Near the end of 2018, the Centers for Disease Control and Prevention data made clear that a small but increasing number of children in the United States were not getting recommended vaccinations. One in 77 infants born in 2017 did not receive any vaccinations; that’s more than four times as many unvaccinated children as we had at the turn of the century. Some of this may be due to lack of access as those without insurance and those living in rural areas have greater rates of non-vaccination. But part of it may be due to the dismissal of science and scientific evidence, the rising conspiracism in America and its move into the White House.
Vaccinations have always provoked anxiety. But the data on vaccines that are in widespread use are now clear: vaccines are safe and save lives. Nonetheless, conspiracism insists that we don't know all the facts: things are not as they seem. Conspiracism fuels the anti-vaccine movement in the acceptance of the anecdote (“I heard about one child who got a measles vaccine and developed autism”) over the statistics.
For conspiracists, the safety of all vaccines comes into question not only because of distrust of the pharmaceutical industry, but also because the role and function of government has come into question. For conspiracists, vaccination policy raises questions about the force and power of the government. The growing avoidance of vaccination seems to be a manifestation of interlocking anxieties about the accuracy of media information, about science, and about power.
And, with the unpredictability of the President’s words and actions, we are one menacing sentence away from real public health trouble. Imagine if the President one day were to announce, “People are saying that maybe we don’t really need quite so many vaccines for our kids. After all, look at all this autism that’s around.” This vague conspiratorial phrasing—“people are saying”—this kind of innuendo, would immediately corrode confidence in our collective public health policy. Conspiracism undermines authority.
Universal vaccination is in our common interest. Knowledge about the efficacy of vaccines and the true risk to our children if vaccination rates fall is nonpartisan. Public health has standards of evidence and falsifiability; conspiracists disregard explanation and refuse any form of correction. One of the surprising gifts of 2018 was that vaccination policy and public health policy more generally did not come under great attack. Let’s hope the vaccination conspiracy theories stay subdued in 2019.
Warmly,
Michael Stein & Sandro Galea