Measles was eliminated
in the United States in 2000. However, between 2013 and 2014 the incidence of measles in the United States tripled -- to more than 600 cases. This figure may not be the world tally of 400 people a day dying from the disease, but it is unacceptable. And the scenario for whooping cough? 2012 saw nearly 50 times as many cases as the low in 1976
, and 2014 data will likely be worse.
As a mom whose 3-month-old daughter got whooping cough, I can get riled up about people choosing not to vaccinate themselves or their children.
As an economist, I have a proposal to increase the vaccination rate: Ask whether your family's caretakers and visitors are vaccinated and, when appropriate, insist that they be.
When my son was born in 2010, right after news reports of two local newborns dying from whooping cough, my husband and I decided to "cocoon" him by ensuring that anyone who visited or came into contact with our newborn was fully vaccinated. This mostly involved staying in a lot and making sure that the grandparents were current on their vaccines. For us, it was the best way to protect him when he was still too young to be vaccinated.
When our daughter was born during an unusually severe flu season last year, we decided also to cocoon her during her newborn phase. However, this time was less simple. My husband had to travel abroad for work a few weeks after my daughter's due date, so I hired a postpartum doula, a professional who focuses on helping mothers at home with their newborns.
In the process I learned that postpartum doulas, despite working specifically with newborns, are not consistently vaccinated against the diseases that pose the greatest risks to those for whom they care. When I later went on Care.com to find child care help, I learned that there was no check box for vaccination status. I placed an ad stating upfront that I was only interested in hiring fully vaccinated individuals, and yet six out of 19 promising applicants were not fully vaccinated. It made me wonder if many nannies and baby sitters are not fully vaccinated for the diseases posing the greatest risk to babies.
I realized that I cannot assume caretakers for my baby or my 98-year-old grandmother are vaccinated. But I am not powerless. I have the ability to do something to protect my family. I can ask those who come into contact with us whether they are vaccinated. If they're not, then I can insist that they get vaccinated before getting near my newborn.
By asking upfront whether a potential postpartum doula, nanny, baby sitter, senior helper or even a visitor is vaccinated, I can show people that immunizations provide the added benefit of opening the door to my home and maybe even a job.
Yes, this can feel awkward. And while it is unlikely to persuade those ardently opposed to vaccinations, it will protect my family and likely sway some who simply could not be bothered otherwise.
As for my daughter, fortunately she contracted whooping cough after receiving the first shot, so her case was relatively mild. However, she is still too young to be vaccinated against the deadly measles. Am I asking people she will come into contact with about that vaccine? You bet.
Economists know that most people make decisions in their own best interest by weighing the perceived benefits of an action against the perceived costs. If we increase the pros and decrease the cons, then we tip the cost-benefit scale in favor of vaccination.
Efforts to do this are already underway. Nasal spray versions of vaccines reduce physical pain, which is a cost. When offering free vaccines at work, companies reduce the time, inconvenience and costs of immunization.
Last year, California implemented a law
requiring parents to get waivers signed by medical professionals before enrolling their unvaccinated kids in school. This reduced the incremental cost of vaccinating for parents who might have skipped vaccinations due to the inconvenience of having to take their children to the doctor.
While we must continue relying on health professionals and journalists to educate the general public about vaccine-preventable diseases and the benefits of vaccination, as individuals, we must also act. We have to encourage -- incentivize, even -- those around us to get vaccinated.