The Needle and the Damage Done
I watched the needle
Take another man
Gone, gone, the damage done.
(Neil Young)
I recently had a student who wrote an argumentative essay for my class. For this particular assignment, the students were allowed to pick their own topic. We had previously written an argumentative essay for which they collectively selected to topic. For this one, with all their argumentative writing skills honed, they picked something that sparked their own interest. The topic of this student’s essay was vaccinations, and they argued against mandatory vaccinations. In the essay, they included many of the talking points from anti-vaxxers — including the claim that vaccines contribute to and/or cause autism. Responding to this one required most of my teaching skills and raised some questions for me.
In 1998, Dr. David Wakefield (as lead author) and 12 colleagues published a study in The Lancet, a British medical journal. (A summary of the controversy can be found here.) The paper suggested that the MMR (measles, mumps, and rubella) vaccine may have a connection with some behavioral and developmental disorders. The study, however, was flawed at nearly every level. For one, the study had a very small sample (just 12 children). Secondly, the study had no control group. Thirdly, the conclusions were speculative in nature. Finally, we discovered that some of the children were inappropriately selected for the study. And while the paper as published did NOT directly establish a connection between the vaccine and autism, that seemed to be the public’s takeaway. And the proverbial cat was out of the bag.
However, shortly after the paper was published, other researchers pushed back against the findings. Another paper published in The Lancet a year later refuted the Wakefield findings, and a paper published in JAMA in 2001 also found no link between the vaccine and autism. In 2010, following much debate and many papers on the topic, The Lancet took the (relatively) rare step and retracted the Wakefield paper and its findings. In the retraction the editors of The Lancet suggested that Wakefield et al. were guilty of “ethical violations” and “scientific misrepresentation.” The British Medical Journal published a series of articles, all of which thoroughly debunked the Wakefield findings.
So, we currently have scientific consensus that vaccines are not causally linked to autism. The preponderance of evidence says it’s just not true. However, just for one moment, let’s suppose that some link exists. Maybe a strong link, maybe a very weak link. Then what? Should we still vaccinate? Why would anti-vaxxers be so opposed to having a child with autism? In short, that calculation and that fear derives from the worst stereotypes of individuals with autism. Anti-vaxxers are willing to risk death based on some irrational and unfounded fear of people with autism.
But that link does not exist, so, here are some facts: Prior to the development of the measles vaccine, nearly everyone got the disease, and hundreds died each and every year. Today, most doctors have never even seen a case of the measles in their office. [Until, that is, a bunch of anti-vaxxers decided to stop getting the shot.] Similarly, diphtheria used to kill thousands. It killed 15,000 in the US alone in 1921. Between the years 2004 and 2014, the CDC recorded only TWO cases of diphtheria. As a final example, rubella killed thousands of people, particularly infants. However, between 2012 and 2018, the CDC recorded only 15 cases of rubella.
Vaccines work. They have saved thousands of lives. Yes, someone can have an allergic reaction to a vaccine and get sick or die. And, yes, that would be absolutely horrible if that were your child. But statistically speaking, your child is far likelier to die of one of the many diseases that we have (practically) eliminated with vaccinations. Every choice we make about our children’s health has risks and consequences. I would suggest, though, that we need to follow the science and the math.
For me, though, the question remains: Why does this myth persist? Is it because it conforms to a particular ideology? Who are the anti-vaxxers making this claim? Is it conservatives? Those who don’t trust the government? Those who are opposed to government regulation (libertarians and staunch individualists). Those who don’t trust science? Those who think vaccines are the work of the devil?
A report by Molly Walker on MedPage (2019) suggests that the arguments of anti-vaxxers fall into four categories: “trust, alternative, safety, and conspiracy.” Regarding trust, they tend not to trust science, medicine, or doctors. Those in the alternatives group simultaneously question chemicals contained in vaccines and advocate homeopathic alternatives. In relation to safety, they argue that both their physical and moral safety are at risk. As noted above, some anti-vaxxers argue that vaccines are a tool of Satan. Finally, they tend to argue that the government is hiding “facts” about vaccines, facts which they have access to and the rest of the (gullible) public does not.
The researchers at Pittsburgh also suggested that making arguments aimed at one group will not satisfy another group. For example, if you argue that the chemicals in vaccines are safe to someone who has religious objections, then they will not be swayed. Or, if you argue that religious leaders also advocate vaccinations to someone who distrusts doctors, they will not be convinced, either. In other words, no one-size-fits-all argument can be made.
Furthermore, the anti-vax attitude does not fall strictly along party lines or educational levels. Citing work done at the University of Pittsburg, Walker notes that the study showed 56% of the anti-vax posters identified as conservative and/or Trump supporters, while 11% identified as Sanders supporters. And nearly one quarter of anti-vaxxers have some post-secondary education.
In the end, my student would not remove the claim that vaccines might cause autism. I suggested to them that the claim had been debunked and withdrawn. I reminded them of the reliability of sources. I reminded them to think of their audience for the paper. Nothing. The claim remained there for every draft of the paper. And this refusal seems to confirm the findings of the Pittsburgh statement. The student must have belonged to one of the four groups, and whatever I was suggesting was not addressing their concern regarding vaccines.
I fear that eliminating the anti-vax (or, as they sometimes say, vaccine hesitant) attitude will be even hard than eliminating polio and the measles.
[N.B.: I do realize that Neil Young was NOT singing about vaccines, but rather about heroin addiction. In the case of vaccines, however, the damage has been done by false reports and anti-vaxxers, not the vaccination needle.]
[N.B.: Just to be clear, I am a parent of children with autism. So, yes, I have a stake in the argument.]
Ritch Calvin is an Associate Professor of Women’s, Gender, and Sexuality Studies at SUNY Stony Brook. He is the author of Feminist Epistemology and Feminist Science Fiction and editor of a collection of essays on Gilmore Girls.
