It doesn’t matter how many works of Ayn Rand you throw at communicable diseases—they will always be communist by nature.
For decades, advancements in modern medicine have been slowly chipping away at some of humanity’s most brutal diseases. On October 26, 1977, for example, the last naturally occurring case of smallpox was diagnosed, and today the disease is dead. 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 continually viewed with suspicion. The measles outbreak that began at Disneyland last December, caused by unvaccinated children, was tragic and foolish, and we should applaud the swift action of California legislators to eliminate personal exemptions to getting children who attend public school vaccinated. However, the passing of SB 277 means that the culture war over vaccinations is far from over. Immediately after Governor Jerry Brown signed the bill into law, Republican politician Tim Donnelly filed a referendum to overturn it. Donnelly proudly acknowledges that he is part of the extreme Tea Party wing of his party and is quite content trending in the political waters where pseudoscience, conspiracy theories, and a myopic philosophy of unadulterated self-interests overlap.
Indeed, anti-vaccination fears have a long and complex history in the United States, and this history reveals much about America’s cultural fetish for extreme individualism.
Today he’s no more than a historical footnote, but in his own day the 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, he 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. Although Jacobson would often invoke religious and medical reasons for refusing to be 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 took priority over community concerns.
Jacobson took his case all the way to the US 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 that the Supreme Court would have none of it. In a 7-2 decision, it decided that the Constitution did grant governments the right to require citizens to be vaccinated. Writing for the majority, Justice John Marshall Harlan concluded, “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.”
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 doesn’t matter how many works of Ayn Rand you throw at communicable diseases—they will always be communist by nature; diseases do not 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 exempt from mandatory vaccinations based on medical reasons, but he denied that this applied to Jacobson; all of the evidence 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. Today, its so-called “science” is little more than an insular echo chamber. There is a wide scientific consensus on the necessity for mandatory vaccination. A recent poll of the American Academy for the Advancement of Science members found that a triumphant 86 percent favored mandatory vaccinations. 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 thirty 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 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 celebrities like Dr. Mehmet Oz, Dr. Joe Mercola, and the much-adored Dr. William Sears. When health care markets are deregulated, snake oil salespeople 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.
Additionally, 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’s a reason why the recent measles outbreak happened to people vacationing at Disneyland, as opposed to traditionally under-vaccinated populations located in poor and immigrant communities. Communities of real poverty simply don’t have time to be flippant about lifesaving medical advice. When a malaria outbreak struck the US, 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 much deeper than the role of science in the public sphere. It speaks to what set of ethics Americans want to live by. We can choose an irrational, conspiracy-filled world, in which case we can’t trust anyone. Being intellectually myopic and emotionally distant are forms of protection, if not ways of life, whereby we are so powerless and isolated that personal consumption issues are the only thing we can control. Or, we can choose to 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 choices are presented in such naked terms, our decision should be obvious. Then again, so is the decision to be vaccinated.