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  • Anti-Vaxxers, Anti-Anti-Vaxxers, Fairness, and Anger
  • Justin Bernstein

Some parents take advantage of legal exemptions for the measles-mumps-rubella (MMR) vaccine. While there are a variety of reasons parents do so—including having children with medical conditions that make vaccination medically unsafe—some parents appear to be driven, at least in part, by (false) beliefs that vaccines cause a variety of diseases or conditions, such as autism. Those who delay or refuse the MMR vaccine because of false beliefs about its side effects (‘MMR-refusers,’ or people who engage in ‘MMR-refusal’) elicit a strikingly strong response from many who endorse MMR vaccine mandates. Accusations of moral wrongdoing, expressions of anger, indignation, resentment, or disgust frequently appear in social media posts, op-eds, open letters, and political cartoons.1 In fact, some MMR-refusers report having received hate mail or physical threats from strangers.

While hate mail and physical threats are morally abhorrent, presumably, some readers will share the judgment that, in many cases, MMR-refusal is morally wrong. And, presumably, some readers feel some of these emotions—anger, indignation, resentment, or disgust—towards MMR-refusers. In this paper, I argue that there is a fairness-based moral obligation to get one’s child vaccinated against MMR. Relatedly, appeals to fairness are well-suited for charitably explaining at least some cases of anger towards MMR-refusers. I have four goals in making this argument.

First, while others have defended the existence of a fairness-based obligation to get vaccinated, these discussions have remained relatively insulated from more general discussions in political and legal philosophy of fairness-based obligations to contribute to the production of certain kinds of public goods.2 Moreover, I believe these more general discussions can help in providing a persuasive defense of the fairness-based obligation to vaccinate for MMR. To this end, in §1 I discuss vaccine-refusal and its effects on herd immunity. I then draw on George Klosko’s articulation of ‘The Principle of Fairness,’ which obligates us to comply with widely observed [End Page 17] legal or social rules that provide indispensable benefits. I argue that the form of MMR-refusal discussed in this paper violates the Principle of Fairness.

My second goal in the paper is to consider, more fully, not just arguments about moral obligations to get vaccinated, but also to take into account the emotional responses to MMR-refusal. While there has been excellent ethics work that discusses the psychology of various MMR-refusers,3 there is far less discussion of the emotional response to MMR-refusers. This paper considers these emotional responses and situates them vis-àvis broader ethical debates about vaccine-refusal. In particular, in §2, I argue that fairness-based accounts are well-suited to providing a charitable explanation as to why some people get so upset in response to MMR-refusal.

My third goal in the paper is to show why the argument from fairness is better at providing a non-revisionary vindication of the obligation to get vaccinated than prominent rival views in the literature that attempt to justify a moral obligation to get vaccinated. I set out criteria for this assessment in §3: all else equal, we should prefer arguments that are less revisionary of our moral judgments, and we should prefer arguments that can charitably explain the emotional response of MMR-refusers. In §4–7, I consider these rivals that feature prominently in the literature—arguments that appeal to (individual or collective) risk-imposition, rights-violations, or failures to protect one’s own child. I suggest that these rival arguments imply that various actions, such as owning a private pool or trampoline, driving a large car for fun, or not getting vaccinated for flu all violate a moral obligation on the same grounds that MMR-refusal does—even though many find such conduct far less objectionable, or even permissible. In other words, the argument from fairness is less revisionary than its rivals. Relatedly, these rival arguments also would seem to entail that much of the emotional response to MMR-refusers is a case of inconsistency or selective outrage. The argument from fairness, on the other hand, can provide a...


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pp. 17-52
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