“Fright doctors”– the vaccine-autism controversy

My essay on the vaccine-autism controversy came out today in Democracy. If you don’t read Democracy, you should. The list of luminaries on the masthead is quite impressive. I’m grateful to Michael Tomasky and Elbert Ventura for the opportunity to publish in such a terrific place, and for the careful editing.

RBC readers know that I’m quite concerned about the vaccine-autism controversy. First, increasing numbers of Americans are choosing not to vaccinate their kids, thus increasing our collective vulnerability to infectious diseases. (See here for just one example).

Public willingness to accept harmful and groundless theories is equally worrisome. Everyone in the media and the blogosphere need to be careful about spreading claims, however widely and sincerely held, that lack proper scientific support. I think it’s fair to say that we progressives are quick to recognize the danger when the topic is creationism or denial of global warming. We are sometimes slower to recognize, or to call out, other ungrounded thinking closer to home, such as when the normally sound instinct to distrust corporate power and embrace parental autonomy lapses into a closed-minded rejection of the public-health enterprise.

Those of us who care for the disabled have special obligations. Because of our responsibilities and our experiences, we are granted a platform to influence people. Equally important, we influence each other. When caregivers–Jenny McCarthy, for example–use this platform poorly, the results are rather frightening.

At the same time, my own profession needs to ask some hard questions about why hundreds of thousands of people choose to believe such things, in conscious opposition to the consensus of the medical and scientific community. The very crudity of the anti-vaccine movement makes it easy to dismiss populist distrust of medical authority as simple boobishness. Sometimes it is; sometimes not.

Unfounded rumors about vaccines are being debunked. Leading figures who spread these rumors, such as Andrew Wakefield, have been punished. These are good things. Yet as long as families and patients have real experiences which lead them to distrust the medical and public health enterprise, some new appealing and dangerous forms of magical thinking are bound to pop up. That remains a sobering lesson of this sad bit of medical history.

Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect, tnr.com, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

12 thoughts on ““Fright doctors”– the vaccine-autism controversy”

  1. Right on Harold, I think we should re-label measles due to vaccine refusal as “Wakefield syndrome” to recognize who is to blame.

    Progressives have not been as hard on the anti-vaccine movement as they have the climate-change-as-myth movement because lefties seem drawn to the former and righties to the latter (God knows why). It’s a dangerous hypocrisy that anyone who cares about public health should point out whenever possible.

  2. I’m still perplexed by the phenomenon of conspiratorial thinking. I should probably read Jonathan Kay’s book, Among the Truthers. But I’m skeptical I’ll come away feeling any more enlightened. I suppose I’m looking for some pretty psychological theory that ties everything up in a nice little personality type or cultural epiphenomenon.

    I will say that without some personal investment in a particular issue (i.e. child with autism), most people who buy into these theories simply haven’t received adequate amounts of pushback. This is likely because they have found themselves in communities in which little divergence in views is expressed or tolerated.

  3. The punishment hasn’t gone remotely far enough; This isn’t just ugly medical history, it’s ugly legal history: A law firm paid for the ‘research’ in question. It was a con job contracted by some lawyers to generate the circumstances for them to file some lawsuits.

    When are the fright lawyers going to pay a price for this?

  4. @ Keith

    Why Wakefield syndrome? Yes, I know Wakefield was the hack who cooked the data much of this is based on, but I think we should give the PR agent co-billing. So, how about Wakefield-McCarthy Syndrome? After all, a woman who takes her clothes off for the camera is clearly much better qualified to reach conclusions about a link between autism and vaccination than are immunologists, neurologists, epidemiologists and statisticians.

  5. If we’re going to offer billing, we should probably hand some to the legislators and other policymakers who have, over the years, made sure that finding a deep-pocketed tortfeasor is the only way for a family to avoid financial (as well as personal) destruction from the accident of having an autistic child. (In earlier decades, we’d also be offering billing, as Harold Pollack implicitly notes, to the psychologists who contended that autism was a disease of bad nurture.)

  6. @Keith,
    I have a hypothesis for why lefties are attracted to the anti-vaxers but are repelled by the climate denialists. The left, although basically a child of the Enlightenment, has several other strains in it, including Rousseauvian romanticism. (The Left contracted that virus from the Right in the 1950’s, with acute sequelae in the 1960’s.) A Rousseauvian romantic thinks that there is Deep Wisdom in Nature. S/he is thus a bit of a technophobe, at least for the technologies that s/he views as interfering with Nature. Both vaccination and carbon injection interfere with nature; both are suspect to the Rosseauvian romantic.

    Most lefties are not Rousseauvian romantics, but most of them are tolerant of Rousseavian romanticism in their midst. But a few of us loathe it.

    The right wing has mostly rejected this particular virus, but in the course of doing so has contracted an autoimmune disease that causes it to reject the Enlightenment wholesale.

  7. Actually, there are some right-wingers who have embraced the vaccine-autism business, even giving Wakefield a place to publish his pseudoscience after his work began to unravel. The American Association of Physicians and Surgeons is a political organization which has given space and solace not only to Wakefield but also to Mark Geier, MD, whose license to practice medicine was yanked after he used leuprolide (a drug for prostate cancer) to treat children with autism. Leuprolide shuts down testosterone production, not that this stopped Geier from using it in kids. They have not only published nonsense on vaccines but also on how “illegal aliens” are bringing thousands of cases of leprosy to the USA. Glenn Beck promotes them on Fox News. Ayn Rand is often cited as an authority on how government works. One of their leaders got into some unpleasant publicity a couple of years ago for a photoshopped image of Obama-as-African-witch-doctor. The FDA is an unconstitutional organization. Medicare is just what Lenin would have wanted. They are quite an organization.

    http://www.jpands.org/vol9no2/bradstreet.pdf is the Wakefield article.
    http://www.jpands.org/vol10no1/cosman.pdf is the immigrants article.
    http://www.jpands.org/vol10no2/kauffman.pdf on fluoridation of water and its effects on our precious bodily fluids. General Ripper, are you listening?

  8. i am no anti-vaxer but big pharma hasn’t exactly endeared itself to this progressive when it comes to marketing and promoting vaccines either. There have been vaccines which have not been resounding successes and even had to be pulled off the market because the side effects turned out to be worse than the benefit of the vaccine. I am thinking of the rotovirus vaccine in particular, but have also seen similar problems with non-vaccine medical devices, such as drug eluding stents, which were deployed in vast numbers to patients before negative effects became known. Right now I am in watchful waiting mode when it comes to the HPV vaccine(s) and don’t believe that this threatens any group immunity that anyone else is counting on.

  9. @Dennis – Amendment accepted, apologies to Ms. McCarthy for previously denying her due credit.

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