In two essays, “Illness as Metaphor” in 1978 and “AIDS and Its Metaphors” in 1988, the critic Susan Sontag observed that you can learn a lot about a society from the metaphors it uses to describe disease. She also suggested that disease itself can serve as a metaphor—a reflection of the society through which it travels. In other words, the way certain illnesses spread reveals something not just about a nation’s physiological health but also about its cultural and political health. For instance, AIDS would not have ravaged America as fully as it did without institutionalized homophobia, which inclined many Americans to see the disease as retribution for gay sex.
Now another virus is offering insights into the country’s psychic and civic condition. Two decades ago, measles was declared eliminated in the U.S. Yet in the first five months of this year, the Centers for Disease Control and Prevention recorded 1,000 cases—more than occurred from 2000 to 2010.
The straightforward explanation for measles’ return is that fewer Americans are receiving vaccines. Since the turn of the century, the share of American children under the age of 2 who go unvaccinated has quadrupled. But why are a growing number of American parents refusing vaccines—in the process welcoming back a disease that decades ago killed hundreds of people a year and hospitalized close to 50,000?
One answer is that contemporary America suffers from a dangerous lack of historical memory. Most of the parents who are today skipping or delaying their children’s combined measles, mumps, and rubella (MMR) vaccine don’t remember life with measles, much less that it used to kill more children than drowning does today. Nor do they recall how other diseases stamped out by vaccines—most prominently smallpox and polio—took lives and disfigured bodies.
Our amnesia about vaccines is part of a broader forgetting. Prior generations of Americans understood the danger of zero-sum economic nationalism, for instance, because its results remained visible in their lifetimes. When Al Gore debated Ross Perot about NAFTA in 1993, he reminded the Texan businessman of the 1930 Smoot-Hawley Tariff Act, which raised tariffs on 20,000 foreign products—prompting other countries to retaliate, deepening the Great Depression, and helping to elect Adolf Hitler. But fewer and fewer people remember the last global trade war. Similarly, as memories of Nazism fade across Europe and the United States, anti-Semitism is rising. Technology may improve; science may advance. But the fading of lessons that once seemed obvious should give pause to those who believe history naturally bends toward progress.
Declining vaccination rates not only reflect a great forgetting; they also reveal a population that suffers from overconfidence in its own amateur knowledge. In her book Calling the Shots: Why Parents Reject Vaccines, the University of Colorado at Denver’s Jennifer Reich notes that starting in the 1970s, alternative-health movements “repositioned expertise as residing within the individual.” This ethos has grown dramatically in the internet age, so much so that “in arenas as diverse as medicine, mental health, law, education, business, and food, self-help or do-it-yourself movements encourage individuals to reject expert advice or follow it selectively.” Autodidacticism can be valuable. But it’s one thing to Google a food to see whether it’s healthy. It’s quite another to dismiss decades of studies on the benefits of vaccines because you’ve watched a couple of YouTube videos. In an interview, Reich told me that some anti-vaccine activists describe themselves as “researchers,” thus equating their scouring of the internet on behalf of their families with the work of scientists who publish in peer-reviewed journals.
In many ways, the post-1960s emphasis on autonomy and personal choice has been liberating. But it can threaten public health. Considered solely in terms of the benefits to one’s own child, the case for vaccinating against measles may not be obvious. Yes, the vaccine poses little risk to healthy children, but measles isn’t necessarily that dangerous to them either. The problem is that for others in society—such as children with a compromised immune system—measles may be deadly. By vaccinating their own children, and thus ensuring that they don’t spread the disease, parents contribute to the “herd immunity” that protects the vulnerable. But this requires thinking more about the collective and less about one’s own child. And this mentality is growing rarer in an era of what Reich calls “individualist parenting,” in which well-off parents spend “immense time and energy strategizing how to keep their children healthy while often ignoring the larger, harder-to-solve questions around them.”
Historical amnesia and individualism have contributed to a third cultural condition, one that is more obvious but also, perhaps, more central to measles’ return and at least as worrying for society overall: diminished trust in government. For earlier generations of Americans, faith in mass vaccines derived in large part from the campaign to eradicate polio, in the 1950s—a time when the country’s victory in World War II and the subsequent postwar boom had boosted the public’s belief in its leaders. This faith made it easy to convince Americans to accept the polio vaccine, and the vaccine’s success in turn boosted confidence in the officials who protected public health. So popular was the vaccine’s inventor, Jonas Salk, that in 1955 officials in New York offered to throw him a ticker-tape parade. (...)
Yet it’s not only conservatives who translate their suspicion of government into suspicion of vaccines. Many liberals distrust the large drug companies that both produce vaccines and help fund the Food and Drug Administration, which is supposed to regulate them. The former Green Party presidential candidate Jill Stein has suggested that “widespread distrust” of what she describes as the medical-industrial complex is understandable because “regulatory agencies are routinely packed with corporate lobbyists and CEOs.” The environmental activist Robert F. Kennedy Jr. claims that thimerosal, a preservative formerly used in some vaccines, harms children. Bright-blue counties in Northern California, Washington State, and Oregon have some of the lowest vaccination rates in the country.
Although polls suggest that conservatives are slightly less accepting of vaccines than liberals are, a 2014 study found that distrust of government was correlated with distrust of vaccines among both Republicans and Democrats. Indeed, the best predictor of someone’s view of vaccines is not their political ideology, but their trust in government and their openness to conspiracy theories.
It’s not surprising, therefore, that a plunge in the percentage of Americans who trust Washington to do the right thing most or all of the time—which hovered around 40 percent at the turn of the century and since the 2008 financial crisis has regularly dipped below 20 percent—has coincided with a decline in vaccination rates. In 2001, 0.3 percent of American toddlers had received no vaccinations. By 2017, that figure had jumped more than fourfold. Studies also show a marked uptick in families requesting philosophical exemptions from vaccines, which are permitted in 16 states.
Now another virus is offering insights into the country’s psychic and civic condition. Two decades ago, measles was declared eliminated in the U.S. Yet in the first five months of this year, the Centers for Disease Control and Prevention recorded 1,000 cases—more than occurred from 2000 to 2010.
The straightforward explanation for measles’ return is that fewer Americans are receiving vaccines. Since the turn of the century, the share of American children under the age of 2 who go unvaccinated has quadrupled. But why are a growing number of American parents refusing vaccines—in the process welcoming back a disease that decades ago killed hundreds of people a year and hospitalized close to 50,000?One answer is that contemporary America suffers from a dangerous lack of historical memory. Most of the parents who are today skipping or delaying their children’s combined measles, mumps, and rubella (MMR) vaccine don’t remember life with measles, much less that it used to kill more children than drowning does today. Nor do they recall how other diseases stamped out by vaccines—most prominently smallpox and polio—took lives and disfigured bodies.
Our amnesia about vaccines is part of a broader forgetting. Prior generations of Americans understood the danger of zero-sum economic nationalism, for instance, because its results remained visible in their lifetimes. When Al Gore debated Ross Perot about NAFTA in 1993, he reminded the Texan businessman of the 1930 Smoot-Hawley Tariff Act, which raised tariffs on 20,000 foreign products—prompting other countries to retaliate, deepening the Great Depression, and helping to elect Adolf Hitler. But fewer and fewer people remember the last global trade war. Similarly, as memories of Nazism fade across Europe and the United States, anti-Semitism is rising. Technology may improve; science may advance. But the fading of lessons that once seemed obvious should give pause to those who believe history naturally bends toward progress.
Declining vaccination rates not only reflect a great forgetting; they also reveal a population that suffers from overconfidence in its own amateur knowledge. In her book Calling the Shots: Why Parents Reject Vaccines, the University of Colorado at Denver’s Jennifer Reich notes that starting in the 1970s, alternative-health movements “repositioned expertise as residing within the individual.” This ethos has grown dramatically in the internet age, so much so that “in arenas as diverse as medicine, mental health, law, education, business, and food, self-help or do-it-yourself movements encourage individuals to reject expert advice or follow it selectively.” Autodidacticism can be valuable. But it’s one thing to Google a food to see whether it’s healthy. It’s quite another to dismiss decades of studies on the benefits of vaccines because you’ve watched a couple of YouTube videos. In an interview, Reich told me that some anti-vaccine activists describe themselves as “researchers,” thus equating their scouring of the internet on behalf of their families with the work of scientists who publish in peer-reviewed journals.
In many ways, the post-1960s emphasis on autonomy and personal choice has been liberating. But it can threaten public health. Considered solely in terms of the benefits to one’s own child, the case for vaccinating against measles may not be obvious. Yes, the vaccine poses little risk to healthy children, but measles isn’t necessarily that dangerous to them either. The problem is that for others in society—such as children with a compromised immune system—measles may be deadly. By vaccinating their own children, and thus ensuring that they don’t spread the disease, parents contribute to the “herd immunity” that protects the vulnerable. But this requires thinking more about the collective and less about one’s own child. And this mentality is growing rarer in an era of what Reich calls “individualist parenting,” in which well-off parents spend “immense time and energy strategizing how to keep their children healthy while often ignoring the larger, harder-to-solve questions around them.”
Historical amnesia and individualism have contributed to a third cultural condition, one that is more obvious but also, perhaps, more central to measles’ return and at least as worrying for society overall: diminished trust in government. For earlier generations of Americans, faith in mass vaccines derived in large part from the campaign to eradicate polio, in the 1950s—a time when the country’s victory in World War II and the subsequent postwar boom had boosted the public’s belief in its leaders. This faith made it easy to convince Americans to accept the polio vaccine, and the vaccine’s success in turn boosted confidence in the officials who protected public health. So popular was the vaccine’s inventor, Jonas Salk, that in 1955 officials in New York offered to throw him a ticker-tape parade. (...)
Yet it’s not only conservatives who translate their suspicion of government into suspicion of vaccines. Many liberals distrust the large drug companies that both produce vaccines and help fund the Food and Drug Administration, which is supposed to regulate them. The former Green Party presidential candidate Jill Stein has suggested that “widespread distrust” of what she describes as the medical-industrial complex is understandable because “regulatory agencies are routinely packed with corporate lobbyists and CEOs.” The environmental activist Robert F. Kennedy Jr. claims that thimerosal, a preservative formerly used in some vaccines, harms children. Bright-blue counties in Northern California, Washington State, and Oregon have some of the lowest vaccination rates in the country.
Although polls suggest that conservatives are slightly less accepting of vaccines than liberals are, a 2014 study found that distrust of government was correlated with distrust of vaccines among both Republicans and Democrats. Indeed, the best predictor of someone’s view of vaccines is not their political ideology, but their trust in government and their openness to conspiracy theories.
It’s not surprising, therefore, that a plunge in the percentage of Americans who trust Washington to do the right thing most or all of the time—which hovered around 40 percent at the turn of the century and since the 2008 financial crisis has regularly dipped below 20 percent—has coincided with a decline in vaccination rates. In 2001, 0.3 percent of American toddlers had received no vaccinations. By 2017, that figure had jumped more than fourfold. Studies also show a marked uptick in families requesting philosophical exemptions from vaccines, which are permitted in 16 states.
by Peter Beinart, The Atlantic | Read more:
Image: Edmon De Haro
