Ignore the Vaccination Debate!
A Yale researcher shows why the best way to defeat the anti-vaccination movement is to stop debating the subject.
In the wake of the Disneyland measles epidemic and widespread coverage of childhood vaccine skeptics and holdouts, California’s Democratic congressional delegation had what may seem like an obvious and logical reaction. They’ve introduced legislation to repeal the religious and “personal” exemptions that allow unvaccinated children to enroll in Head Start. Sen. Barbara Boxer said in a statement, “This legislation is an important first step in the broader effort to strengthen our vaccination policies at all levels of government to help prevent the spread of deadly diseases.”
At the state level, Democratic legislators are taking the next step, with a law to remove exemptions for any child enrolling in public school. More broadly, you don't have to look far to find Democratic activists taking up vaccines as a subtle—or not-so-subtle—jab (ahem) at their opponents. As one recent piece paints the situation:
“[Conservatives] don’t want the government telling them what to do,” said Ronnee Schreiber, who teaches gender and politics at San Diego State University. “It’s about being anti-government regulation and ‘preservation of the privacy of the family.’”
These interventions and analyses are intuitive, if also quasi-partisan reactions, to what story after story paints as a “growing crisis.” But according to science, this is exactly what lawmakers shouldn't be doing. The surest way to turn the demonstrably fringe phenomenon of vaccine holdouts into a public policy crisis is to use the political process to “fix” it.
As recently as just a few weeks ago, the anti-vaccine movement has been both vanishingly small and equally distributed among ideological groups. But the tragically stupid remarks of just a few prominent conservatives have created the precise environment for the movement to polarize along party lines — and possibly grow. Partisan operatives seized upon statements from Chris Christie and Rand Paul as proof of the GOP’s backwardness, and Twitter comedians and op-ed writers ran with it. The legislation from California will only enshrine the divison.
Dan Kahan, a Yale University professor who studies public perceptions of science policy, sees the unfolding partisan divide as a potential health catastrophe. A political attack on an imagined vaccine crisis would be “like going to war with Iraq over 9/11,” he says. “It’s like WMDs. The threat of the anti-vaccination movement doesn’t exist, and going to war with it will cause orders of magnitude more destruction than whatever Jenny McCarthy is doing.”
Indeed, the latest research is in and it strongly suggests that if the “reality-based community” wants to do its part to prevent more measles outbreaks in the United States, it needs to stop mocking vaccine skeptics as “anti-science” and avoid the temptation to lump them in with global warming deniers and creationists. Those tactics have the potential to do what decades of fringe activism hasn’t: Create a widespread incentive for parents to incorporate how they feel about vaccines into their political world view.
Kahan focuses on issues where “settled science” is still the object of intense public debate. His study on perceptions of vaccine risk measure what happens when you expose various ideological types to typical examples “ad hoc science communication” (the kinds of stories you find outside science literature itself).
Kahan set up focus groups containing a cross-section of political views. They saw a dry (and accurate) CDC report, an alarmist warning on “declining vaccine rates” (itself a myth, points out Kahan) and a piece that aligned anti-vaccination beliefs with global warming denial and creationism. The only kind of article that pushed identifiable ideological groups in either direction was the identification of vaccine skepticism as anti-science. That sort of article made those who already tended to be suspicious of policies such as drug decriminalization—typically, social conservatives—less likely to believe that vaccines were worth the risk.
Even more intriguingly, the article that characterized vaccine skepticism as anti-science made those already inclined toward belief in global warming—that is, social liberals—even more sure about the value of vaccines.
Liberals might expect themselves to feel heartened by Kahan’s findings—they’re the ones who expect their worldview to be affirmed by places such as Yale—but what he has to say in fact undermines self-satisfying “us-versus-the-flat-earthers” narrative that characterizes much of the informal debate on such subjects.
First of all, there is no pitched battle between the forces of “science” and “anti-science.” On the vast majority of issues where science helps direct public policy, Americans mostly support the policy and believe in the underlying science—this includes childhood vaccinations. A parallel finding, though more disturbing for liberals: Where there are significant divisions over the validity of vaccination, there is no parallel division in scientific comprehension. Global warming deniers are just as scientifically literate as those who believe in anthropogenic climate change. The major difference between the scientifically literate and the uninformed when it comes to global warming is that the literate have much stronger opinions on the issue, for and against.
Kahan’s paper spells it out: “Cultural conflict over decision-relevant science is not the norm. Indeed, it is a pathology, both in the sense of being rare and in the sense of being inimical to well-being.”
Put more simply: Most people don’t question long-held scientific truths; there is no reason to. Most of these issues just aren’t a part of our national conversation. We tend not to poll the general public on sanitary standards for food preparation or if seat belts save lives. And when these issues do rise to the level at which the general public might grapple with them, the media do not map them directly onto existing cultural divisions.
Ask someone if he believes the Earth revolves around the sun and, unlike the time of Galileo, you’re not also tacitly asking about belief in God. But ask someone if she believes in global warming and you’re also asking her if she wants socialized medicine, or whether #blacklivesmatter. The California Democrats, and untold Facebook and Twitter posters, are turning the question of childhood vaccines into the same kind of litmus test.
Kahan calls these rabble-rousers “conflict entrepreneurs,” a category that includes politicians and activists, as well the media. To him, they are the true villains of the “anti-science” morality play, the ones most likely to turn back the clock on childhood vaccine rates’ success story, “the crown jewel of American public health.”
Kahan doesn’t just call upon his own research to back up his warning. There’s a case study: the tragic—and real—low rate of vaccination against the human papillomavirus, currently at 57 percent for girls, 35 percent for boys. Left-right divisions appear to map easily onto HPV; it’s a sexually transmitted disease, of course the religious right is weirded about it! But then how to explain the complete non-issue of the Hepatitis B vaccine, a shot that targets a sexually transmitted disease and whose uptake rate is over 90 percent—higher than the flu?
Kahan has devoted a lengthy post (and paper) to the sad tale, and it’s worth reading, but I’ll go ahead and spoil the ending: The major difference between the HPV vaccine and the HBV vaccine was the lack of a concerted political and legislative push to mandate HBV.
One can see why the actions of California’s well-meaning lawmakers worries him. The prospect of an all-out “shame war” is even worse. “No issue is destined to have the kind of career” the HPV vaccine did, he says. “Childhood vaccination is a test. If we’re ever going to be sensible about our scientific communications, this is our chance to take responsibility.”
So you, you there with the joke about the GOP’s anti-vaccine wing—“They hate science as much as they hate women,” or whatever else you were going to say—put that down. Step away from the Twitter. Discard that draft, unless you want more children to get hurt.