Overwhelmingly, Americans favor vaccination. If you have any memory or even knowledge of communicable disease outbreaks and the toll they took on people — barely a whisper ago in the long expiration of history — this shouldn’t be surprising. Moreover, we can see what life is like for the unvaccinated in the developing world: capricious, cruel and often brief.
So there is something almost ecstatically rational in the findings of a new survey, conducted by Harris International for the Center for Health and Risk Communication at George Mason University, which shows that 86 percent of Americans favor vaccination (the sample was a nationwide cross-section of 1,003 adults aged 18 and over).
Despite a 15-year crusade against vaccination by activist groups, midwifed into public consciousness by Andrew Wakefield and his flawed measles-mumps- rubella vaccine/autism thesis, “Scary Movie” actress Jenny McCarthy, media mogul Arianna Huffington and her stable of anti-vaccine writers at the Huffington Post, Robert F. Kennedy Jr.’s conspiracy theorizing in Rolling Stone and Salon, and numerous others, the majority of Americans still support science over pseudoscience.
Indeed, as the survey breaks down attitudes toward vaccination, it turns out that even more people — 91 percent of respondents — believe that every child has a right to be vaccinated, 89 percent support the federal government’s Vaccines for Children Program, which pays for immunization when parents can’t, and 86 percent believe the benefits of immunizing children are worth the costs.
Most interesting, perhaps, is the finding that many respondents are just as supportive of vaccination for adults as for children, or believe that both should be considered equally important, which strikes me as a progressive understanding about the nature of transmission and the problem of waning immunity.
Consider the outbreak of whooping cough (pertussis) in California last year, which claimed the lives of 11 babies in Marin County, one of the wealthiest counties in the U.S. Waning immunity in children and adults combined with Marin’s high rate of personal exemption from vaccination (about 8 percent) appears to have created a potent reservoir for the disease. Research from the Netherlands into how pertussis is transmitted to children shows that mothers were almost as likely to be a vector as siblings, so vaccination can be just as important among those at low risk from disease as those whose risk is high.
But the endorsement of mainstream (i.e., science-based) medicine by the American public is also remarkable in a society that has entered what might be thought of as a post-Enlightenment state of skepticism about all claims to knowledge, especially knowledge that seems to benefit industry.
As the late philosopher and anthropologist Ernest Gellner observed, this attitude has been marked by three phases: puzzlement (“How do we know anything?”), amazement (“How is it that we know so much?”) and finally fear — a generalized suspicion of knowledge, focused on the way it is “constructed” by experts, keeps changing and is unchallengeable if you aren’t a member of the expert class.
As one sociologist of science put it to me, the days of scientists and doctors telling people what to believe are over. Such claims to authority are no longer considered legitimate; the best that mainstream medicine can hope for is a democratic collaboration with the public.
In this case, however, the public has listened to the mainstream medical community and believes in vaccination.
The bright cloud does have a dark lining. When a recent Thomson Reuters-NPR survey asked about specific fears related to the safety of vaccines, confidence in mainstream medicine seemed to wane, with one in five respondents believing that vaccination can cause autism. This may reflect the negative framing of the survey questions; the Harris poll shows what happens when you frame the issue differently. But given that MMR vaccination rates are around 90 percent, actual practice seems to reflect the overall support found by Harris.
It could be that while some people are worried about possible side effects of vaccination, they are worried more by not getting their kids vaccinated, leaving the hard core of anti-vaccine believers, totaling 8 to 10 percent of the public.
But this small percentage of refuseniks is still a potentially huge public health problem. Robust herd immunity for measles requires a 95 percent vaccination rate among children. Less than this presents a simple (but deadly) mathematical opportunity for disease to spread.
Even with a 95 percent immunization rate, San Diego had its largest outbreak of measles in almost two decades after an intentionally unvaccinated 8-year-old boy picked up the disease in Switzerland and transmitted it to hundreds of people upon his return to the U.S. in 2008. Eleven children got sick, eight of whom were unvaccinated because their parents — all wealthy and highly educated — believed in the protective power of “natural lifestyles.”
Forty-eight babies had to be quarantined because they were too young to be vaccinated. San Diego was lucky, thanks to a swift and effective response from public health authorities, but the outbreak demonstrates that even though most Americans support vaccination, the many are still put at risk by the fears of the few.
So there is something almost ecstatically rational in the findings of a new survey, conducted by Harris International for the Center for Health and Risk Communication at George Mason University, which shows that 86 percent of Americans favor vaccination (the sample was a nationwide cross-section of 1,003 adults aged 18 and over).
Despite a 15-year crusade against vaccination by activist groups, midwifed into public consciousness by Andrew Wakefield and his flawed measles-mumps- rubella vaccine/autism thesis, “Scary Movie” actress Jenny McCarthy, media mogul Arianna Huffington and her stable of anti-vaccine writers at the Huffington Post, Robert F. Kennedy Jr.’s conspiracy theorizing in Rolling Stone and Salon, and numerous others, the majority of Americans still support science over pseudoscience.
Indeed, as the survey breaks down attitudes toward vaccination, it turns out that even more people — 91 percent of respondents — believe that every child has a right to be vaccinated, 89 percent support the federal government’s Vaccines for Children Program, which pays for immunization when parents can’t, and 86 percent believe the benefits of immunizing children are worth the costs.
Most interesting, perhaps, is the finding that many respondents are just as supportive of vaccination for adults as for children, or believe that both should be considered equally important, which strikes me as a progressive understanding about the nature of transmission and the problem of waning immunity.
Consider the outbreak of whooping cough (pertussis) in California last year, which claimed the lives of 11 babies in Marin County, one of the wealthiest counties in the U.S. Waning immunity in children and adults combined with Marin’s high rate of personal exemption from vaccination (about 8 percent) appears to have created a potent reservoir for the disease. Research from the Netherlands into how pertussis is transmitted to children shows that mothers were almost as likely to be a vector as siblings, so vaccination can be just as important among those at low risk from disease as those whose risk is high.
But the endorsement of mainstream (i.e., science-based) medicine by the American public is also remarkable in a society that has entered what might be thought of as a post-Enlightenment state of skepticism about all claims to knowledge, especially knowledge that seems to benefit industry.
As the late philosopher and anthropologist Ernest Gellner observed, this attitude has been marked by three phases: puzzlement (“How do we know anything?”), amazement (“How is it that we know so much?”) and finally fear — a generalized suspicion of knowledge, focused on the way it is “constructed” by experts, keeps changing and is unchallengeable if you aren’t a member of the expert class.
As one sociologist of science put it to me, the days of scientists and doctors telling people what to believe are over. Such claims to authority are no longer considered legitimate; the best that mainstream medicine can hope for is a democratic collaboration with the public.
In this case, however, the public has listened to the mainstream medical community and believes in vaccination.
The bright cloud does have a dark lining. When a recent Thomson Reuters-NPR survey asked about specific fears related to the safety of vaccines, confidence in mainstream medicine seemed to wane, with one in five respondents believing that vaccination can cause autism. This may reflect the negative framing of the survey questions; the Harris poll shows what happens when you frame the issue differently. But given that MMR vaccination rates are around 90 percent, actual practice seems to reflect the overall support found by Harris.
It could be that while some people are worried about possible side effects of vaccination, they are worried more by not getting their kids vaccinated, leaving the hard core of anti-vaccine believers, totaling 8 to 10 percent of the public.
But this small percentage of refuseniks is still a potentially huge public health problem. Robust herd immunity for measles requires a 95 percent vaccination rate among children. Less than this presents a simple (but deadly) mathematical opportunity for disease to spread.
Even with a 95 percent immunization rate, San Diego had its largest outbreak of measles in almost two decades after an intentionally unvaccinated 8-year-old boy picked up the disease in Switzerland and transmitted it to hundreds of people upon his return to the U.S. in 2008. Eleven children got sick, eight of whom were unvaccinated because their parents — all wealthy and highly educated — believed in the protective power of “natural lifestyles.”
Forty-eight babies had to be quarantined because they were too young to be vaccinated. San Diego was lucky, thanks to a swift and effective response from public health authorities, but the outbreak demonstrates that even though most Americans support vaccination, the many are still put at risk by the fears of the few.
