The Panic Virus, by Seth Mnookin

The Panic Virus

When I used to teach critical thinking, a decent portion of the course involved presenting and explaining common logical fallacies, for instance, ad hominem, begging the question, straw man, etc. I remember it was often a struggle to get students to understand that the fallaciousness of many argument forms depends on context, so you can’t just mechanically label something a fallacy because it fits a certain form.

Take the fallacy of false dilemma, for instance. You can’t say that someone is necessarily committing this fallacy just because they’ve stated or implied that there are only two possible choices, two possible outcomes, two possible positions, etc. To be a false dilemma, they have to be doing that and they have to be unjustifiably excluding other possibilities in the process. If there really are only two possibilities worthy of consideration, then supporting one by arguing against the other isn’t a fallacy.

Maybe the most complex—but also maybe the most important since it is so ubiquitous—such argument form or sometime fallacy is the appeal to authority, which is when you accept a belief because of who claims it. I would try to impress upon my students that you can’t just simplistically say that it’s right to believe what you’re told or wrong to believe what you’re told. You have to be selective. You have to judge on a case-by-case basis how much weight to give the fact that a certain claim comes from a certain source.

So you look at factors such as how likely it is the source knows what they’re claiming, how likely it is they’re being honest, whether other equally well-placed sources say the same thing, etc. My belief that China is bigger than Nepal, for instance, is solely based on appeals to authority. The only reason I believe it is that I’ve seen it claimed implicitly or explicitly by mapmakers, geography teachers, journalists, maybe travel agents, etc. But that doesn’t make it a fallacy. The sources I’ve seen claim it are folks who would know and who have no reason to lie about it, and they pretty much all seem to be on the same side of this issue, so I’d say I’m very justified in believing it.

But it’s a matter of degree. You look at all the factors for and against accepting someone’s authority in a certain area, and sometimes their saying something basically settles it, sometimes it gives it no weight at all, and usually it’s somewhere in between—it provides some degree of support.

Like I say, though, appeals to authority are ubiquitous. The overwhelming majority of the things you believe are things you believe because you’ve been told them. One hundred percent of history before you were born, for instance. If you treated appeal to authority as always a fallacy, and you tried to rid yourself of all beliefs grounded in it, you wouldn’t get far. You’d have so few beliefs left you wouldn’t be able to function.

I think of this in connection with an issue like the recent controversies surrounding vaccines, which is the subject of The Panic Virus. Whatever you believe about how beneficial or dangerous vaccines are, and whatever you decide as far as whether to have your child vaccinated, it’s almost certainly going to come down to believing what some people say and disbelieving what other people say. Unless you have the knowledge, skills, resources, and time to conduct a series of complex scientific tests yourself—which you don’t—you’re going to have to believe someone or other, or have no opinion at all.

So it comes down to justifying believing one set of folks rather than another. Do we believe those who say that vaccines have been a public health boon, that they don’t cause autism and indeed very rarely have side effects at all, and that refraining from having your child vaccinated is an irresponsible and dangerous decision that increases the risk that certain diseases that were nearly wiped out will make tragic comebacks? Or do we believe those who say that vaccines, or certain vaccines at least, do more harm than good by, among other things, causing autism? And why should we believe the side we believe?

I associate most of the anti-science positions in contemporary America with the political right—sometimes the Religious Right, sometimes the Corporate Right, and sometimes both. Think of the debates on things like evolution or climate change. The overwhelming majority of scientists working in relevant fields are on one side, and a large number of conservatives, and precious few others, are on the other side.

The vaccine controversy doesn’t fit that pattern though. I hadn’t really thought of it in those terms before reading this book, but it makes sense.

Mnookin notes that even before he thought about writing a book on this topic, he came across many people who were skeptical about the safety of vaccines, some of whom were confident enough in their skepticism to have not had their child vaccinated. The majority, he notes, were liberals. Specifically they were middle-class-and-above, college-educated, liberal professionals who consistently voted Democratic.

Why? Because on the issue of vaccines, unlike with evolution or climate change (or the deleterious health consequences of smoking), the things the authority figures in the white lab coats are telling us are conducive to increased profits for certain economically and therefore politically powerful entities, rather than being a threat to them. That is, the major corporations that have the biggest stake in the matter benefit insofar as the public believes the experts and acts accordingly. And of course the Left is profoundly suspicious (and I would say rightly so) of anything of that description.

The demographics of the issue overlap considerably, I would think, with those of alternative medicine, i.e., New Age quackery. Mainstream scientists and doctors reject alternative medicine—they accept it if it has been proven to work, but then it ceases to be “alternative”—and the defenders of alternative medicine protest that that rejection is tainted by their seeing alternative medicine as a threat to the profits of doctors, hospitals, pharmaceutical companies, and the like.

I wouldn’t say all or almost all of the people on the anti-science side of vaccines and alternative medicine are left wingers—I think many if not most are apolitical—but they certainly aren’t predominately right wingers, like climate change skeptics. They’re mostly people who are suspicious of corporate power, and who believe the supposedly mainstream scientific position is propaganda from scientists who have sold out to the corporate class.

So if we think of it in terms of an appeal to authority, on the one side you can make the case that the overwhelming majority of the people—scientists, doctors, medical researchers—who are in the best position to know are pro-vaccine. On the other side, you can make the case that such people are not reliable sources of information on this issue because of how much sway “Big Pharma” and other moneyed interests have over them.

When scientific consensus and corporate self-interest are on opposite sides, it’s pretty easy to know whom to trust. On an issue like climate change, for instance, I’m not all that credulous about every last detail from mainstream science (there could easily be a certain degree of exaggeration motivated by wanting to stir the public into action, there could be honest mistakes in a lot of the more speculative areas which will be corrected over time by the scientific method, etc.), but when you have ninety-something percent of relevant scientists on one side, and a comparative handful of oil company shills and conspiracy theorists and such on the other side, it’s not a very close call.

Something like the vaccine controversy, though, requires considerably more thought and analysis before deciding which side represents the more cogent appeal to authority. Unlike the cases where conservatives have created a faux controversy about something in science, both sides of this issue appeal to me to at least some degree. I’m a strong believer in rationality and the scientific method, but also a strong believer that corporations are powerful enough and amoral enough to routinely deceptively skew issues in the direction that favors them.

Skepticism about anything that favors big money in this country is certainly justified, but it should be a starting point, not an ending point. You have to look at each specific case to see what other factors are at play in deciding whom to believe. When I do that, I come down squarely on the pro-vaccine side.

The most important point for me is the scientific consensus. We’re not talking about a situation where 10% or 30% or even 70% of the relevant researchers are on the side of those saying modern day vaccines are safe and effective, with most of those directly or indirectly being paid by corporations who benefit from the mass use of vaccines. Virtually every relevant expert who has conducted or closely reviewed the scientific research on vaccines is on that side of the issue.

Was the corporate side of other science debates ever able to amass such a consensus? The tobacco companies managed to buy off enough people to create some small amount of controversy on the effects of smoking, but really all they did was to get a tiny minority of researchers to shill for their side, and even those few mostly didn’t contend that smoking was safe, but only that it was a close enough call that it was too soon to take action before studying the matter more. Nor have the oil companies and coal companies and such succeeded in using their influence to create a consensus that climate change is a myth. In spite of all their efforts and all their spending, climate change denial is a tiny minority position in climate science.

What reason is there to think that Big Pharma is so much more effective at getting researchers to lie on their behalf than these other behemoths?

Before reading this book, if anything I underestimated the degree of scientific consensus on vaccines. I knew that the most prominent study purporting to show a link between vaccines and autism—the famous Andrew Wakefield article published in the Lancet—had been discredited, but I thought there was still something left on that side of the debate. My vague impression was that a solid majority of researchers rejected the hypothesis of vaccines causing autism—or any other hypothesis claiming vaccines cause some major harm—but that there were still a few experts on the other side, and the evidence was mixed enough that while it certainly favored the pro-vaccine side, there was room for reasonable doubt and further research.

But at least according to this author, there’s really no debate to speak of within science. The Wakefield study wasn’t just the most prominent of those on the anti-vaccine side, but practically the only one. Eliminate that one, and there’s really nothing left that suggests a connection between vaccines and autism.

And the Wakefield study can be eliminated. It turned out not just to be methodologically sloppy or guilty of concluding more than the evidence supported, but out-and-out fraudulent.

Most relevant scientists not only dismiss the claim that vaccines are dangerous, but contend that the matter is settled enough that further studies constitute a waste of scarce research money that could be better spent elsewhere, including on more promising hypotheses concerning autism.

So to believe that the pro-vaccine side is lying requires believing that there’s a conspiracy of almost unimaginable size and effectiveness on that side of the issue, that the corporations that profit from the use of vaccines haven’t just gotten a few dubious maverick scientists to ignore the evidence in favor of their paymasters’ bottom line, but have gotten pretty much the whole relevant scientific community to lie and falsify research in ways they know will have disastrous health consequences. I’m not buying it.

Which is not to say it’s impossible that present day vaccines will turn out to do more harm than good. That’s extremely unlikely, but not impossible. What I think can be safely ruled out is the idea that the currently available evidence supports the notion that vaccines cause autism or are otherwise dangerous, and that we are being lied to about that by scientists who know the truth. But there’s still a nonzero possibility that the evidence strongly points in exactly the direction the researchers claim but that eventually there will be enough evidence to conclude just the opposite.

That’s just the inherent fallibility of science. There’s always that tiny chance that even a belief highly justified by the evidence is in fact false. But if you had to bet on it—as this issue compels us to wager our public health—wouldn’t you rather be on the side strongly supported by the evidence, even if it’s not absolutely certain that it’s the correct side?

The second most important factor that puts me on the pro-vaccine side when assessing these competing appeals to authority—after the existence of a solid consensus of relevant researchers—is that the potentially corrupting element of money isn’t limited to just the one side.

Yes, there are plenty of big corporations who profit from vaccines, and who surely will do and say whatever safeguards those profits, but the other side is not populated solely by squeaky clean folks who care only about truth and the health of their fellow citizens. Wakefield himself has been exposed as a blatant crook whose faked research didn’t just benefit him by making him a famous and in some circles beloved figure, but was very much in his financial self-interest. He was allied all along with attorneys who were looking to cash in on civil suits against companies making and distributing the vaccines that Wakefield’s study purported to show cause autism. That’s every bit as strong a conflict-of-interest as that of any researcher allegedly influenced by the power and money of Big Pharma.

But it’s not just him. As the author points out, plenty of attorneys, hawkers of alternative medicine, sensationalist journalists, and others stand to gain financially by discrediting vaccines.

I’m not saying it balances out, that the corrupting influence of money is just as strong on the anti-Big Pharma side as on the Big Pharma side. If the only available evidence in determining whom to believe was the degree to which each side of the debate had big money in its corner, I’d be on the side of the vaccine skeptics. But certainly the money factor is mitigated by the realization that the other side also has its share of people with a significant financial stake in the game.

In The Panic Virus, Mnookin provides a history of vaccines, including all the times there have been problems with them, some of which involved public officials withholding information or behaving in a paternalistic or not-totally-honest manner.

In a way that seems to cut against his argument. It’s as if he’s saying, “Yeah, in the past they used to rush vaccines into use before they had worked all the kinks out, and sometimes they lied to you about it, but, don’t worry, things are totally different now,” which frankly isn’t very reassuring.

But another way to look at it is that while there have certainly been imperfections in the past in the way vaccines have been manufactured, tested, distributed, sold, etc.—because every human activity is prone to some degree of imperfection—the worst of those incidents doesn’t come remotely close to the degree of coordinated evil and secrecy that would be necessary for vaccines to be a dangerous, autism-causing sham hoisted on us by Big Pharma. So the point would be: When these things happen—a vaccine turns out to have bad side effects, some public official deceptively downplays the risks of some public health policy he’s implementing, etc.—it becomes known pretty darn quickly. Scientists learn from the mistake, public opinion punishes those who screwed up, and things get corrected.

What doesn’t happen is something as consequential as Big Pharma and its minions in science and government successfully covering up for decades clear evidence that vaccines have caused a disastrous epidemic.

One other quick thing that occurs to me about the book is that in his support for vaccines, the author does a good job explaining about herd immunity, but I felt like maybe he dances around a related point. Certainly it’s implied, and it’s possible he mentions it briefly and I missed it, but he doesn’t go into it at any length.

And that point is that due to herd immunity, parents who don’t vaccinate their kids don’t necessarily thereby put them at greater risk. In some circumstances, even if all their beliefs about the dangers of vaccines are bogus, their kids are actually better off not being vaccinated.

Vaccines—even according to their staunchest defenders—are not completely unproblematic. They—rarely—have side-effects. They—more often—can make kids mildly ill, and since kids tend to be more vulnerable the younger they are, once in a great while such a mild illness can get a lot worse and cause permanent damage.

These risks are very small, but they’re not zero. If vaccines did absolutely no good whatsoever, it wouldn’t be a neutral thing to introduce them into your system—it would be something to be avoided. So it’s not that vaccines carry with them no risks, but that the overall benefits outweigh those risks.

Furthermore, vaccines aren’t a hundred percent effective. Some very, very small percentage of people who are vaccinated will still be at risk of contracting the disease if they encounter it. So whether you’re vaccinated or not, it’s to your advantage if other people take countermeasures against the disease. Your degree of risk depends in part on the frequency with which you can be expected to be exposed to the disease, which in turn depends in part on the actions of others.

Well, put all that together, and it entails that, purely from the standpoint of self-interest, the ideal situation would be for everyone except you (or everyone except your child) to be vaccinated. Because if virtually everyone’s vaccinated, the disease will never spread. No one or almost no one will get it because they’re protected by the vaccine, and if by some crazy fluke someone gets it in spite of being vaccinated there’s almost no chance anyone else will catch it from that person. Given that, the disease will be extraordinarily rare if not non-existent, so your unvaccinated child has virtually no chance of ever encountering the disease. Meanwhile, your child has bypassed any possible side effects of the vaccine itself.

I’m not saying that that’s the motive of the people who forego vaccinating their kids. Maybe it is for some small minority, but I think almost all of them sincerely believe the vaccines cause autism or have some other terrible consequence that the medical establishment has hushed up. If people really were motivated by the above considerations, after all, the last thing they’d do is sound the alarm about the alleged dangers of vaccines and encourage other parents not to vaccinate their kids. To the contrary, they’d do whatever they could to make vaccination as near-universal as possible, with their kid being in the small group of exceptions.

Of course the ethical problem with trying to be a free rider like this—benefiting from everyone else vaccinating their child while you don’t vaccinate yours—is the same problem that selfishness by its nature always has: it’s not universalizable. The more people there are who are as selfish as you, the more the strategy breaks down.

But you can see why those who are pro-vaccine don’t emphasize this point. Pragmatically, it’s almost certainly better to state or imply that if you don’t vaccinate your children you’re putting them at great risk. If instead you say, “Yeah, if you don’t vaccinate your child unless and until the proportion of the population not vaccinating their children rises above some threshold where the disease becomes more prevalent, that may well be what is most in the interest of your child, but that’s selfish and you shouldn’t do it,” that runs right smack up against the fact that probably the one area of life where people most readily give themselves permission to be selfish is in their parenting. People act like the most egregious behavior can be justified as long as they can say, “I did it for my kid.”

It also maybe explains the challenge I’ve seen occasionally on anti-vaccine websites. Someone will post that the easiest way to determine whether it’s better to vaccinate or not is to compare the health outcomes of those who vaccinate with those who don’t. Intuitively you would think that—assuming the anti-vaccine folks were wrong in their Wakefield-like beliefs—the people who vaccinate would surely come out ahead. But not necessarily. In communities where the rate of vaccination is still very high, I wouldn’t be at all surprised if those who do not vaccinate come out marginally ahead of those who do. The people who vaccinate are doing their part to establish herd immunity, but in so doing they are (infrequently) paying a (nearly always quite small) price to do so, whereas the people who don’t vaccinate are enjoying the advantages of that herd immunity without paying the price.

For the conspiracy true believers The Panic Virus will be easily dismissed as corporate propaganda. But on the whole I think the author makes a solid case on the pro-vaccine side.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s