Vaccine rejection: a flat earth theory for the 21st century


The flat-earthers are back!

Well, not exactly, but their descendants have come up with the flat-earth equivalent for the 21st century. They reject vaccination.

Vaccine rejectionists are all over the web promoting the “dangers” of vaccination. Vaccine rejectionism isn’t about vaccination, though. It’s all about parents and how they wish to view themselves.

It is important to understand that vaccine rejection is not based on science. There is no scientific data that supports vaccine rejection. Indeed vaccines are one of the greatest public health achievements of all time and virtually every accusation about vaccines by vaccine rejectionists is factually false.

Vaccines have been around for more than 200 years, and vaccine rejectionists have been around for almost as long. Over the years, they have made countless accusations about the “risks” of vaccines, and they have been wrong every single time. Despite the fact that vaccine rejectionists have been 100% wrong in their understanding of vaccines, statistics, risks and claims of specific dangers, they still have a large following. In large measure that is because the cultural claims of vaccine rejectionists resonate with prevailing cultural assumptions. Vaccine rejection is a social construct that has little if anything to do with objective reality or science.

‘Trusting blindly can be the biggest risk of all’: organised resistance to childhood vaccination in the UK (Hobson-West, Sociology of Health & Illness Vol. 29 No. 2 2007, pp. 198–215) explores these cultural attitudes. The first social construct is a re-imagining of the meaning of risk:

A primary way this is achieved … is to construct risk as unknowns… [This] serves as an example of how the realist image of risk as a representation of reality is undermined. In the realist account, uncertainty and unknowns may be recognised but are usually framed as temporary phases that are overcome by more research. For the [vaccine rejectionists], there is a more fundamental ignorance about the body and health and disease that will not necessarily be overcome by more research. Interestingly, this ignorance is constructed as a collective – ‘we’ as a society do not know the true impact of mass vaccination or the causes of health and disease.

The problem that vaccine rejectionism is based on false premises is elided by ignoring the actual scientific data and focusing instead on whether parents agree with health professionals or refuse to trust them. Agreement with doctors is constructed as a negative and refusal to trust is constructed as a positive cultural attribute:

Clear dichotomies are constructed between blind faith and active resistance and uncritical following and critical thinking. Non-vaccinators or those who question aspects of vaccination policy are not described in terms of class, gender, location or politics, but are ‘free thinkers’ who have escaped from the disempowerment that is seen to characterise vaccination…

This characterization of vaccine rejectionists can be unpacked even further; not surprisingly, vaccine rejectionists are portrayed as laudatory and other parents are denigrated.

… instead of good and bad parent categories being a function of compliance or non-compliance with vaccination advice … the good parent becomes one who spends the time to become informed and educated about vaccination…

… [vaccine rejectionists] construct trust in others as passive and the easy option. Rather than trust in experts, the alternative scenario is of a parent who becomes the expert themselves, through a difficult process of personal education and empowerment…

The ultimate goal is to become “empowered”:

Finally, the moral imperative to become informed is part of a broader shift, evident in the new public health, for which some kind of empowerment, personal responsibility and participation are expressed in highly positive terms.

So vaccine rejectionism is about the parents and how they would like to see themselves, not about vaccines and not about children. In the socially constructed world of vaccine rejectionists, risks can never be quantified and are always “unknown”. Parents are divided into those (inferior) people who are passive and blindly trust authority figures and (superior) rejectionists who are “educated” and “empowered” by taking “personal responsibility”.

This view depends on a deliberate re-definition of all the relevant terms, however, and that re-definition is unjustified and self aggrandizing. The risks of vaccination are not unknown. Believing that vaccines work is not a matter of “trust”; it is reality. Questioning authority is not the same as being “educated”; indeed, it isn’t even related. Lacking even basic knowledge of immunology and rejecting medical facts is not a sign of education, independent thinking or taking personal responsibility. It is a lack of education at best, and self serving, self aggrandizing ignorance at worst.

Part 2, the moral dimension: Vaccine rejectionism is unethical.

Part 3, misunderstanding risk: Panicking about small risks, oblivious to large risks.