by Jennifer A. Reich
“Thanks, Anti-Vaxxers. You Just Brought Back Measles in NYC. Measles was considered eliminated at the turn of the millennium. Now it’s back, thanks to the loons who refuse to vaccinate their children.”
This was the lead of a story this spring on the Daily Beast. Although this impassioned post communicates fear and frustration that accompany threats of vaccine-preventable infectious disease, it doesn’t accurately characterize the parents who choose not to vaccinate their children. In this study, published in October in Gender & Society, I interview mothers who reject recommended vaccines for their children, either by opting out completely, consenting to only a few, or reworking the schedule to meet their own preferences to understand how they make sense of the choice. These mothers care about their own children and aim to make the best decisions for them, which they believe requires questioning medical information, educating themselves from sources they see as more reliable (and independent from medical or public health sources), and actively managing their children’s lives.
Research shows that parents who intentionally reject vaccines (versus under-vaccinated children who lack access to care) look different. Children who are intentionally unvaccinated are more likely to be white, have a college-educated mother, and a higher family income (as Table 1 shows). Taking these patterns seriously, my research explores how vaccine resistance is a form of privilege that allows mothers to reject professional recommendations and opt out of state law without fear of repercussion. How do mothers’ explanations reflect their access to privilege and what might be the costs of other families?
Mothers in my study describe their efforts to protect their children’s health in ways they see as making vaccines unnecessary. They focus on organic foods, breastfeeding, health-promoting practices at home, and control of their children’s social exposure as ways they see themselves as mitigating disease risk. As experts on their own children, women saw their efforts as superior to the generic recommendations made by medical professionals who did not know their children. Although many of these practices are not shown to affect vulnerability to infectious disease, mothers worked hard in time and resource-intensive ways to protect their children without vaccines.
Public health law which requires vaccines for school attendance aims to create community-level immunity by vaccinating a critical portion of the population. In the chart below, if you imagine that all the green people are vaccinated and the red people are infected with vaccine-preventable diseases, the blue unvaccinated people are protected from infection because all the green people who are vaccinated create community immunity (or herd immunity) which serves to protect those in the community who would be vulnerable. This includes those who cannot be vaccinated for medical reasons, those for whom vaccines didn’t work to generate immunity, the elderly, the immune-compromised, or those who lack access to care. It also includes those mentioned above, who are undervacccinated because they lack access to healthcare providers and vaccines. Those who simply choose not to participate in vaccines are known in public health literatures as free-riders since they gain protection from the community without actually contributing to public health.
My research shows that although mothers were often familiar with claims that their children were free-riders, they found the argument that they should participate in public health to be unconvincing. Rather, as mothers, they see themselves as uniquely responsible to their own children and do not perceive responsibility for other children who they hope have mothers making good decisions for them. However, they rarely consider that other children’s mothers may not be equally able to invest these same resources of time, education, or money in optimizing their children’s health, or that vigilance cannot necessarily control infectious disease.
Mothers who reject vaccines are not “loons” as popular media would suggest. They spend considerable time and resources deciding what their children need and how to protect them. Yet they do so from a perspective that treats vaccines as a technology for individual consumption that mothers should assess and decide independently whether to use. This ethos—reflecting neoliberal goals that individuals behave as informed consumers responsible for their own health—lies in sharp contrast to the tenets of public health that expect individuals to accept minimal risk to protect those among them who are most vulnerable.
Jennifer A. Reich is Associate Professor of Sociology at the University of Colorado, Denver. Her article, “Neoliberal Mothering and Vaccine Refusal: Imagined Gated Communities and the Privilege of Choice,” is forthcoming in Gender & Society and currently available via OnlineFirst here. For the article press release, click here.