Recently, the phenomenon of anti-vaccine ideology came up in the composition class I teach. I ended the conversational detour by, joking, “If you’re an anti-vaxxer, come talk to me and I’ll set you straight” and one of my students took me up on the offer, approaching me after class to tell me that he, the child of two doctors, was not vaccinated. To say I was floored is an understatement. I was happy that he was out seeking information in order to make an informed decision about whether or not to get vaccinated. But despite my previous joking confidence, I was unsure of how to assert the importance of vaccines to this 18-year-old capitalist business major, who frequently (but politely) challenged me in class on issues about societal problems. I could impart facts and reasoning as he requested, but the anti-vaccination lens he’d inherited from his parents remained.
It will be, I think, little surprise that my student is a white male. The face of the modern anti-vaccine movement is that of a white mother—and, more specifically, that of Jenny McCarthy. The former model/actress began talking publicly in 2007 about her belief that her son’s “autism” (from which he has since “recovered”) was caused by vaccines, and quickly became a figurehead for the anti-vaccination movement. Her books on the subject (including Louder than Words: A Mother’s Journey in Healing Autism and Mother Warriors: A Nation of Parents Healing Autism Against All Odds), as well as her cohosting gig on The View gave her a massive platform, from which she launched Generation Rescue, an organization that advocates the scientifically debunked notion that developmental disorders like autism are linked to environmental factors including vaccines.
Despite no degrees or medical expertise (other than what she’s called the “University of Google”), McCarthy has gotten the likes of Oprah and Time magazine to cover—and, therefore, help spread—information that’s not only inaccurate, but that has been thoroughly discredited. The fact that McCarthy clearly believes what she’s saying does not make her behavior any less harmful. A recent spike in vaccine-eradicated childhood diseases like measles and mumps currently makes confronting the social causes of anti-vaccination ideology particularly urgent. It’s not just that such beliefs reflect a lack of science literacy, though that is a major component. Other facets include the anti-science bent that became a feature of American politics in the George W. Bush era; the increasing distrust in a profit-focused medical establishment; and a deep-seated cultural ableism that leads people to turn down life-saving care and say things, as McCarthy has, like, “If you ask 99.9 percent of parents who have children with autism if we’d rather have the measles versus autism, we’d sign up for the measles.”
Poverty, too, contributes to vaccine hesitancy. The stereotype of anti-vaxxers as white, educated, and wealthy is borne out by vaccination gaps in affluent areas. But similar gaps exist in impoverished communities, where lack of health insurance and access coexist with an inherent distrust of the medical field, where scientific racism still flourishes. But I believe the single largest reason that fringe anti-vaccine beliefs have led to terrifying mainstream realities is a cultural, widespread disavowal of community responsibility. To be crystal clear: Vaccines have saved millions of lives, eradicating smallpox (and, perhaps soon, polio) worldwide and nearly eradicating more than over a dozen other diseases in the United States. Though measles was declared eliminated in the United States in 2000, outbreaks in other countries led to the disease’s reintroduction in U.S. communities with low vaccination rates.
Vaccine success depends on the principle of herd immunity: Simply put, if enough people are vaccinated, a disease cannot spread throughout a community. Members of that community who cannot be vaccinated—like infants; people who are elderly or pregnant; and people with cancer, HIV, and other illnesses, including autoimmune disorders—depend on those who can. Take the Measles, Mumps, and Rubella vaccine, on which McCarthy built her anti-vaccination brand. MMR is generally given to babies at 12–15 months, which means that infants are highly susceptible to these diseases. My own sister-in-law had a baby last February at a time when there was a measles case in the same hospital. The fact that this newborn was surrounded by people who were vaccinated against measles was crucial to making sure she didn’t contract a disease that would have killed her. The point of herd immunity is not to protect those of us who can get vaccinated—after all, enough non-vaccinated people means there is no immunity at all—but to protect those who can’t.
Anti-vaxxers, by definition, eschew community responsibility. But they also manipulate language to shield themselves, often claiming, for instance, that they aren’t anti-vaccine but rather “pro-safe vaccine.” This linguistic hair-splitting is insidious because it casts vaccine denialists as inherently reasonable—after all, who isn’t in favor of safe vaccines?—while infecting others with their fears. Democratic presidential hopeful Marianne Williamson is one such example: Williamson uses classic anti-vax dog whistles like “pro–bodily autonomy” and “anti–Big Pharma” to preface assertions about the inherent danger of vaccines. So-called neutral organizations use this same language—often in the form of promoting “choice”—as either a concession or to hide their actual anti-vaccine beliefs. The tagline for the National Vaccine Information Center, “an independent clearinghouse for information on diseases and vaccine science,” for instance, is “Your Health. Your Family. Your Choice.”
Recasting a social contract as an individual choice is at the crux of the movement’s menace. Anti-vaccine proponents take advantage of the fact that herd immunity works to their benefit by deciding that their own choices are more important than the health of their immediate communities and its nationwide impact. A tacit responsibility to those around us—to the elderly, to those with autoimmune disorders, to the chronically ill, to children and their pregnant parents—has not discouraged their movement. Indeed, why should it? There is no more sacred value at this time, in this society, than individualism.
According to Elena Conis, a historian of public health at the University of California, Berkeley, this pushback is a product of the counterculture of the 1960s and ’70s that “encouraged Americans to question authority and traditional sources of expertise.” “Women pushed back against patriarchy,” Conis told the Los Angeles Times. “Environmentalists pushed back against industry. Patients pushed back against doctors. When you put those movements together, you get a skepticism on the left, which bubbles up and combines with the long-held anti-vaccination views of the libertarians on the right.” The result is that the same people who ask why billionaire Jeff Bezos, who “worked hard for his money,” has to give any of it to “someone lazy on welfare”—a common question, and one I’ve heard from my own students—don’t seem to either understand or care why individual vaccine refusals matter.
Anti-vaxxers, by definition, eschew community responsibility. But they also manipulate language to shield themselves, often claiming, for instance, that they aren’t anti-vaccine but rather “pro-safe vaccine.”
Compulsory vaccinations, too, inspire pushback. My aforementioned sister-in-law told me that when she was growing up in Russia, vaccines were given in schools without parental consent, and that many of those who later immigrated to the United States rebelled against anything that carried the same whiff of authoritarianism. Compulsory vaccination policies vary widely from country to country; with the current tenor of anti-vaxx rhetoric, more European nations are considering making them mandatory, a possibility that may make even more people balk. But aggressive immunization works: It’s what eradicated smallpox. And if the choice is between widespread disease and death and whether or not “our choices” are honored? I’ll take being alive.
It’s important to point out, however, that vaccination can be weaponized for the wrong reasons, and that an implicit racism and xenophobia often characterizes discussions about vaccines and community health. Anti-immigration conservatives, for one, are quick to point—falsely—to undocumented crossings at the U.S.-Mexico border as a cause of the recent spike in measles outbreaks. Elsewhere, New York’s Orthodox Jewish enclaves have recently become the scapegoats for a recent surge in measles cases, with a distinct antisemitism inherent in media reports on these insular communities’ susceptibility to anti-vax rhetoric and propaganda. (Leaders in such communities have been vocal in pointing out that nothing in the Jewish faith casts doubt on the safety and efficacy of vaccines.)
But if trying to convince an anti-vaxxer of their responsibility to those around them is fruitless, what about the responsibility held by larger entities, like corporations, that have the power to effect social change? After all, what’s dangerous about anti-vaxxers isn’t just their own decisions, but the sowing of doubt and fear in those who are battling a constant volley of information and sources, both good-faith and bad. And perhaps more influential than mainstream media’s adoption of a “both-sides” approach to covering most issues, including vaccines, is the role of social media and companies like Amazon.
When I searched the term “vaccines” on Amazon, for instance, almost all the “featured” results were anti-vaccination books—the lone exception, at the bottom of the page, was a medical-school textbook—including the orange-banner bestsellers and sponsored items. Anti-vaxxers also make liberal use of YouTube and Facebook, where channels like VAXXED TV (60,000+ subscribers) and iHealthTube (just under 400,000 subscribers) were, until recently, monetized; and where pages like “Californians for Vaccine Choice,” “Our Kids Our Choice,” and “The Vaccine-Friendly Plan,” all anti-vax accounts, have between 15,000 and 25,000 followers.
In fact, it took until last March, when California Representative Adam Schiff contacted Jeff Bezos and published open letters to Amazon and fellow tech giants Google and Facebook, for these platforms to began taking steps to distance themselves from anti-vax propaganda. (Schiff, the first politician to make such a move, was in part motivated by news of the measles outbreak in Washington state, Amazon’s home base.) In response, YouTube agreed to demonetize anti-vaccination ads, while Facebook posted a statement asserting that it would work to reduce anti-vaccine content. Amazon no longer hosts documentaries by the infamous Andrew Wakefield, whose fraudulent study linking autism to the MMR vaccine has been the core of the modern anti-vax movement; the presence of those documentaries, free to Prime members, was undoubtedly critical to the spread of the message. But why did it take a letter from a congressperson to spark these moves, given that anti-vaccine propaganda has long been linked to user-generated content on the internet? The answer, of course, is money.
On GoFundMe, anti-vaxxers reportedly raised $170,000 over the last four years for their messaging campaigns; much of that money came from advertising such campaigns (or running similar ones) on Facebook. Crowd-sourcing platforms like GoFundMe take a cut of funds raised, so paying for Facebook and Amazon ads that link to GoFundMe pages means increased returns for anti-vaxxers and big corporations alike. The irony of anti-vax advocates using these corporations to disseminate their message is pretty striking, given the movement’s stated belief that greed motivates scientific institutions and Big Pharma to push vaccines. Of course, it’s not wrong to be skeptical of for-profit healthcare, especially at a time when increased privatization drives mounting levels of debt, poverty, and homelessness.
But it’s impossible to ignore the hypocrisy of groups (among them American Citizens for Health Choice, Informed Consent Action Network, Learn the Risk, and Age of Autism) whose operating budgets depend on corporations like Amazon. (As of this writing, the company’s AmazonSmile charity program still allows users to donate to anti-vax groups.) The public image of anti-vaxxers—college-educated, often wealthy, often white—is what allows them to frame their views as a simple matter of “safe” and “informed” choices and receive both the public’s benefit of the doubt and the visibility and revenue granted by the corporations that frame the public’s reality. What I see is a privileged group of ableist individuals who shun scientific literacy, promote fear-mongering among other scared parents, and profit from their rhetoric.
To stop the rise of measles and the other epidemics it foreshadows, we must go beyond restricting anti-vaxx propaganda. Rather, we need to engage with vaccine-hesitant people in order to address their specific fears about specific vaccines in specific moments. As tempting as it is to lump all anti-vaxxers into one boat, studies show that engaging with specific fears is actually a better way to get people to vaccinate. Supporting large-scale public health initiatives can also be a big help, and probably the most obvious solution is putting pressure on lawmakers to, as Schiff did, prioritize addressing the issue as publicly as possible. But if anti-vaxxers are a symbol of larger systemic problems—inherent issues of class and race, of scientific distrust, of buying into the capitalist machine while being faux-critical of it—then we must simultaneously demystify those. We cannot allow conversations around Big Pharma to begin and end with anti-vaxxers, just as we cannot ignore the inherent classist, racist, and ableist underpinnings of this rhetoric. Rather, we must learn to be critical on all fronts without resorting to fearmongering and distrust of actual experts.