Why (More) Americans Don't Vaccinate

Today’s New York Times article on the growth of the Anti-Vaccination movement in America, particularly in response to the swine flu vaccine, got me thinking.  Why would otherwise rational human beings choose not to take advantage of a medical advance that is easily, affordably available?


1.  Memory is short.

The World War II generation saw polio personally and up close, if nowhere else than in their President.  They saw friends disfigured and dying from disease.   The advent of vaccines in the 1950s was considered a gift from God, and their children, the Baby Boomers, were all inoculated and polio, for example went from 35,000 cases a year to 121 in only 11 years .  These same Baby Boomers who are raising kids today didn’t live through that nightmare, don’t see a reason to bother anymore, and people in my generation, Generation X, are also part of this movement for similar reasons.

When I received my travel vaccinations for East Africa a few years ago, I did some research into the diseases I was being innoculated against.  Typhoid, Hepatitis B, Yellow Fever.  Most of these are diseases caused by impure drinking water.   People in Africa are still dying from these diseases, 2.5 Million people to be exact, and the diseases of childhood that none of us know personally anymore, thankfully:  measles, polio, mumps, rubella, diptheria, tetanus.  For a $20 co pay, I have life giving immunity from all of these. And I guarantee that if you asked the hundreds of thousands of African mothers whether the “equivalent inexpensive” value of a vaccination was worth the risk, especially a risk that has never been confirmed by any major medical journal, they’d be lined up around the block.

These diseases have never gone away, and with the advent of Jet Travel and massive waves of immigration, they still can enter the US quite easily.  Maybe a few media headlines of polio outbreaks will be enough to remind us that these diseases are so horrible that the vaccine is worth a slight risk.

2.  Distrust of the Government and Big Business

Over the last 30 years, scandals such as Watergate, Agent Orange, Enron, Big tobacco, the Ford Pinto, Bernie Mathers, political sex and bribery scandals,  the recent credit derivative mess, no weapons of mass destruction, etc etc ad nauseum have disillusioned the population to the point where they no longer trust large entities or soon, authority of any kind.  This is both positive, in that citizens need to be involved in their democracy, and negative, because when the government or big business tries to push a meaningful point such as vaccination or public health care, the populace will not listen. They think the government is corrupt, and that big greedy business is selling a tainted product.

Once trust is destroyed it will take a very long time to regain. Our nations’ political and business leaders would do well to start thinking about how to lead again — because it won’t be long before order will start to break down, which runs the risk of a fascist clamp down. I don’t mean to be all tin foil hat–but if you follow this mistrust to its logical conclusion, that’s where it leads.

3.  The rise of the individual vs. the collective

The 60′s “me” generation has brought their emphasis on self and self actualization to our culture.  There are positives in this–everyone should be free to choose their own path in life, not forced into conformation.  Too much of this, however is leading to a total disregard for the idea of self-sacrifice for the good of society or community.  Those who reject vaccines for reasons other than allergies are thinking only of the risk to themselves and ignoring the cost borne by society of their lack of immunity.  The concept of herd immunity has no relevance if your main value system focuses on self actualization.

That’s a hard one to fix, but certainly in the past the wealthy nobles, even the early robber barons, subscribed to the concept of Noblesse Oblige–literally the obligation of the nobility.  Look all of the philathropic work you see under the Getty, Rockefeller, Annenberg, and other foundations.  Short of Warren Buffet, Bill Gates, Pierre Omidyar, and Jeff Skoll, who is starting foundations out of their wealth gained in the last 30 years? What about all the people who made massive amounts of money in the credit debacle?  Where are they?  We’ve lost in America the sense of We.

4.  Lack of investment in the Educational System

Systematic reductions in education spending and teacher salaries are leading to a decline in test scores.  Less education means a populace less capable of making rational, informed decisions, and subjects us to the risks of populism.

Is it then any surprise that an under educated, forgetful, mistrustful, self oriented people would reject vaccines?

If you’re still on the fence, here’s some more reading:

Measles in Africa cut by 90% due to Vaccines

Remembering Polio, an Oral History

Vaccine Education Center, Children’s Hospital of Philadelphia

  • http://www.yairharel.com Yair ‘Jay’ Harel

    Very good points. The latest issues of Wired and Skeptic magazines feature great coverage of the issue – both are highly recommended. The Skeptic piece is only available in the print addition, the Wired article is available here: http://www.wired.com/magazine/2009/10/ff_waronscience