The Connecticut legislature wants to abolish the last non-medical exception for the compulsory vaccination of children, following in the steps of five other state governments (“Connecticut Lawmakers Brace for Public Hearings on Vaccination Bills,” Wall Street Journal, February 15, 2010). Two serious economic arguments can be made in favor of this measure. (It wouldn’t protect against the coronavirus, for which there is yet no vaccine, but this epidemic is certainly a motivation or an excuse for strengthening compulsory vaccination.)
The first argument is a public good argument, which can be summarized as follows. Everybody potentially benefits from other individuals being vaccinated, the main beneficiary being those whose age or state of health precludes vaccination. Immunization through vaccination is thus a public good, to the production of which everybody must contribute. A large part of this contribution consists in having oneself vaccinated. In order to prevent potential free riders from skirting vaccination while benefiting from that of others—benefiting from the so-called “herd immunity”—compulsory vaccination is justified. Richard Epstein’s article “Let the Shoemaker Stick to His Last” (Perspectives in Biology and Medicine 46:3, 2003) can be interpreted this way.
The second argument for “compulsory” vaccination relates to the fact that, nowadays, it is, thus far, advocated only for children as a condition for admission in public schools (or perhaps private schools too). A child, the argument goes, is, by definition, too young to know where his own interest lies, especially in probabilistic choices such as between the risk and consequences of catching the disease on one side, and the inconvenience and risk of vaccination on the other side. The child’s parents must make the choice. However, as was famously said in a slightly different context:
A priori, parents would ideally always be willing and able to protect children from tobacco themselves. If this happened, there would be little need for governments to duplicate such efforts. Perfect parents, however, are rare.
This statement is due to Prabhat Jha et al., “The Economic Rationale for Intervention in the Tobacco Market,” in Prabhat Jha and Frank J. Chaloupka, Eds., Tobacco Control in Developing Countries (World Bank and Oxford University Press, 2000), p. 164. Note that the title of the book is a misnomer, for it is concerned as much with rich countries as developing ones.
The validity the two arguments for compulsory vaccination, even for children, is not obvious.
The first argument is analogous to the one that Thomas Hobbes, in his 1651 book Leviathan, made for the state in general. Since the security provided by the state is in everybody’s interest—since it is, in today’s terms, a public good—it is also in everybody’s interest not only that everybody contribute to financing the state, but also that the state be the only judge of everybody’s contribution. Otherwise, free riders will ride. Or so claimed Hobbes.
One problem with the Hobbesian argument, as well as with the public-health argument for compulsory vaccination, is that it justifies absolute power. Although Hobbes took the argument very seriously, some would dismiss the fear of tyranny as a slippery-slope argument. As if slippery slopes did not exist. Consider how, in the early 20th century, compulsory vaccination was used to legalize forced sterilization. The famous 1927 Supreme Court decision in Buck v. Bell (274 U.S. 200) said it clearly:
The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.
It was not an abstract matter. The decision legalized previous and future forced sterilizations against individuals deemed to be “imbecile,” “feebleminded,” “defective,” or “socially inadequate.” It is estimated that more than 65,000 Americans were forcibly sterilized up to the 1980s. The last sterilization statute, in Mississippi, was only repealed in 2008. (On this topic, see Paul A. Lombardo, Three Generations, No Imbeciles: Eugenics, the Supreme Court, and Buck v. Bell [John Hopkins University Press,2008].)
Another problem with the public-good argument is that, technically, it only applies to goods or services unanimously desired. If basic security against aggression can be assumed to be a public good, the assumption becomes less valid as it is extended to other goods or services. Indeed, from what we can observe in the anti-vaxxer movements, many people do not want vaccination because they think that its cost is higher than its benefits for them or their children. From the point of view of a philosopher-king, this may be true or not, but it is not correct to think that there is no “objective” risk. For example, philosopher Mark Navin (who believes that compulsory vaccination is morally justified) cites the Centers for Disease Control and Prevention according to whom the DTaP vaccine (against diphtheria, tetanus, and whooping cough) causes long-term seizures or brain damage in “only” one out 1,000,000 children (Values and Vaccine Refusal: Hard Questions in Ethics [Routledge, 2016]).
Furthermore, there is a good economic argument against government pretending to determine the “optimal” vaccination coverage. University of Chicago economist Tomas Philipson brilliantly argued that the fewer the number of people who get vaccinated, the higher the risk factor for the unvaccinated, and the higher the latter’s incentives to get vaccinated (or to use other prevention measures). (See notably his “Economic Epidemiology and Infectious Diseases,” in A.J. Culyer and J.P. Newhouse, Eds., Handbook of Health Economics, Vol. 1 [Elsevier Science B.V., 2000].)
As for the argument that imperfect parents cannot be trusted to make decisions in the best interest of their children, the basic counterargument is quite simple: have you seen many perfect politicians and perfect bureaucrats? Despite a few extreme and troubling cases, parents have been genetically hard-wired to look out for their children’s interests. There is no such hard-wiring for the state.
To be clear—and to this extent that this may seem relevant—I am not arguing that the anti-vaxxers are right. In fact, I don’t agree with their evaluation of costs, but I don’t claim that their children belong to me either.
In this short post, I have only scratched the surface of the issue. It may get especially pressing if an epidemic scare grips the public. It will be interesting to see if populists affirm the primacy of individual choices or, at least, the presumption of individual liberty or, instead, just follow a frightened and irrational mob.
READER COMMENTS
robc
Feb 17 2020 at 7:44am
On the one hand, I oppose mandatory vaccination.
On the other hand, I am fully vaccinated as is my 4 year old daughter (up to date, anyway).
On the gripping hand, she is diagnosed as on the spectrum and I probably am too (undiagnosed).
BC
Feb 17 2020 at 3:00pm
Your positions are not contradictory and don’t require multiple hands. Just because you think that vaccination makes sense for you and your children does not mean that you should want to make vaccination mandatory for everyone else. It means that you understand the concept of freedom and the value of distributed, non-centralized decision making.
On the externality/public goods argument, we have a standard that says the externality imposed on a fetus (certain death) from abortion is insufficiently large to justify infringing a mother’s bodily autonomy. I struggle to find an externality argument in favor of mandatory vaccination consistent with that standard.
Pierre Lemieux
Feb 18 2020 at 12:57am
BC: Interesting argument about abortion.
robc
Feb 18 2020 at 7:56am
I just wanted to make a gripping hand joke.
I thought it was funny (I thinks its funny anyway) that that point would be used as evidence by the anti-vaxxers.
Matthias Görgens
Feb 17 2020 at 7:55am
The arguments here seem a bit convoluted and sometimes far fetched.
Wouldn’t a much simpler argument be: yes, there are externalities from vaccination. But they are finite. So let’s use the standard strategy of pigovian taxes / subsidies.
Herd immunity is not fundamentally a different public good than clean air or uncongested streets.
Do some science to estimate the size of the externalities from vaccination. Then tax unvaccinated people and/or pay vaccinated people an appropriate amount. Once the externalities are internalised, people can go back to making their own decisions.
If you feel fancy, you can make the specific payments depend not only on the specifics of the disease in question, but also vary them depending on the rate of vaccination amongst the general public if that reflects the externalities better. (I haven’t done the math.)
The side that wants to make vaccination compulsory would need the grand morale theories you mention. But the boring and pragmatical approach of pigovian taxes doesn’t interfere too much with individual people’s lives. (But it’s also harder to get anyone excited enough to change their vote based on whether a candidate is for or against small payments for vaccination.)
Matthias Görgens
Feb 17 2020 at 8:01am
PS I formulated my suggestion in the form of a tax/subsidy.
Just as with a carbon tax, you can get theoretically similar results with a cap-and-trade system. (They play out different in political practice, though.)
What’s interesting here, is that with a cap and trade system that eg says that 90% of the population can be unvaccinated to still get herd immuni
Matthias Görgens
Feb 17 2020 at 8:03am
Oops, sent too early.
In any case, a cap and trade system would very clearly show the stark moral divide of the top down force to have eg 90% of the population vaccinated, but any one individual could opt out, if they cared enough.
Jon Murphy
Feb 17 2020 at 8:05am
Pigouvian taxation is straightforward on paper, but in practice, it’s not that easy. Your first step of “do some science” is fraught with all kinds of perils.
robc
Feb 17 2020 at 8:12am
This is a general question, not specific to this case but applies here too:
Why would anyone skip ahead to pigovian taxes without first considering coasean bargaining.
Pigovian taxes is, at best, 3rd choice, behind Coase and doing nothing.
Dylan
Feb 17 2020 at 9:05am
Would it be generally straightforward to be able to prove a specific individual caused an outbreak?
Dylan
Feb 17 2020 at 9:09am
This was meant to be a reply to your response below to Alan.
But, answering the question here. Coasean bargaining seems difficult enough to pull off in cases where it is just two parties transacting (there was a discussion of this a little while back in the comments to one of David’s posts in regards to bargaining with neighbors, which seems like it should be one of the most straightforward applications of Coasean bargaining available). When you’re dealing with all of society, I’ve got trouble even imagining what a Coasean bargain would look like and who would coordinate it if not the government(s)?
robc
Feb 17 2020 at 9:14am
I agree, I think this is a situation when the transaction costs are too high for Coasean bargaining to work.
My issue was with calling Pigovian taxes “the standard strategy”. It should only be considered after Coasean bargaining and doing nothing have been dismissed as viable strategies.
And while I think Coasean bargaining can be dismissed, I think doing nothing is pretty viable for the reasons the article discussed.
robc
Feb 17 2020 at 9:16am
“Patient zero” has been tracked down in the past for other outbreaks, so I would think it is reasonable. Easier than some torts to prove, harder than others. Not so outside the norm to call it extreme.
Pierre Lemieux
Feb 17 2020 at 11:16am
Perhaps. But is it the first human who unknowingly transmitted the virus who is liable, or the owner of the pig that transmitted the virus to the first infected human, or the owner of the mother of the pig without which the specific pig would not have existed, or the owner of the fence that did not guard the pig prophylactically well enough?
robc
Feb 17 2020 at 11:41am
All good questions. That is the kind of thing common law is pretty good at figuring out.
Matthias Görgens
Feb 17 2020 at 11:24am
True, I was a bit too quick off the mark.
You provided some other alternatives.
The point I was trying to make is that you can grant the side that there are real externalities, without conceding their conclusion that individual choice needs to be overridden. Even if you agree that some people make dumb choices.
Thaomas
Feb 17 2020 at 3:45pm
Coasian bargaining is and has been available since the beginning of time. How does one recommend that it “be done?” And If doing nothing is always better than Pigou taxation, that that’s the answer in all cases. No data necessary.
robc
Feb 18 2020 at 12:06pm
Coasean bargaining can be “encouraged” (I guess is the right word), by the legal system defining property rights in the way that minimizes transaction costs.
As far as “doing nothing”, it is always better than Pigovian taxation when it works. For example, I think doing nothing will solve climate issues better than a Pigovian carbon tax, so there is no need to go to step 3.
If coasean bargaining and doing nothing don’t work, then considering pigovian taxes makes sense. And then you still have the knowledge problem that may still make going back to doing nothing as the better solution. There is probably some rare situation when pigovian taxes do make sense, I won’t exclude it as a possibility.
Hazel Meade
Feb 17 2020 at 10:39am
Interesting comment.
I’ve argued in the past for using social sanctions against parents that don’t vaccinate their kids – i.e. don’t let your kids play with kids that aren’t vaccinated. But it seems like pigovian taxes / subsidies might be fairer and less prone to abuse or extremes of behavior. There’s sort of two possible paths (not necessarily exclusive) by which society can regulate behaviors that have negative externalities – you could tax those behaviors (or subsidize the opposite), and/or you could shun people who behave those ways and establish a social norm against that behavior. The informal system involves less coercion, but is more uniform and fair, while the informal system is less coercive but may be prone to abusive extremes of behavior.
It occurs to me that this same choice exist with respect to prejudice and anti-discrimination law – you could have an informal system in which racism/sexism/homophobia/etc. is socially unacceptable and people who exhibit racist speech are shunned and ostracized, but that would also be subject to unfair extremes, such as people being doxed and harassed on Twitter, etc. Or you could have a more formal system in which you basically tax discrimination and/or subsidize non-discrimination.
In other words, you have just provided me with a “third way” that society could suppress racism – instead of making it strictly illegal, you tax it. I.e. provide a tax break to corporations that adhere to EEOC standards, impose a tax on bakeries that won’t bake cakes for gay weddings.
Hazel Meade
Feb 17 2020 at 10:42am
Er the FORMAL system involves more coercion, but is more uniform an fair.
There’s this dicotomy between formal rules and informal rules. Formal rules tend to be more fair and uniformly applied. But informal rules are less coercive. Libertarians tend to come down on the side of informal rules, but that tends to make society overall less fair.
Thaomas
Feb 17 2020 at 12:13pm
I’ve advocated a “small bigot” exemption from anti-decriminalization laws for those who have very strong preferences for bigoted behavior on the grounds that a bit of isolated racism/homophobia/Islamophobia/etc. does little harm. It’s sort of the reverse of the theory of “broken windows” law enforcement.
Hazel Meade
Feb 17 2020 at 1:15pm
Right, but this way there’s no discontinuity or ambiguity in who is a “small bigot” and who is a “large bigot”. You just have a uniform tax of some kind, proportional to corporate income or number of employees or something so it scales with the size of the business.
Thaomas
Feb 17 2020 at 3:53pm
Agree. My guess is that in most cases drawing the line at individual proprietorship would work. In fact the best solution might be discretionary enforcement. It really is idiotic for the state to go after the baker who does not want to make a cake for a gay marriage. Who did the cost benefit analysis on that enforcement action?
Pierre Lemieux
Feb 17 2020 at 11:08am
@Mathias: Your crucial sentence is:
First, it implies that vaccination is not a public good, but only a good that transmits positive externalities to—is public for—a certain section of society.
Second, it emphasizes the need for a grand moral theory as you say, and this theory presumably needs to be, in a sense, unanimously consented to.
Alan Goldhammer
Feb 17 2020 at 8:11am
An extreme argument could be to use tort law to recoup damages from an illness outbreak transmitted by an unvaccinated individual.
robc
Feb 17 2020 at 8:15am
Is that really extreme? Its the way similar low probability events are handled. You could even buy “outbreak insurance” to cover you in case you caused one.
Hazel Meade
Feb 17 2020 at 1:47pm
An option would be to require voluntarily unvaccinated individuals to carry liability insurance. I think it would actually work out to be the same thing though, because the likelihood of being able to track down “patient zero” in all cases is pretty low, and the costs of having to pursue tort cases in all of these events would make it extremely inefficient. The tax on not being vaccinated would cost way less to administer.
Pierre Lemieux
Feb 18 2020 at 11:18am
Hazel: Behavioral taxes on minorities cost less than subsidies because only the (deplorable) people whose behavior is targeted complain while, in the case of a subsidy, a large number of taxpayers will complain. This is a good feature of subsidies.
Hazel Meade
Feb 18 2020 at 3:43pm
True, but it’s also problematic that only a few unvaccinated people will ever actually get “caught” spreading a disease, while most will go unpunished. That’s less fair than applying a uniform tax on not being vaccinated.
Pierre Lemieux
Feb 21 2020 at 11:41pm
Perhaps I don’t understand your argument, Hazel, but if I do understand it, it is not correct. A subsidy has the same effect as a tax (if the endowment effect attenuates this, a slightly higher subsidy will reestablish the equivalence) and can be as fair: the government offers a vaccination subsidy (bribe) to anybody who has not been vaccinated in order to incite him to get vaccinated. The only difficulty I see is that it is more difficult, in a free society, to be sure that a targeted person has not been vaccinated than he has. Under our Surveillance (your-papers-please) State, though, any medical act leaves a trace, so the state can probably find out if somebody has not been vaccinated because there is no record anywhere. At any rate, a non-vaccinated person getting a subsidy could not cheat twice. And, again, there would be a built-in efficiency measure: when the taxpayers don’t want to continue paying, it is an indication that, for them, the benefit of the marginal vaccination exceeds its cost.
Matthias Görgens
Feb 17 2020 at 11:26am
Vaccination are pretty good, but they don’t provide 100% protection.
Though I assume that the outbreak insurance for an insured person would be significantly cheaper.
Thaomas
Feb 17 2020 at 12:22pm
That runs up against Coasian legal transactions costs. Private individuals would need to do the epidemiology to establish the source of the infection and organize the class action suit to make the recovery of damages + transactions cost worthwhile. In theory there could be firms that identify externalities and sell there litigation services to potential class actioners, but probably public health departments exist for a reason.
Pierre Lemieux
Feb 21 2020 at 11:43pm
Yes. The main reason why public health departments as we know them exist is for the majority or a minority to control the lifestyles they don’t like.
Jon Murphy
Feb 17 2020 at 8:31am
One can make the public good argument (either from an economic definition or a colloquial definition), but as you rightfully point out, the issue is fraught with perils. The slippery slope argument is very prevalent, especially in a common law system like ours. Many of these “fine-tuners” believe themselves to be like God commanding the waves “come here, but no farther” (Job 38:11).
All that said, I think one can make an argument for mandatory vaccinations from a classically liberal justice perspective. Drawing on the work of Adam Smith, I invoke the tension between individual liberty and overall liberty.
Smith, in Theory of Moral Sentiments, discusses how a sovereign may “with universal approbation” compel his subjects to act in a certain manner with one another (TMS pg. 81.8 of the Liberty Fund edition). These actions are designed to promote certain propriety and benevolence to one another, actions that cannot be compelled by jural equals. Specifically, Smith mentions the obligation of parents to maintain their children and vice versa. Such a compulsion by the sovereign does indeed violate the individual liberty of the parents (it “messes with their stuff,” which is to say their time and resources), but by preserving the lives of their children, it enhances overall liberty in the community.
In the Wealth of Nations, Smith invokes this overall versus individual liberty condition a few other times, like his conversation on party walls (pg. 324.94), certain prohibitions on banking (323.91), and the Navigation Acts (464.29-465.30).* All these are instances where individual liberty is indeed sacrificed but toward the promotion of greater overall liberty, either through the protection of life and property (Party-walls), facilitation of commerce and prevention of fraud (bank restrictions), and the protection from invasion (Navigation Acts). Mandatory vaccination, by preventing/eliminating the spread of disease, can fall into this framework.
Now, this is not to say that invoking overall versus individual liberty should be invoked carelessly. Precisely the opposite; Smith is very very cautious about invoking the reasoning and in his official capacity as customs commissioner, he often advocated loosening some of the restrictions which were justified in the past but now were not (see, for example, his letter to William Eden, Lord Auckland, 3 January 1780 [pgs 244-246 of LF edition], letter to the same dated 15 Dec 1783 [pgs. 271-272]). Violations of justice, the very virtue which builds the foundation of society, should not be taken lightly.
*This list is not exhaustive
Thaomas
Feb 17 2020 at 10:41am
Smith’s concept of “overall liberty” as you relate it seems pretty close to “general welfare” or utility maximization. It would seem to justify (subject to empirical judgement about how much overall liberty was being protected vs how much individual liberty was being infringed and public choice considerations of how the tax or regulation was likely to be imposed and administered) Pigou taxation of externalities such as CO2 accumulation in the atmosphere.
Jon Murphy
Feb 17 2020 at 10:45am
No! Smith explicitly argues against that interpretation (see TMS pg. 82.1 and the passages I cite above)
Jon Murphy
Feb 17 2020 at 11:46am
Liberty is not synonymous with utility, Thomas. The liberal system of Smith is about maximizing liberty, not maximizing some form of utility.
Thaomas
Feb 17 2020 at 12:26pm
Why does not sea level rise, breathing air with particulates, or some other harm from an externality impinge on my liberty or overall liberty?
Jon Murphy
Feb 17 2020 at 12:46pm
Why does it?
Thaomas
Feb 17 2020 at 3:56pm
@ JM: Many things cannot be done under water. 🙂
Jon Murphy
Feb 17 2020 at 5:30pm
True but doesn’t concern the matter of liberty.
Thaomas
Feb 17 2020 at 10:15pm
@ JM To have the actions of others impede (via sea level rise or other harms from CO2 accumulation) ones range of action is, in my book, an infringement of liberty, whether or not that possibility occurred to Adam Smith.
Jon Murphy
Feb 18 2020 at 8:00am
Fine, but that’s a different definition of “liberty” than the one invoked by Adam Smith and myself here.
Warren Platts
Feb 17 2020 at 4:27pm
The liberal system of Smith is about maximizing liberty, not maximizing some form of utility.
If the ethical system of the Commissioner of Customs & Border Protection really did maximize liberty, then liberty would be, by definition, utility for that system. There is no set definition of what utility actually means (cf. Bentham versus Mill).
Jon Murphy
Feb 17 2020 at 5:38pm
No. See TMS, in addition to the citations I give above, pgs. 179-193, 269-270, and 9-65. See also Haakonssen 1981 pg. 53. Smith also has lengthy discussions of the matter in WN (as cited above) and LJ, but A and B.
Pierre Lemieux
Feb 17 2020 at 11:10am
Interesting take, @Jon, that rejects rationalist Pareto optimality and sides with Hayek, Hume, and… de Jasay. It also, of course, rejects cost-benefit analysis.
Jon Murphy
Feb 17 2020 at 11:45am
Absolutely. I am a classical liberal, after all 🙂
Yes. Cost-benefit analysis serves a purpose, but without a moral framework, it is useless. No, it is worse than useless: it represents a positive harm. As co-blogger Bryan Caplan once said in class, if we take cost-benefit analysis as a moral framework, the Holocaust would have been an improvement if only there were more Nazis.
Thaomas
Feb 17 2020 at 3:27pm
Invoking the Holocaust skates pretty close to Godwin’s law. 🙂
Utilitarianism is — by design — a rule of thumb for small changes: more immigration or less, some discouragement of externalities or less, some compulsory vaccination or none, higher or lower/taxes or spending. Invoking moral judgement on extreme cases may not be helpful. I suppose that utilitarianism fits within many different moral frameworks.
Jon Murphy
Feb 18 2020 at 8:00am
Not in this case. In this case, it’s a reductio.
Thaomas
Feb 17 2020 at 10:18am
The second argument is just the general paternalistic argument that in issue X, because of misinformation a tax or regulation is justified to bring market outcomes to the position that perfect information would lead. To this one can either take the position that it is never justified or that it is justified only on the basis of the costs and benefits to the people involved. I agree with the second position but am empirically skeptical about it being applicable in very many cases: tobacco taxes OK, sugary beverage taxes no.
The First argument one is the general externality argument. The decision not to be vaccinated (for whatever reason) imposes probabilistic costs on others and some regulation/tax is justified. But even if justified, there is still the issue of whether a tax/regulation should vary with the cost to the imposee (is that a word?) taking into account that the number of non-vaccinated does not have to be zero in order to avoid the negative externality.
In principle one might levy a tax calculated to reduce the number of non-vaccinated people to the required minimum; it need not be infinite. Since that’s impossible, it’s probably better to allow exceptions for those with the strongest feelings provided that get us close enough to zero harm to the general public. Alternatively perhaps we could estimate the number of exceptions possible to avoid harm and auction them off those who value non-vaccination the most.
Hazel Meade
Feb 17 2020 at 10:51am
Well, a pigovian tax does allow exceptions for those with the strongest feelings. People are free to pay the tax if they really really do not want to be vaccinated.
Pierre Lemieux
Feb 17 2020 at 11:34am
@Thaomas: The first argument I summarized is a strong public good argument, not a mere externality one. (And thanks for your comment, which represents many of the concerns expressed on this thread).
The externality argument can justify nearly everything. People escaping East Germany impose a negative externality on those who cannot leave and those who are trying to build a model society. So let’s impose a tax on the leavers, admittedly hight but only probabilistic: if you jump the wall, we’ll shoot you. As somebody else in this thread said, once the tax is imposed, everybody is free to make his own choice. You don’t want the risk of being shot? Just stay in East Germany? You hate the country to the point that you are willing to risk being shot by leaving? Be my guest, that’s your choice: it’s a free country here.
Put this way, incidentally, the argument suggests that a subsidy is different from a tax not only morally, but also economically, that is, with regard to its consequences. You don’t want people to flee your paradise? Just subsidize those who don’t leave. You can’t actually give high enough subsidies to incite people to say? That’s your problem, man! The application to vaccination is straightforward.
Hazel Meade
Feb 17 2020 at 1:40pm
I would say that a probabalistic chance of being shot is not really equivalent to a tax.
If East Germany has simply charged people to exist, it would have been a much better place. Besides the goal of East Germany was merely to create a risk of being shot, it was to actually 100% prevent exits.
Hazel Meade
Feb 17 2020 at 1:40pm
exist=exit
KevinDC
Feb 17 2020 at 10:41am
I don’t have much of a take to offer on how justified compulsory vaccination is, because I’ve never given much thought to the issue. I’m sure a smart and dedicated advocate of either side of the issue could argue circles around me, so on this topic (like so many other topics!) I hang a large “no opinion” sign.
However, reading this post and some of the comments did help clarify something for me. At first, I was grumbling at the initial identification of vaccines as a “public good.” They aren’t. Public goods are things which are non-rival and non-excludable. Vaccines are rival and excludable. Granted, they do have positive externalities – I gain immunity from the disease (private benefit) but I also become one less person to transmit the disease to you (external benefit). But “private goods” plus “positive externalities” does not equal “public goods”! Standard economic theory says markets will fail to provide public goods altogether, so they must be provided by the state, but goods with positive externalities will only be under-provided, and therefore should merely be subsidized, not provided. (Obviously assuming away tons of complications here, but that’s the basic 101 level starting point.)
However, one could argue that herd immunity, rather than vaccination per se, is a “public good.” Herd immunity is non-rival and non-excludable. So that does open the door more to a public goods argument for herd immunity rather than the more limited positive externality argument of vaccines as such. I don’t have any sweeping conclusions to draw from that, but it is interesting thought fuel for the moment.
Pierre Lemieux
Feb 17 2020 at 10:59am
@KevinDC: You are right that the public good (if there is a public good) is not the vaccine but herd immunity–just as national defense is the public good, not the tanks. Note however that most people can, with an individual vaccine, get the public-health equivalent of a whole army just for oneself. It is also important to distinguish externalities and public goods, for the latter provide positive externalities to all members of society (otherwise, they are just club goods).
Phil H
Feb 17 2020 at 11:07am
This seems very sensible from PL, but I still disagree with a lot of it.
On the specifics of the argument:
“there is…“objective” risk…long-term seizures or brain damage in…one out 1,000,000 children” While true, I think this can be successfully countered simply by saying: the risks of non-vaccination are higher. Pointing out the risks of X is only ever half an argument. To create a full argument, the risk of X must be balanced against the risk of not-X, and it looks to me as though that argument would fall squarely on the side of vaccination.
“imperfect parents…have you seen many perfect politicians and perfect bureaucrats?” Yes! Yes! A thousand times yes! Or rather: the individual politicians are no better than anyone else, of course. But the political system in which they participate is better than any imperfect parent or other person. This is just the fundamental theory of democracy: government is better than king. In exactly the same way as your doctor is no smarter than you, but knows a helluva lot more medicine; and your maths prof is no smarter than you but knows more maths; and your mechanic is no smarter than you, but is better at fixing cars… your politicians are no better than parents, but they know more about running the country, in part because they have personally learned it, and in part because they work in institutions that force them to act in certain ways, ways that history has proved to be better.
More generally, I know that most libertarians are a bit natural-law inclined, as in they think property rights are some kind of universal animating spirit. But remember that if there are many other very respectable approaches to law that don’t demand such a thing. I don’t believe in rights outside a legal/social framework, so the idea that there is a right to not be vaccinated is barely coherent to me.
One final point, on consistency. As PL notes, most of these vaccination laws are not, in fact, legal requirements. They are simply requirements that anyone who wishes to access certain services or activities get vaccinated. This is the state acting *more like a private entity* than usual. I would think that libertarians should support that kind of thing.
Matthias Görgens
Feb 17 2020 at 11:31am
Declining access to certain services or areas would be easier to defend, if they weren’t financed by taxes.
(That being said, in practice given the choice I’d pick the school that insists on vaccinated kids.
Similarly, I strongly prefer almonds over hazelnuts. But I don’t think making that personal preference a law would be the right thing.)
Phil H
Feb 17 2020 at 12:04pm
That’s only because you know, deep down, that preferring almonds can only be a sign of childhood trauma. If you had the *correct* nut preferences, like me, you could dictatorially impose them with confidence.
Of course, you’re right about the taxes. Baby steps.
Pierre Lemieux
Feb 17 2020 at 3:05pm
@Phil H: I have tried very hard to be sensible, just for you.
Pierre Lemieux
Feb 17 2020 at 3:14pm
@Phil H: If you reread my post (and any of my writings over the past 10 years), you will see that I do not invoke natural-rights arguments. Mind you, I don’t argue that the democratic state is of divine right either.
Robert Schadler
Feb 17 2020 at 11:40am
It seems a bit silly to state what seems obvious, but it might be helpful.
Most of life is lived on a “slippery slope.” Part of that means that life is not a series of binary choices, but more complex, requiring a degree of prudence as well as logic.
Being vaccinated or not has the appearance of a binary choice, but it is obviously not. There are many vaccinations for many prospective illnesses (measles, polio, various versions of the flu, etc). For all I know, getting every possible vaccination, in a short period of time, might cause illness or death. A few are legally mandated in some places for some people. And imperfectly enforced.
Humans are imperfect, as parents, as government officials, as neighbors.
The issue of children, broadly, needs more serious thought on the part of libertarians, since the issue, too, is not binary (i.e. child or adult). Total choice by the child, the parent(s), the mob (peer pressure), or the government (at various levels). There can be no simply logical answer about who should decide about a specific vaccination, at a specific time, for a child of a specific age, with specific health issues. Prudence (and some presumption for individual liberty) needs to be applied differently, even for a brand new vaccine and one that has been successful for decades.
Pierre Lemieux
Feb 21 2020 at 11:51pm
Robert Schadler: Interesting objection, that calls for more reflection. It seems to me that this is the objection that Hayek or Smith or Hume would raise, although they would perhaps have dropped (or I hope they would have dropped) the “some” in your crucially important “some presumption of liberty.”
Craig
Feb 17 2020 at 12:43pm
When I was a kid chicken pox was a thing, a rite of passage associated with childhood. Kids have NO IDEA what it even is anymore. Kids in the third grade. Nobody gets it anymore.
Craig
Feb 17 2020 at 2:14pm
I will add a second anecdote about a time I wanted a vaccination but was denied the vaccine since it was reserved for military use only. I came out of law school in the late 1990s and worked in Midtown for many years. Specifically I worked on 46th Street between 5th and 6th. Aside from 9/11, the blackout and other street mayhem, NYC also saw an anthrax scare just after 9/11 in 2001. Now, one of those anthrax laced envelopes found its way to 30 Rock (a building I would occasionally visit), just north of where I was in Midtown and the letter had come through the post office on 43rd Street, just south of where I was also being the post office that delivered mail to the building I worked in and I would occasionally go to that very post office as well.
So, from my point of view I have anthrax to my north, anthrax to my south in locations I occasionally visited. So, I contacted my doctor because there were various forms of anthrax but apparently the best antibiotics for the inhalation form of anthrax was Cipro. So the doctor had no problem giving me a prescription for Cipro given where I worked and I filled the prescription and carried it with me for a couple of months.
However, I also inquired about getting vaccinated for anthrax and the doctor informed me it wasn’t available to the civilian population. I worked in Midtown but resided in North Jersey so I wrote a letter to the NJ Department of Health and they took my inquiry quite seriously. They wrote me back with a very long letter, explained how the vaccine was only available for the military and that the risks for general civilian use didn’t warrant allowing civilians general access to the vaccine.
Pierre Lemieux
Feb 17 2020 at 3:10pm
Craig: So the benevolent state did not care that much about “our” children and “our” messenger boys?
Thaomas
Feb 17 2020 at 4:33pm
He said that NJ saw the costs and benefits for civilians and the military were different. That seems quit reasonable.
Pierre Lemieux
Feb 17 2020 at 4:41pm
Yes, the King must get the first available dose. Recall de Jasay (emphasis his):
Pierre Lemieux
Feb 17 2020 at 4:43pm
@Thaomas: But I do appreciate your sense of humor. Anything can happen in New Jersey.
robc
Feb 18 2020 at 8:16am
You should be glad you didn’t get the military anthrax vaccine.
Below is a long multi-part series:
https://glibertarians.com/category/anthrax-vaccine/
Thomas Sewell
Feb 19 2020 at 2:51am
There is a chain of reasoning which starts with vaccination is good, therefore governments should make it compulsory.
One of the first things that are generally assumed rather than proven in that chain is that the government making vaccination compulsory is a good way to increase overall vaccination rates.
From this adversarial collaboration on the topic:
Personally, the idea that government officials are going to be better placed to impose a one-size-fits-all decision for children’s medical care than their parent’s will is a slope I’d prefer not to travel down.
Of course, I also default to the side of liberty and personal responsibility.
There is much travail and ado about childhood vaccination, but back in the real world of vaccination rates and herd immunity, those who want to force children to vaccinate are rarely up-to-date on their own vaccines as adults, because they don’t understand when they expire. It’s cargo-cultish, in that the politicians are enforcing guidelines they don’t understand themselves.
Pierre Lemieux
Feb 22 2020 at 12:03am
Thomas: One example is England, where no vaccine has been compulsory since the late 19th century, after an attempt to impose some was eventually abandoned. This is often cited to illustrate the perverse consequence of trying to bully people around. Yet, there seems to be a recent drive (including in England and France) to make children vaccination compulsory.
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