How (Not) to Talk About Vaccines

There are two topics about which people who otherwise tend to agree with each other tend to figuratively rip each other’s throats out about. Since I wrote about Israel and Palestine in my last column, I figured I’d go whole hog and write about vaccines this week.

Now I’m not going to actually make an argument directly about vaccinations. What I do want to do is propose a bit of a theory about the current tone of the discussion:

I think that it’s quite possible that at the moment the biggest thing fueling anti-vax sentiment is the pro-vax movement.

As far as I can tell, the major tactics of people who want to stem the increase in vaccine opt-outs are shame and ridicule. I am particularly concerned with variants that go roughly like this: “Vaccines are science! How could you be so superstitious and anti-science??!! Um, science, bitches?”

Now, it’s understandable that if the sum total you know about people concerned about vaccines are those clinging to a study that claimed to prove a link with autism and has since turned out to be fabricated, you’d be pretty frustrated. There are definitely those who are not taking rational positions.

However, if you take the universe of people who have concerns about the current vaccine recommendations for children, you find the issues are far more subtle and varied than “someone says it causes autism!” (and the decisions being made often far more subtle than no vaccinations at all ever). Again, I am not making a claim one way or the other about these points, but for example, there are concerns about aluminum levels, about the sudden and untested increase in combination shots and their potential to cause the immune system to overreact, about losing natural immunity to chicken pox and increasing the risk of the disease in adults when it is much more dangerous, etc. These may all be factually wrong if you can get down to hard data, or not proportional to the benefits of having herd immunity, but they are not being argued on the basis of God’s word, and they aren’t mere laziness. The sheer amount of information to assess if you try to do so from scratch is positively monumental.

One article I read was particularly bemoaning all the highly educated parents who were anti-vaccine and wondering how that could be. Even people who were scientists! The author concluded that it was a mixture of competitive “natural” parenting and cross applying their perceived sense of themselves as experts to fields they are not qualified to judge.

I have a different theory. It has two parts: First, highly educated parents are aware of the medical profession’s record of telling us what’s good for us. And it isn’t good. They know the history of doctor recommendations on smoking to thalidomide to countless recalled drugs.

At the time they have vaccination aged children, they are likely to have just had a big dose of experience with a medical system that is woefully ignorant about the actual science and best practices behind birth, from laboring positions to eating during labor to episiotomy to breast milk supply. So they are not going to take a pronouncement by the medical establishment as necessarily reliable, and that’s reasonable.

Second, most of them do understand how science works: science is complicated and iterative. It is by its very nature about questioning received wisdom. It gets stuff wrong from time to time. It is generally better than its alternatives, of course, and many of its conclusions, replicated in multiple different ways by different people, are rock solid, even some about health. But scientific findings are not infallible and it’s insulting to scientists to suggest that they should be treated that way. There many sad examples of science illiteracy around the country,

Someone who knows that they don’t have the expertise or resources to actually assess the evidence from scratch is going to have to assess other people’s claims about that evidence. Guess how likely they are to listen to people making fun of them for asking the questions?

If the pro-vaccine advocates want to get anywhere they need to stop wrestling with the few they will never convince, and instead speak to everyone else: cut the attitude, take the concerns seriously enough to know what they actually are, and present clear arguments on the state of the underlying science addressing those concerns.

Take Dr. Sears, who by actually taking concerns about aluminum concentrations seriously and proposing an alternative schedule that addresses it, has probably prevented 100 times more vaccine opt-outs than all the self-righteous shaming screeds on the Internet combined.

For those concerned with actual effects and not blowing off steam, that’s a much better model.

(This column was originally published in Metroland, the Capital Region of New York’s former alt-weekly, on Oct. 9, 2014. For more on this topic see “7 Ways to Increase Vaccination Rates Without Being an Asshole to Anyone.”)

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