Grifters, cynics, and true believers: The family tree of vaccine opponents - Ars Technica

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Stanley Plotkin, 93, was instrumental in developing a number of vaccines over the course of his career. He recently said that he’s “beginning to regret having lived so long—because we’re going downhill.” How could we possibly have gotten here?

Maybe we’ve always been here. It turns out that the anti-vaccine arguments currently flooding the Internet have been around for as long as vaccines have. In his new book A Pox on Fools, Thomas Levenson breaks them down into three categories, as made clear in the book’s subtitle: “The True Believers, Grifters, and Cynics Who Convinced Us to Reject Vaccines.” The accusations these people levy against vaccines can just as easily be used to categorize the arguments themselves: They are wrong, they are bad, and they are intolerable.

Wrong

As Levenson tells it, in the early 18th century, a couple of forward-thinking Westerners learned about inoculations against smallpox from Ottoman women and an enslaved African. At that point, infectious disease was by far the leading cause of death, as it had been forever. In the 19th century, roughly 40 percent of babies died of infection before they turned 5.

(This is why the average lifespan back then was so low. It wasn’t that people didn’t live past their 30s; if they survived childhood, they largely did. It’s just that so, so many small children died that they dragged the average way down.)

When smallpox epidemics broke out in London and Boston in 1721, Lady Mary Wortley Montagu and Cotton Mather initiated inoculation campaigns in their respective cities. Inoculation involved taking pus from a pock of someone with a not-very-severe case of smallpox, making a cut in the arm of the person to be inoculated, and rubbing the pus into the cut.

There was an immediate backlash. It was morally wrong, some claimed, to interfere with the divine ordination of who would sicken and die and who would not. Only God had that ability, and to thwart it was to defy God’s will. It was hubris and blasphemy. Levenson highlights how the subtext of this attitude was that contracting a highly infectious disease was divine punishment for sin and that the only way to avoid disease was to live a virtuous life.

The Transcendentalists and Romantics substituted “nature” for “God” in the mid-19th century, but the argument has remained basically the same: vaccines are an affront to the “natural” world, and clean living is all you need to stay healthy. The implicit moral judgment remains, even without God: if you get sick, it must be because you ate/drank/breathed/wore something that wasn’t pure enough.

The immense strides in public hygiene and sanitation that preceded the heyday of vaccine development certainly did curb the spread of infection and increase lifespans, but clean living will not help you fight off an infection if you’re exposed to a pathogen as effectively as a vaccine will.

The argument that it would ignore most of human history and what we know about microbiology and immunology. But it sounds quite compelling, especially when the modern world around us is so scary and hard to understand. And especially when almost no one alive today still remembers just how many child-sized coffins were involved in the halcyon pre-vaccine days when nature got to take its course.

Bad

Vaccines are unnecessary because our bodies can cure themselves, Robert F. Kennedy Jr. and his cronies claim. But they go beyond that and say they are actively harmful–and certainly more harmful than the diseases they are designed to prevent. This is an alluring argument to many, since the negative effects of vaccines are apparent (shots hurt for a moment, and you might get a sore arm or fever). In contrast, the lack of many small children dying from infectious diseases is harder to notice. Because of the spectacular success of vaccines, we take the lack of those deaths for granted.

This argument, too, has been there since the outset, when there was no data yet to refute it. And in the intervening years, there definitely were some tragic missteps during vaccine development and administration. But 300 years later, it’s eminently clear that vaccines are safe. They are not completely risk-free, of course; nothing in life, certainly nothing valuable, is risk-free.

Vaccines can and have caused serious adverse effects (but not autism) in specific populations. And certain vaccines are not safe for certain subsets of people—infants, the elderly, or the...