A huge thanks to our friends at Colorado Parents for Vaccinated Communities for allowing us to share their Deciphering the Code: Navigating the Tricky Waters of Vaccine Policy and Anti-Vaccine Messaging
“Health choice.” “Parents’ rights.” “Medical freedom.” Do you think you know what those phrases mean? To an anti-vaccine activist, those are code phrases that likely mean something different to them than they do to you. Want to know more? Read on.
Serving as an elected official can feel like drinking from a fire hose on a daily basis. There are SO many things that policymakers have to consider and make decisions about, often with very little time.
This can make vaccine policy — particularly school/daycare exemption issues — especially tricky waters. Added to the mix is the tendency of those who fervently oppose vaccines (known as anti-vaccine activists) to use coded or misleading language.
Anyone who spends time in the world of politics understands that a certain amount of “spin” is par for the course. However, when we’re talking about the critically important issue of children’s health and safety, we need to be clear.
Unfortunately, there is an established history of well-meaning legislators having their positions distorted because of misleading language in anti-vaccine messaging.
Before we dive into the coded language a bit of background:
Vaccines have been called the greatest public health achievement of the 20th century. Non-industry public health groups across the world (from the World Health Organization on down) declare unequivocally that the benefits of vaccines greatly outweigh the risks.
Vaccines protect public health on both an individual and community level. Children (and adults) are safer when their vaccines are up-to-date.
However, no vaccine provides 100% protection against the consequences of a vaccine-preventable disease (VPD) outbreak. It’s like a car seat — you strap your toddler into a car seat to provide them better protection in case of an accident, but you still do everything you can to avoid getting into a car accident in the first place. The way we avoid those metaphorical car accidents — the outbreak of VPDs in a community — is by keeping overall vaccination rates so high that any incidence of the disease that enters the community doesn’t turn into an outbreak. This is called “herd immunity” (click here for a fun explanation from Penn and Teller) and the threshold for blocking a disease outbreak is high.
In fact, the necessary community vaccination/herd immunity rate is 90-95% for many of the most common VPDs. This is part of what makes Wisconsin’s low vaccination rates so troubling. Some schools and child care centers are home to pockets of unvaccinated children and have facility rates that are far, far below what is safe.
And now for the coded language used by those who oppose vaccines…
TRANSLATION: This code relies on a strawman. No one in the policy space is forcing parents to vaccinate their children. Parents do not have to vaccinate — period.
What we do talk about in the policy arena are vaccine guidelines for school entry. All 50 states have a policy of asking parents to show documentation of vaccination against communicable diseases if they want to send their child to school/daycare with other children. Children deserve to learn in safe environment free from preventable disease. No state mandates vaccines for children who are homeschooled, only those who wish to attend an in person school.
All 50 states also have rules allowing parents to exempt if their child is not medically able to be vaccinated (in fact, it’s largely because of those medically vulnerable unvaccinated children that maintaining strong herd immunity is so critical). Where we have our debates in the policy space are over the details of if (and how) parents can exempt their children from school/child care vaccine guidelines for non-medical reasons.
CODE: “Vaccine choice” (or “health choice”) .
Wisconsin’s most active anti-vaccine group is called Wisconsin United for Freedom. Regardless of whether the term used is “vaccine choice” or “health freedom,” the underlying meaning is the same. It’s common for those who don’t believe the scientific consensus on vaccines to attempt to frame the policy conversation as a matter of “choice” rather than having arguments about the science of vaccines. They don’t oppose vaccination (so the argument goes), they just believe it should be a matter of individual choice. You know… freedom.
Of course, no one is forcing anyone to vaccinate, so it already is a matter of individual choice. But when we start talking about children utilizing community schooling or daycare, it’s important to focus not only on “freedom to” (as in, freedom to skip vaccines) but “freedom from” preventable deadly diseases.
Children should have the right to go to school in a safe environment. While we can’t protect them from absolutely everything, we should take steps to prevent what is preventable — which includes vaccine-preventable diseases. Freedom is not an absolute or infinite right. As is often discussed in policy settings, your right to swing your fist ends where my nose begins. We don’t allow drunk driving because it endangers others. Vaccines are the same principle. Those who do not want to vaccinate their children have options. Freedom to make a choice does not free you from the consequences of that choice (e.g. needing to homeschool your child).
Children should have the right to go to school in a safe environment. While we can’t protect them from absolutely everything, we should take steps to prevent what is preventable — which includes vaccine-preventable diseases. Freedom is not an absolute or infinite right. As is often discussed in policy settings, your right to swing your fist ends where my nose begins.
CODE: “I vaccinate my own kids, but I think it should be up to each family to make their own decision.” (i.e. an attempt to find a moderate middle position) .
TRANSLATION: This is a non-sequitur. It’s terrific that you vaccinate your kids, but taking the decision away from families is not what’s on the table. Families DO have the ability to make this medical decision for themselves — that’s not the issue. What is the issue is whether babies and children have the right to be free and safe from preventable deadly diseases when they’re in school and child care. What the above code is really saying is, “I vaccinate my own kids, but I think that other families should be able to endanger vulnerable children and potentially cause a public health emergency in their school.”
CODE: “Parents’ rights”
While no one is advocating a policy that would literally force parents to vaccinate their children, our current laws do not recognize parental rights to the point of child endangerment in the case of a medical crisis. Our laws do not recognize one parent’s right to create a risk to other people’s children, either.
Ultimately, the vaccine conversation is different than other conversations about a parent’s right to make medical decisions for their child, because vaccination decisions affect the entire community’s safety. If parental decisions not to vaccinate create a cluster of unvaccinated children, which then allows one case of pertussis to become a pertussis outbreak, it could — quite literally — kill another mother’s 2-month-old baby.
CODE: “Where there is risk, there must be choice.”
CODE: “Medical freedom”
“Medical freedom” is a term that ties together all of the anti-vaccine codes discussed above. Those who oppose vaccines sometimes ask legislators, “Do you believe that parents have a right to make medical decisions for their child?” If the legislator answers, “Yes,” then the activist will categorize the legislator as being in favor of “medical freedom.”
But the problem is that, to an anti-vaccine activist, “medical freedom” is code for the idea that there should be no sideboards at all on vaccination as a way to protect public health. There is a reason why all 50 states have vaccine guidelines for school/child care entry.
In summary… No one is forcing parents to vaccinate their kids.
Infants and children should have the right to go to child care or school in a safe environment free from preventable disease.
So, if a parent wishes to utilize the benefits of communal schooling or licensed child care, it is reasonable that we set up some parameters for protecting the community’s health.