The measles outbreak suddenly broke into U.S. political banter on Monday after New Jersey Gov. Chris Christie said the government must strike a “balance” between parental choice and public health.
But do private vaccination beliefs belong in public policy?
Yes, assert a leading bioethicist and a top voice on infectious diseases.
That's because the vaccination stance taken Monday by Christie — as well as ones proclaimed by President Barack Obama, Kentucky Sen. Rand Paul and Hillary Clinton — should be compared against known medical facts and the health spending caused by disease outbreaks, the experts said.
In short, the experts argued Americans should know how their leaders view vaccinations because science has shown national vaccination programs keep more Americans disease free, and the money paying for those immunizations saves the country later in higher medical costs.
"The reason we have developed vaccines against these diseases is because these are bad diseases," said Seth Mnookin, a professor of science writing at MIT, and author of the book "The Panic Virus."
"In regard to measles, it creates an incredible public health burden in terms of how much money is spent on containing each case of measles, making sure people are quarantined," Mnookin added. "One study has shown it costs $10,000 per case. So when when you’re talking about ... hundreds of cases, that’s real money that could be spent towards keeping people healthy in other ways."
Christie, a possible 2016 presidential contender, initially said Monday: "You know it's much more important what you think as a parent than what you think as a public official. And that's what we do. But 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."
He made the remark as an outbreak of measles initially linked to Disneyland has sickened more than 90 people in California with the preventable virus. California contains several clusters in which a higher-than-usual percentage of parents have refused to vaccinate their children, state health officials have found.
Hours after Christie spoke on the topic, his office issued a clarification: "The Governor believes vaccines are an important public health protection and with a disease like measles there is no question kids should be vaccinated. At the same time different states require different degrees of vaccination, which is why he was calling for balance in which ones government should mandate."
Obama on Sunday told Americans, "get your kids vaccinated." He told NBC News' Savannah Guthrie, "The science is, you know, pretty indisputable."
Clinton, a possible 2016 Democratic presidential nominee, and Sen. Paul both waded into the controversy as well. Paul gave credence to the idea that vaccinations can lead to "mental disorders" and told CNBC on Monday that most vaccinations should be "voluntary."
Clinton, however, tweeted that the "science is clear" against such an argument.
MIT's Mnookin said those positions could influence larger health-care spending.
"You might need to quarantine a [measles-exposed] child for two to three weeks, [which adds] child-care costs, [and adds] taking time off from work costs," he said. "Even if not a lot of people end up in the ER, even if all that happens is a bunch of measles infections, that still costs."
Americans do and should care what their political leaders and possible candidates have to say about vaccinations, asserts Arthur Caplan, founding head of the division of bioethics at NYU Langone Medical Center, and a frequent NBC News contributor.
"Sadly, our politicians haven't said much for a long time about that. Vaccination has been seen as a local issue, not a national issue. But given the fact that viruses don’t care about state borders, it makes no sense to not ask national officials or candidates about their views."
Part of that reluctance among politicians to take a public position on vaccinations may be fueled by a core of American voters who are staunchly anti-vaccine, some of whom believe — despite what science has shown to the contrary — that immunization shots for children are unsafe.
"When it comes to the vaccination, we haven't gotten much comment until the measles epidemic because it’s a political third rail," Caplan said. "But it shouldn’t be when science says vaccination supports public health. I think politicians should back that position."
A survey released last week from the Pew Research Center showed that 68 percent of US adults believe that vaccinations of children should be required, while 30 percent say that parents should be able to decide not to vaccinate their kids.
In 2009, 71 percent of both Democrats and Republicans said vaccinations should be required. By last August, that number decreased to 65 percent for Republicans, but it's increased to 76 percent for Democrats.
Judy Silverman contributed to this story.