The Needs of the Many versus the Needs of the Few
By Albert B. Kelly
When you’re a government official, elected or otherwise, assuming
you’re trying to do the job right, you go through a process of thinking about
things from the perspective of both the individual and the community as a
whole. I try to do this when considering a new program, policy, or rule. An
important measuring stick is considering whether something is achieving the
greatest amount of good for the greatest number of people. Another way of
measuring is asking whether the needs of the many outweigh the needs of the few.
Nowhere is this more of an issue than in the area of
vaccinations. Recently, New Jersey and New York were among two dozen states
dealing with a significant outbreak of measles, a disease that health officials
had basically declared “eliminated” in this country 20 years ago. If I’ve read
press reports correctly, both New York and New Jersey got hit the hardest with the
number of infected people in double digits over several counties.
In terms of how the measles outbreak began, officials
believe it started when an unvaccinated child contracted the disease during a
trip overseas. As to why we’re having outbreaks here, it’s a little more complicated
but it basically comes down to the growing number of parents that refuse vaccinations
for themselves or their children. The result is clusters of people in various places
who are either infected with or vulnerable to a disease that had previously been
eliminated until now.
Some vaccines, such as the measles vaccine (“MMR” for Measles-Mumps-Rubella),
have been around for decades with a track record that should inspire confidence,
yet that wasn’t always the case. In 1901, nine Camden school children died
after being vaccinated with a type of smallpox vaccine. According to a 2016
article in “Main Line Today” by Mark Dixon, that batch of vaccine turned out to
be contaminated with tetanus. As a side note, the manufacturer of that vaccine
was Bridgeton native Henry K. Mulford who was a big player in the
pharmaceutical industry back in the day.
My point in mentioning the Camden incident is that unlike today,
people in 1901 didn’t have vaccines with long track records nor did they have
the FDA or the regulatory oversight that we now have, so caution and skepticism
were understandable. Today at least in terms of MMR vaccinations, we have
better science and robust regulation, yet mistrust is only growing.
Some decline MMR vaccinations for bona fide religious
reasons while others simply can’t be vaccinated due to age or specific health
conditions. A larger number however, avoid vaccinations because they believe
them to be the cause of conditions such as autism even though medical science simply
doesn’t support this claim. In contrast, we know that measles can easily lead
to pneumonia, swelling of the brain, and even death.
Now some might say that if a person doesn’t want to be
vaccinated, let them assume the risks. Fair enough, but the risks aren’t theirs
alone. Is it acceptable for someone to impose their risk on those who can’t be
vaccinated such as infants, those who are pregnant, people with weakened immune
systems, and the frail elderly all of whom are known to be at high risk for
complications? Keep in mind that the virus can live for up to two hours in the
air and on surfaces where an infected person coughed or sneezed so it doesn’t
take much to infect others.
It’s a hell of a balancing act weighing the needs of the
many against the needs of the few. Officials in NYC wrestled with just this
issue in April and came out on the side of the many concerning the measles outbreak
and declared a public health emergency in response. It required the
unvaccinated in certain neighborhoods to get vaccinated within 48 hours or prove
they were medically exempt. The order came with fines and penalties while also providing
free vaccinations for those in need.
What’s unique about our constitution is the degree to which
it elevates and protects the individual and yet there are an increasing number
of issues today that are like vaccinations, issues where the needs of the many
are pitted against the needs of the few whether gun control, income inequality,
global warming, or access to health care to name but a few. So far our
“national dialogue” hasn’t worked; maybe it’s time to declare a public health
emergency.