Fear and loathing and vaccines

As hard as it is for me to believe when I look back at it, I’ve been writing about the antivaccine movement now for more than seven years here on this blog and combatting it online for at least a decade now. I like to think that over the years my response has evolved somewhat. Back in the beginning, I used to be a bit more—shall we say?—insolent in dealing with antivaccinationists. It’s an easy thing to do because so much of what antivaccinationists write and say is just so darned idiotic. Indeed, even today, I still have a tendency to slip back into my old ways when an antivaccinationist makes a particularly brain dead argument, as Dr. Julian Whitaker did a couple of months ago at FreedomFest and then dug himself in even deeper trying to respond to criticism. Still, these days I tend not to let it rip quite as often or as intensely as I used to. I like to think that part of the reason is that, even at my advanced age, I’ve matured slightly, but it’s also likely that part of it comes from a realization that I need to distinguish more between the real antivaccinationists, the ones spreading the pseudoscience and misinformation, and the vaccine-afraid or vaccine-averse parents who haven’t quite fully drunk the Kool Aid yet and can still be reached.

Although I realize that I can never, ever reach them and that if I ever were to reach one of them it would be a minor miracle, I still wonder sometimes about the motivation of antivaccinationists. Why are they so passionately against vaccines? Why do they, against all reason, science, and evidence, have such an unshakeable belief that vaccines are harmful? To understand this, I’ve learned to listen to the parents themselves as they tell us their reasons on antivaccine blogs, and two of them have done just that (albeit somewhat unwittingly) on two of the looniest antivaccine blogs on the planet. First up, on that wretched hive of scum and quackery, Age of Autism, Cathy Jameson ties herself into metaphorical knots over her inability to forgive her child’s doctor for the wrong she perceives that he’s done her, namely making her child autistic with vaccines. Meanwhile, over at the companion antivaccine blog of AoA, Tninking Moms’ Revolution, BK blames herself for her child’s autism. Combining these posts, one can see in these two mothers intense anger, a need to blame someone for autism, combined with an intense self-loathing and blame for thinking that she caused her child’s autism.

First the anger from Jameson, who asks herself whether she can forgive and “let it all the evils wash away—the guilt, the pain, the anxiety, the despair.” Unfortunately, her thinking is completely unrealistic and fantastical:

Can I truly forget how Ronan’s downward spiral began?

Can I honestly forgive the ills that brought Ronan to where he is (and isn’t) today?
Can I totally look past the medical neglect we discovered only too late?

Can I completely overlook the medical abuse I didn’t recognize?

Can I fully embrace the life-long struggles Ronan may face?

How do I accept all of that?

Here’s what I can accept. I can accept that all of that did happen to my child, but I will not accept that it had to happen.

Of course, vaccines did not cause Ronan’s autism. Scientists might not know yet what does cause autism, but if there’s one thing they do know it’s that it’s almost certainly not vaccines. The science is voluminous, from multiple sources, and overwhelming. Antivaccine activists refuse to accept that for whatever reason, be it that they do indeed need someone to blame or a fear and distrust of medicine.

Let’s also not forget that confusing correlation with causation is natural to human beings. We do it all the time. Moreover, when millions of children receive vaccines during a the time during which autism and autism spectrum disorders are most commonly diagnosed, there will be a large number of children who exhibit their first symptoms of autism sometime around when they receive one vaccine or other. Yes, as hard as it is for human beings to accept, this can be coincidence alone. To demonstrate that it is not, that correlation might imply causation, it’s necessary to do carefully controlled studies of large numbers of children, controlling as well as possible for confounders, to see if vaccination in general or specific vaccines are associated with an increased risk of autism. These studies have been done, and they aren’t. Even so, it’s important to remind skeptics that it’s not necessarily because of stupidity or obstinacy that parents cling to the belief that vaccines cause autism. To a single person looking at a single child, seeing autistic regression in reasonably close temporal proximity to vaccination can appear all the world as though the vaccine(s) caused it. That’s how human beings think. That’s how our brains work. Overcoming how our brains work requires science, but all too often personal experience trumps science.

Human beings also like order. We don’t like it when something “just happens,” as autism does. There must be a reason. Once someone fixates on vaccines as the cause of her child’s autism, it’s very, very difficult to dissuade her, if not impossible, as there are many rewards that come from having a cause. First, it means that there is indeed order in the universe. There is good. There is evil, and that evil is a villain who can be blamed: big pharma, the government, doctors, public health officials. More importantly, there is hope that her “real” child can be “recovered.” It’s a false hope in that none of the quackery the antivaccine movement regularly leads parents to try is an actual cure for autism or even a treatment that provides any detectable benefit. It is, however, hope. Human beings will often defend hope irrationally, no matter how hopeless the situation.

And there is something (and someone) to blame, as Jameson blames her doctor, believing that he owes her and her family an apology for having caused her child’s autism:

I’m sorry you didn’t open your eyes to see the red flags being waved right in front of your face. I’m sorry you weren’t proactive or as concerned as I. I’m sorry you were clueless and that your ignorance failed my child. I’m sorry your medical knowledge of vaccines paled in comparison to mine. I’m sorry you were ignorant of the answers from my endless list of questions. I’m sorry you wasted my time telling me ‘boys will be boys’ and ‘to just wait it out’ when Ronan needed help right away. I’m sorry I didn’t leave your practice and dangerous decisions sooner. I’m sorry I didn’t know as much as I do now. I’m sorry your patients’ parents are still accepting the drivel that comes from your practice about vaccinations, unnecessary and hazardous mind-altering medications and overly-prescribed antibiotics. I’m sorry I have to tear a new one into you now because I should have done it sooner.

This lashing out is very, very common in antivaccine parents. They believe that vaccines caused their child’s autism. It’s a completely erroneous belief, not grounded in any science or evidence, but they really do believe it. Because they believe it, they blame medicine in general but their doctor in particular both for having “taken their child away” and having caused his autism. The result is tirades like this one by Jameson.

Of course, Jameson is reasonable in comparison to the many denizens of AoA. One commenter in particular can’t resist a little argumentum ad Nazi-um:

How many Jews do you think have forgiven Hitler? Where are they?

This same commenter, Willie, uses the informed consent form and the Vaccine Information Sheets that doctors provide when they vaccinate to attack a straw man argument of physicians and medicine:

“No one owes your son any apology except you. Remember that consent form you signed right before your child was vaccinated? YOU signed that paper authorizing the doctor to vaccinate… …The consent form should make parents stop, decline the vaccines, and go home and do some research before signing. The buck stops with the parent who signs that form and therefore is the one responsible when something goes wrong.”

With respect to the consent form discussion and the callus comment above. This comment and argument is incomplete and therefore false and misleading and should be rejected as it assumes facts that are not true i.e. that everyone was offered an informed consent.

This of course is tantamount to letting a killer off on a technicality.

Because giving a child a vaccine is just like being a killer, and an informed consent that doesn’t list every fantastical “risk” that antivaccinationists can dream up in their fevered brains is a “technicality.” Of course, this is nothing more than the concept of “misinformed consent” that antivaccinationists use, both to frighten parents (by demanding that they be “informed” of “risks” that are not risks) and as a weapon to claim that physicians didn’t give them adequate “informed consent.” Of course, there’s no reason that physicians should tell patients or parents about “risks” that science doesn’t support.

On the other hand, Willie’s straw man argument brings us to BK’s post on the Not-So-Thinking Mom’s Devolution on Forgiveness and Stuff. After listing all the evil vaccine-supporters she’s mad at, such as pediatricians, the government, the CDC, Bill Gates, and the like, she reveals whom she is really angry at:

No, the anger that I feel toward “the system” is not my biggest problem. My problem is the one person that I hold the most responsible for my son’s illness: MYSELF. The anger and contempt I feel toward myself is unlike anything I have ever dealt with before. I am not angry at myself because I didn’t know not to vaccinate at the beginning of my son’s life. I am angry because I didn’t see what was happening to him as autism set in and began to take root and grow deeper with each set of shots.

Oh , NOW I can see it. All I have to do is look through my son’s baby pictures. Instead of bringing me joy, they bring me great pain. I see how attentive he was back then, how he looked and smiled at the camera when he was 18 months old (something he lost and still doesn’t do now at age 10), and just how much more “with us” he was. His regression was much slower than a lot of kids; it wasn’t an overnight loss of skills, but rather things disappearing rather gradually, and language that just would not progress at all, even though he said his first words at around 10 months old. It wasn’t until he was five years old that his behaviors turned violent; he changed from my sweet, compliant little boy to a self-injurer. So, when I look back at his pictures, I see “before self-injury” and “after self-injury,” and I kick myself repeatedly for what I didn’t know then, and how I continued to vaccinate him year after year. Why didn’t I know? How could I be so blind? If I had stopped vaccinating him, he would be so much better by now. Look what I did to him! It’s all MY fault!

And this is arguably the most harmful effect of the antivaccine movement on actual antivaccine parents. As wrong as their beliefs are, as scientifically unsupported their pseudoscience is, as much as we know that vaccines do not cause autism, the belief that they do is a corrosive force that leads to self-anger, guilt, and self-doubt, all due to the false belief that they caused their child’s problems. Imagine it! Think about what it must feel like to believe that you caused your child’s autism. Never mind that it’s not so. It doesn’t matter to the feeling, which is still there and still real because you believe. None of this means that we should in any way respect the pseudoscience that antivaccine parents are peddling. We need to make sure that their delusions do not infect the public at large.

On the other hand, as much time as I spend combatting antivaccine nonsense, even as I’ve been attacked for doing so, I can’t help but feel sorry for women like Cathy Jameson, whose antivaccine beliefs lead her to be angry at the world; BK, whose self-hatred appears to be truly pathological because she believes she caused her child’s autism; or Kent Heckenlively, whose belief that vaccines caused his daughter’s autism has led him to take her to one quack after another. They are miserable people whose misery would be greatly alleviated if they could just find a way to accept science and get on with their lives. As it is now, they aren’t doing themselves or their children any good. They certainly aren’t doing public health any good.