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There are situations where you should convince people, there are situations where you must mandate a decision. Whenever personal freedom produces large negative

There are situations where you should convince people, there are situations where you must mandate a decision. Whenever personal freedom produces large negative externalities, the law must mandate behaviours. These mandated behaviours should be such that freedom is restricted by the minimum needed amount. As an unrelated example: smoking is not prohibited; Smoking in closed public spaces is. For vaccination, I believe the sweet spot of mandated behaviour is to mandate vaccination of children participating in large public groups. Children that go to public schools must get vaccines. Children playing team sports must be vaccinated. Parents then maintain the freedom of not vaccinating their kids, but must abide by the rules that prevent those kids from being a menace to the rest of the population. Note that this is only needed because vaccines rely on "herd protection". If vaccination coverage drops, vaccine efficacy drops precipitously. The effect is very pronounced. 90% coverage is much less effective than 99% coverage. Not vaccinating a child poses a risk for the child, but also poses a risk to all other children he/she is in regular contact with. P.S. A lot of other discussions may arise: Government prohibitions tend to be slippery slopes; Children should be somewhat protected from their own parents; Should groups be allowed to skip vaccination altogether?. These are secondary issues, irrelevant to the main decision that is: Mandate vaccination for children that are members of larger groups, so that the group maintains disease protection.

JonFish85 12y ago
I think one problem would be how much can we legally restrict from society someone who isn't vaccinated? Can work places restrict this (especially ones like hospitals and the like)? What about government jobs? What about health insurance companies? Life insurance companies? Public transportation? Flying? What about the government-subsidized/provided health care? Can they mandate vaccines? They're free to roam about our society as they please (within reason).
- sergiosgc 12y ago
  Here, it helps that the problem is more acute in children groups. It is acceptable for schools to require proof of vaccination on admission. It is also acceptable for sports clubs to do so on admission. Mixed adult/children environments are not as problematic, because adults resist better to these diseases and so the infection rate gets a lot lower. A lot of text to say that this is a Pareto rule scenario. Cover the 20% of places where kids spend 80% of their social time and you get most of the needed protection.
  - notacoward 12y ago
    I think you're missing the point. The question is not whether it's effective for a business to exclude the unvaccinated. The question is whether it's legal, or perhaps whether it's morally acceptable. AFAIK yes it is, and it should stay that way for the exact same "get the government off everyone's back" reason that people use to resist a vaccination mandate. Businesses of all types should have that freedom, and IMO they should use it.
- notacoward 12y ago
  "Can work places restrict this" Absolutely. Voluntary disease carriers are not a protected class under any law. If there is a scientifically and legally provable threat to others' health and safety, I'd say a business has a responsibility to reduce that threat. The main way these outbreaks start, quite likely including the one at Disneyland, is unvaccinated people coming back from places where measles are still endemic. Those people are walking bioweapons. If they're not going to be quarantined at the border, then it's up to businesses to contain the damage as best they can.
  - DrJosiah 12y ago
    A good lawyer could argue that non-vaccinated people are not taking sufficient precautions in preventing themselves from being an accidental bioweapon, and are through voluntary and explicit negligence committing a treasonous act.
  - JonFish85 12y ago
    What about the ones that do it for religious reasons? I have to imagine that these are a non-trivial number of people.
    - notacoward 12y ago
      Religion is protected, of course, but the majority of refusals to vaccinate are based on "personal belief" or "philosophical" rather than true religious grounds. https://www.americanprogress.org/issues/healthcare/report/2013/11/14/76471/the-effect-of-childhood-vaccine-exemptions-on-disease-outbreaks/ https://www.americanprogress.org/issues/healthcare/report/20... Unfortunately, once you allow for religious exemptions it becomes hard to distinguish sincere people of faith from the more common agnostic (sometimes even actively atheistic) bioterrorists. Thus, it might be impractical for businesses and their proprietors to exercise their rights in this area.
    - DrJosiah 12y ago
      There are people who claim religious exemptions, but aside from fringe sects of Christianity (some Amish, and a handful of <20k member denominations), no major religion or religious denomination practiced in the US forbids vaccinations.
- Kevguy 12y ago
  Most hospitals(1) require all their employees to get yearly flu vaccinations with threat of termination if you refuse. (1) I only have direct experience with two hospitals in the area, but based on other employees reactions, this is standard procedure.
conkrete 12y ago
Pardon my ignorance, but I am curious. If one child in classroom full of children is not vaccinated, what risk is posed to the vaccinated children?
- wtallis 12y ago
  Vaccines aren't 100% effective.
  - ptaipale 12y ago
    ... on a single person, but in a close to 100 % vaccinated population, they are close to 100 % effective.
- notacoward 12y ago
  The issue is not just risk to vaccinated children, but risk to the legitimately unvaccinated - too young, immunocompromised, any other condition that's scientifically known to make vaccination unsafe. Those people can't rely on vaccination, so they must rely on herd immunity. When herd immunity weakens beyond a certain point, those people are completely vulnerable for reasons that have nothing to do with their own choices. When we talk about the freedom of some people to forego vaccination, we're talking about taking away these other people's freedom to participate normally in society without significant risk of contracting an often crippling or even fatal disease.
- austenallred 12y ago
  Not all children are able to be vaccinated for medical reasons (allergies, weak immune systems/cancer). They could also potentially carry the disease to children who aren't old enough to be vaccinated yet.
- undersuit 12y ago
  In the recent Disneyland/California measles outbreak, 5 of the infected were considered vaccinated against measles. http://www.cdph.ca.gov/Pages/NR15-008.aspx http://www.cdph.ca.gov/Pages/NR15-008.aspx
- 12y ago
noonespecial 12y ago
We should handle this the same way we handle other negative externalities. With taxes. You certainly have the right not to vaccinate, but you should bear the full cost of that decision and not simply be allowed to free ride on the herd immunity of other people who did accept the small (mostly perceived) risk of vaccination. I'm betting once there is even a small tax on skipping out, most of this nonsense will vanish like smoke.
- undersuit 12y ago
  Taxing people who don't vaccinate their children has got to be the easiest way to pour gasoline on the libertarian fire.
  - aidenn0 12y ago
    I don't see why; if we can quantify the average economic cost to others of you not vaccinating your children, then by charging that to people who don't vaccinate, we are merely increasing the efficiency of the free market by removing an externality. That's about as Libertarian as you can get.

JonFish85 12y ago

I think one problem would be how much can we legally restrict from society someone who isn't vaccinated? Can work places restrict this (especially ones like hospitals and the like)? What about government jobs? What about health insurance companies? Life insurance companies? Public transportation? Flying? What about the government-subsidized/provided health care? Can they mandate vaccines? They're free to roam about our society as they please (within reason).

sergiosgc 12y ago
Here, it helps that the problem is more acute in children groups. It is acceptable for schools to require proof of vaccination on admission. It is also acceptable for sports clubs to do so on admission. Mixed adult/children environments are not as problematic, because adults resist better to these diseases and so the infection rate gets a lot lower. A lot of text to say that this is a Pareto rule scenario. Cover the 20% of places where kids spend 80% of their social time and you get most of the needed protection.
- notacoward 12y ago
  I think you're missing the point. The question is not whether it's effective for a business to exclude the unvaccinated. The question is whether it's legal, or perhaps whether it's morally acceptable. AFAIK yes it is, and it should stay that way for the exact same "get the government off everyone's back" reason that people use to resist a vaccination mandate. Businesses of all types should have that freedom, and IMO they should use it.
notacoward 12y ago
"Can work places restrict this" Absolutely. Voluntary disease carriers are not a protected class under any law. If there is a scientifically and legally provable threat to others' health and safety, I'd say a business has a responsibility to reduce that threat. The main way these outbreaks start, quite likely including the one at Disneyland, is unvaccinated people coming back from places where measles are still endemic. Those people are walking bioweapons. If they're not going to be quarantined at the border, then it's up to businesses to contain the damage as best they can.
- DrJosiah 12y ago
  A good lawyer could argue that non-vaccinated people are not taking sufficient precautions in preventing themselves from being an accidental bioweapon, and are through voluntary and explicit negligence committing a treasonous act.
- JonFish85 12y ago
  What about the ones that do it for religious reasons? I have to imagine that these are a non-trivial number of people.
  - notacoward 12y ago
    Religion is protected, of course, but the majority of refusals to vaccinate are based on "personal belief" or "philosophical" rather than true religious grounds. https://www.americanprogress.org/issues/healthcare/report/2013/11/14/76471/the-effect-of-childhood-vaccine-exemptions-on-disease-outbreaks/ https://www.americanprogress.org/issues/healthcare/report/20... Unfortunately, once you allow for religious exemptions it becomes hard to distinguish sincere people of faith from the more common agnostic (sometimes even actively atheistic) bioterrorists. Thus, it might be impractical for businesses and their proprietors to exercise their rights in this area.
  - DrJosiah 12y ago
    There are people who claim religious exemptions, but aside from fringe sects of Christianity (some Amish, and a handful of <20k member denominations), no major religion or religious denomination practiced in the US forbids vaccinations.
Kevguy 12y ago
Most hospitals(1) require all their employees to get yearly flu vaccinations with threat of termination if you refuse. (1) I only have direct experience with two hospitals in the area, but based on other employees reactions, this is standard procedure.

conkrete 12y ago

Pardon my ignorance, but I am curious. If one child in classroom full of children is not vaccinated, what risk is posed to the vaccinated children?

wtallis 12y ago
Vaccines aren't 100% effective.
- ptaipale 12y ago
  ... on a single person, but in a close to 100 % vaccinated population, they are close to 100 % effective.
notacoward 12y ago
The issue is not just risk to vaccinated children, but risk to the legitimately unvaccinated - too young, immunocompromised, any other condition that's scientifically known to make vaccination unsafe. Those people can't rely on vaccination, so they must rely on herd immunity. When herd immunity weakens beyond a certain point, those people are completely vulnerable for reasons that have nothing to do with their own choices. When we talk about the freedom of some people to forego vaccination, we're talking about taking away these other people's freedom to participate normally in society without significant risk of contracting an often crippling or even fatal disease.
austenallred 12y ago
Not all children are able to be vaccinated for medical reasons (allergies, weak immune systems/cancer). They could also potentially carry the disease to children who aren't old enough to be vaccinated yet.
undersuit 12y ago
In the recent Disneyland/California measles outbreak, 5 of the infected were considered vaccinated against measles. http://www.cdph.ca.gov/Pages/NR15-008.aspx http://www.cdph.ca.gov/Pages/NR15-008.aspx
12y ago

noonespecial 12y ago

We should handle this the same way we handle other negative externalities. With taxes. You certainly have the right not to vaccinate, but you should bear the full cost of that decision and not simply be allowed to free ride on the herd immunity of other people who did accept the small (mostly perceived) risk of vaccination. I'm betting once there is even a small tax on skipping out, most of this nonsense will vanish like smoke.

undersuit 12y ago
Taxing people who don't vaccinate their children has got to be the easiest way to pour gasoline on the libertarian fire.
- aidenn0 12y ago
  I don't see why; if we can quantify the average economic cost to others of you not vaccinating your children, then by charging that to people who don't vaccinate, we are merely increasing the efficiency of the free market by removing an externality. That's about as Libertarian as you can get.