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Tuesday, February 3, 2015

STUCK ON VACCINATION


There has been a good deal of puzzlement expressed on Television about the widespread anti-vaccination sentiment on the political right.  I have a theory about it, but inasmuch as I have never actually had a conversation with someone who so much as voiced doubts about the procedure, my theory is purely speculative.  Indeed, if you were inclined to snark, you might say it is philosophical.

I begin, as I so often do, with the wise saying by Freud that in an analysis, if there is any topic that the patient finds it unacceptable to discuss, sooner or later the entire analysis comes to be about that topic.  [I have been unsuccessful in my search for the text, and when I Googled it, I came up with my own blog!!]

In America today, it is no longer forbidden to talk about previously unmentionable parts of the body, or about previously unmentionable sex acts, or about the excretory functions of the human body, or about religion, or about money in politics [although you are not supposed to name names], or even about inequality of wealth and income.  But it is absolutely unacceptable to talk about class.  Not surprisingly, therefore, most of the public discourse is covertly about class.

In the United States, there are sharp differences in taste, behavior, and life chances that everyone knows about and immediately recognizes, but which no one is willing to label as distinctions of class.  All of us are aware of these differences  -- in tastes in drinks, food, restaurants, amusements, and television shows, in clothing and makeup, differences in speech patterns, in relations between men and women.  We are also aware individually, but less so collectively, of the sharp differences in life chances facing different segments of the society.  As I have often observed, two-thirds of the adult population in America  do not have college degrees.  This large majority of Americans  cannot aspire to be doctors or lawyers or college professors, or corporate management trainees, or high school teachers, or FBI agents, or elementary school teachers, or Walmart store managers. 

The vast majority of these folks are, and aware that they are, lower class, looked down on subtly or not so subtly by television commentators and other opinion makers.  They are also more or less excluded from the benefits of such economic growth as has taken place in America in the last several decades.  Not surprisingly, they are resentful and angry, and their resentment and anger is focused more on the insults of class than on the raw numbers of wage stagnation and real income loss.

I am convinced that the rejection of vaccination is one more instance of this anger against class disadvantage.  It goes along with the widespread belief that White people are under assault, that religion is under assault, that traditional values are under assault, and that the people who are doing the assailing are the same snooty, stuck-up, college graduate know-it-alls who laugh at people who doubt global warming and believe the biblical stories of creation.

There is really no point trying to counteract this rejection of medical science with facts or arguments, because although the rejectionists may not be Ivy League graduates, they are not stupid, and about the fundamental question, "Am I being disrespected?," they are in fact right.

So what on earth is up with the upscale college educated New Age vaccination rejectionists, who do not fit this profile at all?  I am not entirely sure, so I shall leave that for another day.

11 comments:

David Goldman said...

Frankly, the right-wing anti-vaccination sentiment that's cropped up recently puzzles me. In my experience as a parent (in California, CT, and central Ohio—but I've really only encountered actual vaccine skeptics in CA), vaccine rejection has been *overwhelmingly* an upscale college-educated new-age ("all-natural", anti-corporate) phenomenon.

This LA Times map of vaccination rates is pretty much a map of wealthy, whiter areas of L.A. (and many of the red dots are private schools, to boot). I'd be curious to know if actual vaccination rates (as opposed to rhetoric against government mandates) (hm, there's an important distinction) are lower in lower class, white, conservative areas, too. On the basis of my experience I doubt it, although my confidence in that prediction isn't very high.

http://spreadsheets.latimes.com/immunization-levels-california/

Robert Paul Wolff said...

That is fascinating. Why is the upscale rejection focused on vaccination, rather than, say, radiation treatment for cancer or cellphones or pasteurized milk? Or is it? Clearly there is much here I do not understand.

Jim Westrich said...

I would love to see some good sociology done on this. There is some class resentment in this but there has to be some "charismatic FUD" involved (some celebrity but also local and loud anti-vaxers). Some of it is libertarian anti-authority but some of it is rabid control freakery ("nobody is putting poison in my kids body!")

I have looked at the data for Vermont and its very revealing. It is not necessarily the richest towns or the most "new agey" or "earthy/crunchy" The 5 or 6 towns that stand out are mostly above average wealth but towns just like them have in Vermont have really high vax rates as well(Prof. Wolff may be interested to learn that some of the lowest vax rates in Vermont are in Marlboro and West Brattleboro--a small college town--and in Montpelier, the smallish state capital).

Vermont has a notable lower vax rate (MMR rate for Kindergartners is 93%) but the state rate is misleading as there is high variance between towns (easily half of Vermont Kindergartners go to schools with 98%+ vax rates).

There are clearly some pockets of anti-vax in Vermont but they are concentrated in a dozen or so school districts spread out in different "type" towns. There is also, sadly, an anti-Vax lobby, which has power far beyond its actual numbers that has successfully made refusing vaccines easier than it should be.

David Goldman said...

Well…
http://www.ifc.com/shows/portlandia/blog/2015/01/in-portlandia-raw-milk-is-the-future

David Goldman said...

Also—the VT information is interesting. I wonder what effect all of the publicity surrounding the measles outbreak will have on people far removed from the outbreak itself. (In CA there's been a swing back towards vaccination in the past few years, one that seems likely to strengthen in response to this outbreak.)

Jim seems to me to get one strain of the rationalizations exactly right with the controlling/"no-poison!"/purity ideology. And while (in my experience, at least) the well-off, liberal, &c anti-vaxxers don't tend to be strongly libertarian, there is a tendency towards anti-*corporate* anti-authoritarian conspiracy theorizing. (The vaccine requirement is a plot to make Merck billions!)

Paul said...

I recently attended a talk given by sociologist Larry Hamilton (http://pubpages.unh.edu/~lch/). In the talk, he discussed the (largely anecdotal) claim that anti-vaccination attitudes are more likely to be held by liberals than conservatives. However, his empirical work did not support this claim. Instead, he found that anti-vaccination attitudes were held by (proportionately) far more conservatives than liberals. In fact, the anti-vaccination attitude looked similar (in terms of distribution according to political affiliation) with other anti-science attitudes, like climate change denialism (though, if I remember, climate change was particularly polarizing).

There was something else that he discussed in the talk, which I found interesting. Apparently, he found that the effect of education on one's scientific attitudes differs dramatically according to political affiliation. So, for liberals, those with more education were more likely to hold scientifically accurate views. For conservatives, however, those with more education were actually *less* likely to hold scientifically accurate views (in other words, conservatives with advanced degrees were more likely to deny climate change, believe that vaccinations are dangerous, etc. than conservatives with no advanced education) Fascinating!

Robert Paul Wolff said...

Paul, it is enough to make one weep! So educating conservatives makes them stupider. And they say there is no God. Only a very powerful and truly malevolent deity could produce such a result. I must rethink my commitment to the Enlightenment.

David Auerbach said...

I'm wondering (i.e. doing a priori philosophy) if anti-vaxxing on the (so-called) left side is a bit of (perhaps only semi-conscious) rational free-loading. After all, herd immmunity works to protect the involuntarily unimmunized (infants, immune-compromised, etc.) So, I can have my child free-load on herd immunity and everything's fine. (Until too many catch onto to the trick and herd immunity for that disease reaches the tipping point.)

Robert Paul Wolff said...

David, it is conceivable, but surely implausible, since vaccinations are all but free and risk-free as well. I cannot help thinking something more deeply irrational is at work.

David Auerbach said...

Oh sure, I was trying to cleave the left from right anti-vaxxers. The "cost" isn't $, but perceived risk. So even though they are rational enough to see the risk as low (though exaggerated), free-loading makes sense.

James said...

Autism disproportionately affects white upper-middle class communities. Or, there is a selection bias, or we hear more about their autism cases because their class status affords them the privilege to be heard in society. Either way, because of this perceived link, anti-vaccine sentiment is strong in well-educated, affluent areas, which mostly vote on the left. For the upcoming election, this is actually a genius wedge issue for Republicans to own. Democrats won't voice this concern because they are currently the party of responsible government, and distrust of compulsory government influence has Republican written all over it. Republicans may pick-up some affluent voters and donors who are compelled by this single, highly charged issue. The sad corollary to this, is that giving prominent political voice to the issue will give credence to the skeptics, and encourage working-class Republicans to view being anti-vax as being pro-individual freedom. It's a deeply cynical position to take, as it will inevitably cause children of poor people to die.