The anti-vaccine movement, as is probably typical for ideological movements, has natural enemies and allies. Once the notion that mercury in the form of thimerosal in vaccines might be responsible for neurodevelopmental disorders (it’s not) became popular in the anti-vaccine crowd, this made them natural allies with the “mercury-militia” – those who blame environmental mercury for a host of ills. The fact that some anti-vaccinationists seek to provide their children on the autism spectrum with unconventional biological treatments, based on their disproved “toxin” hypothesis, made them natural allies with the alternative medicine community. Both seek freedom from pesky regulation, and rail against the perceived deficiencies of science-based medicine.

Another ideological alliance is brewing – that between the anti-vaccine movement and extreme environmentalists. This post is not a commentary on environmentalism, and please do not take it as such – the purposes and claims of the two movements are quite distinct. But they share a common thread: distrust of scientific experts and government regulators who reassure the public that environmental exposures are safe.

Robert F. Kennedy Jr. has been the most prominent environmentalist to take up the anti-vaccine cause, in several articles and speeches. While he appears to be only a part-time anti-vaccinationist, his celebrity and street cred among environmentalists lend a great deal of weight to his paranoid musings about scientific fraud and government cover ups. It seems he wants to recapitulate the moral clarity that his uncles displayed in the 1960s, defending the little guy against abuses by the powerful and privileged. He is ready to see a conspiracy, and he wants to be the crusader for environmental justice – and if kids are the alleged victims, all the better. His article in the Huffington Post – “Attack on Mothers,” says it all.

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I try not to let my blog get too focussed on any one topic, but the point of this blog is to engage the public and the media and so at times a hot topic requires increased attention. When the creationists are campaigning to impose their ideology on science education, for example, they will garner my blogging attention.

Perhaps one of the hottest media science topics today is the swine flu/H1N1 pandemic and upcoming vaccine, and the anti-vaccine movement in general. This is a perfect storm of quackery, sensationalism, misinformation, and public concern.

One aspect of the anti-vaccine movement is that those who are proponents for an unscientific medical modality are keen to criticize science-based medicine because they are their competitors (ideological and/or financial). The same is true generally of pseudoscience – in order to promote your pseudoscientific claims you have to simultaneously attack the real scientists who are likely to point out that your claims are bunk.

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There is a dedicated fringe anti-vaccine movement. They are dedicated to some permutation of the collection of beliefs that vaccines are: 1) not effective; 2) have not reduced or eliminated any infectious disease; 3) are not safe; and 4) are a conspiracy of Big Pharma, the government, and paid-off doctors. Specific claims have wandered over the years, but they have as a central theme that vaccines are bad. When one specific claim collapses, they will move on to the next anti-vaccine claim.

While anti-vaccine cranks have been around as long as vaccines, it is only recently that they have captured the attention of the mainstream media and the skeptical movement and the battle has really been engaged.

Anti-vaccinationists have focused much of their recent efforts on the claim that vaccines cause autism. At first the MMR vaccine was blamed, sparked by a now-discredited study performed by Andrew Wakefield. This led to declining vaccination rates in the UK and a resurgence of measles.

As the MMR claim was in decline (although by no means abandoned), attention shifted to thimerosal – a mercury-based preservative in some vaccines. There are many flaws with the thimerosal hypothesis, and numerous studies have shown no link between thimerosal and autism or any neurological disorder. But the fatal blow to the thimerosal hypothesis was struck when thimerosal was removed from the routine childhood vaccine schedule (thimerosal, incidentally, was never in the MMR vaccine) in the US by 2002. In the subsequent 6 years the rate of autism diagnoses kept increasing at their previous rate, without even a blip. Only the most rabid (or scientifically illiterate)  anti-vaccine fanatics still cling to the thimerosal claim.

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It’s not enough to mean well. You have to get the science right.

I believe that Jim Carrey and Jenny McCarthy mean well. They think they are saving the world from greedy corporations, corrupt government, and arrogant doctors. In their minds they are enlightened saviors, leaders of a “green” army alerting the rest of us to the dangers of toxins and the malfeasance of those in charge. Yesterday they lead a “green our vaccines” rally in Washington DC to help save the world.

But it’s not enough to mean well. Carrey and McCarthy get the science terribly, hopelessly, and tragically wrong. In fact, meaning well is part of what makes them dangerous. They display that toxic brew of arrogance and self-righteousness, combined with the power of celebrity to do real damage.

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RFK Jr., who is now running for the Democratic presidential nomination, is anti-vaccine. He will vehemently deny this, but I don’t buy it for a second. He is simply playing the, “I’m not anti-vaccine, I am pro-safe vaccine” gambit, which is disingenuous and always has been. We have been covering this topic for years, and David Gorski did a recent excellent review of this at SBM. You can’t claim not to be anti-vaccine, and then defend a long list of anti-vaccine tropes.

RFK has apparently been avoiding his views on vaccines on the campaign trail, but it always seems to come up. On the Joe Rogan podcast RFK found what he must have thought was a friendly environment, and felt free to repeat is claim that vaccine cause autism. This is a topic I have been covering for two decades – vaccines do not cause autism. But let’s do a quick review of this harmful claim.

This first appeared in the 1990, when the anti-vaccine movement hit upon the increase in autism diagnoses as a new tactic. They start with the assumption that all bad things that happen to children are caused by vaccines, so obviously they must also be causing the rise in autism. When Andrew Wakefield came out with his fraudulent and now retracted study claiming an association between the MMR vaccine and autism, he became an instant celebrity of the anti-vaccine movement. Trouble is – the MMR vaccine does not cause autism. Wakefield, it turns out, had a patent on an alternative vaccine and was trying to torpedo the competition. But the anti-vaccine movement does not let science, evidence, or basic logic get in their way. So they simply moved over to a vaccine ingredient, thimerosal, which is a mercury-based preservative.

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Happy New Year to all my readers.

Early in each new year I like to see what the preliminary reports are for the climate over the past year. Final number crunching won’t be available for months, and it may take more than a year for the final tweaks to be reported and reviewed. But we do have a preliminary estimate of the temperature over the last year. The World Meteorological Organization reports:

The global average temperature in 2022 is estimated to be about 1.15 [1.02 to 1.28] °C above the 1850-1900 average. 2015 to 2022 are likely to be the eight warmest years on record. La Niña conditions have dominated since late 2020 and are expected to continue until the end of 2022. Continuing La Niña has kept global temperatures relatively «low» for the past two years – albeit higher than the last significant La Niña in 2011.

It looks like 2022 will be the fourth hottest year on record globally. Some specific locations had their warmest year, such as the UK and Spain (and perhaps most of Europe). As the WMO points out, we are in the middle of a La Niña cycle, which brings cooler temperatures globally. That is a short term fluctuation on the longer term trend. This also means that as we shift into an El Niño cycle we are likely to break new records.

I feel compelled to point all this out (as I am sure many scientists and science communicator will) because it is a critically important piece of information. But I also want to put it into a broader long term context. I have been engaged in skeptical activism now for 27 years, and followed many skeptical topics for longer than that. There is one extremely important pattern that emerges when you cover a topic for a long time – scientifically valid concepts tend to not only accumulate evidence but the evidence gets better and builds on itself. Meanwhile, pseudosciences do not display this pattern. They tend to go around in circles with low quality evidence. You can see this pattern across multiple disciplines.

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It is not uncommon, if you do not like any particular finding of scientific research, to attack the institutions of science or even the very notion of science itself. These kinds of attacks are now common in the anti-vaccine pushback against common sense public health measures, and often from a religious or ideological perspective. It’s not surprising that the false claim that science is just philosophy has reared its head in such writings. The attack on science also tends to have at least two components. The first is a straw man about how scientists are pretending that science is a monolithic perfect and objective entity. This is then followed by the claim that, rather, science is just opinion, another form of subjective philosophy. This position is entirely wrong on both counts.

Here is one example, embedded in a long article loaded with misinformation about vaccines and the COVID pandemic. There is way too much misdirection in this article to tackle in one response, and I only want to focus on the philosophical claims. These are now common within certain religious circles, mostly innovated, at least recently, in the fight against the teaching of evolution. They have already lost this fight, philosophically, scientifically, and (perhaps most importantly) legally, but of course that does not mean they will abandon a bad argument just because its wrong.

First the straw man:

The second consequence of “following science” is that it reinforces one of modernity’s most enduring myths: that “science” is a consistent, compact, institutionally-guaranteed body of knowledge without interest or agenda. What this myth conceals is the actual operation of the sciences—multiple, messy, contingent, and tentative as they necessarily are.

The myth is itself a myth. It exists almost nowhere except in the minds of science deniers and those with an anti-science agenda. Elsewhere the author admits:

As a lay person, unqualified to judge the technical issues, I have concluded only that there might be a legitimate question here, and one that must, necessarily, remain open until time and experience can settle it.

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The pandemic has brought into sharp focus the potential danger of misinformation. There are times when we need to act collectively as a society to accomplish certain goals. This is particularly challenging in a society that is organized around a principle of individualism – a principle I endorse and value. Liberty is a precious right to be jealously defended. But it is not the only right, or principle of value. So at times we have to delicately balance various competing interests. I like my freedom, but I also really like not catching a deadly disease, or spreading it to my family.

In a perfect world (one we definitely do not live in) there would be no need for restrictive or draconian measures. All that would be necessary was distributing information – hey, if you want to protect yourself and others, wear a mask, socially distance, wash your hands, and get vaccinated. If you’re really interested, here are the facts, the published studies, the expert analysis, to back up these recommendations. Here are the error bars and level of uncertainty, the risk vs benefit analysis, and comparison to other options.

This approach is necessary, and works to a degree, but it is insufficient. There are two main shortcomings of the information approach. First, people are only semi-rational beings, not Vulcans. We are susceptible to tribalism, motivated reasoning, confirmation bias, and a host of cognitive biases, faulty heuristics, and logical fallacies. Our intuitions about balancing risk and benefit are also flawed, and we have a hard time dealing with very large numbers. Just peruse the comments to any blog post on this site that is even slightly controversial and you will find copious examples of every type of flawed thinking.

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This was inevitable. We are in the midst of a massive rollout of two new vaccines for COVID-19. Anxiety and fatigue levels from the pandemic are already running high, and there is a pre-existing anti-vaccine movement who is sure to exploit this. But perhaps most significantly, we are now living in a post-social media world. Information, even medical or scientific information, may get to the public unfiltered, ripe to be misinterpreted by people who do not understand the relevant science. Such is the case with a “viral” video showing a woman who claims her symptoms are a side effect of the Moderna vaccine (short answer – they almost certainly are not).

Messaging is critical to the success of public health measures. Normally information about possible side effects from a drug or vaccine would be filtered through medical experts. When millions of people are involved there is going to be a lot of noise. Coincidence alone would result in many negative outcomes occurring by chance alone shortly after getting a vaccine. Epidemiologists need to look for patterns in the data that indicate there is likely to be an actual causal relationship to the vaccine. It helps if there is also a plausible mechanism. This system has captured vaccine side effects in the past, so you cannot reasonably argue that the system is rigged not to find such associations. The swine flu vaccine in the 1970s caused cases of Guillaine Barre Syndrome. A specific flu vaccine (Pandemrix – no longer on the market) likely caused cases of narcolepsy in 2009. So if any of the current COVID vaccines have a similar side effect, we will catch it.

Reporting scary anecdotes that have not been scientifically evaluated to the public is not a good idea. This is likely to misinform rather than inform, and will have a death toll attached to it. But with social media there is no way to stop this from happening, so we just have to do damage control when it does.

As a side note, I have to point out that I usually refrain from commenting on a specific individual’s medical condition in public. This is to respect the privacy of those individuals, and also because if I have not personally examined them and taken their history, commenting is inappropriate. But medical science communicators can comment about topics relevant to a public case or issue. I can speak generally about the relevant topics. There is also an exception when a private person puts their own medical history into the public domain, especially if they also use that history to make recommendations to the public, and doubly so if those recommendations are false and harmful. They have surrendered any expectation of privacy and they have made their own personal history relevant to the discussion about a public health issue. That is the case here.

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This week should see the first people in the US to actually receive an approved (at least EUA) vaccine to prevent SARS-CoV-2. There are three vaccines currently ready to go in the West, the Pfizer vaccine which received it’s EUA in the US on Friday and was already approved in the UK, Moderna which should get approval this week, and the Astra Zeneca vaccine which should not be too far behind. The (arguably) biggest challenge has been met – a massive scientific effort to develop vaccines in record time. This has been a collaboration between government and industry, and shows what we can accomplish with sufficient motivation (which translates into both money and easing red tape).

Now we have three further challenges in front of us. The companies need to mass produce their vaccines. This is happening with about 100 million doses ready to ship. We should have another 2 billion Pfizer doses by the end of 2021, and 1.5 billion Moderna doses. We also need to distribute the doses. This is happening through collaboration among FedEx, UPS, and the military who will get the doses to hospitals and physicians, who can then administer and track the doses. So far, so good.

The final hurdle, however, may prove the stickiest – we need people to accept the vaccine. In a December 9th survey by the AP-NORC, only 47% of Americans said they would get the vaccine, with 26% saying they would not, and 27% saying they are not sure. These and similar results have caused some to comment that the disinformation virus may prove deadlier than the COVID virus. We have a vaccine that can protect people from a deadly pandemic – this is a no-brainer. Resistance is partly due to a dedicated anti-vaccine movement that appears immune only to logic and evidence. We can only marginalize them. But these numbers go beyond the hard-core anti-vaxxers. People also fear what they don’t know, and these are the first mRNA vaccines to hit the market. So let’s review what these are, and the safety data.

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