The Necessity of Curing Fear

Two weeks ago, the Supreme Court heard arguments regarding whether or not vaccine manufacturers could be sued outside the traditional “vaccine courts” over damages potentially caused by their products. Its hearing has brought renewed interest on vaccine safety and has been used as a rallying cry for thousands of families with vaccine-injury cases in the litigation pipeline. The impact of the court finding against manufacturers is enormous; their spokespeople, both in the past and today, have warned that lawsuits would make it economically infeasible to produce vaccines.

There is a problem here, and it isn’t the current litigation model in place for vaccine compensation. The problem is that overly permissive public discourse has allowed vaccines to be framed as dangerous products without strong scientific backing, confounding Americans who have begun to question the safety of public health’s arguably greatest innovation. A September 2009 Kaiser Family Foundation poll found that 40 percent of Americans had at least some degree of uncertainty about whether MMR, polio, and whooping cough vaccines were safe, despite those vaccines being scientifically proven to carry only an infinitesimally small chance of causing any sort of severe reaction. Blogs focusing on autism have picked up the Supreme Court story, committed to the belief of a causal link between childhood vaccinations and autism. A vast number of the pending vaccine-injury cases are brought by parents of autistic children, convinced of the role that immunizations have had with their child’s condition.

Arguing with facts alone has not been helpful. Though numerous epidemiological studies have been carried out debunking that assertion, more and more Americans are becoming skeptical and making the choice to opt out of some or all vaccinations over fears of autism. That choice has threatened this country’s combined immunity against illness and brought about a resurgence in vaccine-preventable illnesses such as whooping cough. In the face of all this evidence, anti-vaccine crusaders have been able to successfully frame vaccines as “a matter of choice,” grounded in alleged scientific literature including a famous, now-debunked Lancet article that suggested the initial link. Vaccinations have been permitted to become an issue of personal liberty, rather than an essential health benefit that we should feel compelled to embrace.

The public health and scientific community is getting pummeled in the battle for America’s attention, as numerous news and media sources allow people to hear multiple sides to vaccines, not all of which have rigorous scientific backing. The discursive permissiveness may be due to the very nature of science, which bases its progress on innate skepticism toward convention. Science requires there to be uncertainty in measurements and analysis, yet that inherent uncertainty is not necessarily translated accurately from the scientific realm to the public arena. In addition, the heavier reliance on statistics within public health means researchers cannot give the “100 percent” that is so revered among a public seeking concrete, definitive answers, yet for all intents and purposes a statistically significant finding ought to carry that same weight.

It is imperative for public health officials to be able to construct the debate over vaccinations in a manner that is easily accessible to the average individual. The Risk Characterization Theater, a model that darkens seats on a seating chart of a theater to express odds and risk, is the type of analogy that should be considered when trying to conduct outreach to wary Americans; it promotes a mode of understanding that can be quickly grasped by the average person. In addition, public health officials must recognize there exists a conflict in values that explains why some refuse to comply despite proof to the contrary. Officials would do well to remember the case of Singapore during SARS, which proved the importance of building trust and engaging in active dialogue to maximize compliance with a populace that did not always possess a full understanding of the facts and issues.

Any continued fall in our country’s vaccination rates will be amplified many times over as time progresses. It is crucial to reverse this trend and encourage Americans to have the same faith in the public health apparatus that allowed it to eradicate smallpox and polio. We must battle falsehoods and cure the fear that inhibits the progress of our health. The horrors of diseases past have no place in our modern society.

Byran N. Dai ’11, a Crimson editorial writer, is a History and Science concentrator in Currier House.