Phobia word cloud on a white background.

What if we’ve been approaching the anti-vaccine phenomenon the wrong way?

We’ve been operating under the assumption that anti-vax is fundamentally a misunderstanding, reflecting lack of knowledge of immunology and statistics. But what if it is actually a culturally mediated phobia like triskaidekaphobia, fear of the number 13?

That would explain why fear of vaccines has continued to metastasize even though in the entire 200+ years of the movement, anti-vaxxers have never been right even once. It would explain why attempts to educate anti-vaxxers have been utter failures. It would explain why anti-vaxxers huddle together on social media; only another sufferer of the irrational fear can understand it. And it would explain why anti-vaxxers keep moving the goal posts — It’s mercury! It’s aluminum! It’s autism! It’s vaccine “injuries”! — to justify their irrational fear.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]What does fear of vaccines have in common with fear of the number 13? Both are culturally mediated phobias.[/pullquote]

What is a phobia?

According to Wikipedia:

A phobia is a type of anxiety disorder, defined by a persistent and excessive fear of an object or situation… The affected person goes to great lengths to avoid the situation or object, to a degree greater than the actual danger posed. If the feared object or situation cannot be avoided, the affected person experiences significant distress…

Phobias can be divided into generalized fears like agoraphobia (fear of leaving home), social phobias (fear of being judged by others) and specific phobias involving fear of specific objects and situations, like fear of heights (acrophobia) and fear of enclosed spaces (claustrophobia).

A specific phobia can reflect a previous bad experience. For example, getting bitten by a dog can lead to a paralyzing phobia of dogs, not merely a rational fear of aggressive dogs.

Specific phobias can be the result of watching others have a bad experience, such seeing another person bitten by a dog.

Phobias can also be taught, and therefore be culturally mediated. That’s how people become afflicted with fear of specific numbers like triskaidekaphobia, fear of the number 13.

Although it may seem trivial, triskaidekaphobia is an issue that affects western societies economically. Because of the superstition, some people delay doing business on the 13th of any month, while statistically there are more people who do not go to work on the 13th day of any month …

Friday is also considered to be an unlucky day in western culture…

The term for the fear of Friday the 13th is paraskevidekatriaphobia.

It is estimated that the United States loses about $900,000,000 in productivity every year because of Friday the 13th as some people are so superstitious about it that they wouldn’t even get out of bed.

Different numbers are the source of phobias in different cultures. These include:

Tetraphobia, fear of the number 4. In China, Taiwan, Singapore, Japan, Korea and Vietnam, as well as in some other East Asian and South East Asian countries, it is not uncommon for buildings (including offices, apartments, hotels) to omit floors with numbers that include the digit 4 … This originates from Classical Chinese, in which the pronunciation of the word for “four” is very similar to that of the word for “death,” and remains so in the other countries’

17 is an unlucky number in Italy, perhaps because in Roman numerals 17 is written XVII, which can be rearranged to “VIXI”, which in Latin means “I have lived” but can be a euphemism for “I am dead.” In Italy, some planes have no row 17 and some hotels have no room 17…

Obviously there is nothing inherently dangerous or harmful about these numbers, or any numbers, yet many people are very afraid of them and some people are so afraid that it affects their life in significant ways.

What would it mean if vaccine hesitancy were not a rational fear, but rather a phobia, vaxophobia? It would mean that we must change our entire approach to people who refuse vaccines.

First, we would stop spending so much time educating people about the real risks of vaccine preventable diseases and focus instead on the irrational fear of vaccines itself. When treating a person who suffers from claustrophobia, we don’t spend much time explaining why the chances of being trapped for long periods inside an elevator is low. A phobia is not a rational fear, so it’s not amenable to rational explanations. Instead we try to trace the origins of the fear and help people to desensitize themselves by controlled exposure to the fear.

As this Mayo Clinic website explains:

The best treatment for specific phobias is a form of psychotherapy called exposure therapy. Sometimes your doctor may also recommend other therapies or medication. Understanding the cause of a phobia is actually less important than focusing on how to treat the avoidance behavior that has developed over time.

Second, we would spend more time and effort in understanding how this specific, culturally mediated phobia is transmitted from affected to unaffected individuals. It is an urgent question. While triskaidekaphobia may be harmful to the American economy, vaxophobia is very harmful to the health and wellbeing of babies and children. It puts them at risk of illness, serious injury and even death. And that doesn’t even count the economic impact of wages and productivity lost to vaccine preventable diseases.

Third, we would recognize that anti-vax physicians, naturopaths, chiropractors, etc. are not empowering their patients, they are reinforcing their enslavement to the phobia. The “service” an anti-vax doctor like Bob Sears provides by writing vaccine medical exemptions is no different than the “service” of providing a medical exemption for working on Friday the 13th. Both are abuses of the medical system.

Finally, we would stop arguing with and pandering to vaxophobes. We don’t excuse people from working on the 13th of every month simply because they are phobic about the number 13. Similarly, we should not allow philosophical exemptions for vaccination. There’s no philosophy involved here, just an irrational fear, and pandering won’t fix it; it will only make it worse.