On Oct. 13, a group of doctors and medical ethicists called on the Trump administration to abandon an effort to include a “noncritical” mention of vaccines in the National Vaccine Injury Compensation Program, an effort to reduce emotional trauma that can occur among parents seeking compensation for vaccine-related injury or death.
The Washington Post recently reported on the Department of Health and Human Services’ plan, and published a letter from the members of the Committee for Responsible Medicine, an anti-vaccine group that had issued a news release on Oct. 10 saying that its members would present a letter “challenging NIVCIP’s consideration of the best course for the program.” The committee responded with an in-depth letter addressing the process for formulating a guideline.
Their letter questioned the criteria used to evaluate the severity of injury and death that could qualify for compensation, the prevalence of vaccine injury claims, and other factors that would affect the process. The letter also questioned whether the “vulnerable group” as defined by the Vaccine Injury Compensation Program’s intent language — people who are undergoing prolonged medical treatment or are elderly — has been defined correctly in its current form.
The letter also questions whether steps taken to reduce vaccine injury claims will better the lives of children and decrease unfounded fears about vaccines.
“We doubt this practical approach to enhancing public health will serve children well; our experience with children comes from cautioning health care providers and the public that many vaccines may have permanent or milder side effects, including if immunizations are given late,” the committee wrote.
When asked for a response to the committee’s letter, a department spokesperson said the department’s plan “addresses concerns raised by the Committee’s letter,” and that it “will develop a guidance document that addresses all of the Committee’s recommendations.”
Of course, neither doctors who recommend vaccinating children nor the influential anti-vaccine lobby have always been able to let the facts stand in the way of their beliefs. They hope that past histories will keep people skeptical of vaccines and prevent a reversal of pro-vaccine policies.
The committee’s letter suggests that the anti-vaccine contingent’s skepticism has already established itself. This isn’t just the group’s position, but the position of a growing number of anti-vaccine thought leaders: They suggest that experts are the problem, not the solution.
Interestingly, their point that people may be completely wrong to be skeptical about vaccine safety is an old one: Maybe not vaccines. Perhaps the people we recommend to our patients are actually incredibly wrong to have doubts about their safety.
The question we’re asking in this story is whether the skepticism itself is wrong, or whether there is a different mechanism for spreading misinformation about vaccines, which the committee and letter indicate are present in some of the anti-vaccine movement.
One possible pathway is the closed circuit between the anti-vaccine leaders and their audiences; they echo the many hours that their young children spend in daycare and preschool, and attempt to spread these beliefs as quickly as possible to make them seem both justified and applicable. The longer they keep their audiences believing in the merits of their beliefs, the longer they will retain their supporters.
A more sophisticated argument may be found in the anti-vaccine activists’ place within a society that is broadly unwilling to acknowledge the connection between vaccines and autism. The phrase “I don’t know anything about that” might become a path toward discovery. For example, we may remember that vaccines often contain preservatives, but the word “sterilizer” doesn’t elicit the same kind of visceral reaction as the word “vaccine.” In this way, vaccines can seem less dangerous, and people may feel more comfortable taking them.
All of this may be an accurate view of the situation, but is it an idealistic view? We’ve found one strong candidate: Early in this new world of internet disease scares, most people aren’t yet vaccine-aware, but they are also pretty much immune to the most alarming examples of disease and suffering. Even then, people are profoundly unskilled at reading the scientific literature, which they almost certainly read more closely than any other kind of literature. And it is in the scientific literature that our ability to discover new information is most keenly tested, especially if we believe in a pseudoscientific attack on vaccines.