Wednesday, February 16, 2011
Over at Slate is a book review of Seth Mnookin's The Panic Virus: A True Story of Medicine, Science and Fear, which "traces the history of the myth that vaccines cause developmental disorders like autism." Among the many thought-provoking points raised by this review is the following:
Here is what baffles Mnookin most: How so many caring, well-educated, affluent parents came to buy leaky theories that vaccines cause autism. How 48 states allow parents to exempt their kids from vaccines for religious reasons, and how in 18 states all you need is a philosophical reason. How, in 2010, the journal Pediatrics reported that a staggering 25 percent of parents believed that vaccines can cause developmental disorders in healthy children. How, even after a 2002 study in the New England Journal of Medicine found no link between MMR and autism, the anti-vaccine camp grew stronger. (A well-known study claiming to link vaccination to autism has recently been retracted and called an "elaborate fraud.")I was about to omit the second sentence of the above excerpt as irrelevant to the issue I am focusing on here -- until I realized that legal requirements for vaccination may well be part of the problem.
Why would so many educated, concerned parents not vaccinate their own children? Momentarily assuming, for the sake of argument, that forcing vaccination is a proper role for the government (It isn't.), one might say that vaccination programs are victims of their own success. Until recently, for example, such resurgent childhood diseases as whooping cough were all but forgotten. Certainly, not having to think much about them played a part of why parents' guard was down. But might a blanket legal requirement for vaccination have also taken the question of whether to vaccinate off most parents' agendas, as well?
What if the state didn't threaten parents with jail for not vaccinating their children? For one thing, many schools would voluntarily require proof of vaccination for enrollment. Some would not -- at least until some school-wide outbreak of disease gave them a well-deserved reputation for not requiring vaccinations. (Also, today's situation of unvaccinated children running around in public schools, freely spreading disease would not obtain, thereby better limiting the spread of such diseases to the children of parents who don't vaccinate.) Practically all parents and educators would be more aware of these diseases, and would give serious thought to the question of whether children should be vaccinated.
In other words, the question would become a fully medical question, and not the part-political and part-medical one that we see here. Parents could focus on the medical facts, and would generally be more used to thinking about such matters for themselves, rather than assuming that the government will have their back or, tragically, throwing out the baby of vaccination with the bathwater of tyranny.
The above is just one aspect of the curious phenomenon of how a quack achieved so much influence among so many well-meaning people. For one thing, a free market in education would better prepare more people to evaluate scientific questions properly. (Note that although the fraud was exposed more recently, Wakefield's 1998 "results" were called into question by 2002.)
In attempting to rescue us from the fact that there are no guarantees in life, the nanny state can cause us to think less effectively about even life-and-death issues like vaccination when it hasn't duped us into not thinking about them at all. And then, as the reviewer I quote above shows when he complains about loopholes in vaccination laws, too many resort to the only solution they can imagine: more of the nanny state.