The anti-vax movement is the paradigmatic “alternative” health movement. It is one of the oldest, and largest; it seduced millions of parents, co-opted the mainstream media for a time, made fortunes for celebrity quacks, and … it was always utterly, totally, spectacularly wrong.

The lessons from this debacle go far beyond anti-vaccination advocacy and strike at the heart of the multi-million dollar industry of alternative health.

All of alternative health, from homeopathy to chiropractic, from reiki to cranio-sacral therapy, from homebirth to lotus birth, from GMO hysteria to essential oils, and all the myriad of other alternative “therapies” are all as intellectually bankrupt as anti-vaccine advocacy, and all for the same reasons.

Like anti-vax, they have nothing to do with science. They’re not based on science; they ignore existing scientific evidence, and they make up their own “evidence” that they disseminate through websites, books and message boards.

Like anti-vax, they are promoted by industry shills (the industry of alternative medicine) who profit by fooling average people into parting with their hard earned money.

Like anti-vax they appeal not to the intellect, but the ego, constantly praising and affirming the superiority of believers who are so much better than the “sheeple” who consult experts and follow their advice.

Like anti-vax, they appeal to the desire to defy authority. Oncologist says you need chemotherapy? Well, you’ll show him and use herbs and supplements instead! Obstetrician says that a C-section will decrease the risk that your baby will die during labor? Well, you’ll show her and have your breech baby at home attended by a pretend “midwife” and if that baby dies, it wasn’t meant to live. Pediatrician says that there is little you can do for your baby’s colic? Well, you’ll show him and get your baby “adjusted” by a cranio-sacral therapist to treat the infant’s traumatic birth “memories.”

Like anti-vax, alternative health is about denial. Sure, other people can get cancer, but not you. Other people could lose a baby during childbirth, but not you. Other people might die, but not you.

Like anti-vax, anyone can be an expert. No need to feel inferior to or intimidated by a doctor. You can boast that you are an expert in your own health.

Like anti-vax, alternative health privileges intuition over rationality. Okay, you may not have much of that “book learning” and you may not be able to construct a logical argument even if your life depended on it (and it might), but your intuition is just as good as anyone else’s, regardless of how much more education they have than you.

Ultimately, all of alternative health, like anti-vax advocacy, is a form of ego massage. It does nothing to improve your health, but does a lot to improve your sense of self-worth.

Unfortunately, though, all of alternative health will ultimately come up against reality:

Just as measles exists whether you acknowledge it or not, alternative health is quackery whether you recognize it or not.

Will alternative health believers learn anything from the measles epidemic that has shown them to be utterly, spectacularly wrong?

I doubt it. That would take insight, something that is in nearly as short supply among alternative health believers, as scientific education and understanding.

Anti-vaccine parents are rather unimaginative.

It requires imagination to recognize that just because you haven’t seen a vaccine preventable illness, that illness still exists. It requires imagination to recognize that just because you’ve never seen anyone die of a vaccine preventable illness, that doesn’t mean they aren’t deadly.

I thought we might help out anti-vaccine parents by offering a thought experiment:

What if measles were head lice?

Every parent, except those of the very youngest children, is familiar with the scourge of head lice. Most of us have had the experience of a child who comes home from school or camp with an infestation. Though I’ve met many parents who dismiss the risks of measles, I haven’t yet met anyone who thinks an ongoing infestation of head lice is just fine.

Why is that?

It can’t be because head lice are more dangerous than measles. Head lice aren’t dangerous at all, while measles sickens and kills.

It can’t be because head lice are more contagious than measles. The transmission of head lice requires very close personal contact, while measles is transmitted through the air.

It can’t be because head lice have more complications than measles. Head lice don’t have complications, while measles can lead to brain damage.

It can’t be because head lice are more natural than measles. Both have been with us from time immemorial.

It can’t be because the treatment for head lice is more natural than measles vaccine. Effective treatment for head lice usually involves harsh chemicals, while vaccination involves working in harmony with the body’s immune system.

There’s nothing wrong, unnatural or dangerous about head lice.

So, anti-vaccine parents, how would you feel if other parents made the following claims?

• I refuse to treat my child’s head lice because I don’t want to expose them to harsh chemicals.
• I refuse to treat my child’s head lice because head lice are natural.
• I refuse to treat my child’s head lice because I am philosophically opposed to killing lice.
• I refuse to treat my child’s head lice because ex-Playboy Playmate Jenny McCarthy told me that treating head lice causes autism.
• I refuse to treat my child’s head lice because I had lice when I was a kid and it didn’t hurt me.
• I refuse to treat my child’s head lice because I’m not concerned about whether all the other children around him or her get head lice, too.
• I refuse to treat my child’s head lice because freedom means that I am free to let my child pass head lice to all the other children he meets.

Anti-vax parents, would that be okay with you?

Would you be willing to let your own children (and probably yourself) get head lice repeatedly because other parents refused to treat their own children for head lice? Would you cheerfully pick the nits out of their hair, wash and dry their bedding, clothes, stuffed animals, etc. each time they got head lice? Would you cheerfully pick the nits out of your own hair repeatedly, since infestations would be very common, and you couldn’t avoid them? Or would you just accept the itching and the live lice crawling through your hair since they are natural?

I’m going to go out on a limb here and guess that you would be very, very upset if other children kept infecting your children with lice. I doubt you’d be setting up websites to advocate for the freedom to ignore lice, or creating message boards to support parents who have philosophical objections to treating lice.

What’s the big difference between measles and head lice?

Most anti-vax parents have never seen a case of measles, but nearly all have seen head lice. It’s just a matter of personal experience.

But you know what? Measles, like head lice, exists whether you’ve personally experienced a case or not.

And if you wouldn’t abide another parent sending her child to school with head lice and passing it on to your child, why should anyone else abide your decision to send your child to school unvaccinated, and therefore capable of transmitting measles?

They shouldn’t, should they?

As if the anti-vaccine movement wasn’t already a complete circus!

The arrival of Presidential pander bears Chris Christie and Rand Paul has made it a three ring circus, the third ring being anti-vaxxers’ much vaunted “freedom” to do what they want.

The argument goes something like this:

If I lose the freedom to sicken small children and let babies die by refusing to vaccinate my children, the next step will be jackbooted thugs implanting us all with computer chips to control our minds and pave the way for world government.

Haven’t heard about the freedom to sicken small children, let babies die, and bring nearly abolished deadly diseases back from near extinction?

I don’t know why not. It is enshrined in the same place as these freedoms:

• The freedom to dodge the draft because you’re afraid of being harmed by war.
• The freedom to dodge income tax when you don’t like the President.
• The freedom to dodge laws against theft and robbery when you need a little extra cash.
• The freedom to burn down your neighbor’s house when it obstructs your view.
• The freedom to obstruct your neighbor’s view by building a 90 ft. fence surrounding your property.

Wait, what??!! We’re not free to do those things? Why not?

Because the greatness of America lies in the fact that its two most important principles are freedom AND justice! American freedom is not absolute. It is tempered by the American commitment to justice. To those on the Right who seem to have forgotten the justice component, let me remind you that it comes from the Judeo-Christian tradition that you claim animated the founding of this country. Your freedom ends where the harms to others begin.

How do we settle disputes where your freedom to do what you want harms others?

John Rawls, the greatest political philosopher of modern times wrote that if we want to know what justice requires of us, we ought to imagine the world we would want if we didn’t know the position that we would occupy in that world. In other words, justice is what we would choose if we didn’t know if we were rich or poor, black or white, brilliant or plodding, talented or talentless. In the case of vaccination, justice is what you would want if you didn’t know whether you were immunocompetent and could potentially fend off vaccine preventable diseases, or immunocompromised and would almost certainly die if exposed to those same diseases. Rawls was harking back to the principle of Immanuel Kant:

Act only according to that maxim whereby you can at the same time will that it should become a universal law without contradiction.

In other words, if you want to know whether an action is ethical, imagine a world where everyone behaved as you did.

Imagine a world where everyone dodged the draft. The country would be overwhelmed and destroyed in short order.

Imagine a world where everyone stole anything they could. You couldn’t run a business or operate a bank. You couldn’t accomplish anything if people had the “freedom” to steal whatever they coveted.

Now imagine a world where everyone had the “freedom” to refuse vaccination, and imagine further that you don’t know whether you and your children can potentially survive the inevitable resurgence of vaccine preventable disease or you (or more likely) your children will certainly die.

What would that world look like? There would be a lot of dead bodies in it and some of them would be your children.

A world in which everyone has the “freedom” to refuse to vaccinate is a world of death and misery, hardly better than a world where everyone has the “freedom” to steal from others.

Just as there is no “freedom” to burn down your neighbor’s house to improve your view, there is no “freedom” to refuse to vaccinate your children against vaccine preventable diseases.

It doesn’t matter whether your neighbor could easily rebuild his house elsewhere; it doesn’t matter if he didn’t really care about his view; it doesn’t matter if he was thinking about moving across the country, anyway; your “freedom” to see what you want from your windows ends where his house begins.

Similarly, it doesn’t matter whether you think vaccines work; it doesn’t matter whether you think vaccines cause autism; it doesn’t matter if you think it would be safer for your children to refuse vaccination; your “freedom” to raise your children as you see fit ends where the lives and health of other children begin.

Listen up:

You never had the “freedom” to sicken small children and let babies die, so stop whining about being deprived of it!

We’ve finally found an issue that unites the American Left and the American Right!

Unfortunately, that issue is anti-vaccination.

As many pundits have noted, anti-vaccine activism is prominent among diverse political groups that have virtually nothing else in common. Why?

Because when it comes to science, we are all postmodernists now.

PBS offered this definition of postmodernism in connection with the topic of faith and reason:

[P]ostmodernism is highly skeptical of explanations which claim to be valid for all groups, cultures, traditions, or races, and instead focuses on the relative truths of each person. In the postmodern understanding, interpretation is everything; reality only comes into being through our interpretations of what the world means to us individually.

If there is any discipline that claims to be valid for all groups, cultures, traditions and ethnicities, that discipline is Science.

As philosopher Daniel Dennett noted:

“Postmodernism, the school of ‘thought’ that proclaimed ‘There are no truths, only interpretations’ has largely played itself out in absurdity, but it has left behind a generation of academics in the humanities disabled by their distrust of the very idea of truth and their disrespect for evidence, settling for ‘conversations’ in which nobody is wrong and nothing can be confirmed, only asserted with whatever style you can muster.”

Academics in the humanities were not the only ones disabled by their “distrust for the very idead of truth and their disrespect for evidence.” Ordinary citizens are similarly disabled.

Simply put, what many on the Left and Right share is the belief that each of us create our own reality. For the Left, that reality is that Nature is perfect, intuition takes primacy over rational thought, and all authority should be distrusted. For the Right, that reality is that American/Western European values are supreme, fear takes primacy over rational thought, and government is evil and controlling.

Postmodernism has typically been associated with the Left, and most on the Right, particularly the far Right, would be horrified to find themselves in company with the postmodernists. In my view, however, the “pre-eminent” postmodernist of the early 21st Century was not a philosopher, but a politician, President George W. Bush.

His philosophy, was famously summarized by an aide (believed to be Karl Rove) in speaking to a journalist:

The aide said that guys like me were “in what we call the reality-based community,” which he defined as people who “believe that solutions emerge from your judicious study of discernible reality.” … “That’s not the way the world really works anymore,” he continued. “We’re an empire now, and when we act, we create our own reality. And while you’re studying that reality—judiciously, as you will—we’ll act again, creating other new realities, which you can study too, and that’s how things will sort out. We’re history’s actors…and you, all of you, will be left to just study what we do.

How has this view played out in the world of anti-vaccination?

Reality is that vaccines are one of the greatest public health achievements of all time, saving literally hundreds of millions of lives.

But the Left has created its own reality in which industry is engaged in a gigantic conspiracy to render eveyone autistic while making copious profits. And the Right has created its own reality in which government is engaged in a gigantic conspiracy to abrogate parental authority to determine what is safe for their children.

This belief by the Left and the Right that we can create our own reality is not limited to the vaccine issue. It extends to climate change, evolution, genetically modified food products (which, in reality, is ALL food that has ever existed) and food itself. It makes no difference to the “postmodernists” that the science on these issues is settled and massive consensus exists among experts. Both the Left and the Right feel free to ignore reality in an effort to shore up their philosophical and religious beliefs. Cognitive dissonance is hard; making your own reality is much easier.

The Disneyland measles outbreak is a stark reminder to the “postmodernists” on the Left and the Right, that reality exists independent of their prejudices and beliefs.

Both had argued that the disappearance of measles was the result of “sanitation,” not vaccination. Both had argued that vaccines don’t work and herd immunity was a figment of the imagination. And both had argued that refusing to vaccinate would not allow measles to reappear because it was “gone.”

Those arguments were spectacularly demolished by the reality of one unvaccinated child exposed to measles who then visisted Disneyland. The outbreak has spread to multiple states by now and the unstated consensus that we should let citizens ignore science in favor of personal beliefs has been blasted apart.

The real lesson of the Disneyland measles outbreak is a harsh one. The real lesson is that there is a reality independent of individual belief and that individual belief is powerless to change that reality.

Climate change is real.

Evolution is the only explanation for the world that currently exists.

GMOs in food are not harming anyone.

Alternative health quackery is not saving anyone.

And … unequivocally … vaccines prevent disease and save lives.

If there is one thing that every anti-vax parent believes, it is that she (or he) is educated on the topic of vaccines. She’s done her “research.” She’s read books, websites and message boards that have supplied her with a plethora of information and citations to scientific studies. Give her half a chance and she will overwhelm you with lists of vaccine ingredients, anecdotes of vaccine complications, and bibliography salad of dozens of studies she hasn’t read.

Want to stop her in her tracks?

Ask her a simple question: How do vaccines work?

It is truly amazing how many anti-vax advocates are dumbfounded by that simple question. Surely, if they are critiquing the safety and efficacy of vaccines, they must know how they work, right? They must understanding the difference between cellular and humoral immunity; they surely know how and why antibodies are created; they must understand the role of each vaccine component; they must be conversant with the workings of her immunity.

But they aren’t and they often don’t even realize it until you ask them to explain it to you.

How can it be that the same people who preen about their “knowledge” of vaccines are so woefully ignorant about the basics of vaccines? Two reasons: they don’t have knowledge; they have pseudo-knowledge. And they’re not aware of how woefully uneducated they are because they bask in the warmth of alternative communities of internal legitimacy.

What is pseudo-knowledge?

We are surrounded by pseudo-knowledge in everyday life and most of us understand that it isn’t true. Advertisements of all sorts of products, both legitimate and bogus, and filled with pseudo-knowledge. Most of us are quite familiar with the language of pseudo-knowledge:

“Studies show …”
“Doctors recommend …”
“Krystal S. from Little Rock lost 30 pounds in 30 days …”

In the era of patent medicine, claims like these were usually enough to sell a product. But consumers have become more jaded and the language of pseudo-knowledge has become more sophisticated as a result. Consider this explanation of the benefits of acai, a favorite among the scourge of bogus nutritional claims. According to Dr. Perricone (a real doctor!):

The fatty acid content in açaí resembles that of olive oil, and is rich in monounsaturated oleic acid. Oleic acid is important for a number of reasons. It helps omega-3 fish oils penetrate the cell membrane; together they help make cell membranes more supple. By keeping the cell membrane supple, all hormones, neurotransmitter and insulin receptors function more efficiently. This is particularly important because high insulin levels create an inflammatory state, and we know, inflammation causes aging.

This exerpt is classic pseudo-knowledge. It contains big, scientific words and sounds impressive. It contains actual facts, although they are entirely unrelated to the benefit being touted. It contains completely fabricated claims that have no basis in reality (“they make the cell membrane more supple”) and which, not coincidentally trade on the gullibility of some lay people (if my skin is no longer supple, it must be because the membranes of the individual cells are not supple) and it asserts that “we know” things that are flat out false.

Acai has been little more than a giant credit card scam. Anti-vax parents have been scammed in exactly the same way.

Much of what they think they know is flat out false (“the incidence of vaccine preventable diseases was falling before vaccines were introduced”), is anecdotal information proving nothing about anything (“Jenny McCarthy cured her son of autism!”), or goofy conspiracy theories that are ludicrous on their face (the entire medical pharmaceutical complex is aware that vaccines are not safe and not effective but they’re giving them to their own children anyway).

How is it that anti-vax parents don’t recognize that they don’t even know the most basic facts about immunology? They are part of communities of like minded believers. They inhabit an alternate world of internal legitimacy.

As Anna Kirkland explains in the paper The Legitimacy of Vaccine Critics: What Is Left after the Autism Hypothesis? published in Journal of Health Politics, Policy and Law in October 2011.

[They]have built an alternative world of internal legitimacy that mimics all the features of the mainstream research world — the journals, the conferences, the publications, the letters after the names — and some leaders have gained access to policy-making positions. Mixing an environmentally inflected critique of vaccination and Big Pharma with a libertarian individualist account of health has been a resonant formulation for some years now, with support flowing in from both the Left and the Right.

Anti-vaccine websites and message boards maintain totalitarian control of this alternative world, by deleting comments that question the anti-vax received wisdom and banning commentors who have independent (and generally conflicting) knowlege of immunology, pediatrics and public health. Moreover, these communities do everything possible to reinforce the positive self-image of anti-vaxxers as heroes, brilliant heretics who question received wisdom in order to save their children’s lives.

Anti-vax parents occupy an alternate world of internal legitimacy, which means never having to face dissent, never having to respond to real scientific evidence, and never having to acknowledge that most of what they think they “know” is pseudo-knowledge, not real knowledge.

Want to bring them face to face with reality?

Just ask them to explain how vaccines work.

TV star and attachment parenting celebrity Mayim Bialik doesn’t vaccinate her children.

She wrote a whole essay on why she doesn’t want to talk about it:

Children today get about four times as many vaccines as the average 35-year-old did when we were kids. Besides visiting the CDC website … here are the books we used to research each vaccine and discuss each with several doctors before deciding what was right for our family.

She then recommends anti-vax books by Mothering Magazine contributor Dr. Lauren Feder (primary care medicine, pediatrics and homeopathy) and super-quack Dr. Bob Sears.

She did offer a bit more while promoting her book in an interview with NPR:

So my feeling is you can really do whatever you want, just like I get to do whatever I want, but I don’t inherently think that no one should get the flu, for example. And that’s my personal opinion.

… My feeling is everyone gets to decide and do research based on their family and their needs as to what they want to do. But it’s completely separate from attachment parenting or from my book.

She couldn’t make it any clearer, right? Everyone gets to make their own choice based on their family and their needs, right?

Wrong!

Yesterday Bialik wrote about the Similac commercial, which as I pointed out last week last week is opposed by lactivists.

Surely, if there’s any decision that is personal, for which each woman should make her own choice based on her family and her needs, it’s how she uses her own breasts.

Wrong!

Yesterday Bialik pleaded: Don’t Fall For That Similac Commercial

Bialik is shocked, shocked that Similac presents breastfeeding as a personal choice:

The ad shows breastfeeding as “just another choice,” ignoring that it is the medically recommended way to feed human babies. It’s not the same as cloth versus disposable diaper choices or deciding which baby shampoo to use. This commercial undermines medical and scientific fact under the guise of “It’s all the same, don’t judge. And if you do, you are the bad mom.”

In other words: Tolerance for me, but not for thee.

At first I thought that Bialik was being inconsistent. Vaccination is a personal choice, but breastfeeding isn’t?

Maybe it’s because one decision has the potential to harm innocent bystanders, but the other doesn’t.

That can’t be it, because vaccination affects more than Bialik’s children and she thinks that is just a “choice,” while breastfeeding affects no one else but the mother-child pair in question.

Then I thought it’s because one decision is much more serious than the other.

But that can’t be it, either, since even in first world countries vaccine preventable diseases could kill thousands of children each year, whereas formula feeding doesn’t harm anyone.

Then I realized that Bialik isn’t being inconsistent at all.

She believes that whether or not she vaccinates her children should be HER choice and …

Whether or not you breastfeed your child should be HER choice, too!

Because we should never forget that breastfeeding is a medically recommended way to feed babies.

Kind of like vaccination is the medically recommended way to protect babies against deadly diseases.

Oops!

We have a word for people like Bialik. The word is hypocrite.

On Saturday I wrote about the fact that the anti-vaccine movement has never been about children, and it hasn’t really been about vaccines. It’s about privileged parents and how they wish to view themselves, specifically as defying authority and empowered by self-education. This is why efforts to educate anti-vax parents about the science of immunology has been such a spectacular failure. It is not, and has never been, about the science.

That does not mean that anti-vaccine parents understand the science behind vaccines. They emphatically do not, and it is this lack of understanding that undergirds most of their philosophical claims.

As a threshhold matter, if you ever want to stop anti-vaccine parents in their tracks, ask them to explain how vaccines work. They can’t do it!

I don’t mean simply how vaccines lead to immunity. That’s relatively straightforward in any case. Vaccine stimulate the production of antibodies. Antibodies are proteins that recognize specific bacteria or viruses and bind to them, thereby signaling to other immune cells that they are targets for swift neutralization. Each antibody binds to a specific site on a specific bacteria or virus.

Everyone with an intact immune system makes antibodies. We can make them in response to the disease or we can make them in response to the vaccine. The difference is that the disease can kill us before we make enough antibodies to kill it. Vaccines give us a huge head start. We make antibodies to the specific virus or bacterium after being exposed to an inactivated part of (or whole) virus or bacterium. Then if and when we are attacked by the pathogen, we ramp up production of antibodies before the virus or bacteria can multiply enough to kill us.

That’s how vaccines lead to antibodies, but that’s NOT how vaccines work to protect everyone’s health.

The way vaccines work to protect health is by making it impossible for pathogens to jump from person to person.

Even the best vaccines are not 100% effective, and we can’t vaccinate 100% of the population. For example, babies can’t be vaccinated for specific diseases until they can mount the appropriate antibody response. Immuno-compromised people may not be able to mount an immune response at all.

In other words, if vaccines needed to be 100% effective to work, they wouldn’t work in the real world.

Instead, vaccines work by dramatically reducing the chance that an infected person will encounter an unprotected person. As I explained last week in Anti-vaxxers, the real welfare queens:

Imagine that little Ainsley comes in close contact with 10 children per day. Now imagine that Ainsley develops diphtheria. Who is likely to catch diphtheria from Ainsley? If 99% of children are vaccinated and the vaccine is 95% effective, the odds are low that any of the 10 children she comes in contract with could get diphtheria. Thus, the outbreak of diphtheria ends with Ainsley (though it may end poor Ainsley’s life).

Now imagine that only 50% of children are vaccinated against diphtheria. That means that half the children are likely to be susceptible, and therefore diphtheria is almost certain to be transmitted. And since the children who catch diphtheria from Ainsley are going to expose additional children who aren’t vaccinated, the disease begins to spread like wild fire.

In other words, in 2015 if Ainsley’s mother doesn’t vaccinate her against diphtheria and she never gets diphtheria, it’s NOT because she was breastfed, eats organic food and has a strong immune system. It’s because herd immunity ensures that she’s never exposed to diphtheria.

When parents refuse to vaccinate their children, herd immunity is disrupted and deadly diseases can spread.

This cartoon on the awesome Facebook page of Refutations to Anti-vax Memes makes it easier to understand the issue.

The people holding the umbrellas are everyone who has been vaccinated (or has had the actual disease and survived). You can see that there’s room for more than the umbrella holders under the umbrella, just as vaccinating everyone who can be vaccinated protects those who can’t be vaccinated.

You can also see a person announcing that he doesn’t feel any rain so there’s no need for an umbrella. That’s just like the anti-vax parents claiming that they’ve never seen a person suffering from a vaccine preventable disease so there’s no need for vaccination.

You can also see that the belief that the rain has stopped is wrong, just as the belief that vaccine preventable disease are no longer a threat is also wrong.

Now imagine that half the people holding the umbrellas closed them and dropped them. A lot of people would get wet, not just those who aren’t holding umbrellas, but also those who have malfunctioning umbrellas. That’s what happens when herd immunity is compromised. Both the vaccinated and the unvaccinated are threatened (although the threat to the vaccinated is much smaller than the threat to the unvaccinated).

It’s easy to see how refusing to vaccinate hurts everyone, not just the children who aren’t vaccinated.

It’s also easy to see how the anti-vax parents whining that there’s no need for vaccinations are clueless. They don’t understand that they are standing under the umbrellas. So not only are anti-vaccine parents often wrong about the science of vaccines, their lack of understanding undermines their philosophical arguments supporting the refusal to vaccinate.

The primary philosophical argument deployed by anti-vaccine parents to defend their decision not to vaccinate is predicated on the scientific falsehood that vaccines work by being 100% effective and therefore, the only children threatened by their failure to vaccinate are their children.

But that’s not how vaccines protect public health. They work by dramatically reducing the chances that a vaccine preventable illness can travel through a population.

So when you refuse to vaccinate your own children, you aren’t just hurting them; you’re hurting many others.

We told them this would happen.

We told them that it was only a matter of time before a childhood disease that had nearly been eliminated from the US would come roaring back if they failed to vaccinate their children. And that’s precisely what has happened. Measles has come roaring back, but not simply because a child incubating measles visited Disneyland.

Twenty years ago, if the same child had visited Disneyland, the measles would have stopped with him or her. Everyone else was protected — not because everyone was vaccinated — but because of herd immunity. When a high enough proportion of the population is vaccinated, the disease simply can’t spread because the odds of one unvaccinated person coming in contact with another are very low.

Of course, we told them that. We patiently explained herd immunity, debunked claims of an association between vaccines and autism, demolished accusations of “toxins” in vaccines, but they didn’t listen. Why? Because we thought the problem was that anti-vax parents didn’t understand science. That’s undoubtedly true, but the anti-vax movement is NOT about science and never was.

The anti-vax movement has never been about children, and it hasn’t really been about vaccines. It’s about privileged parents and how they wish to view themselves.

1. Privilege

Nothing screams “privilege” louder than ostentatiously refusing something that those less privileged wish to have.

Each and every anti-vax parent is privileged in having easy and inexpensive access to life saving vaccines. It is the sine qua non of the anti-vax movement. In a world where the underprivileged may trudge miles to the nearest clinic, desperate to save their babies from infectious scourges, nothing communicates the unbelievable wealth, ease and selfishness of modern American life like refusing the very same vaccines.

2. Unreflective defiance of authority

There are countless societal ills that stem from the fact that previous generations were raised to unreflective acceptance of authority. It’s not hard to argue that unflective acceptance of authority, whether that authority is the government or industry, is a bad thing. BUT that doesn’t make the converse true. Unreflective defiance is really no different from unreflective acceptance. Oftentimes, the government, or industry, is right about a particular set of claims.

Experts in a particular topic, such as vaccines, really are experts. They really know things that the lay public does not. Moreover, it is not common to get a tremendous consensus among experts from different fields. Experts in immunology, pediatrics, public health and just about everything else you can think of have weighed in on the side of vaccines. Experts in immunology, pediatrics and public health give vaccines to their OWN children, rendering claims that they are engaged in a conspiracy to hide the dangers of vaccines to be nothing short of ludicrous.

Unfortunately, most anti-vax parents consider defiance of authority to be a source of pride, whether that defiance is objectively beneficial or not.

3. The need to feel “empowered”

This is what is comes down to for most anti-vax parents: it’s a source of self-esteem for them. In their minds, they have “educated” themselves. How do they know they are “educated”? Because they’ve chosen to disregard experts (who appear to them as authority figures) in favor of quacks and charlatans, whom they admire for their own defiance of authority. The combination of self-education and defiance of authority is viewed by anti-vax parents as an empowering form of rugged individualism, marking out their own superiority from those pathetic “sheeple” who aren’t self-educated and who follow authority.

Where does that leave us?

First, it explains why efforts to educate anti-vax parents about the science of immunology has been such a spectacular failure. It is not, and has never been, about the science.

Second, it suggests how we must change our approach. Simply put, we have to hit anti-vax parents where they live: in their unmerited sense of superiority.

How? By pointing out to them, and critiquing, their own motivations.

Anti-vax parents are anxious to see themselves in a positive light. They would almost certainly be horrified to find that others regard them as so incredibly privileged that they can’t even see their own privilege.

We need to highlight the fact that unreflective defiance is just the flip side of unreflective acceptance. There’s nothing praiseworthy about it. Only teenagers think that refusing to do what authority figures recommend marks them as independent. Adults know that doing the exact opposite of what authority figures recommend is a sign of immaturity, not deliberation, and certainly not education.

Finally, we need to emphasize to parents that parenting is not about them and their feelings. It’s about their children and THEIR health and well being. It’s one thing to decline to follow a medical recommendation. Most of us do that all the time. It’s another thing entirely to join groups defined by defiance, buy their products, and preach to others about your superiority in defying medical recommendations. That’s a sign of the need to bolster their own self-esteem, not their “education.”

We have to confront anti-vax parents where they live — in their egos. When refusing to vaccinate your children is widely viewed as selfish, irresponsible, and the hallmark of being UNeducated, anti-vax advocacy will lose its appeal.

I have had to remove a substantial portion of the comments because the 2000+ comments were crashing the page, and intermittently crashing the entire site.

Poor Kelly!

Not only was treated disrespectfully by her obstetrician, but she’s been endlessly exploited by the folks at ImprovingBirth.org who have used her story to raise their own public profile while doing NOTHING to help Kelly.

You may remember when I wrote last fall about the exploitation (What has Improving Birth done for the woman in the “forced episiotomy” video besides exploit her?)

What has Improving Birth done to seek redress for “Kelly,” the mother in the video? Not a damn thing because they don’t really care about Kelly beyond using her for fundraising. They haven’t assisted her in filing an official complaint with the hospital, they haven’t helped her file a complaint with the California Board of Medicine, they haven’t helped her obtain legal counsel, and, most importantly, they have not outed the doctor and hospital where the incident took place.

What does Improving Birth recommend that viewers of the video should do:

What a surprise! Every suggestion — sign a petition, use social media to promote Improving Birth, attending an Improving Birth rally, tell a story of violation under the aegis of Improving Birth, and give money to Improving birth — benefits Improving Birth. And NONE of the suggestions benefit Kelly in any way!

Now they’re boasting about the latest plan to exploit Kelly.

Tomorrow, we’re accompanying Kelly to the police station with the video of her forced episiotomy, and to the hospital one last time to give them the chance to do the right thing before we publish their name and the name of her doctor. She is strong and courageous, but it will surely be an emotional day. Please send prayers and thoughts for Kelly–there are so many of us standing behind her!

You may notice that going to the police station was not one of the ways that I mentioned for Kelly to seek redress. Why?

Because the police can’t do anything for Kelly! They are too busy dealing with murders, robberies and rapes to file a losing assault case against a doctor and hospital who are likely to defend themselves in the courts as vigorously as the law allows.

Who could do something for Kelly?

1. A lawyer who files a lawsuit against the doctor in question
2. A lawyer who helps Kelly file a complaint against the doctor with the California Board of Medicine
3. Expert witnesses to testify at the legal trial that would be the consequence of her lawsuit

But those things cost money, and ImprovingBirth.org appears to spend money only to publicize itself, not to help people like Kelly. Heading to the police station is cheap grandstanding designed to obtain press coverage for ImprovingBirth.org.

See? It’s a win-win for ImprovingBirth.org. They don’t have to spend money on hiring a lawyer, and they get free publicity.

What about Kelly?

Who cares about Kelly?

Apparently, the folks at ImprovingBirth.org are extending their exploitation of Kelly from tragedy to farce. Birth advocates should take note. It costs money to provide real help to Kelly, and the money they raise goes to enhancing THEIR public visibility. It costs nothing to drag Kelly to the police station, have her share an intimate video with strangers who aren’t going to be able to help her, while garnering free publicity of ImprovingBirth.org.

The publicity campaign started last night by boasting about the impending farce at the police station.

No doubt the folks at ImprovingBirth.org imagine that they are oh so clever.

Too bad that Kelly is being used yet again.

I admit it.

When I saw headlines like this one from Yahoo Parenting, A Week After Welcoming the Twins She Longed for, Mom, 56, Dies, I assumed that she died as a result of her decision to attempt pregnancy at such an advanced maternal age. I expected that when I read the article, I would learn that she died from a heart attack, or postpartum cardiomyopathy, or a worsening of a long term serious medical condition. In other words, I figured that she was partly responsible for the deadly outcome.

But she didn’t die as a result of advanced maternal age. According to the article, she died as a result of a bowel obstruction, a surgical complication, and one that is very treatable if recognized early.

Nonetheless, the focus seems to be on the age of Dr. Lisa Swinton McLaughlin, mother of premature twins Dylan and Jordan.

… Dr. Vincenzo Berghella, …, a professor of obstetrics and gynecology at Thomas Jefferson University in Philadelphia, says he is all for pregnancy for any woman who wants it. But he’s also careful to go over all the risks involved, he says, and compares opting for IVF pregnancy at an advanced maternal age to that of people who choose to not wear helmets while riding their bikes. “If the risks are not too high for you, then you do it,” he says. “But while the baby might be healthy, it might not be able to enjoy a healthy mom.” The risk of pregnancy-related death for women 40 and over, according to the Guttmacher Institute, is five times higher than that of women 25 to 29.

Medical News Daily weighs in:

Pregnancies in older women are associated with greater risk of miscarriage, stillbirth, cancer, needing a caesarean or assisted delivery, fetal anomalies such as Down syndrome, and even a heart attack in pregnancy, albeit a rare event, Dr Tony Falconer, the president of the Royal College of Obstetricians and Gynecologists (RCOG) in England told The Guardian. These types of pregnancies are also associated with increased risk for gestational diabetes and multiple pregnancy, such as what occurred in McLaughlin’s case. Both these conditions can complicate childbirth and increase the risk of developing injuries.

But McLaughlin did not die of any of those complications.

Due to her condition, doctors decided to deliver her sons via C-section on Dec. 27, 2014. Though their birth was premature, the boys were reportedly born healthy. Unfortunately, the same could not be said for their mother. McLaughlin complained of stomach pain, which she had attributed to her C-section incision. In reality, the new mother was suffering from a severe bowel obstruction. A week after giving birth McLaughlin passed away from her condition, leaving her newborn sons in the care of her husband.

A bowel obstruction, a kink in the intestine that stops all flow through the digestive system, is a well known surgical complication. It is unusual after a C-section since the bowel is not touched during the typical C-section, but it can happen. They symptoms include pain, intermittent and often severe, as well as nausea and vomiting.

A post surgical bowel obstruction is a treatable condition. Sometimes it will resolve on its own if the bowel is allowed to rest and nothing is taken by mouth. If it does not resolve on its own, surgery must be performed to untwist the kink. It’s important to diagnose and treat a bowel obstruction in a timely fashion. That’s because the kink can also cut off the flow of blood to that area of the intestine, leading to gangrene and/or perforation (a hole in the bowel spilling its contents into the abdominal cavity). These are potentially deadly complications.

Let me stress that I don’t know what actually happened. I, like everyone else, know only what I have read in the mainstream media. But if Dr. McLaughlin died of a bowel obstruction, it is unlikely that her age had much to do with it and far more likely that this was a surgical complication, possibly one that was not diagnosed and treated in a timely fashion.

This is a terrible tragedy. A woman who desperately wanted children died shortly after meeting those them, and two premature babies who desperately needed their mother are destined to grow up motherless. There’s not much that could be worse than that, except perhaps for implying that Dr. McLaughlin’s death was the result of a bad choice on her part when the reality is that is may have been the result of a medical error.