Mayoral Musings: Common Good

By: Albert B. Kelly, Mayor, City of Bridgeton

The needs of the many versus the needs of the few comes into play regarding vaccinations and other issues. 

When you’re a government official, elected or otherwise, assuming you’re trying to do the job right, you go through a process of thinking about things from the perspective of both the individual and the community as a whole. I try to do this when considering a new program, policy, or rule. An important measuring stick is considering whether something is achieving the greatest amount of good for the greatest number of people. Another way of measuring is asking whether the needs of the many outweigh the needs of the few.

Nowhere is this more of an issue than in the area of vaccinations. Recently, New Jersey and New York were among two dozen states dealing with a significant outbreak of measles, a disease that health officials had declared “eliminated” in this country 20 years ago. If I’ve read press reports correctly, both New York and New Jersey got hit the hardest with the number of infected people in double digits over several counties.

In terms of how the measles outbreak began, officials believe it started when an unvaccinated child contracted the disease during a trip overseas. As to why we’re having outbreaks here, it’s a little more complicated but it basically comes down to the growing number of parents who refuse vaccinations for themselves or their children. The result is clusters of people in various places who are either infected with or vulnerable to a disease that had previously been eliminated.     

Some vaccines, such as the measles vaccine (“MMR” for Measles-Mumps-Rubella), have been around for decades with a track record that should inspire confidence, yet that wasn’t always the case. In 1901, nine Camden school children died after being vaccinated with a type of smallpox vaccine. According to a 2016 article in Main Line Today by Mark Dixon, that batch of vaccine turned out to be contaminated with tetanus. As a side note, the manufacturer of that vaccine was Bridgeton native Henry K. Mulford who was a big player in the pharmaceutical industry back in the day.

My point in mentioning the Camden incident is that unlike today, people in 1901 didn’t have vaccines with long track records nor did they have the Food and Drug Administration or the regulatory oversight that we now have, so caution and skepticism were understandable. Today, at least in terms of MMR vaccinations, we have better science and robust regulation, yet mistrust is only growing.

Some decline MMR vaccinations for bona fide religious reasons while others simply can’t be vaccinated due to age or specific health conditions. A larger number, however, avoid vaccinations because they believe them to be the cause of conditions such as autism—though medical science does not support this claim. In contrast, we know that measles can easily lead to pneumonia, swelling of the brain, and even death.

Some might say that if a person doesn’t want to be vaccinated, let them assume the risks. Fair enough, but the risks aren’t theirs alone. Is it acceptable for someone to impose their risk on those who can’t be vaccinated such as infants, pregnant women, people with weakened immune systems, and the frail elderly, all of whom are known to be at high risk for complications? Keep in mind that the virus can live for up to two hours in the air and on surfaces where an infected person coughed or sneezed so it doesn’t take much to infect others.

It’s a hell of a balancing act weighing the needs of the many against the needs of the few. Officials in NYC wrestled with just this issue in April and came out on the side of the many concerning the measles outbreak and declared a public health emergency in response. It required the unvaccinated in certain neighborhoods to get vaccinated within 48 hours or prove they were medically exempt. The order came with fines and penalties while also providing free vaccinations for those in need. 

What’s unique about our constitution is the degree to which it elevates and protects the individual and yet there are an increasing number of issues today that are like vaccinations—issues where the needs of the many are pitted against the needs of the few. These include gun control, income inequality, global warming, and access to health care, to name but a few. So far our “national dialogue” hasn’t worked; maybe it’s time to declare a public health emergency.