reasons (fear of autism being the unstated theme here).
Personal freedom is great, but exercising personal freedoms can lead to tragedies in the commons. Benjamin Franklin famously said that “Those who would give up essential Liberty, to purchase a little temporary Safety, deserve neither Liberty nor Safety.” That was a cool thing to say. But Franklin’s maxim only makes sense in the context of a public movement or a shared civic purpose. That’s what he was talking about. Unfortunately, that quote — like so many — is easily twisted into a celebration of selfishness or as an individualist cri de coeur.
For parents, this American tendency to lionize the personal over the public creates problems. The whole “don’t tell me how to raise my kids” rhetorical tradition in this country has led, one can easily argue, to the government materially divesting from the American family. American parents receive very little support. We look out for our own. We are given the legal means to raise our children as we choose and little incentive not to do so.
Maybe that’s okay, but it’s also an unprecedented experiment. For most of human history, parenting has been a communal endeavor. For thousands of years, children were reared in what psychologists refer to as “The Evolved Nest.” In hunter-gatherer societies, this is still normal. Touch is nearly constant, responsiveness to baby’s needs is universal, adult caregivers are ubiquitous, and free play with multiple-aged playmates is encouraged. Unfortunately, this model doesn’t work too well in an agricultural setting and definitely doesn’t work in industrialized countries, where childhood is more about discipline and joining the labor force. In a post-industrial society, all bets are pretty much off. And that’s where we stand: Individuals are raising kids, but not with the clear purpose of putting them to work. Parents are raising kids to reflect their values and ideas.
And here’s where we run into trouble because not all ideas are good ideas.
Opting out of vaccines feels like a personal or parental decision and that’s how it is approached, but the potential harms of non-vaccination put communities at risk. An unvaccinated child can easily spread measles through a town, school, or NBA game, putting the old and those too young to be vaccinated at very real risk (vaccines aren’t 100 percent effective so even vaccinated kids share some of this risk).
The only way to truly offer protection is is to ensure that all those who can be vaccinated are vaccinated. A vaccination rate of around 95 percent is the sweet spot. That rate provides what’s called community immunity, essentially a layer of protection for those unable to get the vaccine. And that rate is not too far off America’s national numbers. The issue is that local numbers can start to look very different. Anti-vaxxers are a small, radicalized community, but when they get together they can do harm at speed.
Or they can give up some liberty. And, rest assured, they already have. Car seat laws impinge on liberties. People just don’t care because those laws save lives. More strangely, consider lawn darts: American parents gave up their right to play lawn darts with their kids due to the death of a single child and 6,000 emergency room visits over eight years. Over the last eight years there have been five measles deaths and 2037 measles cases in the United States. Those numbers are going to tick up this year.
Well, it’s ultimately the same with vaccines and legal mandates may be coming if anti-vaxxers don’t change their tune. It’s an unfortunate, but perhaps inevitable endgame. Individual liberty has a tendency to eventually submit to public good. This makes a lot of Americans uncomfortable — and perhaps it should — but happens for a reason.
Parenting in America has become a lonely business. That’s unfortunate. As parents, we need to start seeing that we are part of a larger community and behaving accordingly. We need to do this to ensure not only our wellbeing (think: mental health), but the safety of our children, who are are not simply raised in private homes. Hopefully, the outbreak in Washington will help us accept that we have a responsibility to one another and that we owe each other the best of our intentions.