By: Nicole Magas, Opinions Editor and Gabrielle McLaren, Editor-in-Chief
On April 30, The Washington Post published the op-ed, “Anti-vaxxers are dangerous. Make them face isolation, fines, arrests” by Juliette Kayyem, suggesting that fines be implemented for parents who refuse to vaccinate their children. The article offers this solution as a next step to banning unvaccinated children from public spaces. It reasons that the choice not to vaccinate lies with the parents, therefore punishment must as well.
The Peak’s Editor-in-Chief, Gabrielle McLaren, and Opinions Editor, Nicole Magas, take turns discussing the pros and cons of this proposal in an informal dialogue.
GM: Overall, I agree with the piece. The conversation around vaccination has to be reframed as a public safety concern, since the crisis created by anti-vax movements literally endangers lives. I’m not sure that a fine will be enough to dissuade someone who is really gung-ho about the evils of vaccines since that kind of position gets entrenched, but in a country like the U.S. where healthcare is so dystopically monetized already, maybe it would. At the very least, it opens a door for anti-vax fines to be redirected towards the medical bills of immunocompromised individuals who suddenly find themselves hospitalized with measles.
NM: I’d like to start by saying I’m firmly pro-vaccine. That said, I’m skeptical of the efficacy of fines to change health behaviour. The article directs its criticism toward new-age hippie types, but laws and regulations can’t only apply to one group. I worry that already marginalized populations could get hit harder for this than the middle class. A fine for not vaccinating one’s children would be regressive in that it would hurt poorer families — children included — more than well-off families.
GM: Fair point. Laws and regulations vary, but in the school district where I grew up, if something was up with your immunization file your parents would get a notice from the city and school board. You’d have a grace period where they could then get you vaccinated. I think a similar system would need to be in place to avoid innocent mistakes resulting in massive penalties.
It’s worth saying that this would be unthinkable in a healthcare system where vaccination isn’t covered by the state. Measles doesn’t care about your income level, so equal opportunities for immunization need to exist. Programs to cover immunization exist in the States, though I can’t vouch for their effectiveness, and routine vaccination in Canada is covered.
This isn’t to say that our healthcare system is perfect, but the state does offer opportunities for vaccination. If you’ve still chosen not to do your best to avoid a formerly-eradicated disease, I think there should be a fiscal cost associated with the social and ethical costs of that choice. If not to change minds, then at least to fund further immunization campaigns.
NM: It definitely would be a win-win to use fines to better fund other parts of the healthcare system. Unfortunately, fines may not be an effective deterrent. I think the “health belief model” developed by the US Public Health Service can explain some of the reasoning behind a diehard anti-vaxxer’s motivations. This model basically asks: am I likely to get this disease, what are the consequences if I do, and what’s keeping me from taking preventative steps?
Unfortunately, because measles has not (until recently) been publicly visible, many people without exposure to it may not feel that they or their children are likely to get sick, or, if they do, won’t be in serious danger. The flip side is that with the erroneous association of vaccines with autism — which has recently been more visible than measles — many parents may feel that the consequences of an autism diagnosis are far worse than that of contracting measles.
This isn’t to suggest that they are in any way correct, especially given the wrongness of implying that the potential death of a child would be preferable to autism. However, given that these are strongly held beliefs, trying to correct them with fines may not actually change the behaviour. In fact, for the parents who believe that vaccines are a government conspiracy, having the government impose a fine for not vaccinating may only further ingrain their incorrect ideas.
GM: The reasoning behind the anti-vaccination is an important consideration here. Policing and criminalizing health is also a really problematic idea — the AIDS epidemic or even the opioid crisis right now are really good examples.
That being said: anti-vaxxers are adults whose anti-science beliefs are harming children. Socially, that’s horrifying. I’m a history major who studies not just how the past shaped the present, but also what contexts have brought us to where we are and what needs to be done or undone to preserve or deconstruct them. Plus, my little sister is autistic, so my personal bias is to have zero pity for the anti-science vaccine noncompliant.
Closing thoughts: We worry that being lax with adults who actively choose to ignore science just gives them more wiggle room, and children (theirs and others) end up suffering. There are 16 states where you can be fined for leaving your dog in a hot car. Yet when it comes to parental negligence and health care, penalties only come when it’s too late. That’s how we end up with these tragic stories about parents who lose their children and are convicted of “failing to provide the necessities of life.” Herd immunization is our collective responsibility; we shouldn’t fail each other, and we shouldn’t let each other slither away either.
At its core, the issue is this: do we want to punish people, or do we want results? Lauren Vogel’s work on winning over the vaccine hesitant might be helpful here. She argues that you won’t be able to win over anti-vaxxers with brute force.
Indirect social and grassroots campaigns such as those advised by Vogel may be more effective, though perhaps less satisfying, than the hardline financial punishments suggested by Kayyem.