Anti-Vaccinators and Issue Salience

Basic American Government 101 test question:

Why might politicians find it useful to express sympathy for people who oppose vaccination?

Although most anti-vaccination campaigning is on the far left, it is really something of a bipartisan phenomenon.

Here's Chris Christie:

Speaking in Cambridge, England, New Jersey Gov. Chris Christie said he vaccinated his four children — “the best expression I can give you of my opinion.” 

But unlike other officials, Christie also said parents should have a choice in whether to vaccinate. 

“It’s more important what you think as a parent than what you think as a public official. I also understand that parents need to have some measure of choice in things as well. So that’s the balance that the government has to decide,” Christie said, according to multiple press reports.

Here's Rand Paul:

Republican Sen. Rand Paul is standing by his statement that most vaccinations should be "voluntary," telling CNBC that a parent's choice not to vaccinate a child is "an issue of freedom." 

In an interview with the network Monday, Paul said that vaccines are "a good thing" but that parents "should have some input" into whether or not their children must get them. And he gave credence to the idea - disputed by the majority of the scientific community - that vaccination can lead to mental disabilities. 

"I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines," he said.

On the Democratic side, here's Barack Obama from 2008:

"We've seen just a skyrocketing autism rate. Some people are suspicious that it's connected to the vaccines. This person [not Obama] included. The science right now is inconclusive, but we have to research it."

Here's Hillary Clinton:

Senator Hillary Clinton, in response to a questionnaire from the autism activist group A-CHAMP, wrote that she was "Committed to make investments to find the causes of autism, including possible environmental causes like vaccines." And when asked if she would support a study of vaccinated vs. unvaccinated children, she said: "Yes. We don't know what, if any, kind of link there is between vaccines and autism - but we should find out."

You can parse the exact meaning of the quotes, but the tone of each says everything you need to know: these politicians--at the very least--do not want to alienate this constituency. (Rand Paul is probably more enthusiastically on their side, but Christie, Clinton, and Obama all tread very carefully on this issue.)

The key factor that has gotten left out of most discussions is issue salience. For the vast majority of the population, vaccination is just something you do. It's not controversial; it's just part of having children and getting them ready for school. So they don't think much about it. For most of recent history, they probably didn't know very many people who admitted to not vaccinating their kids.

But for the subculture of the country that is opposed to vaccination, it's a much different story. This medical choice becomes a major part of their life; it has to. It comes up in medical visits, presumably all the time. They probably face a fair bit of social shame from experts who are involved in medical treatment. Moreover, they're the ones whose status quo is at risk from government coercion: in theory, the government could compel vaccination. (Legally, you'd be looking at a framework something like the Religious Freedom Restoration Act, where the government needs a compelling interest to force action. Public health qualifies, certainly, and vaccination is a far easier sale for the government than, say, birth control.)

So the politician that offers the full-throated endorsement for vaccination risks alienating this subculture that takes the issue seriously, for only limited political gain.

This is the standard political calculation, I'd hazard, for most politicians who wade into this thicket. But the calculation changes in a country with an active measles outbreak, particularly if we see vaccinated kids start to come down with the disease. All of a sudden, the complacency of the broad majority--those who support vaccines--is challenged, because the activities of the subculture officially begin to disrupt the mainstream's plans and health. Right now, what we're seeing is the transformation of a low salience issue into a higher salience issue. The hostility from the pro-vaccine crowd towards the anti-vaccine now is much more visceral, now that we see the consequences for ourselves. (We may have thought about these risks in theory, but it's a lot different when childhood diseases that we thought we'd largely eradicated come roaring back.)

So it wouldn't surprise me if we start to see more public pushback from politicians who sense the ability to jump on this wave of public anger. Indeed, it is sort of Chris Christie's stock-in-trade, so I was surprised by his equivocating comments. And, in fact, if Republicans don't jump on board and reject this forcefully, they're going to pay a political price.