Public Belief Formation & The Politicization Of Vaccine Science: A Case Study In Respecting Truth

September 10, 2015 Picture: World Bank/Flickr.

This article is part of The Critique’s September 2015 Issue on “Vaccines, Belief & Autonomy“.

In this age of science denial, it is easy to imagine that resistance to the idea of childhood vaccination is just part of the larger problem of political ideology run amok that has been poisoning our minds and spinning every factual question into a political one for the last two decades. Certainly the debate about climate change has skewed along political lines in recent years, with 78% of Republicans refusing to believe either that the planet is warming or that human activity has anything to do with it, versus only 25% of Democrats who do not trust scientists on this issue.[1] Similarly, a 2013 Pew Poll found strong political polarization on the subject of evolution, with 57% of Republicans versus 33% of Democrats who questioned this scientific consensus.[2] We are a long way from that bipartisan moment in 2008 when Newt Gingrich sat alongside Nancy Pelosi on a couch to make a TV ad urging the public to do something about global warming.

But if we drill a bit deeper into the vaccine debate, we notice an interesting fact. Unlike resistance to scientific findings about climate change and evolution, belief in the idea that childhood vaccines may be linked to autism (based on research that has now been discredited) has for the most part been bipartisan. After initial efforts by some to make a case that this was a good example of liberal science denial, science writer Chris Mooney has pointed to some compelling data which show that belief in this bogus idea is more or less evenly split along party lines.[3]

But even if this were true, couldn’t it still be the case that the vaccine debate has been “politicized?” In addition to showing that resistance to vaccines is irrational and scientifically unfounded, can it also be shown that it is based on the kind of ideology which tells us that our intuition can be substituted for empirical evidence when we do not like the facts? I believe that this is possible; that despite the fairly even Democrat/Republican split on this belief, it still makes sense to understand vaccine rejection as deeply rooted in the type of fact-free conspiracy-theories that have been polluting our political landscape for the last generation.[4]

It is tempting at the outset to dismiss those who reject the science on vaccines as ignorant, hard-hearted, or somehow so confused about the idea of truth that they have all but rejected the most likely means of getting there. According to a recent article in Psychology Today, however, this would be a mistake, for those who deny vaccines are motivated by love for their children just as much as those who insist that every child be vaccinated. But why, then, in the face of an avalanche of scientific evidence, would a group of people who did love their children engage in such bald-faced rejection of an intervention that is much more likely to help their children than to hurt them? This is where the politicization comes in….for even while it is not a customary right/left or liberal/conservative split, the science of vaccines has nonetheless been infected by those who have learned from the sort of lying that goes on in our political process to pander to a “skeptical” attitude toward beliefs that clash with their ideology, based largely on misguided fear and/or distrust of institutions that claim to have authoritative knowledge. This is to say that even while irrational rejection of the facts about vaccines does not fall neatly along political lines, it is nonetheless the product of a political culture that has encouraged us to trust our ideological convictions and our “gut” even when confronted by empirical evidence which tells us that we are wrong. Is vaccine denial based then on ignorance? Yes, but it seems not to be the kind of simple ignorance that can be remedied by exposing someone to the facts. Instead, it seems to be the kind of willful ignorance that has been the byproduct of those political ideologues who have perfected the art of persuading us to reject those facts that do not sit well with our extra-scientific commitments.

“Those who deny vaccines are motivated by love for their children just as much as those who insist that every child be vaccinated”

The idea that childhood vaccines cause autism may at some point have been a credible scientific hypothesis. Although the mechanism was unclear, a 1998 study by Dr. Andrew Wakefield was published in the respected British medical journal Lancet, in which he proposed that there was a linkage between the MMR vaccine and autism. The resulting outcry – driven by concerned parents, some of whom were Hollywood celebrities – was enormous. Vaccination rates began to drop in some communities to levels where experts worried about “herd immunity.” If only one child is unvaccinated, the concern may be slight. But if multiple families stopped vaccinating their children, could the recurrence of childhood diseases be far behind? This is exactly what occurred in Ashland, Oregon, where exemption rates for childhood vaccinations reached as high as 30%, and in Marin County, California, where 7% of children showed up to kindergarten without state-mandated vaccinations. Consequently, whooping cough, measles, and mumps are making a comeback after virtually disappearing in the United States. According to the CDC, there were 178 reported cases of measles across more than 14 states from January to June 2015, 117 of which could be traced to a December 2014 outbreak at Disneyland.[5] And just this year, the USA saw its first fatality from measles in 12 years.

But do vaccines cause autism? The scientific verdict is a resounding no. Ever since Wakefield’s original study, scientists have engaged in a desperate search for any linkage between vaccines and autism. As a precautionary measure, many pharmaceutical companies stopped using thimerosal in MMR vaccines, due to concerns about mercury. When it was later found that Wakefield’s work was flawed, the shift from public health to conspiracy theory began. That Wakefield’s hypothesis has now been scientifically discredited is beyond dispute. First came the suspicious circumstances. Wakefield’s research was based on interviews with just twelve families, which seemed too few to support such a sweeping hypothesis. Then it was learned that Wakefield had a serious undisclosed conflict of interest due to his patent application for a measles vaccine that would have competed with the classic MMR shot. At this point, ten of the thirteen authors of the original paper retracted their contribution. Next came the substantive challenges.

Epidemiologists in Finland pored over the medical records of more than two million children . . . finding no evidence that the [MMR] vaccine caused autism. In addition, several countries [had] removed thimerosal from [their] vaccines before the United States [had]. Studies in virtually all of them – Denmark, Canada, Sweden, and the United Kingdom – found that the number of children diagnosed with autism continued to rise throughout the 1990s, after thimerosal had been removed. All told, ten separate studies failed to find a link between MMR and autism; six other groups failed to find a link between thimerosal and autism.[6]

Ultimately, the Lancet retracted the paper and the British medical association revoked Wakefield’s medical license. Still the drumbeat of conspiracy continued. If thimerosal did not cause autism, why was it removed? What were they hiding?

A 2004 report from the Centers for Disease Control, which discredited any link between autism and thimerosal, became a flashpoint for controversy, raising suspicions of a governmental cover up. U.S. Representative Dan Burton, R-Indiana, held emotionally-charged hearings, during which Robert F. Kennedy, Jr., said that the report proved that “the CDC paid the Institute of Medicine to conduct a new study to whitewash the risks over thimerosal.” When confronted with the CDC report, actress Jenny McCarthy said, “. . . we vaccinated our babies and something happened. . . . My science is named Evan and he’s at home.”[7]

At what point does “skepticism” become crackpot? How long before the preference for anecdotal over scientific evidence tips the balance toward a conspiracy theory that ranks with AIDS deniers and those who believe that NASA faked the Moon landing? The larger problem here, I believe, is one of respecting truth, which means not that every scientific finding ultimately results in a true belief, nor that there is no difference between theory and certainty. It is important to understand that science is a tentative process, whereby we are committed to revising our theories in the face of new evidence and that technically speaking no scientific theory – not even gravity or the heliocentric universe – can ever be accepted as finally proven. But this does not mean that one belief is just as good as another, or that belief must be withheld until one hundred percent of the evidence is in; that is just not how science works, nor is it a rational process for forming one’s beliefs. Instead it means that when we are doing science we must understand ourselves to be engaged in a process where evidence matters and where, if we are going to reject a theory, it is because the evidence has given us good reason to suppose that it is not true. Even though science may sometimes get it wrong, the process of scientific belief formation is one where there is a mechanism in place for rationally revising what we think which, more often than not, will lead us down the right path even where other methods will fail. If anything can tell us the truth about the empirical world, science can. It is arguably the best method that the human mind has ever invented to find truth, where it is possible to know it. Science is our best means for respecting truth.

By contrast, the crackpot belief system behind rejecting the consensus of scientific findings – or insisting on a standard of proof that can never be met in the actual world (where it is often said that one cannot “prove a negative”) – is just not a rational process for forming one’s beliefs. Despite the cries of “skepticism” by those who wish to reject the scientific consensus which tells us that childhood vaccines donot cause autism, one must come to realize that this has much less in common with philosophical or scientific skepticism, and much more in common with those who believe in conspiracy theories.

“If anything can tell us the truth about the empirical world, science can. It is arguably the best method that the human mind has ever invented to find truth, where it is possible to know it. Science is our best means for respecting truth”

Conspiracy theories are one of the most insidious forms of disrespecting truth for, even while they profess to be guided by the fervent desire to discover a truth that someone else is hiding, they simultaneously undermine the process by which most truths are discovered. Conspiracy theorists are customarily proud to claim the highest standards of skepticism, even while expressing a naive credulity that the most unlikely correlations are true. But refusing to believe something in the face of a landslide of scientific evidence is not skepticism; it is gullible acceptance that it is more likely that there is some kind of wild conspiracy amongst scientists than that the vast majority of them have merely reached the same conclusion based on good evidence. This is disrespect, if not outright contempt, for the truth.

“Conspiracy theories are one of the most insidious forms of disrespecting truth for, even while they profess to be guided by the fervent desire to discover a truth that someone else is hiding, they simultaneously undermine the process by which most truths are discovered”

But if the evidence for the link between vaccines and autism is so bad, why do so many people still believe it? An important part of the answer is surely the mainstream media’s gutless response to any accusations that they are being partisan merely for telling the truth. Although it has gotten somewhat better lately in the vaccine controversy, it was not so long ago that we witnessed the common practice of split-screen television “debates” between eminent scientists and self-appointed “skeptics,” who were given equal time to make their case, after which the commentator pronounces the subject “controversial,” then turns to the camera as if to say “you decide.”[8] This worship of the false god of “objectivity” – as if one proved lack of bias not by upholding the truth but instead by giving liars and cranks equal time – has seriously misled the public on a number of scientific topics in recent years (most prominently climate change). And remember that we are here discussing the mainstream media. We have not even touched the subject yet of those who are just pretending to be journalists.

The presence of partisan media outlets like FOX News and MSNBC has surely made the problem worse. Once we cut ourselves off from information sources that challenge our prejudices it is easy to reach a state where the other side looks not just wrong but demented. Of course the sort of wired-in response that psychologists call “confirmation bias” – where we look for reasons why our beliefs are true rather than false – has probably been around for as long as the species, but its effects may be worse now that it is so easy to insulate ourselves from facts that we just don’t like. In its final stages, this can metastasize into the sort of spectacle witnessed on election night 2012, when Karl Rove’s worldview blew up on live TV as he just couldn’t accept that Obama had won reelection and insisted that Romney could still win in a landslide, long after the commentators on his own network told him that this was impossible.

“Once we cut ourselves off from information sources that challenge our prejudices it is easy to reach a state where the other side looks not just wrong but demented”

By the time ideology reaches this point, it may be too late. Many global warming deniers probably actually believe that there is a scientific conspiracy. Most vaccine deniers seem passionate that there is a cover up of the link with autism. How can we reach these people? First we must accept the idea that such a cognitively skewed relationship to scientific facts isn’t a result of simple ignorance, but instead of willful ignorance, which is the refusal to learn things that might clash with what we already believe. Unlike confirmation bias and all of our other built-in cognitive foibles (which are richly described in Daniel Kahnemann’s recent book Thinking Fast and Slow), willful ignorance is a choice – at least at first – to embrace a kind of ideological wish fulfillment that can lead to a cascade of negative effects that culminate in disrespect for truth.[9]

Full blown disrespect for truth occurs when we graduate from neglecting to look for new evidence to refusing to believe the facts even when they are in front of us. As Upton Sinclair once said “it is difficult to get a man to believe something when his salary depends upon him not believing it.” But if you play this game long enough, you just might arrive at the day when you actually believe your own lies. Given such titanic forces and hardened opposition, what can the rest of us do to live in a world that is not brought to its knees by irrationality? We can put more money into science education. We can bear witness to the sort of willful ignorance that leads to disrespect for science. And we can ourselves set a good example of what it means to respect truth.

But perhaps we don’t need to do any of these things, because it is impossible to convince those who disagree with us on ideological grounds that we are right? Maybe all we need to do is outvote them. In recent months, the State of California passed a bill that removed the religious and “philosophical” exemption to childhood vaccinations, and mandated parents who did not want to get their child vaccinated either to pursue a medical exemption or homeschool their children. This turns out to be one of the toughest anti-vax laws in the country, joining only West Virginia and Mississippi in having virtually no non-medical process for getting an excuse from vaccines. The response by some parents has been predictably vitriolic; even if they are misinformed, remember that they love their children too. But while such emergency measures may be necessary to grab the reins and guarantee the safety of all the rest of our children while the ideological minority sorts through its latest science-denial follies, it does not lessen our responsibility to take seriously the task of educating those who have given up on science, either because they are misinformed, willfully ignorant, or blinded by fear, any more than we could excuse ourselves for walking away from someone who was abusing their child by letting him bleed because they thought it was God’s will.

If we do not attempt to reach these people – and simply rely on outvoting them – their false beliefs (and attitudes) will fester. As a consequence, much suffering will ensue. But we also risk that in losing a chance to educate someone, we raise the probability that the day might come when we ourselves get outvoted on some equally important issue for our collective future – such as climate change – that is rapidly crippling the ability of our gridlocked Senate to do something about an issue of global urgency.

The standards of respecting truth must be upheld, and the case for reason should relentlessly be defended, by those who believe that empirical questions should be decided on empirical grounds. We must call it what it is when there is an unwarranted intrusion of emotion and ideology in a scientific debate, by those who insist that they should be allowed to trust their “gut” or their God to guide them on matters of fact.

And the case for beliefs based on science should be a pleasure to make. If we live in a world that is better than it was a century ago, this is largely due to science. We no longer need suffer from those diseases that have been eradicated. And if we can ever get our political act together, there just may be time to do something about climate change before the consequences of inaction are too obvious even for the science deniers to ignore. For the benefits of science, along with the larger obligation to respect truth, accrues not just to the enlightened, but to the science deniers as well. In a shared world – where our children inhabit a common classroom and the overuse of fossil fuels degrades our home planet – we are all in this together. The politicization of science affects us all.

Footnotes & References:

[1] Cited in Chris Mooney’s “Stop Pretending That Liberals Are Just as Anti-Science as Conservatives,Mother Jones, September 11, 2014, footnote #7.

[2] http://www.pewforum.org/2013/12/30/publics-views-on-human-evolution/

[3] In a 2009 Pew Poll it was found that 71% of Republicans and 71% of Democrats agreed with the idea that childhood vaccinations should be required; the same poll showed that 26% of Republicans and 27% of Democrats said we should let parents decide. Chris Mooney, “More Polling Data on the Politics of Vaccine Resistance,” Discover Magazine, April 27, 2011.

[4] I am not claiming here that science denial is an exclusively Republican issue. But I do think a strong case can be made for the idea that conservative ideologues have been behind much of the effort in the last few years deliberately to undermine scientific credibility on those issues that threaten their economic and political interests. The fallout of this, however, has infected both Democrats and Republicans, as we see in the polling results on climate change and evolution. See Chris Mooney’s, The Republican War on Science (New York: Basic Books, 2005).

[5] Korin Miller, What California’s Strict New Vaccination Law Means for the Rest of the Country,” Yahoo News, July 1, 2015.

[6] Michael Specter, Denialism (New York: Penguin, 2009), p. 71.

[7] One’s heart breaks that anyone has to live through this, but that hardly rules out the strong probability of naïve correlation, given that childhood vaccines tend to be given around the same age that autism is usually diagnosed. But this would be like saying that colonoscopies cause Alzheimer’s Disease.

[8] And notice that this is still common practice when it comes to climate change.

[9] (New York: FSG, 2011).