It has been one month since ringing in the New Year, and already, the United States has racked up more cases of measles than it usually sees in an entire year. The current outbreak, thought to have originated in Disneyland, has expanded to at least 14 states and affected more than 100 patients. Last year, there were 644 reported cases of measles, more than the entire preceding 5-year period combined.
The resurgence of measles, whooping cough, and other virtually eradicated diseases has renewed public concerns about vaccination, or the lack thereof. By now, it’s been established that the 1998 study linking the MMR vaccine and autism was fraudulent; it has since been retracted by The Lancet, and its author has been roundly discredited and stripped of his license to practice medicine.
None of this, however, stopped Senator Rand Paul (R-KY) and Governor Chris Christie (R-NJ), two presidential hopefuls, from stoking the flames of the anti-vaccine movement. Christie initially promoted “a measure of choice” in vaccination until a blistering media backlash ensued. Paul argued that vaccines should be “voluntary,” citing “many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines.” Paul’s remarks, it should be noted, cut a little deeper. Before he was Senator Paul, he was Dr. Paul, MD, and his seeming ambivalence to the return of previously-eliminated diseases flies in the face of that responsibility. And, that his comments lean so heavily on anecdote and circumstance betrays the very essence of the scientific method.
“I have heard of many tragic cases of walking, talking normal children who wound up with profound mental disorders after vaccines.” —Senator Rand Paul, February 2, 2015
Christie and Paul are hardly the first politicians to propagate misleading narratives on vaccines. During the 2008 campaigns, Senator John McCain cited “strong evidence” that vaccine preservatives caused autism. Then-Senator Obama thought the science was “inconclusive;” now, President Obama thinks it is “indisputable” that vaccines and autism are unrelated.
It’s tempting to characterize Christie and Paul’s statements as a poorly advised exercise in political opportunism — a way to assert their small government, personal freedom bona fides in advance of inevitable presidential campaigns. But their comments draw on a deeper, more insidious strain of American political culture: science denialism. From water fluoridation to GMO safety to climate change to evolution, there has always been a constituency that has vociferously rejected established scientific consensus. The stronger that consensus is, the deeper the conspiracy must run.
Stylistically, it doesn’t help that the scientific community is poorly equipped to respond to these misconceptions. Science is an inherently meticulous and precise field, one that sees nuance and uncertainty as virtues. When confronted with questions about vaccines and autism, its response is that there is “no evidence” that the two are related — not exactly a stirring rallying cry. Though science certainly succeeds in rationality and accuracy, it can’t always match the passion of its deniers.
Rand Paul and Chris Christie have been widely excoriated for their comments, and prominent Republican leaders have since reiterated strong support for vaccines. And, recent polling shows that a majority of the American public remains in favor of vaccination. But, as long as there are parents who opt out of vaccines, our society will be haunted by the scourge of measles, mumps, pertussis and polio, among others. How, then, do we approach people who have been misled by the vaccine-autism hoax and its enablers? If this is a problem of misinformation, then surely the solution is accurate information, presented in a way that respects the patient’s autonomy, intelligence, and concerns. But recent research on vaccine myth-busting seems to challenge this strategy. After presented with accurate information on vaccine safety, vaccine skeptics with a high level of concern reported that they were actually less likely to get vaccinated. Information backfired. Facts simply weren’t enough.
Now what?
Columnist and in-Training Staff Member
Morsani College of Medicine at the University of South Florida
Ajay is a pediatric resident and a Class of 2017 graduate of the SELECT MD program at the University of South Florida. He is passionate about delivering primary care to underserved populations—specifically, low-income and homeless patients in urban centers. Ajay will be specializing in pediatrics, with a particular interest in child maltreatment.
M.D. or Bust
Numerous studies have documented that medical students lose empathy during clinical years, becoming jaded and pessimistic. This has been linked not only to diminished enjoyment of our work, but also to worse patient outcomes. My goal is to sustain the humanistic values that drive so many of us to medicine, so that, instead of being quelled by cynicism, our idealism can be refined by wisdom.
