This week put to rest a significant part of the anti-vaccine movement’s claim to scientific legitimacy. A paper purporting to show a link between the MMR (measles, mumps, and rubella) vaccine and autism rates was retracted by The Lancet. The journal, which published the 1998 paper, based the decision on a finding by a British medical panel that one author (Andrew Wakefield) had violated certain human experimentation regulations and had misreported how the data was gathered. As Chris Mooney observes, this follows a string of other reviews of the paper which found its conclusions unwarranted by the data and unsupported by attempts to replicate the study. A 2004 review by the Congressionally-chartered Institute of Medicine found that the paper was “uninformative with respect to causality” and that, in general, “the evidence favors rejection of a causal relationship between MMR vaccine and autism.”
This has been clear for some time (just ask Orac), and the continued efforts to discourage vaccination based on the study can clearly not be ascribed to any scientific basis. Like creationism, global warming denial, stem cell opposition, and anti-GMO sentiments, this is a cultural and political battle being confusingly fought on scientific turf. As such, the debunking of this and any other supposed scientific basis for opposing vaccines does not ultimately dissuade anti-vaccine activists from their work. And public health suffers as a result.
This is similar to the situation in the creationism wars. We spend a lot of time on blogs and in books and in the occasional debate arguing about fossils and genes and homologies, but none of that will ever convince someone wholeheartedly committed to creationism. No one becomes that sort of creationist on the basis of the science. They become a creationist of that sort because of how they see religion, and how they think that relates to science.
This is why I think Orac is right to object to the conclusion to Chris’s article on the vaccine result. He notes that the anti-vaxxers have already integrated this paper’s retraction into their paranoid worldview, but then he writes:
I believe we need some real attempts at bridge-building between medical institutions—which, let’s admit it, can often seem remote and haughty—and the leaders of the anti-vaccination movement. We need to get people in a room and try to get them to agree about something—anything. We need to encourage moderation, and break down a polarized situation in which the anti-vaccine crowd essentially rejects modern medical research based on the equivalent of conspiracy theory thinking, even as mainstream doctors just shake their heads at these advocates’ scientific cluelessness. Vaccine skepticism is turning into one of the largest and most threatening anti-science movements of modern times. Watching it grow, we should be very, very worried—and should not assume for a moment that the voice of scientific reason, in the form of new studies or the debunking of old, misleading ones, will make it go away.
As Orac observes, “scientists have been trying to reach out and build bridges to leaders of the anti-vaccine movement for years, if not decades. It hasn’t worked.” He cites several examples where anti-vaxxers were even invited to take part in the design of experiments, only to turn around and attack the studies when they failed to reach the pre-determined conclusion.
But Orac goes wrong when he writes, “Chris is profoundly misguided in his apparent belief that any amount of ‘bridge building’ will bring anti-vaccine activists around.” Just as there are gradations within creationism, anti-vaxx has its gradations. Duane Gish will never change his mind. Changing Glenn Morton’s mind took intense effort, and was not resolved by his awareness of evolutionary science, but his discovery of a suitable theology which could accommodate evolution.
But Duane Gish isn’t the target of pro-evolution messages, and neither was the young Glenn Morton. The target is that third of the public which simply isn’t aware of what evolution is, and of the range of theological responses to evolution. So the goal is to build bridges through the religious institutions they trust, so that they’ll even be ready to hear the scientific message, and then to build bridges through science education, so they see that evolution is good and reliable science and isn’t threatening in the ways they’ve been told. Some of the groups one builds bridges to in that process are creationist in some sense. They might be a Methodist church group which believes God created the world, but is open to the idea that science can explain the way God’s plan unfolded. That openness is what allows a bridge to be built, and commerce across that bridge ultimately yields dividends to the community of scientists and to the group being reached out to.
I haven’t studied the anti-vaxx movement carefully enough to know what the sticking point is for anti-vaxxers, but I can guess. It’s not (entirely) a Luddite movement, any more than creationists are Luddites. They want to control technology and science because science and technology are taking on an ever greater role in our society, and people feel like they are losing control of their lives as a result. Creationism grew out of that same tension in the late 19th century, and came back with a vengeance in the 1960s for similar reasons. Anti-vaxx, anti-global warming, and anti-evolution movements today are rooted in the same fears of anonymous scientists in lab coats (and mounted on ivory towers) controlling our bodies, our economies, and other aspects of social policy.
The solution is surely outreach. But not outreach to the committed opponents. Such outreach rarely serves any benefit, in part because both sides are talking past one another. That’s a recipe for a shouting match, but not for dialog. The target for dialog is the middle ground, and that’s where the bridges need to be built. The fear driving anti-vaxx and other denialist movements is bigger than those movements, and it can be addressed through an open and thoughtful interaction between scientists and the public. I think the long-term effect of CRUhack will be beneficial in that sense, as it will force scientists to abandon some of their traditional insularity.
(I wrote this on somewhat of the fly, and may return to it and add links inter alia and revise some of this. Suggestions on where those links should be placed, and which passages are ambiguous are, as always, welcome.)