The present is a fragile thing. Without constant vigilance, it can be easily devoured by the past. For decades, advancements in modern medicine have been slowly chipping away at some of humanity’s most brutal diseases. On October 26, 1977, the last naturally occurring case of smallpox was diagnosed. Today, the disease is dead. Polio is on the way out. In 1988, when the World Health Organization launched its Polio Eradication Initiative, over 350,000 people were paralyzed by polio each year. By 2013, that number had dropped to 416 cases. The destruction of both these diseases would not have been possible without vaccines. Smallpox had plagued humanity for over 10,000 years. After the first vaccine against it was developed by Dr. Edward Jenner, it took less than 200 years to eradicate it. Without a doubt, vaccines have been the most effective form of preventable medicine in history.
Despite these remarkable breakthroughs, vaccines have always been controversial. Competing medical modalities, whether faith-based or ideological, have always sought to overthrow the achievements of science-based medicine, and, for some reason, vaccinations have been viewed with suspicion. The recent measles outbreak in Disneyland caused by unvaccinated children is tragic and foolish, but not new. Anti-vaccination fears have a long and complex history in the United States, and this history reveals a lot about America’s cultural fetish for extreme individualism.
Today, he is relegated to a historical footnote, but in his own day English social reformer and spiritualist William Tebb was a minor celebrity. As a tireless campaigner for many progressive causes, Tebb’s influence was felt on both sides of the Atlantic. Much of his activism is admirable, but what he is best known for—his tirades against modern medicine, vaccines specifically—is not. Armed with a mountain of anti-vaccination literature and a radical liberal philosophy, Webb led the struggle against “vaccinal tyranny” throughout the nineteenth century. In focused, but melodramatic language, Tebb compared mandatory vaccination laws to the Fugitive Slave Act, and, in a manner that both diminished black suffering and exaggerated white problems, would insinuate that the “tyranny” of modern medicine was just as oppressive as the Antebellum South.
Tebb’s influence on the anti-vaccination movement in the United States and Europe cannot be understated. His efforts came to real political fruition in the United States in 1902, when Henning Jacobson, a Swedish minister, refused to vaccinate himself and his family during a smallpox epidemic in Cambridge, Massachusetts. While Jacobson would often invoke religious and medical reasons for refusing to get vaccinated, the crux of his argument rested on notions of individual liberty. According to Jacobson, the US government did not possess the power to mandate vaccinations. Individual rights should take priority over community concerns.
Jacobson took his case all the way to the Supreme Court. Finally, the anti-vaccination movement would get the chance it always wanted to expose the horrors of “vaccinal tyranny.” The only problem was the Supreme Court would have none of it. In a 7-2 decision, the Supreme Court decided that the Constitution did grant governments the right to require citizens to get vaccinated. Writing for the majority, Justice John Marshall Harlan concluded that “the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint. There are manifold restraints to which every person is necessarily subject for the common good.”
Justice Harlan’s focus on the “common good” exposed two forms of self-centeredness inherent within the anti-vaccination movement. The first is a medical self-centeredness. It does not matter how many works of Ayn Rand you throw at communicable diseases; they will always be communist by nature. Diseases don’t infect individuals, they infect whole populations, and those who suffer most from those infections are usually the weakest within the group. In this way, refusing to get vaccinated is qualitatively different from other forms of medical intervention. If I ignore my doctor’s advice regarding cancer treatment, it does not mean everyone around me is more likely to get cancer, but when it comes to measles, mumps, and rubella, that is exactly what it means.
The second is an intellectual self-centeredness. Justice Harlan was willing to concede that certain individuals should be exempted from mandatory vaccinations based on medical reasons, but he denied that this applied to Jacobson; all the evidence that he put forward on the dangers of the smallpox vaccine suffered from “incompetency or immateriality.” In other words, the Supreme Court believed Jacobson was using junk science. Since that time, vaccines have become even safer and more effective, and the science of the anti-vaccination movement has become even junkier. There is wide a scientific consensus on the necessity for mandatory vaccination. A recent poll of the America Academy for the Advancement of Science members found that a triumphant 86% favored mandatory vaccinations. In order to discount this broad scientific consensus, the anti-vaccination movement has been forced to engage in desperate forms of gainsaying. Rather than let their view be challenged by the evidence, they have attempted to turn the tables on scientists by depicting the dismissing of their bogus ideas as an elaborate conspiracy.
The self-centeredness at the core of the anti-vaccination movement explains much of its rapid expansion in recent years. For the past 30 years, the American zeitgeist has been held hostage to a cult of extreme individualism. Nearly everywhere we look—culture, politics, and especially economics—sole individuals are assumed to take priority over group welfare. Health care has not escaped this phenomenon. The drive to deregulate health care markets in the United States has not only created monopolistic hospitals and exorbitant drug prices, but has also generated an entire industry of “alternative” medicine practitioners and products that seeks the imprimatur of science without the pesky public oversight or professional ethics. In just a few decades, “alternative” medicine has grown from a few fringe quacks into a $34 billion industry. Nearly all of the major anti-vaccination doctors who stoke the fears of “big pharma” turn around and sell people ineffective supplements and herbal remedies. This includes such celebrities as Dr. Mehmet Oz, Dr. Joe Mercola, and the much adored Dr. William Sears. When health care markets are deregulated, snake oil salesmen come back with a vengeance, and they have become quite sophisticated at selling people’s own anti-corporate attitudes right back to them for a considerable margin.
In addition, the political wing of “alternative” medicine, the Health Freedom Movement, has sought to transform American health care into a wellness bazaar. Informed consent, transparent advertising, and reasonable regulations are thrown out the window. Patients are no longer thought of as patients, but as consumers. Whatever they want to do regarding their health, no matter how absurd or dangerous, providers should offer. The only real requirement is if something can be marketed as being sufficiently “natural.” If so, its benefits are considered self-evident, no rigorous scientific testing required. Despite the criticisms of scientific “materialism” so often heard in “alternative” medicine circles, it turns out that medical mysticism and free market capitalism make very comfortable bedfellows.
Not surprisingly, this movement has its greatest appeal among people of privilege. Statistics from the United States’ own Center for Complementary and Alternative Medicine show that interest in “alternative” medicine actually increases with wealth and education. Only people of relative privilege can afford to dabble in medical absurdities without having to fear any serious consequences. There is a reason why the recent measles outbreak happened to people vacationing in Disneyland, as opposed to traditionally under vaccinated populations located in poor and immigrant communities. Communities of real poverty do not have time to be flippant about lifesaving medical advice. When a malaria outbreak struck America, the great anti-vaccination agitator William Tebb, being a successful middle class entrepreneur, escaped infection by moving his family back to England. Others were not so lucky.
The great vaccine debates, like global warming and evolution, do represent a type of culture war in the United States. However, the issues go a lot deeper than the role of science in the public sphere. It speaks to what set of ethics that Americans want to live by. On one hand, we can choose an irrational conspiracy filled world. In this case, we can’t trust anyone. Being intellectually myopic and emotionally distant are forms of protection, if not ways of life. We are so powerless and isolated that personal consumption issues are the only thing we can control. On the other hand, we can live in a world where we face harsh realities as a community. We understand that scientific literacy and social solidarity are vital to creating a good life for all, and that the most privileged among us must be willing to accept certain limitations on their freedom if it means that the weakest among us will be lifted up. When the decision is presented in such naked terms, the answer of what we should do should be fairly obvious, but then again, so is the decision to go get vaccinated.
Marco Rosaire Rossi, a graduate of the University for Peace in Costa Rica, is a resident of Olympia.