Because I said so: The vaccination debate and a waning trust in science

trust

Written By Dr. Erika E. Alexander

A few weeks ago, I opened my Facebook page to find a war in progress. Shared posts from CNN, Time Magazine, the New York Times, and a wide variety of blogs about vaccination and the “anti-vaxxer” movement littered my timeline.  Each post by members of my highly educated, scientist-heavy friend list was accompanied by the poster’s vehement condemnation of the anti-vaccination movement in Facebook status form.  Although spirited, this war of words appeared to be one-sided, in that I generally only saw one type of argument: Vaccinate your child because SCIENCE says so.  But is “Science says so” a valid argument in this day and age?

This vaccination debate has been going on for over a decade now, but has most recently been brought back into the public eye due to an outbreak of measles traced back to a particularly sensational place: Disneyland, USA .  That a disease considered eradicated in the United States since 2000 could attempt a comeback in what is affectionately known as “the happiest place on earth” horrifies many, and for good reason. Since January 1 of this year, over 150 cases of measles have been reported in 17 different states, according to the Centers for Disease Control and Prevention (CDC). These numbers are reported from 3 separate outbreaks in California, Illinois and Nevada, with California having the largest reported outbreak of the three.  The CDC also reports that the majority of people (read: children) who fell ill were unvaccinated.

The anti-vaccination movement (also known as the  “anti-vaxxer” movement) has also been in the news of late, because of this most recent outbreak and the idea that unvaccinated children are its cause. Many attribute the beginning of the anti-vaccination movement to a 1998 study done in the UK by Andrew Wakefield, which drew a link between the MMR (measles, mumps, and rubella) vaccine and increased numbers of autism spectrum disorders in vaccinated children (Read more here).  The story was immediately picked up by the media, and inspired panic among parents worldwide.  Vaccination rates in the UK and Ireland dropped significantly, while rates of measles and mumps skyrocketed, which of course, resulted in deaths and severe injuries.

Numerous studies have since discounted Wakefield’s link between MMR vaccine and autism, and the article was retracted due to fraud and “improper research practices” (see here). Wakefield was eventually found guilty of professional misconduct by the General Medical Council and banned from practicing as a doctor in the UK, as a result of this fraudulent work (here), although he still does speaking engagements in support of his work. His story is used in ethical research classes across the nation to illustrate the destructive power of bad science and the dangers of media misinterpretation of science. However, the damage to the public confidence in vaccines appears to be done. Celebrities like Jenny McCarthy, Donald Trump and Alicia Silverstone continue to be vocal in their support of the anti-vaccination movement, some even citing the now-debunked Wakefield study and “personal experience”. Meanwhile, measles is out here becoming a “thing”.  Again.

As I think about all of this, what comes to mind is something that I tell my students:  Science is based on trust.  I explain to them that the lifeblood of science is trust, and that without trust, research and even Science as we know it would collapse into a pile of spreadsheets and pipet tips.

Trust from one scientist to another: I trust that you will complete this portion of our experiment correctly and efficiently, and that you will not fabricate or change data. Trust between scientific colleagues/community members: I trust that when you publish your work and interpret the findings, that you are making these assertions based on your trustworthy (and expert) opinions. Trust between the government and scientist: I trust that when I give you this multi-million dollar grant, that you will produce high-quality, tangible and useful work in return. And finally, trust between the general public and science/scientists:  I trust that you as a scientist are very intelligent/an expert, and that what you tell me about the world is important and correct.  (As a note, polls show that although the perceived contribution of scientists to society as a whole is much lower than say members of the military and teachers, they are rated by the public as one of the most highly regarded professions; lawyers and politicians are the least esteemed. (See here)  However, other polls have found that while Americans view scientists as highly competent individuals, they are also not trusted, possibly because they are not seen as warm or friendly. (here)  Interestingly enough, the PRC study also found that public esteem of scientists has actually gone down between 2009 and 2013, although it’s unclear whether that is statistically significant. Clearly science has a complicated relationship with society.)

Trust is the reason I get so worked up about the anti-vaccination movement or any movement that is based on anti-science or anti-medicine rhetoric. I should state here that I believe in vaccination of children, and I believe that great science is one of the hallmarks of a thriving society.  But I also know that not every published paper is good science. I know that not every scientist has the best interest of the general public (or even science) at heart. And not only that, I know that biomedical jargon and government mandates are no match for perfectly tanned, rich celebrities and good old-fashioned fear-mongering.

Examine the trajectory of the public opinion on climate change, for example. It wasn’t so long ago that many people simply thought global warming was an incendiary attempt by Al Gore to sell more books.  Although the current public sentiment appears to agree with the concrete scientific evidence for climate change, we still have Americans lawmakers, who not only distrust it, but actively fight against the idea that humans are negatively impacting our planet. So how is the public to know whom to trust?  Or should they trust anyone at all?

Scientists understand the basic tenet of success in research is this: trust no one, especially when he comes bearing gifts of interpretation perfectly aligned with his own agenda and no data to back it up. We poke and prod at arguments and data, mull over what we are told, and decide whether it makes sense to believe it, as we were trained to do.  In this way, we can feel confident in our ability to maintain trust between colleagues, funding organizations, and institutions, and to root out those among us who are not worthy of our confidence. The vast majority of the population does not have this training, thus many simply rely on what the media, their personal experiences, or their favorite celebrity to tell them what to do. In addition, there have been many past and present instances of scientists exhibiting untrustworthy behavior, without the globally known repercussions seen in the Wakefield case. Can we truly blame the public for the waning trust in science and scientists? Should we really be surprised when measles outbreaks begin at amusement parks or politicians pass a bill that ignores climate change? Should we be asking the general public to become more science saavy?  Or should we be asking how science can become more trustworthy?

 

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