I like to think that I am not prone to irrational fear. Flying worries me, but mostly because I'm stuck inside a metal cigar tube hurtling five miles above ground at 300-plus mph. Tall bridges unnerve me, on a similar "radically denaturing into a crushed pizza" basis. I was in a 6.9 earthquake and a Category 4 hurricane and am fond of neither for what would appear to be perfectly adequate reasons.
On the other hand, I've been sort of shot at — and once had a drunk good ol' boy reach behind his back for what he most certainly wanted me to think was a gun — and apart from those two instances have never thought, "I need to orient my life around gun anxiety." On matters of terror attacks, car theft, burglary, giant snakes, killer bees or numerically obsessed serial killers, I am imperturbable. I live across the street from alligators, and I only wish they were larger so that the neighborhood cats might be fewer. SARS, necrotizing fasciitis, Mekong whiskey and Hong Kong Flu do not exercise me.
That said, the United States' recent entirely optional measles outbreak, even at this early stage of fraught potential, is seriously fucking with my life, fucking with my son's life, and making everything fucking anxious. I don't think I'm out of line in saying privileged assholes are to blame.
* * *
If there is one thing the anti-vaccination movement has taught us, it's that correlation does not equal causation. That being said, let us stipulate a few points. One, that a virus declared essentially eliminated in 2000 does not make a roaring comeback in 15 years without intervening acts. Two, that huge chunks of licensed medical professionals did not all forget how to properly administer injections, the correctly administered remainder of which did not all spontaneously fail. Three, that there's a relationship between all the people who skipped giving their kids the Measles, Mumps and Rubella (MMR) vaccine and their kids getting measles, especially since those are the kids who keep getting it.
Whence the anti-vaxxers? Their current movement goes back to a 1998 Lancet article and personal comments by (former) doctor Andrew Wakefield, linking autism and the MMR vaccine. Many people rightly felt disinclined to give their kids autism via a shot, but that paper has since been withdrawn and Wakefield stripped of his medical license, which seems like it could be important! Wakefield's study featured, at best, a fatuously small sample size, and its conclusions could not be replicated. Worse, some of Wakefield's patients were recruited by attorneys looking to sue MMR vaccine manufacturers.
It's science the way "Catherine the Great died having sex with a horse" is history.
If you've ever encountered anti-vaxxer rhetoric online, you know that one of their favorite arguments is follow the money, which is a tactic the above detail T-bones like a speeding truck with a slashed brake line. Supplying litigators with proof of lifelong side-effects to a drug administered to virtually every child in England has a direct monetary incentive. Meanwhile, the follow the money whisper makes no sense as regards "Big Pharma." If vaccines are a money grab, they're a pitiful one compared to forcing you to put your infected kid in the hospital for days of ice baths, IV drips and expensive aspirin — followed by decades of compensatory care for things like blindness. Big Pharma would do better if we brought back cholera, the black plague and the yellow jack.
Anti-vaxxers have other arguments, too, and they are just as bad. Encounter one, Google it, and the slightest effort turns up some exhausted science blog debunking it. Anti-vaxxer science is science in the same way that saying the word "FUCK" came from "For Unlawful Carnal Knowledge" or "Fornication Under Consent of King" is etymology. It's science the way "Catherine the Great died having sex with a horse" is history. It's shit that sounds plausible only if you're someone never in danger of double-checking it or stumbling across something like topical expertise. Christ, you could figure out most of this stuff is bullshit just by reading the questions and answers on NTN Bar Trivia at your local Buffalo Wild Wings for more than a few hours.
It's no surprise that people believe stupid medical "data" because they won't do the reading, or because they seek out reading that tells them what they already want to hear. There are thousands of kids at Hillsdale College and Liberty University right now learning that upper-income tax cuts eliminate wealth inequality and spending $25,000 per year to be told that they're rational economic actors. People do dumb shit of little complexity all the time, so the fact that dumb shit trammels something as complex as biochemistry and neurology is at least going for par, if not a birdie.
But if people want to believe there's a nefarious element to vaccines, those beliefs don't originate in the same places.
For some, the anti-vaxxer pose is just Hofstadter run through biology class, a different update on an old paranoid style. America didn't even invent it. Fin-de-siècle England abounded with conspiratorial anti-vaccination thinking, viewing mandatory injections as Trojan horses for the eradication of liberty via population control. America's John Birchers updated that riff in the post-war world, adding socialism/communism and one-world-government control to the nefarious scheme.
Look, that's fine. We can write these people off. Someone who believes that vaccination is a needlessly elaborate mind-control protocol is someone who reads this wailing jackass and InfoWars and nods without laughing. If vaccines weren't a communist tool, then they'd be something else — drugs designed by Chinese triads to get Americans addicted to gambling and to create a flight of U.S. dollars out of the country via rigged mah-jongg games. Or something. These people don't need a good reason, because they can just make one. Obama's probably a Muslim because he got Indonesian vaccines. Hillary Clinton's ovaries are filled with reptiloid eggs.
These people aren't the problem. The problem is people too comfortable in life to give a fuck about yours.
* * *
It's probably not a coincidence that you can trace higher numbers of measles outbreak to the more expensive counties of the country's already alternate-medicine-prone left coast. The next time you see a California measles story, run a Zillow search for homes in the $200k-250k range, in wherever it's located, then marvel at all the 900-square-feet options you turn up for 40-year-old one-bathroom, two-closet, coffin-sized dwellings. You'd be right to think epidemic would be tied to real estate — just not the good kind. That's why Mississippi goes against type by making the rest of the country look stupid.
This arrangement plays out in my personal life, where I know a handful of anti-vaxxers, all of whom would be getting lowballed if I merely described their lives as reliably funded. Which brings up the most infuriating thing about the non-paranoid anti-vaxxer phenomenon: it's one thing if your bad decisions kill your kid, but if you're doing well enough, your bad decisions will probably only hurt someone else.
I understand the personal anti-vaxxer arguments. Most of these people either tell a story of vaccinating their first kid — or relay stories of friends' vaccinating a child — and then witnessing something akin to "the light going out of their eyes." It's a totally unscientific observation, correlation rearing its head again, but it is eminently, achingly human. I used to mock antsy parents as irrational and self-absorbed, and now I am one of them. I instinctively share the anxiety that I might do something wrong. A couple weeks ago, I accidentally bonked my kid's head on the crib, watched him go limp and was so terrified I'd paralyzed him that I started to have a panic attack. Which is stupid. Half of a kid's job is to collide with shit. But this is the instant byproduct of being a parent — a constant sense of vigilance and second-guessing habitually interrupted by guilt.
Given that that's a common state of modern parenting, the urge to avoid seeing the lights go out in your child's eyes is almost overwhelming. Any other option becomes worth examination. If you're convinced that your vigilance as a parent could see your child to the doctor's office before any classic epidemic-level diseases risked his or her life, and you're convinced that medical science can handle things from there, then why wouldn't you opt to skip a potential permanent neurological development, junk science or no?
The problems with this sort of thinking are two-fold.
One, as autistic writer Sarah Kurchak points out, it's not only insulting but also mortally preposterous to assume that being autistic is a fate worse than death. Autism as we understand it today is a spectrum, not the inaccurate Rain Man pop-culture boogeyman of even 10 years ago, and to treat it as equivalent in consequence to a death sentence is almost savage in its indifference to both people on the spectrum and to herd immunity and the communal consequences of death in general. Autism is now often a very manageable condition, something that others can fail to observe in adults who've grown up with it, and treating it as more severe than measles is essentially to privilege future parenting convenience over corpses.
Two, as my friend science writer Leigh Cowart points out, anti-vaccination decisions are desperately uninformed about their most negative consequences. In a society where measles is at most bad luck and usually just a fantasy, weighing it against the autistic kids you might have met results in a fantastically unequal judgment. The kid in daycare like Abed from Community is more real than people with permanent facial scarring or blindness, because you've probably never met the latter. As a kid I giggled at my grandmother's horror when I'd drop food on the floor, blow on it, then pop it in my mouth. She'd raised two kids before the polio vaccine was available, and to her the sight of me eating floor food reflexively meant risking death or disfigurement. All I knew was a give-no-fuck world with a vaccine. She seemed silly. But she was the one who had to drive home from school and see students who had been removed from her classroom — teenagers lying inside iron lungs in the front room of the house, gazing out a window to give some sense of being able to see the outside, waiting to live or die.
In a sense, then, not knowing the risks is a privilege, just as opting to create the risks by foregoing a vaccine is. And this ultimately presents the most insufferable aspect of this most non-mandatory of epidemics: that it's the poor kids and the poor parents who are going to get fucked.
Again, skip the paranoids and the Birchers and the InfoWars crew. They are insane, and they will die that way, and none of us will reach them. The really toxic humans in this exchange aren't the ones opting out of vaccines to serve a sociopolitical narrative but rather those who think they know better and can afford to be wrong. Risking Liam and/or Dakota getting measles means diddly shit if you can drop $30,000 on hospital bills when your insurance might be voided by ignoring a vaccine schedule or when a deductible is small change. That's one of the real insufferable privileges at work: the idea that you can buy a kid's health back from the brink of death that you pushed them toward. The second is this: that anyone not as well-off as you can start picking out coffins because they lack your resources or can see their child overwhelmed by a failure of herd immunity.
Two weeks ago, I had to take my kid to a pediatrician's office I'd never been to before, in an affluent neighborhood. We didn't know it, but one of the doctors had called in sick, bumping everyone's appointments back at least 90 minutes. We wound up spending two hours in the "well kids" waiting room, which was separated from the "sick kids" waiting room via an open doorway that the sick kids kept running through. It was the same day that Chris Christie and Rand Paul issued statements advocating parents' choice to opt-out of vaccines, and I spent the time guarding my son's car seat with my body and reading articles on my phone in horror, wishing that I could instead be in a clinic in a less well-off part of the county, where people would be too poor to think, "Fuck it, I can afford to play five-figure roulette with my kid's life," and would instead just get the proven treatment that helps kids not die.
Here's the fun thing: I get to do this for the next seven months. My kid isn't old enough to receive an MMR yet, relying on the immunity of the kid and adult herd around him to keep measles from floating into his face and down his lungs, and in the meantime I have to repeatedly undertake a dire existential calculus. Do I wait for my wife to get home and leave my son with her so I can go to the store and pick things up? What kind of restaurants can we go to? Should I try to book certain appointment times at the doctor? Can I risk leaving my kid at a daycare now and then, or should I take him everywhere with me, and is one riskier than the other? And what about my own behavior? Should I travel for work anymore? If I do, should I stay with someone else for a few days before coming home? What communal activities become less safe as more people opt out of a system designed to create and reinforce communal health? At what point does others' narcissistic self-expression drive everyone else homeward and inward, making us all dependent on and terrified of exiting autonomous family states?
None of this is natural-disaster calculus. None of this involves weighing being in public versus the chance that someone may engage in a public terror strike with bombs or even handguns and rifles. This is dread processed through the normative conduct of being a citizen. Nobody has to form a requisite malicious intent for my son to be at risk of death or disfigurement. They just have to be selfish, or misinformed, or more terrified that their kids might turn out less than neurotypical and that that might be a hardship. Then they merely have to be nearby, where breath can atomize and virulence spew.
When his time on the schedule comes, I will vaccinate my son with extreme prejudice, with the faint sympathetically magical hope that my enthusiasm for doing so radiates far beyond him and binds and defends all the children he may one day giggle near and hold hands with. And maybe this backfires for me, and he winds up on a neurological spectrum. If that should happen — pace actual science — I will be forever riven with guilt that I might have foisted a condition on him that he might never have had. But that will be the downside of my own pernicious tendency to believe that I owe it not only to him but to a common weal, and that the commonwealth I contribute to as a citizen owes it back to me and him just as dearly. And if something should happen, I trust that I will not blame an injection for it, because finding horror in events proximal to you for no other reason than that they are there seems as inherently reasonable as saying, "He took poorly because the redhead woman gave 'im the evil eye, she did."
What I will not do, however, is gamble with his immunity and the immunity of dozens or hundreds or thousands of others — both infant and elderly, all less capable of defending themselves — to assuage my guilt about what could happen by the lights of perverted science. Even if I could probably sell a car or get a mortgage to cover any catastrophic medical bills that ensue. Because that solipsistic reading of science and suffering is the most repugnant and most destructive vision of privilege: when what might be inexorable and mortal to everyone else is something worth my countenancing, because it doesn't have to apply to me. Because, in your house, all the bad things might be fatal — whereas in my house they're just optional.