Commentary

Vaccination and Free Will

In Steven Spielberg’s 2002 sci-fi film Minority Report, a special police agency called PreCrime nabs suspects before they ever commit an offense. No trial is necessary because the crime is seen as an infallible prediction of the future and thus a matter of fact. The movie challenges viewers to consider the tension between technological determinism and free will, between the rights of an individual and the health of a community. It’s a useful metaphor for the argument against coercive vaccination.

Some argue that mandatory mass vaccination is an act of communal self-defense, and thus completely compatible with the principles underpinning a free society. Unless people are forcibly immunized, they will endanger the life and health of innocent bystanders, goes the argument. But such a position requires a level of precognition we haven’t yet attained.

Not everyone who is vaccinated against a microbe develops immunity to that microbe. Conversely, some unvaccinated people never become infected. Some people have inborn “natural” immunity against certain viruses and other microorganisms. Central Africans born with the sickle-cell trait provide a classic example of such inborn immunity: Their sickle-shaped red blood cells are inhospitable to the mosquito-borne parasite that causes malaria. Other people are just lucky and never get exposed to a contagious microbe.

Just like not every pregnant woman who drinks alcohol or smokes tobacco passes on a malady or disability to her newborn baby, not every pregnant woman infected with a virus or other microbe passes on the infection to her fetus-nor are all such babies born with birth defects.

A free society demands adherence to the non-aggression principle. No person should initiate force against another, and should only use force in retaliation or self-defense. Forcibly injecting substances-attenuated microbes or otherwise-into someone else’s body cannot be justified as an act of self-defense, because there is no way to determine with certainty that the person will ever be responsible for disease transmission.

Ronald Bailey suggests that the choice to remain unvaccinated is analogous to “walking down a street randomly swinging your fists without warning.” But this is a poor analogy. Such a person is engaging in a deliberate action, as opposed to choosing inaction. And, unlike those prevented from opting out of vaccination, the fist-swinger incurs no threat to life or limb when prohibited from throwing his punches.

If someone chooses the inaction of non-vaccination based upon the belief-right or wrong-that the vaccination is harmful or even life threatening, then coercive vaccination in this context is clearly a case of aggression. For it to be otherwise requires certainty that those beliefs are wrong. And certainty in this case is not possible. How can you be sure, for example, that a child won’t have an adverse or even fatal reaction to a vaccine? And how can defending forced immunization as self-defense be justified when it can never be shown with certainty that the non-vaccinated person would have been responsible for another person’s harm?

Then there is the matter of “herd immunity.” The phenomenon of herd immunity allows many unvaccinated people to avoid disease because they free ride off the significant portion of the population that is immunized. Economists point out that free riding is an unavoidable fact of life: People free ride when they purchase a new, improved, and cheaper product that was “pre-tested” on more affluent people who wanted to be the first to own it; people free ride when they use word-of-mouth reviews to decide whether to buy goods or services, or to see a film; those who choose not to carry concealed weapons free ride a degree of personal safety off the small percentage of the public that does.

So here is a way of thinking about it: As long as the person who is being free-ridden is still getting desired value for an acceptable price, and is not being harmed by the free riding, it really shouldn’t matter. Achieving a society without free riders is not only unnecessary, it is impossible.

Perhaps allowing a certain number of free riders could mitigate the disruption to liberty caused by mandatory vaccination programs. But then, how many free riders should be allowed? I don’t think that question can be answered with any degree of certainty. And what criteria would be used to decide who gets to ride free? An objective answer to this question appears equally elusive. Finally, how can the population be monitored to make sure the proportion of free riders is maintained at the right level without unreasonably infringing on civil liberties and privacy rights? The task would be titanic. I think the only practical solution-and the solution that is in the best interest of liberty-is to just accept the free riding of the current regime as a fact of reality, and focus instead on persuading people about the benefits of vaccination.

Most states coax, but don’t coerce, vaccination of children in the public school system. Two of the 50 states, Mississippi and West Virginia, are indeed coercive. But the remaining 48 allow parents to opt out for religious reasons, and 19 allow for some kind of philosophical objection. Some states require parents to read about the risks of opting out before exempting their children. Some require them to acknowledge in writing that, in the event of a major school outbreak of a contagious disease for which their child has not received immunization, he or she will be held out of school until the outbreak clears.

Private schools requiring vaccination of children as a precondition for admission is not coercive, since private education is a voluntary transaction. But even with the government school monopoly in existence today, immunization policy in at least 19 states is compatible with the non-aggression principle.

As a medical doctor I am a strong advocate of vaccination against communicable and infectious diseases. I am irritated by the hysteria and pseudo-science behind much of the anti-vaccination literature and rhetoric. In my perfect world, everyone would agree with me and voluntarily get vaccinated against the gamut of nasty diseases for which we have vaccines. (In my perfect world, pregnant women also wouldn’t smoke tobacco or drink alcohol until after delivery.)

But free societies are sometimes messy. To live in a free society, one must be willing to tolerate people who make bad decisions and bad choices, as long as they don’t directly infringe on the rights of others.

A strong argument can be made that it is self-defense to quarantine people who are infected with a disease-producing organism and are objectively threatening the contamination of others. But in such a case, the use of force against the disease carrier is based upon evidence that the carrier is contagious and may infect others.

Any mass immunization program that uses compulsion rather than persuasion will, on balance, do more harm to the well being of a free people than any good it was intended to convey.

Jeffrey A. Singer practices general surgery in Phoenix, Ariz., and is an adjunct scholar at the Cato Institute.