In which pro-vaccine advocates are inappropriately portrayed as frenzied, self-righteous “zealots”

One of the odd things about having been a blogger as long as I have been is that, occasionally, posts that I wrote years ago rise up to bite me long after I’ve forgotten that I even wrote them. Actually, that’s usually not the right way to put it. Blogging is a very short term activity in that most posts are very ephemeral. They’re usually (but not always) about something immediate, of the moment. Don’t get me wrong. There are quite a few posts that I’ve written that aren’t so ephemeral and could be read now without reference to the events or news that inspired them and be just as good now as they were then. But most posts are firmly rooted in the moment they were written. Actually, what usually happens is that someone finds and old post of mine, is offended by it or otherwise unhappy, and then writes an article or a blog post in response.

So it was yesterday, when a post from three years ago was resurrected for the sake of complaining about how very, very unfair and mean I am about antivaccinationists and how I should never, ever have called a man by the name of Mark Largent “clueless” even though what he wrote was, in fact, evidence of cluelessness. Those of you who’ve followed the antivaccine movement along with me for a while will know, upon seeing the title of the article (What if not all parents who question vaccines are foolish and anti-science?, with the subtitle It is not completely unreasonable for parents to ask about safety concerns) just how problematic its contents likely will be. The first indication that the author of the post is attacking a straw man is right there in the very title! No one, least of all I, says that all (or even most) parents who doubt vaccines are antiscience and antivaccine. Rather, we recognize that the leaders of the antivaccine movement tend to be profoundly antiscience because science doesn’t support their antivaccine views. Indeed, I long ago lost track of how many times I’ve said this and added that it is at the fence sitters and the parents who have doubts that I aim my deconstructions of antivaccine pseudoscience. I don’t blame the author of this piece, Alice Dreger, for not reading some of the other posts I’ve written on the subject. No one expects that. But it would have been nice if she actually read the post that she uses as an example of “pro-vaccine zealots” supposedly mindlessly label all parents who express doubts about vaccines as “antivaccine,” because nowhere in that post do I recognize her characterization of my arguments.

Indeed, Dreger arguably missed the point entirely when I pointed out that the fears of vaccines are almost always rooted in pseudoscience. They are, but, as I’ve pointed out more times than I can remember, to someone who is not knowledgeable enough about the topic to recognize the pseudoscience, those irrational pseudoscientific arguments seem rational. If you mistakenly believe the misinformation, it is rational, based on what you know, to start to fear vaccines. It’s concept I’ve referred to as “misinformed consent” not to vaccinate. If you start to believe the misinformation of the antivaccine movement claiming that vaccines are dangerous and that they don’t work that well, then of course you’re going to start to become worried and fearful! That’s what we’re fighting, the misinformation that poisons the decision-making process of these parents who are vaccine-averse!

Let’s take a look at Dreger’s complaints. Before she launches into her harangue directed at me (and other skeptics who battle antivaccine pseudoscience), she very explicitly (and defensively) tries to inoculate herself against charges of being “antivaccine” by holding up her 15 year old son as an example, wielding him like a shield by emphasizing that she always kept him “exactly on the vaccination schedule required by our state of Michigan” and bragging that at age 15 he is “fully vaccinated according to public health recommendations.” All of this is well and good, but none of it means that the arguments she makes are a good ones, nor does it necessarily inoculate her against charges of being “antivaccine,” particularly given that she definitely comes across as trying too hard when she goes on to relate how she pesters her doctor about whether there are any vaccines she’s missing and how she got the HPV vaccine, even though it’s not specifically recommended for women in their 40s, because she thought it would give her more authority when she urged young people to get it. After all, Robert F. Kennedy, Jr., one of the most vociferous antivaccinationists out there over the last decade, risibly describes himself as “fiercely pro-vaccine” and brags about how he vaccinated all his children—while neglecting to mention that his youngest child was born five years before he started publishing antivaccine articles and likening vaccination to the Holocaust. Don’t get me wrong. I don’t think she is antivaccine. Rather, like Largent, she is merely ignorant about the antivaccine movement and a little too enamored of her self-proclaimed “reasonableness” because she’s not a “zealot.”

This brings her to the crux of her complaint:

But I suspect all that testimony won’t matter given what else I’m about to say. Because as soon as one questions anything about vaccines – as soon as one expresses any doubt or concern about any vaccine practice – one risks being labelled an “anti-vaxxer”. Or at least represented as a kind of gunrunner to the anti-vax camp.

Or, as Warren Zevon put it and Linda Ronstadt sang it so long ago, Poor, Poor Pitiful Me. Let’s just put it this way. Express pro-vaccine advocacy and criticize antivaccine pseudoscience, and you’ll be labeled a corporate shill, an unfeeling monster who attacks mothers of special needs children, or even downright evil. You might even be subjected to campaigns to get you fired from your job. Oh, wait. I was! On multiple occasions!

This segued into her account of a meeting with Mark Largent, author of Vaccine: The Debate in Modern America, which Dreger describes thusly:

In his work, Largent refuses to take sides with either a) the anti-vaxxers, who think vaccines cause disorders such as autism, or b) the anti-anti-vaxxers – let’s call them the vaccine zealots – who think any parent who resists any vaccination is a dangerous idiot. Even though Largent is easily as “pro-vaccine” and pro-science as I am, among the frenzied zealots his sympathy for resister parents has marked him out as a heretic.

And Dreger wonders why Largent catches flak. She should look no further than her own description of him. Then she should go back and look at what I actually wrote about him in a post whose title should tell you where I’m coming from: Respecting parental concerns versus pandering to antivaccine fears. What pediatricians do when discussing vaccines, even with vaccine-averse parents, is to respect parental concerns and try to address them. What people like Largent and Dreger seem to think we should be doing is to pander to antivaccine fears, as you will see. Ironically, in her post, Dreger even describes an example of how a pediatrician should respect parental concerns even as she’s complaining about a nurse whom she perceived as not doing that. (See below.)

Note the framing of the issue by Dreger. She couldn’t be more blatant (while claiming to be even-handed) if she tried. To Dreger, Largent is oh-so-reasonable because he refuses to take sides between the “antivaxers” who think vaccines cause autism and the “anti-antivaxers,” who are portrayed as being “zealots,” the implication being that they are just as unreasonable as the antivaxers. It’s the appeal to moderation (a.k.a. the fallacy of the golden mean) writ large. Where people like Largent and Dreger go wrong is in the assumptions inherent in this fallacy, which are that (1) extreme positions are never reasonable or correct and (2) the correct answer lies between the two extreme positions somewhere. An excellent example to illustrate the problem with this fallacy can be found here, where an example is provided:

Bob wants to exterminate all the termites in the house. Alice doesn’t want to exterminate them at all. Therefore, the correct course of action is to kill exactly half of the termites.

This is an exaggeration to make a point, of course. Sometimes the “golden mean” will involve killing 75% or 25% of the termites. The point behind the fallacy is that it is never, ever correct in the minds of those appealing to moderation to take one side or the other. Unfortunately for Dreger and Largent, for some questions of science there are actually right and wrong answers. The answer to the “debate” between science and pseudoscience is not halfway between the two. It’s science. This is the fundamental problem with the sorts of arguments Largent and Dreger make.

Also, as I said before, none of this means that one can’t respect parental concerns without compromising on science, but that’s the fundamental false dichotomy on display here. To her, Largent is a brave maverick historian because he “thinks differently”:

Largent also bucks the usual trend among the sometimes self-righteous zealots by refusing to see public-health vaccine recommendations as a purely scientific prescription. In fact, he calls the recommended childhood vaccination schedule “a political artefact” – not a simple blooming of the science but a wrangled set of mandates and recommendations that it is not unreasonable for parents to question.

Which shows that, when it comes to who is and is not “antivaccine,” Dreger is just as clueless as Largent. (Yes, I’m intentionally using that word.) She’s attacking yet another straw man. First of all, no one has said that it’s completely unreasonable for parents to question the recommended vaccine schedule or claim that the CDC-recommended schedule is a “simple blooming of science.” However, when you compare the claims of antivaccine zealots (to steal Dreger’s term shamelessly) with the CDC schedule, only one is supported by science. (Hint: It’s not the claim of antivaccinationists.) In fact, as I read through Dreger’s article, I couldn’t help but thinking of a term I once heard: A pyromaniac in a field of straw men. It’s a good description.

Dreger relates an incident that gives an idea where she’s coming from. Basically, it’s all about the needles and how some health care professionals deal with parents. Dreger starts by lamenting how in the first 18 months of life children receive 25 vaccinations and how that was too much for her, at least, to process:

I remembered with some surprise that I could have reasonably been labelled a “vaccine-anxious parent”. My maternal instinct was riled with every new round of shots and cries and tears: I remembered one particular visit to our paediatrician when my gut instinct had a sharp argument with my brain. I can’t even remember what the vaccine was; I just remember that Gut was yelling, “Enough already! Stand between our baby and that needle!” Trying to stay calm, Brain answered: “Vaccines are safe, and necessary not just for our baby’s health but for the health of those around him, especially children more vulnerable than him . . .”

That one time, I asked the nurse if I could see the written literature on this vaccine. I wanted more information not because I was going to refuse the shot, but because I wanted Brain to shut Gut up. She looked shocked and annoyed and told me testily that there wasn’t any information available. The jab was just compulsory.

No pamphlet in the box, for parents? I asked.

No, she said.

I suddenly regretted even asking. Would I be labelled a “worried” mother, or worse, a “non-compliant” one?

At this point the doctor came in the room and addressed her fears, printing out information sheets about the vaccine. In other words, she encountered what sounds like an impatient nurse, who might have been a bit more snippy than she should have been with a patient’s mother. Then the doctor came in and was more patient and allayed her fears. I’m sure scenes like this play out in pediatricians’ offices all over the country. And who knows? If the doctor isn’t effective in allaying the fears or isn’t as understanding as Dreger’s pediatrician was, they probably contribute to antivaccine views. Moreover, contrary to Dreger’s straw man portrayal, it is also these parents that I’m worried about because they are the very ones who are susceptible to the blandishments and pseudoscience promoted by the antivaccine movement. They’re the ones who have doubts that can be inflamed by the misinformation promoted by the likes of Jenny McCarthy.

Largent and Deger go especially wrong in giving way too much benefit of the doubt to a leader of the antivaccine movement. I’m referring, of course, to Jenny McCarthy, whom Largent doesn’t label as an “antivaxer.” That, of course, is truly clueless as well. I’ve discussed on many occasions how Jenny McCarthy’s claim that she is “not antivaccine” but rather is “pro-vaccine safety” is disingenuous and not convincing (it is, after all, one of many antivaccine tropes), and her knowledge of science that she uses to justify her antivaccine views is epically woeful. Let me quote Jenny McCarthy again:

People have the misconception that we want to eliminate vaccines. Please understand that we are not an antivaccine group. We are demanding safe vaccines. We want to reduce the schedule and reduce the toxins. If you ask a parent of an autistic child if they want the measles or the autism, we will stand in line for the fucking measles.

If that’s not antivaccine, I don’t know what is. So is this post by Laura Hayes, hot off the presses on the antivaccine crank blog Age of Autism, in which she asks questions like:

  • What mother willingly poisons her own child?
  • What mother would allow something that could cause cancer, say asbestos, to be injected into her child?
  • What mother would allow something that could cause life-altering and life-threatening asthma and allergies to be injected into her child?
  • What mother would allow something that could kill her baby to be injected into her otherwise healthy child?
  • So then, what mother willingly poisons her child with the vaccines recommended by our nation’s CDC, which are then mandated by the state in which she lives?

And then she makes it very clear:

Please help stop this vaccine madness, this vaccine holocaust against our children.

In case you think she doesn’t know how ridiculous her exaggeration is or what the Holocaust was, she defines it parenthetically:

(The definition of a holocaust is destruction or slaughter on a mass scale, which is exactly the effect that our nation’s vaccine program is having.)

There’s another post on the very same day (today) that very much like that by William Gaunt entitled The Elephant in the Living Room. The post is built around a metaphor involving a two-year-old child found in the living room with his head crushed. In the room there is also an elephant whose “hooves” are dripping with blood. This happens as the police are examining the crime scene:

The younger detective says, “What about the elephant? It seems clear that…” His older partner interrupts him and takes him aside. He says, “If you want to keep your job, you will disregard the elephant as a suspect. It is an absolute career killer to accuse an elephant of anything bad. The CDC has funded several scientific studies which show that elephants are safe and effective and above reproach. Take it from me, you don’t want to go there. We can come up with any cockamamie story we want but it is totally politically incorrect to even mention the possibility that the elephant had any role in this child’s death.” The younger detective said, “Sorry. I didn’t know.”

That’s right. To this naturopath, using a metaphor in which vaccination is likened to an elephant crushing a toddler’s head but not being suspected because of a religious or ideologic belief that the elephant can’t do anything wrong is perfectly “reasonable.” And you know what? That post on AoA sounds not unlike what Dreger is claiming when she accuses us “vaccine zealots” of this:

But as Largent has been learning, you can’t say these things. You have to subscribe to vaccine exceptionalism – vaccines are all necessary, safe and effective and should never be questioned! – or risk being crushed. In the zealots’ eyes, in the battle to vaccinate the world, moderates must be crushed so that children can be saved.

It’s eerie how much Dreger sounds like Gaunt, isn’t it? Hers is exactly the same complaint as Gaunt’s (that you can’t criticize vaccines, no matter what), minus Gaunt’s nauseating dead child metaphor.

Elephants aside, what would Largent or Deger call someone like Hayes, who likens the vaccine program to the Holocaust and means it. She’s not alone among these “vaccine-averse” parents, either. As I alluded to above, no less a luminary of the antivaccine movement, Robert F. Kennedy, Jr. has used that very same analogy at least twice that I know of. RFK, Jr. is not alone, either. Perhaps the most offensive example of this sort of behavior comes from Heather Barajas, one of these “vaccine averse” parents, who unironically donned a badge with a syringe with a red line through it and juxtaposed that image with Jews during the Holocaust being forced to wear a badge with a yellow Star of David on it. Indeed, I have a whole running series of posts called Annals of “I’m not antivaccine” in which I’ve documented these “vaccine averse” parents likening vaccines to human trafficking, rape, and other evil as varied as the Oklahoma City bombing and the sinking of the Titanic. This series has been going on for five years now and is up to installment #17, with no sign of running out of material. I could go on and on if I want to.

I wonder whether Largent or Dreger has ever asked one of these “vaccine averse” parents like Jenny McCarthy or one of the merry band of antivaccinationists at, say, Age of Autism or The Thinking Moms’ Revolution a couple of very simple questions:

  • Is there a vaccine that you consider safe and effective enough to give to your child? (The answer will either be no or consist of dodging the question.)
  • What would it take to demonstrate to you that vaccines are safe and effective? (The answer will inevitably be levels of evidence not attainable in the real world.)

That’s because, as I point out from time to time, aside from a few refreshingly honest and self-aware antivaccine zealots, no one wants to be perceived as “antivaccine.” So antivaccinationists tell themselves that they aren’t “antivaccine” but rather “pro-vaccine safety” in order to deflect that charge.

Not surprisingly, Dreger, as pro-vaccine as she is, can’t resist agreeing with certain antivaccine tropes. She points to the varicella vaccine as unnecessary because chickenpox is a “a minor disease for most healthy children.” (Don’t mind those kids who suffer encephalitis or secondary infections.) Yes, it’s uncommon, but Dreger seems to be echoing the appeal to The Brady Bunch argument, which downplays the seriousness of measles based on an old sitcom, only with a different disease. She goes on and on about pharmaceutical company influence (yawn). She cites the anthrax vaccine as an example of an unsafe vaccine, as if public health scientists and physicians don’t weigh the risk-benefit ratios of the various vaccines in the pediatric schedule, which by any stretch of the imagination are incredibly safe.

Make no mistake, Dreger paints pro-vaccine advocates as being fanatics. She uses the word “zealot” repeatedly to describe them, adding to them on occasion the descriptors “frenzied” and “self-righteous.” I respond, at least to the charge of self-righteousness: Pot. Kettle. Black. Dreger’s article oozes self-righteousness out of every paragraph. Just look at the way she repeatedly takes great pains to contrast herself and Largent to those self-righteous frenzied pro-vaccine zealots, painting them as being unfairly attacked for daring to be different and speak The Truth because those damned vaccine zealots are too dogmatic to be able to see that they really are pro-vaccine. In Dreger’s mind, she and Largent are clearly oh-so-reasonable (and therefore oh-so-superior to those of us who take a stand), while “pro-vaccine zealots” (like me and, presumably, many of my readers) are fanatics who subscribe to a black and white view of everything and view her and Largent (who, of course, can see the “shades of gray”) as “heretics” against what she refers to as the “deeply embedded dogma.”

Indeed, I find it amusing how much she complains about my language when her post drips with language every bit as loaded as anything I’ve ever written. I mean, seriously. Her whole point in this article is to portray us as religious zealots, the implication being that our beliefs are more akin to religion than science. This leads me to ask: Is it any less hard core to portray someone you disagree with as a self-righteous zealot subscribing to unscientific beliefs who can’t see shades of gray than it is simply to label someone clueless about the realities of how the antivaccine movement operates? I say no. In fact, I ask you to go back and read my original article. See if you don’t agree that, in many ways (other than the use of the word “clueless” to describe Mark Largent in one paragraph), its language is more nuanced and less loaded than Dreger’s article. Let’s just put it this way. If she thinks that we don’t know that vaccine guidelines are not pure science or that public health recommendations involve making hard tradeoffs, it is she who needs an education.

In the end, Dreger’s problem is obvious to me. She doesn’t seem able to properly differentiate between real vaccine-averse parents, whom those of us who are pro-vaccine completely sympathize with, from the hard core antivaccine movement whose face has been Jenny McCarthy. While it’s true that the line between the two is not always a sharp one, Dreger seems all too willing bend over backward to draw the line deep in antivaccine territory, to the point where she is willing to agree with Largent that Jenny McCarthy is not antivaccine. As I point out frequently, the normal run-of-the-mill vaccine-averse parent isn’t antivaccine, but she does have fears. These fears often flow from the same primal instincts that led Dreger to recoil at having her baby stuck with needles, but they are stoked by the pseudoscientific propaganda promoted in the media by Jenny McCarthy and multiple antivaccine blogs, websites, Facebook pages, and Twitter accounts.

Dreger mentions an observation by Largent that the number of hard core antivaccinationists (the ones who refuse all vaccines) has remained steady at around 3% for the last century (as if we don’t know this), further noting that he doesn’t include “people who resist particular vaccines or who deviate from the mandated schedules.” What Dreger doesn’t seem to recognize is that we don’t count those people as antivaccine either. We worry about them because they are the ones influenced by the hard core antivaccinationists, who, thanks to the Internet, have far more easy outlets to spread their misinformation and stoke the fears of these parents about specific vaccines. It is not these parents at whom our criticism is primarily aimed. It’s at the 3% who make up the population who maintain blogs like Age of Autism, publish books like Thimerosal: Let the Science Speak: The Evidence Supporting the Immediate Removal of Mercury–a Known Neurotoxin–from Vaccine make movies like The Greater Good, and publish false antivaccine research like Mark and David Geier or Andrew Wakefield.

And, no, we do not hold back when attacking these antivaccinationists.