Text settings Story text Size Small Standard Large Width * Standard Wide Links Standard Orange * Subscribers only Learn more Minimize to nav Stanley Plotkin, 93, was instrumental in developing a number of vaccines over the course of his career. He recently said that he’s “beginning to regret having lived so long—because we’re going downhill.” How could we possibly have gotten here?
Maybe we’ve always been here. It turns out that the anti-vaccine arguments currently flooding the Internet have been around for as long as vaccines have. In his new book A Pox on Fools, Thomas Levenson breaks them down into three categories, as made clear in the book’s subtitle: “The True Believers, Grifters, and Cynics Who Convinced Us to Reject Vaccines.” The accusations these people levy against vaccines can just as easily be used to categorize the arguments themselves: They are wrong, they are bad, and they are intolerable.
As Levenson tells it, in the early 18th century, a couple of forward-thinking Westerners learned about inoculations against smallpox from Ottoman women and an enslaved African. At that point, infectious disease was by far the leading cause of death, as it had been forever. In the 19th century, roughly 40 percent of babies died of infection before they turned 5.
(This is why the average lifespan back then was so low. It wasn’t that people didn’t live past their 30s; if they survived childhood, they largely did. It’s just that so, so many small children died that they dragged the average way down.)
When smallpox epidemics broke out in London and Boston in 1721, Lady Mary Wortley Montagu and Cotton Mather initiated inoculation campaigns in their respective cities. Inoculation involved taking pus from a pock of someone with a not-very-severe case of smallpox, making a cut in the arm of the person to be inoculated, and rubbing the pus into the cut.
There was an immediate backlash. It was morally wrong, some claimed, to interfere with the divine ordination of who would sicken and die and who would not. Only God had that ability, and to thwart it was to defy God’s will. It was hubris and blasphemy. Levenson highlights how the subtext of this attitude was that contracting a highly infectious disease was divine punishment for sin and that the only way to avoid disease was to live a virtuous life.
The Transcendentalists and Romantics substituted “nature” for “God” in the mid-19th century, but the argument has remained basically the same: vaccines are an affront to the “natural” world, and clean living is all you need to stay healthy. The implicit moral judgment remains, even without God: if you get sick, it must be because you ate/drank/breathed/wore something that wasn’t pure enough.
The immense strides in public hygiene and sanitation that preceded the heyday of vaccine development certainly did curb the spread of infection and increase lifespans, but clean living will not help you fight off an infection if you’re exposed to a pathogen as effectively as a vaccine will.
The argument that it would ignore most of human history and what we know about microbiology and immunology. But it sounds quite compelling, especially when the modern world around us is so scary and hard to understand. And especially when almost no one alive today still remembers just how many child-sized coffins were involved in the halcyon pre-vaccine days when nature got to take its course.
Vaccines are unnecessary because our bodies can cure themselves, Robert F. Kennedy Jr. and his cronies claim. But they go beyond that and say they are actively harmful–and certainly more harmful than the diseases they are designed to prevent. This is an alluring argument to many, since the negative effects of vaccines are apparent (shots hurt for a moment, and you might get a sore arm or fever). In contrast, the lack of many small children dying from infectious diseases is harder to notice. Because of the spectacular success of vaccines, we take the lack of those deaths for granted.
This argument, too, has been there since the outset, when there was no data yet to refute it. And in the intervening years, there definitely were some tragic missteps during vaccine development and administration. But 300 years later, it’s eminently clear that vaccines are safe. They are not completely risk-free, of course; nothing in life, certainly nothing valuable, is risk-free.
Vaccines can and have caused serious adverse effects (but not autism) in specific populations. And certain vaccines are not safe for certain subsets of people—infants, the elderly, or the immunocompromised. But this is not an argument that healthy people shouldn’t get them; rather, it’s an argument precisely for why healthy people should get them. They keep circulating levels of pathogens low enough to protect those who cannot get vaccinated themselves, which brings us to the final argument.
This last thread has nothing to do with whether or not vaccines are effective, necessary, or safe. It is not a biological argument but a visceral, philosophical one. Because it is not anti-vaccine; it is anti-vaccine mandates. It is about the responsibilities that our governments have to us and that we have to each other, and about the inevitable clash between an individual’s needs and wants and the good of society as a whole.
The Supreme Court case of Jacobson v. Massachusetts lays out the two schools of thought. Boston and Cambridge enacted vaccine mandates during the smallpox epidemic of 1901, and Jacobson refused. He argued that “a compulsory vaccination law is… hostile to the inherent right of every freeman to care for his own body and health in such way as to him seems best.”
But the majority ruled that our liberties are not absolute. The Constitution does not allow us to do whatever we want—it is there to protect everyone’s rights and freedoms, and that entails sometimes curtailing each person’s rights and freedoms. Associate Justice John Marshall Harlan summarized: “Liberty itself, the greatest of all rights, is not unrestricted license to act according to one’s own will. It is only freedom from restraint under conditions essential to the equal enjoyment of the same right by others.”
The concept of herd immunity hadn’t been developed yet, but the court’s decision still relied on germ theory; refusing vaccination endangers those around you, and your liberty of bodily autonomy must be limited because insisting upon it infringes on everyone else’s right to health—and possibly life itself.
Facts and figures can demonstrate how many lives have been saved by vaccines. But they will never be an effective counterargument to “the government can’t tell me what to inject into my kid.” The only potential argument to sway someone who fervently believes that is appealing to their sense of solidarity—to the obligations that every member of society has to every other, to the sacrifices that everyone must make to ensure that society is safe for all. Alas, that sense of solidarity… does not seem to be at its peak in the US right now.
As Levenson makes clear, these three arguments have been plied for as long as vaccines have. But there are a couple of key differences now. The first is that 300 years ago, people who claimed that vaccines were either ineffective or harmful could be forgiven for thinking they had a point. But we now have germ theory to explain exactly how vaccines work and centuries of data showing how infection and death rates from every disease have plummeted once a vaccine was introduced to counter it. We know better.
The second is that now, arguments against vaccines tend to be touted by only one particular subgroup of people: Republicans. And that has come with predictable consequences. “In the US from 2021 onward,” Levenson writes, “being a Republican has become a measurable risk factor for illness and death.”
Levenson teaches in and has directed the Graduate Program in Science Writing at MIT, so you might expect his writing to be clear, concise, engaging, and informative, with an effective mix of statistics and anecdotes. You’d be right. And despite the incendiary nature of his topic, his tone remains measured throughout; he never descends into anger or ranting.
What does come through is his anguish that Robert F. Kennedy Jr.’s lies and policies will cause kids to needlessly be sickened by and die from diseases we have the tools to prevent.
