If you have any doubts, I'll be clear: the antivaccination movement is dangerous. Despite vast amounts of evidence that vaccines don't cause autism (and a host of other ailments), and the equally vast amount of evidence that vaccination is among the greatest medical achievements in human history, a lot of people have been scared into not vaccinating their kids. This puts their children at risk, as well as children around them: many of the outbreaks of measles, pertussis, and other diseases we've seen in the past few years are directly due to low vaccination rates.
What can we do? Some people advocate requiring parents to vaccinate their children. This is in theory a good solution; it would drastically lower outbreaks of preventable and potentially fatal diseases. And it's not like we have no other laws on how parents must care for their children. Almost every state requires children be in safety seats for cars, for example. And many schools require children be vaccinated before they can attend.
I'll admit though, that the idea of requiring vaccinations bugs me. I don't like it when the government forces me to do things for my own good, even when that good is overwhelmingly positive (like, say, seat belt use). I'll admit this is not a completely rational reaction -- more visceral, I'd say -- but it's a good indication that if we did try to pass laws requiring vaccinations, the outcry would be substantial.
But what's the alternative?
Well, physician Rahul Parikh has an idea: raise insurance premiums for parents who don't vaccinate their kids:
It's that fiction and the fear it incites that has challenged and frustrated pediatricians like me for 10 years. I don't foresee any quick shift in the trend among affluent, highly educated older parents against childhood vaccines. As [vaccine advocate Paul] Offit often points out, it's much harder to unscare people once they've been scared. [Antivaxxer Jenny] McCarthy has it easy. We doctors have to do the hard part.
Refusing to vaccinate a child is dangerous not just for that child but for entire communities. It's precisely this point a colleague of mine was considering when he had the idea that parents who refuse to vaccinate their kids should pay substantially higher health insurance premiums.
I love love love this idea. It makes sense, and follows logically from precedent. If you behave in a non-healthy or risky manner -- smoking cigarettes, and so on -- you have to pay a higher premium for health insurance. Given that insurance companies might have to pay maybe a few hundred dollars for vaccines, but potentially hundreds of thousands of dollars for health support for kids who are unvaccinated and who infect dozens of others -- there is some rational basis for having parents produce proof they have vaccinated their kids before qualifying for a lower premium.
This way, if you don't want to vaccinate your kid you still have that choice, but it'll cost you. Of course, there are details to this that need to be hammered out; some kids are allergic to vaccine ingredients, some might have religious reasons not to vaccinate (though I cast a very, very dim eye on that as you might expect), and so on. The point here is that not vaccinating is a choice, and one with potentially very serious consequences. I know that the nonsense the antivax movement peddles can be very persuasive to a newly-minted parent, but I also know most Americans can be very pragmatic when it comes to the bottom line.
I wonder how an idea like this gets traction. I'd love to see some actual research into it, and see how viable such a thing would be.
Syringe pic from ZaldyImg's Flickr photostream.
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