Here’s my suggestion for dealing with anti-vax parents in the United States:
Every person who receives a vaccination pays 75 cents per dose (so $2.25 for a triple-dose like MMR) into the National Vaccine Injury Compensation Program (NVICP). Because vaccination is SO important for public health but does have measurable risks, the government created a special program that removes vaccinations, from the most part, from the expensive system of tort liability and puts it in a special no-fault liability system. If you develop one of the known complications of a particular vaccine, you are paid out of the NVICP fund, without even having to prove your complication came from the vaccine specifically. (If you develop an unknown complication, you can go through a court-like process to request compensation.) As vaccines overall get safer, the cost-per-dose paid to NVICP falls; if vaccines get more dangerous, it rises. All victims are compensated appropriately (and have rights of appeal) so that we can get the great public health good of vaccinations while paying recompense to the small number of people who will, inevitably, suffer the rare side effects.
Now, we will remove children with medical exemptions from this question (although the medical exemption will now have to be approved by a state medical official, not just a drive-through doc who hands out medical exemptions for anything). They’re among the people who need protection! If we want, they can pay the 75-cent excise tax on their medical exemption per dose. So leaving aside that group:
I propose that anyone, for any reason may pursue a Certificate of Non-Vaccination and to do so, they will pay into the Vaccine-Preventable Illness Compensation Fund. This fund will cover ALL of the costs of ALL vaccine-preventable diseases — all medical care for all patients, all governmental costs for intervention to prevent an epidemic, reasonable compensation for time and inconvenience and lost work for workers/parents who are subject to quarantine, and reasonable compensation for long-term injuries or deaths, exactly the way that the NVICP does for people injured by vaccines. Part of the problem is that the cost of vaccine injuries is borne by those who vaccinate for the good of public health, while the cost of failing to vaccinate is borne by taxpayers generally, so what we need to do is shift the cost of failing to vaccinate on to those who refuse to vaccinate.
So a couple of years ago I worked this out for California, which has pretty good vaccination statistics and had recently had a measles epidemic (2008 maybe?). I looked at the CDC’s estimates of the costs of medical care for all the patients under the age of 18, the costs to the state government for controlling the epidemic, and I threw in a reasonable (small) compensation amount for the two (I think) children who died based on lawsuits for wrongful death in other sorts of cases. Then I divided that total number by California’s estimate of the total number of unvaccinated children in the state of California, to work out what it costs the state of California per unvaccinated child in the case of a very small measles outbreak.
You’ll be happy to know that you could acquire a Certificate of Non-Vaccination for Measles for the low, low price of $10,000 per skipped measles dose.
Give parents the choice. Vaccinate their children and pay the 75-cent excise towards the total cost of the injuries caused by vaccines, or let them skip vaccinations and pay the $10,000 excise towards the total cost of injuries caused by vaccine-preventable diseases. It will probably help them make more appropriate risk assessments, and of course the cost of the vaccine vs. the certification will rise and fall with the risk of vaccinating vs. not vaccinating. If, in fact, skipping vaccinations is as safe as claimed, that cost will fall dramatically! Let the free market solve the problem by shifting the costs onto the appropriate people.