People get really wound up about whether vaccinations cause autism. The science is very strong to say that it does not. I have a friend with a doctorate in social science. She has two sons, identical twins, who are autistic and she’s an anti-vaxxer. Upon request, she’ll send a mighty list of scientific papers that argue that one of the potential causes of her sons’ condition was vaccinations. Apparently it only matters if the child is vulnerable to that kind of trigger, which of course, one doesn’t know before the vaccination is delivered.
Here’s the thing, though. The debate about the potential harm from vaccinations is the wrong one. There is always a personal risk in having a vaccination. Potential side effects can include rashes at the site, light headedness, or worse. There’s a reason medical professionals make you sit there for 20 minutes before you leave, because if you’re going to have an adverse reaction, it will probably happen while you’re sitting there. The most serious potential adverse reaction is anaphylaxis, which occurs in about 2 cases per million doses given to children or infants. These cases are far less likely to be fatal if the person is still in the medical office where the vaccine was administered when the reaction occurs. There is no known causal link between vaccines and sudden infant death syndrome, and other deaths following vaccinations have been been shown to be due to other causes. Individual susceptibility to vaccination side effects are poorly understood.
So the risks of taking a vaccination are always personal. They are small, no matter how you slice it, and medical professionals are required to give you the run-down on the potential side effects from any vaccination given. If you follow the instructions and hang around the medical office for the requisite 20 minutes, the risks are much lower because if you do have a reaction, the medical professionals are right there to mitigate the impact.
The risks are personal, that’s the bottom line.
The benefits are mostly social. Herd immunity keeps really bad diseases from breaking out, something that is missing in the current measles outbreaks in the US and in Europe. If enough people get the vaccination, the disease can’t spread as easily and those who cannot be vaccinated, like people undergoing cancer treatments, or who are otherwise immune compromised, are far less likely to run into a carrier.
Economists are known for dismal discussions about the tragedy of the commons. This tragedy is a known phenomenon when a commonly managed resource gets run down because everybody has an incentive to over-consume because they are competing with their neighbours. The classic example from Hardin’s paper from whence we get the phrase “tragedy of the commons” is about over grazing of sheep, where each farmer has an incentive to let their animals consume as much as possible so they get to it before their neighbours do.
Hardin’s main point was the need to keep population down, but the majority of interpretations over the years has been to change the way things are managed, and to eliminate the commons in favour of private ownership. If you own all the land, you don’t need to compete with others for the use of its resources, and you’re more likely to conserve it as an asset for future use. The basic idea is that the benefits are personal and the costs are social if the asset is commonly owned. However, if it’s personally owned, the benefits and the costs are personal, so the incentive to conserve is stronger.
With vaccinations, the risks are all personal, and the benefits are most likely social. The medical system constantly emphasizes the benefits to the “herd” when talking about the importance of vaccinations. But to the parents who focus only on the risks to their own children, it doesn’t much matter what those actual risks are — autism or whatever. They are personal, and families have to pay the costs if something goes wrong. There is not much incentive other than altruism to convince skeptical parents that they need to vaccinate their kids. We know that talking facts at someone determined to disagree backfires, and further entrenches their own beliefs. And it seems altruism is not enough in the light of fear mongering.
We need to change the conversation around why people should nor should not vaccinate their kids. We already know the risks are personal. The pro-vaccination proponents do a terrible job of addressing these very real, if over-inflated fears, and move straight to the herd benefits. Talking about the social benefits is never going to convince a skeptic that their own kids are going to be safer. The two sides are talking past each other.
Let’s change the debate, change the conversation. Both sides of the debate need to be more nuanced in our arguments. Pro-vaxxers can start by acknowledging that personal risks are real. Maybe then we can get the people who are against vaccinations to listen and we can have a better dialogue and conversation.