In Chapter 6 of The Wild and the Wicked: On Nature and Human Nature, Benjamin Hale described an argument available to those who oppose vaccinating their children that makes some sense within the structure of desirism.
Mind you, I think everybody should get their child vaccinated, with the standard caveats applying. But a moral argument from the perspective of those who oppose vaccination is, at least, understandable.
It has to do with the distinction between killing and letting die. Or, more to the point, it has to do with killing your child or having it be the case that some disease killed your child.
A parent says, "Go ahead, vaccinate my child." And 3 days later the child is dead.
The parent has to deal not only with the fact that her child is dead, but also with the fact that "I killed her. I made the decision that caused her death. I told the doctor to give her a shot, and she died."
That would be an awful thing to have to live with. That would be brutal.
It is different from the case in which something happens to the child and the child dies.
It's still horrible. The news that one's child has died is still one of a parent's worst nightmares. However, it is different - importantly different - from a situation in which one's child has died "and I killed her."
If the child dies from a preventable disease, there is still the argument that can be made to the parent that, "You refused to save her." Since the odds of getting a serious disease are significantly greater than the odds of suffering from a reaction to an immunization shot, it follows that among those who refuse vaccinations, incidents of "I failed to save my child" will be far more common than "I killed my child" would have been.
Still, this is an important moral distinction.
Let me ask you, the reader, to imagine taking a gun and shooting a child - killing a child. What is the chance of that happening? I am going to guess that for the vast majority of my readers the answer will be, "No chance at all."
And, yet, what effort have you taken to prevent those children from dying?
My guess is that the answer is, "Not as much as I could have."
You are willing to accept a situation where a preventable child catches and dies from a preventable disease (such as malaria) under conditions where you will not accept actually killing a child. The anti-vaxer can make the same argument. She is horrified at the idea of performing an action that kills a child, but finds it a lot easier to accept the possibility that some other force - some preventable disease - might kill a child.
How can you, the reader, be so insistent on parents getting their children vaccinated to prevent them from getting a disease, and yet be so indifferent to other children that are at risk of preventable diseases that you make no effort to prevent?
These different attitudes between killing a child and letting some other force of nature kill a child are not so rare.
There is a reason, within the theory of desirism, to form a far stronger aversion to killing than to letting die.
Imagine if your reaction to every instance of a child dying a preventable death was met with the same emotional involvement as killing a child. You and I would both be emotional wrecks. We could not handle it. Well, I know that I would be - if I think about it too much. It is, literally, just too much to bear. Not killing children is easy - I could do it in my sleep. Attaching the same level of concern to preventing children from falling victim to preventable harms - I would find even eating and sleeping difficult.
So, we have more and stronger reasons to promote an aversion to killing than we have for promoting an aversion to allowing a child to suffer from a preventable disease. You do it. I do it. The anti-vax parent does it.
I have to say, as a moral philosopher, I am not always able to defend everything I do (or fail to do). I do not always come across as the best possible person. Others, who do not devote so much time and effort to thinking about such things, can likely come up with a convenient rationalization and go on with their lives. This option is not so readily available to the person who opts to forego convenient rationalizations.
Now, we cannot deny that an obligation of a parent to their own child should be more than, "I didn't kill her". There is a duty to protect the child - a duty to protection that non-parents do not have. This duty of protection does not apply to strangers - at least not so much. It is from this that one can argue that the non-vaxing parent may be condemned. Certainly, they are living up to the duty not to kill their child, but they are neglecting the duty to protect the child from harm. And this is a duty - a sentiment that people generally have reason to promote and encourage universally.
Though too much protection is also a fault. A parent has to simply live with the fact that it would be wrong to protect a child from all possible risks.
With these considerations in mind, it is possible to see the anti-vax parent as one for whom the sentiment of not harming their child is particularly strong, and is being put up against a weaker sentiment of a duty to protect that is simply not as strong. In this light, it is not such an unreasonable position. I still hold that it is wrong, though these considerations are able to portray it as not such a foolish and contemptible error.
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