It is time we stop viewing the anti-vax movement and its adherents’ responsibility for the measles outbreak as a public health problem. With more than 700 reported cases confirmed in 22 states, it is now a public safety crisis, and the tools of public safety — arrests, fines, isolation — are absolutely necessary.
We are not in a “both sides” moment. On Friday, President Trump finally conceded that his previous statements questioning the safety of vaccinations (promoting the debunked claim that vaccinations contribute to autism) were erroneous. He didn’t put it that way, of course; instead, when pressed, he said, “They have to get the shots.” Just as he does with “both sides” statements regarding white supremacists, Trump promotes risky, unscientific ideologies until the reality of their harms becomes too dangerous to ignore.
And, when it comes to the measles, it is too late to ignore. “Get the shots” is not a plan. We are in a crisis; an avoidable one, but a crisis nonetheless. Measles cases in the United States have exceeded the highest number on record since the disease was declared eliminated nationwide in 2000. Trump’s statement came too late; the measles are back.
It is important to remember that the measles outbreak is not only the result of low-information communities or religious exceptions. Indeed, religious leaders are urging their adherents to get the shots, even in the Hasidic communities hit hardest by outbreaks. Imagine, instead, that this outbreak is what happens when negligent people do negligent things, such as sending a kid to school with a loaded gun and hoping for the best.
In some places, sadly, more education is necessary, especially in isolated communities. But some of the crisis was bred in well-off and informed communities, where voodoo science is given equal weight with yoga and kale; vaccination rates in areas of California have, at times, been less than rates in South Sudan. And this utter negligence has had, until last week, a safe harbor in the White House (and is being amplified by Russia, a hostile foreign power that exacerbates this false narrative through its disinformation bot-farms to promote an unsafe America).
The initial steps we have taken are essential: prohibit non-vaccinated children from public spaces, including schools; promote educational efforts; and, in extreme cases, force isolation on pockets of populations that might have been exposed to the outbreak, as is happening now in the University of California system. But these efforts impact the children who might have been put at risk by the decision of individuals not to vaccinate. Viewed through the lens of public safety, it is the parents who should be punished. Why not make them pay for the harms they are causing?
Fines for the increased public safety burdens put on these communities by a few ought not to be the responsibility of all. In many states, when hikers ignore warnings that certain trails are too dangerous and then have to be rescued, the fees for the rescue must be paid by the hikers. It’s a fine for making a self-centered decision that placed an unreasonable burden on a larger community. Measles should be no different.
In the same way we have created sex-offenders lists to protect our children, communities can inventory families that choose not to be vaccinated, notifying employers of these parents as well as neighbors who may choose not to expose their children. Exceptions might be made for religious or medical reasons, but not for those who are simply choosing to ignore the science.
The anti-vaxxers are also putting at risk populations that cannot be vaccinated due to health conditions or allergic reactions. Mostly children and the elderly, these people are dependent on the rest of us being vaccinated so that they can benefit from herd protections; they should be the only acceptable free-riders.
Yes, this language is harsh, the language of a homeland security expert, not a pediatrician. Maybe the threat of greater penalties will get these parents to be less self-centered. But, sometimes a crisis requires a change in orientation if only to scare the free-riders into loving my children as much as I love theirs.