GELFAND’S WORLD-It's a week in which the measles outbreak that started at Disneyland is now up to 67 confirmed cases. The origin was one unvaccinated woman who went to Disneyland in December and then took a plane ride.
The confirmed cases now include Disneyland employees. We should count our blessings that the outbreak is only at this level, because in the rest of the world, measles cases occur in the tens of thousands, and even now around 400 children die of measles every day.
Prior to the existence of the MMR vaccine, measles routinely infected several million American children a year, and killed about 450 on the average. We've been lucky this time around, because the American population has a high enough percentage of immunity to keep this outbreak under some level of control.
As the news stories have made clear, the sick people are largely concentrated among those who never had the vaccine. There are a few people who got the vaccine at some time in the past and are now ill from the disease, but they are fairly few and far between. The non-vaccinated, both children and adults, are a far smaller fraction of the population as a whole, but have been the strong majority of those who come down with the illness.
Measles is not Ebola, but it is potentially dangerous, so we are entitled to ask why there is such a large amount of vaccine avoidance among some American groups.
Perhaps we have a clue. There is one curious characteristic of vaccine avoiders. There is an over-concentration among wealthy, highly educated people. Having a college diploma and lots of money apparently doesn't always correlate with toeing the line on accepted medical practice.
Scientific rationalists find this avoidance perplexing. They concentrate their ire on the fact that lots of Orange County and Marin suburbanites, people with advanced degrees and scads of cash, don't do the right thing by having their kids immunized.
Allow me to speculate.
When we describe people as highly educated, it does not usually mean highly educated in medicine or public health. These are specialties that involve only a small fraction of the population.
It's the process of higher education in other fields that is at issue here. Such training, if it is to be effective, is supposed to teach you how to think critically about issues. This typically involves reading and hearing competing arguments, whether the question is the causes of the Civil War or the reign of Napoleon Bonaparte.
Napoleon was a great leader. Or was he a monster? Both views have validity, and at some level they are probably equally true.
I would hazard a guess that for the highly educated anti-vaccine crowd and even the fence sitters, the issue is not that they are highly educated in the subjects that count. Rather, they are highly educated in the attitude of criticality and doubt, so they apply this same attitude to what authority figures tell them about vaccination, nutrition, and often enough, government policy.
There is a problem with carrying this way of thinking over to a question such as the safety of vaccines or the usefulness of chemotherapy. One reason is that there is actually a right answer and a wrong answer to the question, "Are vaccines safe?" The other reason is that the consequences for taking the wrong side of the argument can be death or disability. We've seen such consequences in recent stories about parents refusing to let doctors provide chemotherapy to their children who have cancer.
We're now seeing analogous results for vaccine preventable disease. Children are getting measles because they didn't get their shots. The outcome is generally not as serious as failure to treat leukemia, but measles has risks, and a not insignificant fraction of the current victims have been hospitalized.
How do you justify something as irrational as refusing chemotherapy for a teen with lymphoma, or refusing to let your children get vaccinations? It correlates with parents accepting the lame arguments about vaccine dangers as being essentially equal to the evidence in favor of vaccine safety.
The two sides are not equal. Not nearly equal. But if you have been trained in a tradition in which everything is simply a matter of opinion, and all opinions are equally valid, then you have been equipped with the intellectual tools to rationalize such sentiments.
When you read the statements made by anti-vaccination activists, this approach becomes clear. Evidence for vaccine safety is dismissed out of hand, as if experimental data were simply a matter of opinion.
Science isn't supposed to work this way. There are scientific opinions, yes, but they are supposed to be based on the scientific method, not just on preconceived notions and circular reasoning.
There is one bit of good news attached to the current outbreak. The news media, including both television and radio, have largely abandoned the style in which vaccination is treated as just a matter of opinion. The radio and television stations have been reporting the spread of the disease, the increasing case numbers, and following up with advice from public health officials to get immunized. This may be the result of pushback from pro-science critics and from medical professionals. Whatever the underlying reasons, it is a welcome change and should be applauded.
We might also take note that one influential liberal opinion maker, the Daily Kos website, has been featuring pro-vaccine stories and comments that are frankly critical of the anti-vaccine position.
(Bob Gelfand writes on culture and politics for CityWatch. He can be reached at firstname.lastname@example.org)
Vol 13 Issue 7
Pub: Jan 23, 2015