The United States recently saw an outbreak of the measles (644 cases in 27 states) with the overwhelming majority of victims being people who had not been vaccinated. Critics of the anti-vaccination movement have pointed to this as clear proof that the movement is not only misinformed but also actually dangerous. Not surprisingly, those who take the anti-vaccination position are often derided as stupid. After all, there is no evidence that vaccines cause the harms that the anti-vaccination people refer to when justifying their position. For example, one common claim is that vaccines cause autism, but this seems to be clearly untrue. There is also the fact that vaccinations have been rather conclusively shown to prevent diseases (though not perfectly, of course).
It is, of course, tempting for those who disagree with the anti-vaccination people to dismiss them uniformly as stupid people who lack the brains to understand science. This, however, is a mistake. One reason it is a mistake is purely pragmatic: those who are pro-vaccination want the anti-vaccination people to change their minds and calling them stupid, mocking and insulting them will merely cause them to entrench. Another reason it is a mistake is that the anti-vaccination people are not, in general, stupid. There are, in fact, grounds for people to be skeptical or concerned about matters of health and science. To show this, I will briefly present some points of concern.
One point of rational concern is the fact that scientific research has been plagued with a disturbing amount of corruption, fraud and errors. For example, the percentage of scientific articles retracted for fraud is ten times what it was in 1975. Once lauded studies and theories, such as those driving the pushing of antioxidants and omega-3, have been shown to be riddled with inaccuracies. As such, it is hardly stupid to be concerned that scientific research might not be accurate. Somewhat ironically, the study that started the belief that vaccines cause autism is a paradigm example of bad science. However, it is not stupid to consider that the studies that show vaccines are safe might have flaws as well.
Another matter of concern is the influence of corporate lobbyists on matters relating to health. For example, the dietary guidelines and recommendations set forth by the United States Government should be set on the basis of the best science. However, the reality is that these matters are influenced quite strongly by industry lobbyists, such as the dairy industry. Given the influence of the corporate lobbyists, it is not foolish to think that the recommendations and guidelines given by the state might not be quite right.
A third point of concern is the fact that the dietary and health guidelines and recommendations undo what seems to be relentless and unwarranted change. For example, the government has warned us of the dangers of cholesterol for decades, but this recommendation is being changed. It would, of course, be one thing if the changes were the result of steady improvements in knowledge. However, the recommendations often seem to lack a proper foundation. John P.A. Ioannidis, a professor of medicine and statistics at Stanford, has noted “Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome. In this literature of epidemic proportions, how many results are correct?” Given such criticism from experts in the field, it hardly seems stupid of people to have doubts and concerns.
There is also the fact that people do suffer adverse drug reactions that can lead to serious medical issues and even death. While the reported numbers vary (one FDA page puts the number of deaths at 100,000 per year) this is certainly a matter of concern. In an interesting coincidence, I was thinking about this essay while watching the Daily Show on Hulu this morning and one of my “ad experiences” was for Januvia, a diabetes drug. As required by law, the ad mentioned all the side effects of the drug and these include some rather serious things, including death. Given that the FDA has approved drugs with dangerous side effects, it is hardly stupid to be concerned about the potential side effects from any medicine or vaccine.
Given the above points, it would certainly not be stupid to be concerned about vaccines. At this point, the reader might suspect that I am about to defend an anti-vaccine position. I will not—in fact, I am a pro-vaccination person. This might seem somewhat surprising given the points I just made. However, I can rationally reconcile these points with my position on vaccines.
The above points do show that there are rational grounds for taking a general critical and skeptical approach to matters of health, medicine and science. However, this general skepticism needs to be properly rational. That is, it should not be a rejection of science but rather the adoption of a critical approach to these matters in which one considers the best available evidence, assesses experts by the proper standards (those of a good argument from authority), and so on. Also, it is rather important to note that the general skepticism does not automatically justify accepting or rejecting specific claims. For example, the fact that there have been flawed studies does not prove that the specific studies about vaccines as flawed. As another example, the fact that lobbyists influence the dietary recommendations does not prove that vaccines are harmful drugs being pushed on Americans by greedy corporations. As a final example, the fact that some medicines have serious and dangerous side effects does not prove that the measles vaccine is dangerous or causes autism. Just as one should be rationally skeptical about pro-vaccination claims one should also be rationally skeptical about ant-vaccination claims.
To use an obvious analogy, it is rational to have a general skepticism about the honesty and goodness of people. After all, people do lie and there are bad people. However, this general skepticism does not automatically prove that a specific person is dishonest or evil—that is a matter that must be addressed on the individual level.
To use another analogy, it is rational to have a general concern about engineering. After all, there have been plenty of engineering disasters. However, this general concern does not warrant believing that a specific engineering project is defective or that engineering itself is defective. The specific project would need to be examined and engineering is, in general, the most rational approach to building stuff.
So, the people who are anti-vaccine are not, in general, stupid. However, they do seem to be making the mistake of not rationally considering the specific vaccines and the evidence for their safety and efficacy. It is quite rational to be concerned about medicine in general, just as it is rational to be concerned about the honesty of people in general. However, just as one should not infer that a friend is a liar because there are people who lie, one should not infer that a vaccine must be bad because there is bad science and bad medicine.
Convincing anti-vaccination people to accept vaccination is certainly challenging. One reason is that the issue has become politicized into a battle of values and identity. This is partially due to the fact that the anti-vaccine people have been mocked and attacked, thus leading them to entrench and double down. Another reason is that, as argued above, they do have well-founded concerns about the trustworthiness of the state, the accuracy of scientific studies, and the goodness of corporations. A third reason is that people tend to give more weight to the negative and also tend to weigh potential loss more than potential gain. As such, people would tend to give more weight to negative reasons against vaccines and fear the alleged dangers of vaccines more than they would value their benefits.
Given the importance of vaccinations, it is rather critical that the anti-vaccination movement be addressed. Calling people stupid, mocking them and attacking them are certainly not effective ways of convincing people that vaccines are generally safe and effective. A more rational and hopefully more effective approach is to address their legitimate concerns and consider their fears. After all, the goal should be the health of people and not scoring points.