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Monday, April 6, 2015

How Not to Talk to an “Anti-Vaxxer”: Seven Assumptions to Avoid

Really?
Following the most recent measles outbreak, popular contempt for vaccine skeptics (or, as their detractors prefer, “anti-vaxxers”) has reached an alarming high.  Even mainstream news sites have run articles with titles like “People Who Don't Vaccinate Their Kids Need An Anti-Stupidity Shot” (Huffington Post), “Rich, Educated and Stupid Parents are Driving the Vaccination Crisis” (LA Times), and “The Real Contagion of Anti-Vaccine Idiocy” (Time).  Now, I want to clearly state at the outset that my intention is not to defend a particular position on the vaccine debate.  My limited objective is to advocate for a more respectful dialogue with vaccine skeptics.  To this end, I call attention to seven flawed assumptions that some in the pro-vaccine community seem to have of vaccine skeptics.

1. Vaccine Skeptics are Bad Parents
While vaccine skeptics are frequently portrayed as negligent parents, it seems that the very effort involved in researching vaccines on one’s own proves the contrary.  After all, what’s easier: spending countless hours investigating vaccines oneself, or simply trusting society’s assurances that vaccines are safe, effective and necessary?  Most vaccine skeptics aren’t willing to rely on the anesthesia of popular opinion to numb their sense of responsibility to conduct their own research for the sake of their children’s well-being.  And they are the ones viewed as negligent parents?  No, no, no - I’m not implying that pro-vaccine parents are negligent.  But if we are going to make the blanket assumption that a particular group of parents is less caring than another, it would be difficult to persuade me that this charge should be levelled on vaccine skeptics (thankfully, I know enough parents on both sides of the debate to reject this unreasonable assumption).  In short, arguing that vaccine skeptics are wrong is one thing, but to suppose that they are indifferent to their children is not only uncharitable; it’s absurd.

2. Vaccine Skeptics Have no Sense of Social Responsibility
According to the popular caricature, vaccine skeptics are selfishly abdicating their social responsibility to vaccine their children, free-riding off of those who do.  But a free-rider would be someone who agrees that mass immunization is a collective good, but decides not to contribute to the provision of this good, assuming that others will pick up the slack.  This free-rider charge would only make sense if vaccine skeptics believed that vaccines are safe, effective, and necessary.  They don’t (not all vaccines, at any rate).  So, it’s nonsense to judge them as free-riders.



3. Vaccine Skeptics are Stupid
Sure, I suppose that some vaccine skeptics are stupid.  But it seems to me that stupidity is pretty evenly spread across both camps of the vaccination debate.  As recent scholarship suggests, “conspiracy theorists” – a category in which vaccine skeptics are often placed - aren’t drawn from a particular I.Q. stratum.  Further, while education is not perfectly correlated with intelligence, it is at least suggestive, and to some vaccine proponents ironic, that vaccine-resistant parents are more educated.  And while this certainly falls short of a scholarly study, I surveyed friends and their friends on Facebook and discovered no statistically significant difference in composite ACT scores (which strongly predict I.Q.) or educational attainment between vaccine proponents and those who were more skeptical of vaccines.  So, there is no need to dumb down your case for vaccines when dialoguing with vaccine skeptics; they’ll understand you!

4. Vaccine Skeptics are Anti-Science
Popular epistemology (or how we know what we claim to know) is somewhat naïve.  Supposedly, all one must do in order to know the truth on an issue concerning a particular area of knowledge is appeal to those who specialize in this area.  If there’s disagreement among the specialists, then the opinion held by the greatest number is to be taken as the “truth”.  In other words, truth is discovered through a majority vote of specialists. 

Unfortunately, however, reality isn’t so convenient, and the reason why should be obvious: humans, including the specialists among us, aren’t perfect, and there are innumerable cases of scientific misconduct to substantiate this very simply point.  Pharmaceutical research is certainly not immune to these charges.  Authors of a 2012 study published in Pharmacotherapywere surprised to find the proportion of retractions due to scientific misconduct in the drug literature is higher than in general biomedical literature.”  Also problematic is the recent discovery that the U.S. Food and Drug Administration, “an agency that has long enjoyed a profitable relationship with pharmaceutical companies,” is “failing to disclose scientific fraud.”

Yes, we don’t have the time to investigate every matter of scientific interest, and thus it makes sense to humbly defer to the specialists on areas that aren’t particularly important to us.  But since scientists are fallible, it’s irresponsible (and lazy) not to question the consensus on areas that affect us personally.  Of course, nothing that I’ve said thus far validates a single claim that vaccine skeptics have made.  But I think it’s unreasonable to judge vaccine skeptics for simply questioning the conventional wisdom on vaccines.  Doing so confuses the distinction between science and scientists; we should have confidence in the former, but not blind faith in the latter. 

Those who criticize clerical abuse aren’t necessarily anti-religion, and those who criticize police brutality aren’t necessarily anti-police.  Similarly, vaccine skeptics aren’t necessarily anti-science.  Indeed, they are far more familiar with the scientific literature on vaccines than we’ve been led to believe, and they can cite a number of studies that point to the potential harm of vaccines.  The latter point is acknowledged even by the pro-vaccine Institute of Medicine (IOM), which has otherwise been criticized for its failure to disclose conflicts of interests among its panel members.  While insisting that most vaccine side effects are “very mild or very rare,” the IOM concluded in its 2011 review of epidemiological and biological/clinical studies that certain vaccines are responsible for such adverse events as anaphylaxis, encephalitis, and meningitis (see p. 6 for a summary of its causality conclusions).  Sure, the studies that vaccine skeptics call attention to are outnumbered by pro-vaccine studies (though, for reasons discussed above, the consensus opinion is no guarantor of the truth).  But it would be patently false to suggest that there is no scientific research justifying their concerns.

5. Vaccine Skepticism Emerged in the Late ‘90s
We’re often given the impression that the vaccine controversy began in 1998, when a provocative, yet retracted article reported a link between autism and the MMR vaccine.  There’s an inclination to think, therefore, that the vaccine skeptical movement stands or falls on the credibility of a study.  But vaccine skeptics have been around since at least the mid-19th century, and, as fairer proponents of vaccines acknowledge, it’s not “only because of autism” that parents have expressed concerns about vaccines.

6. Ad Hominem Arguments are Bad…Unless They Involve Jenny McCarthy
It seems that many are dismissing the concerns of vaccine skeptics by appealing to the perceived ignorance of their supposed spokeswoman – Jenny McCarthy.  They’re thus committing the ad hominen logical fallacy, or attempting to discredit an argument by attacking the arguer.   Of course, I must confess that this strategy - which seems to play on bigoted anti-blonde stereotypes – is a brilliant way of ridiculing vaccine skeptics.  Logically-speaking, however, this is a lousy approach.

7. Vaccine Skeptics are “Conspiracy Theorists”
Vaccine skeptics are often ridiculed as “conspiracy theorists” because they believe that profit-seeking pharmaceutical companies (i.e., “big pharma”) have wielded tremendous influence on government policy and academic research.  But the fact of the matter is that most of us are conspiracy theorists.  After all, it’s fashionable to believe, among so many other things, that the oil lobby pushed our government into invading Iraq in 2003 (an idea which former British Prime Minister, Tony Blair, once derided as an absurd “conspiracy theory”), that the guns lobby has been blocking passage of stricter firearms legislation, or that government policy on fracking is based on research sullied by funding from the natural gas industry.  Somehow, vaccine policy and research has been singled out as an exception to this rule of growing corporate influence.  Shouldn’t our anger be directed at this ominous trend, rather than at the vaccine skeptics who correctly point to the conflicts of interests that may arise as a result? 

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It should go without saying that if one genuinely wishes to convince others of the safety, effectiveness, and necessity of vaccines, expressing contempt for them isn’t the most fruitful way of going about it.  Indeed, according to “experts on fighting the anti-vaccination movement,” it’s counterproductive.  Yes, there may always be the occasional article with the shocking title or policy proposal, perhaps because some are more interested in writing viral content than they are in promoting the common good.  But I remain convinced that most mean well.  So, the sooner we discard the assumptions that give rise to the contempt, the sooner we’ll be able to ascend to a higher level of discourse.