My colleagues, and others around the web, have been doing an admirable job combating the nonsense that Joe Mercola and Barbara Loe Fisher are peddling as part of their so-called Vaccine Awareness Week (VAW). It’s especially gratifying to see, considering the size of their organization and audience, that a rag-tag, loose association of bloggers can spread so much science so fast.
Yet as much distaste as I may have for the organizers of VAW, I have to admit that Riff Raff & Magenta are only part of the problem. After all, it’s not just bloggers who are fighting the good fight — our public health authorities, physicians, hospitals, and research community continue to promote evidence-based approaches to infectious disease control and combat the misinformation promoted by fringe academics, CAM practitioners, and other unsavoury characters. The public is not at a loss for good information, which raises the question of just why — after decades of research and overwhelming scientific consensus — the anti-vaccination sentiment finds such fertile ground with the public.
Those that read my series on magical thinking last week will know that part of the problem rests in our mind design. One of the underlying operators of magical thinking identified in the research of psychologists like Paul Rozin is contagion, the notion that the properties of things we come in contact with can be transferred to one’s vital essence. Contagion seems to be an evolutionary adaptation that functions like a native, internal germ theory, triggering our disgust response when we’re in the presence of contaminants — especially other people’s fluids and excretions. While there’s an obvious benefit to such a mind design, this “template” is often misappropriated to aid in magical thinking. Thus toxin fears of all kinds — from EMF and Wifi to fluoride and vaccines — rely heavily on this mental quirk.
But there has to be more at work here, because the currency and success of the anti-vaccine movement are relatively recent phenomena. A generation ago, few questioned the efficacy and relative safety of immunization, and now people increasingly question both — which is especially odd considering that contagion doesn’t have to transfer only negative properties. Admittedly, it shows a negativity bias, but positive contagion can be seen in many magical beliefs, e.g. good luck charms, protective amulets, and crystal healing. So even if magical thinking is the reason people believe vaccines are dangerous (negative contagion), it doesn’t provide a complete answer as to why few seem to believe that vaccines are also effective (positive contagion). Indeed, the very notion that something could be dangerous and effective seems inherently counterintuitive.
To understand why this should be, we need to look at a different branch of our mind design — how we make decisions about risk. The research coming out of cognitive psychology points to two heuristics — mental shortcuts we use to make quick, unconscious decisions — that seem to have relevance to this topic.
The first of these is the affect heuristic identified by Paul Slovic. Affect, in psychological terms, refers to emotion, and the research shows that how we feel about an issue greatly impacts the decisions we make about it, especially our perception of its relative riskiness. To be more specific, issues that evoke positive emotions are intuitively viewed as less risky, and those that evoke negative emotions are intuitively viewed as more risky — a fact that led Dan Gardner to dub the affect heuristic the “Good/Bad Rule”. This is why people worry far more about the radiation from a nuclear reactor than from laying on a beach in the Caribbean. Mortality statistics be damned — compared to Chernobyl and Three Mile Island, the Club Med vacation certainly feels like the antidote for civilization.
The affect heuristic is also why the notion that contagion can work positively and negatively at the same time — effective and dangerous — doesn’t occur to us. We can’t feel both positions at once: the ensuing cognitive dissonance would result either in suppressing one emotion or bringing the decision up a level from our heuristic to our rational decision making process. (For more on this, see my earlier discussion of dual process theory).
OK, fine, so how we feel about vaccines impacts how risky we perceive them to be. But why should we associate them with negative emotions? Immunization saves lives — which is a good thing, right?
Well, it used to be. Time was when people had real experience with the diseases we were immunizing against, knew they were risky, and had positive emotional associations with the thing that helped you avoid them. But that was a long time ago, and in many ways immunization has become a victim of its success. I’m nearly 40, and the only time I’ve ever encountered the measles was when the Brady kids got them. The closest I came to the mumps was when Bobby kissed that possibly-disease-ridden hussy Millicent (turned out she was clean). Nowadays, thanks to immunization, we’re far more likely to hear a story about the dangers of vaccines than the dangers of a largely-eradicated disease — “nobody got sick” isn’t much of a story, after all. And stories matter because of another cognitive heuristic known as availability.
Although skeptics are fond of saying that “the plural of anecdote is not data”, our native cognitive processes beg to differ. Thanks to the availability heuristic, our perception of risk is indeed correlated to how many instances of a bad outcome we can recall. Start piling on stories, and all those anecdotes add up to a pretty clear picture to our mind — especially if those stories are emotionally resonant (affective).
And where might we find repeated, emotionally resonant stories about things that might kill us? Tune in at 10:00 to find out. As Dan Gardner oberves: “In journalism schools today, students are told there is a list of qualities that make a story newsworthy, a list that…always includes novelty, conflict, impact, and that beguiling and amorphous stuff known as human interest.”
Yes, the news media is in the business of telling emotionally resonant stories, over and over and over again until your eyes bleed. And then a few more times. Followed by a Where are they Now? retrospective. And it’s not just at 10:00 anymore with today’s 24 hour news cycle.
Now the cynical among us may see this merely as a big plot to keep viewers glued to the TV in order to sell them more Viagra, and there’s little doubt that commercial concerns play a role. But I’m inclined to a more charitable read, which is that journalists are human, and their assessment of what’s newsworthy is rooted in the mind design they share with their viewers. It’s rare that I doubt a journalist’s motives, and indeed rare that I doubt the motives of even the most shrill of the alarmists they interview. But being honest is not the same thing as being correct — you can honestly report a position for which there’s little or no actual evidence, providing you intend no deception.
The same is true of many others with a financial interest in propagating the anti-vaccination narrative — while there are certainly those whose profit motive trumps all else, for the most part marketers of so-called “natural” alternatives actually believe in what they’re selling. The mind’s ability to suppress cognitive dissonance through confirmation bias and social reinforcement is indeed impressive. If you doubt that, just try to have a cocktail conversation with a naturopath — it’s eerily similar to talking to a creationist.
The result of all this is exactly what you’d expect. Those with naturally strong metacognitive capabilities will second-guess their mind design, realize it’s faulty, and put their trust in the data. Everyone else will be swayed by the cultural factors that impact that mind design, i.e. how many stories they’ve heard about the dangers of vaccination vs. the dangers of the disease itself; who they heard those stories from; and how emotionally resonant they were. Unfortunately, with the pervasiveness of our media and the marketing tenacity of the natural health industry, I fear that the anti-vaccination forces will continue to have the upper hand in this battle for hearts & minds.
At least for now. Because the stronger they get, the more herd immunity will be lost, and the more children in our community will die from preventable diseases. Nothing will get on the news faster, and the tide will start to swing back for exactly the same reasons it started swinging away in the first place. It won’t be driven by reason, but at least it’ll be effective.
And that’s some comfort. I guess.