The controversy over vaccination is grabbing the headlines again. Never mind that the “intellectual” father of the MMR-childhood autism connection, Dr. Wakefield, was exposed as a fraud and his infamous paper was retracted. He was censured by the British Medical Society and was barred from ever practicing medicine in the U.K. Never mind that the National Academy of Medicine found absolutely no link between autism and MMR vaccination after reviewing over 350 papers on the subject.
An unrepentant fraudster
If the outbreak proves anything, it’s Wakefield’s enduring legacy. Even years after he lost his medical license, years after he was shown to have committed numerous ethical violations, and years after the retraction of a medical paper that alleged a vaccine-autism link, his message resonates. Facebook is populated by pages like “Dr. Wakefield’s Work Must Continue.” There’s the website called “We Support Andrew Wakefield,” which peddles the Wakefieldian doctrine. And thousands signed petitions pledging support.
Under such circumstances, most doctors would retreat into obscurity. But not Wakefield. So, where is Dr. Wakefield hiding now? In plain view, in Texas, of course, the home of libertarianism. The anti-vaxxers find a true martyr in Wakefield, who still preaches the gospel of anti-vaccination from Texas. To them, he is a man who has sacrificed everything to take on powerful pharmaceutical companies and the biggest villain of all—the government. “To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one,” J.B. Handley, Co-Founder of a group that disputes vaccine safety, told the N.Y. Times.
Persuading skeptical parents to vaccinate their children has grown more difficult because of concerns about a possible link between vaccines and autism—now thoroughly debunked by science. Their anti-vaccination arguments have expanded to more general, and equally groundless, worry about the effects of multiple shots on a child’s immune system.
Who are these people?
The Los Angeles Times published an outraged editorial. It didn’t blame Disneyland, where the outbreak originated before going on to infect 70 people across six states. Nor did it blame any public agency. Instead, it took aim at a buoyant movement that won’t
“get over its ignorant and self-absorbed rejection of science.“
“They often suggest that vaccination is motivated by profit and is an infringement of personal liberty and choice; vaccines violate the laws and nature and are temporary or ineffective; and good hygiene is sufficient to protect against disease,” said a 2008 editorial in Nature.
The Washington Post highlighted a graph that starkly illustrates the measles resurgence. The accompanying article noted a study that “found that only 51% of Americans were confident that vaccines are safe and effective, which is similar to the proportion who believe that houses can be haunted by ghosts.”
You’d think that the latest outbreak would give these true believers reason to rethink their beliefs. No such luck. A publication calling itself Natural News ran a piece headlined “Afraid of the Disneyland measles outbreak? Don’t be fooled by Mickey Mouse science—READ THIS FIRST.” The website newsmaxhealth.com published a commentary headlined “Vaccine risks the government won’t tell you about.”
In the past 5 years, the percentage of kindergartners in California who are up to date on all vaccinations has held pretty steady from 90.7% in the 2010-11 school year to 90.4% in 2014-15. But there are some wealthy communities in Los Angeles and Orange counties and in Northern California with double-digit vaccination exemption rates. The Wall Street Journal reported that the “vast majority of cases are in Southern California.” The WSJ added that Mark Sawyer, professor of clinical pediatrics at UC San Diego, said that in some schools around San Diego, including some upper-middle-class neighborhoods, 20% to 30% of children aren’t immunized. The WSJ quoted Sawyer saying,
“It’s because these people are highly educated and they get on the Internet and read things and think they can figure things out better than their physician.”
What makes them tick?
Starting from fundamental evolutionary psychology principles, it is pretty well established that our brains crave order and abhor uncertainty. This is why people invented supra-natural explanations (gods of various persuasions and capabilities) to bring order to a chaotic and menacing universe. Conspiracy theories are close cousins of metaphysical explanations of life; both are pure inventions of the mind, without basis in reality.
We usually associate paranoid views of government with right-wing libertarians. Turns out nobody has a monopoly on either paranoia or the libertarian worldview. The vaccination opposition inhabits the political left, which has long been suspicious of the lobbying power of the pharmaceutical industry and its influence on government regulators, and also the fringe political right, which has at different times seen vaccination, fluoridation and other public-health initiatives as attempts by big government to impose tyrannical limits on personal freedom.
The effects of money on behavior
But this doesn’t explain the concentration of anti-vaxx ideologists in wealthy communities. Kathleen Voh and her colleagues studied the effects of money on behavior. Some of the conclusions in her study on “The Psychological Consequences of Money” give us part of the answer. The results of her 9 experiments suggest that money brings about self-sufficient, but also more self-centered, orientation in which people prefer to be free of dependency and dependents. Translated to the issue of MMR vaccination: I am entitled to do whatever I damn please with my child, the risk to other children (immunocompromised due to chemotherapy, children post radiation therapy, children on immunosuppressant drugs) is really their problem.
Still, not all wealthy people are self-centered; many are not. So what goes on in the brains of the ones that are?
We have a two-layered mechanism for making decisions. Layer one is rapid and impulsive. It is responsible for forming the first impression of a person we just met, or making a snap decision to jump out of the way of an approaching car. The second layer is slower and more contemplative. It re-examines our initial reaction in light of more extensive evidence. But there is a caveat: The brain is basically lazy. If it can get away (be satisfied) with initial impressions as being good enough, it will let them stand. Of course, this is not really laziness—it has survival value. If we second guessed every decision we made, we’d end up making none. And the energetic cost of all this brain activity would be unsustainable. Which explains why we look for the easy way out in making decisions, and why it is so difficult to change our minds.
When a mother hears Katie Couric, Michelle Bachmann, or the actress Jenny McCarthy spouting their anti-vaccine message day in and day out on “The View” and other TV daytime shows, she easily understands and accepts it, and the message gets firmly embedded in her unconscious brain. Her layer one accepted it, and layer two was not activated; have you seen many infectious disease experts, or epidemiologists, on “The View” lately?
And this, I think, is the toxic brew that poisoned the minds of those wealthy people who refuse to vaccinate their children—uncritical thinking, coupled with self-centeredness and a sense of entitlement. And I used to think that these traits were reserved for the uneducated poor…what an irony.