In our politically polarized country, it’s tempting to see arguments about the efficacy of medical interventions like vaccines as examples of “non-political arguments.” True, the less-kind among us (I plead guilty) tend to view “anti-vax” parents as deranged left-wing versions of rightwing conspiracy theorists, or less judgmentally, arguably sane but credulous people who haven’t had access to accurate information. We don’t, however, see this particular controversy as a particularly political argument.
Vaccination is a basic political issue, because it is the subject of community agreement. When a high-enough percentage of community members are immunized, a disease can be effectively vanquished. In epidemiological terms, this is known as “herd immunity,” which cannot be maintained below a certain threshold. When enough people reject the community agreement, they endanger the rest. Willfully unvaccinated adults and children can spread diseases to those who cannot be vaccinated or haven’t been vaccinated, such as infants and people with a compromised immune system; these vulnerable populations would probably be safe in conditions of herd immunity. Vaccination and the refusal to vaccinate are political acts: individual decisions that affect others and the very ability of people to inhabit common spaces.
The author cites evidence that a majority of anti-vaxxers are educated white people who have ample access to credible public-health information and scientific studies about vaccination. Much like those who refuse to believe that climate change is real, they simply choose to reject the science; they choose not to believe the medical consensus. As Frank Bruni recently wrote in the New York Times,
Their recklessness and the attendant re-emergence of measles aren’t just a public health crisis. They’re a public sanity one, emblematic of too many people’s willful disregard of evidence, proud suspicion of expertise and estrangement from reason.
The irrationality triggered by anti-vaccination propaganda is yet another example of the current raging conflict between facts and lies in America–a conflict exacerbated by social media. According to the author of the article in The New Yorker, there are even some reports that Russian trolls have been exploiting anti-vax fears as part of the Russian effort to use disinformation to splinter American public opinion.
What would cause well-educated parents to believe that the entire scientific and medical community is lying to them about the risks of vaccination?
The article attributes this reaction to current levels of public distrust–distrust of authority, of government, and especially of a complex, overly-expensive, profit-driven medical system that has few incentives for robust public-health interventions.
The solution to under-vaccination lies not in getting the right kind of information and messaging to the “vaccine-hesitant” but in changing the politics of health care. Political agreement is unlikely among partners who do not trust each other, and near impossible when one side is explicitly profiting from the other. The American health-care system is ill-suited to protect public health, because a profit-driven industry cannot serve as the guardian of public good.
It’s hard for people to trust the credibility of pharmaceutical companies when those companies are jacking up the price of insulin and other life-saving drugs.
The role of trust is something to consider as lawmakers debate the pros and cons of “Medicare-for-All” and universal systems like those in place in most other modern countries.