How should we deal with the fact that some people, relying on junk science, are refusing to vaccinate their kids, putting everyone else at risk? It is a tricky question, and last week Matt Novak of Gizmodo offered a simple-sounding solution: ridicule anti-vaccination beliefs until people realize the errors of their ways.
“I’m here to convince you that the best way to deal with anti-vaxxers is to ridicule their position so much that it’s no longer acceptable to say in polite company that vaccines cause autism,” he writes. “Ridicule is our best option to help stem the tide of dangerous superstition washing over this beautiful, measles-infested country of ours. Because shaming works.”
Now, Novak isn’t advocating a careless sort of ridicule with a massive blast radius. He’s suggesting something a bit more subtle:
Let me be clear that I’m not advocating that individuals on street corners be shamed for not vaccinating their kids. Fundamentally, individuals choosing not to vaccinate are doing so largely out of misguided concern for the health of their children. I’m arguing that we need to do something much more radical and difficult: we need to support a culture that shames its members for not vaccinating their kids — and by extension, for endangering their communities. Vaccination is a social issue, and therefore shame should regulate it.
It may sound like a childish idea at first, but there is some historical precedent. As Novak points out, many sea changes in public opinion — like the rather shocking recent swing in support for gay rights in the last decade or so — have come about in part because people started frowning upon once-popular ideas. The number of people willing to go on TV and compare homosexuality to bestiality is probably now at an all-time low, and that’s in part because there are increasingly potent social norms against uttering these sorts of hateful sentiments out loud.
Could a similar strategy work for promoting vaccination? I’m skeptical for a few reasons.
For one thing, the analogy to civil-rights battles over race and homosexuality isn’t quite apt. The vast majority of people are already in the pro-vaccination camp — this was something my sources repeatedly emphasized for the story I wrote last week about the dangers of politicizing these issues. With both racism and homophobia, on the other hand, there were millions upon millions of people opposed to granting full civil rights. You had to change social norms if you were going to get anywhere — the numbers simply posed too great an obstacle.
Modern anti-vaccine folks are different. Even though they are very small in number, the internet allows them to carve out self-reinforcing communities with their own social norms and standards of evidence. Within many of these communities, the idea of vaccinating your kids is seen as obviously terrible. This doesn’t happen because of any sort of broad social norm against vaccination; there isn’t any such norm. It happens because anti-vaxxers are convinced they’re seeing through an evil illusion and/or conspiracy woven by some combination of the pharmaceutical companies and the Centers for Disease Control. Why would ridicule sway them when their children’s health is at stake?
As Novak mentions, there’s a difference between shaming everyone who holds anti-vaccine views and shaming the most high-profile proponents of these views — people like Jenny McCarthy. So maybe the shame needs to be directed at elites and media figures who up anti-vaccine scare-mongering, either directly or by pretending that there’s a “scientific debate” to be had here?
That’s what Dartmouth professor Brendan Nyhan, who has studied this sort of opinion-change stuff in depth, argued in an email:
In my view, it’s appropriate to name and shame media organizations who give a platform to vaccine misinformers as well as anti-vaccine activists and elites who mislead parents in public forums. We need to strengthen the reputational consequences for misleading the public, which currently are quite weak. However, it’s not only unfair but likely counterproductive to attack well-meaning parents who have been misled or are misinformed. They are the victims here, not the villains.
It certainly sounds like a reasonable approach. But Dan Kahan of Yale, another source from last week’s story, had qualms about it: Sure, some of those prominent figures promoting anti-vaccine nonsense or muddying the waters “deserve ridicule and are awful people,” he wrote in an email. “But denouncing or shaming them actually only gives them exactly what they want — more attention, which in turn does make more members of the public agitated and confused.” In addition, this kind of shaming “likely chills anxious parents who aren’t militant or political but just confused from trying to get answers to their questions from their doctors or neighbors.”
The fact that Kahan and Nyhan disagree, at least to an extent, highlights what a tricky issue this is. Nothing has yet been proven to convince vaccine skeptics to fall in with modern science. There is, however, something of a consensus about what’s most likely to work: pro-vaccine messages coming from local, trusted sources, with pediatricians probably the best and most commonly cited example. In the quiet of a pediatrician’s office, there’s some reason to be hopeful that a parent’s concerns about vaccines can be calmly addressed, empathized with, and assuaged.
If instead we couch this debate in terms of big, ostentatious arguments over who is and isn’t worthy of shame, however, there’s a chance we’ll only make things worse.