The real debate over vaccinations concerns whom one is going to trust

[KingCharlemagne]

By way of explanation, my wife is (or used to be) a fan of Oprah Winfrey and tells me that Oprah at one point featured Jenny McCarthy (spouse of Jim Carrey) who popularized anti-vaccination ideas for a broad audience. (As far as my wife knows, although McCarthy has apparently recanted somewhat, Oprah never repudiated McCarthy.) But a lot of people trusted (and still trust) Oprah, maybe as many or more than trust official U.S. government pronouncements. So when Oprah gave a broad platform to an anti-vaccination stand put forward by someone with credibility our celebrity culture confers, it struck at the heart of established science.

I was also reminded yesterday that various demographics in the U.S. may have much legitimate reason to be suspicious of official government pronouncements about the public health. I'm referring to the Tuskegee Syphilis Experiments, carried out by the U.S. Public Health Service from 1932-72 on an unsuspecting and trusting population of black men.

The Tuskegee syphilis experiment (/tʌsˈkiːɡiː/) was an infamous clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to study the natural progression of untreated syphilis in rural African American men who thought they were receiving free health care from the U.S. government.

http://en.wikipedia.org/wiki/Tuskegee_syphilis_experiment

I know that the U.S. has since recognized the wrong it propagated at Tuskegee and attempted to do some acts of penance for it, but I mention it because it seems to me that the vaccination problem being seen in the measles outbreak is as much a matter of trust or loss thereof as it is of willful evil or selfishness.

Government officials should be concerned with trying to restore the public trust in science and scientists and not so much with trying to debate the merits of the science of vaccines. Once trust has been violated or the public's doubt has been engineered, the first order of business I think is not going full-tilt Spock in reaction but instead engaging in non-judgmental dialogue with the objective to restore trust. The people need to be able to trust their government and trust their public officials. Without trust, the land is made fertile for doubt and for the types of behaviors that are now manifesting with the measles outbreak.

Here's my bottom line: the Scientific Method -- observation, hypothesis, experiment, conclusion, new hypothesis -- is the best way to determine scientific truth. The Scientific Method does not observe politics. The Scientific Method has conclusively proven the indisputable values of vaccination for the public. So the government and all scientists should be attempting to educate the people about the non-partisan quality of the Scientific Method and how powerful and rigorous a tool it is and not screeching at people about how stupid or uneducated they are. The first thing that needs to happen is a broad rebirth of trust in science and the scientific community. This may be a tall order for a culture that has given us Tuskegee, 3 Mile Island and Love Canal, but I think it is really important.

[jollyreaper2112]

1. a touch of skepticism is good

Too much skepticism, skepticism without continued reevaluation, is not good.

The problem people face is few of us are subject area experts in the big questions. Few of us are equipped to assess. We go to our doctor, we go to our mechanic, we are basing our judgement of what they say professionally on our gut opinion of them as an authority figure. We are taking what they say on faith.

Put it this way: you ask a physicist to prove relativity to you and he provides the math, there could be the equivalent of a 2+2=5 error in there and you'd never know. For crazy physics, the best thing that can be done is make predictions and see the results. We've seen gravity wells bend light. We've measured time dilation with atomic clocks in orbit. Without understanding relativity, our GPS devices wouldn't work. I don't have an in-depth understanding of aeronautics, jet turbine design, metallurgy or any of that. But I have seen a 200 ton aircraft lift off the ground just like they said it would. I can believe what I see. The doctors say the vaccination works and the rate of deaths have gone down. They do get things wrong. When we had less women using midwives and giving birth in hospitals rather than at home, mortality figures skyrocketed. Doctors were slow to embrace sanitation and the germ theory of disease. But eventually they had to concede to evidence.

[KingCharlemagne]

3. Thanks for responding. I suppose I start from the assumption that most parents do not

wish ill on their children. Nor do they wish ill on anyone else's children. (Yeah, I know there are a few Republican sociopaths out there who may be the exception that proves that rule.) But if you start by giving people credit for their good intentions (as I do in this case), you are left with a couple mutually-reinforcing ideas:

1) a lot of people do not understand science, but they should

and

2) a lot of people do not trust scientists, but they should.

So my thread is more concerned with healing that breach in the public trust that Oprah's show and Tuskegee explain and exmplify. It's a tall order because the same Scientific Method that gave us the polio vaccine also gave us Hiroshima. But the notion that an experiment's results can be replicated and replicated again -- one of the by-products of the logic of the Scientific Method -- should offer a way to rebuild trust. IOW, except maybe at the Quantum level where few of us reside, a given experiment will always produce the same results, whether that experiment is conducted by a Republican, a Democrat or a raging Commie. If that doesn't establish grounds for trust, I don't know what does.

[jollyreaper2112]

7. yup

A lot of ill has been done by people in white coats. As you said, the scientific method is amoral, apolitical, irreligious. It simply is. What we do with it is up to us.

Trust is everything. Our entire lives are based on trust. You trust your spouse isn't going to cheat on you the moment you turn your back. You trust your house won't be robbed when you leave for work. You trust your boss will pay you on payday, you don't need him to cash you out at the end of every day. You trust the police will keep you safe, that the other driver will stay in his lane. We take so many things for granted. Start breaking the trust and society falls to pieces in an instant. Fear and superstition will take root.

[YarnAddict]

2. There are other reasons . . .

Diethylstilberol (DES) was prescribed to pregnant women to prevent pregnancy loss and complications. It was in use for this purpose from 1940--1971. In 1971 it was discovered that it causes vaginal cancer in the daughters of the women who used it. Thirty years, and who knows how many women trusted their physicians, trusted the AMA, trusted the FDA. They are now finding that it also may affect the fertility of the granddaughters of the women who took it.

http://en.wikipedia.org/wiki/Diethylstilbestrol

Thalidomide. Although I don't believe thalidomide was approved by the US FDA, it was prescribed worldwide, and we all know how that ended up.

Some of these vaccines have been around for many, many years, and some are relatively recent. You can draw distinctions between vaccines and the medications I described above, but you really can't convince most people that the FDA, AMA, and their own physicians know everything.

[Leith]

8. They Don't Know Everything

No human being of any degree of expertise is 100% infallible.

But doctors know a hell of a lot more about these things than we do, as do just about every other professional that we pay to provide services. In our complicated way of life, we need to rely on those who have specialized knowledge to get things done.

We don't do that with other professions:

Old buildings have asbestos. Does that mean that builders today don't know how to build so we have to construct our own houses?

Car manufacturers often have recalls. How many people refuse to own a car because of that?

A fastfood place a couple states over had a food poisoning incident so you will never eat in a restaurant again?


Given the choice of taking my doctor's advice or listening to a daytime TV personality on what is the best treatment for health, I'll take a competent doctor every time.

[KingCharlemagne]

13. 'Competent doctor' - there's the rub. There were a couple stories out here that certain

affluent members of the booboisie were shopping around for physicians who would give them permission not to vaccinate. (Again, my wife saw these stories and mentioned them to me, so I don't have links at hand.) I find it absolutely ludicrous that any physician -- save maybe those who graduate from Liberty U. -- would go along with an anti-vaccination regimen (for healthy children whose immune systmes aren't compromised or suppressed). But this was apparently happening up around Santa Barbara and north of San Francisco.

These doctors may be outliers, but they service the confirmation bias of people predisposed to distrust the estalbishment and affluent enough to have the means to get away with it.

I like your mentality though. Pretty much suits my own.

[emulatorloo]

4. MSM has mainstreamed whack jobs (teabags etc). Republicans lie about Science. Fox lies

and fearmongers. I think you underestimate how much ignorance and distrust of science that these groups have promoted

[KingCharlemagne]

6. Or maybe I give people too much credit for their good intentions, i.e., not wishing

harm to their children. Some of the distrust in science has been earned by scientists themselves, I think. But there's clearly a crisis of trust when the overwhelming majority of climate scientists concur on the issue of anthropocentric global climate change and the majority party in the Senate -- at least one or two of whom make claims to a scientific background -- repudiate that position en masse.

I think what I'm trying to get at is that the vaccination issue right now is reflective of a broader breakdown in institutional trust and a symptom (npi) of a much deeper problem in our society. My own hypothesis (about the failure of trust and need to rebuild it) is somewhat tentative itself. I put it out there so that DU could test and challenge it and maybe someone here will take my hypothesis and build a better one.

[emulatorloo]

11. Fair enough. But take into acct how Fox,RNC etc have poisoned the well

24/7 lies/conspiracy theories about Obama and 24/7 promotion and pandering to ignorant science deniers.

All in the name of profit and power

See Hannity: "I'm Not Trusting President Obama To Tell Me Whether To Vaccinate My Kids"
http://mediamatters.org/video/2015/02/02/hannity-im-not-trusting-president-obama-to-tell/202389

[KingCharlemagne]

14. The weird thing is, I can't disagree with you one bit. "All in the name of profit and

power" explains so much, but it may also explain people's skepticism about vaccinations also, because they don't understand how cost effective vaccination is compared to treating the illness those vaccines prevent but only see a privately-owned pharmaceutical sector enriching itself at the trough of a too-pliable government and health care economy.

[Avalux]

5. Here's the problem with your bottom line.

I've dedicated my life to clinical research, mostly infectious diseases. Some people don't have the ability to comprehend scientific method and the rigorous testing that occurs for every vaccine and drug. I'm sorry if I'm going down the stupidity road, but if a person just can't understand what I'm talking about and engage in critical thinking, it means nothing to them and they discount it. That void is filled with an irrational fear, propagated by a few people with microphones who prey on that fear.

Trust has nothing to do with it. It's about KNOWLEDGE, being able to understand and make an informed decision. It's completely idiotic to think governments and drug companies aren't going to make mistakes.

Our kids need to learn science. That could change things in coming generations. Not anytime soon though.

[KingCharlemagne]

9. Back in the Middle Ages, most people could not understand the vagaries of Scholastic dispute, but

they trusted the institutions of the Roman Catholic Church, as personified by the parish priest and local bishopric.

If we could simply get people to understand the difference(s) between science and superstition, we'd be doing ourselves a giant favor. Most people will claim they know and understand the difference. But most people, I think, would be ill pressed to define the Scientific Method. (My wife has experimented on her FB list of about 1,000 folks and her results tend to confirm my statement.)

BTW, kudos to you for a life dedicated to clinical research. A long time ago, in a galaxy far, far away, I faced a choice after taking Genetics and doing really well at it as to whether to pursue a career in life sciences or continue on in humanities and social sciences. I chose the latter but have always chided myself for not taking a few more steps down that road not taken. Oh well, maybe in the next life (or one of the alternate universes

[jollyreaper2112]

12. yup

I do think that is the level most people operate on, a shockingly simplistic understanding of the world and a willingness to accept claims without demanding proof. The difference between science and religion is religion tells you to not put the lord thy god to the test; science not only welcomes testing, it demands it. But most will take it on faith.

[jollyreaper2112]

10. Almost

How about when you talk to your mechanic? You probably have a general understanding of how an internal combustion engine works but when he tells you x must be done, do you verify yourself or take his word on it? Could you tell if he was lying?

I agree scientific education is important, critical thinking is important, skepticism and bullshit detection are all important, but there's only so far we can go on our own. It does come down to trust at some point. Are you also a climatologist? I have no special education in it. I am going by what other climatologists say. When 99% of the field is in agreement -- and especially when someone can make a name skewering a popular theory -- I think the work is solid. That's why I think climate change skeptics at this point are idiots. If some new physicist could demonstrate a breaking of a law of thermodynamics, why, he'd be able to write his ticket anywhere. Let's say that a given discovery pisses on a famous scientist and a popular school of thought. Well, you may see resistance to adoption for a number of years but eventually the truth will win out. Plate tectonics ruffled a lot of feathers and there were scientist skeptics even in the 1950's! There aren't any now. I'm not a geologist so I'm not studying the direct evidence myself, I'm reading what the popularizers say. And it makes sense.

[ND-Dem]

15. i disagree. trust has everything to do with it. the general population wasn't any more educated

in the 40s -50s, but it was certainly less skeptical of gov't, science, big business, etc.

[greymattermom]

16. in the 40s and 50s there were major epidemics

People saw friends and family suffer and die. Vaccines were life savers. Once a few epidemics occur among the anti vaccine groups, things will change.

[Enrique]

17. excellent post

this is an issue where I think it is highly irresponsible for the people deliberately fomenting distrust against the government for political purposes. And I'm saying this making a very big distinction between legitimate skepticism and bogus skepticism.

Also I think this is why the CIA's fake vaccine program in Pakistan should be seen as a major scandal. The Pakistani government is pretty much desperate for people to trust them and our CIA dealt them a huge blow in that regard.

[KingCharlemagne]

18. Jesus, i totally forgot about that CIA fake vaccination program in Pakistan. Talk about winning

a Pyrrhic victory! (If we neutralize Osama bin Laden, only to see a rebirth of polio in this country because it is imported here by accident or exported from there on purpose.)

Thank you for the compliment. Like many other non-scientists here I am struggling to understand why science that had been broadly accepted for so long has now fallen back into dispute. There have been some excellent and thoughtful responses in this thread.

[PADemD]

19. Are you aware of the CDC Possible Side Effects of Vaccine Page

http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#mmr

MMR vaccine side-effects
(Measles, Mumps, and Rubella)

Severe Problems (Very Rare)

Serious allergic reaction (less than 1 out of a million doses)
Several other severe problems have been reported after a child gets MMR vaccine, including:
Deafness
Long-term seizures, coma, or lowered consciousness
Permanent brain damage

These are so rare that it is hard to tell whether they are caused by the vaccine.


Is this just a CYA statement? This is not very reassuring to parents who are concerned with the safety of vaccination.

I am not an anti-vaxxer, btw.

[Bluenorthwest]

20. Anyone who discusses medicine and public trust and distrust without mentioning AIDS is making a huge

mistake. I can't even begin to address that here. I will however speak about facts and media and this OP. Let's look at a statement by the OP that has nothing to do with medicine at all. The statement 'Jenny McCarthy (spouse of Jim Carrey)'. The two were never married, Carrey has had two spouses and McCarthy is not one of them and, I went and looked it up, Carrey and McCarthy broke up 10 years ago.
So 'spouse of Jim Carrey' is not a true statement. Never was. But it is repeated here along with some other materials about other people and things. Not HIV/AIDS of course, that is absent from the discourse even as it reaches back to Tuskegee and Love Canal. Jesus.
Those of you who spread distrust in vaccines are not my idea of good people, good people are the ones out there trying to develop new and better vaccines.

[KingCharlemagne]

21. Jesus, I did nothing to merit this level of scorn. Sorry, I used the word 'spouse' instead of

'partner' or 'paramour'. I think you have missed the forest of my OP for its trees. But that's just me. Did you read my last paragraph?