That’s interesting you say that, about isolation, because it’s been reported that many of these recent measles outbreaks have occurred within rather insular communities.
Infectious disease blows apart our assumptions about insularity. It’s true that within the last five years, the majority of measles cases have happened in relatively insular communities — a Somali community in Minnesota, an Amish community in Ohio, an Eastern European community in Washington. And I’ve observed anti-vaccine attitudes in my own insular community, which is “women poets who are highly educated and fairly economically privileged.”
A few years ago, The Hollywood Reporter ran a story about low vaccination rates in very wealthy areas of Los Angeles; one of the observations made in that article was that vaccination rates there were as low as some countries like Chad and South Sudan, countries that have little access to medical care. At one time, I was thinking of vaccination more in terms of privilege. But it’s more that one of the aspects of privilege is that you tend to circulate among other privileged people. There is an insularity to privilege, too.
Within communities where people believe themselves to be living apart from the mainstream — and I’m speaking from my own experience here — you can begin to have the illusion that you really are living apart and that your actions alone may affect your community but won’t reverberate beyond it. When the reality is no such community exists when it comes to infectious disease. A disease, once it’s moving within a community, will never stay solely within that community. What I failed to appreciate, before I started researching this deeply, was the consequences for people who weren’t like me.
And that’s something we’re not always so great at doing in the U.S. There’s this amazing fact that’s a little mind-boggling to me: You’re more likely to catch an infectious disease if you’re a vaccinated person in a totally unvaccinated community than if you’re an unvaccinated person in a totally vaccinated community. Vaccination is not all that effective if only one person does it, but it’s incredibly effective if nearly everyone does it.
But in order to achieve that affect, we need to reach consensus on vaccination. For a disease like measles that’s highly contagious, the percentage of people who are vaccinated needs to be in the upper 90s.
But what are the challenges for the U.S. in reaching that kind of consensus? You said our social structures are not set up for it, and I tend to agree. In the United States, our political structures don’t operate by consensus; they operate by majority. Which means we accept that there will also be a minority opinion — people who feel themselves to be outliers from the majority will behave differently than the people around them. It’s part of our diverse society. But when it comes to something like climate change or vaccination, it’s not functional for us to have a few pockets of people who are not participating.
