Because few people are actual infectious disease experts or experts in immunology, vaccinating children requires reliance on the authority of the scientific consensus, which is that vaccines are very safe and effective.
There are a couple of barriers to analyzing the medical literature. The details of scientific primary sources require subscription or fee-based access. Even when access is available, most members of the lay public are simply not trained to accurately interpret the data. I rely on secondary sources, primarily Science Based Medicine, for an accessible and credible overview of the literature. It’s straightforward and matter-of-fact, which is exactly how I like to consume scientific information. Unfortunately, SBM is not as seductive or emotive as purveyors of medical misinformation such as Mothering Magazine.
Mothering is a gorgeous publication that features delicious recipes, lovely family activity ideas, eco-friendly lifestyle advice, and other harmless-yet-interesting fluff that resonates withe me. Unfortunately, readers also encounter a great deal of medical misinformation. The format taps into fears of inadequate mothering and offers counter-culture solutions that will finally make one a “good” mother. It’s very seductive, especially when it elevates even mundane parenting choices to self-righteous political positions. Of course Mothering is strongly against vaccination, and provides all kinds of science-y sounding language and anecdata to support this position. It’s very hard to sort out credible information about vaccines, and I have a lot of sympathy for parents who choose not to vaccinate. It’s even more difficult when anti-vaccination confers social status.
I have long thought that alpha moms jockeying for position within parent groups contributed to decreasing rates of vaccination. More recently, I’ve been thinking about the larger societal pressures that influence anti-vaccination.
I was inspired by a discussion in the comment section of an SBM article by Dr. David Gorski about Mothering Magazine’s deadly medical advice, including a plethora of vaccine misinformation and HIV denial. The entire comment thread is worth reading because there are a number of very bright people who contribute a great deal of interesting insight. Below is an excerpt of my small bit.
Commenter Windriven asks:
“So what drives Mothering’s readers? Why are so many people willing to ignore science and medicine in favor of anecdote? Clearly these are engaged parents; why else would they subscribe to a parenting magazine? One presumes that they have been exposed to the pro-vaccination argument. One presumes that they are aware of the thorough discrediting of the MMR link to autism.
Are there any studies examining this?”
“@ Windriven: I’ve actually thought quite a bit about this, and I have some ideas about what I think might be going on. This is based on my anecdotal observations, not on any rigorous study.
Many women who can afford to stay home gave up careers to do so. Larger society undervalues stay-home moms (as well as teachers and other child care workers). So bright, educated women find themselves in clusters, isolated from prestige, and they bring the work ethic and focus that advanced them in careers to parenting. They must seek status and validation from other members of the stay-home community, and this requires separating themselves from the unwashed masses. (My friend calls this “competitive parenting.”)
This subculture fosters increasing intensity and extremism, and practices that might have begun as reasonable choices are pushed to extremes. Once everyone in the group is breastfeeding infants, for example, the higher-status women are the ones who breastfeed kindergartners.
This trajectory translates to increasingly harmful cultural norms. Once everyone treats vaccination as an ala carte menu, the higher-status women are the ones who are rejecting vaccines, or rejecting prenatal care, or obstetrical care, or whatever. Statistics are such that the individual mothers and children are likely to be unharmed by these decisions, and this leads to strong confirmation bias.
Mothering is one more source of validation and status. It feeds right into the paradigm I attempted to describe. The pressure to conform is intense, and I’ve actually heard mothers defensively/apologetically rationalize to other mothers things like weaning early, or allowing a doc to prescribe antibiotics for something potentially serious. [...]”
Yours is a fascinating conjecture. It certainly explains the herd mentality. But why woo instead of science? Why don’t these mothers end up as uber-vaccinators?”
‘Why don’t these mothers become uber-vaccinators?’
My personal biases tends to lead me (correctly or not…) to conjectures involving status and power. My read is that challenging the authority of conventional medicine and MDs is one way of artificially ascribing status to oneself. [...]”
The contemporary anti-vaccine movement should by all rights be a small fringe movement. Its tenants have been roundly and repeatedly discredited, and yet it persists. It’s going strong both on the pages of Mothering and other parenting sites, and in real-life parent subcultures. I think that there is a good deal of observational evidence favoring my off-the-cuff theory of a convergence of in-group status and societal marginalization of stay-home parents. This, coupled with misinformation that appears credible published on mainstream sources, fuels the unfortunate rise in potentially deadly preventable diseases.
Whether or not my assessment about the anti-vaccine movement is correct, treating parents, teachers, and childcare workers like respectable, contributing members of society would benefit everyone.
Vaccine image from the CDC public domain image gallery.