Measles makes a comeback. Who's to blame?

One of the biggest public-health issues facing American children today is a terrifying rise in the number of unvaccinated kids. The kids themselves, of course, are blameless: it’s their parents who are to blame. And who are those parents? Overwhelmingly, they’re millennials. In 2013, the latest year for which we have data, there were 3,932,181 live births in America. Of those, 3,054,449 — roughly 80% — were to mothers between the age of 20 and 34.

Right now, the big public-health scare is measles: there were over 100 cases reported in January alone, after the 2014 numbers shattered all records. Most of the people who contracted the disease were unvaccinated — but five of them had received their shots, and became ill just because the number of unvaccinated children was high enough to put an end to “herd immunity” in the area.

So, what’s going on? A large part of the answer can be found in the fact that women of childbearing age are disproportionately likely to have the false belief that there’s a link between vaccines and autism. A recent YouGov poll found that 21% of Americans between the ages of 18 and 29 think that early childhood vaccinations can “definitely” or “probably” cause autism, compared to just 13% of the American population as a whole. There’s a significant margin of error on those numbers, but don’t be reassured by statistical variance: given the margin of error, we know that somewhere between 15% and 27% of young Americans think there’s a link between vaccines and autism.

In a way, it’s more worrying that only 27% of 18-29 year-olds gave the correct answer, “definitely not”, to the question “Do you think early childhood vaccinations can cause autism?” If you include the people who answer “probably not” or “don’t know”, then three-quarters of American 18-29 year-olds, and 70% of Americans as a whole, are dangerously confused about vaccines.

Most worrying of all, the confusion is here to stay — and is only going to get worse. The idea of a link between vaccines and autism was first proposed in a 1998 paper which has long since been retracted, by an author who has long since been discredited. But even though there is no link, we’ve now had 17 years of headlines about whether or not there’s a link, 17 years of “controversy”, 17 years of people from Jenny McCarthy to Michele Bachmann suggesting that hey, maybe there is a link after all. Even Barack Obama, in 2008, said that he was “suspicious” about a possible link, adding that “the science right now is inconclusive”. (It wasn’t, and isn’t.) The inevitable consequence, given that most Americans have limited scientific literacy, is that they’re increasingly going to simply — and truthfully — say that they don’t know whether there’s a link or not.

Most new parents can’t even remember a time when vaccines were uncontroversial. Which is why the current political consensus — that vaccination decisions should be made by parents — is lethally dangerous. We don’t ask consent before putting fluoride in water or iodine in salt; we just do it, and as a result our societies are healthier, whether they like it or not. The way to do vaccination right is to make it mandatory, like in Mississippi. If you make it optional, after 17 years of high-profile controversy, it is certain that large numbers of parents will refuse to vaccinate their children. And that, as a result, parents across the country will see their children fall desperately ill. And sometimes die.

The current vaccination crisis, then, is not something which education can solve. (In fact, teaching anti-vaccine parents the truth about vaccines tends to make them even more anti-vaccine.) Today’s parents are well aware that there is a controversy about vaccines; many of them have also been taught by more than a decade of political rhetoric that the government is dangerous and not to be trusted in such matters. If we delegate this vital public-health decision to the current generation of parents, they will make the wrong decision. (Which is to say that more than 10% of them, in various parts of the country, will decide not to vaccinate.)

Any public-health official who decides that parents should have the final choice is a public-health official who is sentencing children across the country to needless suffering and death. We can’t blame the children, in these cases; but, frankly, we shouldn’t even be blaming the parents, either. The parents are behaving in entirely predictable ways. The real blame lies with the politicians who are refusing to accept responsibility for their decisions.