Vaccines and Their Critics

This year we witnessed a lot of contentious debate in newspapers and on television shows about the safety and efficacy of vaccines. Recently, for example, the actor and anti-vaccine activist Jim Carrey spoke out against a new law in California that eliminates personal-belief exemptions from mandatory vaccination. Carrey tweeted: “California Gov says yes to poisoning more children with mercury and aluminum in manditory [sic] vaccines. This corporate fascist must be stopped.” Carrey received Twitter support from other celebrities including Kirstie Alley, Selma Blair, and Erin Brockovich. Meanwhile, a woman from Washington state died of measles in June, reportedly the first measles death in the United States in a dozen years. And,

in Seattle, only 81 percent of kindergarten students have been vaccinated against the polio virus, a rate “lower than the 2013 polio immunization rates for 1-year-olds in Zimbabwe, Rwanda, Algeria, El Salvador, Guyana, Sudan, Iran, Kyrgyzstan, Mongolia and Yemen, among other countries.”

In a 2014 post on this blog, I told the story of a child in the hospital who nearly died from whooping cough. I pointed out that vaccine critics today make similar objections to vaccine critics from the eighteenth and nineteenth centuries. But why has this criticism persisted such that outposts of communities still refuse to vaccinate their children? Why does the vaccine controversy continue to resurface?

I have since followed up on this subject with a full-length essay in The New Atlantis, now available online: “Vaccines and Their Critics, Then and Now.” If you’re at all interested in the topic, or if you’re interested in history and public health policy, this piece worth your time. I argue that vaccine criticism has a long and robust history. And historical vaccine criticisms repeat themselves today, though they are voiced by new anti-vaccinationists and shaped by cultural trends like feminism, environmentalism, and radical patient autonomy.

What exactly do these critics say? And how do we confront such a persistent and unyielding group of arguments? It’s all there in the essay. Here is a taste:

It is true that high vaccination rates are important for public health, and when people make false claims about the dangers of vaccines it is the responsibility of scientists, journalists, and politicians to criticize and refute them. But calls to ostracize and ridicule vaccine critics may be as likely to harden hearts as they are to persuade. For example, in a recent article in the journal Pediatrics, researchers studying the effects of different communication strategies reported, somewhat counterintuitively, that giving vaccine-hesitant parents more information about the safety of vaccines, or telling them about the risks of vaccine-preventable disease, whether through scientific information, dramatic narratives, or arresting images, were not effective at persuading them to vaccinate their children. And yet, another recent study in Pediatrics suggests that parents are less likely to vaccinate their children if physicians ask them what they want to do about vaccinations (as opposed to taking a presumptive approach and asserting that the children will receive their shots).

Given this impasse, where ought we to turn? Perhaps what is needed is a better understanding of the long history of vaccine critics’ objections, going back to the very origins of vaccination. This will help us not to bemoan, accuse, or fight but to educate, persuade, and vaccinate.

The whole essay is online here. Image via Shutterstock

Practicing Medicine

July 28, 2015