“Building bridges” to the leaders of the anti-vaccine movement?

Thanks to Andrew Wakefield, it’s been pretty much vaccine week for me. Well, mostly anyway, I did manage to have some fun with Mike Adams and the immune system, but otherwise it’s been all vaccines all the time this week. As I mentioned yesterday, at the risk of dwelling on one topic so long that I start driving away readers, I’ve just decided to ride the wave and go with it until it’s over. Unless something blows up over the weekend, I rather suspect that, for all intents and purposes, it’ll be over as of today and I can move on to other topics starting Monday. At least I hope so.

But there’s one more issue related to the Andrew Wakefield case that I feel I’d be remiss not to cover, as it’s a very important issue. I was reminded of it by Chris Mooney in a post entitled Will the Vaccine-Autism Saga Finally End? He and I both know the answer to this question (no), but in discussing why neither the General Medical Council’s finding Andrew Wakefield to have behaved dishonestly and unethically in doing the “research” that led to his 1998 Lancet paper that launched the MMR scare in the U.K. nor the decision of the Lancet’s editors to retract said 1998 paper would end the vaccine autism manufactroversy, Mooney suggested a way out of this problem that is profoundly misguided, naive, and reveals a profound misunderstanding of the anti-vaccine movement.

Before I explain what it was he said and why I find it so problematic, let me just point out that I was actually surprised at his post, because Chris has done good work before. I like Chris, by and large. I’ve gone drinking with Chris before (in Washington, DC three years ago, when I was at a conference). Moreover, last year Chris published an excellent overview of the anti-vaccine movement and why it is a danger to public health for the June issue of Discover Magazine, entitled Why Does the Vaccine/Autism Controversy Live On? (In the interest of full disclosure, I’ll point out that Chris interviewed me for the article, and I did my best to give him as much background as I could, but he also interviewed numerous other people.) In rereading it, saw the germ of a promising idea for how to try to restore public confidence in vaccines, but in reading Mooney’s latest, I wonder if he’s taken that idea too far. I’ll explain.

First, though, let me point out that I completely agree with Chris when he writes:

Here’s the thing, though. It seems obvious to all recent commentators–myself included–that the latest Wakefield news will have virtually no impact on Wakefield’s passionate followers, the anti-vaccine ideologues in the UK and United States who have long cheered him on, and will continue to do so. If anything, it will probably only make them still stronger in their convictions.

Which is very similar to what I’ve said more than once this week. In the eyes of his supporters, Wakefield has become a martyr, struck down by The Man in the form of pharmaceutical companies, governments, and uncaring science that wants to poison children with toxic vaccines. It’s all a fever dream, a fantasy, of course, but that’s how they view Wakefield, despite his callous disregard for children, his incompetent science (and even possible outright fraud), and his lack of ethics. Truly, it is a cult of personality, and recognizing that Wakefield is likely to be even more lionized than ever by the anti-vaccine movement is what Chris gets right.

What Chris gets so very, very wrong is this:

…I believe we need some real attempts at bridge-building between medical institutions–which, let’s admit it, can often seem remote and haughty–and the leaders of the anti-vaccination movement. We need to get people in a room and try to get them to agree about something–anything. We need to encourage moderation, and break down a polarized situation in which the anti-vaccine crowd essentially rejects modern medical research based on the equivalent of conspiracy theory thinking, even as mainstream doctors just shake their heads at these advocates’ scientific cluelessness.

Chris’s naïveté on this issue is astonishing in light of his excellent Discover piece last year. He appears utterly unaware that scientists have been trying to reach out and build bridges to leaders of the anti-vaccine movement for years, if not decades. It hasn’t worked. It doesn’t work. As Mike Stanton pointed out in a comment, public health bodies courted Barbara Loe Fisher of the National Vaccine Information Center (whom I’ve discussed recently here, here, and here). The only result is that it raised her profile. She hasn’t budged an inch; she is still as anti-vaccine as ever. One recent example that stands out in my mind occurred in 2007, when Sallie Bernard of SafeMinds participated as a consultant in the design of a large study designed to ask whether there was a link between thimerosal containing vaccines and neurodevelopmental disorders other than autism. Unfortunately for her, the study failed to find a link. All investigators found were a handful of correlations, both positive and negative, that occurred at a frequency consistent with random chance. In a case of sour grapes, Bernard disowned the study before it was published and then, after it was published, launched attacks against it, even going so far as to write a letter to the New England Journal of Medicine criticizing it.

Another example came to mind. Almost two and a half years ago, Dr. Thomas Insel, Director of the National Institute of Mental Health, appointed prominent anti-vaccine activists to the Interagency Autism Coordinating Committee (IACC), apparently in the name of “inclusiveness” and “building bridges” The anti-vaccinationists appointed to the committe were Lyn Redwood, Vice President of SafeMinds; Lee Grossman, President of the Autism Society of America; and Stephen Shore, who included in his book Understanding Autism for Dummies clearly showed anti-vaccine proclivities and supports the idea that chelation therapy can be used to treat autism. It’s been a total disaster. Not only did anti-vaccine propagandist David Kirby crow over it as “proof” that the government considers the idea that vaccines cause autism to be a scientifically viable hypothesis “worth studying,” but Redwood and her pal Mark Blaxill (another Vice President of SafeMinds and an editor at the anti-vaccine propaganda blog Age of Autism) have hijacked the process at every turn. Dr. Insel, again apparently in the name of being “inclusive” and “tolerant” won’t rein them in. He basically lets them run wild, and other members of the committee are complaining. As Sullivan has pointed out, this mischief has a cost:

Hours and hours were spent in the IACC meetings wordsmithing the vaccine language. To groups like SafeMinds and people like Lyn Redwood, the Strategic Plan was a political document. It was a statement by the government, and it was critical to get as much “admission” of autism being caused by vaccines as was possible. So what if another generation of minorities gets mislabeled with Intellectual Disability or some other Special Education category when SafeMinds was able to get the IACC to admit that many parents think vaccines cause autism?

This is what happens when psuedo “Vaccine-injury” advocates pretend to be Autism advocates and take seats at the table. Lyn Redwood put her own interests and those of her organizations ahead of the well being of people with autism.

Which is what the anti-vaccine movement does, because at its heart it’s not about autism to them, the names of their societies notwithstanding. It’s all about the vaccines; specifically, it’s all about opposing vaccines and promoting the idea that vaccines cause autism and all sorts of other “horrors.”

Chris is profoundly misguided in his apparent belief that any amount of “bridge building” will bring anti-vaccine activists around. Their beliefs are as ingrained as those of any fundamentalist religion and just as resistant to bridge-building over the core belief around which they revolve. Indeed, trying to reach out to leaders of the anti-vaccine movement is pointless. It is, as AutismNewsBeat so pithily characterizes it, akin to “bridge-building efforts by evolutionary biologists toward creationists. Or by B’nai Brith to mend fences with the Nazis. I’m sure those meetings went well.” I agree fully. Thinking that “building bridges” to the leaders of the anti-vaccine movement will achieve anything except giving them more opportunity to sabotage public health by giving them an unearned feeling of power and legitimacy is likely to be as productive as evolutionary biologists engaging with Ken Ham, Casey Luskin, or Dr. Michael Egnor or for Deborah Lipstadt to engage with David Irving. As they say, you can’t use reason to lead someone away from views that they didn’t reach using reason.

No, the leaders of the anti-vaccine movement, people such as J.B. Handley, Lyn Redwood, Mark Blaxill, Jenny McCarthy and her boyfriend Jim Carrey, Barbara Loe Fisher, and Lee Grossman, don’t need bridges built to them. It’s a pointless exercise, as has been shown time and time again. Every attempt to do so is viewed by them as a sign of weakness or vindication of their crank views, never as an opportunity for compromise. That is why they need to be cut off from the oxygen that fuels their movement: publicity. AutismNewsBeat is correct to point out that we need to change the public narrative from “vaccines might cause autism” to “vaccine rejectionists are barking loons who endanger us all” because the are barking loons who endanger children by destroying herd immunity and increasing the chances of vaccine preventable diseases returning. Indeed, we’ve already seen this in the U.K., where MMR vaccination uptake has plummeted, thanks to Wakefield, and measles has come roaring back. As Mike Stanton says:

Instead of building bridges we should be building a cordon sanitaire to keep these predators at bay. We have our own compelling stories to tell. What about the childhood cancer victims who cannot be vaccinated and cannot attend day care for fear of a lethal encounter with the unvaccinated offspring of the worried well? What about the excellent journalism of of people like Trine Tsouderos at the Chicago Tribune, exposing the money grubbing quacks who feast on parental fears offering false hopes at a premium price? Or the vaccine success story in Africa where Measles deaths fell by 91% between 2000 and 2006, from an estimated 396,000 to 36,000 thanks to a mass vaccination campaign?

We will never persuade the die-hards. Our best tactic is to act to prevent them from persuading anyone else.

Exactly. In a free society, that means countering their misinformation in uncompromising terms and holding editors and reporters to task when they allow the “tell both sides” ethic to give the false appearance of equivalence between real science and the pseudoscience of vaccine denialists. Remember that the anti-vaccine loons are out there in force doing exactly what commenter Kim on AoA is doing:

Here’s an idea, call your local health reporters and introduce yourself. Tell them when anything comes up in the news about autism that you are their “go-to”. Make sure they have all your contact numbers/email, etc and tell them if you don’t know the answers, then you will find someone in the community who does. I’ve got 2 stations and the newspaper in town calling me everytime something happens anywhere remotely close to autism. It’s great for awareness and if only ONE parent learns something, we all win! This week I even got my own 3.5 minute spot on the Fox station in town. I’ll post when it’s online…

Although, for instance, I’ve made myself available to the media, I haven’t been proactive about it. Nor, I daresay, have most of us trying to defend science against pseudoscience. I have, however, written to the odd local reporter who has written a credulous story about autism “biomed” treatments and the anti-vaccine movement, in which an anti-vaccine group is portrayed as an autism advocacy group. I think it helped, but I won’t know until these reporters write another story on the subject, which, for all I know, could be months. Still, blogs aren’t enough. Twitter isn’t enough. The “old media” is still very powerful and will likely always be powerful. Web 2.0 is great, but it’s not (yet) enough to counter the power of mass media.

It is important to remember, however, that we are talking about the leaders of the anti-vaccine movement. We are talking about the J. B. Handleys of the world. We are talking about the Barbara Loe Fishers of the world. We are talking about the Lyn Redwoods of the world. We are not talking about parents who are afraid of vaccines because of what they hear on the Internet but are not committed to the cause of promoting the idea that vaccines cause autism. They may even be parents who have autistic children who think that vaccines were responsible. It is for these parents that Mooney’s strategy might have a chance of working. Indeed, I would liken these parents to the moderate religious people whom Mooney advocates working with to promote good science evolution, including evolution, and to defend science education against the intrusions of creationism. In essence, this is two-pronged strategy in which the die-hards are marginalized as much as is possible in a democracy through cutting them off from the easy access to the media that they have enjoyed thus far while at the same time building bridges not to the leaders of the anti-vaccine movement but to the moderates who are not beyond recovery.

I’m under no illusion that it will be easy to distinguish one from the other or even to work with those who are not in so deep that they can’t be persuaded. I do know, however, that scientists and the government have tried time and time again to “build bridges” to leaders of the anti-vaccine movement. It doesn’t work, and it’s time to try something different.

If Chris (or anyone else, for that matter) has any specific ideas for what that something different is, I’d be more than happy to listen. In fact, if Chris (or anyone else, for that matter) can show me that I’m dead wrong about the uselessness of trying to “build bridges” with the leaders of the anti-vaccine movement, I’d be more than happy to listen. Who knows? I might even change my mind if the arguments are compelling enough and backed by strong evidence.