Preventable diseases have had a good year, thanks in no small part to some willing hosts who have opened the doors, put out the welcome mat and said, "Come on in!"
Not all diseases, of course. But measles flourished beyond all expectation – there were outbreaks in British Columbia and Alberta, cases in Ontario and Manitoba, and the number of infections reached a 20-year high in the United States, according to the Centers for Disease Control. There have been 10,000 cases of whooping cough in California alone, an outbreak partly attributed to the effects of the vaccine wearing off but also to the fact that thousands of parents are not having their kids vaccinated at all. We saw Sidney Crosby puffy-faced with mumps. (He had been vaccinated, but was still one of a number of National Hockey League players to contract the virus.)
The HPV vaccine, available to adolescent girls and boys and shown to be useful preventing numerous types of cancer, is still ridiculously controversial on the grounds that it might – get the smelling salts! – encourage teenagers to have sex. (Not true, as it happens: A study released last week showed no correlation between receiving the vaccine and increased sexual activity in young women.)
In some parts of North America, vaccination rates for preventable diseases have plummeted, despite repeated warnings from public-health officials about the dangers not just to individuals, but to communities as a whole, especially the most vulnerable members.
What could possibly unite vaccine foes, whether they're downtown Catholics, members of rural religious sects or the smoothie-drinking power elites of Los Angeles – a city that has pockets, as the Hollywood Reporter discovered, with immunization rates as low as Chad's?
For one thing, the stories they tell themselves to justify not vaccinating are more powerful than any facts and figures. And those belief systems – or moral frameworks, or pernicious superstitions, depending on how you look at it – are incredibly tenacious, and not likely to be swayed by any amount of foot-stamping and statistic-waving by those of us on the other side of the divide. A study earlier this year in the journal Pediatrics found that trying to convince anti-vaccination parents with stories and images of ill children was not just counterproductive, but actually hardened their attitudes: "Current public-health communications about vaccines may not be effective," the authors concluded. "For some parents, they may actually increase misperceptions or reduce vaccination intention."
American academic and essayist Eula Biss has just written a compelling and wide-ranging book tited On Immunity, in which she tries to listen to, and understand, the anti-vaxxer position, in the context of history, politics and philosophy. She may not share their ethical choices, but as a new parent herself, she extends empathy – everyone wants to protect their children. (I would argue that the divide occurs over wanting to protect other people's children, too.)
What she finds is the narratives that anti-vaxxers tell themselves are very powerful and deeply embedded within their cultures. They see themselves as persecuted, ferocious mama bears. They're not callous threats to the herd's health but "conscientious objectors." It's a complicated mixture of believing in "nature" and not believing in authority, in trusting instinct over science, gut over head.
"Our fears are informed by history and economics, by social power and stigma, by myths and nightmares," Ms. Biss writes. "And as with other strongly held beliefs, our fears are dear to us." When we're given information that contradicts those beliefs, even if it's a lecture delivered by a pediatrician or a set of statistics from a government health organization, "we tend to doubt the information, not ourselves."
This, as Seth Mnookin writes in his invaluable book The Panic Virus, is evidence of "confirmation bias," or as your granny might put it: We see what we want to see. "A lot of parenting decisions come down to our gut reactions … and when it comes to vaccines, most of the 'commonsense' arguments appear to line up on one side of the equation: Vaccines contain viruses, viruses are dangerous, infants' immune systems aren't fully developed, drug companies are only interested in profit."
Both Mr. Mnookin and Ms. Biss spend entire books countering those arguments with facts, figures and history. Both of them also acknowledge the power of the stories that anti-vaxxers tell themselves – stories that ultimately put other people's kids in jeopardy. There's no point in pretending they don't exist, or trying to outscream them. The trick is developing an equally powerful narrative of vaccines not as threat, but as the gift and bounty they are.