Anti-vaxxers: so friendless that free speech is enough to defeat them

That’s the headline the Guardian used for my latest piece on calls to deny a visa to pro-disease advocate Sherri Tenpenny. Discussion welcome, but I’d like to stress one particular point about the case for free speech

On considerations of equity alone, we should not be excluding people on the grounds that they advocate views that are wrong, dangerous and unpopular [antivaxers], while admitting those whose wrong and dangerous views have powerful backing[climate science deniers].

42 thoughts on “Anti-vaxxers: so friendless that free speech is enough to defeat them

  1. Good piece. I read it yesterday on The Guardian.

    I note the drawing of parallels between anti-vaxers and climate-deniers. The “deniers” on one side and the science on the other side with the observation that, in one case the money is behind the deniers (climate) and in the other it is against the deniers (vaccination).

    In one case the science is with the money and in the other it is against the monied interests.

    Over the years I have noticed how feral the Anti-Anti-Vaxxers can be, really nasty sometimes. It may be that where the money goes, so goes the vitriol? Hardly anyone would have heard of Tenpenny if not for all the PR the vilification campaign has provided.

    I agree with the suggestion that, like Monckton, they should be allowed to have their meetings and discuss their disinformation with those who wish to hear it. In both cases, for the genuinely inquiring minds there is plenty of much more authoritative information to be found on the “other” side.

  2. I have noticed how feral the Anti-Anti-Vaxxers can be

    I don’t think that’s accurate, Megan. It’s more that the people who accept the science also believe that the anti-vaxers (and climate change denialists) should be confronted with the consequences of their beliefs. I find wilfully ignorant people extremely annoying and occassionally lose patience with them as well.

  3. I can’t help thinking the anti-kids-dying people have scored an own goal here – the Streisand effect and all that. It would have been much better just to stand outside Tenpenny’s talks and speak to the people attending.

    And Megan’s right that there is rarely a risk of a Streisand effect with the climate delusionists, because they’ve got the money and influence behind them to get all the favourable coverage they want.

  4. Most of the media comments I’ve read in support of vaccination of children are too simplistic to weaken the anti-vaccination message. It is all about risk. While it is true that there are risks from being vaccinated, the statistics show that the risk to a given individual is extremely low, lower than the risk of dying in a car accident; on the other hand, if the proportion of vaccinated children in the population is too low, the diseases spread readily, and the risk of death by infection far exceeds the risk of death due to vaccination. Furthermore, the survivors of measles, chicken pox, mumps, are not home free: they can suffer chronic after effects, such as shingles, a very painful recurring affliction. I know of several people who have shingles.

    As for polio, if you have ever seen an iron lung and imagined living the rest of your life in one, you’d be vaccinated on the spot. Again, even if a person makes a full recovery from polio, years later they can suffer post-polio neurological symptoms, very painful and chronic.

    Surely this sort of information can be passed out to parents wondering about vaccination for their children? A picture of an iron lung wouldn’t hurt…

  5. @Donald Oats

    I very much agree with you. Vaccination is not perfectly safe just as (for example) air travel is not perfectly safe. But vaccination is many orders of magnitude safer than the alternative of having many serious disease epidemics.

    I remember my father (born 1924, Victoria) telling me stories of his school days. He said in every new school year there were kids missing from the last year sometimes from his own class. These were kids who had not moved away but had died from one epidemic disease or another. In the time of (Admiral Horatio) Nelson’s childhood about 1 in 2 to 1 in 4 infants died before the age of two depending on county and diocese. These records are in church records of baptisms and funerals.

    As usual, ignorance comes from not reading history, as much as anything. How do these ant-vaxxers think our current level of health was achieved? Not doubt there are many factors but the top four (in any order) must be public health and sanitation, proper nutrition, vaccination and anitbiotics/antivirals.

    I one hundred percent agree with J.Q’s. article too.

  6. I agree with your point in the Guardian piece about how the ABC characterises the opinions they present. I find it unbelievable that they don’t give the viewer the benefit of knowing the background of the people whose views they are hearing.

    As for anti-vaxxers, a good show would be to look at them and ask why they are so misguided. Maybe link to other weird belief groups, and see if they have anything in common.

  7. Alan Marshall’s book, “I can jump puddles”, ought to be on the reading list of every anti-vaxxer.

  8. I find it astounding that anyone supports a principle of free speech for these people, given the way that they have abused it. The Lancet article was a text book case of fraudulent, unethical and potentially harmful research conducted without any scientific validity, and as a result of it there has been a growing measles epidemic in the UK, with one person dead because of it. The author has been denied the right to practice in the UK and fled to the USA. Every single aspect of his campaign, and of the public work of his supporters in e.g. The Daily Mail, has been dishonest, fraudulent, and deliberately trading on the medical profession’s reputation to damage the efficacy of one of the world’s most effective public health interventions.

    Anti-anti-vaxxers are not “feral.” The anti-vax movement are feral.

    Also engaging with these people or allowing them to speak their crazy ideas has not dragged those ideas into the light and revealed their stupidity. Rather, it has given their ideas traction and led to an epidemic of measles. They have shown that they can win this debate if they are allowed to have it.

  9. The point Donald makes about risk also extends to risks the rest of us are forced to assume by default because there are still parents who don’t vaccinate their children against diseases that should be preventable nowadays.

    Such parents and antivaxer advocates are directly responsible for this state of affairs and for the fact that diseases that could/should have been eliminated are still with us – and continue to cause suffering and death. In other words, there are serious consequences arising from the notion of free speech in a public health context, if views are not challenged and if people act on information given.

    One solution is to hold antivaxer advocates and people who follow these views accountable in some way for costs the public health system has to bear through parents choosing not to vaccinate.

  10. @Donald Oats That’s always been a problem, scientific language is by nature is limited and not very exciting whereas rhetoric can be ramped up to whatever you like. The only problem for the anti crowd is that using emotion to drive your message is limited as most people can’t maintain sufficient rage.

  11. @rog
    I agree with you to an extent, for we certainly have some painful examples of rhetoric (and outright corruption) drowning out scientific news which scientists are trying to impart. Nevertheless, one of the issues I have with attempts at confronting the anti-vaxxers is that it is simply a confrontation. It is no use saying vaccinations save lives and leaving it at that: this is the kind of statement I’ve been reading and hearing in defence of vaccination. It isn’t a nuanced statement, so we cannot argue that it is limited by the nature of scientific language, for in this instance it is the nuance that is absent, fatally so.

    The main difficulty with a blunt defence of “vaccination saves lives,” is that while it is true, there is a second clause of “ but occasionally kills one.” My point is that this second clause has to be explained satisfactorily if there is to be a hope of convincing some anti-vaxxers to accept vaccination. There are some who are so resolute in their beliefs, they’ll never accept the practice of childhood vaccination, but the rest of them are just not fully informed in a way they feel is truthful, and which allows them to fully apprehend the importance of vaccination programs.

  12. faustusnotes :
    I find it astounding that anyone supports a principle of free speech for these people, given the way that they have abused it.

    The problem is that the right, for example, would feel exactly like this about some environmentalists. The best thing is to let everyone talk, as much as you can. Let the loonies talk, so that you’ve got a leg to stand on when someone you support wants to talk.

  13. I agree with the angle in JQ’s article, however this comment caught my attention; “Cases like those of neo-Nazi David Irving and “pickup artist” Julien Blanc are different, since they can be excluded on grounds of bad character. But the case for excluding Tenpenny (and, hypothetically, Monckton) rests entirely on their stated views.”

    Who decides what is bad character? Surely bad character also derives from “stated views”. The examples given are clearly separable, however there is a grey area in between that is difficult to define. It is easy to brand someone a neo-Nazi, case shut, end of debate, but I would argue half the current government display “bad character”.

  14. @faustusnotes

    Maybe the point is that while yesterday they killed some journalists and cartoonists, tomorrow they will want to tell everyone how they can live. We have some rules about that, the main one being that we elect the people who decide the rules by which we live. Lots of our ancestors died to get this system. We will defend it.

  15. Anti-vaxing arose in the context of assertive libertarianism (the government will not tell me what to do with my precious child’s body) and a kind of new age puritism that sought to rid the sacred human body of anything ‘unnatural’ (e.g. “is that water organic?”). So I don’t believe the original motivation had much to do with “risk” as such – although the risk of side effects did then became a justification around which the movement could cherry pick data and mobilize a small army of conscientious objectors. They might not be so conscientious though. A friend related the story of the decision not to vaccinate their child a decade ago, “It was kind of trendy you know – we just went along with it”. That’s a relatively safe strategy in a well immunized society.
    Risk actually plays into the hands of the anties. As Donald notes (at #4) the risk of contagion dramatically increases as the proportion of those vaccinated declines. A healthy society where virtually everyone is vaccinated is not unlike Garrett Hardin’s tragic commons. Up to a point, the gain from not vaccinating (the social prestige of not being a beholden to the nanny state and the promise of organic purity) accrue exclusively to the individual while the costs are borne by a society in the form of rising infection rates. Beyond that point, as infection rates rise, it becomes increasingly dangerous not to vaccinate and you can probably forget about Hardin.
    Anyway it seems that it was the very idea of free speech that gave rise to this movement who then used a form of science which might be called agnotology – the production of ignorance – to grow to the point at which we now debate their entitlement to free speech.

  16. According to a 2013 survey (http://www.scienceinpublic.com.au/media-releases/vaccinationsurvey), 53% of Australian parents are concerned about vaccinating their children. I think this undermines the idea that, if only Tenpenny had been ignored, vaccination wouldn’t be such an issue. Anti-vaxxers don’t need money and influence to frighten parents and gain traction, they only need internet sites and a network of cranks providing bogus healthcare services. But the fact that these mechanisms are so effective for spreading their message also undermines the idea that preventing Tenpenny from speaking here would do much to help, and I agree that its main effect would be to play into the conspiratorial delusions of anti-vaxxers.

    Many of those parents who have concerns about vaccination would benefit from careful explanations of why the risks associated with vaccination are far outweighed by the risks of eschewing vaccination, but these people have their children vaccinated despite their concerns. According to that survey, only 8% of parents delay or avoid vaccines. But these parents are different: they have intractable views borne not out of ignorance, but out of rejection of scientific evidence, because they see it as incompatible with their values.

    Because their positions are not formed on the basis of evidence or logic, they cannot be changed through the presentation of scientific evidence. Rather, vaccination needs to be framed as being compatible with their views. The fact that their motivations for rejecting vaccination vary from a belief that science has been corrupted by capitalism, on the left, to a deep distrust of government, on the right, makes this extremely difficult. For those on the left, framing vaccination as part of a long and proud tradition of public health interventions that saw widespread disease and death as things towards which a laissez faire attitude could no longer be tolerated is one possibility.

  17. @Dave Lisle

    I think difficulties in handling risks lie at the heart of it. In its analysis of community attitudes towards science and technology (https://publications.csiro.au/rpr/pub?pid=csiro:EP145330), the CSIRO identifies 23% of the population as belonging to a “risk averse” group. Here is what it says about them:

    “This segment tended to be less positive towards the benefits of science and technology. They were also more concerned with risks. But in contrast to Segment D, they had relatively high awareness of science. They were least likely to agree that Human activities have a significant impact on the planet and least likely to agree that Not vaccinating children puts others at risk.”

    Vaccination is about accepting a small risk in order to avoid a much larger risk. Those who are risk intolerant refuse to make this trade, demanding that vaccination be proven completely safe, and are drawn to promises made by cranks that alternatives can offer the same benefits without any potential side effects. Those things that are perceived as natural are viewed positively because they are also viewed as safe. These people seem to have severe difficulty in comparing and weighing risks, and appear to treat risks (and consequences) arising from human intervention as much more important than those arising from non-intervention. They seem to need to believe that there is a completely safe option, and discount the risks associated with it.

    The comments thread for Professor Quiggin’s piece at The Guardian provides numerous examples of this: people demanding that doctors guarantee that vaccines are 100% safe, people arguing that deaths arising from medical intervention in and of themselves show that medical intervention is harmful overall, calls for those affected by the side effects of medical intervention to be given special treatment compared with other ill people, and so on.

  18. Back in the early ’70’s when my first child was vaccinated there was no choice about it; nobody ever suggested that I could choose not to vaccinate. I think I would have been horrified and thought it so selfish and a very anti-social thing to do; to choose to keep my child safe from something that was very unlikely to happen and put everyone else’s child at risk.

    The chances of a bad reaction was not explicitly explained to me by my doctor but he made it clear that the baby could get sick if I was unlucky. Back then one didn’t ask for stats or google before consulting the doctor. My doctor was also the public health doctor who did the injections and polio vaccinations in the Brisbane City Council building.

    He trained as a doctor after returning from WWII and his practice was in a beautiful old Qlder house on Main St in Brisbane with a number of magnificent fig trees in the grounds.

    The waiting room furnished with the classic Victorian lace curtains and upholstered mahogany chairs and a very discreet lady receptionist led into the doctors room and a surgery and then consultation over, one departed through a heavy curtain that I imagined came from Freud’s study.

    During the ’80s I think it was Telstra then, wanted to buy his house as part of the whole block upon which to build an office tower – it is very close to the Gabba if anyone knows Brisbane – and he refused to sell to them despite all sorts of inducements. Telsta built their tower around his house and he lived there til he died.

    It was always nice to see the greenery and the lovely old house at the bottom of the building.

    My baby did actually get very sick that night and it was very scary even with my mum there to advise and reassure me and our doctor on the end of the phone and just down the road. But my son was fine in a few hours and he was fine for all the other vaccs he had and none of my other 3 children had any sort of reaction from their vaccinations.

    One would think that for the lefty anti-vaccers it would be obvious that they have a responsibility to make their society a better place and the righist anti-vaccers who claim to be rational, have a responsibility to do the rational thing.

  19. @Luke Elford

    If you took your child to get vaccinated and they had a bad reaction and died or were permanently disabled, you would feel very, very bad about it. That is the fear behind it. The thought that you deliberately did something that killed your child.

    Its difficult to be rational about this. My own technique was just to view it as a lottery – and I never win those, so I was safe.

  20. I think it is impossible for humans to be rational about anything using our own cognitive processes. We humans are social beings – some of us more than others of course – and we need to be part of a group to develop our opinions and beliefs.

    Despite the culturally created desire some of us have to be one of those bloody wonderful individuals that have been so admired over the past few decades – like the not so awesome Steve Jobs. Very few people could function as an individual without some sort of reference group – peer group – that approves of us and our behaviour.

    This recent ‘need’ to be seen as a special individual has been nurtured by vested interests who use it to manipulate people – for profit and power of course – and particularly young people who are trying to become an adult who can take responsibility for themselves are influenced by the idea that it is not a good thing to be one of those ‘sheeple’.

    From what I see on my facebook page from younger family members who do dabble in conspiracy theories and anti-vax ideas, they really want to be seen as *not* sheeple and it is this need to be admired by their sub-culture that provides the motivation for them to show that they are smarter than the ‘authorities’; smarter than the scientists and the government and the corporations and so very much smarter than those so very stupid ‘sheeple’.

    Trust no one and always be not only suspicious of authority but determined to deny that there is any value in it, seems to the mark of an individual for one of the many sub-cultures that contribute to these irrational responses.

    Dan Kahan at the Cultural Cognition blog is trying to sort out how and why we do this – ie he is looking at the patterns of cognition and how they are culturally determined.

    Using the example of a Pakistani doctor working in the US who rejects evolution in his private life but in his professional life is fully cognisant of the theory and accepts the evidence, Kahan writes that:

    “What we believe or know—the objects of those intentional states—don’t have any existence independently of what we do with them. The kinds of things we do, moreover, are multiple and diverse—and correspond to the multiple and diverse roles our integrated identities comprise.

    The Pakistani Dr is an oncologist and a proud member of a science-trained profession. His belief in evolution enables him to be those things.

    He is also a devout Muslim. His disbelief of evolution enables him to be that—when being that is what he is doing.

    There’s no conflict!, he keeps insisting. The evolution he “accepts” and the evolution he “rejects” are entirely different things—because the things he is doing with those intentional states are entirely different, and, fortunately for him, perfectly compatible with each other in the life he leads.”

    Kahan in this more recent blog uses a Kentucy Farmer to illustrate the same pattern of cognition that people in different cultures utilise to rationalise cognitive dissonance.

    http://www.culturalcognition.net/blog/2015/1/7/so-you-want-to-meet-the-pakistani-dr-just-pay-a-visit-to-the.html

    Interestingly Kahan also links to an article about Monsanto’s approach to climate change and their plan to make a profit from it. I think I’ll go into moderation if I provide the link to this article.

  21. If we are going to deny visas on the basis of dangereous ideas then the anti-vaxers qualify. But I’d put them lower on the list than some of the people we seem to routinely let in.

  22. I think the answer to trying to get people to support vaccination is education and awareness building. That is what our shire council is doing about it.

    It’s a bit of a difficult issue though , since if people are opposed to using all or parts of modern medicine I don’t think they should really be forced to.

    There was an article in the paper today about alternative health colleges being funded more per student than universities with this government’s higher education reforms –

    “Accredited private colleges would become eligible for grants of $6323 a year for each student enrolled in courses such as homeopathy, naturopathy and mind body medicine. This is more than public universities would receive per student studying law, economics, languages or the humanities under the new funding structure”

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