I was personally really surprised to find out that Mississippi, which is one of the poorest and least educated states, actually has the highest rate of vaccinations in the country, and no outbreaks of preventable illnesses that I'm aware of. On consideration, though, that doesn't seem so strange. When you leave a decision like that up to each individual, a lot of people, probably most, will make the most obvious, logical decision. But there's always a certain percentage of people who won't, for whatever reason.
The only method that's every been successful in attaining near universal coverage for anything is to make it mandatory. That's the only way we get almost every child into school, it's the only way we get almost everyone to buy car insurance, and it's the only way to get almost everyone vaccinated. Mississippi has simple rules: if your kid is medically able to be vaccinated, they will be, period. If you don't like it, too bad.
Bluntly, the state of Mississippi doesn't leave this decision up to parents. For the reason (the very good reason, in my opinion) that doing so would endanger not only their own lives, but public health in general. My baby, who's too young for the MMR vaccine, is at risk of being infected by your unvaccinated baby. Let enough people shrug off vaccinations and children are inevitably going to end up dead. So vaccines are simply not optional.
In California, on the other hand, the state effectively leaves the decision up to individual parents, with the "personal philosophy" exemptions. That means that a certain percentage of people will always decline. I can only speculate about the psychology of Silicon Valley, but there's a phenomenon that occurs when educated and rich people get together, where they tend to feel like they're above conventional wisdom. I saw an interview with one women in San Francisco who talked about how educated and intelligent her neighbors all are, and said that if they're choosing not to vaccinate, "there must be a good reason". I think that sums up the danger of having education, but no expertise in a particular field. You feel like you're smart enough to overrule the experts.
Now, with that level of arrogance, you add a healthy dose of fear. Raising a child is a petrifying thing, you never know whether what you're doing is going to hurt your baby in one way or another, and people with the education, intelligence and leisure time to sit around thinking about it will tend to tie themselves up in emotion knots worrying about what might go wrong, and what we don't know. Humans are provably very bad at judging risks, and very susceptible to making decisions based on emotions, rather than facts. The danger of being smart is that you feel like your decisions must be valid (because, look how educated I am!) and don't admit that you're falling prey to human flaws.
The final aspect is that people who are educated, prominent and rich, tend to feel entitled, often grossly entitled. And as long as most of the public is vaccinating, you can count on herd immunity to keep your baby safe, without taking the risk (no matter how small) that could, potentially, maybe come with vaccines. I read one article in which the author describes a doctor who encouraged most of his patients to vaccinate, but didn't vaccinate his own children because there was no one left to infect them. Even if you acknowledge that vaccines are important in general (which anyone who's not horribly ignorant must), that doesn't mean my baby needs to be vaccinated. As long as most babies get vaccinated, we're safe. And my baby is special.
The problem with that, of course, is that if everyone accepts that idea, then no one will get their children vaccinated. It's the tragedy of the commons applied to public health.
The good news is that this tends to be self-correcting. The bad news is the self-correction mechanism is horrifying. The fewer people vaccinate, the more outbreaks we'll see. Sooner or later, we'll start hearing stories of children being permanently injured or dying from these diseases, and the same, panicky parents who exempt themselves now will start vaccinating. Unfortunately, it will take a few dead children to get us there.
Of course, more vaccinations will remove the diseases from the public eye, parents will get complacent again, vaccination rates will fall, and the diseases will return, and we'll go through the same nonsense over and over. The only way out of this cycle is to aggressively push a global, mandatory system of innoculations until all outbreaks, everywhere, are quashed and the disease goes extinct, like we did with smallpox.
I never thought I'd say these words, but we need to be more like Mississippi.
Read other answers by Geoffrey Widdison on Quora:
- Why aren't vaccines mandatory in the United States?
- Aren't the religious vaccines exemptions in the US a violation of the First Amendment?
- Can Jenny McCarthy be held liable for harm caused by people choosing not to vaccinate based on her quackery?
from Quora http://ift.tt/1OhOVqD
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