“Vaccine hesitancy,” the term given to parents reluctant to immunize their kids from measles or mumps or any of the other 18th century diseases spreading through 21st century immune systems, is wreaking global havoc.
In 2018, Europe had 60,000 documented measles cases — a 20-year high experts put squarely on the shoulders of anti-vaccine skeptics, the Guardian reports. Here in the U.S., massive measles outbreaks in Washington and New York have led officials in both places to declare a state of emergency — 60 new cases were reported in New York City in the week of April 1 alone.
All this despite overwhelming evidence that vaccines are not just safe, but critical to a healthy, functioning society. And the bulk of the naysayers, research shows, is a group of people fully equipped to know better.
Disease experts say the parents least likely to vaccinate their kids live in some of the most affluent neighborhoods in the country. They’re well-educated, and have exceptional access to healthcare. And while some pockets of low-income communities of color are “under vaccinated” for religious or financial reasons, studies published in places like the American Journal of Public Health show that the parents opting out for “philosophical reasons” are mostly white and mostly wealthy.
“Helicopter parenting” is partially to blame, says Linda Fentiman, a Pace law professor who specializes in health law and vaccine exemption.
Parents who opt out of vaccines tend to “believe, simply, that they can make the scientific determinations about the efficacy and dangers of vaccines for themselves,” she says.
They have more free time on their hands than lower income parents — time that can be spent poring over anti-vaccine forums and websites, and applying for state-specific exemptions required to bypass school immunization laws.
And they believe what they’re reading: That vaccines cause autism, or contain harmful toxins; claims have been thoroughly debunked.
To be fair, there’s a lot of effort that goes into making them think otherwise.
Anti-vax theories don’t live and die in Reddit threads — these are mainstream movements bolstered by powerful nonprofits. So even as Facebook and Pinterest crack down on posts from vaccine skeptics, charities like the National Vaccine Information Center, famous for erecting anti-vaccine billboards in Times Square, are still leading the conversation.
On the grassroots level, independent vaccine skeptics like Larry Cook have raised tens of thousands dollars on GoFundMe, and use at least some of those funds to pay for Facebook ads targeting new moms, the Daily Beast reports (like other social platforms, GoFundMe recently announced it would remove all anti-vax campaigns on its site).
Currently, 47 states allow parents to “opt out” of the Center for Disease Control’s recommended vaccine schedule for religious beliefs (California, Mississippi, and West Virginia are the outliers), and 17 states have exemptions for “philosophical” reasons.
Some states make this process harder than others. In Pennsylvania, you can opt out just by submitting a letter to your kid’s school. In Washington, you need a doctor to verify you’ve had a thorough talking-to on the benefits and risks of vaccination. Again, Fentiman says, “Wealthier parents have the time and ability to jump through [these] hoops.”
When an outbreak does happen, rich families aren’t the only ones affected, of course. Usually, they aren’t even the hardest hit.
In New York, recent measles waves in Brooklyn and Rockland County are largely confined to ultra-orthodox Jewish communities. When measles hit Minneapolis in 2017, most of the sick kids were Somali-American.
These are immigrant and insular communities that are tight-knit, but unshielded from anti-vax disinformation campaigns — New York City health officials told Vox that propagandists are actively targeting orthodox neighborhoods. And because they tend to have fewer resources than most Americans, they’re less protected when tragedy strikes.
This underscores a more sinister theory about why rich Americans are opting out of vaccines.
A string of research referenced in the Washington Post last year suggests that wealthy people simply have less empathy than everybody else. They’re more likely to cheat on their taxes, and their spouses. And they give lower proportions of their income to charity.
"Wealth is basically a mechanism for power, and power has a freeing effect on people,” the social psychologist Adam Galinsky told the Post. “It takes away the constraints of society and frees people to act according to their dominant desires.”
If you’re rich, the consequences of “opting out” aren’t particularly dire. After all, it’s easier to rationalize the risks of bypassing immunization if you can afford a lengthy hospital stay, or to pull your kid out of daycare if her classmate gets sick.
And while the U.S. has a long history of stigmatizing poor parents—“free range parenting,” versus neglect, “welfare moms” versus stay at home mothers—if you’re a wealthy anti-vaxxer, you probably won’t face any social ramifications either.
“Mothers and fathers who choose not to vaccinate … they’re not really vilified,” Fentiman says. “It’s really an anomaly.”
Correction: An earlier version of this story referred to the communities most heavily impacted by measles outbreaks as "immigrant communities." In regards to ultra-orthodox Jewish neighborhoods, the phrase "insular communities" has been added.