How quickly things change.
If there’s one thing I always feel obligated to warn my fellow pro-science advocates about vaccines and the antivaccine movement, it’s that we can never rest on our laurels or assume that the tide is turning in our direction. The reason is simple: Antivaccinationism is a powerful belief system, every bit as powerful as religion and political ideology. It’s powerful not just among antivaccinationists, but also because it taps into belief systems that are very much part and parcel of being an American. In fact, depressingly, yesterday I learned of a perfect example of this unfortunate phenomenon. Remember my discussion of Oregon Senate Bill 442? It’s a bill that was being considered in Oregon in the wake of the Disneyland measles outbreak that would eliminate nonmedical exemptions to school vaccine mandates. It’s also the same bill that chiropractors (amazingly) wanted to have antivaccine guru Andrew Wakefield testify in front of the Senate health care committee, but that plan was rendered null and void by the justifiably negative reaction to the possibility of having a scientific fraud like Andrew Wakefield testify against a bill. At the time, I thought that was an indication that the bill might have a chance of passing.
I was wrong. I should have known better. The power of the antivaccine dog whistle is not easily denied. If you don’t believe me, take a peak at the antivaccine crank blog Age of Autism and what it posted last night, basically a link to this article in the the Statesman Journal entitled Oregon senator to propose new school vaccine policy:
Oregon legislators are backing off a proposal that would have made it tougher for school children to opt out of vaccinations.
Instead, Sen. Elizabeth Steiner Hayward said Wednesday she will propose a different policy that would encourage more school children to get vaccinated but continue to allow nonmedical exemptions. It also would provide alternative paths for parents to comply with the law.
Senate Bill 442, which had one public hearing and attracted national attention, would have eliminated religious and philosophical exemptions from school shots. Only medical exemptions would have been allowed.
So why did this happen? Why did Steiner back off? Simple. pressure from an unholy coalition of antivaccine loons and “health freedom” advocates:
Before the bill’s first public hearing, Steiner Hayward was confident it had the majority of votes in both the Senate and the House. However, on Wednesday, she said that support had weakened, necessitating an alternate course.
“Some of my colleagues changed their minds,” she said. “They got a lot of pressure one way or another. This is an issue that really mobilizes a very small minority of people, but it makes them very loud. I get that. That’s their right. But there were a bunch of people who weren’t prepared to take on this controversial of a topic at this point.”
While the bill had strong support from public health and medical leaders, including Oregon Health & Science University, Oregon Medical Association and Providence Health & Services, a vocal group of parents who either delay or avoid vaccines for their children has been active in opposing the bill.
While many are concerned about vaccine safety, some opposed the bill on grounds of medical freedom and parental autonomy.
If you want to know how bad things got in Oregon, consider this. After the furor over the invitation by chiropractors to Andrew Wakefield to testify in front of the Senate committee, Robert F. Kennedy, Jr—RFK, Jr.!—lobbied Oregon lawmakers not to pass this bill. As a result, the bill appears to be dead, although it sounds as though Sen. Steiner wants to try to pass a bill similar to California Bill AB 2109, which requires parents seeking a personal belief exemption to vaccine mandates to see a health care professional to sign the exemption form. the purpose, as I discussed before multiple times when AB 2109 was being considered, was to make it more difficult for parents to claim personal belief exemptions than just signing a form. Even then, Governor Jerry Brown neutered the new law with a signing statement instructing the California Department of Public Health to include on the exemption form a religious exemption that doesn’t require a healthcare professional to cosign the form. It was a profound betrayal of California children and an almost certainly unconstitutional abuse of his authority as Governor in which he basically overrode the legislature’s intent.
So, instead of a strong bill that eliminates nonmedical exemptions to vaccine mandates, Oregon is likely to pass a much weaker bill, although even that is not assured, given the fierce resistance of antivaccine groups, who have been relentless. In the meantime, there is even a legislator, Sen. Tim Knopp, R-Bend, who is considering this, “”Ultimately, we probably need to review whether or not Oregon needs a constitutional amendment to make sure parents are in control of their kids’ health care.” Meanwhile, another legislator, Sen. Jeff Kruse, R-Roseburg, published a newsletter saying he believed vaccines are linked to autism and accusing the CDC of mismanagement and corruption, both of which are talking points “made in the documentary Kennedy showed to lawmakers last week.” What documentary was that?
He showed the documentary “Trace Amounts,” which centers on mercury in vaccines and its relationship to autism, at Cinebarre in downtown Salem. The documentary also accuses government researchers and public health agencies of corruption and fraud.
Kennedy made the trip to Salem with one goal. To influence lawmakers to vote against Senate Bill 442, the vaccine mandate bill.
It wasn’t just Robert F. Kennedy, Jr., either:
Kennedy was accompanied by Brian Hooker, a California biomechanical engineer. Hooker wrote a reanalysis of a 2004 research that found no links between the measles, mumps and rubella, or MMR, vaccine and autism. In the paper, Hooker accuses the CDC of covering up data that showed black boys had a 3.4 times greater risk of autism associated with the MMR vaccine.
Hooker’s study, which was published in Translational Neurodegeneration in October 2014, has been retracted. The retraction statement reads that “post-publication peer review raised concerns about the validity of the methods and statistical analysis, therefore the Editors no longer have confidence in the soundness of the findings.”
Despite that, Hooker’s findings continue to be used to argue against vaccines.
You remember Brian Hooker, don’t you? Think “CDC Whistleblower” pseudo-scandal. Think a reanalysis of the 2004 DeStefano et al paper that was so utterly incompetent that even a brand new journal eager to attract submissions saw no other choice but to retract it. Think a biochemical engineer who believes that the simplest statistical methodology is the best and applied it to the DeStefano et al data in such a way that epidemiologists who saw what he did wanted to tear out their eyes to unsee the atrocity against epidemiology he had committed in the name of “simplicity.” (Let’s just put it this way: “Simple” often means not adjusting for confounding factors.”)
I’ve discussed the concept of the “antivaccine dog whistle” on multiple occasions before. A dog whistle, of course, produces a sound at a higher frequency range than most humans can hear, but dogs can hear it. In politics, a “dog whistle” says something that most of the population finds admirable (or at least inoffensive), but people of certain groups recognize it as speaking to them, as telling them that the person blowing the dog whistle is “one of them.” It’s a technique that’s been used of late by everyone from antivaccine-sympathetic pediatricians like “Dr. Bob” Sears to Rand Paul to the aforementioned Oregon Sen. Robert Kruse to, yes, Robert F. Kennedy, Jr.:
Kennedy made the trip to Salem with one goal. To influence lawmakers to vote against Senate Bill 442, the vaccine mandate bill.
“We can’t solve a credibility problem by forcing people to undergo a medical procedure without informed consent,” Kennedy said before the event.
That “health freedom” argument in which vaccine mandates are portrayed as denying parents “informed consent”? Pure antivaccine dog whistle, an appeal to parental “rights” over the rights of their children. True, it’s not as blatant as Rand Paul’s infamous statement, “The state doesn’t own the children. Parents own the children, and it is an issue of freedom.” It does, however, do what most antivaccine appeals to “freedom” and “informed consent” do, and that’s to ignore the child as an autonomous being. Rather, the child is simply an appendage of the parent, and it is the parents’ “freedom” and “rights” that trump the child’s right to good health care and preventive medicine.
More importantly, as I’ve explained multiple times, what antivaccinationists like Robert F. Kennedy, Jr. are really arguing for is something I’ve dubbed “misinformed consent.” That’s consent based on the antivaccine message, which massively exaggerates risks of vaccination, makes up risks that science has not found despite looking intensively (such as autism due to vaccination), and greatly underplaying the benefits of vaccination. If enough misinformation is aimed at parents to demonize vaccines as dangerous and ineffective and the parents accept that information, either because they don’t know any better or because there is no counterbalancing source of information, then it becomes “reasonable” to refuse vaccinations. That is the very essence of misinformed consent.
Lately, the grande dame of the antivaccine movement, Barbara Loe Fisher herself, has been dog whistling up a storm, invoking language favored on the right of the “culture war” in a post entitled The Vaccine Culture War in America: Are You Ready?:
In this case, in addition to the usual appeals to “freedom” and “rights,” Barbara Loe Fisher takes a particularly despicable turn:
More than 1.2 million people in the United States are infected with HIV 1 but government officials do not ban HIV infected children and adults from attending school, receiving medical care, being employed, or otherwise participating in society. In fact, there are anti-discrimination laws that guarantee civil rights protections for Americans infected with HIV or living with AIDS.
In 2012, public health officials reported that about two million people in America are infected with chlamydia, tuberculosis, syphilis and gonorrhea, 3 and they estimate another three million people are infected with hepatitis C. 4 Like those with HIV or AIDS, these citizens are not targeted for discrimination and blocked from getting a public education, being employed or moving freely in society.
Right off the bat, Fisher is being intellectually dishonest to a degree even beyond what I’m used to seeing from her. You can see her setting up a comparison to unvaccinated children by comparing how they are not allowed to go to school with how children with AIDS and various sexually transmitted diseases are. It’s clearly and blatantly an attempt to argue that the government treats people with these diseases better than it treats unvaccinated children. Of course, HIV is not easy to spread. It requires sex or contact with blood or bodily fluids like semen, and even then it’s not that easy to catch. Hepatitis C also requires direct contact with blood or bodily fluids, although it is much easier to spread by those means than HIV. The rest of the diseases, with the exception of tuberculosis, are all sexually transmitted diseases that won’t spread unless the kids are having sex.
Tuberculosis itself is—fortunately—no longer that common in the US, and, if it has been treated properly, rapidly becomes no longer contagious. Moreover, if a case of active TB is identified in a student, health officials do take strong action. It just happened in Oklahoma a week ago, when a student with active TB was identified. This student was isolated and treated, and 315 students were ordered to undergo TB testing.
So what’s the problem? The diseases vaccinated against, with the exception of HPV, vaccination against which is intended to prevent cervical cancer, the diseases vaccinated against for school are highly contagious. Measles, for instance, is one of the most contagious diseases known to humans, with infective particles hanging in the air for long periods of time after a measles victim coughs. To compare a bunch of diseases transmitted by sexual contact and blood contact with diseases spread through the air with droplets or through contact with fomites is as intellectually dishonest as it gets. In any event, the rest of Fisher’s tirade is a “greatest hits” of recent antivaccine responses to the Disneyland measles outbreak (e.g., this one) and any whiff of a hint that states want to restrict non-medical vaccine exemptions, with complaints about censorship, “shaming,” and concerns about revocation of the licenses of antivaccine doctors (this last of which, by the way, will almost certainly never happen anywhere).
Here’s where Fisher goes into full dog whistle mode:
Rational thinking has been the first casualty in this 21st century equivalent of a 17th century witch hunt 43 led by defensive doctors in government, industry, academia and media, who are fed up with parents asking them questions about vaccine risks and failures they can’t answer. 44 45 46 47 Assisted by communication conglomerates 48 and Astroturfers, 49 50 51 52 53 they piously wave the science flag and call parents “anti-social” if they don’t vaccinate 54 but completely ignore parents with vaccine injured children talking about how their vaccinated children are never healthy anymore. 55 Some of the most vicious attacks have been on families consciously choosing to stay healthy a different way 56 57 and on doctors caring for families whose children are unvaccinated or receive fewer vaccines on an altered vaccine schedule. 58 59
After headlines like “What would Jesus do about measles?” 60 and “God wants you to vaccinate your children” 61 marked a new low in American journalism, it became clear that the so-called “vaccine war” 62 63 is really a culture war 64 on freedoms, values and beliefs that have long defined who we are as a nation. 65 66 67 How it is fought and where it ends will determine the kind of nation America will become in the 21st century.
Funny that Barbara Loe Fisher would make a reference to the 17th century, given that the views that lead her to spread fear, uncertainty, and doubt (FUD) about vaccines derive from ideas dating back at least that far. In any case, notice how neatly she co-opts the language favored on the right of the “culture war,” language that was rose to prominence when Pat Buchanan, in his speech at the 1992 Republican Party Convention, declared a “cultural war,” a “struggle for the soul of America.” Her video is about as obvious an example of the antivaccine dog whistle as I’ve been able to find, in which it’s not really about vaccines but rather about “freedom,” “values,” and what America should be.
If you want to know why antivaccinationists use this rhetoric, look no further than Oregon. It works. It taps into a very deep well of distrust of overweening government dating back to the very formation of our country and deeply embedded into the very DNA of our culture. Because of that, it attracts people who are not antivaccine to work for antivaccine goals, such as easier-to-obtain non-medical exemptions, all in the name of freedom. It’s why antivaccinationists won in Oregon even in the middle of a major measles outbreak, an outbreak that’s accounted for 119 cases in Quebec alone due to a the child of a missionary who visited Disneyland on the way home and brought measles to a religious community whose members don’t vaccinate. It worked even though the Disneyland measles outbreak had seemingly turned the tide of public opinion against the antivaccine movement. Antivaccine loons will quite possibly win in California again against a similar bill designed to eliminate non-medical exemptions, SB 227 for the same reasons. Antivaccine activists appeal to emotion because they don’t have the science, but it’s a potent weapon, as emotion frequently does trump science. It’s not enough for us to fight antivaccinationism with science. We have to find a message as potent as the invocation of freedom to counter the antivaccine dog whistle. Until we do, we will likely continue to lose.