Anti-Vaxxers Are Spreading Concern

February 27, 2015 | By Neil Howe

This editorial originally appeared in Forbes.

By now, you’ve heard of the Disneyland measles outbreak that‘s working its way across the country. In response, California lawmakers have introduced legislation that would end personal exemptions for vaccination. Despite the fact that vaccines are utterly safe, an unlikely alliance of parents—wealthy, green-oriented liberals and skeptical, anti-government conservatives—are refusing to get their kids vaccinated.

This wave of resistance has been pushed by Generation Xers, whose concern for their kids’ safety trumps any notion of “public good”—and among Millennials, who trust parents to do what’s right for their kids. In the end, the war between “anti-vaxxers” and outraged parents boils down to one essential question: What is the right balance between personal choice and public safety?

The recent measles outbreak has drawn attention to a growing public health crisis: Once-eradicated diseases are resurfacing. As of Monday, the number of measles cases nationwide hit 154—fifteen years after the disease was deemed eliminated from the United States. According to the Council on Foreign Relations, from 2008 to 2014, North America showed a stunning 600% increase in cases of vaccine-preventable diseases such as measles, whooping cough and mumps, while the rest of the world saw a 57% decrease.

This crisis has been driven by falling childhood vaccination rates. Doctors generally recommend that children receive one vaccination shot between 12 and 18 months of age, and then another between 4 and 6 years of age. However, the preschool measles vaccination rate has dropped below 90% in 17 states. This statistic is alarming, since in order to maintain “herd immunity,” at least 92% of the population must be vaccinated. Though all states officially mandate vaccination, only Mississippi and West Virginia do so without exception: Every other state allows religious exemptions, and 20 allow “personal belief exemptions” (PBEs).

Behind the declining rates are anti-vaxxer parents, many of whom believe vaccines cause autism. This perception largely traces back to claims made by Jenny McCarthy in a much-publicized 2007 interview. These parents cite steadily rising autism rates and scientific articles as proof that they are right in not vaccinating their kids.

But experts say these beliefs are unfounded. There’s no link between vaccines and autism: One of the main crutches for anti-vaxxers, a 1998 paper that connected the MMR vaccination with autism, was retracted in 2010. Furthermore, the CDC has stated that low doses of thimerosal (a common vaccine preservative containing mercury) are not correlated with autism. International case studies have confirmed this claim. In Denmark, even after the MMR vaccine was taken out of circulation, autism diagnoses continued to climb.

Though people think of this as a “wealthy liberals” issue, it’s actually red states that have historically been the most anti-vaccine. The Los Angeles Westside has been painted as a prime example of blue-zone anti-vaxxer sentiment: Some preschools in the area have PBE rates exceeding 50%. But this is a relatively new phenomenon. Vaccination rates are actually lowest in red states—and have been for some time. Of the 17 states with a preschool vaccination rate below 90%, 11 are red. And most red states’ vaccination rates have declined since 2006.

Both groups have a high rate of parents who reject vaccines, but the reasons for their rejection differ. For blue zoners, it’s more of a desire to go natural. These countercultural whole-earthers are suspicious of the decidedly inorganic nature of vaccines, which contain ingredients like mercury, aluminum, and bovine serum.

Red-zone anti-vaxxers have a different set of triggers. Many poor families in red states simply don’t have the money to vaccinate their kids—or the states themselves don’t have the money. And among those who can afford it, lack of government trust runs rampant.

It’s no surprise, then, that anti-vaxxer sentiment is rooted so strongly in Generation X. Fully 35% of 30- to 49-year-olds (a mostly-Xer bracket) believe parents should choose whether or not to vaccinate—compared to 23% of Boomers and 20% of Silent. This generation’s low levels of civic trust means they’re more likely to go with their gut over government “experts”—even if it puts public health at risk. Additionally, late-wave Xers have never seen the gruesome effects of a measles or polio outbreak, unlike their Silent parents.

Millennials echo this Xer sentiment, but for a different reason: They trust parents to do what’s best for their kids. A full 41% of 18- to 29-year-olds believe parents should be able to choose whether or not to vaccinate their children. This strong response isn’t too surprising: Diseases like measles are even more distant from Millennials’ childhood memories than they are from Xers’. Additionally, Millennials may think they’re choosing the protective, pro-parent response, even though the outcome (more kids getting infected) would hurt more parents than it helps.

This debate has put GOP politicians in a difficult position, forcing them to choose between protecting citizens and adhering to their political principles. GOP leaders like Chris Christie and Rand Paul have taken a mixed stance on vaccines, often contradicting themselves in the same breath. Their waffling has received widespread backlash from a public that expects public officials to put the safety of their constituents ahead of their political ideals. Parents who choose not to vaccinate are a classic case of the “tragedy of the commons,” where the actions of a few put the safety of many at risk.

What’s at stake is not just childhood diseases, but potentially something much bigger. Many epidemiologists say we’re getting closer to a “super-pandemic” due to higher population density, increased air travel, and the accelerating mutation of viruses. The perfect storm of events could lead to a major global outbreak, threatening the lives of millions. The expectations we set now may set the tone and make all the difference later. In the event of a disaster, we wouldn’t be able to afford a lengthy debate about private rights vs. public safety of the sort triggered by the Ebola panic—and is continuing around the measles outbreak today.