Common Sense About Vaccines from SkewedDistribution

While I flit around, reading articles and blog posts from hither and yon, there are a few blogs that I subscribe to and read on a regular basis.  SkewedDistribution is one such blog.  The author is an epidemiologist who works at a university, and provides scientific information about vaccines as well as her thoughts on the subject of vaccination.

Last week, SkewedDistribution posted a wonderful article examining the phenomena of "Us vs Them" that seems to infect all the anti-vaccination material I've read.  I asked if I could repost it here, so without further ado...

Vaccination fears: People Like Us vs. People Like Them

Hi Reader,

If it weren’t behind a paywall, I would tell you to take yourself with haste over to Harper’s to read the incredible essay entitled “Sentimental Medicine: Why we still fear vaccines” by Eula Biss. But since it is, I’m afraid you’ll either need to pony up about $17.00 for yearly access to the archive (which may well be worth it), or just settle for my impressions and thoughts on the article.

First, both the writing and research in this article are simply wonderful. If you’ve ever gone into the archives of old medical journals and read the articles, you will know what I mean. The language is simply delightful, and in some aspects Biss manages to capture that feel, while providing an accurate historical perspective of the anti-vaccination movement, about which I very much enjoy writing myself, as my reader of course already knows. Biss’ piece is a very useful reminder of why writing is often best left to the professionals, but nonetheless I will blunder on with my musings.

The thing that absolutely floored me is that Biss has brilliantly managed to put into words an idea that has been rattling around in my brain for some time, but which I have not been able articulate very well. This is the concept of People Like Us and People Like Them. In the olden days of disease theory, People Like Them were awash in filth. Filth caused disease, and People Like Us were simply not affected, because we were clean and pure. As Biss writes, all one needs to do is replace the word “filth” with “toxins” and viola! You have today’s anti-vax movement. Toxins are sufficiently scary-sounding and simultaneously elusive enough to pack a wallop of emotional fear, marinated in Facebook and seasoned with Google and Twitter.

These days, there are a great many folks in the anti-vax movement who still strongly believe that vaccines are only for People Like Them. The poor, the less fortunate, and the children of drug addicts, in other words. Biss goes on to point out that it is often People Like Them who do not have adequate medical care and who for a variety of reasons may miss some vaccinations. The idea of public health has traditionally been that People Like Us are meant to protect both ourselves and the less fortunate by taking steps to prevent disease in our communities as a whole. At times this approach has taken on a distinct odor of paternalism, and to be fair, I’m not sure that when it comes to healthcare decisions, the Haves ever acted solely for the benefit of the HaveNots. The parents who rushed to enroll their children in the Salk polio trials were most likely motivated by helping their own children, with the health of the community as a secondary concern. Nonetheless, vaccination has always been a community contract of sorts, yet this system is falling apart before our eyes, as the entitled parents of wealthy countries ignore their neighbors’ health and safety in order to worship at the altar of People Like Us.

If you’ve spent any time on anti-vax sites, you know what this altar looks like. It is constructed upon a base of false belief that because of our education and opportunities, we understand more than doctors, nurses, and public health practitioners. Mixed in are impressions that a “natural” lifestyle will combat any disease that comes our way, while ignoring the fact that People Like Us will be the first to run to an idiot doctor when something really goes wrong, because we have the time and money to do so. And sprinkled in is a hefty dose of not caring about others. Not giving a damn about the child in the local school whose mother works 3 jobs and hasn’t yet been able to sneak in immunizations. Not caring about the newborn infant next door who could die from pertussis, even though that child comes from a family of People Like Us.

The key part here is that they do not see that they are also putting their own children at risk. Because, you see, vaccine preventable disease does not care about Us or Them. It does not “care” about anything at all, though like all living things it will seek out a hospitable living environment, like a nice trendy Craftsman in a “transitional neighborhood”, or possibly even a yurt. The infectious disease Craftsman will be found among the Unvaccinated, who provide prime real estate for the homeless microbe. And with more and more People Like Us falling into the Unvaccinated category, we are likely to see that in the very near future, it will be People Like Us who are spreading disease hither and yon, and People Like Them who are justifiably giving us the finger and calling us vermin.

Reader, I strongly recommend that you take the time to read Biss’ thoughtful essay. You can tell that like us, she’s done some time in the online anti-vax trenches, and the piece is far more comprehensive than just the snippet that I wrote about here. It’s an article that strikes at the heart of some of the issues I wrote about in this post, albeit with much more eloquence, and it’s well worth a read.