Intended for healthcare professionals

Rapid response to:

Education And Debate

Anti-vaccinationists past and present

BMJ 2002; 325 doi: (Published 24 August 2002) Cite this as: BMJ 2002;325:430

Rapid Response:

Evolution shows the immorality of anti-vaccination movements

Wolfe and Sharp [1] seem to suggest that public health
authorities should not choose "a heavy handed approach"
to cope with anti-vaccination groups, because it "can
threaten the values of individual liberty and freedom of
expression that we cherish" [1]. Evolutionary arguments,
however, suggest that the respect for those values is
intrinsically immoral if it causes detrimental consequences
for the community [2, 3].

The biological ethic that has wisely guided humankind for
millions of years was far more concerned with the well-being of the
community than with individual interests,
because evolution rewarded the moral - ie socially beneficial - decisions
of a group by favouring its survival, and punished the immoral - ie
socially harmful - decisions by
hastening its extinction [2].

If human beings were still living in social groups consisting of a
few tens of members, as humankind did for the 99% of
its evolution [4], the individuals of those small communities
would hardly be so crazy and immoral as to oppose immunisations, because
an epidemic of a fatal contagious disease, besides killing themselves and
their relatives, will
menace the survival of the entire community. By contrast,
even in the case that immunisations produce adverse effects on some social
members, that small community will
survive. Evolutionary arguments, therefore, clearly show that what counts,
in any social decisions, is the good of the
community, not the good of the individual [2].

The immorality of anti-vaccination movements is not easily
recognisable socially in the present immense communities,
because, unlike in the small primitive ones, epidemic diseases harm and
kill only a minority in today's societies,
which consist of millions of individuals [2]. Such minority,
however, often exceeds the population of thousands of little ancestral

Since evolution has taught human beings that what could
potentially jeopardise the well-being and the survival of the
community is to be regarded as immoral and condemnable
[2], public health authorities should use a heavy handed approach to face
anti-vaccination propagandists, whose individualistic claims cannot but
harm the community. As has righty been pointed out, "We can't afford to be
half hearted about vaccination programmes" [5].

Humankind, as an eminently social species that survived for millions
of years thanks to its biological ethic aimed at preserving the good of
the community, should firmly reject any philosophical positions that,
invented in the last 0.1% of human evolution, favour the interests of the
individual at the expense of the community.

1. Wolfe RM, Sharp LK. Anti-vaccinationists past and present. BMJ
2002;325:430-2. (24 August)

2. Baschetti R. Ethical analysis in public health. Lancet

3. Baschetti R. People who condemn eugenics may be in minority now.
BMJ 1999;319:1196.

4. Wilson DS. Human groups as unit of selection. Science

5. King S. Vaccination policies: individual rights v community
health. BMJ 1999;319:1448-9.

Competing interests: No competing interests

26 August 2002
Riccardo Baschetti
retired medical inspector
CP 671, 60001-970 Fortaleza (CE), Brazil