Has vaccination become a partisan issue?

by John Quiggin on February 8, 2015

Some recent statements by Chris Christie and Rand Paul[^1] have raised the prospect that vaccination, or, more precisely, policies that impose costs on parents who don’t vaccinate their kids, may become a partisan issue, with Republicans on the anti-vax (or, if you prefer, pro-freedom) side and Democrats pushing a pro-vaccine, pro-science line. Christie and Paul took a lot of flak from other Republicans and even Fox News, and tried to walk their statements back, so it seems as if it won’t happen just yet.

But there are some obvious reasons to think that such a divide might emerge in the future, and that Christie and Paul just jumped the gun. The outline of the debate can be seen in the ferocious response to Reason magazine’s endorsement of mandatory vaccination. And, while Reason was on the right side this time, they’ve continually cherrypicked the evidence on climate change and other issues to try to bring reality in line with libertarian wishes.

The logic of the issue is pretty much identical to that of climate change, gun control, and other policies disliked by the Republican/schmibertarian base. People want to be free to do as they please, even when there’s an obvious risk to others and don’t want to hear experts pointing out those risks.[^2] So, they find bogus experts who will tell them what they want to hear, or announce that they are “skeptics” who will make up their own minds. An obvious illustration of the parallels is this anti-vax piece in the Huffington Post by Lawrence Solomon, rightwing author of The Deniers, a supportive account of climate denial[^3].

As long as libertarians and Republicans continue to embrace conspiracy theories on issues like climate science, taking a pro-science viewpoint on vaccination just makes them “cafeteria crazy”. The consistent anti-science position of people like Solomon is, at least intellectually, more attractive.

Update Another issue that fits the same frame is speeding. Anti-science libertarians in Australia and the UK are strongly pro-speeding, but I get the impression that this isn’t such a partisan issue in the US, the reverse of the usual pattern where tribalist patterns are strongest in the US.

[^1]: Christie was just pandering clumsily, but Paul’s statement reflects the dominance of anti-vax views among his base and that of his father (take a look at dailypaul.com). [^2]: Of course, the situation is totally different in cases like Ebola and (non-rightwing) terrorism, where it’s the “others” who pose the risk. [^3]: The Huffington Post used to be full of leftish anti-vaxers. But the criticisms of Seth Mnookin and others produced a big shift – Solomon’s was the only recent example I could find. Similarly, having given equivocal statements back in 2008, Obama and Clinton are now firmly on the pro-vaccine side.

{ 295 comments }

1

P 02.08.15 at 9:32 am

As an anti-dote to Quiggin’s partisan silliness, I recommend Dan Kahan’s many excellent posts showing that Americans are overwhelmingly pro-vaccination, and that the issue does not divide the public along traditional partisan lines. Vaccination is completely different from topics like climate change and evolution in this respect. Start here.

2

Pat 02.08.15 at 10:23 am

I’m not entirely sure how much valence this has, but the anti-vax sympathies on the American right reminds me of Ayn Rand’s bitter refusal to quit smoking, solely on the grounds that if the American government and social movements were trying to make people quit, then she was by God going to keep doing it.

She eventually contracted lung cancer (shock) and died of heart disease.

It needn’t be said out loud, but if you really need evidence that the anti-vaccination movement is not symmetrical about the left-right axis, just look at the list of Democratic politicians who are hemming and hawing about whether vaccines are safe and effective against disease. There are none, at least no prominent ones. (RFK Jr. is probably the biggest name, he’s never served in office, and his name is of course not famous because of his own accomplishments.) Just watch: GOP presidential hopefuls will start prefacing their remarks on this question “Well, I’m not a doctor…” just as frequently as they answer climate change questions by disclaiming being a scientist.

3

Pat 02.08.15 at 10:29 am

P @1, just you wait. Count the Republican presidential hopefuls who say that vaccines might cause autism when asked at some debate in Iowa this turn. It will be a significant number. Possibly it will be a majority of the panel.

It hasn’t been a partisan issue yet. But the current mass of Republican voters have pretty well demonstrated they will make anything a defining issue of American values once the Democratic president takes a side on it. (See: the individual mandate, TARP, national school curriculum standards, for instance. Each was a Republican initiative; each is currently being identified as communist Nazism by some yahoo on the Internet.)

4

Collin Street 02.08.15 at 10:31 am

Many apparently-political issues are in fact mental-health ones.

5

Metatone 02.08.15 at 10:50 am

I wrote a long post about Kahan, but I realised it would be a thread derail. Suffice to say, I think there’s a lot of debate to be had about his work – but that’s for another thread.

I think it’s clear that vaccination has the potential to become a partisan issue – a label of identity. However, I think it’s less likely than some previous elements to truly catch on – because in general people have a different relationship with clinical staff than with climate scientists or evolutionary biologists.

Of course, one should also observe that in the USA this relationship is less trusting than in many places, because there is often great suspicion about the economic motives of clinical staff.

6

Adam Roberts 02.08.15 at 10:57 am

I daresay people have already seen this:
http://robertmoorejr.tumblr.com/post/110101466091/im-an-anti-braker

I post it not just because it’s great, but b/c (to step from brakes to belts) I’m old enough to remember when seatbelts were made legally compulsory for drivers in the UK. There was a libertarian storm in a teacup then, threatening to turn ‘the right to choose not to wear a belt’ into a political rallying cry. It petered out, I’d guess because the advantages in wearing a belt so massively and patently outweigh the advantages (if there are any: I can’t think …) of not wearing a belt. Vaccination is similar. Denying climate change looks like a no-cost performance, because the issues are huge and, you can kid yourself, far away. Not vaccinating your kids is small-scale and very close to home. That you oppose the nanny state with fervour doesn’t mean that you’re happy with the prospect of your own kid getting measles.

7

Ze Kraggash 02.08.15 at 11:17 am

Where is the partisan line: mandatory vs. voluntary? Or is it something else?

8

Brett Bellmore 02.08.15 at 12:08 pm

“and Democrats pushing a pro-vaccine, pro-science line.”

That would be a positive change, at least, from only a few years ago. As your footnotes indicate you’re aware. That it would still be a change, you seem less aware of.

Ok, let’s be clear about something: Vaccines work, science. People should be forced to be vaccinated? NOT science. It’s that is/ought gulf you likely covered very early in philosophy… Science is about “is”, not “ought”. In fact, give scientists too much say over “ought”, and they have a disturbing tendency to stop being scientists.

And Paul is pushing a pro-vaccine, pro-science, pro-freedom line.

It’s one of those philosophical divides between the left and the right, I guess. We’re not as enthusiastic about this notion that being convinced you know which choice is best entitles you to impose it on somebody, as your side is.

9

William Burns 02.08.15 at 12:23 pm

Actually, Brett, conservatives do tend to think that they have the right ideas on abortion, and do think that entitles them to impose it on everyone else. I must admit that one of the most unintentionally hilarious aspects of conservative anti-vaxxism is hearing conservatives go on about the importance of making choices about your own body.

10

Ebenezer Scrooge 02.08.15 at 1:03 pm

Ze and Brett are right–the politically more astute Republicans are now saying that vaccination is a good idea, but do not endorse mandatory vaccination. This way, they can pretend to support both Science and Liberty.

11

Ze Kraggash 02.08.15 at 1:36 pm

“This way, they can pretend to support both Science and Liberty.”

They pretend – obviously the real goal is the destruction of humanity. While it’s not too late – they must be exorcised!

12

Rich Puchalsky 02.08.15 at 2:07 pm

I’m just going to recycle recent comments on another vaccination thread starting around here. In short, it was quite reasonable to be concerned about thiomersal as opposed to vaccination, and this concern was reflected in the official decision to remove it from vaccines. Statements like “The Huffington Post used to be full of leftish anti-vaxers” (and now they’re not) may be in part a rhetorical change, but they may also reflect people catching up on changes in scientific knowledge and regulation.

It would be catastrophic if this did become a partisan divide, and as such I think it doesn’t help for people on the left to use dubious arguments on the assumption that people concerned about vaccination can’t see that they’re dubious. See here.

13

Anarcissie 02.08.15 at 2:14 pm

The vaccine issue, like many others involving science, goes back to the priesthood of all believers, the notion that every person can interpret the Scriptures for him- or herself. Science has partially replaced religion as a system of general authority and required belief. Before contemptuously dismissing the priesthood of all believers, one might want to reflect that it is also the source of such ideas as democracy and equal rights.

It is curious that, in this case, authoritarianism is assigned to the ‘Left’ and resistance to authority to the ‘Right’.

14

Cheryl Rofer 02.08.15 at 2:18 pm

Brett Bellmore @ 8:

It seems very neat and nice to say that science is about “is” and politics is about “should,” and that works for the vaccine argument as long as you define it as being about individuals or even individual families: I can decide whether I should be vaccinated.

But there is another aspect to vaccines that involves “is” and “should” and blurs that nice individualistic line: herd immunity. Once you know the probability that people will contract a disease like measles from a carrier and a few other relevant variables, you can calculate an “is”, namely the percentage of the population that must be vaccinated to prevent the spread of that disease. Measles is highly contagious before any symptoms appear, so its percentage for herd immunity is well over 90%.

So if enough people decide to free ride on others’ decisions to vaccinate, then that benefit goes away. There are some people who can’t be vaccinated – very young babies, those with compromised immune systems, and so on, and one might think that they “should” be in the priority for that less than 10% who go unvaccinated, rather than those who call whim “freedom.”

I suppose you can call that a political judgment, whether to have herd immunity or not. If you do, you are giving the free riders something like ten times the voting power of those in favor of herd immunity.

15

Rich Puchalsky 02.08.15 at 2:27 pm

“There are some people who can’t be vaccinated – very young babies, those with compromised immune systems, and so on, and one might think that they “should” be in the priority for that less than 10% who go unvaccinated, rather than those who call whim “freedom.””

We discussed this on that recent thread as well — and to add to what you wrote, if you’re talking about measles then it goes beyond very young babies and people with compromised immune systems. It appears that (according to a source at the CDC) getting the standard two doses of measles vaccine is only 97% protective, so there is a relatively large pool of people of all ages who have done everything they could do but who are still not protected if herd immunity fails.

Bringing up “ought” is not something that libertarians really should do, because all it shows is that they don’t want to take responsibility for negative externalities.

16

Fiddlin Bill 02.08.15 at 2:44 pm

I thought the whole point of vaccination is that it needs to be mandatory (with a few rational, specific, individual exceptions no doubt). It’s a public health issue. One of the fault lines is that conservatives do not accept the concept of public good at all–it’s like public schools, public libraries, the post office. Conservatives dream of a world where it’s all individual rights, and if that means no public health, fine–they think they can survive because they’ll be the rich ones. Senator Tillis carried the ball on this when he talked of the freedom not to wash one’s hands even when one is serving food to others.

17

Brett Bellmore 02.08.15 at 2:50 pm

“It is curious that, in this case, authoritarianism is assigned to the ‘Left’ and resistance to authority to the ‘Right’.”

I think I need to note that what the left appears to be doing here is simply excluding all consideration of persuasion. You know what the right thing to do is, some people don’t want to do it, so, instantly, without consideration of other options, force comes out.

Why is your first response not increased efforts at persuasion?

If the benefits of vaccination producing herd immunity are shared, why not PAY people to be vaccinated? If they’ve being vaccinated, not for their own sake, but for the sake of others, shouldn’t this be a reasonable response?

But this idea, that the appropriate response to people not doing what you think they should is persuading them to do it, rather than forcing them, just gets rejected so instantly it wasn’t apparently even given consideration.

In light of that, why is it so curious that authoritarianism was assigned to the left?

The left is, typically, only anti-authoritarian, when somebody else gets to exercise the authority. Louis Veuillot nailed it: “When I am the weaker, I ask you for my freedom, because that is your principle; but when I am the stronger, I take away your freedom, because that is my principle.”

That’s the left in a nutshell.

18

Anon. 02.08.15 at 3:04 pm

For someone expounding the virtues of empiricism you sure seem reticent to use it yourself. Could it perhaps be because the data doesn’t fit your narrative?

Look at any survey concerning vaccines, you’ll find the same thing: there are nutters across the spectrum. Sure, there’s slightly more of them in the middle and on the right but the differences are a few percentage points. It’s nowhere near a partisan issue.

19

bianca steele 02.08.15 at 3:06 pm

I agree with Anarcissie @ 13.

The whole idea of the priesthood of all believers, it seems to me–at least as it operates right now in the current divvying-up of theological positions among sects–is that “believers” means people without any especially high level of education. The opposite idea, that only specially designated (educationally and institutionally) members of the clergy have valid opinions, also obviously assumes they’re the only one with any significant degree of education.

When most people are reasonably well educated, and into the same ideas as “the clerisy,” the idea that only a small number of people have a right to an opinion, and no one else knows anything worth mentioning, has to go away. And most educated people, though they’re only able to access and interpret parts of the scientific arguments (the rest hidden away in archives or too specialized) do agree with the experts.

What’s really at issue, and the reason it looks like the sides have been reversed, is the opposition of certain groups to this new dispensation. They actually preferred it when advanced knowledge was inaccessible to almost everyone. They prefer it when their members keep their minds pure and separate from the new scientific knowledge. And they don’t like it when people on the other side make them feel wrong.

20

Mark Navin 02.08.15 at 3:13 pm

Add me to the chorus of people who think it’s unhelpful to characterize Christie and Paul’s comments as representative as an ‘anti-science’ perspective.

You don’t have to be a science denialist to think that we need not mandate all vaccines, and that parents ought to have some discretion. In particular, I think we can reject a principle according to which the law should compel parents to maximally promote public health through their children’s vaccinations.

It shouldn’t be controversial to say that parents may make choices for their children that fail to produce the best all-things-considered outcomes. Few people object to parents who drive their kids to school, even though everyone would be safer if they walked. (And I don’t imagine that many people think it should be illegal to drive children to school.) Of course, this doesn’t mean that parents may do anything they want. In the case of driving, parents have to put their children in car seats and they need to obey speed limits and traffic laws.

I think we can say something similar about vaccine choices. There should be limits on parental discretion: Parents should have a political obligation to vaccinate against diseases that place their children and others at significant risk of serious harms. For example, there should be no parental discretion when it comes to vaccines against polio and measles. But the risks and harms of some other diseases – like chicken pox – are not nearly as high. When it comes to these vaccines, Chris Christie may be right that parents should get to make a choice.

21

Anarcissie 02.08.15 at 3:13 pm

Brett Bellmore 02.08.15 at 2:50 pm @ 17:
‘… The left is, typically, only anti-authoritarian, when somebody else gets to exercise the authority. …’

That depends entirely on how you define ‘the Left’. Your definition excludes those who favor freedom, equality, and peace, who may be a disorganized minority, but still form a considerable proportion of both the population and the noosphere. Now you have no word for them.

22

David 02.08.15 at 3:15 pm

I’ll leave it to Americans to try to interpret the bizarre politics of their country. But it’s evident that the vaccine “debate” is a painfully clear and unambiguous example of the continuing conflict between individual rights and collective benefits, whose centre has moved steadily towards the former and away from the latter, in tandem with the widespread adoption of neoliberal economic and social policies by most mainstream political parties. Without that movement, arguably, there wouldn’t be a “debate” at all.
It’s interesting that the Left has not developed a genuinely anti-vaccination discourse of its own. In addition to traditional wariness about the good intentions of the state, and the commercial ambitions of drug companies, it seems to me there are at least two arguments which could be used by the modern Left against vaccination and I’ll set them out very briefly as thought experiments.
First, the Left has moved away from pragmatic, consequentialist arguments, about improving the lives of ordinary people, to normative arguments about things that Should be Done or things That Are Right, and the indefinite extension of various concepts of human rights under all circumstances. An evaluation of potential consequences, by this thesis, is not just an inferior kind of argument, it’s not an argument which is allowed into the debate at all, because consequences don’t count. An example would be the intervention in Libya, which was “right”, and whose consequences are thus irrelevant. Another would be current pressure in France to enable couples (including homosexual couples) to pay women in Africa to bear children for them. The idea was withdrawn from a draft law last year after much protest, but its proponents continue to argue that every couple has an absolute human right to have children, and that considerations of the practical effects, on the child or on society, are simply irrelevant. So for vaccination, it’s easy to argue that everyone has an absolute and exclusive right to control over their own body, and, that, since children are not capable of making informed decisions at the time they are vaccinated, vaccination should not take place and the state (or even parents) should not seek to control the bodies of children. Clearly, the discourse of unlimited abortion rights is available for (mis?)use here.
The second is the move away from consideration of the collective interests of society, towards the separate (and often conflicting) demands and analyses of identity groups. Someone could reasonably point out that the vast majority of those who recommend vaccinations are white and male. There is, indeed, an immense online literature about medicine itself as a “patriarchal” system, in which male ideas are exclusively represented, and where women doctors are unconsciously programmed into masculine ways of thinking. So it could be argued that women doctors and experts who advocate vaccination have simply been brainwashed by a patriarchal system. Obviously, such an assertion could never be disproved.
So far as I can see, neither of these arguments has been made, and one must hope they won’t be. But why? As Adam Roberts above says (and I remember the seat-belt “freedom” argument as well) it hits close to home. If we intervene in Syria, none of those killed will be close to me. If we allow homosexual couples more parental freedom, then any negative social consequences are for others to worry about. But if my children get measles because your children are not vaccinated, then that affects me very much. Nonetheless, if that’s the psychological explanation, it obviously won’t do as a logical one. If the collective good should take priority over the infinite extension of human rights here, then why not elsewhere? If the male patriarchy-dominated medical system is right about vaccination, could it conceivably be right about other issues? If not, in either case, why not?
I may be optimistic, but I hope that this issue is the beginning of the recovery by the Left of its old virtues of solidarity and social responsibility, and, indeed, to more emphasis on such things across the political spectrum as a whole.

23

bianca steele 02.08.15 at 3:18 pm

Similarly, having given equivocal statements back in 2008, Obama and Clinton are now firmly on the pro-vaccine side.

Did they really? That might illustrate the difficulty of getting safety regulations passed in the US more than anything else. If presidential candidates weren’t willing to give a free pass to thiomerisol, that might have had a hand in getting it banned. In 2008 the US was still resisting banning BPA from baby bottles and dishes, too (and the market was only slowly providing alternatives, to us worrywart parents).

24

RoyL 02.08.15 at 3:27 pm

This is a completely made up controversy. Exemptions exist because of concern for civil liberties, the only state that has no exemption is Mississippi and this is not because it is super progressive but because it is a place that doesn’t tolerate the sort of people who don’t vaccinate, religious dissenters or crunchy granola people. This is why the block of states with the highest vaccination rates are in the South, it is why Utah has a very high vaccination rate and Colorado doesn’t. It is why Oregon with a decent statewide vaccination rate does worst in places like Eugene and Bend, and why Idaho with a truly terrible rate has its problem areas in the parts of the state that you can get liquor easily and social life isn’t governed by which Mormon ward you attend.

And all of this is about considerably less than 10% of the population, in most places it is about 5%. If Mississippi makes it impossible to get an exemption and Texas isn’t much better the Republican Party isn’t going to endorse it. Southern Baptists like vaccinations as do Roman Catholics. You can call them anti science but two centuries after Jenner debates about them are even less about “Science” than internal combustion engines.

Not everything is a partisan divide.

25

DME 02.08.15 at 3:38 pm

Partisanship along essentially the same lines as currently argued can be traced back at least to the mid-50s when the Republicans pushed for a voluntary polio vaccination program and the Democrats called for Federal mandated distribution. Truman and Stevenson both publically criticised Ike for his stance. One Senator Hobby called Federal funding for the program an implementation of socialized medicine.

26

DME 02.08.15 at 3:41 pm

– error – Hobby was Secretary of Health not a Senator.

27

bob 02.08.15 at 3:48 pm

#17 “If the benefits of vaccination producing herd immunity are shared, why not PAY people to be vaccinated?”
That is a question that must be addressed solely by empirical evidence: is paying people to be vaccinated more effective or less effective in increasing herd immunity than legal requirements for vaccination, enforced e.g. by requiring proof of immunization for kids to be admitted to schools.
Libertarians, however, treat it as simply a matter of self-evident principle, which of course is nonsense. (This is not to say that some leftists don’t do the same.)

28

Barry Freed 02.08.15 at 3:52 pm

I know, never read the comments, but the comments on that Reason article are some full-bore bizarro world crazy.

29

Josh Jasper 02.08.15 at 3:54 pm

The idea that “And Paul is pushing a pro-vaccine, pro-science, pro-freedom line.” is dangerously negligent to public welfare in much the way that allowing “safe” drunk drivers on the road would be.

I’m sure there are large numbers of people who think they’re able to drive safely while under the influence, of, oh, say, 3-4 glasses of whiskey consumed in an hour or so. This does not mean they’re not a menace on the roads, but it’s “pro freedom” to allow them this dangerous choice, and not mandate that they stay off the roads until sober.

If all a lack of vaccines did was mean your own kids got sick, this would be no problem, but Paul and Christie are proposing pandering to people creating a proven public health menace. It’s not “pro-freedom” to allow people to create conditions for public health menaces. We regulate things like food prep, agriculture, driving safety and so on. We do so because *not* doing so endangers no only those who do these things dangerously, but others as well.

If it’s “pro-freedom” that drunk driving, unsanitary food prep, unsafe automobile manufacture, unclean medical practices, etc. should be allowed, and you should only be punished after hurting someone else (if at all), the “pro-freedom” movement is a menace.

30

Neil 02.08.15 at 3:59 pm

About that is/ought gap, Brett. Like many other things you might learn in philosophy 101, that’s simple, clear and quite wrong. As Dennett says, empirical facts are the only thing one could possibly hope to derive normative claims from.

31

Marshall 02.08.15 at 4:08 pm

It seems to me these days we have a serious problem with collective action. Vaxing is totally about socialism vs. democracy and socialism is losing … unions are largely irrelevant, political parties are about spinning up a majority, and even nations are seen to mostly just thrash. Did someone here recommend Peter Mair? He saw people withdrawing from “politics” (organized political parties, or as we used to say “machines”) as large-scale policy becomes more rationalized, institutionalized, expertized, unaccountable. Increasingly since he wrote, and perhaps more in the US than elsewhere or maybe not, in reaction people are attempting to empower themselves around random issues like vaxing, guns, abortion, climate change. It’s totally irrelevant to the real coercion in modern life and just feeds the spin machine, but there you are. Maybe soon it will all fly to pieces.

Personally, I think the PC notion that you can and should yell at whatever and whoever you disagree with gives that problem nutritious food; we should learn to be nicer, even to stupid people. And still waiting on Belle’s post about Freddie??

32

CRHayne 02.08.15 at 4:13 pm

There’s measles, but there’s also hep-b. Should that vaccine be mandatory? I was sure my wife was not an IV drug user and not having sex with one. Only one in a million has a severe allergic reaction. Good odds, right? But another way to look at is that 100 people have had severe allergic reactions so far, and some of them were babies not really at risk for hep-b.

Polio is contracted mostly from drinking water with infected feces in it. There is no heard immunity issue. There hasn’t been a “wild” case in the US for decades. Should the polio vaccine be mandatory? Forever?

Should the whole recommended schedule be mandatory?

33

Bruce Wilder 02.08.15 at 4:15 pm

“. . . empirical facts are the only thing one could possibly hope to derive normative claims from.”

Thank you for yet another example of “simple, clear and quite wrong.”

It seems to me that this is perfect illustration of why letting an issue because a matter of partisan dispute can be so counter-productive. You argue with stupid, you become stupid.

There might be all kinds of issues and concerns with regard to vaccines, but as soon as it becomes a matter of partisan dispute — at least in the current American mode — one side has to be on the side of the angels and the other side has to assume the role of foil. It becomes a matter of identity — affirming your own goodness and their badness — and you cannot acknowledge the legitimacy of those issues and concerns any more: “And they don’t like it when people on the other side make them feel wrong.”

34

Anarcissie 02.08.15 at 4:32 pm

Neil 02.08.15 at 3:59 pm @ 30:
‘… As Dennett says, empirical facts are the only thing one could possibly hope to derive normative claims from.’

Maybe. But what will we decide is an empirical fact, and which empirical facts will we hold to be significant? Messages from the gods may be part of my empeiria, but you may have other gods. In any case, intuitions, aesthetics, learned traditions, and moral judgements are substantial, indeed, dominant parts of almost everybody’s experience. The material world does not interpret itself without them.

35

Cranky Observer 02.08.15 at 4:38 pm

= = = If all a lack of vaccines did was mean your own kids got sick, this would be no problem, = = =

As I believe was explained thoroughly in a previous thread, children are Citizens in their own right (in the United States, definitely under the 13th Amendment), and parents do not have the absolute right to take away their children’s inalienable rights.

36

bianca steele 02.08.15 at 4:38 pm

Bruce, could you clarify whether in your last paragraph you’re objecting to my phrasing of “they don’t like it when people on the other side tell them they’re wrong”? Because it sounds to me like–regarding your last paragraph–we are saying much the same thing. And I can’t tell whether you have a point to make. or whether you’re making a scholarly kind of general statement of analysis.

37

Bruce Wilder 02.08.15 at 4:42 pm

We’ve always had a problem with collective action — collective action is inherently problematic in a complex (centralized and de-centralized — two mints in one!) political and economic system with a high degree of specialization and cooperation.

Our political and economic system is almost too complex for even educated people to understand and most of our political ideologies are vast oversimplifications, in which the simplification is a feature, not a bug. (And, no, I am not only looking at Brett Bellmore’s talk-radio glibertarianism.)

The vending through the mass media of political identities (“I’m pro-science, I’m a Democrat; they’re racists, that explains their Republicanism, etc.”) is just a ghost of participation and commitment in a genuine membership organization of the kind that generates a feeling of political solidarity and some mechanism of trust and discipline between followers and leaders. Identity politics is a symptom of the low ebb of social affiliation, but it is also a deliberate product of a concentration of wealth and power: a means of manipulating a largely atomized and passive population.

Feeding symbolic issues into the maw of partisanship can create drama and maybe contributes, for better or worse, to cultural change, but feeding more substantive issues — issues where resources or organizational capability might be required — seems to generate political paralysis and impotence. When being smart about an issue matters to the resolution, it is self-destructive for the society to turn to rival Manicheisms.

38

James Wimberley 02.08.15 at 5:04 pm

Cheryl Rofer in #14: “Measles is highly contagious before any symptoms appear ..”

Before today I used to think that the distinction between infectious and contagious followed the Latin: contagious means transmission by touching, infectious means or includes transmission by droplets in the air. Apparently this is not (or no longer) the trade usage. Contagious is now the only term useful for the public, as it covers human-to-human transmission by any means. Infectioushas become a pure term of degree, for the numbers of the beastie needed for transmission. So we annoyingly now have to distinguish between touch-contagious like Ebola and air-contagious like the flu, and of course measles.

39

dn 02.08.15 at 5:06 pm

Issues such as this reveal the genuine force of the theocrats’ critique of philosophical liberalism as inherently nihilistic. After all, if the guiding principle of liberal discourse is that “reasonable people can disagree”, then the next question obviously becomes: “and who, exactly, is reasonable?”

As was astutely observed by Anarcissie above, this is just the “priesthood of all believers” debate in a new guise. Today’s naive libertarians, like Luther and company before them, get a lot of mileage out of insisting on this principle, but push them and you quickly find that their tolerance, too, has limits. Even for a Reformer, Anabaptism is a bridge too far. (Take Jon Chait, for example. Some feminists on the internet disagree with him. His response to them is “you are heretics and apostates from the One True Liberal Faith and should shut up”.)

As Josh Marshall smartly explained last year in a piece I often return to, the Reformation was not necessarily the glorious advance for civilization that many people continue to believe it was – quite the contrary: “It is probably not too much to say that most of what we now see as the legacy of the Reformation is in fact the outgrowth of its failure.” Modern secular society is not exactly what the Reformers had in mind, but the Reformation put us on this road by showing the unworkability of the alternative. Free-associating now, but the experience of the Thirty Years’ War, viewed in this light, seems parallel to that of the US Civil War as characterized by Lincoln in his Second Inaugural: “Each looked for an easier triumph, and a result less fundamental and astounding … The Almighty has his own purposes.”

40

Bruce Wilder 02.08.15 at 5:11 pm

bianca steele @ 35

I am certainly agreeing “they don’t like it when people on the other side make them feel wrong.”

If I demur to anything in your comment @ 19, it is to the condescension, which I thought Anarcissie @ 13 had deliberately put aside, but which you added back. Adding it back, though, did make your punch line that much more effective, so I quoted it.

My point was that partisan political identity — as constituted in the current American mode — ties an issue (any issue, really) into personal self-esteem in a way that doesn’t improve the intellectual quality of the argument. The argument becomes a matter of making me feel good about being pro-science (or anti-racist or whatever) and “them” feel bad about being wrong. It becomes tribalism. And, I think making any issue into one of partisan political identity can make it that much harder to recognize and manage substantive conflicts of interest, and — most relevant — hold elites accountable.

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bianca steele 02.08.15 at 5:32 pm

Bruce, I think you’re reading the condescension into the comment, I don’t think it’s there. First, is it a fact that they don’t like it when people on the other side tell them they’re wrong? Is it condescending to be accurate about that fact? I think they don’t mind much when people on their own side tell them they’re wrong–and I’m using “they” here because it’s important that in their worldview scientists aren’t on their side, but another kind of authority figure is. Second, I think it’s also the case that the authority figures “don’t like it” when their flock is made to feel bad by authority figures “on the other side.” Is it also condescending to criticize authority figures from a group I don’t belong to and don’t have power over? (I might point out that those authorities’ complaint against authority figures “on the other side” is one you echo when you use the word “condescending,” and this is one point where it seems we do have a difference of opinion.)

I think the whole idea of “the priesthood of all believers” and related questions are fascinating. Consider Ross Douthat’s op-ed in today’s Times. He (or his headline writer) accuses Obama of pretending to be a theologian. But it could be equally argued that Obama is appropriately deferring to a real theologian, and doing exactly what Douthat claims to be asking him to do. What kind of deference to authority do we expect in today’s world of mass college education? Too often it seems we cloak partisanship in pretend calls for “deference to authority.” It depends which authorities, doesn’t it?

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dn 02.08.15 at 5:44 pm

The POAB thing strikes me as a natural development in any highly-specialized society. Everyone has their own little corner of the economy where they’re an authority, where they get to be the priest. The problem is that extreme specialization also means that we’re very tiny cogs in a very big machine; as wannabe priests, we all find this limitation on our authority deeply dissatisfying, and wish we had slightly bigger parishes to manage.

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Barry 02.08.15 at 5:46 pm

Brett Bellmore 02.08.15 at 2:50 pm

“I think I need to note that what the left appears to be doing here is simply excluding all consideration of persuasion. You know what the right thing to do is, some people don’t want to do it, so, instantly, without consideration of other options, force comes out.

Why is your first response not increased efforts at persuasion?”

This whole statement is a lie, pure and simple. Persuasion has been used for vaccinations for many, many decades. It proved to be insufficient, and therefore it was mandated. That proved to be effective, where persuasion was proven to be ineffective. And that was in a time when parents and grandparents would have been far more painfully aware of the horrors of childhood diseased.

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dn 02.08.15 at 5:52 pm

Meant to add – And democratic politics is the space in which our urge to expand our priestly purview plays out. This is certainly problematic, but is it not, in at least some sense, preferable to a world in which an actual specialized priesthood claims that its priestliness gives it authority over all spheres of life, whether they know anything about those spheres or not?

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bianca steele 02.08.15 at 5:55 pm

dn @ 38

Good points, though I think it’s possible to overplay the similarity between intellectual (or cognitive) and theological questions. Dissent under liberalism isn’t all that usefully understood by analogy to Luther’s 95 Theses, and so on. It’s possible to take the analogy too seriously and get captured by one or another church, and accept their solution to the paradoxes too quickly. It’s also possible for outsiders to be misled about the nature of the dispute and end up, at best, looking silly.

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Bruce Wilder 02.08.15 at 6:01 pm

Have you ever actually read Martin Luther’s polemical writing? Because it seems to me he would fit right in, in any of the internet’s darker comment threads: ranting, scatological, etc.

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William Berry 02.08.15 at 6:03 pm

Anarcissie, Cheryl, Rich: Great comments, all.

I will have to finish digesting my lunch before I tackle BW’s . ; )

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David 02.08.15 at 6:07 pm

I think this is a situation where classic liberalism does not help, and is indeed actively harmful, because here, there is a right answer and a wrong answer. A civilised discussion between reasonable people would probably lead to a conclusion that, whilst vaccination is highly desirable, it’s wrong to make people do things against their will, so it should not be compulsory. And then you get thousands of illnesses and hundreds of deaths.
This is linked to the issue of defence to authority, since, on this occasion, the only authorities worth taking seriously, as I mentioned before, are actually right. But can you have a general distrust of authority (which, it is true can be misused) combined with exceptions for particular cases?
As it happens, I was talking to a health professional today, who said that there are now the beginnings of a whooping cough epidemic in parts of London – not poor areas, but areas inhabited largely by upper-middle class professionals. These people are often of broadly “liberal” views, and are exercising their independent judgement in what they see as their children’s interests, as well as defending their principles. Many educated middle-class women are refusing to be vaccinated while pregnant. So how do you “persuade” an upper-middle class couple (a lawyer and a banker, say) to accept vaccination?

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Marshall 02.08.15 at 6:09 pm

Bianca, are you saying that people on “your side” (content not specified here) are OK with being told they are “wrong” by people on “their side”? I don’t think so. Nobody likes being told they are flat wrong. Nobody thinks their ideas come out of nowhere.

The alternative to the priesthood of all believers is Popishness, hierarchy, dogmatism. The point is that whatever the nature of the direct unmediated connection of God to Humankind, it belongs to anybody and everybody who wants it. By Grace, not Law.

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bianca steele 02.08.15 at 6:15 pm

To expand a little: as far as I can tell, religious arguments against trust in authority are often based in assumptions about alternative sources of revelation. The skeptic may question how different these are from authority, whether they’re not simply authority under a different guise (except in their extreme forms, with something like Rousseau on the one side, and a religiously acceptable authority like the Vatican on the other), but the answer is that they’re really not. But that just pushes the question “which authority?” off to a question about “which non-authorities get to have a voice, and which are excluded because of non-goodness?”

And “these non-authorities don’t get to have a voice, because they don’t obey these authorities, but it’s not about authority at all,” is, well, paradoxical.

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bianca steele 02.08.15 at 6:23 pm

Marshall, we cross-posted. The short answer to your question is that I’m doing two things: describing (some of) the people who are opposing vaccination, and addressing a question about authority. There are some people who simply do not believe that there’s a modern-day religion that isn’t based on authority and persistent, centralizing criticism of error. They explain anti-authoritarian religion either, as Brett does, by calling it “left” even when it perceives itself as “right”, or by excluding it (at least temporarily) from the true kind of authoritarian religion.

No one “likes” to be criticized. But some groups hold that it’s really impermissible to criticize the flock from certain directions. These groups really exist. The unwillingness to be criticized in certain ways isn’t just an optical illusion that disappears once you look at those groups from inside.

I think the manichean dichotomy you’re describing (priesthood of all believers vs. “popishness”) is only true of a pre-modern society and is harmful as a description of the present-day world, especially the political world and of science.

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dn 02.08.15 at 6:23 pm

bianca @44: Of course all historical analogies can be pushed too far. Modern liberalism isn’t Lutheranism, nor is it the Catholic Church. I think confusion possibly arises when a person tries to empty out the empirical component so as to view the purported ideological clash in purely formal terms.

Arguing about “disagreement” or “dissent” in the abstract is kind of a second-order dispute; but it’s the weight that we accord to the first-order disputes that lends the second-order dispute urgency. What gave the theological battles of the Reformation era their force wasn’t just the formal existence of disagreement over the Eucharist or whatever; it was that people really believed that it mattered, and that if you got it wrong you were going to hell. Today the disputes are, instead, over the validity of conclusions in natural science, and their connection to matters of life and death is often seen as attenuated – except, of course, in cases like abortion or vaccination where the moral implications are unavoidable.

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adam.smith 02.08.15 at 6:28 pm

Re: “Paying people to get immunized”:
Why stop there: why not pay people to not drive drunk? That seems like a pretty neat analogy: not being allowed to drive drunk certainly impinges on your freedom, while also making it less likely that you hurt yourself and others. The main reason for drunk driving laws, of course, is the “and others” part.
I thought even for most libertarians, freedom stops were reckless endangerment of others starts.

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js. 02.08.15 at 6:35 pm

The really fucking frightening thing about Brett Bellmore’s comments on this thread is that they provide evidence for JQ’s thesis. As Rich and others have noted, this is likely to be catastrophic.

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Bruce Wilder 02.08.15 at 6:37 pm

dn @ 41:

Everyone has their own little corner of the economy where they’re an authority, where they get to be the priest. The problem is that extreme specialization also means that we’re very tiny cogs in a very big machine; as wannabe priests, we all find this limitation on our authority deeply dissatisfying, and wish we had slightly bigger parishes to manage.

Oddly, I find myself thinking just the opposite: even in our own little corner of the economy, we do not get to be the authority. We all end up having to learn vast bodies of rules handed down from above or from some remote authority. If I am running a bakery, say, I have to follow all kinds of rules — many of which seem arbitrary to me — and these rules are enforced by, say, two or three different government agencies that come and inspect and find fault: I left a bag of flour on the floor for ten minutes or the door between the kitchen and the office wasn’t closed. It is not as if I do not know how to bake or as if I want to make my customers sick. If I am a professional of some sort — say, a nurse practitioner in our vast health-care system — I cannot just evaluate my patient using my own judgment and experience; I have to follow guidelines derived from statistical studies of treatments and outcomes, about when it makes sense to do this expensive test or administer that expensive drug. Or, I have to navigate the obstacles thrown up by insurance companies.

We live in a highly bureaucratized political economy, in which expertly crafted regulations permeate our lives. Even if we recognize the necessity of public inspections and oversight, it necessarily generates resentments, and when it has been co-opted and corrupted, suspicion. Our vaunted educations are just preparation for following the complex rules, the operative details of our economic theology are dictated to us, as in an encyclical letter to the parish priest.

Part of what makes “news” programming entertaining is the illusion of moral clarity at the core of the most compelling “stories”. And, that same sense of clarity feeds the manipulations behind partisan political identities: I have to support the Democrats, because the Republicans are terrible people. The “Big Issues”, after they get the partisan treatement, seem more comprehensible than the day-to-day issues of properly disposing of waste or seeing that employees wash their hands in the lavatory (an issue an idiot Republican congress critter attracted attention with last week).

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Robespierre 02.08.15 at 6:38 pm

@8:

“People should be forced to vaccinate” really means “people should not be allowed to be walking bio-weapons”.

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dn 02.08.15 at 6:45 pm

Bruce: Sure, we have to follow the rules handed down from on high. So do actual priests. That’s the Sacred Tradition of the Church, systematized in the form of dogmas and canon law. Even popes are afraid to mess with it too much. But popes and priests still get to be the ones to enforce it on the laity. As head baker, you may have to follow health regulations, but you still get to be the one deciding how much icing makes for a perfect cake. Your area of priestly authority is tiny, tiny, tiny, but nonetheless real.

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Bruce Wilder 02.08.15 at 7:00 pm

Vaccination has the valence it does because the rules in question involve the most intimate of responsibilities: the care by parents of children. Prescribing and enforcing rules “inside” the family feels even more invasive of privacy, of private discretion than rules affecting the conduct of a business.

The truth of the science is complex and nuanced and not always the kind of moral slam-dunk required for making it a dispute shaped around partisan political identity and conceits. Vaccination does involve complex trade-offs and risks, and as medicine has advanced, the risks and trade-offs have been finer and more subtle. It’s a control problem, and as is typical of control problems, there’s no stable equilibrium solution in the economic sense, short of completely eradicating the disease and ceasing vaccination. As we’ve pushed back the frontier, the balance of risk has changed, as was discussed on previous threads.

Politically, it seems to me, that we need to be holding elites accountable, not either confirming the authority of expertise blindly or criticizing from superstition.

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Marshall 02.08.15 at 7:02 pm

I think the manichean dichotomy you’re describing (priesthood of all believers vs. “popishness”) is only true of a pre-modern society and is harmful as a description of the present-day world, especially the political world and of science.

I think you are trying to import archaic (pre-enlightenment) religious language into a sphere where it leads you into problems. What you are describing as an opposition, I view as the historical development of Christianity. (Rules are not bad, but they won’t get you home, either.)

Typically secularists strongly resist being labeled “true believers” who defer to authority they are not in a position to thoroughly examine. Circling the wagons is something any community needs to be able to do. Not saying at all that a religious ecclesia is in the same situation as a racial minority (here and now) but the notion of “community” implies some necessary problems. What I said above about socialism vs. democracy: same issue.

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Ze Kraggash 02.08.15 at 7:02 pm

“So how do you “persuade” an upper-middle class couple (a lawyer and a banker, say) to accept vaccination?”

You won’t persuade them, but you also won’t force them. What’s likely to happen is that rich people will pay bribes to get certificates without actually vaccinating their children.

Which is, basically, a less attractive alternate of bribing poor people for vaccinating their children.

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bianca steele 02.08.15 at 7:10 pm

Marshall, I’m at a loss to figure out what you’re trying to say. Maybe you could explain? (Also explain whether you meant to imply, in your first comment here, that pro-vaccination position is “socialist”?)

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Freshly Squeezed Cynic 02.08.15 at 7:12 pm

I’m not exactly sure who this The Left is that Brett is always talking about. Didn’t Norbizness retire?

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Rich Puchalsky 02.08.15 at 7:35 pm

A whole lot of this discussion, except Bruce Wilder’s, seems to me to be beside the point in many ways. As a first-order, immediate matter, it seems to be that the eagerness on the political left to adopt this as a differentiating factor is harmful. I Googled the phrase “anti-vaxxer”: the first 2 or 3 pages of hits were all negative uses of the phrase. Do people concerned about vaccination use this phrase themselves? If they don’t, don’t give them a subcultural identity marker. Once this becomes a subcultural identity, it doesn’t go away. If it becomes a subcultural identity linked to the GOP coalition, then it not only doesn’t go away, it becomes an important part of public policy in the U.S.

Less immediately, this is more complex than just competing concerns among members of the public. There are economic interests involved. For global warming denialism, the denialism can never go away because wealthy corporate interests are always there to prop it up. The conditions behind vaccination are different. Big Pharma would like to abandon vaccination, and the “bribes” that people talk about have to be paid not to wealthy people or to poor people, but by government to industry to keep vaccination available (because ideology in the U.S. forbids that the government produce vaccines directly). That politics of e.g. the flu vaccine are weird and complex, and not suitable for quick simplification.

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Bruce Wilder 02.08.15 at 7:47 pm

dn @ 56:

I just watched The Hundred Foot Journey the other night. A cute little romantic movie, it has at its core the mythic archetype for your priestly authority over a tiny domain. The hero of the movie is a young man from India, who comes to aspire to become a chef de cuisine in France.

On another recent thread — the epic bureaucrat — there was some desultory discussion of Hannah Arendt’s The Human Condition, a frustrating (to me) book in which she tried to get at the phenomenology of life, work and political achievement in our modern, disenchanted, bureaucratized world. The movie hero follows a course that illustrates what she may have been trying to express: he labors with his family to create a restaurant, working as a cook. He studies the rules of French cuisine, mastering “the basics” of the five sauces, learns to distinguish poisonous toadstools from delightful mushrooms and so on. He has by grace and the instructive nurturance of his deceased mother, a discerning palette and nose. Finally, he rises in confidence to the level at which he breaks the rules and begins to make his own rules: he alters a two hundred year old recipe, replying to his mentor’s challenge: “Perhaps, two hundred years is enough.” We see him in triumph in Paris, the star chef of an establishment high above the Pompidou, where the motto is: innovation, innovation, innovation. He’s making the new thing — something Arendt celebrated as praxis, the lost political and heroic art of the Greeks in pursuit of arete and gusto. (I’m sure I’m fracturing all of that terribly — god forbid Corey should ask for textual support from Arendt! I did watch the movie, though.)

My point, here, is to affirm that, yes, there’s a mythic ideal of the innovator, whose good taste and discernment leads to a kind of breakthrough to the realization of new values, from the phenomenological miracle of expecting the unexpected. Steve Jobs at Apple. The fictional chef from The Hundred Foot Journey. Napoleon on horseback at Jena, as Hegel saw him.

Most of us, most of the time, don’t experience that. As the head baker, we apply the frosting, and no one much cares — neither our customers nor our apprentices. At best, we find ourselves featured on http://www.cakewrecks.com/ because, like Billy Joel said, You’re not the only one who’s made mistakes; But they’re the only things that you can truly call your own

What we experience is resentment and failure. And, sometimes, some things much, much worse. Like being a protective, responsible parent, who makes a well-intended choice for a child — a gamble, as most choices are — and it all goes terribly wrong. That’s the praxis of the every day, the tragedy of life. And, it is political.

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Neil 02.08.15 at 7:54 pm

Bruce Wilder,

I didn’t offer an argument for the claim. I pointed to somewhere you can find an argument (a blog just isn’t the place to do philosophy). Go and read and try thinking. Or do you prefer abuse?

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mattski 02.08.15 at 8:10 pm

As the head baker, we apply the frosting, and no one much cares — neither our customers nor our apprentices. … What we experience is resentment and failure.

Where I live there are many small artisan bakeries with quasi-heroic status. They make exceptional goods and their customers deeply appreciate it, paying well above the typical price for similar mass-produced products.

Obviously we can’t all be Olympian Artisan Bakers, but I’ll say the following from personal experience. No matter how mundane your job is, if you look for opportunities treat people with honor and respect you will be rewarded, most of the time, with a feeling of having done something worthwhile.

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The Raven 02.08.15 at 8:11 pm

Viruses and bacteria don’t care about our individuality; they just know we taste good. It’s not a domain where the “individual rights” analysis has much to say to reality. The realities of disease are simple to observe and the effectiveness of vaccination is proven by the simplest of statistical methods. (Alas, sometimes these are got wrong!) It is not like climate change, where one has multiple big noisy sets of data that have to be studied and reconciled. (I generally hold with Hansen that the paleoclimate data, as well as comparative data from other planets, is more persuasive than simulation results.)

One of the reasons, I think, many conservatives come out pro-vax because they perceive a risk of infection to themselves. It’s another version of the “deserving poor;” they see that they themselves deserve protection, so of course their concerns must be pressed on everyone. It also doesn’t demand a big social change like a response to climate change; vaccinations have been routine for two generations.

Bruce Wilder, have you ever actually run a small business or worked in a regulated industry? That is not how regulation works in practice. For one thing, most practitioners are very well aware of the reasons for the regulations. Nurses and doctors understand the reasons to wash hands in hospitals. For another, enforcement is not executed day-to-day except in a few special cases; it is largely after the fact. Instead, it is education and practices that are mandated, spot checks are undertaken, and enforcement is largely after the fact in the case of failure.

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Main Street Muse 02.08.15 at 8:21 pm

What is the percentage of those who are vaccinate who will now come down with these viruses, thanks to the loss of the herd immunity? Are we all at risk of these viruses – or is the risk more heavily born by those who choose not to vaccinate?

The real and significant issue with vaccination is NOT political – and I doubt that it is really even “anti-science” (I’ll bet you’ll find anti-vaxxers who believe in evolution and global warming.) The big issue is that there is a significant portion of the public (about 10% or so) who absolutely do NOT buy what the CDC and the medical establishment are selling with regard to vaccines. If vaccines are so safe, so valuable, so without harm, why is this? Are anti-vaxxers really just stupid, ignorant anti-science nitwits? That kind of attack does nothing to address the underlying issue in this debate – the lack of trust in the health care establishment.

Some people I know who are anti-vaxxers are dealing with autism in the family. Some people I know who delayed the schedule saw a scary adverse reaction to an early vaccination. Are they really just “anti-science”? There is absolutely NO problems with injecting a 2 month old baby with multiple viruses?

I realize there are tons of studies to disprove a link to autism and vaccines – but what constitutes the control group? Do we have enough unvaccinated children to disprove a link? How is this proved? WHY is autism on the rise? And by autism, I mean more than just “on the spectrum” – I mean incidence of severe autism, which is a serious public health issue today. Anyone know the answers to these questions?

What’s ignored right now is that vaccines themselves – fantastic though they are (my children are fully immunized!!) – are not without problems – when you bring your child to be vaccinated, you leave the office with a stack of papers filled with “adverse reactions” to be on the watch for. When they talked about the safety of ethyl-mercury (once in all children’s vaccines, now limited to flu shots and adult vaccines), the language was not reassuring – a key difference is that ethyl-mercury has a shorter half-life than methyl mercury and is only in the body for 1.5 weeks before it is flushed out. Add up all the shots a baby gets in that first year – that’s a lot of weeks of exposure for infants with immature immune systems… and probably a reason why the CDC removed it from children’s vaccines.

Also, the CDC paid out nearly $3 billion to families to compensate for vaccine injury last year – it is commonly believed that many injuries don’t even get reported. And yet, anyone with any doubt of any kind about the safety of vaccines is branded as a lunatic and an “anti-science” anti-vaxxer. Whether vaccination is a political issue, the result of ignorant anti-science idiots, it is clear that the “attack mode” is not working… perhaps an American outbreak of polio will provide the cure for this fear? (Are there really people refusing to immunize their children for polio?! I find that a terrifying concept.)

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js. 02.08.15 at 8:25 pm

For one thing, most practitioners are very well aware of the reasons for the regulations. Nurses and doctors understand the reasons to wash hands in hospitals.

This I think is a really important point that, appropriately generalized, would help dispel the unnecessary obscurities of this (to me) exceedingly weird discussion.

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David 02.08.15 at 8:48 pm

I suspect that vaccines, as such, may be a surrogate for something else. It’s not a religious question (except possibly in the US) and it’s not a question of contrasting authorities, because no authority I’m aware of is really against vaccines. It’s not even really a symptom of a general crisis of authority, although as I said earlier, the two are linked. It’s primarily about the exaltation of the subjective experiences and emotions of the individual, and their right to have these treated as seriously as any objective process of evaluation. So I “doubt” the effectiveness and safety of vaccines, I “fear” what might happen to my child, I am “suspicious” of the medical establishment, I “feel” that my child is a victim because he/she became ill reasonably soon after receiving an injection. I demand, and in this age I usually get, acknowledgement the validity of my concerns. Ironically, in spite of the discrediting of the autism link, one can say that this kind of behavior by parents has autistic elements to it. I want my subjective fears acknowledged: I don’t care what happens to your children. The last point, to repeat what I said earlier, seems to me the most problematic. How do you deal with someone who says “even if what you say is true, I’m not getting my child vaccinated. What duty do I have to your children?”

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b9n10nt 02.08.15 at 8:58 pm

Re: the claim that vaccination shouldn’t be politicized:

Perhaps what’s happening here with all of the righteous indignation against anti-vaccers is liberal’s bootstrapping this particular issue to a general affirmation of and confidence in the liberal technocratic ability to discover, promote, and institute policies for the general welfare.

Fundamentally, individual rights should be valued because they are useful rather than them being an absolute good in themselves. (Even “the individual” is, to a degree, an abstracted construct, not ultimately Real to mystics nor science.) But once this is acknowledged, the invocation of “individual rights” as a defense against economic equality and corporate personhood (and strategically amidst the Culture Wars) loses much of its force.

So perhaps this is sensed. We’ve been taking on the chin for being “do-gooders” and ideologically incapable of seeing “unintended consequences” for our schemes and told to let Americans have their “freedom”…and along comes a perfect illustration of the value of the technocratic liberal project and the vacuity of its most prominent and powerful dissenters.

Wouldn’t we be foolish to pass up this opportunity?

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Rich Puchalsky 02.08.15 at 9:03 pm

“Ironically, in spite of the discrediting of the autism link, one can say that this kind of behavior by parents has autistic elements to it.”

I think that Collin Street will tell you that the use of autism as a metaphor for any behavior that one don’t like is, itself, an indicator of autism. Maybe you should have yourself checked out and treated.

One of my children is a high-functioning autistic child, and I “fear” for what will happen to him once people like you thoroughly change the term from a medical one into an insult.

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b9n10nt 02.08.15 at 9:14 pm

@ 67: “attack mode” May or may not be working as a pro-vaccination campaign (how do you know it isn’t?), but what will help are mandatory vaccinations for public school attendance and more and more doctors informing parents that they will deny their practice to unvaccinated children.

@69: re: surrogacy: Yes! anti-vaxxers are the apotheosis of egoic identity and consumerist individualism. (Well, we all are frequently, but they rather unintentionally are exposing the limitations and absurdities of the great Cause to have it “your way”).

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David 02.08.15 at 9:15 pm

@Rich Pulasky. Tut tut. It wasn’t intended as an insult, but as a metaphor, rather like blindness or deafness are routinely used, and in this case I think it’s rather precise.

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Bruce Wilder 02.08.15 at 9:15 pm

The Raven @ 66

Of course, I was taking the examples from the experiences of people in businesses I am personally familiar with. So, yes, it is exactly how regulation works, in those cases. People resent it. I am yet to see anyone with a food preparation or processing business, who did not resent some aspects or instances of the inspection and record-keeping process. The things you can get criticized or cited for may seem trivial or arbitrary, and may actually be trivial and arbitrary in context. Some of the rules are not simply an embodiment of good practice; some of the rules are meant to set boundary conditions. If your food processing business is fairly large, you can opt for a form of self-regulation, where your processes and systems are reviewed at a kind of meta-level, because you can prove that you devoting resources to inspection and monitoring, but smaller processors get inspected, usually by at least two agencies. And, if you also serve food retail — as many small processors do (and the examples I had in mind do), you get inspected again. Restaurants and retail food serving businesses in Los Angeles are inspected and a letter grade publicly posted, reflecting the result — getting anything less than an “A” can damage your revenues significantly, and it’s really not that hard to get a “B”. And, many months will elapse before another inspection can be scheduled.

And, yes, of course, people understand the reasons for the regulations. I thought I said as much. Much of what passes for education and technical training consists of learning the reasons for the rules alongside the rules. It doesn’t mean that people follow the rules. Doctors and nurses know, in theory, the reasons for hand-washing and a great many other procedural guidelines. Still, iatrogenic illness remains very, very common and hospitals are very dangerous places.

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adam.smith 02.08.15 at 9:28 pm

@67 – the risk is obviously much higher for those without immunizations, but those include newborns prior to immunizations and people with medical reasons not to immunize (such as Leukemia patients). The Disney Measles outbreak, for example, did include a fair number of infants under 12 months, i.e pre-MMR immunization. Those are the people who rely _only_ on herd immunity.
As for the rest — every one of the arguments you bring forward has been amply addressed at any given level of detail from the simple, non-technical summary to the Cochrane Meta Review. The sad state of affairs is that we simply have no idea how to convince people (who aren’t convinced) to vaccinate their children
http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365
Interestingly, the more drastic messages actually makes it worse, though.

Rich says above we shouldn’t give people a lable like anti-vaxxers, but is that necessarily true? Do we have any evidence that a label with a strongly negative connotations actually builds rather than prevents group cohesion? (e.g. it strikes me that calling homophobes, well, homophobes has been relatively effective).

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adam.smith 02.08.15 at 9:34 pm

It wasn’t intended as an insult, but as a metaphor, rather like blindness or deafness are routinely used, and in this case I think it’s rather precise.

not it’s not. Would it, for once, really have been so hard to apologize and move on?

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Peter K. 02.08.15 at 9:38 pm

Bruce Wilder @ 36

” Identity politics is a symptom of the low ebb of social affiliation, but it is also a deliberate product of a concentration of wealth and power: a means of manipulating a largely atomized and passive population.”

I don’t buy this. There can be progress on different fronts. MLK, Malcom X and Mandela pushed for progress on the racial front. The whites were/are engaging in identity politics and the freedom fighters were fighting for universalism. Same with women and the vote, gay marriage, etc.

Vaccines could be a stand in for socialized medicine or for the priorities of the medical industry. It’s interesting how some on the left see Obamacare as either progress or a giveaway.

What’s interesting to me is how a general distrust in the authority of government and institutions can be a good thing, something that begin in earnest after Vietnam.

It also can lead to more atomized society. If you don’t trust the government which is a product of democratic participation to work for your interests, then what? Just go it alone? Tend your garden?

79

dn 02.08.15 at 9:40 pm

Bruce @63, point taken. I actually think we’re at least partially in violent agreement, as they say, insofar as I think both of us are acknowledging that modern hyperspecialization is imposing some rather miserable strictures on most peoples’ lives.

In any case, Rich @62 is on point; credit to him for bringing this conversation back onto the rails. Are vaccines becoming a partisan issue? I sure hope not, but for God’s sake let’s not encourage those who want it to be one!

MSM @67: Yes, you can find anti-vaccine people who accept evolution and global warming. You can also find pro-vaccine people who don’t buy what the IPCC is selling. What does that tell us? Only that human beings have a boundless capacity for selectivity in their reasoning. I certainly don’t believe for a minute that there’s not a political dimension in at least some quarters. Hell, isn’t the statement that “people mistrust the health care establishment” basically conceding the point? (“It’s the Establishment, man!”) Maybe “anti-science” is not a useful rhetorical frame. I welcome better alternatives.

80

Peter K. 02.08.15 at 9:41 pm

I also think of Marx’s words on capitalism: “all that is solid melts into air” as everything is reduced to the cash nexus. The elites running institutions owe no real allegiance to society as whole. The institutions are to be used. And so they are no longer trusted, nor is authority.

81

Rich Puchalsky 02.08.15 at 9:51 pm

adam.smith: “Do we have any evidence that a label with a strongly negative connotations actually builds rather than prevents group cohesion? (e.g. it strikes me that calling homophobes, well, homophobes has been relatively effective).”

I could be wrong about this, of course, but it seems to me that homophobia was not subcultural: rather the reverse. If the cultural damage has already been done, one can’t fix it by then refusing to talk about it: one has to confront it at that point. So, for example, one can’t make racism disappear from American culture by saying in the late 20th century that no one should ever talk about racism.

On the other hand, if people don’t already think of themselves as X and have long-standing cultural connotations of X in their heads, then calling them that seems to me to be a way of building group identity. In particular, if all of the different people who have different reasons to be concerned about vaccination start to think of themselves as the group of “anti-vaxxers” because people call them that, that seems to me like a very bad thing.

If I was going to design a campaign around this in the U.S. context, it would be congratulatory — something like “You were concerned for your children, and once you brought that to the authorities they shared your concern. So they took thiomersal out of vaccines, and now you can go back to vaccinating with confidence.” But I’m not an expert at this kind of thing, and maybe an expert would say that mentioning a problem would be the part that people remember.

82

Omega Centauri 02.08.15 at 10:42 pm

I think this is indicative partly of the human difficulty with understanding probability. Most of us want the simplicity of binary logic. So we want a vaccine to be effective one hundred percent of the time, and to have exactly zero risk of a side effect. Yet, reality comes on a sliding scale, but our primitive emotional processing has little regard for probabilities, and lots of regard for the emotional salience of imagined potential outcomes. So for many parents the tiny risk of negative consequences can be blown up into a huge emotional burden.

Likewise at the communal/political level. No non-medical exemptions isn’t a desirable policy, unless it is the only thing that can push herd immunity over the epidemiologic threshold. Its been noted elsewhere that true religious (vax) objectors are small enough in number not to constitute an important threat. But, how do you exclude those who claim that their ungrounded (or wildly) overblown fear in fact stem from religious convection. We risk imposing on both types the same regulatory sanctions.

I’m not convinced that the cultural conditions for vax versus anti-vax aren’t changing substantially. Until the media attention to the latest measles epidemic, the downsides of allowing vaccination rates to decline, just wasn’t on the mental radar outside of public health circuits. Now those who resist vaccination face potential social consequences. Maybe their kids will be socially shunned as potential Typhoid Tami and Timothies. Maybe the risk of possible social isolation will tip the balance towards compliance without the need for draconian regulation?

83

Bruce Wilder 02.08.15 at 11:02 pm

The actual science, math, medicine and biology is complex. And, what the balance of risks may be, for society or for the individual, in managing public health and private well-being are not necessarily obvious or invariant. Neither judging for one’s self in the Dunning-Krueger version of the Priesthood of All Believers nor the Ultramontane version of trust in scientific expertise and authority would make for a sensible politics, so why try to reduce inevitable controversy to that kind of dichotomy?

84

Barry 02.08.15 at 11:29 pm

Main Street Muse: “If vaccines are so safe, so valuable, so without harm, why is this? Are anti-vaxxers really just stupid, ignorant anti-science nitwits? That kind of attack does nothing to address the underlying issue in this debate – the lack of trust in the health care establishment. “

Because a lot of people lie, and lie repeatedly, and pass on those lies. And the ‘liberal media’ happily puts an Playmate vs a scientist, as a debate which makes Stalinist show trials look fair.

85

Matt 02.08.15 at 11:35 pm

Politically, it seems to me, that we need to be holding elites accountable, not either confirming the authority of expertise blindly or criticizing from superstition.

What does that mean, concretely, in the context of the recent measles outbreak? Did American children have higher measles vaccination rates 10 years ago because elites were more accountable then? Personally, that’s not how I remember 2005.

I don’t want people confirming the authority of expertise blindly. I would like people to learn enough statistics and design of experiments in school to interpret research affecting public policy. Nobody can any more be a scientific generalist across all fields. But most people could, IMO, learn enough statistics to differentiate low-ambiguity, high-signal statistical research from other kinds. There are of course other questions to answer even if the statistical evidence is sound: what premises and values do you use to make meaning from statistical evidence? Are there gaps in research in related areas? I think it would be about as hard to teach these skills and analytical approaches to high school students as it is to teach them algebra and trigonometry, and for most it would be significantly more useful later in life.

I agree that it’s bad tactics and factually unsupported at the present to try to interpret vaccination attitudes as another tribal marker attached to already-defined tribes. If presidential candidates for 2016 prominently sort themselves into pro- and anti- mandatory vaccination groups then the prophecy of tribal markers is more likely to become self-fulfilling.

86

dn 02.08.15 at 11:52 pm

Saying “we need to hold elites accountable” is a truism. To avoid the trap of confirming the authority of expertise blindly, people need to develop a modicum of expertise themselves, at least enough to tell good research from bad. But that’s just the problem, isn’t it? If anti-vaccination views are really on the rise, it would seem that we are failing at this.

87

Matthew Ernest 02.08.15 at 11:56 pm

“We’re not as enthusiastic about this notion that being convinced you know which choice is best entitles you to impose it on somebody, as your side is.”

This presupposes that the opposite position does not impose on others.

Allowing choice in vaccination imposes increased exposure to those who would choose to vaccinate in ways that they cannot control. The difference is that this imposition on top of being an involuntary restriction on freedom also increases deaths from communicable disease.

88

Jeremy Fox 02.08.15 at 11:59 pm

According to polling data, the answer to the question posed in the title of the post is “no”. Though I guess it’s possible that might change in future:

http://www.culturalcognition.net/blog/2015/2/5/what-does-christie-know-that-the-rest-of-us-dont-my-guess-is.html

89

JanieM 02.09.15 at 12:02 am

We’re not as enthusiastic about this notion that being convinced you know which choice is best entitles you to impose it on somebody, as your side is.

Hilarious. (But consider the source, I guess.)

90

Tabasco 02.09.15 at 12:30 am

“Anti-science ibertarians in Australia and the UK are strongly pro-speeding”

Is ibertarian a typo or a weird derivative of Iberian? If the latter, shouldn’t the speeders be Spanish and Portuguese?

91

Layman 02.09.15 at 12:40 am

MSM @ 68

“If vaccines are so safe, so valuable, so without harm, why is this? Are anti-vaxxers really just stupid, ignorant anti-science nitwits?”

In a word, yes. Most people are stupid, anti-science nitwits with respect to any experiment they can’t conduct themselves. They believe in electricity, because their lights work, but the don’t believe in sub-atomic particles in any meaningful sense of the word ‘believe’. They simply bow to authority, and they want to select the authority they credit.

You go on to pose a number of other question which, it seems to me, are poorly disguised, soft anti-vaxer claims. Use the google.

92

phosphorious 02.09.15 at 12:52 am

It has clearly become a partisan issue. Several republican politicians, presidential hopefuls among them, have made public statements expressing nuances on the topic.

A topic which requires no nuance; vaccinations are an example unqualified success in science driven policy. But a republican candidate for president must make it clear that they are aware of all the controversies, and that whatever their own position, they will not be quick to apply the power of the state against those who might, quite reasonably in the opinion of the candidate, disagree.

I haven’t yet seen a democratic hopeful do that particular dance. Have I missed one?

Quote all the polls you want, and cite all the liberal Huff post anti-vaxers you like. . . a mainstream republican candidate MUST at least nod to the loonies on this question if they hope to win the nomination.

93

derrida derider 02.09.15 at 1:28 am

The original libertarian position is supposedly the JS Mill one -“I should be free to do whatever I want, even if it harms me, just so long as I don’t harm anyone else”. That’s an intellectually consistent but operationally useless principle – we are social animals and absolutely everything we do affects other people for good or bad.

The right response by liberals (“liberals” in the JS Mill sense, not the Fox News sense) is to think case-by-case about where the balance of individual autonomy and harm to others should lie. Of course the response of “libertarians” is generally “I should be free to do whatever I want and to deny any effect on other people”. That’s where the anti-science bit comes from.

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Main Street Muse 02.09.15 at 2:17 am

Layman @ 90 “Most people are stupid, anti-science nitwits with respect to any experiment they can’t conduct themselves. They believe in electricity, because their lights work, but the don’t believe in sub-atomic particles in any meaningful sense of the word ‘believe’. They simply bow to authority, and they want to select the authority they credit.

You go on to pose a number of other question which, it seems to me, are poorly disguised, soft anti-vaxer claims. Use the google.”

This is exactly the problem – anyone – ANYONE – who questions vaccines is stupid. I, too, recommend Google. The issue is more complex than you know. CDC paid out $3 billion to families with vaccine injuries last year – and again, claims filed are supposedly a small percentage of people who feel they or a family member has been injured by vaccines. The argument that vaccines are without harm is simply not true.

And 90% of American children ARE fully vaccinated. SKY IS FALLING….

95

js. 02.09.15 at 2:29 am

If the herd immunity threshold (for some vaccine) is 10%, then that 90% of kids are vaccinated is cold comfort. The thing is, this is genuinely at “sky is falling” level of awfulness—or at least, it could very well be, esp. if the US right-wing decides that this is one of “their” issues.

96

Rich Puchalsky 02.09.15 at 2:36 am

MSM: “CDC paid out $3 billion to families with vaccine injuries last year”

False. From here:

Since the first National Vaccine Injury Compensation (VICP) claims were filed in 1989, 3,941 compensation awards have been made. More than $2.8 billion in compensation awards has been paid to petitioners and more than $121.6 million has been paid to cover attorneys’ fees and other legal costs.

Note that this is over the life of the program, since 1989. Not “last year”.

MSM: “The argument that vaccines are without harm is simply not true.”

Misleading. Literally no one that I know of makes the argument that vaccines are without harm. On the contrary, vaccines are known to very rarely cause injury. But the risk of injury is, as far as we know, outweighed by the increased risk of injury from getting the disease that the vaccine is designed to protect against that you undergo if you aren’t vaccinated.

97

nick s 02.09.15 at 2:45 am

Why is your first response not increased efforts at persuasion?

What could be more fucking persuasive than infectious diseases killing lots of people in the past? Well, clearly MONEY THE ONLY TRUE GOD for our resident compoundista.

See also: the “libertarian” position on municipal water and sewage, firefighting services, etc. There is no social advance over the last 200 years reliant upon some degree of collective rights and responsibilities that an arsebadgertarian like Bellmore won’t question because Freedom®.

One thing you can say is that the spread of shitty ideas about vaccines has spread like an infectious disease, and epidemiologists will probably get some good research out of it.

98

Dr. Hilarius 02.09.15 at 2:49 am

Main Street Muse: Total compensation paid out for vaccine-related injuries is $2.8 billion dollars for all claims since 1989. That covers 3,941 awards. See:http://www.hrsa.gov/vaccinecompensation/data.html

It’s worth noting that anyone can report a vaccine-related adverse event to the CDC without needing any proof of causation. As for under-reporting of vaccine problems, we enter into the realm of pure speculation.

Most adverse reactions to vaccines are minor; swelling at injection site, brief fever, transitory pain at the injection site. For those of us old enough to have seen people in iron lungs or scarred by smallpox these are pretty small potatoes.

99

Main Street Muse 02.09.15 at 2:59 am

How many people died of measles in the US prior to the vaccine? Let’s go to the CDC for an answer (http://www.cdc.gov/measles/about/faqs.html):

“Before the measles vaccination program started in 1963, we estimate that about 3 to 4 million people got measles each year in the United States. Of those people, 400 to 500 died, 48,000 were hospitalized, and 4,000 developed encephalitis (brain swelling) from measles.”

According to the CDC, in the era before the measles vaccine, approximately 2% of the population became infected with measles each year (4 million in a country with a population of about 189 million in 1963.) Of those 4 million or so people infected with measles, approximately 0.01% died of measles; 1.2% of those infected were hospitalized; 0.1% of those infected developed encephalitis.

100

Main Street Muse 02.09.15 at 3:03 am

Rich @ 95 – yes you are right – I misread it late the other night.

101

The Raven 02.09.15 at 3:09 am

“Bruce Wilder, have you ever actually run a small business or worked in a regulated industry?”

BW: “Of course, I was taking the examples from the experiences of people in businesses I am personally familiar with.”

Is that no or yes?

In any event, food and agricultural regulation is different from the public health laws that cover vaccination and the regulatory regime that covers individual medical care. I don’t think you can generalize from food to health–the authorities and legal responsibilities of doctors is different from that of bakery owners, for instance.

102

dn 02.09.15 at 3:34 am

MSM – Going off Dr. Hilarius’ numbers, the CDC since 1989 has paid out just under 4,000 individual awards in 25 years – just under 160 per year – while many, many more than 4 million get MMR shots each year. That’s settlements for vaccine injuries – I see zero evidence in this thread of any actual deaths from vaccines, and no indication of how serious these reported injuries were (and Dr. Hilarius says they don’t even need proof of causation – am I reading this right?).

And we’re supposed to take your measles numbers as proof of something other than “vaccines have saved 400-500 lives and a great deal of additional suffering every year”? Forgive me for my harshness, but I really don’t understand what you’re trying to convince us of here.

103

Steve Sailer 02.09.15 at 3:53 am

Scientific experts have discovered much about, say, IQ, sex differences, race, crime, and so forth that liberals really, really don’t like to hear, as the Summers, Watson, and Richwine witch-sniffing brouhahas made clear

104

Rich Puchalsky 02.09.15 at 3:54 am

“Dr. Hilarius says they don’t even need proof of causation – am I reading this right?”

The program was purposefully set up to cover more than the likely actual injuries from vaccines. The court has more relaxed standards of evidence and burden of proof than typically are used.

And yes, by comparison, the 1 in 10,000 chance of dying of measles and 1 in 1,000 chance of having a serious brain injury are relatively huge risks. Having 2% of the population infected with measles each year when the U.S. didn’t have vaccines happened because almost everyone got measles (and then got immunity to measles).

105

JanieM 02.09.15 at 4:11 am

From here:

John Quiggin 08.21.12 at 12:51 am

As I expect Tedra is asleep, I’ve unapproved a bunch of comments from Steve Sailer, and also banned him from my comment threads. I expect a comprehensive ban soon, unless other CT-ers have a more charitable reading than mine. In the meantime, let’s get back to homeschooling.

Sorry to go OT, but I’d love to hear from Tedra around here again, and since CT doesn’t do open threads, I thought I’d throw it in..

106

Steve Sailer 02.09.15 at 4:18 am

Here’s a good medicine related example: The 1980s AIDS epidemic in the United States was in large measure the result of the gay liberation of the 1970s unleashing gay male promiscuity. The science is obvious on this topic, but stating this plainly will lead to much outrage.

107

nick s 02.09.15 at 4:21 am

Fuck off back to your racist shithole, Sailer.

108

Zach 02.09.15 at 4:30 am

RFK Jr. is regularly granted private meetings with top Democratic congresspeople and their staff as well as HHS and other public health agencies. As far as I know, few if any prominent Democrats have called out him by name for his dangerous, uninformed nonsense. It’s only a partisan issue in that the right-leaning anti-vax crowd seems to be more motivated by profiting off of rather than spreading idiotic paranoia.

109

Zach 02.09.15 at 4:46 am

“It needn’t be said out loud, but if you really need evidence that the anti-vaccination movement is not symmetrical about the left-right axis, just look at the list of Democratic politicians who are hemming and hawing about whether vaccines are safe and effective against disease. There are none, at least no prominent ones.”

I’m a partisan Democrat. I’ll defend the party where it’s OK to do so but this isn’t right at all. Obama did in fact hem and haw during his 2008 campaign (as did McCain) when he got the vaccine/autism question. There’s some retrospective waffling going on now, but anyone who was paying attention to the issue at that time remembers how dumb it was and that neither campaign issued a full throated retraction advocating mandatory vaccination. Obama’s administration and top Senate offices have regularly granted RFK Jr. face-to-face access with the most powerful people in DC to spread his nonsense. Until very recently, Democratic-leaning TV hosts, etc would regularly invite RFK Jr. to spread his anti-vax gospel… many still do.

More controversially, various government or government-funded agencies are spreading the “news” that autism is soaring (e.g. I recently heard an Ad-Council PSA produced by Autism Speaks claiming that autism had increased some 30% in 2 years). In fact, research has shown that a majority, at least, of modern increase in autism cases is attributed to increase in diagnosis rather than incidence (because of greater access to care and because of an increasingly wide definition of autism)… and certainly no increase in 2 years. I suspect public funding/subsidy of autism hysteria is, to some extent, fueling anti-vax support, and Democrats in and out of elected office have been very influential in this area.

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Rich Puchalsky 02.09.15 at 4:54 am

I think the scientific and moral questions about this have quickly reached their expected end. Yes, the risks of not vaccinating vastly outweigh the risks of vaccinating; yes, people who define freedom as causing significant negative externalities for others really don’t have a leg to stand on in any common system, whether conservative, liberal, libertarian, or leftist. Even the question of whether viewing the issue as partisan would be harmful when it isn’t has, in my opinion, pretty much been answered by Dan Kahan unless someone cites other science that indicates differently.

Which brings me to this article by Fredrik deBoer. I think that he said the most sensible things about the recent Chait / call-out topic. I pretty much agree with the analysis that the right thing to do about this doesn’t really matter: the U.S. is already committed to a culture-war treatment.

111

js. 02.09.15 at 5:30 am

@JanieM, thanks. Especially in light of @106, which is so fucking beyond the pale, I can’t even.

112

js. 02.09.15 at 5:52 am

A couple of things.

1. Going back to JQ’s post: A fair number of commenters have objected, citing polls and such, that the anti-vax sentiment or vax-skepticism or whatever doesn’t break on clear partisan lines. But of course, everyone concedes this. (I guess there was one commenter who held otherwise.) But JQ’s clear point was that there are good indications that this is changing and that vax-skepticism, say, is likely to become a partisan issue. And I’m not really seeing any counter to this at all. And this isn’t about point-scoring. It’s that the possibility is so utterly, devastatingly sad—and especially I suppose to someone from my background, growing up around widespread polio, etc.—that I’m really at a loss for words.

2. I was reading this recently, and I haven’t read the book, but I think Biss had an article in Harper’s a while back that covered some of this (unless it was someone else taking a very similar line), and while I didn’t quite agree with all of it (from what I remember), I thought there was a lot of very good stuff in it (and with apologies to commenters I like and respect, stuff that seems a lot more relevant than whatever Luther did or didn’t do a few centuries ago).

113

Meredith 02.09.15 at 6:22 am

“Christie was just pandering clumsily….”
Yes, this. He was vaguely remembering (my guess) law school discussion of case law (1905?) re balance balance balance…. Massachusetts won that vaccination challenge. Funny thing, who’s got the strongest state requirements for vac right now? Mississippi!

114

Sebastian H 02.09.15 at 6:23 am

Why don’t we frame it another way?

What could be done to keep this from becoming a partisan issue? Are there methods of approaching the problem that are more or less likely to turn it into partisan issue? How would we go about engaging people who have worries about vaccination without politicizing them?

So far it seems as if most of the comments are suggest demonizing them as the best way to keep it from becoming partisan, and speak as if them becoming partisan is almost inevitable like gravity.

We are seeing something that is on the cusp of becoming a stupid partisan issue. The question is how do we keep it from crossing the line?

115

adam.smith 02.09.15 at 6:48 am

I think we know very little about how to prevent things from becoming partisan issues, except for the fact that, ideally, high-profile politicians should talk about them as little as possible. That’s particularly true for Obama (even if he’s right)–research shows that issues become partisan as soon as a not-super-popular president touches them–but obviously Christie and Paul bear the brunt of the blame here for saying stupid stuff in the first place and opening this up for partisan debate.
The problem, of course, is that, given the polling numbers on vaccination, there’s a huge incentive for Democrats to pounce on Christie’s and Paul’s vacillations. That’s why H. Clinton was first in line.

The question about “demonizing”, and why I’m still not sure I agree with Rich’s argument against “anti-vaxxer” is this: if being labeled anti-vax is sufficiently toxic; if it’s going to cost you centrist votes that you need to win national elections, that may actually deter Republicans. And to some degree that seems to have worked with Christie and Paul. I’m not at all sure about this, but I’m also not at all convinced that the “be nice and patient” strategy that I think Rich and Sebastian H are endorsing is not actually going to do more harm by legitimizing anti-vax views as legitimate “opinions.”

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Sebastian H 02.09.15 at 7:06 am

I’m not really sure I’m advocating anything in particular. I vaguely sort-of think that social pressure regarding vaccination is likely to work amazingly well with respect to middle and upper class woo-woo types (who at the moment seem to be much more of a problem than serious religious objectors). Saying that their kids can’t go to orchestra camp should hit home just fine.

I vaguely sort of suspect that Rich is onto something about denying a pithy label for people who don’t understand the statistics behind relative risk of bad stuff and vaccines.

I guess I don’t have a good feel for why certain things become highly politicized and why others don’t. Some things seem to fester for a long time and then suddenly gain political valence for reasons that I don’t understand. Silly objections to vaccines and woo-woo wories about GMOs strike me as two areas that have been simmering just under serious political valence for a while. Why and when they break out isn’t clear to me. But having been a member of out groups at different times in my life (the harshest one being that I was gay in a fundamentalist Christian upbringing) suggests to me that demonizing often doesn’t bring change in the way the people doing the demonizing want.

117

John Quiggin 02.09.15 at 7:06 am

Zach @108 RFK Jr is a pretty good test case. The “partisan alignment” view suggests that Dems will soon start cutting RFK Jr loose (unless he recants, which seems unlikely), despite his famous name and generally well-regarded work on environmental issues. That certainly seems to be happening in relation to an interview he did with Jon Stewart 10 years ago. Stewart has already given an apology (a bit weak) and is being pressed to go further.

While RFK Jr stays in good standing with the Democratic Party, partisan alignment is incomplete.

118

David 02.09.15 at 9:47 am

You can intimidate people into silence, but you can’t make them feel ashamed unless they share at least some common moral framework with you. Shame cultures exist because people understand there are rules and recognise when they have broken them. But there are no common rules here. Genuine religious opponents of vaccination (and there will be few in most societies) believe they are bound by heavenly rules, not earthly ones, and the libertarian, the plain selfish and the politically-committed aren’t reachable by such arguments anyway. So how do you shame somebody who doesn’t feel shame?
Oh, and don’t forget the 95% of the world’s population that lives outside the US. Culture Wars issues are quickly imported into Europe, and I shudder to think what happens if this example gets before the European Court of Human Rights, for example.

119

Steve Sailer 02.09.15 at 10:22 am

A lot of my wife’s friends in the early 1990s on the Chicago lakefront were skeptical of vaccinations. They were a self-selected group who were also into Waldorf schools (just as the data in the post below about vaccination rates by type of school suggests), organic foods (they called themselves “brown ricers”), home births with female midwives rather than hospital births with male doctors,breastfeeding, co-sleeping, secular homeschooling, and a variety of other vaguely hippieish, post-Sixties things. Nice people.

My wife, who had worked in medical research and is adept at statistics, would point out to them that the ideal would be if your child was the only unvaccinated child in the world … but that’s not going to happen so you ought to get your child vaccinated. But that kind of statistically-grounded thinking was rather alien to the Brown Ricers.

Most of them saw themselves as liberal feminist Democrats.

On the other hand, they tended to be the epitome of the upper middle class pattern that Charles Murray identified two decades later in “Coming Apart” of talk liberal, live conservative. This set of environmentalist beliefs among women tended to presume their husbands would work long hours at remunerative jobs to afford them the time to concentrate upon providing their young children with natural upbringings.

That was back in the 1990s when the Red-Blue divide wasn’t quite as salient as it seems now. In the 2000s, the real dividing line in terms of voting among white Americans has been not the celebrated Gender Gap, but the Marriage Gap. From 2000 onward, there has been a remarkably high correlation between how Red or Blue a state is and how likely a youngish white woman is to be married.

So it’s quite possible that in the 20 years since I had contact with them, the anti-vax people have moved from Democrat to Republican. Still, it wasn’t like that on the Chicago lakefront in the 1990s.

120

Brett Bellmore 02.09.15 at 10:49 am

“The 1980s AIDS epidemic in the United States was in large measure the result of the gay liberation of the 1970s unleashing gay male promiscuity. The science is obvious on this topic, but stating this plainly will lead to much outrage.”

“Fuck off back to your racist shithole, Sailer.”

Ah, the party of science. You can just smell the rational response to evidence.

He’s right, you know. Even today, knowing how nasty AIDS is, and how to prevent it’s transmission, over half of new AIDS cases are male homosexuals, even though they’re a tiny fraction of the population. AIDS transmission among the straight population is almost entirely due to transmission from homosexuals, because AIDS doesn’t transmit efficiently enough between straights who are taking even the slightest precautions.

In an entirely straight population, there would have been no AIDS epidemic, and if homosexuals were taking proper precautions, the epidemic would have extinguished itself by now. It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity. They are the infectious reservoir that keeps the epidemic going.

That’s science, even if you don’t want to hear it.

See, that’s the problem with branding Democrats as “the party of science”. Science, not having a political agenda, isn’t always going to produce results that a particular party likes. And Democrats are not shy about viciously attacking, yes, science, if it tells you something you don’t want to hear.

121

Robespierre 02.09.15 at 11:04 am

“In an entirely straight population, there would have been no AIDS epidemic”.

You might be aware of a place called Africa.

122

Brett Bellmore 02.09.15 at 11:18 am

Oh, sorry, I was unaware that there were no homosexuals in Africa. My bad, how did I overlook that?

123

Freshly Squeezed Cynic 02.09.15 at 12:22 pm

80% of HIV cases in Africa are transmitted through heterosexual sexual activity.

124

bianca steele 02.09.15 at 1:47 pm

Here are the elected offices RFK Jr. has held:

125

Rich Puchalsky 02.09.15 at 1:56 pm

adam.smith: “I’m not at all sure about this, but I’m also not at all convinced that the “be nice and patient” strategy that I think Rich and Sebastian H are endorsing is not actually going to do more harm by legitimizing anti-vax views as legitimate “opinions.””

I don’t know whether I can address this without going on about ideas that I’ve already expressed a good deal already in other recent threads. But keep in mind that this isn’t about being “nice and patient” as virtues in themselves, it’s about recognizing how subcultural identity works and how identity politics works. It’s very difficult to shame people out of a behavior and not have that behavior appear first as a subcultural marker and then as a component of a political coalition. “Treating anti-vax views as legitimate” assumes that there is such a thing as an anti-vax view. I’m saying that it’s natural for parents to be concerned about their children, and in the process trying to deny “anti-vax” legitimacy as a classification. I certainly wouldn’t e.g. legitimize “anti-vaxxers” by having a nice and patient public debate between chosen advocates of pro-vax and anti-vax sides.

There’s a lot of people on this blog who really don’t understand fundamental things about what politeness or civility are. That’s why you can get things like “PC is just politeness” expressed by people whose writing is all about mockery. Politeness is sort of necessarily two-way, at least in possibility: you can’t shame someone out of a politeness violation and still say that you’re just being polite. Essentially, the contemporary concept of civility is not about defending a shared public space within which people can coexist despite differences: it’s all about power relationships and about who gets to control behavior. All right: all politics is, at the end, about power relationships and about who gets to control behavior. But is creating a relationship between shamer and shamee really the same as getting people to vaccinate?

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bianca steele 02.09.15 at 1:56 pm

It’s not up to “us” to decide whether it becomes a partisan issue (unless “our” solution is to take on anti-vaccine or anti science views on the left too). It’s up to the Republicans which factions to give more power within their party and which to give less.

If Republicans decide to hand over all their power to the crazy faction in their party, Democrats and the left can’t change that by cooperating with them and wishing for the benefits of cooperation to all go to the non-crazies.

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Ronan(rf) 02.09.15 at 2:04 pm

” That’s why you can get things like “PC is just politeness” expressed by people whose writing is all about mockery. Politeness is sort of necessarily two-way, at least in possibility: you can’t shame someone out of a politeness violation and still say that you’re just being polite. Essentially, the contemporary concept of civility is not about defending a shared public space within which people can coexist despite differences: it’s all about power relationships and about who gets to control behavior.”

Indeed, well said.

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bianca steele 02.09.15 at 2:06 pm

If there’s anyone who’s responsible for making the issue partisan, I’m going to suggest it’s Jenny McCarthy. She could have prevented the whole thing by labeling herself differently.

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Ze Kraggash 02.09.15 at 2:22 pm

When/where I was growing up, we had mandatory vaccination, and no one could even imagine any other arrangement. My mother was a physician: science, professional ethics, the whole nine yards. And her instructions to me were simple: try to avoid being vaccinated any way you can. You are safe when everyone around you is vaccinated, and you don’t need any crap injected into you blood.

The whole thing is something like human sacrifices to some evil Zahhak, or somesuch. Some children have to be sacrificed, but don’t expect people to volunteer their own.

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Trader Joe 02.09.15 at 2:28 pm

The way you shame parents is getting the kids to do it.

A big part of the success of anti-smoking campaigns in the 80s-90s was marketing to kids how unhealthy smoking is and them encouraging their parents to stop.

Kids are far more sensitive to difference and likely to react to them. When a kid goes home and tells his mom that everyone is treating him like a “germ” because has hasn’t been vaccinated the parent can do two things – go to the doctor and get them vaccinated or go to the school which will say “well, gee, it was your choice afterall.” They probably aren’t going to try explaining to their kid the nuanced view of why they chose not to vaccinate and make the kid eat it.

I’m not a big fan of using kids as pawns, but maybe the responsible adults owe it to the children of less responsible parents to help bring them the facts (like was done with smoking).

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Anarcissie 02.09.15 at 2:50 pm

adam.smith 02.09.15 at 6:48 am @ 115:
I think we know very little about how to prevent things from becoming partisan issues….

If my theory about the priesthood of all believers is correct, then issues like vaccination politics begin with the exertion of authority. When the exertion is questioned or resisted, the response is simply to treat the resisters or skeptics as insane, deluded, or evil — that is, politically illegitimate. That is the beginning of the politics.

Liberal constitutions were supposed to contain mechanisms which restrict authority and thus legitimate that which remained, but few non-elite people today believe they have any significant part in the conduct of government and state, and I think they are right. Thus, no authority is legitimated.

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Map Maker 02.09.15 at 3:01 pm

“But JQ’s clear point was that there are good indications that this is changing and that vax-skepticism, say, is likely to become a partisan issue. And I’m not really seeing any counter to this at all. And this isn’t about point-scoring. “

It is a real issue, for real parents. Labeling them stupid, ignorant, or republican, doesn’t seem to move the ball forward, so I don’t engage in that. And while calling someone a republican shuts them up pretty quickly on this board, I know some of the people on this board, and I know that there is a lot of vax-skepticism that cuts deeper than the republican anti-science narrative that is being thrown around this thread.

Consider the current schedule of vaccines – what is the right number/right schedule? There is a movement of parents looking to slowdown or change the “standard” program of vaccine schedules. Before you call these people republicans, ask yourself why the US vaccine schedule is different than most of Europe’s (no republicans there)? Is Europe anti-vaxx? Some European countries have more, some less. But these decisions are not entirely driven by science. Asking questions and having PARENTS make decisions is not a bad thing IMHO.

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bianca steele 02.09.15 at 3:11 pm

Follow-on to @131

Let’s put Main Street Muse on one side and Jenny McCarthy on the other.

MSM wishes her concerns about vaccine safety, which she’s formed as an educated person by reading official reports, were taken more seriously. The reaction is to frame her as opposing the liberal (i.e. left) establishment, and suggesting that she’s in danger of picking up ideas from the right wing. There seems to be no danger that she’ll switch to voting Republican, given her other opinions, so perhaps the only choice for her will be to shut herself up, or even change her mind. Or she might be alienated from politics altogether. She could pursue the issue in a nonpartisan way, but that option isn’t open to her, if others decide to react in a partisan manner: she can’t control how others react. She has a responsibility to her children (though she hasn’t said she didn’t have them vaccinated), and doctors can’t relieve her of that responsibility.

Jenny McCarthy, on the other hand, though you may have expected her to be all rock-and-roll, love me I’m a liberal, is a child of the Reagan era and calls herself a libertarian and a Republican. She thinks the idea of being a Democrat is ridiculous, and the idea of being on the left probably doesn’t even occur to her as within the bounds of possibility. Her reading of whatever she read, maybe official reports, maybe second- or third-hand interpretations, was that OMG there’s a link between vaccines and autism. She handily fits this into “the scariest words ever spoken are ‘I’m from the government and I’m here to help,'” spoken by Ronald Reagan. What is there that “demonization” can do to change her mind, one way or another?

Are there people who fall in between the extremes? Sure. But nobody draws conclusions in a vacuum.

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Rich Puchalsky 02.09.15 at 3:26 pm

Trader Joe: “When a kid goes home and tells his mom that everyone is treating him like a “germ” because has hasn’t been vaccinated the parent can do two things – go to the doctor and get them vaccinated or go to the school which will say “well, gee, it was your choice after all.””

I think that there is some point at which that 1 in 10,000 chance of death, 1 in 1,000 chance of brain injury starts to look acceptable compared to some of the alternatives. Maybe the point at which we start to suggest turning our societies into SF dystopias is one of them. “Foster, You’re Dead!” was not supposed to be a manual of political engagement.

I think that Trader Joe is just getting carried away with this comment rather than really supporting it, but re-read #70, #72, #74 above. There’s really not much more to say about this before John Holbo comes in and starts asking why people just start insulting people for no reason again.

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John Holbo 02.09.15 at 3:33 pm

“There’s really not much more to say about this before John Holbo comes in and starts asking why people just start insulting people for no reason again.”

I feel like Ricardo Montalban, round about minute 3:03:

“Nancy, do I smell fajitas?”

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Z 02.09.15 at 3:39 pm

AIDS transmission among the straight population is almost entirely due to transmission from homosexuals, because AIDS doesn’t transmit efficiently enough between straights who are taking even the slightest precautions. In an entirely straight population, there would have been no AIDS epidemic, and if homosexuals were taking proper precautions, the epidemic would have extinguished itself by now. It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity.

Absolutely, incontrovertibly true scientific statements (no less!) should be easy to back-up with multiple, sound, credible scientific references, presumably from primary sources. Would you care to provide any?

That’s science, even if you don’t want to hear it.

Oh, I do want to hear it. Please show me where.

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bjk 02.09.15 at 3:48 pm

Unless there are a lot of Reason subscribers in the Westside of LA, probably not:

THR mapped the risk level, showing the percentage of unvaccinated children by school, using the number of students whose guardians said they just decided not to go ahead and follow that CDC schedule. This map lists two particular vaccinations: DTaP (diphtheria, tetanus, whooping cough); and MMR (measles, mumps, rubella).

The schools that have the most unvaccinated kids, according to the number of these forms turned in, are on the Westside, from Malibu and into Beverly Hills and WeHo. An average of 9.1 percent of parents of preschoolers turned in forms this past year, which is a staggering 26 percent more than two years before. And in L.A. County on the whole, there’s only been 2.2 percent jump.

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Trader Joe 02.09.15 at 3:49 pm

@134
Yes, my comment was meant to be purposefully over the top.

The point, however, is that parents don’t necessarily see this as a political or scientific or even logical issue – they see it as an “I want to protect my kid issue.”

Maybe they’ve researched, maybe that haven’t. Mamma bear don’t always care about facts (see McCarthy, Jenny), they care about baby bear. The only way you reach them is to convince them that the ramifications of non-vaccination are greater than vaccination….1 in 10,000 chances don’t mean much to people. If there’s something more day to day, it will be weighed in their calculus of what to do.

That’s where public service adverts on everything from kids shows to daytime TV about smoking, drug use, drunk driving, drinking milk or even, yes, vaccination, might reinforce some awareness that the alternative isn’t a safe no-risk choice.

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bianca steele 02.09.15 at 3:56 pm

The end of the world must be near when we say, “this is the wealthiest county in the universe, there’s no way there are any right-wingers there.”

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Rich Puchalsky 02.09.15 at 4:21 pm

Trader Joe, there’s a huge difference between “smoking isn’t cool” and “you’re not cool if your parents smoke”. An adolescent can choose whether or not they start smoking. They don’t choose whether or not they get vaccinated. (I suppose it’s theoretically possible that kids, shamed by a media campaign, could sneak off to get vaccinated without their parents’ permission.)

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dn 02.09.15 at 4:38 pm

@139 – Yeah, the LA burbs are not exactly the first place that springs to mind when I think “liberal paradise”.

Hell, if I were specifically looking for Reason subscribers, that would actually be just about the first place I would look. Ayn Rand country.

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TM 02.09.15 at 5:01 pm

I’m surprised nobody yet mentioned the HPV vaccine (H
PV causes, or contributes to, cervical cancer) story. If I remember correctly, when the vaccine became available, one of the first to enthusiastically endorse it was Texas governor Perry. He faced a lot of backlash from conservative moralizers who fumed about promoting promiscuity. But the backlash was also from parents rightfully concerned that their children were being used as guinea pigs for a medical intervention of very dubious benefit and effectiveness. As of now, nobody thinks this particular vaccination should be mandatory. It’s one of many health-care related decisions that people have to make for themselves or in this case, their children, hopefully guided by reliable information and trustworthy health care professionals.

The tone of the vaccination discourse is exasperating. On the one hand, it is inexcusable for the mass media to give so much space to fringe “experts” making unwarranted claims about the supposed dangers of vaccination; that fearmongering unfortunately is mirrored by some on the other side. On the other hand one must not ignore the fact that vaccination is a medical intervention. For good reasons, medical ethics dictates that medical interventions cannot be forced on a patient against their will. This prohibition is not to be taken lightly. It is by no means on the same level as seatbelt or smoking laws. (And for that reason, many countries, including Germany, do not mandate any vaccinations for humans).

Is there a partisan divide on vaccinations? It seems unlikely given that the vast majority of Americans support vaccination (although perhaps not every single kind of vaccination). It is really a tiny minority that doesn’t, although they appear somewhat concentrated geographically (note that Mississippi is the model state with almost 100% MMR vaccination rates). If Republicans manage to make hay by framing their side as defending individual autonomy against government overreach, that would be a huge failure of messaging on our part (but also, again, this wouldn’t be possible without media collusion). We should be on the side of both autonomy and responsibility.

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bjk 02.09.15 at 5:01 pm

If it’s the same people who send their kids to Los Feliz day care ( **We do not accept immunized children** ) then it’s definitely not Reason subscribers.

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Rich Puchalsky 02.09.15 at 5:12 pm

TM: “I’m surprised nobody yet mentioned the HPV vaccine (HPV causes, or contributes to, cervical cancer) story.”

I’ve mentioned upthread that a lot of these controversies are driven by economic decisions by corporations, and that turning them into morality plays between sets of people is leaving out a lot of the process.

I’ll quote from Dan Kahan at length:

These conditions were all an artifact of decisions Merck self-consciously made about how to pursue regulatory approval and subsequent marketing of Gardasil. It sought approval of the vaccine for girls and young women only in order to invoke “fast track” consideration by the FDA. It thereafter funded—orchestrated, in a manner that shielded its own involvement—the campaign to promote adoption of mandatory vaccination programs across the states. To try to “counterspin” the predictable political opposition to the vaccine, it hired an inept sock puppet—“Oops!”—whose feebly scripted performance itself enriched the cultural resources available to those seeking to block the vaccine.

Had Merck not sought fast-track approval and pushed aggressively for quick adoption of mandatory vaccination programs, the FDA would have approved the vaccine for males and females just a few years later, insurance companies plus nongovernmental providers would have furnished mechanisms for universal vaccination sufficient to fill in any gaps in stated mandates, which would have been enacted or not by state public health administrators largely removed from politics. Religious groups—which actually did not oppose FDA approval of the HPV vaccine but only the proposal to mandate it—wouldn’t have had much motivation or basis for opposing such a regime.

[…]

But it wouldn’t have been good for Merck. For by then, GlaxoSmithKline’s alternative vaccine would have been ready for agency approval, too, and could have competed free of the disadvantage of what Merck hoped would be a nationwide set of contracts to supply Gardasil to state school systems.

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bianca steele 02.09.15 at 5:36 pm

If my daughter’s doctor recommends the HPV vaccine when she’s the right age, she will be vaccinated.

That said, I was appalled to learn at forty that cervical cancer is 100% a sexually transmitted disease and that there’s no other medical reason women have to have yearly OB/GYN exams. I don’t know of anyone who knew this (except Amanda Marcotte). This left a bad taste all around. But it didn’t leave me wanting yearly exams in place of vaccines.

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Sebastian H 02.09.15 at 6:02 pm

“Genuine religious opponents of vaccination (and there will be few in most societies) believe they are bound by heavenly rules, not earthly ones, and the libertarian, the plain selfish and the politically-committed aren’t reachable by such arguments anyway.”

Genuine religious opponents of vaccination aren’t the problem here. The problem appears to be parents who are listening to woo-woo buzz about vaccinations in their social circles–especially in liberal circles of California. A few posts down Kieran has some thumbnail research confirming that here. Framing this as a religious objection issue (at least from a traditional right/Baptist/Catholic/Protestant angle) is missing the reality entirely. The traditionalist religions in the US don’t seem to have a problem with vaccinations. In fact they seem to vaccinate at higher rates even than the general population. Pigeon-holing this into a classic right-wing-religion lens is starting off looking at the wrong thing entirely.

I’m not sure what it IS. But it isn’t what you’re saying.

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someguy88 02.09.15 at 6:16 pm

John Quiggin,

No and it won’t. Let’ bet. You pick the timeframe. If the percentage of Republicans supporting the benefits of Vaccination is below 50% at the end of the time frame I pay. Other wise you pay.

The public policy behind this is well established and non controversial.

http://www.motherjones.com/environment/2014/02/vaccine-exemptions-states-pertussis-map

The states with higher opt out rates and higher out break rates should look to make the opt out a bit tougher/ less appealing.

On top of all of this the real question is not what a Republican or a Democrat tells their pollster what they think about vaccination. It is how many do and do not vaccinate their kids. Opt rates in states with personal exemption vs religious exemption opt outs are 2.5 times higher.

Public policy on vaccination is pretty darn homogenous and successfull. [Catholic schools are even stricter than public schools] 31 states did introduce bills to loosen opt outs but all 31 were defeated and 3 states toughened the opt out. The dark force of anti vaccination sentiment is not Republican and is not winning. Good job everyone!

John alas your dream will not come true. This is not and will not ever become a partisan issue.

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MPAVictoria 02.09.15 at 6:29 pm

“As of now, nobody thinks this particular vaccination should be mandatory.”

I think it should be.

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MPAVictoria 02.09.15 at 6:30 pm

“John alas your dream will not come true. This is not and will not ever become a partisan issue.”

Just like climate change?

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TM 02.09.15 at 6:32 pm

Ok I stand corrected. But you are aware, are you, that at best 70% of HPV infections are prevented by the vaccines?

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SamChevre 02.09.15 at 6:33 pm

It seem stop me that vaccination could become a partisan issue, but is not likely to unless Democrats do something intensely stupid (but looking more likely).

There are two questions, not one:

1) Would it be a a good thing for all children without medical contra-indications to be vaccinated against contagious diseases for which vaccines are available?
2) Who should make the decision about whether children are vaccinated-parents or someone else?

Question 1 seems unlikely to become partisan, unless Democrats succeed in getting it thoroughly tangled with 2; the issue of parental control of children is a huge issue for a lot of Republican-leaning constituencies.

So if making vaccines a partisan issue is your goal, saying Christie’s statements were anti-vaccine is a great way to move toward it.

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MPAVictoria 02.09.15 at 6:35 pm

“Ok I stand corrected. But you are aware, are you, that at best 70% of HPV infections are prevented by the vaccines?”

Indeed. Still think it should be part of the basic vaccination package and should be paid for by the government.

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Roger Gathmann 02.09.15 at 6:35 pm

I think John Q missed a trick here. Just throw race in the equation and you change the GOP mindset. With ebola (read, black disease), no coercive measure by the government was strong enough. Christie was for quarantining practically anyone who had been to Africa. If measles was mainly transmitted through African Americans, you can be sure the GOP would be for maxi maxi enforced vaccination, followed, hopefully, by mass incarceration. For white folks though – we gotta have choice!
That said, 65 percent of Republicans in the latest poll are for mandatory vaccination. It is only for the guys out in the weeds, who control party organizations at the state and local level, that this is an issue of freedom freedom freedom.

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Brett Bellmore 02.09.15 at 6:37 pm

Based on facebook posts from some liberal friends, it already is, though not in the sense John thinks it will. More in the sense John demonstrates: A basis for self-congragulatory sneering, however ill based it might be in reality.

But self-congragulatory sneering isn’t about reality, it’s about feeling good because you think worse of somebody else. Works just fine even if it isn’t reality based.

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JanieM 02.09.15 at 6:48 pm

But self-congragulatory sneering isn’t about reality, it’s about feeling good because you think worse of somebody else. Works just fine even if it isn’t reality based.

Brett has said he comes here to argue, but most of his comments are the finest quality examples of self-congratulatory sneering. Hmmmm.

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Matt 02.09.15 at 7:00 pm

If the percentage of Republicans supporting the benefits of Vaccination is below 50% at the end of the time frame I pay. Other wise you pay.

Why 50%? Based on the California school data and other studies linked in these discussions, I don’t think that vaccination has yet become a partisan issue. But it could manifest as a partisan issue even if both Republican and Democrat vaccination support doesn’t go below 50%.

As an example, according to this 2012 poll Americans love solar power. 84% of Republicans support using more solar power. 63% of Republicans even think the government should provide solar incentives like tax credits. Support is even higher among Democrats and independents. Surely opposition to solar power is not going to take on partisan characteristics when it enjoys majority support in every major political group.

But in reality solar power opposition does have partisan characteristics. Majorities of Republican and Democrat voters support solar, and you can find large numbers of D and R politicians who support solar, but opposition is concentrated in the Republican camp. That’s where you will find legislatures and governors looking to roll back renewable energy tax credits and Renewable Portfolio Standards, also where you will find mouthpieces like the Heartland Institute praising coal and panning solar. An issue can be supported across the D and R camps but still have its opposition concentrated in one camp or the other, even if the opposition doesn’t reach 50% or greater. Solar power is fortunately popular enough that it seems unlikely to become a tribal marker that some people want to reject just because opposing tribes like it. Vaccination will probably — I hope — stay the same way.

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MPAVictoria 02.09.15 at 7:07 pm

Look at how Republicans turned on equal pay for women at the last State of the Union. As someone on twitter commented Obama should come out against drinking Draino…..

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Marshall 02.09.15 at 7:32 pm

@Bianca: The “socialism” point is that eg herd immunity is a property of the herd, of the sociality, and not of individuals. Trying to frame the social issue in terms of individual self-interest is a category error. “What do I owe other people’s kids” is the wrong question … you have no parental duty towards random children (beyond a broad duty to public safety). The correct question is “How much am I obliged to sacrifice myself and my family in favor of social goals?” How much do I have to ask other peoples’ permission? Follow the somewhat arbitrary guidelines because smart/powerful/many people say so. Whereas democracy is about one man, one vote according to each individually determined self-interest. A society is something more than a bunch of people doing their own thing, the global world is a big container ship with loads of its own proper inertia. Right now the political situation is such that we are not encouraged to sacrifice for social goals except for sending our boys and girls overseas to kill terrorists and thereby defend America. (Although paradoxically, the first duty of a cop is to go home to his family). You might view insurgent identity politics as attempts to nucleate meaningful societies of “brown rice people” (see in comments above). Hope this clarifies.

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bianca steele 02.09.15 at 7:40 pm

Welcome to CT, Marshall.

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John Quiggin 02.09.15 at 8:16 pm

Sorry for letting Steve Sailer slip through. I’ve put him on automoderation.

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nick s 02.09.15 at 8:18 pm

Ah, the party of science. You can just smell the rational response to evidence.

Oh, fuck off back to your personal armory, cabin boy.

The argument here seems to be that Professional White Supremacists and Amateur Middle-Aged White Male Gun Hoarders need to be patted on their ickle haids and given due respect for their tics and hobby-horses, otherwise liberals have only themselves to blame for the spread of infectious diseases from crunchy woo-peddlers and tinfoil-hat types into the general population. Well, fuck that for a lark.

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Bruce Wilder 02.09.15 at 8:53 pm

dn @ 86: Saying “we need to hold elites accountable” is a truism. To avoid the trap of confirming the authority of expertise blindly, people need to develop a modicum of expertise themselves, at least enough to tell good research from bad. But that’s just the problem, isn’t it? If anti-vaccination views are really on the rise, it would seem that we are failing at this.

Anarcissie @ 131: Liberal constitutions were supposed to contain mechanisms which restrict authority and thus legitimate that which remained, but few non-elite people today believe they have any significant part in the conduct of government and state, and I think they are right. Thus, no authority is legitimated.

Rich Puchalsky @ 144: . . . a lot of these controversies are driven by economic decisions by corporations, and that turning them into morality plays between sets of people is leaving out a lot of the process. RP linked to Dan Kahan’s narrative analysis concerning Merck’s Gardisil campaign, its attempts at political manipulation and its political fallout.

If I thought that that base problem was simply that people didn’t understand the scientific rationale for vaccination, didn’t understand the statistics or the balance of risk, then my view of the politics would be more straightforward and optimistic. I would see that the most likely to forego vaccination have been among the highly educated, and I would think that recent events, highlighting the consequences, would be a salutary corrective. People would pay attention to the news, and re-think. Problem solved.

I think the base problem is a breakdown of governance. That Republican politicos Paul and Christie chose to rhetorically step in the dog poo reinforces my sense that the base problem is the breakdown of governance. I don’t think it is helpful in getting at how the breakdown of governance is implicated to call their views “anti-science”, as if the logical alternative to be taken up by any partisan alternative (aka Democrats) is “pro-science”.

As the OP points out, Paul and Christie vocalized resentments of “people [who] want to be free to do as they please, even when there’s an obvious risk to others”. CNN got a lot of attention with an interview with an nutty Arizona cardiologist, who campaigns strenuously against vaccines. This was the widely reproduced money quote:

“It’s a very unfortunate thing that people die but unfortunately, people die, and I’m not going to put my child at risk to save another child. I’m not going to sacrifice the well-being of my child. My child is pure. It’s not my responsibility to be protecting their child.”

This is a political problem of solidarity, not a political problem of expertise or authority, per se. There’s an intersection, sure. But, confusing the two masks rather than reveals the problem of governance. Committing the partisan centre-left (aka U.S. Democrats) to “pro-science” rather than pro-solidarity mistakes the problem.

The OP may be right that a latent cleavage point has been revealed, but if a partisan divide follows, it is symptomatic, I think, of how politics has been converted from a means of popular governance into a irrelevant distraction, an unpopular entertainment.

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William Timberman 02.09.15 at 9:40 pm

Bruce Wilder @ 162

As I see it, the collapse of trust has preceded, and perhaps engendered the current respectability of ignorance, and the demagogues who take advantage of it. It’s unfair to blame the prevalence of antisocial attitudes like those expressed by the libertarian cardiologist on the failure of liberalism as an idea, but you can certainly blame it on the clever folks who looked upon liberalism, saw how vulnerable it was to the self-aggrandizement of those charged with implementing its ideas, and thought oh boy, now’s my chance!

It’s in no way surprising, in my view, that watching liberalism embrace without so much as blinking behavior like torture, money-laundering for multinational criminal enterprises — as with HSBC today — and prurient peeping-tomism on an international scale makes garden-variety honest people gag, and people without any hope of patronage decide that their prejudices are as good as anyone else’s. Why should I pay my taxes when….

As you say, it’s a failure of governance, but perhaps that failure was in the cards all along. In any event, it’s difficult to see how anyone could have prevented it. Quis custodiet, etc., doesn’t apply just to selected villains, but rather to the entire edifice of modernity. Call it the Bruce Wilder theory of institutional growth and decay, if you will, with bad intentions baked in, and therefore neither here nor there in a moral sense since, when viewed over time, they’re a recurring and apparently ineradicable constant.

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Ze Kraggash 02.09.15 at 10:29 pm

Of course it’s in the cards. The ideology is based on – and insists on – personal autonomy, individual rights, and competing interests – and then, suddenly, an appeal for solidarity? Get real.

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adam.smith 02.09.15 at 10:41 pm

Nice article on some more studies on how hard it is to convince people to vaccinate, even where it is individually rational.

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adam.smith 02.09.15 at 10:41 pm

167

bjk 02.09.15 at 10:47 pm

How many times does it have to be pointed out – by Kieran Healy no less – that this isn’t a conservative phenomenon?

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Popeye 02.09.15 at 10:48 pm

Fewer than 1% of American children receive no vaccines, suggesting that the search for Grand Ideological Causes here is unlikely to have much basis in empirical fact, and is much more likely to be an indulgent exercise in blaming all of society’s ills on opposing political ideologies.

Like nearly everyone, anti-vaxxers draw on a wide range of inconsistent beliefs that cut across political ideologies, including anti-authoritarianism, distrust of corporations, distrust of scientific research, the idea that “natural” is good, and the idea that parents are uniquely well positioned to make decisions on behalf of their children. Anyone interested in anti-vaxxer psychology should note how common and popular these beliefs are in different contexts. The fact is that ideology is of limited value in determining behavior, although it does serve the social functions of bonding people together and creating out-groups.

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praisegod barebones 02.09.15 at 10:50 pm

So, I quite like the idea of paying people to get vaccinated. But there’s an obvious flaw which is that you’ll create an incentive for people to immigrate illegally so that they can get paid for being vaccinated; unemployed people will have more kids just so they can live on their vaccination money etc. Basically a disaster, unless you place fairly strict constraints on who can get paid for being vaccinated: no immigrants, no-one on welfare etc. And then you’ve got the whole problem of vaccination fraud to deal with.

So here’s a more modest suggestion, which might be more capable of getting bipartisan support. Why not pay subsidies to amusement parks and other places of entertainment conditional on them enforcing mandatory vaccination policies?

Back in the day, people used to claim that Obama was capable of playing eleven-dimensional chess. If he was, this is what he’d be pushing.

170

TM 02.09.15 at 10:58 pm

“The ideology is based on – and insists on – personal autonomy, individual rights, and competing interests – and then, suddenly, an appeal for solidarity? Get real.”

If you seriously believe that personal autonomy, individual rights, and solidarity are mutually incompatible values (or “ideologies” if you wish), then you are (1) demonstrably wrong, and (2) as a matter of political tactics, committing a disastrous mistake.

171

TM 02.09.15 at 11:00 pm

A mistake consisting of course in positing your side as the one opposed to personal autonomy. You are making the right-wingers dream come true.

172

js. 02.09.15 at 11:14 pm

TM,

That dude’s been trolling this blog for a decade—and yes, really trolling. ‘Ze Kraggash’ is at least his fifth handle. Just saying that I wouldn’t expect anything very constructive out of him (or from engaging with him).

173

TM 02.09.15 at 11:17 pm

Ok, my mistake. I hope nobody around here would ever give credence to that stupid dichotomy.

174

John Quiggin 02.09.15 at 11:22 pm

Roger G @ 153. I mentioned this in footnote 2. Or is “others” too obscurely coded?

175

Ze Kraggash 02.09.15 at 11:34 pm

“So, I quite like the idea of paying people to get vaccinated.”

Actually, mandatory vaccinations plus availability of opt-out indulgences could be a more logical solution.

You must educate your children, but you can opt out of the public school system – by paying a lot of money. Same sort of thing.

176

Harold 02.10.15 at 12:10 am

Films like “Contagion” are very good. Also, measures to strengthen providers’ communications skills. Finally, I read a suggestion someplace that simply making exemptions more difficult to get (more paperwork, requiring quizzes to make sure parents understand the issues, and the like) could also be effective in reducing the exemption rate without recourse to draconian or punitive methods or crude financial incentives unworthy of a democracy.

177

mattski 02.10.15 at 1:18 am

I like Popeye’s remarks @ 168. Bruce W is certainly right about broken governance but I don’t see this issue shining huge light on that problem.

178

Rich Puchalsky 02.10.15 at 1:29 am

Bruce Wilder: “This is a political problem of solidarity, not a political problem of expertise or authority, per se. There’s an intersection, sure. But, confusing the two masks rather than reveals the problem of governance. Committing the partisan centre-left (aka U.S. Democrats) to “pro-science” rather than pro-solidarity mistakes the problem.”

I sort of agree, but I don’t see how the center-left could commit itself to solidarity even if prominent elements of it wanted to. National solidarity is right-wing, class solidarity is a trainwreck (for reasons that I’m not going to go into yet again), and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime: all of our culture wars really come from the end of legal racism, and the well is thoroughly poisoned. All of the people insisting that people concerned about vaccination are “anti-vaxxers”, and that anti-vaxxers are naturally right-wing, are hunting for solidarity, and it just makes things worse.

179

Phil 02.10.15 at 2:05 am

But there’s an obvious flaw which is that you’ll create an incentive for people to immigrate illegally so that they can get paid for being vaccinated

You mean from all those places in Latin America that already have vaccination rates equal to or better than that of the United States? Yeah, you can practically taste the danger.

180

The Raven 02.10.15 at 2:36 am

Sebastian H@144

“What could be done to keep this from becoming a partisan issue?”

Um, resurrect US anti-fascist media regulation?

One of the major media strategies of the radical right is to convert rational debate to incoherent fights. So I suppose this is ultimately in the hands of Roger Ailes at Fox News.

181

Belle Waring 02.10.15 at 3:00 am

Our blog was vaccinated against Steve Sailer, but unfortunately it’s one of those that is relatively ineffective and requires a high rate of internet herd immunity to work.

182

Harold 02.10.15 at 3:08 am

It also would help if we adequately funded the federal bureaucracy.

183

John Quiggin 02.10.15 at 3:12 am

Since comment #1 has been repeated, with minor variations, quite a few times, I’ll repeat a response already made by others.

As with climate change and evolution, attitudes with respect to vaccination were largely uncorrelated with political partisanship until the recent past. Clearly, that has ceased to be so in the first two cases. The OP notes indications that the vaccination issue is going the same way.

184

John Quiggin 02.10.15 at 3:20 am

On the broader political significance of all this, I see two processes going on

* A breakdown of the political system in general, reflecting the failure of market liberalism/neoliberalism

* Pathological responses to this breakdown on the political right, encompassing various forms of tribalism and irrationalism

The response of the centre-left (and, to the extent that it still exists, the radical left) needs a more complex discussion, which I’m hoping to start on before too long

185

js. 02.10.15 at 3:21 am

At this point, I’m really curious about Kahan-related “long post” mentioned (but not posted) by Metatone @5. Any chance of a précis?

186

Popeye 02.10.15 at 4:32 am

The evidence that vaccination is “going the same way” as climate change and gun control is rather slim at this point, almost seeming to amount to wishful thinking. RFK Jr. and the Huffington Post have actively peddled large amounts of anti-vaccine nonsense over the years, did anyone get excited about the prospect of them turning vaccination into an ideological issue?

The function of ideology is not to answer the question “Should I care about other people or should I follow my heart’s desire?” — no one answers that question the same way in all contexts — the function of ideology is to identify who a good worthy member of my tribe and who is bad unworthy member of the out-group. Conservatives also sit around and bemoan how liberals have selfishly ripped out the fabric of society (religion, gender roles, sexual revolution, distrust of prosperous corporations, racial hierarchies) in the name of individualistic self-interest. It’s just an unhelpful framing.

187

John Quiggin 02.10.15 at 7:42 am

RFK Jr. and the Huffington Post have actively peddled large amounts of anti-vaccine nonsense over the years, did anyone get excited about the prospect of them turning vaccination into an ideological issue?

As a matter of fact, Yes. Until very recently, alleged Democratic anti-vaxerism (based mainly on RFK Jr) was a standard element of tu quoque defences of the Repubs against the charge of being anti-science.

Here’s an example from 2012

188

David J. Littleboy 02.10.15 at 7:56 am

” It’s just an unhelpful framing.”

Hmm. It looks to me as though it’s becoming a helpful framing. If the anti-vaxxers can be packed off to the right, then that’s one more issue where we’re right and they’re wrong. I’d like to see my fellow lefties less sympathetic to alternative medicine, though, and perhaps this is a first step in persuading people who think that stupidity is, well, stupid. (I think it hilarious that three-quarters of the herbal remedies on the shelves of US stores don’t actually contain the herbs they claim to contain. I wonder if the Japanese do any better? Here, various “kanpo” (Chinese herbal remedies) snake-oil products are widely advertised, and apparently health insurance covers some amount of acupuncture and the like. There’s been a recent study* finding that expensive placebos work better than cheap placebos (which makes sense, since the point is to persuade the patient that the placebo works, although neither works as well as the real drug), and given the cost of OTC medicines in general here, it seems the Japanese are aware of this effect.))

*: http://theincidentaleconomist.com/wordpress/the-placebo-effect-is-crazy/

By the way, while the anti-vaxxers are silly, it’s not all bad to insist that we keep a careful eye on exactly what the NNH (number needed to harm) is for current vaccination technologies, and think about how we can do even better. My annual flu shot leaves my arm quite sore for a week. That’s very much worth one less bout of influenza every 3 or 4 years (assuming worst case of only 25 to 33% effectiveness), especially since I use public transportation almost daily. Again, in a worst case world this is really quite fine, but even better would be nice.

189

reason 02.10.15 at 7:57 am

anarcisse
“If my theory about the priesthood of all believers is correct”
I think you need to rethink your theory about theories. Theories aren’t correct or incorrect.

190

reason 02.10.15 at 8:09 am

anarcisse
“It is curious that, in this case, authoritarianism is assigned to the ‘Left’ and resistance to authority to the ‘Right’.”

I’m not sure that left and right are all that useful at the best of times. The key point here is whether you believe externalities imply collective responses or not. The left tends to be for such as belief.

191

reason 02.10.15 at 8:20 am

Maybe the right could be persuaded to pay people to vaccinate. (O.K. just joking – but they would probably be for it if Bill Gates paid for it.)

192

Ze Kraggash 02.10.15 at 8:41 am

” National solidarity is right-wing, class solidarity is a trainwreck […], and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime”

Class and cultural solidarity have nothing to do with it. Vaccinations is a national project where you are required to sacrifice something (your child, in the minds of some) for the nation. This sentiment can be right-wing or it can be left-wing, but most certainly it ain’t liberal. It’s not just collectivist; considering what’s at stake (to some), it’s radically collectivist, totalitarian.

193

reason 02.10.15 at 8:52 am

Ze Kraggash
” Vaccinations is a national project where you are required to sacrifice something (your child, in the minds of some) for the nation.”

This is absolute nonsense (even if some may see it this way). Humans just don’t handle stochastic processes well. Vaccinating your child will reduce their risk of serious illness even if they do it alone, but if it is collectively done then it reduces the risk even more (eventually even to the extent that the risk virtually disappears – see smallpox and polio). But people have trouble getting their minds around “risk”. Human brains are made to see the world as deterministic, hence Austrian economists :).

194

Ze Kraggash 02.10.15 at 9:12 am

“Vaccinating your child will reduce their risk of serious illness even if they do it alone, but if it is collectively done then it reduces the risk even more (eventually even to the extent that the risk virtually disappears – see smallpox and polio).”

Now, that’s a framing that suggests voluntary vaccinations. It’s in your interests to protect your child, and if a large enough number of people decide to do it, you get a huge extra benefit – so much the better. But isn’t this what’s considered “anti-vax”?

195

reason 02.10.15 at 9:18 am

Ze Kraggash,
but vaccinations ARE voluntary. People get fined for not vaccinated or banned from certain institutions, but that is a pigouvian tax. People don’t get thrown in jail for not vaccinating.

196

reason 02.10.15 at 9:25 am

This is the typical right wing spin. I want my privileges (to impose externalities on everyone else and to free ride on them) to receive special protection.

197

Peter T 02.10.15 at 9:59 am

If the wingnuts do take this up, it will not be because liberals called them nasty names. There really is no predicting what the wingnut mind will light on next, and certainly little chance of influencing it (because the wingnuts are not arguing with liberals, they are arguing with themselves. One says “Kenyan” and the next says “Muslim” and a third says “Fake Birth Certificate” and a fourth says “Raised by Satan-worshippers underground” and on it goes). All the sane can do is hope that this particular meme fails to latch on.

198

Ze Kraggash 02.10.15 at 10:06 am

If it’s voluntary and no one wants to make it mandatory, then what’s all this brouhaha?

199

Brett Bellmore 02.10.15 at 10:59 am

“As a matter of fact, Yes. Until very recently, alleged Democratic anti-vaxerism (based mainly on RFK Jr) was a standard element of tu quoque defences of the Repubs against the charge of being anti-science.”

Ok, let’s make this clear: While, “tu quoque” isn’t a defense against a charge that you do something, it IS a valid defense against a charge that you do something MORE. It isn’t a defense on an absolute basis, but where the charge is relative, it is right on point.

And that is the general nature of the attacks where you end up yelling “tu quoque”: Not, “The Republicans are anti-vaccine science deniers! Too bad we are, too.”, but, “The Republicans are anti-vaccine science deniers! Rah, rah, left, we’re so much better than them!”

Yes, the usual charge is not just that Republicans are bad, but that they are worse, and tu quoque isn’t a fallacy in that particular context. And every time you shout “tu quoque” in that relative context, you demonstrate your failure to grasp what is a fallacy about tu quoque, and what isn’t.

“If it’s voluntary and no one wants to make it mandatory, then what’s all this brouhaha?”

Republican shit stinks, that’s what all the brouhaha is about. So does Democratic shit, but it’s “tu quoque” to point that out.

200

Brett Bellmore 02.10.15 at 11:21 am

Peter T:

Before One said “Kenya”, there was Zero, and Zero said Kenya first. And that’s how the whole thing got rolling. Wasn’t a Republican who invented this particular meme.

201

Zamfir 02.10.15 at 12:19 pm

So, this whole birth certificate debate was based on a mistake on a book cover from 1991? I presume that people stopped their protests against Obama once they realised the source of the confusion.

202

Josh Jasper 02.10.15 at 12:39 pm

Mmm, no, it was based on racism looking for something to latch onto. Just like the claims that he’s Muslim because he went to a school in Indonesia that was attended by Muslims, and where Islam was a topic.

I went to school in Singapore, there were probably Muslims at my school, and Islam was a topic in some of the classes I attended to. I’m pretty sure I’m still Jewish.

203

Barry 02.10.15 at 1:35 pm

Brett: “Ok, let’s make this clear: While, “tu quoque” isn’t a defense against a charge that you do something, it IS a valid defense against a charge that you do something MORE. It isn’t a defense on an absolute basis, but where the charge is relative, it is right on point.”

In general, yes. In this case, it’s false. There are no Democratic politicians who are anti-vax.

204

reason 02.10.15 at 2:11 pm

Ze Kraggish
“If it’s voluntary and no one wants to make it mandatory, then what’s all this brouhaha?”

I’ll try reprise some things
(From the OP)
“or, more precisely, policies that impose costs on parents who don’t vaccinate their kids, may become a partisan issue, “

Me @195
“but vaccinations ARE voluntary. People get fined for not vaccinated or banned from certain institutions, but that is a pigouvian tax. People don’t get thrown in jail for not vaccinating.”
Me @196
“This is the typical right wing spin. I want my privileges (to impose externalities on everyone else and to free ride on them) to receive special protection.”

Is all clear now?

205

Popeye 02.10.15 at 2:15 pm

And which Republican politicians are anti-vax? This is literally the rare case where “both sides do it” is perfectly accurate.

187: I guess my “anyone” in 186 was implicitly referring to the leftish community here. But this is just further evidence that this is more a case of partisans hoping that the other side fully embraces a questionable cause, which of course is very likely because the other side is full of misguided morons in the grip of a foolish ideology that harms society. In the real world vaccination turning into a partisan issue would be a public health clusterfuck of enormous proportions, but in the meantime I guess thinking about it can help us feel more secure in our group identity.

206

Ze Kraggash 02.10.15 at 2:22 pm

Reason 204. The OP says that “Christie and Paul took a lot of flak from other Republicans”, and then in the next para: “The outline of the debate can be seen in the ferocious response to Reason magazine’s endorsement of mandatory vaccination.”

I take it you’re against mandatory vaccinations?

207

Rich Puchalsky 02.10.15 at 2:47 pm

John Quiggin: “The OP notes indications that the vaccination issue is going the same way.”

I’ll attempt to characterize what I’ve read of Dan Kahan’s work by saying that the vaccination issue could go the same way, but that current evidence does not indicate that it has already started to.

Here’s the part of your original post that I most disagree with:
“The consistent anti-science position of people like Solomon is, at least intellectually, more attractive.”

I don’t see how, intellectually, one should favor consistency as the highest value. I generally don’t think people who have a simple principle that causes them to be consistently wrong are intellectually superior to people who have unacknowledged conflicts in their thought that allow them to be right at least part of the time.

208

TM 02.10.15 at 2:49 pm

The US and also the states have mandatory vaccination policies. Even if nobody goes to jail for not vaccinating, mandatory is mandatory and it’s not helpful to pretend otherwise. It’s also not helpful to conflate mandatory (like measles) with non-mandatory (like flu or HPV) vaccinations. Re Ze 192, I know I shouldn’t bite but… a policy that requires anybody to “sacrifice their child for the common good” would be monstrous and no liberal or progressive advocates such a thing. Are you posing as a parody of a stalinist to generate talking points for the right or what?

209

Main Street Muse 02.10.15 at 2:54 pm

Are we really in the midst of an epidemic of anti-vaxxers? The data indicates we are not.

From the CDC: “This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013–14 school year. Median vaccination coverage was 94.7% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.0% for varying local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine; and 93.3% for 2 doses of varicella vaccine among those states with a 2-dose requirement. The median total exemption rate was 1.8%.” (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6341a1.htm)

Less than two percent of the population opts out of vaccines – and a key indicator is poverty.

The CDC figures show measles – in the era prior to vaccines – to be rarely fatal (400 deaths per 4 million cases of measles – again this data is prior to vaccines.) I’ve read stories that say measles has a very high incidence of complications – but the CDC data prior to vaccination does not support that claim (48,000 hospitalized out of 4 million cases.) (http://www.cdc.gov/measles/about/faqs.html and http://www.cdc.gov/vaccines/vpd-vac/measles/faqs-dis-vac-risks.htm)

The hyperbole surrounding this issue is puzzling. The Ohio measles outbreak last year was characterized by the media as “massive” – 382 cases confined to an Amish community – is that really massive?

Are communities with high vaccine rates (which, according to the CDC, is the majority of communities in the US) at risk for becoming the next epicenter of measles?

WHY is all this ink and angst being devoted to this issue? Honestly, pro-vaxxers sound like the marketing team for big pharm.…

210

Rich Puchalsky 02.10.15 at 2:59 pm

Ze Kraggash: “Class and cultural solidarity have nothing to do with it. Vaccinations is a national project where you are required to sacrifice something (your child, in the minds of some) for the nation. This sentiment can be right-wing or it can be left-wing, but most certainly it ain’t liberal. It’s not just collectivist; considering what’s at stake (to some), it’s radically collectivist, totalitarian.”

I’ll try answering you one more time, though if your reply is as foolish as the last time I tried answered you, I’ll go back to ignoring you again. No, vaccination is not a national project. Some diseases have been eliminated from the world entirely. How do you think this was done? Through vaccination in one country? Measles is one of the diseases that can be globally eradicated, which would be possible by spending a mere $8 billion by 2020.

211

Trader Joe 02.10.15 at 3:03 pm

The reason it draws attention is because the most vulnerable members of the community, babies, aged and infirm, those with compromised immune systems are the ones that do end up most ill or dying…its not otherwise healthy teens or adults (as has been pointed out). Its the herd protection afforded to the most vulnerable – not the individual immunity, that the anti-vaxxers, by their collective choice, impair.

Normally, if society owes any collective duty to anyone (I know some dispute this), it is to these most vulnerable members of it. The fact that some people make choices that are selfish vis a vis the collective is what provokes the response we’ve seen.

212

Rich Puchalsky 02.10.15 at 3:19 pm

I have to agree with Popeye @ 205. I’m seeing sentiments like these:

David J. Littleboy: “It looks to me as though it’s becoming a helpful framing. If the anti-vaxxers can be packed off to the right, then that’s one more issue where we’re right and they’re wrong.”

If concern about vaccinations was taken up as a tribalist right-wing issue in the way that global warming has been, that would be a public health catastrophe. You’re valuing scoring political points over people’s lives.

And I disagree with all of the comments about how a one-sided culture war is possible and how this up to powerful people on the right-wing side and not anything that the left contributes to. The whole “Obama is Kenyan / Muslim” (birther) thing is obviously not an isolated question about where he was born or his religious affiliation, it’s an expression of American racism, something with the highest stakes on both sides. Maybe we can avoid giving this the reinforcement it needs, maybe we can’t, but there are no actual stakes for the left here (unlike feminism, resistance to homophobia, and so on) and deciding to try to gleefully reinforce this is making an attempt in the wrong direction.

213

reason 02.10.15 at 3:50 pm

OK
So people (including me) are now playing semantic games about “mandatory” and “voluntary”. I just wanted to point out, that what a libertarian calls “voluntary” isn’t always actually “voluntary” (because it carries a cost), and what we might call “mandatory” isn’t always mandatory (because you choose to pay the cost), and perhaps this sort of muddies the waters.

214

Ze Kraggash 02.10.15 at 3:51 pm

“No, vaccination is not a national project. Some diseases have been eliminated from the world entirely.”

My point was that vaccination is not class- or culture-related. But yes, it is a national project. Diseases are eliminated from the world by coordinated national projects. This is how WHO operates.

215

Z 02.10.15 at 3:57 pm

Brett Bellmore, upthread you have written

It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity. They are the infectious reservoir that keeps the epidemic going. That’s science, even if you don’t want to hear it.

I have asked for sources to defend this “absolutely, incontrovertibly true” statement, which I admit was novel to me and which I would like to scientifically investigate. Since then, you have written a couple of posts, so I assume you are still reading this thread, yet I have seen no sources. Should I assume you know none?

216

David J. Littleboy 02.10.15 at 3:58 pm

“You’re valuing scoring political points over people’s lives.”

No, I’m not. The anti-vaxxers are going to be crushed. I just want to score some political points along the way, both stomping on righties, and working to clean up our own act..

217

TM 02.10.15 at 4:12 pm

“The reason it draws attention is because the most vulnerable members of the community, babies, aged and infirm, those with compromised immune systems are the ones that do end up most ill or dying”

Frankly, that touching description doesn’t sound like the America I know. If this were really about how to protect the vulnerable, we would have other conversations. The US has one of the higher infant mortality rates among developed nations and African American infant mortality is twice the white average. This is not for lack of vaccination. (Mississippi, which has near 100% vaccination rates, ranks 50 among states for infant mortality). I’m not mentioning this to argue against the importance of vaccination (although somebody will probably misquote me in that sense) or to put up a false dichotomy between vaccination and other factors like childhood nutrition. But it strikes me that the “battle lines” in the vaccination debate to some extent reflect people’s propensity to trust in simple technical solutions. Low vaccination rates are far from being a significant problem in this country but it’s a problem that seems easy to solve (and easy to find somebody to blame on).

218

Rich Puchalsky 02.10.15 at 4:15 pm

“My point was that vaccination is not class- or culture-related. But yes, it is a national project. Diseases are eliminated from the world by coordinated national projects. This is how WHO operates.”

Well, I’ll reply to that. WHO necessarily has to operate closely with nations, because it’s part of the United Nations and because nations are the de facto authorities over most areas in the world. But it works with non-state actors as well, and what it says under “About WHO” is “In the 21st century, health is a shared responsibility, involving equitable access to essential care and collective defence against transnational threats.”

More broadly, I was talking about solidarity. Solidarity necessarily implies that one feels connected to some kind of group, in implicit separation or opposition to some other kind of group or groups opposed or distinct. World health is a world concern and doesn’t really make sense as a national concern.

219

Trader Joe 02.10.15 at 4:28 pm

@217
Maybe. Additionally, we’re just a generation or two removed from people who actually remember and know people who had some of these diseases. I know a guy who is one of the last Americans to have contracted childhood polio…its an awful toll to extract on people and on society, that is entirely preventable …maybe what’s needed most of all is a reminder that this stuff isn’t playground word games, its real people and real lives.

I don’t discount that the anti-vaxxers might have some points with respect to themselves, but that’s ultimately not the point. Its a communal action problem that requires certain threshholds – its precisely because the program has been successful for so long that a re-education process is useful. With luck the recent measles scares will reinforce responsible collective behaviour.

220

Ze Kraggash 02.10.15 at 4:31 pm

“So people (including me) are now playing semantic games about “mandatory” and “voluntary”.”

Look, where I grew up, they would show up in the middle of a school day and vaccinate everybody. You couldn’t say no, the best you could do is to try to hide under a desk or something. That’s what I call ‘mandatory’. And I’m not saying mandatory is good or bad, right or wrong – that depends on the situation; obviously if you’re anticipating some deadly epidemic, then mandatory might very well be the way to go. Or if you value public health well above personal autonomy. And that’s the controversy, as I understand it. Declaring some minor disagreement about small fees and inconveniences a “partisan divide” doesn’t make for an interesting discussion.

221

mattski 02.10.15 at 4:40 pm

Are you posing as a parody of a stalinist to generate talking points for the right or what?

I think he’s posing as debating for the sake of understanding when in fact what gets him off is being an irritant.

222

TM 02.10.15 at 4:46 pm

“Look, where I grew up, they would show up in the middle of a school day and vaccinate everybody. You couldn’t say no”

Of course children don’t get to say no. But parents do. Could you please stop that BS.

223

js. 02.10.15 at 4:52 pm

posing as a parody of a stalinist to generate talking points for the right

This is in fact a really good description of the commenter in question. I’ll have to remember it!

224

Rich Puchalsky 02.10.15 at 5:01 pm

TM: “Of course children don’t get to say no. But parents do. Could you please stop that BS.”

He apparently didn’t grow up in the U.S. Probably parents couldn’t actually say no, wherever it was. Yes, “vaccination is totalitarian!” is annoying. But don’t get baited into making counterstatements that are actually, provably false.

One of the things that I often talk about within the U.S. is what is called eliminationism — treating people like a disease. It’s common on the right. Someone could conceivably say “Ah ha, you too talk about mobilizing everyone to wipe out this ‘disease’: that’s totalitarian.” But treating a literal disease like a disease really doesn’t suffer from the same problems.

225

Brett Bellmore 02.10.15 at 5:07 pm

Z, take a look at this: http://www.cdc.gov/hiv/statistics/surveillance/incidence/

If that doesn’t spell “disease reservoir” to you, I’m not the one with a blind spot.

226

TM 02.10.15 at 5:25 pm

Rich, medical ethics is unambiguous: any medical intervention, with narrow exceptions (mostly concerning patients in a state where they are unable to give consent), requires informed consent of the patient or legal guardian. That definitely applies to vaccinations, mandatory or not. I don’t tolerate anybody blurring these lines.

227

Harold 02.10.15 at 5:44 pm

@209 Main Street Muse ) “I’ve read stories that say measles has a very high incidence of complications – but the CDC data prior to vaccination does not support that claim (48,000 hospitalized out of 4 million cases.)”

Serious complications do not necessarily entail hospitalization. For example deafness and blindness caused by scarring. I had a friend who lost the hearing in one ear from measles. Fatal complications were more likely to occur in adults, we were told, in whom the disease was even more severe and in those who were already ill from something else.

When I had measles as a child of nine years old, the doctor’s instructions (doctors made house calls in those days) were to keep me in a darkened room for two weeks to prevent blindness (I don’t know how that was supposed to work). I remember lying in bed crying and groaning and moaning for days on end. Symptoms included a severe headache, high fever of 104 or 5 for four days or so, delirium, vomiting, diarrhea, dark red blotches all over body, inside and out.

At first I, myself, was skeptical of the vaccine. I thought, I toughed it out and learned the meaning of what it was to be really really sick and I’m fine now, and maybe even a better person for the experience, why can’t other people do the same? But that was before I understood the statistics or was meant by severe complications. Did you read Roald Dahl’s account of losing his daughter? I remember a conversation I had with a nurse who was distraught over caring for adult patients in intensive care with measles — prognosis poor. Do we really want to see 30 out of 100,000, or 300 out of a million (0.3 % per wikipedia) people undergo death when it could be avoided? Not to mention the scarring of eyes and ear drums.

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Bruce Wilder 02.10.15 at 8:44 pm

RP @ 178: . . . I don’t see how the center-left could commit itself to solidarity even if prominent elements of it wanted to. National solidarity is right-wing, class solidarity is a trainwreck . . . , and cultural solidarity runs into the most salient political fact of the U.S. in my lifetime: . . . racism, and the well is thoroughly poisoned.

And, I do not see how the centre-left can achieve even a transitory political power, while conceding to the demagogues and dominators of the right, leadership of all of the mass of followers.

Politics, as a variant of morality, is founded not in philosophy, but on the primitives of social psychology. Raising politics from animal emotion to the level of analytic philosophy was an Enlightenment project that I very much endorse: that project, which founded the social sciences and partially displaced religion in attempts to improve society and ethics, is the core of liberal and social democratic politics and the general left point of view that we can deliberately govern ourselves in a shared, common or public interest.

The superstructure of political philosophy and allied social science has not displaced the emotional foundations and political attitudes still count, political arguments are still more hypnotic trance induction than Aristotelian syllogism, more slogan than logic. At best, bringing the human capacity for deliberation and analysis into the political realm enables cooperation on the basis of an enlightened self-interest that favors the resolution of conflict on a basis that enhances mutual benefit from cooperation. It doesn’t eliminate the potential interest of some in taking advantage of others, whether in the domination by an exploitive elite or in the oppression of an out-group by an in-group.

Nationalism, which you condemn as right-wing, was a liberal invention. The liberal campaign for institutions of bourgeois democracy was built around motivating national solidarity behind ideals of liberty, equality and fraternity, and claims of a People’s right to national self-determination and self-governance. And, it continued to be employed in the liberal and social democratic campaign for the technocratic social welfare state, in competition, it should be noted, with fascist demagoguery — a competition lost in some countries with catastrophic results.

I refer to history, because I think people tend to lose their perspective without it, lose their sense that political coalitions and movements are contingent on ephemeral circumstances, rotating in a kaleidoscope of changing patterns.

On another thread, some are marvelling that Jim Crow might be polemically tacked on as a caboose to the Republican campaign train in long-ago 1944, when FDR still claimed the Solid South (and would win benighted Mississippi’s 9 electoral votes, backed with 93.5% of the popular vote.) Democrats would ask the Senate’s Republican majority in 1947 not to seat Mississippi’s Bilbo, elected in 1946. It was a messy time. They’re all messy times.

Nationalism is tainted with fascism, class consciousness is a train wreck (especially with the passing of Fordist mass-production), cultural solidarity is prone to racism, etc. because 1.) the primitives of political psychology are primitive and 2.) the alignments are embedded in political struggle (hello!) for power.

The other day Atrios pointed to an article about how Hilary Clinton had 200 advisers struggling to find a way to make populist appeals that address the increasing hardships of economic inequality without insulting or alienating the rich, who are the engineers and beneficiaries of said inequality. So it goes.

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mattski 02.10.15 at 8:59 pm

The other day Atrios pointed to an article about how Hilary Clinton had 200 advisers struggling to find a way to make populist appeals that address the increasing hardships of economic inequality without insulting or alienating the rich, who are the engineers and beneficiaries of said inequality.

Some situations are so utterly bolluxed up & precarious that it’s best back out of them softly and quietly.

:^)

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Z 02.10.15 at 10:00 pm

Brett Bellmore,
Thank you for providing a source. However, this source is not even close to back-up the claims you made that “the epidemic would have extinguished itself by now [were it not for male homosexuality]” and that “It is absolutely, incontrovertibly true, that you can blame the continued AIDS epidemic on male homosexual promiscuity” (and in fact the source does not come even close to making such statements).

I am not an epidemiologist (and I would venture you are not one either) but I am a mathematician and I can easily construct an abstract contagion model such that a fragment of the population has a much higher incidence rate than the rest of the population and yet the epidemic would by no mean whither out were this fragment to disappear (all is needed is that the two fragments are separated and that they have has different contagion property one for the other; two properties which are not completely unlikely for the AIDS epidemics with respect to male homosexuality, as you yourself note, by the way). Nothing in the source you give presents evidence that the AIDS epidemics does not conform to this abstract model.

Do you have further evidence that it doesn’t? If not, I suggest you treat the adverbs absolutely and incontrovertibly with slightly more skepticism. Because, you know, skepticism and demanding evidence is not exhibiting ideological blind spots. Rather the contrary, in fact.

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The Raven 02.11.15 at 1:10 am

I don’t, on balance, think this is going much of anywhere in the long term; the benefits of vaccination are too great and in too many lives. The conflict with up close and personal reality is going to make it very hard to sustain. In the short term, I think it’s clear there is the potential for making it into a partisan thing, yes. It is interesting that it shows crunchy granola liberals as having a libertarian streak; this is something I might have worked out if I’d thought about it enough, but I hadn’t.

Meantime, teh crazy! It buuuuuuuuurrrrrrns!

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Anarcissie 02.11.15 at 4:07 am

Once upon a time the Left had a libertarian streak.

233

Ze Kraggash 02.11.15 at 9:00 am

“It is interesting that it shows crunchy granola liberals as having a libertarian streak”

Is it only the crunchy granola liberals? I would like to hear from any regular commenter here – either resident troll or serious person – who is NOT an anti-science anti-vaxer by the standard of this post (as I understand it). Anyone demanding a Mississippi-style no-nonsense no-opt-outs national law?

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David 02.11.15 at 9:45 am

I just wonder if there’s actually an opportunity here. A number of people, me included, think that the Left will never regain any meaningful degree of power until it re-learns the vocabulary and habits of thought of solidarity and community. (It will be easier in some countries than others, of course.) Vaccination protects children irrespective of the ethnicity, skin color, gender or sexual orientation of their parents. Indeed, it even protects children largely irrespective of things like the wealth or education of their parents as well. If there was ever a case to be made in favor of collective action, and against the indefinite extension of personal autonomy, then this must be it. Here’s an open goal to kick into at a distance of five paces. Can a fragmented Left manage to combine enough to do it?

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Brett Bellmore 02.11.15 at 11:03 am

“(all is needed is that the two fragments are separated and that they have has different contagion property one for the other; two properties which are not completely unlikely for the AIDS epidemics with respect to male homosexuality, as you yourself note, by the way)”

Now, where did I note anything of the sort? I’m sure you’re aware that exclusive homosexuality is fairly rare compared to some degree of bi-sexuality, and the “MSM” categories in that link do not in any way imply that “Men who have Sex with Men” do not also have sex with women. So the model where a small sub-group of the population have a high rate of the disease, and transmit it to the general population, which has a transmission rate below extinction, but non-zero, is quite to the point. AIDS would not be the only disease that follows this model.

Indeed, this is the big problem with ant-vaxxers. If they were randomly distributed, that would be one problem, but easier to deal with. However, as they cluster, and that creates an entirely different and much worse problem. Because the clusters become disease reservoirs where all sorts of infectious diseases can multiply, and then spread back into the general population.

Clustered anti-vaxxers are much more effective at defeating herd immunity than randomly distributed anti-vaxxers. Just think of male homosexuals, with risky sex practices, as a particular variety of clustered anti-vaxxer.

OTOH, clustered anti-vaxxers are more suited to targeted PR campaigns, if you’re not committed to ignoring the clusters just because the political identity of the people in them is inconvenient. That’s the good side of clustering: You don’t need to educate the entire population.

And that’s where John’s anti-empirical take on opposition to vaccination is problematic: To effectively deal with a problem, you need to look at it honestly, not pretend it’s what you’d like it to be.

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Anarcissie 02.11.15 at 1:40 pm

David 02.11.15 at 9:45 am @ 234:
‘… A number of people, me included, think that the Left will never regain any meaningful degree of power until it re-learns the vocabulary and habits of thought of solidarity and community. … If there was ever a case to be made in favor of collective action, and against the indefinite extension of personal autonomy, then this must be it.’

Will that be ‘the Left’, though? There is a politics of solidarity and community under authority which has been quite successful at times in the past, but it usually isn’t assigned to the Left.

237

Robespierre 02.11.15 at 2:50 pm

“Anyone demanding a Mississippi-style no-nonsense no-opt-outs national law?”

Yes. Free of charge and mandatory. But then, I don’t live in the United States.

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David 02.11.15 at 5:02 pm

@237. Yes, of course there are other types of solidarity and community which are not of the Left, and many of them have authoritarian overtones. But I was thinking of mass political parties, trades unions, public utilities run not for profit, but also more spontaneous, community-based systems of cooperation, as well as things like public libraries and free medical care which are coming under attack and need to be defended. In reality, people in most countries today are fed up with liberal ideology, and have no particular desire to run their entire lives as just autonomous economic and social actors. They prefer (so would I, frankly) the sense of being embedded in a community with shared interests and values, and a shared support mechanism. This is a function that the Left used to help perform, but which in many countries now no longer happens. In France, for example, the old Communist Party had offices everywhere and a huge network of volunteers who among other things helped people with problems in their daily lives and created and supported community organizations. That’s all gone now, and you wouldn’t catch the modern Left in France even going into the areas where communities need help most. And guess who is? The National Front of course. “At least they care about our problems” say ordinary people.

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TM 02.11.15 at 5:24 pm

It turns my stomach to see solidarity treated as a dirty word. If the “Left” can’t even hold up the standards of solidarity set by Catholic Social Teaching, that’s a declaration of bankruptcy. In my experience, this is a uniquely American thing (correct me if I’m wrong). Only in America do people not know the meaning of Solidarity.

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Brett Bellmore 02.11.15 at 5:28 pm

“Solidarity”? Wasn’t that the Polish trade union that successfully fought communism?

I think communists only have use for solidarity where they don’t rule.

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TM 02.11.15 at 5:28 pm

And who came up with the absurd idea that the Left has to choose between Liberte and Fraternite?

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TM 02.11.15 at 5:40 pm

Also I would still love to hear some thoughts re 217.

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Anarcissie 02.11.15 at 5:53 pm

David 02.11.15 at 5:02 pm @ 238 —
The problem with anti-vaccinationists, though, isn’t a lack of community and solidarity, if vaccination is free, universally available, and performed with proper technology, as I think it is. There is no lack of community and solidarity in that. The problem is with authority — for something like vaccination, there are always going to be a certain number of resisters, and the question is what one is going to do about them. Summarily overriding their preferences seems like a dangerous precedent, a dangerous habit, especially when the contested territory consists of people’s bodies.

TM 02.11.15 at 5:24 pm @ 239 —
The slogan of Food Not Bombs, an American invention, is ‘Solidarity Not Charity’.

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TM 02.11.15 at 6:05 pm

Vorwärts und nicht vergessen,
worin unsere Stärke besteht!
Beim Hungern und beim Essen,
vorwärts und nie vergessen:
die Solidarität!

http://de.wikipedia.org/wiki/Solidarit%C3%A4tslied

“The slogan of Food Not Bombs, an American invention, is ‘Solidarity Not Charity’.”
That’s great. My point, if I really need to spell it out, is that the idea of solidarity is close to completely absent from American mainstream discourse.

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David 02.11.15 at 8:49 pm

@243. I take your point, but solidarity necessarily involves a degree of altruism, and the sacrifice of some degree of one’s personal autonomy for the common good. (And of course in turn others sacrifice a degree of their ultimate autonomy for your good). Our type of democracy, after all is based on the idea of compromise, and those who have lost the argument giving way. Otherwise, nothing would ever get done.
So far as authority is concerned, the distinction, I think, is between acts of authority imposed on society, to which anyone might object, and acts of authority intended to ensure a greater good. Forbidding people to read certain books or watch certain films, or alternatively demanding that everyone attend church on Sundays, are of the first type. There, my refusal to accept authority doesn’t actually hurt, or even affect, anyone else, in any real sense. When Joyce’s “Ulysses” was banned in Britain, travelers came back from Paris with copies in their luggage, but there’s no sign that others, who did not read the book, were in any way affected. But obeying the road traffic laws, paying your taxes honestly, or observing the terms of a contract, are a second type of refusal to obey authority, since they clearly have negative effects on others. Whatever vaccine opponents may say, their refusal is actually of the second type – i.e. it’s really just selfishness, dressed up in the fashionable language of individual freedom and resistance to authority.
So, yes, there are times when too much liberté undermines égalité, and you have to choose between one and the other. The major figures of the French Revolution (who were middle-class Lockean liberals, not really revolutionaries) understood this perfectly well, and would have been stunned to learn that liberté could be interpreted to mean, in the immortal words of somebody or other, “everybody does whatever the **** they like you got a problem with that?” On this kind of issue, I have a problem with that.

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David 02.11.15 at 8:57 pm

Sorry. Too much liberté undermines fraternité (which is not the same as solidarité). Sigh.

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Brett Bellmore 02.11.15 at 10:53 pm

“So far as authority is concerned, the distinction, I think, is between acts of authority imposed on society, to which anyone might object, and acts of authority intended to ensure a greater good. “

It strikes me that these two, as above described, are orthogonal. An act of authority imposed on society could be for the greater good, or for the worse. An act for the greater good could be imposed, or voluntarily adopted.

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Bruce Wilder 02.11.15 at 10:55 pm

Brett, you don’t think people cheat?

249

The Raven 02.12.15 at 4:32 am

Anarcissie@243: “Summarily overriding their preferences seems like a dangerous precedent, a dangerous habit, especially when the contested territory consists of people’s bodies.”

In my very first comment on this: “Viruses and bacteria don’t care about our individuality; they just know we taste good.” It’s the same with climate change. I don’t believe in arguing with thermometers—they don’t budge—or micro-organisms—they don’t listen.

Ze Kraggash@233: “Anyone demanding a Mississippi-style no-nonsense no-opt-outs national law?”

Some, yes. It never was an issue before. Persuasion was adequate. So we’ll have to see how it develops.

Which is the point of this thread.

250

Anarcissie 02.12.15 at 5:07 am

The Raven 02.12.15 at 4:32 am @ 249:
‘In my very first comment on this: “Viruses and bacteria don’t care about our individuality; they just know we taste good.” It’s the same with climate change. I don’t believe in arguing with thermometers—they don’t budge—or micro-organisms—they don’t listen.’

You’re not arguing with microorganisms or thermometers. You’re arguing with other human beings about a particularly intimate matter, the interior of their own bodies. Or, rather, you’re not going to argue with them, you’re just going to use force. Well, at least it’s obvious why the issue has become overtly politicized.

251

The Raven 02.12.15 at 7:47 am

Anarcissie@250: as far as viruses are concerned, our bodies are not distinct things; all our flesh is grass, ripe for the harvest. Do you think they will stop taking what they will because of our scruples?

252

The Raven 02.12.15 at 8:04 am

And—never forget—this is not a remotely personal decision. Measles is one of the most contagious of viruses. That is why a few cases have led to an epidemic. It is possible we will see many more cases. The disease is most dangerous to the very young, the very old, and the already ill.

This is not a false threat, designed to stampede people into doing unreasonable things. The danger is real and prevention is easy and low-risk.

(My wife, a sometime health care professional who is checking my facts, is sitting in the other chair, spitting mad.)

253

Ze Kraggash 02.12.15 at 8:47 am

@249 “It never was an issue before. Persuasion was adequate. So we’ll have to see how it develops.”

If it’s still not clear, my objection is to framing this as a conflict between the enlightened/pro-science (pro-mandatory) side and the unenlightened/anti-science (anti-mandatory) side.

I believe it’s more like paleocon nationalists (fraternité people, if you prefer) who are pro-mandatory, and the whole spectrum of liberals-libertarians who are, ideologically, very much anti-mandatory.

The way things are now, liberalism dominates, and I don’t think paleocons have a chance. Thus, I believe, some sort of middle-class or upper middle class opt-out mechanism is inevitable.

254

David J. Littleboy 02.12.15 at 9:01 am

“the whole spectrum of liberals-libertarians “

The idea that liberals and libertarians are on the same side of just about anything is completely nuts: libertarianism is about denying that individuals have any responsibilities to society, and liberalism is about building a society based on our mutual responsibilities. Complete opposites.

But you know that and are just trolling, right?

255

David J. Littleboy 02.12.15 at 9:07 am

“Or, rather, you’re not going to argue with them, you’re just going to use force.”

Oh, dear me. No. We’re not going to use force. We’re just going to not let anyone not vaccinated (of their own will) endanger people who can’t be vaccinated, or for whom vaccination happens to be ineffective. If you want to go to a movie theater, eat in a public restaurant, go to school or college, get your shots. If you want to be a libertarian and not get your shots, then you have made a clear statement that you don’t have need of those services.

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Ze Kraggash 02.12.15 at 9:23 am

“But you know that and are just trolling, right?”

If it’s still not clear: no I don’t. I am well aware of the self-righteous streak in American liberalism (that you’re demonstrating here); its unwillingness to acknowledge its shortcoming and limitation, and so on. But that just means that you and I are unable to communicate, not that I’m trolling.

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David 02.12.15 at 9:47 am

I don’t actually think this is really about the sanctity of bodies. If it were, there would be similar arguments against dentistry, invasive surgery and even medicines. But everyone accepts these things, and even seeks them out, because they are necessary for their own welfare. Oh, and I’m pretty sure that anyone traveling to West Africa would rush along and get themselves vaccinated against some of the nasties that lurk there. The problem with vaccinations is that they not only protect you, they also protect other people, whilst simultaneously posing a very small risk of unpleasant side-effects to you. So it’s perfectly possible that you may have an abreaction to a vaccination, and may feel bad for a while, yet never encounter the disease yourself.
You have therefore wasted your time (and in some societies your money) and acquired a rash and a headache for nothing. The counter-argument, that you have benefited society as a whole, is one that we have simply forgotten how to make; The related idea that we have a duty to others would be received with derision across most of the political spectrum today.
Words mean different things in different countries. The “Liberal” ideology I and others have mentioned is the full-on liberal economic and social pursuit of personal autonomy at any cost, not the Kumbaya happy-clappy let’s all be reasonable variety. That’s why conventional “left” and “right” distinctions are largely beside the point here, since both sides have effectively embraced this ideology. In this context, there’s a debate about whether libertarianism is a diseased form of liberalism, or whether it’s just a natural development of it. I incline to the second view personally, but I don’t think it affects the argument much either way.

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Brett Bellmore 02.12.15 at 10:41 am

I think libertarianism is neither a diseased form of liberalism, or a natural development of it. Libertarianism, essentially, IS liberalism. And what calls itself “liberalism” today is just a sort of Fabian socialism that successfully appropriated the word early in the last century, in a massive PR coup.

Something like what’s going on with originalism today, where the living constitutionalists are in the process of appropriating the term, and soon actual originalists will have to find a new name for themselves to avoid confusing people.

Movements often attempt to take the name of their opponents, when their opponents have a much better reputation. Like all those communist dictatorships that called themselves “democratic republics”. That’s what happened with liberalism early in the last century.

At least in the US.

259

Salem 02.12.15 at 10:42 am

I don’t actually think this is really about the sanctity of bodies. If it were, there would be similar arguments against dentistry, invasive surgery and even medicines.

Hang on a minute. I would be extremely upset if I were required to undergo dentistry/invasive surgery/take medicines on a compulsory basis. We rightly insist that these are voluntary. Indeed, almost every medical procedure is strictly voluntary, precisely because of the sanctity of bodies.

That vaccines may be compulsory makes them the exception, not the rule. There are reasons to treat vaccination differently from other medical procedures, but don’t misrepresent the anti-vaxx position.

260

Collin Street 02.12.15 at 10:49 am

> That vaccines may be compulsory makes them the exception, not the rule.

Trying to turn a continuum into a dichotomy and then focussing on the dichotomy is unwise, I think.

[things before labels.]

261

Robespierre 02.12.15 at 10:58 am

@258:

One would think that infecting other people when easily avoidable, would count as aggression. We don’t think people are free to run through crowded buildings holding torches.

262

Brett Bellmore 02.12.15 at 11:18 am

OTOH, we don’t charge people who walk through a mall sneezing with a crime, either. Short of being under some sort of explicit quarantine order, or deliberately going out of your way to infect somebody with a deadly illness, it doesn’t legally get treated as aggression.

263

David 02.12.15 at 11:36 am

@Salem 259. Sort of, yes, but we’re really coming at the same point from different ends.
To repeat, we accept, and even seek, all kinds of invasive medical procedures. In theory these are voluntary, but in practice, as has just been noted, it’s a continuum. Cosmetic dental surgery is a choice, whereas CPR when you are unconscious isn’t. Moreover, the vast majority of us accept and act on advice and instructions from medical experts, even though we could theoretically reject it. And don’t forget that a number of countries (especially in Africa) require you to show proof of vaccination against certain illnesses before you are allowed in. You don’t hear people protesting about that. The only difference with vaccination is that it’s so important for society as a whole that governments act as an agent for the medical community in proposing and trying to enforce vaccination regimes. It’s not, in other words, just an idea which occurred to some bureaucrat in an office one day. Governments thus encourage people to behave in a way that benefits society as a whole, but, as I think this thread itself indicates, we find it hard these days to employ the vocabulary of altruism convincingly.

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Ellie Kesselman 02.12.15 at 12:06 pm

David #263
Many extreme right-wing and lefty types (choose to?) misunderstand what you so perfectly expressed. Vaccination isn’t contrary to rugged individualism nor to the well-being of the collective.

Small pox and polio are distant memories or forgotten by most of us. They haven’t been forgotten in Mississippi, West Virginia or Africa though.

I read a chapter of a book from the CDC, Vaccination Mandates: The Public Health Imperative and Individual Rights [PDF] that said government imposed inoculation was constitutionally allowed under Parens Patriae, see p. 273. I’m a statistician, not a lawyer, so I can’t be certain.

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Ellie Kesselman 02.12.15 at 12:27 pm

Actually, anti-vaccination is a policy that imposes costs on parents who DO vaccinate their children!

Americans forget that in our insurance-dependent healthcare system, the collective pays for the individual. Since the group suffers the cost when any given individual falls ill, it benefits everyone to do all that is possible to prevent anyone from requiring medical attention, and vaccines are just one small way to do this.

What could happen if large numbers of people choose not to vaccinate, thereby allowing a resurgence of preventable illnesses? Insurance companies have to make profits to stay in business, so eventually these additional medical costs will likely be passed down to consumers in the form of increased premiums. Local city/state/federal taxes may also bump to help fund hospitals who care primarily for the uninsured and economically disadvantaged.

If a hospital is forced to spend resources on patients with preventable illnesses, then it cannot help other patients who come in the door. A PICU full of unvaccinated children means there is no room for the victim of child abuse, the child struck by a drunk driver, the infant born 10 weeks early, etc.

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Rich Puchalsky 02.12.15 at 1:30 pm

David J. Littleboy: “If you want to go to a movie theater, eat in a public restaurant, go to school or college, get your shots.”

Fredrik deBoer, in his blog post on this that I otherwise thought was pretty good, also said something like this — that if you don’t get vaccinated, you basically shouldn’t be allowed outside. And it’s ridiculous and draconian, much like the people who wanted everyone who’d travelled to Africa during the Ebola scare to be quarantined. No actual public health person is going to recommend that; no politician is going to implement that; people who seriously want that (as opposed to just getting rhetorically carried away) are worse than the anti-vaxxers.

267

TM 02.12.15 at 2:31 pm

Rhetoric is getting out of hand around here. A hundred cases of a disease that is harmless in the vast majority of cases don’t make an “epidemic”. This fearmongering is just dumb.

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Jerry Vinokurov 02.12.15 at 2:39 pm

Rhetoric is getting out of hand around here. A hundred cases of a disease that is harmless in the vast majority of cases don’t make an “epidemic”. This fearmongering is just dumb.

It is absolutely not harmless. At best, it’s the source of a significant amount of suffering for the patient; at worst it’s fatal. Not to mention that infected people are themselves disease vectors and potential breeding grounds for mutated variants of the disease.

The fact that we’re having this conversation is a testament to how effective vaccination has been: people are alive today (myself included!) who have no memory of any life-threatening infectious diseases, so they think vaccination is no big deal. It actually is a very big deal, and a very serious public health issue. People who don’t understand this basic fact don’t deserve to have a voice in the conversation.

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TM 02.12.15 at 2:58 pm

It is (now, in developed countries) harmless in the vast majority of cases. That is an empirical fact. And the vast reduction in infectious disease mortality observed in the developed world in the 20th century is mostly not due to vaccination but to sanitation and nutrition improvements. Ignoring such facts just undermines your credibility, sorry.

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Ellie Kesselman 02.12.15 at 3:05 pm

TM: What is harmless? You said, “It is (now, in developed countries) harmless in the vast majority of cases.”

What is “it”: Vaccination? Or polio/ smallpox/ measles/ mumps/ diptheria/ pertussis etc.?

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Jerry Vinokurov 02.12.15 at 3:16 pm

There’s no question that sanitation has a huge role to play in reducing the spread of infectious diseases; no one is arguing against that. Nevertheless, it is also empirically true that vaccines have saved millions of lives and have resulted in certain diseases literally disappearing from the populations of developed countries.

On the one side, we can pretty much eliminate the societal risks of a large number of diseases through one of the most successful and safe medical interventions known to humankind. On the other hand, MAH PERSONAL LIBERTAY /makes farting noises. There’s no debate here to be had.

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Anarcissie 02.12.15 at 3:33 pm

I think one of the fundamental principles of liberalism is the idea of equal rights — significant, inalienable, normally indefeasible rights, rights being defined areas of freedom of situation and conduct. Your little suburban yard in the polity, one might say. These rights are held by many to be of extreme importance. One of them, a right of privacy, is so important that it was not written in the Constitution but simply assumed, and was eventually discovered in the interior of women’s bodies, so that the government was prohibited from either preventing or compelling abortion and contraception, even though the lives of other individuals might be at stake. So crossing the line, or rather penetrating the surface of the human skin against the will of its owner, is not a question to be taken lightly. It is certainly a violation of what are widely held to be natural or God-given rights, and the political question is at what point a communal threat defeats this very important right of physical privacy, and how we determine that point. It does not seem like an issue to be treated contemptuously, nor one in which opposition is to be dismissed out of hand simply because one happens to have superior power at the moment.

Remember, you will not always have superior power, and you will not always be right.

273

Jerry Vinokurov 02.12.15 at 3:41 pm

It’s almost like living in a society requires some compromise with the very rules that render that society’s existence possible!

Look, all this high-minded business about natural rights and privacy and so on is great, but there’s also the danger that you’re going to float off into the clouds of theory without really facing the concrete issue in front of you. The tradeoff is: infinitesimal inconvenience for any healthy person capable of receiving immunizations vs. potential illness and death for others. We’re nowhere near any kind of gray area and this was a non-issue until some very stupid people listening to a bunch of snake-oil salesmen decided to make it one.

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Rich Puchalsky 02.12.15 at 3:49 pm

“Look, all this high-minded business about natural rights and privacy and so on is great, but there’s also the danger that you’re going to float off into the clouds of theory without really facing the concrete issue in front of you.”

All right, then look at the concrete recommendations of trained public health experts, epidemiologists, and so on. Exactly zero of them are recommending what is effectively quarantine for people who don’t get vaccinated. Some of them probably recommend making the personal exemption forms less easy to claim.

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Jerry Vinokurov 02.12.15 at 3:59 pm

All right, then look at the concrete recommendations of trained public health experts, epidemiologists, and so on. Exactly zero of them are recommending what is effectively quarantine for people who don’t get vaccinated. Some of them probably recommend making the personal exemption forms less easy to claim.

Yes, quarantine for people who don’t get vaccinated is impractical and would probably be a larger violation of liberties than is warranted in this particular situation. On the other hand, being told “you can’t get a vaccination exemption because feelings and if you don’t get vaccinated you can’t come to school” is a thing that can, and should be done. Somehow, plenty of states and countries have in fact done this and are actually not real-life examples of a communofascist dystopia.

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Layman 02.12.15 at 3:59 pm

I’m reasonably confident that vaccinations were a requirement of public schools when I was a child. That seems now not to be the case. Isn’t the solution here to restore that requirement? Anti-vaxers can send their kids to private schools, or home school them, while everyone else can benefit from the reduction of risk by sending their kids to public schools where everyone is vaccinated. An imperfect solution, I know, but one which strikes a balance between personal freedom and the public welfare.

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Brett Bellmore 02.12.15 at 4:15 pm

“Remember, you will not always have superior power, and you will not always be right.”

Good luck with that. I’ve been hitting that note for years, and it’s no match for “emerging Democratic majority” and “so far I always have been”.

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bianca steele 02.12.15 at 4:23 pm

“Remember, you will not always have superior power, and you will not always be right.”

Is this a quote from Wolf Hall?

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TM 02.12.15 at 4:28 pm

Elie 270: “it” referred to measles. Sorry for any confusion.

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TM 02.12.15 at 4:32 pm

Laymen 276: Vaccinations – certain vaccinations – are still a requirement in US public schools, but there are exceptions, and the exact conditions vary by state.

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Layman 02.12.15 at 4:49 pm

“Vaccinations – certain vaccinations – are still a requirement in US public schools, but there are exceptions, and the exact conditions vary by state.”

I assumed this was the case, but my suggestion stands. Other than some narrowly defined medical exceptions, why should any public school grant exceptions? And why should conditions vary by state?

Frankly, for a parent to withhold vaccinations from a child on the basis of anything other than medical necessity smacks of neglect, if not child abuse. What’s the reason for the state to promote and support that sort of behavior?

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Jerry Vinokurov 02.12.15 at 5:21 pm

Oh look, a real actual thing that happened in 2015!

Sorry, pregnant woman! Sorry, immunosuppressed cancer patient! Sorry, months-old-infant who isn’t old enough to be vaccinated! Sucks to be all of you, whose health and ability to use public transit is potentially compromised by imaginary fears of autism and chemicals and government jackboots. Remember, nothing says “personal liberty” like being able to infect your fellow humans in shared public spaces.

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Robespierre 02.12.15 at 8:46 pm

Not that it’s going to convince anyone, but I think I must underline, at least once, that all this talk of liberty is really about the parents’ power. Kids don’t choose whether to vaccinate or not, nor should they be expected to.

@Brett: I don’t think we disagree that much. No, clearly we don’t arrest people who sneeze. That’s because 1) it’s most likely harmless, 2) doing so would be impossible and unenforceable and 3) one can’t really help it, can one?
But clearly there is some kind of cut-off point where people do not have the freedom to practice behaviour dangerous to them and everyone else.

To change metaphor, in, say, a community of farmers, if one allowed pests or predators to multiply on his land, and they caused problems to others, how long would it take for neighbours to have a talk with him?

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Bryan 02.12.15 at 8:54 pm

If you have unprotected sex and have aids it can be a crime; if you don’t get vaccinated, get a potentially deadly virus and then go around in public with it…
I’m just thinking there should at least be a big degree of civil liability in it.

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Anarcissie 02.13.15 at 12:35 am

bianca steele 02.12.15 at 4:23 pm @ 278:
Is this a quote from Wolf Hall?

More like a quote from Third Grade. It does sound like a poppy historical novel, though. Maybe I missed my calling. In any case, some people still don’t believe it. So….

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David J. Littleboy 02.13.15 at 1:05 am

“I’m just thinking there should at least be a big degree of civil liability in it.”

Exactly. The amount of harm one can cause by not getting your kids vaccinated is large. The civil liability should be proportional to the amount of harm. Ergo, no public school, movies, public transportation for libertarians (and their kids) who think getting vaccinated is a personal choice, since they can’t possible carry enough insurance to compensate everyone who might be hurt by their stupidity.

Also, (re: @276) if you are running a private school, there’s no way you can let unvaccinated kids in: that’d open you up to horrific lawsuits (to say nothing of your moral responsibilities to the other children in your care), so there’s really no place to send unvaccinated kids. Interesting libertarian catch 22 here: presumably libertarians don’t like the government telling private schools how to run their business, so the right of private schools to refuse admission to unvaccinated libertarian kids is the sort of thing that libertarians will defend to the death. Oops.

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The Raven 02.13.15 at 1:18 am

Jerry Vinokurov@273, 282: you’re making sense. Is that allowed in this discussion?

Anarcissie@272: Yes, you’re right, respect for the person’s body is very important. I worry about the legal abuse of a vaccination mandate, though it is more likely to take the form of a fine than a forcible injection. But if there is a right to spread infectious diseases, I don’t want to know about it! Truly, it is not so hard to tell the difference between an abortion and a vaccination.

Beyond that, I don’t see how to practically deal with a large unvaccinated majority. Do day care centers start requiring proof of vaccination? Do pediatricians and obstetricians forbid unvaccinated people from entering their offices? What happens if someone lies about that, and a child or an expectant mother gets severely ill because of it? Is the unvaccinated person liable? Do we have to bring back quarantine laws?

Ze Kraggash@253: I don’t personally know any anti-vax liberals; I have only encountered them in print. All the anti-vaxxers I know are either conservative or some sort of radical. What is one to make of anti-vax liberals? The objections I have read seem to be mostly “Ew, ick” (the purity argument) and this is not a reliable way to make medical decisions.

Rich Puchalsky @266, Pre-vaccination quarantine laws are still on the books in most jurisdictions. We may see them used before the current measles epidemic is over.

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The Raven 02.13.15 at 1:20 am

tm@267: “Rhetoric is getting out of hand around here. A hundred cases of a disease that is harmless in the vast majority of cases don’t make an “epidemic”. This fearmongering is just dumb.”

It is, technically, an epidemic. If it makes you feel better, call it an “outbreak.” I don’t think it’s peaked yet, either; two infected people have ridden commuter trains, and that probably means a fair number of additional cases.

The rate of complications from measles is quite high. They are most serious in children under age 5 and adults over age 20. The CDC notes the following rates of complications: “Diarrhea – 8% reported. Otitis media [middle ear infection, can lead to hearing loss] – 7% reported. Pneumonia [the most common cause of death from measles in young children] – 6% reported. Encephalitis [this often leads to permanent brain damage or death] – 0.1% reported. Seizures – 0.6-0.7% reported. Death – 0.2% reported”

Eye infections, sometimes leading to blindness, are also possible, but seem to have been left off the list.

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The Raven 02.13.15 at 1:24 am

Duh, meant, “large unvaccinated minority.” Sorry.

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Collin Street 02.13.15 at 1:35 am

>Other than some narrowly defined medical exceptions, why should any public school grant exceptions?

Because the headroom exists.

It’s an allocation problem: there are a limited number of spaces available. Previously, demand for exemptions was low and could be easilly met — we didn’t need a formal allocation process because there was no shortfall — but increased demand has left the old “whoever asks for one can have it” unworkable/unsuitable.

Since we have the headroom there’s no reason not to allocate it if we can. I mean, christian scientists have pretty solidly-established religious objections to vaccination. I don’t like christian science, but if we’re not going to ban it outright then we have to tolerate it to the degree that we can tolerate it, and it turns out that, yes, we can tolerate christian science vaccination exemptions, by-and-large.

But not them and the modern anti-vaxers simultaneously. We have to establish some sort of allocation protocol; it’s a commons situation, and those are only solvable by regulation in some format. Libertarians would no doubt argue for auction, or tradeable exemption-certificate fractions; I’d suggest an external merits assessment, which does involve comparing competing religious claims [but strikes me as better than the alternatives]. Simply vastly increasing the paperwork for non-medical exemptions would actually work ~reasonably~ well; allocation by willingness to commit time rather than money would help overcome the equity problems you’d have with a libertarian-style market allocation.

End of the day, if we can do something that makes people happy and doesn’t make anybody unhappy we should; I think pareto efficiency is a fucked-up measure but it works here. We can grant some exemptions and therefore we should.

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David J. Littleboy 02.13.15 at 1:54 am

“Because the headroom exists. “

Actually, it doesn’t. “Herd immunity” is defined as a rate of infection below some arbitrary threshold. The threshold isn’t some mathematical property of herd immunity but is a level that society declares acceptable. So your “headroom” is a level of disease some amount higher than the best we could do if everyone got infected. If the number of unvaccinated kids goes up 0.1%, the number of cases goes up by some monotonically increasing function of 0.1%.

“End of the day, if we can do something that makes people happy and doesn’t make anybody unhappy we should;”

Unfortunately, the math is that we can’t. As California is finding out.

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David J. Littleboy 02.13.15 at 2:04 am

The Raven @287:
Beyond that, I don’t see how to practically deal with a large unvaccinated (minority). Do day care centers start requiring proof of vaccination? Do pediatricians and obstetricians forbid unvaccinated people from entering their offices? What happens if someone lies about that, and a child or an expectant mother gets severely ill because of it? Is the unvaccinated person liable? Do we have to bring back quarantine laws?

I can’t see how any day care center could accept a child without a vaccination certificate. It’d leave them open to nasty lawsuits.

Pediatricians is a harder question. Some think they are morally required to not turn away unvaccinated kids, some think that their other patients shouldn’t be exposed so they should turn them away.

If someone lies, they are liable to both criminal and civil lawsuits.

I don’t think quarantining will be necessary. Just vaccination certificates and the right to turn away unvaccinated children will do fine. And no exemptions other than medical exemptions. (I suppose there’s an argument for religious exemptions, but that means defining what is a religion, and the state shouldn’t be in that game, so no religious exemptions. Religion is your private relation with your god; the state shouldn’t speak to that.)

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David J. Littleboy 02.13.15 at 2:05 am

Me: ” if everyone got infected.”
Oops: if everyone got vaccinated.

Sheesh, what a pessimist.

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Layman 02.13.15 at 2:05 am

@286

“Also, (re: @276) if you are running a private school, there’s no way you can let unvaccinated kids in: that’d open you up to horrific lawsuits (to say nothing of your moral responsibilities to the other children in your care), so there’s really no place to send unvaccinated kids. “

Yet private schools currently honor personal exemptions and permit unvaccinated kids. Undoubtedly some private schools offer that as a feature, since there’s a market for it.

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The Raven 02.13.15 at 4:32 pm

(One last whipstroke on this dead horse.)

“I can’t see how any day care center could accept a child without a vaccination certificate.”

As far as I know, there are many in California that do not impose such requirements. We are such fools about this; we think because these diseases are suppressed, they are gone. Not so.

Today on Facebook an immune-compromised friend in California writes that he is having trouble sleeping for fear of the measles epidemic; for him the best outcome of a case of measles would probably be severe disability.

Someone tell me again how vaccination is a personal decision. I’m having trouble believing it.

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