Anti-vaccine advocacy as a form of social identity


I’ve been writing for years that anti-vaccine advocacy has nothing to do with vaccines or even children. At its heart, anti-vax is a form of social identity; it’s all about parents and how they wish to view themselves.

Now comes a scientific paper, Parenting as politics: social identity theory and vaccine hesitant communities, by Attwell and Smith, that expresses a very similar view.

This paper argues that the decision to vaccinate or not is an inherently social one, not a matter of pure individual rationality. This is a novel approach to engaging with what is often characterised and studied as an individual decision.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]It’s ironic that while anti-vaxxers like to preen about their independence from authority, they are desperately dependent on in-group validation.[/pullquote]

In other words, vaccine refusal has nothing to do with understanding of science (although anti-vaxxers do have a deficient understanding of science) and is therefore not amenable to change by improving knowledge about vaccines. It’s about group-think, belonging and a sense of empowerment derived from opposing the majority. It’s ironic that while anti-vaxxers like to preen about their independence from authority, they are desperately dependent on in-group validation.

…[V]accine hesitant people are often found in tight-knit geographical communities, they take comfort and inspiration from people who share similar beliefs all around the world, connected via the internet, with whom they feel a sense of kinship as an enlightened but besieged minority… [T]he social context of vaccination puts choices beyond the realm of pure individual rationality. The decision to vaccinate or not is tied to how individuals view society and their place in it, the social groups they value, and the shared worldviews of social groups they belong to.

But don’t anti-vaxxers come from widely different economic, social and religious backgrounds? They do, but the authors argue that these are simply tribes within the larger group.

There are various worldviews among these tribes, some of which are affluent and some of which reject materialism; some of which follow traditional religion and some of which favour non-traditional forms of spirituality. However, we suggest that all are formed in opposition to what they perceive as the damaging practices of modern mass society.

The commonality between the distinctive tribes is a “natural” approach to parenting and lifestyle.

People who adhere to this worldview value their own expertise and that of alternative health practitioners over mainstream medical and scientific expertise. They distrust what they see as unthinking deference to industrialised, commodified and financially co-opted medicine, and do not believe that the vaccinating mainstream has any valid claim on them or their children… [They] appear to hold specific beliefs around the damage of mass society as it pertains to the realm of health, and the health of their children in particular. When it comes to this, they seemingly do not aspire to acceptance from mainstream society; rather, they define themselves in opposition to it.

The authors use the insights of social identity theory (SIT):

SIT posits that individuals see the social world in terms of in-groups and out-groups, develop favourable biases towards members of their own in-groups, and make judgments about others based on this in-group bias.

That’s a remarkably apt description of anti-vax groups.

Ultimately, it’s about parental self-esteem, not vaccines and not children:

The individual drive for self-esteem is central to SIT. Individuals enhance their own self-esteem by their association with highly valued groups. They are therefore motivated to regard their own in-group highly, and to favour other members of that group. Degradation of out-group members may be a further means of enhancing in-group, and thus individual, self-esteem.

How are these groups created?

While historically this has relied upon physical proximity or tangible relationships, the internet and social media have opened up avenues for geographically disaggregated individuals to connect around ideas and practices.

The groups cohere around a particular cultural “style.”

[W]e posit that there is a recognisable identity to a central VHR tribe, referencing wellness and the pre-eminence of nature… [We] explore how this identity is reliant on particular resources. These resources enable an emphasis on individualism, which can be recognised as further attributes of this identity.

This style is closely tied to belief in “alternative” health, natural childbirth, breastfeeding, the centrality of nutrition.

Reich explicitly teased out how her mostly white, educated subjects in California saw feeding as “key to both their mothering and health promotion practice”, breastmilk was seen as conferring immunity, and on this basis mothers quasi-rationalised refusing vaccines, even while implicitly recognising that vaccination might be appropriate for other children. “[E]fforts to manage nutrition generally” were seen as “protective of […] children’s health”, whether because the mother took supplements during pregnancy or fed her child organic food.

Anti-vaxxers reject the notion that they have any responsibility to others:

To “live naturally”, one needs the resources of money or time, as we noted above; only then can one act and reason individually. This “me-first” perspective provides a salient rationale for dismissing the impact on others, as highlighting the special and unique properties of one’s own child makes it hard to justify population-level interventions…

In summary:

Vaccine hesitancy and refusal is also about one’s own self-image in relation to groups to which one perceives oneself as either belonging or proudly oppositional. Vaccine refusers possess the social or economic capital to define themselves against the mainstream, and seek to act according to their own beliefs and desires. Whether following a natural lifestyle and questioning big pharma, or using wealth to insulate one’s family from child care, bad food and “the riff raff”, VHR parents are able to separate themselves conceptually and physically from the rest of us.

Anti-vaxxers cling so desperately to their failed ideology, not out of concern for children’s health, but as a critical source of personal validation.