I had always though that refusal to get a flu vaccination was relatively harmless masochism. Refusal to vaccinate one's own children, on the other hand, should probably be prosecuted as child abuse, but at the least the negative consequences stay close to home.
Yesterday, however, I read two articles on vaccination. One in Slate looks at the risks the unvaccinated pose to people with immunity problems (she's unable to get childcare for her child, who is undergoing cancer treatment, because the risk of being around unvaccinated children is too high). If that seems like a parochial problem ("my kid doesn't have cancer; why should I worry about vaccination rates?"), the other article, appearing in Wired, is feature-length, and focuses on the anti-vaccine movement and the dangers it poses to the health of everyone.
Both note the rise in non-vaccination and the concomitant rise in outbreaks of the scourges of yesteryear. And they were scourges:
Just 60 years ago, polio paralyzed 16,000 Americans every year, while rubella caused birth defects and mental retardation in as many as 20,000 newborns. Measles infected 4 million children, killing 3,000 annually, and a bacterium called Haemophilus influenzae type b caused Hib meningitis in mor ehtan 15,000 children, leaving many with permanent brain damage...
But refusing to vaccinate is more than just a convenient way of decreasing the probability you'll have to pay for college (and that your neighbor's kid with leukemia will survive). This is because the un-vaccinated put the vaccinated at risk.
The Risk to Us All
As told in the Wired article, an unvaccinated 17-year-old Indiana girl picked up measles on a 2005 trip to Bucharest. When she returned, she went to a church gathering of 500 people. Of the 50 attendees who had not been vaccinated, 32 developed measles. Any adults who got measles had at least made the choice to take on that risk, but the children had not.
Even worse are the two people who had been vaccinated but nonetheless got sick. They had been responsible and protected themselves, but this reckless 17-year-old and her parents endangered their lives. First, though, three cheers for vaccines. Of the unvaccinated, 64% got sick. Of the vaccinated and those with natural immunity, only 0.8% got sick.
But still, vaccines don't always work. Sometimes they don't take. Sometimes your immune response may have weakened (for instance, through aging). Or you might just have bad luck. A 2002 study in The Journal of Infectious Diseases determined that you were safer as an unvaccinated person in a well-vaccinated country than as a vaccinated person in a largely un-vaccinated country.
People who refuse vaccines aren't just risking themselves, and parents who refuse vaccines for their children aren't just risking their children, they are risking you and me.
What makes this even worse is that every baby is initially unvaccinated. Children have to reach a certain age in order to get vaccines. What protects babies is that everyone older is healthy (i.e., vaccinated). So adult vaccine-refuseniks made it through infancy partly thanks to everyone else getting vaccinated. But they aren't willing to give other babies the same chance.
Do people have the right to choose for themselves whether they want vaccines? Sure -- as long as they live on top of a mountain or on a deserted island away from contact with anyone else. Mandatory vaccination**, and now!
(**With medical exceptions, of course)