Thursday, February 23, 2012

The Super Bowl and Measles

There was an interesting story from the Johns Hopkins Bloomberg School of Public Health newsfeed yesterday on the Super Bowl and measles.  I've provided a link to the Center for Disease Control and Prevention's (i.e., the CDC's) website on measles just so that people who have never really had to think about measles can find out a little more about what it is and what risks come with it.  The story (from PBS's News Hour) is interesting in illustrating the risks that come with large sporting events that attract people from all around the world.  As an economist, the main thing that I ask is how this reflects on the appropriate role of government.  In this case, even most economists I've met--despite their general lack of interest in government regulation--are willing to go along with the idea that the government has a role in mandating vaccination.

Why?  Well, the piece from PBS points out that the vaccination against measles is 95% effective.  If you could get nearly everyone vaccinated with something that is 95% effective, it will make the continued spread of a disease very unlikely.  And, in the United States, that was achieved.  Over the past decade more and more people have made a decision not to get vaccinated.  The issue here is that when nearly everyone else was vaccinated, a few unvaccinated people (as long as they were not traveling to parts of the world with insufficient vaccine coverage) would not likely get the measles and would not be a threat to others for whom either (a) the vaccination was not effective or (b) the vaccination was medically contra-indicated.

When many people choose not to get vaccinated the risk starts to increase.  And it is a risk for more than just the person who chose not to get vaccinated.  It is also a risk for the people in (a) and (b) above.  Given that 1-2 of 1000 children who get measles will die what we have to ask ourselves it this.  First, is there a role for government to make even a weak mandate for vaccination in this case because people should not be allowed to create risks for others at this level?  In other words, what is the minimum risk we can create for others that society is willing to try to regulate?  We regulate driving under the influence because it creates not just a risk for the driver but a risk for others as well.  Second, how much should the government strenuously enforce the regulation?  In other words, should the government allow parents to make a relatively weak objection to the vaccination and have their children unvaccinated.  In this case it gets really complicated.  We do mandate certain things about parenting.  The parent is making a decision not just for themselves but for another person.  And that person's susceptibility can then affect others.

No easy answers.  There almost never are.  

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