Chris Christie (R), governor of New Jersey and likely presidential aspirant, recently announced that parents should have choice over obtaining vaccinations. Though he has since stated this choice should not be applied to the measles vaccine, Sen. Rand Paul (R-Ky.), another presidential aspirant, has taken up the call for vaccine choice. Such statements raise an important question: Is it possible to have true vaccine choice without endangering the most vulnerable members of the population, so that everyone’s rights are protected? This is no idle question, given recent outbreaks of the potentially deadly measles virus.

A comparison with the evolution of public smoking laws provides an avenue to see how vaccine choice might work. It used to be the case that one could smoke anywhere. Then it gradually became apparent to the public that smoking had negative health effects, not only for the smoker, but also for some of the people in the vicinity of the smoker. At first, this led to a patchwork of public and private rules banning smoking in tightly enclosed areas such as airplanes and restaurants and workplaces. Over time these rules were extended to places in which smoke could more indirectly impinge on others, such as dorm rooms and hotel rooms and doorways.

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