Treat the state’s vaccination exemption as public act it is
Shouldn’t we know where they live? California’s measles outbreak has touched off a debate about how to tighten state laws that make it easy for parents to choose — in defiance of all credible public health information — not to vaccinate their children. Newly introduced state legislation would eliminate the “Personal Belief Exemptions” that thousands of parents have used to avoid school vaccination requirements.
I’d be more than happy to see this proposal become law. But the politics of reducing parental choice are fraught, and there are limits to the law’s ability to compel good parenting. There’s also cultural reality: few things are more Californian than the freedom to believe the pseudo-religious or pseudo-scientific nonsense of your choice. So it’s likely parents will still find ways to avoid vaccinating their children.
So instead of targeting the choice of anti-vaccine parents, why not target the secrecy that surrounds that choice?
Under today’s privacy laws, school and health authorities must protect the identity of parents who choose not to vaccinate. That’s wrong. Parents who endanger the community’s health don’t deserve official protection. And the confidentiality of such exemptions makes it harder for communities to protect themselves.
After all, a parent who won’t vaccinate is not making a private family deci- sion: She is making a public health decision that profoundly affects others.
So let’s treat the exemption as the public act it is. Require a public body (city council or school board) to approve each exemption in a public session. And make each exempt parent’s name and address available on the Internet via a public registry.
The virtues of disclosure are clear. Having your family’s name published as a potential hazard to public health would be a powerful incentive for all but the most committed anti-vaxxers to vaccinate their kids. And the rest of us would be able to identify our unvaccinated neighbors. This would be especially helpful to pregnant women and the parents of children who are either too young to be vaccinated or have serious diseases like cancer that compromise immune systems and preclude vaccination.
In effect, the question of how to handle unvaccinated children and their parents would move from the realm of school administrators to the community at large. And the community level is where the question is best addressed, since we encounter the unvaccinated not only at school but also in parks, churches and stores.
There would be some risk of conflict in this shift (and any harassment must not be tolerated). But there would also be potential for the kind of conversations necessary to change minds and get more children vaccinated.
Those who have studied the question of how to persuade people to vaccinate report that the warnings of distant authorities — health departments, governors, President Obama — aren’t particularly effective. People you know — neighbors, friends, co-workers — make better emissaries to the unvaccinated. But you can only be an emissary to unvaccinated neighbors if you know they are unvaccinated.
Some committed opponents of vaccines may howl about their identities being made public, but such objections are easily turned against them. If you believe you have the power to make whatever decision you want for your children, why would you deny me the right to do the same, including the right to decide whether my children should be playing at the homes of people who have recklessly opted out of modernity?
That response may sound insufficiently sensitive to privacy. But for better and for worse, it fits the obligations of 21st century child rearing. As a parent myself, I’m repeatedly reminded — by all manner of officials and all the legal waivers that daily life requires me to sign — that I am required to know everything I can about my kids — where they are at all times, who they hang out with, and all their online movements. Why should this be any different?
This issue is personal. My own children are still little, and it will be a few more years before all three are old enough to have had all their vaccinations. It bothers me that, according to media-compiled data on vaccine exemptions, three of the 95 kids who attend our local kindergarten with my oldest son are unvaccinated because their parents have obtained Personal Belief Exemptions.
I should have the right to know who those families are. And I look forward to the day when I can engage them in conversation about what our families owe each other.