Vaccination

The coronavirus pandemic has caused our public spaces to shut down. The economy has stopped, we’ve socially distanced from our loved ones, and we may not get back to normal until there’s a vaccine. Could the extremity of this situation lead vaccine dissenters to change their minds about the benefits of vaccination?

Bernice Hausman leads the Department of Humanities at the Penn State College of Medicine, where she researches the history and meaning of anti-vaccination sentiment. She’s interested in medical controversies that spill over into the public realm, becoming social controversies. “It’s this interface between science and society,” she says, “which means you’re working with culture and tradition and ritual and history — not just with science.”

In order to understand why skepticism about vaccines is so durable, you have to understand the long history of anti-vaccination movements in the U.S., and how they connect to very big ideas about individual freedom and state power.

The earliest method of immunization, which dates back to the 10th century, was something called variolation* and it was used to protect people against smallpox. Variolation involved collecting matter from active smallpox lesions and then scraping it into the arms of people who weren’t ill. The idea was that hopefully, a mild, protective infection would result. 

*IMAGE SEARCH OF “VARIOLATION” NOT RECOMMENDED.

Variolation eventually spread from China and India, where it originated, to the west, where the practice gave way to vaccination. In the late 1700s, an English physician named Edward Jenner made a vaccine for smallpox that was based on cowpox, a related animal infection. And while many people welcomed the new vaccines that began to develop from that point forward, there were also objections, right from the start. “Some of them based on the notion that… it’s always dangerous to mess around with nature, and people who do so are punished,” cites Hausman. “There were some anti-scientific arguments based on the notion that naturally becoming ill was preferable to being vaccinated. There were perceptions about the danger of vaccination. So all of the same concerns that we see today in contemporary vaccination dissent, you can see them historically.”

A big sticking point for a lot of people was vaccine mandates. Great Britain implemented compulsory vaccination in the mid-1800s and people rioted in response.

In the U.S., vaccine dissenters organized to challenge state mandates. Eventually, in 1905 there was a famous Supreme Court case, Jacobson vs. Massachusetts. The case upheld the rights of states to enforce their vaccination laws, arguing that sometimes public welfare is more important than individual freedom. But even though the decision allowed for some exemptions, it mobilized the anti-vaccination movement in the U.S., providing them with fuel. As time went on, Dr. Hausman says that two broad groups of vaccine dissenters began to emerge. One group was largely made up of educated, middle-class people who had ideological objections to vaccines, believing them wrong or dangerous in some way. The other group was largely working-class, and they objected to the government’s intrusion on the family.

Vaccine dissenters believed the government should not be telling people what to do with their bodies— and that was especially true if there might be even a small amount of danger involved. “What you tend to see, in the United States at least, is a mingling of arguments about freedom and individual rights with the notion of bodily danger,” says Hausman.

Hausman traces the modern anti-vaccination movement to the 1970s when parents started to express concerns about the original pertussis vaccine, which caused high fevers and febrile seizures in some children.  “There was an increasing belief that it could cause some neurological damage,” says Hausman.

In the early 80s, a TV news program called Vaccine Roulette highlighted the growing controversy. In general, the program emphasized the risks of the vaccine while minimizing the dangers of the actual disease. Some of its more serious claims have been debunked by further research. The story also provided a big platform for a group called Dissatisfied Parents Together, which would go on to become the National Vaccine Information Center — which is now one of the biggest self-styled “vaccine safety” organizations in the country.

Another example of a single article having outsized influence is Andrew Wakefield’s fraudulent paper linking the MMR vaccine and autism, published in 1998. His findings have since been disproven many times over. There is no link between MMR and autism. But the association remains stubbornly persistent and still motivates some vaccine refusal.

Today, Dr. Hausman is observing and formulating some questions that might be interesting to investigate. She says this is an unprecedented time to be studying attitudes about vaccination because we’re in the midst of the first worldwide pandemic of the vaccine era.

As she watches anti-vaccination communities and messaging from organizations like the National Vaccine Information Center, she’s seeing a lot of fear among more ideological anti-vaxxers. People are watching the government enact stay-at-home orders and they’re worrying that it might lead to other heavy-handed government action. They worry about the possibility of more tightly enforced vaccine mandates and a crack-down on exemptions.

But Dr. Hausman also predicts that the pandemic may influence the views of those who are more “vaccine-hesitant,” leading them to embrace vaccination when they may not have before.

She’s also keeping an eye on the development of one potential coronavirus vaccine, which is being developed at the University of Pittsburgh. It takes the form of a patch, not an injection. It’s placed on the skin like a band-aid and over the course of a few days, it delivers the vaccine through a number of tiny needles. “Think about what it would mean if you went to the doctor’s office and instead of giving your child shots, they gave you four patches,” she says. The patient could administer them over a number of weeks, watching to see if their child had an adverse reaction to any of them. “You’re more in control as a parent. Even if it’s the same delivery of the same vaccines, it changes your relationship to the whole process.” She’s curious if the mechanism of delivery might change patient attitudes about vaccination.

Ultimately, what Hausman is seeing at this moment displays the same dynamics we’ve seen over and over again in history. Even when there’s overwhelming scientific evidence that vaccines are a good thing for public health, it doesn’t necessarily mean everyone just gets on board.