Privilege and the Anti-Vaccination Movement
With nearly 300 reported cases, Brooklyn is facing the New York City area’s largest measles outbreak since the late 1980s [1, 2]. In response, the city has ordered mandatory vaccinations for certain neighborhoods and banned unvaccinated children from indoor public spaces . The outbreak has been exacerbated by high-profile movements to sow seeds of skepticism. At its core, the anti-vaccination movement is not a campaign for liberty and choice, but a regressive disinformation campaign fueled by privilege. Children should not have to pay for their parent’s ignorance with their own health and well-being.
The near-eradication of a number of diseases that formerly caused widespread illness and death can be overwhelmingly attributed to the advancement of modern science in the form of immunization therapy. Since the introduction of their respective vaccines, the incidences of diphtheria, polio, smallpox, rubella, mumps, pertussis, and several other diseases have been eradicated by nearly 100% in the U.S. . These facts provide striking contrasts to the mortality rates for such diseases prior to the creation of their vaccines. In 1900, 21,064 cases of smallpox were reported in the United States and 894 patients died . In 1920, 468,924 measles cases and 147,991 diphtheria cases were reported respectively, claiming a total of 13,745 lives . In 1922, there were 107,473 pertussis cases reported, and 5,099 people died . The success of immunization is predicated upon the concept of herd immunity, which is the resistance to the spread of disease that arises when a sufficiently high proportion of the population is immunized. Herd immunity protects those who are unable to get vaccinated due to pregnancy, allergies, or other medical reasons. If fewer people get vaccinated, the incidence of the disease can increase, which can in turn create doubts about the vaccine’s effectiveness. What we are left with is a vicious cycle in which diseases spread quickly throughout an increasingly- vulnerable population.
Melinda Gates, the co-founder of the Bill and Melinda Gates Foundation which works to deliver vaccinations to underserved communities, commented on the rising movement against immunization:
"We take vaccines so for granted in the United States. Women in the developing world know the power of [vaccines]. They will walk 10 kilometers in the heat with their child and line up to get a vaccine, because they have seen death. [Americans have] forgotten what measles deaths look like" .
Many of those who will bear the cost of the choices made by overwhelmingly-affluent anti-vaccination individuals, apart from those who are unable to be vaccinated due to medical reasons, will be those from lower-income communities who lack access to medical care. Studies show that unvaccinated children tend to come from higher-income backgrounds, with parents who are educated but who intentionally choose to refuse vaccinations out of a belief that they are unsafe . On the other hand, children from lower-income families - often members of racial and ethnic minority groups - tend to be under-vaccinated (not unvaccinated) because they lack access to the necessary resources .
Despite some pushback, New York City made the legal and necessary decision to require vaccinations in certain areas. The 1905 Supreme Court case Jacobson v. Massachusetts ruled that states have the authority to enforce mandatory vaccination orders and reaffirmed the government’s role in protecting public health . In order to combat the influence of the anti-vaccination movement, governments at various levels must work with local communities to educate individuals on the benefits of vaccination, expand affordable access to medical care, and impose mandates when necessary to safeguard the health of the public.
“Mandatory Measles Vaccination Makes Sense”, Bloomberg, April 10 2019
“Recent Outbreak in Brooklyn and Queens”, NYC Health, April 15 2019.
Paris, Francesca. “Amid New York Measles Outbreaks, One County Orders Exclusions from Public Spaces”, April 17 2019.
“Vaccines Have Killed off These Diseases”, World Economic Forum, September 11 2017
“Achievements in Public Health, 1990-1999”, CDC, April 2 1999.
Lopez, German. “Melinda Gates has the Perfect Response to Anti-Vaccine Movement”, June 1 2015.
Smith, Philip et al. “Children who Have Received No Vaccines: Who are They and Where do They Live?”, Pediatrics, vol. 114 no. 1, June 2004.
“Expression of Privilege in Vaccine Refusal”, Science Daily, August 27 2014.
Ducharme, Jamie. “New York City is Requiring Some Residents to get Vaccinated Against Measles. Is That Legal - And Ethical?”, April 10 2019.