Respecting parental concerns versus pandering to antivaccine fears

In common colloquial usage, there is a term known as “gaydar.” Basically, it’s the ability some people claim to have that allows them to identify people who are gay. Whether gaydar actually exists or not, I don’t know, but I claim to have an ability that’s similar. That ability is the ability to sniff out antivaccinationists. Over the last decade, I’ve become very good at it, so much so that it’s almost instinctual and rarely wrong. My guess is that it’s nothing more than my having internalized all the tactics and tropes that antivaccinationists like to use to the point where I don’t need to think about them and can instantly compare the words and behavior of a person with patterns I’ve learned to identify in antivaccinationists and make an accurate assessment. True, there are the occasional false positives (although these false positives always strike me as people who could easily turn antivaccine in an instant), but by and large, since it’s been developed, my instinct for these things has served me well.

All of this is a way of saying that I don’t think that Mark Largent is antivaccine. One of the other types of false positives I sometimes get comes from people who are clueless about the antivaccine movement and, in a laudable but misguided effort to be “fair” and give people the benefit of the doubt, end up coming to conclusions that are outrageously wrong. That is the category that Mark Largent appears to fall into, so much so that I’ve heard from a source I completely trust that he has said in public that Jenny McCarthy is not antivaccine. But I get a head of myself. Who is Mark Largent? He’s an academic who recently wrote an Op-Ed that revealed mind-numbing ignorance of the antivaccine movement entitled In the Great Vaccine Debate, Parents’ Fears Should be Respected and has apparently just released a book entitled Vaccine: The Debate in Modern America. I haven’t read the book (although I might), but I have read the op-ed, and if the book is anything like the op-ed I’m not likely to be pleased. I’ll show you what I mean.

In the op-ed, Largent starts out with a fairly standard recounting of how the parents of as many as one in ten children refuse to vaccinate their children with what he refers to as “state-mandated” vaccines and more than a third may delay or refuse “doctor-recommended vaccines” for their children. Personally, I found this part confusing, because pediatricians (unless they’re Dr. Jay Gordon or “Dr. Bob” Sears) generally vaccinate according to the CDC-recommended schedule, which also forms the basis of which vaccines the various states mandate for school attendance. He then mentions (of course!) Andrew Wakefield, the MMR-autism scare, and how Wakefield was ultimately refuted and his 1998 Lancet paper retracted. Nothing objectionable there. Here’s where Largent goes off the rails:

What are parents really worried about? They are worried about the high number of shots kids get in the first several months of their lives. Today, a fully vaccinated six-year-old will receive nearly three-dozen inoculations, most of them in the first 18 months of life.

The routine vaccination schedule now calls for shots at almost every well-child checkup, including four inoculations at the two-month appointment and five inoculations at both the four- and six-month appointments. As parents scramble to explain their fears, the only explanation available to them is the claim that vaccines might cause autism. But when their anxieties are carefully and respectfully examined, we see that they emerge from a wide variety of often well-informed philosophical and moral concerns parents have about their children’s health.

Uh, no, at least not in most cases. First of all, unlike the claims in Largent’s introduction, vaccines were not always “saviors.” As long as there have been vaccines, there has been an antivaccine movement. Indeed, back in the 1800s in England, for instance, they were a lot more honest about it, admitting that they were, in fact, antivaccine and even publishing tracts and journals with the word “antivaccine.” In any case, back then, there were actual riots after health authorities tried to mandate vaccination against smallpox. So, sure, there’s an element of not wanting to be told what to do. However, in reality, there’s a huge amount of misinformation about vaccines that is far more readily available than it was in the past, and it has an enormous effect. Not only does it provide ammunition for motivated reasoning against vaccines, but even small doses of this misinformation can sway parents with the least tendency to distrust medicine and, by proxy, vaccines.

So, in a way, although Largent is partially correct in that fear of vaccines isn’t always just about the vaccines, he misses the larger issue, namely that of an active, committed antivaccine movement whose leaders actually gloat when they see statistics indicating that vaccine uptake has fallen. That is the agenda, although few in the antivaccine movement will publicly admit it. Indeed, four years ago, Jenny McCarthy led an antivaccine rally in Washington, DC. In the lead-up to that rally, I noticed a distinct tension between the realists, who wanted to proclaim themselves “vaccine safety watchdogs” or “pro-safe vaccines” and antivaccinationists, who wanted to proclaim vaccines to be the equivalent of toxic waste. Anyone who’s been fighting the fight against antivaccine information knows this, but apparently Largent doesn’t. In fact, he knows so little that he an write something like this with an apparently straight face:

The routine vaccination schedule now calls for shots at almost every well-child checkup, including four inoculations at the two-month appointment and five inoculations at both the four- and six-month appointments. As parents scramble to explain their fears, the only explanation available to them is the claim that vaccines might cause autism. But when their anxieties are carefully and respectfully examined, we see that they emerge from a wide variety of often well-informed philosophical and moral concerns parents have about their children’s health.

“Well-informed” is not the word I would use to describe the sorts of beliefs that lead parents to refuse vaccination. In fact, as I’ve written about over and over and over again, the concerns of these parents are almost always rooted in pseudoscience, fear mongering, and outright scientific misinformation. If Largent thinks that the concerns about vaccines that lead to Jenny McCarthy, Age of Autism, and the like are “well-informed,” he’s more clueless than my initial impression of him indicated. After all, what “moral concern” could lead parents to leave their children unprotected against vaccine-preventable diseases, particularly potentially deadly ones? Is it “well-informed” to believe lies about vaccines, such as claims that they are loaded with antifreeze, toxic doses of formaldehyde, and all sorts of other horrific “chemicals”? No, I would argue. It is not.

In the comments, when he is called to task, Largent claims to be more “moderate”:

Unfortunately, a 700-word op-ed is far too constrained to explore the many issues surrounding today’s vaccine anxieties. It is my hope that by pressing a more moderate position in this op-ed and in my book Vaccine: The Debate in Modern American (Johns Hopkins University Press) we can get more parents to vaccinate more children against more vaccine-preventable diseases. I firmly believe that the best way to do this is to actually address their concerns, not cast them as ignorant fools who mindlessly follow a celebrity. Wakefield and McCarthy would never have garnered as strong a following had there not already a substantial pool of vaccine-anxious parents whose concerns were not being adequately addressed.

“Address their concerns”? As if pediatricians don’t try to do that every time a parent brings her child for a well child visit and balks at allowing her child to be vaccinated! What planet is Largent living on? Does he have any idea how out of touch he sounds? He’s confusing blog rants with how pediatricians behave in one-on-one encounters with real parents of real patients in real doctors’ offices.

How does Largent think parental concerns should be addressed? Maybe he says so in his book, but he sure doesn’t say so in this op-ed, nor does he say in the description of his book, although, I must say, his description of his book doesn’t exactly make me all warm and fuzzy with confidence that there will be some sort of grand revelation about how to address parental concerns that pediatricians aren’t already doing. In fact, quite the contrary. My reading of it is that it’s full of the fallacy of the golden mean, or, as I like to call it, the fallacy of false balance. He even goes so far as to refer to “extremists for and against vaccinations.” Really? Really? I’d like to see Largent name a “provaccine extremist,” because I’ve never encountered one. I have, however, encountered many antivaccine extremists.

There are certain people who value compromise and comity above all else. They assume that when people disagree that the “true” answer must be somewhere in between, so much so that they are willing to bend over so far backwards that they twist themselves in pretzels in order to try to paint both sides as being reasonable and “well-informed.” In the case of vaccines, nothing could be further from the truth. On the one side, there are pediatricians and scientists showing that vaccines are safe and effective. On the other side, there are the likes of Jenny McCarthy, promoting outright misinformation, pseudoscience, and lies about vaccines. His periodic assertions that “of course I don’t Largent falls into the trap of treating them as though they were equally legitimate. He confuses respecting parental concerns with pandering to antivaccine fears.