Over the past few days, journalists have been quizzing several national political figures on whether vaccinations should be required for children. And some politicians, like Chris Christie and Rand Paul, have gotten into hot water by saying parents should have a choice in the matter.
But it was less noticed that President Obama wouldn't say vaccines should be mandatory either.
Asked if "there should be a requirement that parents get their kids vaccinated" on Sunday, Obama responded with the following:
OBAMA: Measles is preventable. I understand that there are families that in some cases are concerned about the effect of vaccinations. The science is, you know, pretty indisputable. We've looked at this again and again. There is every reason to get vaccinated, but there aren't reasons to not.
Obama's response was a ringing endorsement of the science of vaccines, and an exhortation to parents that they should vaccinate their kids. But he didn't call for any new compulsory measures to make that happen.
That's probably not an accident. Because despite Christie and Paul's recent comments, vaccines aren't a partisan issue in US politics — at least not yet. But a focus on government mandates is the quickest way to make it one.
The politics of vaccination
In 2009, the views of Republicans and Democrats on whether all children should be vaccinated were almost indistinguishable, according to a Pew Research Center poll. Since then, there's been a slight uptick in support for vaccines on the Democratic side, and a slight decline on the Republican side. But support for vaccination remains by far the most common opinion in both parties. This corroborates a study by Professor Dan Kahan of Yale, who found that anti-vaccine attitudes are a minority viewpoint distributed across the political spectrum.
Right now, every state calls for vaccinations for children attending school. But nearly all allow for religious exemptions — and 19 go further in allowing for "philosophical exemptions." As Sarah Kliff wrote, there's no evident partisan division here on which these are.
There are real and serious policy differences about whether these philosophical exemptions should be permitted, and how easily those exemptions should be invoked. Those arguments are currently playing out at the state level.
Yet framing the issue as a question of what the government should mandate or require risks polarizing it along national partisan lines, like so many other issues — and alienating people who are inherently suspicious of such mandates.
As political scientist Brendan Nyhan warns, politicization of the vaccine debate could be "dangerous" and have a "perverse effect." For instance, if support for vaccination becomes primarily identified with President Obama and Democrats, and opposition to it becomes identified with leading Republicans, people could begin to follow partisan cues in making up their own minds.
All this talk about mandates is the quickest way to bring that about.
Obama and his staff don't talk about government vaccination mandates
The White House messaging strategy on vaccines is clear. Emphasize the science, and emphasize that parents should get their children vaccinated. Don't get bogged down by the fraught topic of government health mandates. It's a state issue anyway, and they've been burned by topics like this before.
That helps explain why President Obama deftly dodged Guthrie's question about vaccination requirements. "You should get your kids vaccinated. It's good for them. We should be able to get back to the point where measles effectively is not existing in this country," he said.
Indeed, when White House Press Secretary Josh Earnest was asked about the topic last week, he also said vaccination decisions "should be made by parents." He added that "the science on this is really clear," and that "our public health professionals recommend" vaccinations. At today's White House briefing, Earnest again wouldn't say that vaccines should be mandatory at the federal level, and characterized vaccination in schools as a state issue.
Christie and Paul tried to answer the question Obama dodged
No one batted an eye when Earnest said parents should make vaccination decisions — because he paired it with a strong endorsement of the science and a recommendation to do so.
But Christie and Paul tried to have it both ways — praising the science of vaccines, but putting serious emphasis on their desire to let parents have the final say. "Parents need to have some measure of choice in things," Christie said. "The state doesn't own the children. Parents own the children," Paul said. Paul additionally nodded to the discredited theory that vaccines can cause mental problems in young children.
Nodding to the health concerns that some have about vaccines was common during the 2008 presidential campaign. Then-senator Barack Obama said "the science right now is inconclusive, but we have to research it." Hillary Clinton said on a questionnaire that vaccines were a "possible" cause of autism. And John McCain said there was "strong evidence" that "a preservative in vaccines" was connected to autism.
Since then, however, the one prominent study that found a link between vaccines and autism was retracted. (It was already viewed as a minority opinion by the scientific community, since there were several other major studies that found no such link, but the full extent of the paper's fraud wasn't yet clear.)
And now, with a spreading measles outbreak that originated in Disneyland, the potential costs of non-vaccination seem more urgent — and Christie and Paul's comments appear more irresponsible.
Christie has walked back his statement somewhat, saying that "with a disease like measles there is no question kids should be vaccinated" — but he still said there should be "balance in which ones government should mandate." Paul's walkback was also murky — he said vaccines "should be administered to children" but that many "should be voluntary."
Still, both frame the issue as one of personal choice. But as Sarah Kliff wrote, vaccine isn't a personal decision, but a social obligation — it prevents diseases from spreading to the weak or sick, who don't have the option to get vaccinated themselves.
Other Republicans are taking a different approach
But the Republican Party doesn't have to follow Christie and Paul's lead. For instance, Ben Carson, a former neurosurgeon and likely Republican presidential candidate in 2016, quickly released a statement Monday with a sharply different emphasis.
"Although I strongly believe in individual rights and the rights of parents to raise their children as they see fit, I also recognize that public health and public safety are extremely important in our society," Carson said. "Certain communicable diseases have been largely eradicated by immunization policies in this country and we should not allow those diseases to return by foregoing safe immunization programs, for philosophical, religious or other reasons when we have the means to eradicate them."
Carson's message is clear — vaccinations, and public health, come first. He's not affirmatively saying that government should mandate them — but he's not framing this particular issue as one of choice and freedom.
House Speaker John Boehner chimed in with a similar view Tuesday. "I don't know that we need another law," he said, "but I do believe all children ought to be vaccinated." Sen. Marco Rubio, another potential presidential candidate, also reportedly said that children should "absolutely" be vaccinated and that there's no evidence of any link between vaccines and autism. Louisiana Gov. Bobby Jindal, too, released a statement saying "vaccinations are important. I urge every parent to get them. Every one."
This message is close to Obama's, in that it calls for vaccinations and endorses the scientific consensus without using those divisive words "mandate" or "requirement." It also resembles the approach Hillary Clinton is taking:
If other top Republicans and conservatives follow this path — and unite with Democrats around the message that this isn't about government overreach or mandates, but rather safety — that will be great news for public health. But if the issue becomes viewed as one of personal freedom, political polarization and division will likely follow.