I received my absentee ballot in the mail yesterday. Imagine my surprise on finding a referendum question, not about sticking it to big pharma, or about the sacred principle of bodily autonomy, but about routine vaccination requirements for people choosing to attend public schools or seek employment in certain settings. It’s almost as if the forces behind the referendum, recognizing that few people support their desired outcome, are working (with a lamentable degree of success) to obscure what is and isn’t at stake here.
Individual laws do specific things, and should be evaluated on the costs and benefits of those specific things. Perceived weakening of a general principle is a potential cost of a given law, but a credible argument along those lines duly weighs the scope of the law and its likely effect on the principle. This law itself is modest in scope. It removes an abused exemption to a mandate for a routine and overwhelmingly safe procedure, and leaves in place the option of home-schooling for those whose objection to vaccination is genuinely strong. Turning to the principles, the idea that a yes vote will strike a blow against the pharmaceutical industry requires a belief that vaccination is central to its profit margin, which is certainly not the case. (It is, in fact, a common false claim of the anti-vaccination movement.) The loss of the comparatively small boost to pharmaceutical profits that would come from the law’s marginal increase in vaccination rates is not something that would cause wailing and gnashing of teeth. The Yes on 1 campaign’s suggestion to the contrary is, like the argument that you could stick it to the elites by supporting Donald Trump or Brexit, an attempt to take legitimate anger and manipulate it for selfish ends.
Then there’s the question of bodily autonomy. It is, indeed, an important general principle that you control what happens to and in your body or your child’s body. But in a complex society, any general principle is subject to certain exceptions. That’s why we have a society: to limit individual freedoms in certain ways and at certain times in the name of the greater good. What we have to consider here is, on the one hand, the likelihood that the law will lead to meaningful infringements on bodily autonomy, and on the other, the severity of the threat posed by declining vaccination rates. As for the former, I’ve seen no evidence that there is some great appetite to pass laws mandating or banning medical decisions that only a Yes vote on this particular law can check. (There is, of course, the desperation of the Republican Party to deny women control of their own bodies, but that’s obviously a phenomenon beyond the scope of the present law.) The more people pontificate about slippery slopes without identifying a single other sign that we’ve left level terrain, the less you should believe them. And as for the latter…
The great danger of the present historical moment is that Americans who grew up in an environment of extraordinary stability and safety take it for granted and dismiss warnings about its fragility as paranoia. But yes, declining vaccination rates do pose a serious risk. And you can’t entirely avoid that risk by getting vaccinated yourself. People who think that their personal willingness to get vaccinated means they can treat Question 1 purely as a philosophical dilemma are forgetting that there’s a reason it’s called public health. Even setting aside the fact that others you care about may have legitimate reasons not to be vaccinated and will therefore be at risk if breakdowns in herd immunity cause outbreaks, there’s a more basic calculation. Medical resources are finite, and outbreaks of preventable disease consume those resources, increasing the costs and risks of all treatment. In other words, you may well actually be doing the unscrupulous side of the pharmaceutical industry a bigger favor by opposing vaccinating mandates than by supporting them: there’s greater urgency, and greater profit potential, in sickness than in health.
I understand the appeal of treating this as a matter of principle. It’s nice to go to the polls and feel like you’re standing up for freedom, or the little guy, or anything else Jimmy Stewart once embodied in a movie. But life isn’t like that. It’s full of compromises and imperfections. As I said in my earlier blog post about this referendum, I regret that this law was necessary. But it was, and just as you do when you vote for the better of two candidates even if you don’t like either one, you should vote to uphold it, even if you would prefer to pretend that the other, easier answer is the right one.