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Discussion point: compulsory vaccination

Stop return of measles by making MMR jab compulsory, say GPs.

The Guardian headline makes it sound as if all GPs (General Practitioners) have said this. In fact only four named doctors are quoted, and when one reads the article the “compulsory” of the headline is not fully justified, but I think most GPs would agree with the government moving from a “nudger” to a shover on this issue.

The MMR jab should be compulsory for children before they are allowed to start primary school to stop the resurgence of measles and mumps, leading GPs are demanding.

Schools should ask all parents to prove their four- or five-year-old has had their two recommended doses of the vaccine before they can attend, they say in a letter to ministers seen by the Guardian.

They want school entry procedures toughened so that the only exceptions made to the new rule would be for children whose parents have registered a conscientious objection to the measles, mumps and rubella vaccine or those whose health means they cannot have it.

The four London GPs, who include a former government adviser on health policy, have urged the health secretary, Matt Hancock, and the education secretary, Gavin Williamson, to embrace the proposed change in policy.

Many a libertarian shuffles their feet when questions of herd immunity come up. The ghost of Typhoid Mary laughs. What do you think?

20 comments to Discussion point: compulsory vaccination

  • bobby b

    “Schools should ask all parents to prove their four- or five-year-old has had their two recommended doses of the vaccine before they can attend . . . “

    My inner weak-libertarian has no issues with this.

    It doesn’t appear to be “innocculate your child or go to jail.” I would have problems with that.

    But this preserves the parents’ ultimate choice: you can forgo the shots legally.

    You simply cannot hang out with the rest of us if you do.

    Win/win – you don’t infect us, and, if you’re going to leave your child immunologically-compromised, you won’t want us infecting him.

    (I rank the fear of vaccination right up there with the fear of climate change. Unsupported. And I’ve read up on it a bit, to convince a non-scientifically-educated wife.)

  • Nicholas (Unlicenced Joker) Gray

    Why isn’t there more use of the carrot, instead of the stick? Why not give every vaccinatee a free sweetie, or some cash?

  • Deep Lurker

    The sticky part is that vaccinations don’t always take. If vaccinations were 100% effective, it would only be the anti-vaxers at risk of disease and the rest of us could laugh and let them go to hell in their own way.

    As it is, I’m still inclined to a “Let the unvaccinated go unvaccinated if they insist” libertarian view, with a “Yeah, I do see the argument on the other side” added. Because people aren’t vaccinated against everything but only against those things where the Best Government Experts judge that the benefits outweigh the cost. (We don’t require getting vaccinated against smallpox anymore, for example.) So why should that decision be left to the Best Government Experts?

    As a compromise, and to avoid perverse incentives, I could go with a system of “You must pay for the vaccinations, even if your kid doesn’t get the shots.”

    Of course this all leaves aside my view of Public (US usage) / State (UK usage) schools: Burn them down, salt the grounds with toxic radioactive salts, and strangle the last school administrator with the guts of the last teacher.

  • Fraser Orr

    I think there are three entirely separate issues here: your duty to your children; and your duty to those around you; and the rights of public schools to set their own standards.

    In regards to the first issue: people, of course, do have the right to do with their own bodies whatever they want; this is a pretty well established principle in libertarianism. However, here we are not talking about that. Here we are talking about what one person does to another person’s body (namely their child.) It is the bargain of parentage: a child is incapable of deciding for themselves and so we turn over those decisions to another person, generally their parent, and the parent decides for them. However, that transfer of rights is contingent on them exercising them in the best interest of the person being decided for.

    FWIW, this is no different than cases like obligations to prisoners in state ward, or people with mental illnesses, or seniors who have lost their senility and have transferred their rights by way of a power of attorney.

    Imagine, if you will, that your mom has lost her marbles and had turned over her rights to you. You are not now free to exercise them in anyway you wish, but must act in her best interest. However, you are not at liberty to entirely decide on your own what is in her best interest, the state may intervene to say your decision to withdraw care when she is perfectly viable for many more years of life, is not allowable. In this case you would be expected to make medical decisions in line with recognized medical practice.

    I think the parallels with children is clear. You cannot make decisions for your children’s medical care that are contrary to good solid medical advice without risking loosing your guardianship over them.

    This is of course an utterly terrifying statement, and anyone who, like me, has had the misfortune of dealing with the typical employee at the department of children and family services will be utterly chilled by such a thought. So the degree to which this should be implemented by law should be in the category of last resort.

    A more extreme example of this might be the question of Jehovah’s witnesses. Imagine the child of such a parent were in a car accident and taken to hospital in need of an operation. Would the parents be at liberty to refuse the surgeons the right to use blood products in the operation? Would their religious convictions be allowed to put the child in a position where they have a greatly increased chance of death? Again, I think that the parents have no right to fail to provide that child with adequate medical care, irrespective of their religious beliefs. And in that case the state may well have justification in stepping in and abrogating their rights, terrifying though that might be.

    It is a curious thing, don’t you think, that the Jehovah’s witness family would not be hassled by the DCFS yet the non vaccinating parents would be, which just shows the mythical role that “religion” plays in the thinking of politicians and regulators.

    The case of vaccination is not quite so stark, and my personal feeling is that it is right on the edge of “the state should not do this”, but it is pretty damn close.

    Regarding the obligations to others, I think again we have a terrifying slippery slope. The state does have the right to preemptively remove a serious threat even if the threat is caused by ignorance rather than malice. For example, it seems to me perfectly reasonable of the state to ban that traditional middle eastern celebration of firing automatic weapons in the air as part of a celebration in a heavily populated area, even if the participants are not actually directly shooting at anyone. Similarly, although I am in favor of the legalization of drugs, it seems perfectly reasonable for the state to say that you can’t run a meth lab — prone to explosion — in the middle of a residential neighborhood. If I pull a gun on you you don’t need to wait till I shoot you to react.

    However, again with regards to the potential “violence” from carrying around a strain of measles in the general population, I’m not convinced it comes up to the level where the state is justified in taking action. I don’t know how to define that level, but there is a level there for sure. Which of course is a horrible slippery slope. One day you are saying you can’t empty your AK-47 to celebrate your birthday, next day you are locking up all the Japanese citizens, just in case.

    The third issue I am far more sure about. Any organization is perfectly at liberty to set its rules of membership, including saying vaccinated children only. Of course I am not in favor of public schools anyway, and public money does befuddle this issue as it befuddles all issues, but to me that seems a perfectly reasonable rule.

    One must remember that there is a significant cohort of children who cannot be vaccinated. Those with egg allergies for example (because many vaccines are grown in chicken eggs) and those who are immuno-compromised due to disease treatment. I suspect though, that children in these circumstances have to be extremely vigilant anyway, and some random kid with a strain of measles is fairly far down the list of significant threats.

  • William H. Stoddard

    I think that exposing me to a contagious illness, without my freely given consent, is in some measure a violation of my rights, and a really serious one if it’s an illness that could kill me. So I think that at least some compulsory measures, such as quarantine, are legitimate. I don’t have a fully worked out theory of vaccination, particularly in our current society that is permeated with surplus coercion.

  • Ben David

    Despite the obligatory, knee-jerk trashing of public schools in many of these comments – and their focus on individual rights – the practical solution starts with the right/expectation that a “public accommodation” look out for the safety of its patrons (backed up by liability law).

    So this becomes a version of “no shoes, no service” or “you must be this high to get on this ride”. Breast-beating by nutty parents is irrelevant.

    Libertarians swear they don’t want to tell others how to live. So they should stop hair-spliting discussion of how society should be, uh, ordered and learn to love tort law.

  • bobby b

    “However, again with regards to the potential “violence” from carrying around a strain of measles in the general population, I’m not convinced it comes up to the level where the state is justified in taking action.”

    I don’t think that “violence” is a demarcation in this case. Is the state justified in taking action when I route my sewer drain down the shore to the lake water? When I butcher and sell as steaks my cow that died of bovine spongiform encephalopathy? When I light my cigarette as I fill my gasoline tank?

    There are myriad ways the state enforces regs preserving the general welfare. Most don’t offend a libertarian bent. Most such offenses don’t require hostile intent, because we don’t care if you intend to harm everyone else’s health or if you’re doing it out of ignorance.

  • John B

    ‘… exceptions made to the new rule would be for children…’

    Once you allow exemptions it rather destroys the argument for compulsion. Exempt children are no less likely to be an infection source than merely non-compliant children, nor are they likely to be less numerous.

    Then the ‘slippery slope’ argument that those who seek to impose try to rubbish. Of course the war on tobacco won’t be extended to other things. But here we are: war on fats, war on sugar, war on meat, war on booze.

    So to prevent teen pregnancy why not make contraceptive implants compulsory for female school attenders?

    And how about ‘flu vaccination? Should that be compulsory? Flu is more deadly than measles. How about compulsory medication with appetite suppressant to stop the ‘epidemic’ of child obesity?

    Compulsory medication… NO under any circumstances nor in the name of any ‘reasonable’ cause.

  • John B

    @bobby b and @ Ben David

    There is the matter of sovereignty of the individual. The alternative to that is slavery.

    It is one thing for the State to intervene in a person’s actions which may harm others, quite another to intervene in their bodies and force changes to it.

    For example, in the case in question an argument could (and in past times has been) built for the social and economic harm from handicapped people, the old and incapable, babies born to teens and/or single mothers particularly of low intelligence. Therefore forced abortion justified?

    Oh, but, but… that could never happen. 23 States of the USA passed legislation to allow forced sterlilisation of low intelligent girls who got pregnant. And then of course there was the Third Reich.

    Be careful to dismiss so glibly, liberalism. Without it we are on the road to Hell, never mind it may be paved with good intentions.

  • I don’t have a fully worked out theory of vaccination, particularly in our current society that is permeated with surplus coercion. (William H. Stoddard, September 9, 2019 at 4:37 am)

    The part I emphasised is my true reaction. To reduce the surplus coercion, pick the battles to fight.

    However Niall-pedant-Kilmartin can rarely resist the intellectual seductions of ill-prioritised thinking. Long before I reached William’s wise comment, I had thought that we believe in free association, so why is a parent’s right not to vaccinate their tiny tot different from another parent’s right not to let their tiny tot mix with “that kind of person”?

  • bobby b

    “It is one thing for the State to intervene in a person’s actions which may harm others, quite another to intervene in their bodies and force changes to it.”

    But isn’t this a situation that involves both? That’s where the tension arises here.

    And that’s why I like the elegance of this solution. No state mandate – “vaccination or jail.” Merely “vaccination or our building is closed to you.”

  • Jacob

    In the name of equality and according to it’s duty to educate all, the State should provide special schools for non-vaccinated children.

  • Rob

    They want school entry procedures toughened so that the only exceptions made to the new rule would be for children whose parents have registered a conscientious objection to the measles, mumps and rubella vaccine

    Absurd. Immunity is undermined whether your objections are ‘conscientious’ or not. A middle-class cop-out, dishonest and undermines the credibility of those proposing the vaccine.

  • Fraser Orr

    @John B
    There is the matter of sovereignty of the individual. The alternative to that is slavery.

    No it isn’t. It is exactly the opposite of that — it is a matter of the “sovereignty” of one person over another, the parent over the child. The rights of a parent are not unconstrained, and the way our societies are organized there is only one entity that can adjudicate that relationship — namely the state.

    But this is, I think, one of the most complicated of all issues in libertarian philosophy because it is multiple different issues all enmeshed, and each of these issues is an edge case in the whole underlying concept of individual sovereignty, with slippery slopes abounding.

    As I said above, I’d ask, with regards to one of these issues, is it OK for the parent of a child who is bleeding to death to tell the surgeons to not give their child blood products, as would often be done by Jehovah’s witness patients? FWIW, I think the answer today is “yes”, though I think it should be “no”. No because it breaches the parent’s most fundamental fiduciary duties to the child sacrificed on the altar of silly religious sensibilities.

    This question surfaces one of the real underlying questions of vaccination by eliminating the randomness element.

  • Rich Rostrom

    “The state has the right to…” [override some individual’s choice].

    No. The community has the right to… The state is, or should be, the agent of the community, not some autonomous force.

    The question is not whether some bureaucrat has “the right to…”, but whether the community has the right to do it, and to empower the state as its agent to carry out its decision.

    The state should have such power only with the clear decision of the community as a whole – which does mean overriding a dissenting individual or minority.

    The power (and the responsibility) lie with the majority of the community – not the state.

  • Julie near Chicago

    bobby b
    September 9, 2019 at 8:23 am

    “It is one thing for the State to intervene in a person’s actions which may harm others, quite another to intervene in their bodies and force changes to it.”

    But isn’t this a situation that involves both? That’s where the tension arises here.

    And that’s why I like the elegance of this solution. No state mandate – “vaccination or jail.” Merely “vaccination or our building is closed to you.”

    NAILED.

  • Lord T

    Currently there are lots of kids who have not been immunised for various reasons. I wonder what the infection rate is compared to say, flu, and what the immunisation rate is in the area that they are in.

    Not sure what the problem is here. It may be nothing and limited to certain schools or communities.

    Personally I think that lack of immunisation is pretty well spread across the country. I bet the spread of measles is pretty much in a few hot spots.

  • TDK

    I think we are missing an aspect.

    Many of the people who object to the MMR jab would not object to individual vaccinations. The theory being that the problems are caused by the simultaneous nature of the jabs.

    At the time when this became a big issue, Tony Blair (or his wife) were asked if their kids had been vaccinated. They refused to answer. Eventually they announced that (AFAIK) Leo had been vaccinated but the delay in response meant that it was disbelieved by many, particular the anti-MMR brigade. The logical step the government should have taken was to announce “while further studies are carried out we will permit parents to take separate Measles, Mumps and Rubella vaccines over a 4 month period. If the studies show that Dr Wakefield’s results are not proven then the separate injections may be withdrawn”.

    That said the same option can be applied now. Offer separate vaccines for the next 20 years.

  • neonsnake

    And that’s why I like the elegance of this solution. No state mandate – “vaccination or jail.” Merely “vaccination or our building is closed to you.”

    NAILED.

    And hammered in flush.

    Also +1 to the freedom of association point raised by Niall, and intimated by others.

  • William H. Stoddard

    The power (and the responsibility) lie with the majority of the community – not the state.

    A society in which the majority of the community freely exercises its power is not a free society. Freedom is about having legal restraints within which power can be exercised.

    Back in junior high school, I first read Kipling’s “As Easy as A.B.C.,” with its image of the statue of The Nigger in Flames, inscribed “To the eternal memory of the justice of the people.” It made a lasting impression on me—one of mistrust of democracy and the will of the people.

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