The Individual and the Herd

How the rhetoric of freedom can lead us astray.


The question Governor Chris Christie was asked seemed simple enough:

There’s a debate going on right now in the United States, the measles outbreak that’s been caused in part by people not vaccinating their kids. Do you think Americans should vaccinate their kids? Is the measles vaccine safe?

He could have just said: “The measles vaccine is safe and parents should get their kids vaccinated.” That appears to be what he believes, and the question required nothing more. But instead he decided to expand the context and give a more complex answer:

All I can say is that we vaccinated ours. That’s the best expression I can give you of my opinion. It’s much more important, I think, what you think as a parent than what you think as a public official. And that’s what we do. But I also understand that parents need to have some measure of choice in things as well so that’s the balance that the government has to decide.

In response to follow-up questions, he explained that vaccines for different diseases have different risks and benefits (which is true), so the government should be careful about which ones it mandates and which ones it leaves up to parents (which hardly anyone disputes). “I didn’t say I’m leaving people the option,” he protested. And when asked again whether vaccines were dangerous, he responded: “I didn’t say that.” But he also stopped short of saying: “The measles vaccine is safe.”

In short, if you parse Christie’s words very carefully and give him just a little benefit of the doubt, he didn’t say anything all that objectionable. But the question lingers: Why did he go there in the first place? Why not just give the simple answer, if that’s what he believes? After all, that’s the image Christie works so hard to project: a man who bluntly says what he thinks without a lot of political doubletalk. Why couldn’t “Is the measles vaccine safe?” get a “yes” answer, rather than a long-winded discussion followed by a denial that he was saying it was dangerous?

The obvious implication was that (as he progresses towards an as-yet-unannounced presidential campaign) Christie was trying not to offend some bloc of Republican voters. And many then jumped to the conclusion that the bloc in question is the anti-vaccine conspiracy theorists, who believe the scientifically groundless theory that vaccines cause autism.

The controversy Christie’s remarks started might have died out quickly, if rival presidential hopeful Senator Rand Paul hadn’t jumped in and said explicitly what Christie was accused of implying:

I’ve heard of many tragic cases of walking, talking, normal children who wound up with profound mental disorders after vaccines.

(He later backed off, claiming that after just means that vaccines and mental disorders are “temporally related”, not that one causes the other. So I’m sure he won’t mind if the media publishes a slew of stories of the form: So-and-so did something horrible after listening to Rand Paul. Or maybe a headline like “ISIS Beheads Hostage After Paul Speech”.)

But here’s the problem with the pandering-to-Republican-anti-vaxxers theory: First, there just aren’t that many anti-vaxxers. [See endnote 1]  And second, they aren’t all Republicans. There’s a liberal version of anti-vax that focuses the conspiracy theory on drug companies rather than government. [2]

So the theory that a Republican primary might be decided by anti-vaxxers casting a single-issue vote is a little sketchy. That’s why as soon as their position got labelled as pandering to anti-vaxxers, other potential candidates took the opposite side of the argument [3] and both Christie and Paul had to back down to a certain extent.

So who were they pandering to? The Libertarian/Theocrat side of my model in “The Four Flavors of Republican“.

Again Paul was the more explicit:

The state doesn’t own your children. Parents own their children. [4]

In other words, decisions about vaccinations shouldn’t be made by the American people as a whole through the democratic process, or by the medical experts that the people delegate those decisions to. Libertarians believe those issues should be decided by sovereign individuals, and Theocrats want them decided by the fathers that God made sovereign over their households.

When you look at the world through either one of those lenses, vaccinations aren’t the point, they just symbolize larger issues about authority. So sure, I’m going to vaccinate my kids, but the decision should be up to me. “It’s an issue of freedom,” Paul said, and when the CNBC interviewer pressed him, he got sarcastic. “I guess being for freedom would be really unusual.”

This ties vaccinations to other “freedom” issues, like your freedom to go without health insurance rather than accept ObamaCare, your freedom to let your kids grow up ignorant rather than send them to a government-approved school (or report their home-schooling progress to an education bureaucrat), or your freedom to take the low wages and poor working conditions an employer offers rather than negotiate through a union. Newly elected North Carolina Senator Thom Tillis defended the freedom of food-sellers to set their own hygiene standards rather than be bound by government regulations:

“I was having a discussion with someone, and we were at a Starbucks in my district, and we were talking about certain regulations where I felt like ‘maybe you should allow businesses to opt out,'” the senator said.

Tillis said his interlocutor was in disbelief, and asked whether he thought businesses should be allowed to “opt out” of requiring employees to wash their hands after using the restroom.

The senator said he’d be fine with it, so long as businesses made this clear in “advertising” and “employment literature.”

“I said: ‘I don’t have any problem with Starbucks if they choose to opt out of this policy as long as they post a sign that says “We don’t require our employees to wash their hands after leaving the restroom,” Tillis said.

“The market will take care of that,” he added, to laughter from the audience. [5]

So in Tillis’ ideal republic, you would have to study the diverse hygiene practices of all the places you eat, so that you can make an informed decision about whether it’s safe to eat there. Because freedom.

Taken to its logical extreme, the freedom agenda says that you should be free to drive on the left side of the interstate. You wouldn’t, of course, because it’s dangerous and you’re not stupid. At least, you wouldn’t most of the time. Most people wouldn’t, most of the time.

But it wouldn’t take many to screw everything up. What if, of all the drivers who would be traveling north during your next trip south down the interstate, you knew that only one would be using his freedom to drive on the left side and come straight at you? How would that change your driving experience?

Here’s what it boils down to: Human beings are simultaneously individuals and members of society, not fundamentally one or the other. Some issues (like free speech) are easier to understand from the individual point of view, while others (like traffic) require a  social point of view. [6]

Public health is fundamentally social. Germs pay no attention to your individuality; they just spread through the herd. You personally may do everything right, but whether or not you get sick also depends on social things like the quality of the sewage system, whether other infected individuals have access to health care or paid sick leave, how well your city controls rats and other vermin, whether restaurant workers wash their hands, and what percentage of people get vaccinated. In extreme cases, it depends on really draconian government interventions like quarantines and travel restrictions.

No matter what kind of intellectual contortions you do, you can’t square all that with a pure individual-freedom agenda. What if a free individual exposed to Ebola doesn’t want to be quarantined in a treatment facility? (Maybe he has his own theory about diseases and doesn’t believe all this germ-and-virus nonsense. Or maybe he was only probably exposed, and he’s willing to risk it.) If your ideology limits you to looking at everything from the individual-freedom viewpoint, your thinking about public health is going to be crippled.

So that’s who Christie and Paul were pandering to this week: people whose thinking about public health has been crippled by individualist ideology. If either becomes president, he may continue to pander to them.


[1] Anti-vaxxers only dangerous because it doesn’t take many to screw up herd immunity, which protects people who can’t use the vaccine. (In other words: Even if you can’t be vaccinated or haven’t been vaccinated yet, you’ll be safe because you are unlikely to come into contact with sick people.) According to the World Health Organization, as reproduced in Wikipedia, the herd immunity threshold for measles is 83-94% vaccinated, so as few as 6% in a local community might be enough to make that community vulnerable to an outbreak.

If you think of this in terms of the free-rider problem, the herd immunity threshold measures how many free riders the vaccination system can stand before it starts breaking down.

[2] Anti-vaccine liberals are sometimes used to prove that in their own way Democrats are just as much at war with science as Republicans who deny climate change or evolution. But here’s the clear difference: Anti-science liberals are on the fringe of the Democratic Party, and elected officials seldom pay much attention to them. Conversely, climate-change denial is a core position of the conservative base, so virtually every elected Republican has gotten in line.

[3] Marco Rubio demonstrated that a Republican presidential contender can give the simple, direct answer: “There is absolutely no medical science or data whatsoever that links those vaccinations to onset of autism or anything of that nature. And by the way, if enough people are not vaccinated, you put at risk infants that are three months of age or younger and have not been vaccinated and you put at risk immune-suppressed children that are not able to get those vaccinations. So absolutely, all children in American should be vaccinated.”

Also Ted Cruz: “On the question of whether kids should be vaccinated, the answer is obvious, and there’s widespread agreement: of course they should.”

But both avoided a direct endorsement of mandatory vaccinations, like Ben Carson’s.

[4] Rekha Basu of the Des Moines Register had the right response:

No, we don’t own our children. From slavery to child sexual abuse, the notion of owning another human has led to nothing good. Legally, we’re responsible for our kids and their care, feeding and safety until they’re old enough to take care of themselves. But they are autonomous human beings, which is why, unlike property, there are laws and standards governing what we can and can’t do to them.

[5] We’ve seen this two-step before. The same politicians who say that a well-informed public can sort things out without government help will also oppose any regulations that inform the public. Today, Tillis says he’d make Starbucks post that sign, but when the time came to vote on it he actually wouldn’t, for exactly the same reason: The market can sort out whether businesses should have to post their hygiene policies.

[6] It’s like the wave/particle thing with light, if that analogy makes sense to you. If not, forget I mentioned it.

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Comments

  • mfennvt  On February 9, 2015 at 9:17 am

    Your wave/particle footnote made me smile. I love reading your posts every week.

  • Anonymous  On February 9, 2015 at 9:35 am

    Hi Doug,
    One of my pet peeves is the anti vax crowd. I wish I believed that it was all conservatives, but I just heard an NPR program that put an anti vax mother on with an internationally respected pediatric physician. He kept saying her statistics were bogus and asking why NPR was treating it like a scientifically neutral debate. All I could think is that they would never do this with a climate change denier. The public schools where parents opt out in large numbers, as I understand it, are in places like Beverly Hills and Vermont, wealthy areas of NYC. I think there is something about the issue, but I only have poorly developed thoughts about it that refuse to gel. Kathy Brackett

    • weeklysift  On February 9, 2015 at 12:22 pm

      Kathy, The vaccine-conspiracy-theory people are a pretty mixed bag of folks, with a libertarian-right side and a new-age-left side. In terms of party politics, though, the difference is that the Democratic anti-vaxxers don’t have a rhetoric to plug into like the Republican anti-vaxxers do. So on the right there’s a substantial you-have-the-right-to-be-wrong contingent that you don’t find on the left.

      That’s why among prospective Democratic candidates, Hillary came out for vaccination and nobody has challenged her on it.

    • Kim Cooper  On February 13, 2015 at 10:30 pm

      As soon as a kid dies of measles in Beverly Hills or Vermont things will start to change. Too bad it will take that.

  • Arvid Jedlicka  On February 9, 2015 at 10:07 am

    I am confused.

    The Senator said “he’d be fine with it, so long as businesses made this clear in “advertising” and “employment literature.” but what incentive is there for a business to do this?

    Without a “regulation to make it clear” there would be no incentive for a company to do so. No regulation … no ‘made this clear’ activity.

    So is he saying he does not want a regulation to require “doing the right thing” but would not mind a regulation requiring companies to “emphatically state when they are doing the wrong thing”?

    This does not seem logical to me but then again I probably just do not understand the political thought process.

  • lonemtn  On February 9, 2015 at 12:17 pm

    The first ‘environmental legislation’ occurred in California in 1884. The Sawyer Decision prevented hydraulic tailings (produced by a privately owned company) from being dumped into the Yuba River — an action which was causing flooding, death and destruction in the California Central Valley. The decision was based on the social issue that it’s not okay to do things, even in your own private space, that harm others in the community/society. I believe this is an important part of our heritage. It’s NOT okay to do whatever we want, any time, anywhere, if it hurts other people.

  • coastcontact  On February 9, 2015 at 12:59 pm

    This is a beyond belief stupid debate. Polio, small pox, diphtheria are among the diseases that have essentially been stopped almost entirely in most industrialized nations. An argument about the quality of a vaccination that has stopped measles and mumps makes no sense. When the right of freedom of choice rises above the good of the community we have anarchy. lonemtn is correct: “It’s NOT okay to do whatever we want, any time, anywhere, if it hurts other people.”

  • Chris Tierney  On February 9, 2015 at 1:11 pm

    With Paul, the Libertarian connection is pretty clear, but I don’t normally associate Christie with that part of the spectrum. Do you think that his position could be (at least partly) explained by the “oppose whatever Obama says” strategy rather than a specific political position?

    • weeklysift  On February 9, 2015 at 4:44 pm

      No idea. As I hope I made clear, Christie didn’t exactly endorse the libertarian position on vaccines, he just tried very hard not to contradict it. He may have thought he was in a dog-whistle situation, where only people on one side of the issue were paying attention.

  • BobD  On February 9, 2015 at 1:32 pm

    I love the fact that Tillis, while opposed to government regulations *forcing* businesses to require food servers to wash their hands, is perfectly OK with government regulation forcing businesses to post signs when they opt out of the hand-washing regulation. In other words, it’s still not freedom for individuals, or even fewer regulations and smaller government. It’s freedom for businesses to opt out of one regulation as long as they comply with a newly imposed one. We wind up with two regulations instead of one.

  • lsnrchrd1  On February 9, 2015 at 1:49 pm

    Car Crashes Through Mailbox, Into Dining Room –
    Early last evening in Anywhere, Anystate, USA, a car driven by Citizen Dazed suddenly departed Bewildered Avenue, crashing through the mailbox at the end of the Innocent family driveway on its way to penetrating the dining room of the Innocent home just below a picture window and knocking two vacant chairs into the table. “Luckily our kids weren’t down at table yet,” said a tearful Mrs. Innocent. Mr. Innocent, clearly angry, said “I hate video games with a passion, but luckily my three boys were competing in one and refused to come eat when we called them. One or two would probably be dead right now if they’d been on time.”

    The driver, Mr. Dazed, told police that he was driving home as usual when the radio news channel he listens played comments by Ron Paul about the after-effects of vaccine upon children. “My mind just went blank when I heard that,” said Dazed. “The next thing I know, I’m sitting in my car looking at a man and a woman sitting at a table inside a house, and I don’t know how I got there.”

    Food Poisoning Outbreak Mystery Solved –
    After six months, scores of hospital visits, hundreds of missed work and school days, two deaths, and a huge city budget impact, Freedom Restaurant has been identified as possibly the sole source of contaminated food attributed as the cause.

    The owner and two employees face as yet unspecified charges. Neither employee’s name will be released until charges are filed. An unnamed source who is formerly was employed by the restaurant says a female employee “looks sorta filthy and has a lot of body odor most of the time, like maybe she hates to shower” and that she “never covers her mouth to cough or sneeze. The source claims a male employee who was terminated a few weeks ago after “working at the place for months” sometimes bragged “I wipe my ___ and don’t wash before I make hamburger patties. ____ the owner and anybody who eats at this joint.”

    Libertarian free market advocates say this restaurant is the kind of place that cannot compete and will go out of business as a result, proving burdensome regulation is not necessary and un-American. “The market works,” says Rand Ayn, president of the state Chamber of Commerce. “Just watch. In a week or less this restaurant will close its doors permanently, and it doesn’t require Nanny Government to make it happen.” When asked about the possible illnesses and deaths the business may have caused, Mr. Ayn stated: “There is a price for freedom, and any of us must be prepared at any time to pay that price. This is what makes America exceptional instead of socialist.”

  • Anonymous  On February 9, 2015 at 3:23 pm

    In the “discussion” of “the rights of the individual” and vaccinations; will this lead to dog and cat owners refusing to get RABIES vaccines? I can see it all now . . .Rabid, vicious feral pets stalking our neighborhoods like pet zombies from the walking dead!
    I am 68, and I can’tt figure out what the hell these fool are thinking!

  • samuraiartguy  On February 9, 2015 at 10:14 pm

    I’ve been having this issue out in my own FB page, and things get heated pretty swiftly. People get rather invested in their children. I even had to pull down one post to chill folks out.

    I am leaning in favor of some medically informed choice on the part of parents. But medically informed is the rub, and the level of scientific literacy among the citizenry is abysmal and dropping. Faced with scientific language, many people’s eyes roll up and they turn to corporate media, politicians, and celebrities for their cues, all people who are highly motivated to lie and manipulate for their own ends.

    Unfortunately another issue is that trust in expert opinion is falling. The institutional authorities on much of this issue are the FDA and the CDC, whose close ties with Big Pharma, and their legendary profit-driven bad behavior gives weight to a spectrum of conspiracy theorizing. And there are some lingering questions of the toxicity and continued use of Thimerosal, albeit reduced. As usual, there is plenty of noise in the signal. Unfortunately, my training as a biochemist and neuroscientist is insufficient (um… NONE) to evaluate the validity of assertions on both sides of the controversy.

    Here’s one:
    http://preventdisease.com/news/13/093013_Despite-Thimerosal-Mercury-Ban-Imposed-By-FDA-60-Percent-Flu-Vaccines-Still-Contain-Deadly-Neurotoxin.shtml

    Here’s the flip:
    http://www.forbes.com/sites/emilywillingham/2014/02/20/on-autism-environmental-toxicants-and-bias/

    And part of the issue is that we seem to be losing our cultural memory of just how awful many of these diseases were. When I was a young sprat, I remember these diseases used to kill LOTS of kids.

  • zac  On February 12, 2015 at 1:26 am

    What’s weird to me is that at the same time as this conversation about how bad it is to get vacinated, part of the anti-immigration talking points is that they bring in disease because they aren’t vacinated.

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