Is the "personal freedom" argument against vaccines a logical fallacy?
It`s a very common argument in anti vaccine and vaccine hesitant circles of people - and on the surface, it seems completely reasonable. Why shouldn't you be allowed to have autonomy over your decision-making and indeed your life? Of course. It makes complete sense, at first glance….
At first glance
Then I took a second glance, and a third, fourth, fifth, and soon realised something very interesting. “Personal”, by definition, only refers to an individual, as opposed to a group or community. This doesn't apply to vaccination, as a core principle of vaccination is that it protects many others through herd immunity. This is a pillar of not only vaccination, but of Microbiology and Immunology more broadly.. For that reason,it could be said that the “personal freedom” argument against vaccination is a “strawman fallacy”. This means that what someone said is distorted/twisted so that it is easier to debate them.
Let's apply this in a more practical way.
2 . Why vaccination is distinct from other healthcare decisions
Take someone who is on medication; maybe it's blood pressure medication for instance. In theory, they`re free to stop taking it at any time. Nobody is going to stop them, right? The consequences of not taking it are going to affect them and only them. Nobody else is going to become ill , hospitalised or die because of this. In my opinion, in this case it's a personal choice. So, here the personal freedom, my-body-my-choice arguments would absolutely apply.
Here's the distinction between this and vaccines. According to Dr. Gretchen LaSalle, family physician, vaccine hesitancy expert and author of Let's Talk Vaccines, Immunocompromised people are at risk when others don't vaccinate. There are different reasons for immunocompromisation - a disease itself (like leukaemia or lymphoma) may put someone at risk. Alternatively, some medications used to treat autoimmune disease can lead to immune compromise. For diseases like Rheumatoid Arthritis, Multiple Sclerosis, Psoriasis and others, some of the medications used to treat the disease work by suppressing the immune system so the body won’t attack itself (which is what autoimmunity means - the immune system is attacking the body in a variety of ways).
In suppressing the immune system, they increase the risks of infectious disease. Prednisone at doses over 20 mg per day and medications like Humira, Enbrel and others cause a risk of contracting infections. They may not be able to get certain live vaccines, for example, such as chickenpox, rotavirus, or the MMR vaccine. Generally, immune compromised patients need vaccination, however the reason for immune suppression often decreases the person's response to vaccines. Further, as people age, they experience what is called immunosenescence - a gradual deterioration of immune response due to advancing age. This is why older people tend to get sicker from infectious disease and why they may not be as strongly protected against disease through vaccination. Immune compromised, elderly, infants, pregnant women, really all of us, need to immunise ourselves for individual protection but we also rely on others immunising to create a bubble of protection around us. So, they depend on you and others around them to vaccinate. That means that the decision of others to vaccinate or not affects them.
Again, I'd argue that this decision doesn`t fit the description of what “personal” actually means.Vaccination is distinct from other healthcare decisions. There is no such collaborative element to other healthcare decisions, and not at such a huge scale.
There`s a reason why many people are passionate about the topic of vaccines. The Internet is inundated with tweets, posts, blogs, etc on the topic of vaccines and vaccine hesitancy. People have rioted, protested, and looted over vaccines. Why? It affects their lives. Families have actually been broken apart because of the topic.Think about COVID-19 lockdowns, without just one vaccine. Jobs were lost, businesses closed, the global economy suffered. I had to complete my final year of college under lockdown. Nobody would make such a significant effort to make their thoughts known on a topic unless it had affected them in some way. The fact that so many people do tells you that many people have been affected; especially in the last few years. So if you want to understand how much vaccination impacts others lives; simply look around. No other healthcare intervention affects the lives of each of the 7 billion people on the planet.
Of course, that's not to say that vaccines don't benefit people individually. They do.
Vaccines work by mimicking an infection, which is a disease-causing organism in the body. This stimulates natural defences. In all vaccines, the key ingredient is an antigen, which is anything that causes the immune system to make antibodies. This may be a weakened or killed bacterium or virus, part of their surface, or a toxin. Newer vaccines contain the instructions to create antigens, and not the pathogen itself. The person will still launch an immune response to this, however will not get the disease from it.
According to the website of the CDC; herd immunity, also known as “community immunity” (or sometimes population immunity), refers to “a situation in which a sufficient proportion of a population is immune to an infectious disease (through vaccination and/or prior illness) to make its spread from person to person unlikely. Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered some protection because the disease has little opportunity to spread within the community.”
This phenomenon, as mentioned, is a core principle of vaccines, as well as Microbiology and Immunology more broadly. The exact percentage of people needing vaccination varies with disease. For highly contagious diseases like polio, measles, and pertussis (whooping cough), the vaccination rate required to achieve herd immunity is much higher. According to the World Health Organisation,, it is above 80% in the case of polio, and 95% for measle. According to a 2021 paper by Dr. Pedro Plans Rubio; achieving herd immunity against pertussis requires a vaccination rate above 90%. I`m saying 80 and 90% however, these are really the minimum.
Those percentages are really just a baseline. Disease incidences aren't suddenly going to stop at some defined point - it is more of a gradual process. We ideally need as close to 100% of people as possible vaccinated to truly harness the power of herd immunity. Some pathogens are always going to “slip through the cracks'', so to speak. Others have breakthrough infections. Disease transmission is also dependent on human behaviour too. Some people have an increased risk individually, as I described. If there is one person in 10 who is immune compromised and vaccinated they will have some level of protection. However, if 8-9 out of those 10 people around them are also vaccinated, that one immune compromised person is so much more protected.
So from this, it should be clear that yes, there certainly is a personal component to vaccination decisions. However, their power at the community level lies in herd immunity. This collaborative element to vaccination decisions is what (in my opinion) makes them distinct from other healthcare decisions.
However, why does this matter? Shouldn't we all just have autonomy; and decide whether or not to vaccinate regardless of the outcomes? Well, of course you can. Nobody is going to force you to vaccinate or not. However, I`ll say something else. Someday, that immunocompromised patient might just be you, or one of your loved ones. Someday, you might just have to trust strangers to make the decision that saves your life (ie. vaccinating). Thanks for reading.