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Monday, September 8, 2008

We're going to need a bigger clue bat

Via Coturnix: last week's Science Friday had an interview with Dr. Paul Offit about the increasing refusal by parents to get their children vaccinated and the corresponding re-emergence of vaccine preventable diseases such as measles and mumps. For those who aren't familiar with this story, the short version is that an appallingly large number of people (including one person I know who went to medical school) have become convinced that vaccines are somehow responsible for the rising number of autism diagnoses in children; for further details, I defer to Orac over at "Respectful Insolence".

Early in the interview, Dr. Offit identifies the root cause for this anti-vaccine insanity, namely the age old problem of bad science communication:

Ira Flatow: Why do you think the science [behind vaccines] is not compelling?

Dr. Offit: I think we're not very good at explaining it. I think that scientific literacy isn't great. I think people tend to see science as just one more opinion in a sea of opinions. I think that the media certainly can be confusing; I think the Internet can be confusing. So I think it's disappointing.

Dr. Offit goes on to properly distribute blame for this situation. He blames anti-vaccine propagandists for constantly moving the goal posts and offering increasingly ludicrous hypothesis about the causative link between vaccines and autism. He blames today's media, who seem obsessed with the notion that stories, especially those involving science, must have at least two equally valid sides — the same notion that gives creationism the same footing as evolution or "alternative medicine", such as homeopathy, the same footing as conventional, evidence-based medicine.

Dr. Offit also notes that today's young parents don't truly know how to assess the risks of not vaccinating, primarily because they haven't had to live with outbreaks of diseases such as smallpox or polio or measles-induced encephalitis.

The last 11 minutes (of this 18 minute piece!) was a pointless argument with a caller named Shantal (sp?), who basically had me banging my head on the desk and lead to the title of this post. Over the course of her call, Shantal managed to run the gamut of anti-vaccine hysteria, starting from too much aluminum in vaccines (ignoring the fact that environmental doses are much higher) to too many vaccines at once (ignoring the fact that a cold presents a much greater immunological challenge) to truly looney tunes conspiracy theory mongering (you know, "no independent studies" since Big Pharma bought the FDA and Dr. Offit off). Her entire stance can be succinctly stated by two of her own words; when asked whether anything Dr. Offit could say would change her mind, Shantal replied, "Absolutely not."

Dr. Offit correctly points out that Shantal and people like her (i.e., the kind who are immune to even the clue bat equivalent of a tactical nuke) are not the type of people that we scientists should be trying reach; they're already too far gone. Instead, scientists need to focus on those parents "who are concerned but are re-assurable with good science."

Unfortunately, I don't entirely share Dr. Offit's optimism that this is entirely doable. Referring back to Robert Krulwich's commencement address, I suspect that the stories anti-vaxers have to tell, no matter how logically and experimentally flawed they may be, are far too alluring and far too easy to believe. In an era where smallpox and polio are dim memories (at least in the developed world), I simply don't see the stories of Jenner and Salk being quite as attractive as those about the big uncaring bogey man (in the form of doctors, the FDA/CDC, or Big Pharma — take your pick) coming to get you. I only hope I'm wrong about this, before we as a society learn the hard way why vaccines are currently required in the first place.

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