Back in 1998, disgraced former doctor, Andrew Wakefield, falsified data claiming that routine MMR vaccines were linked to autism. Now, 23 years later, the ripple effects from this debunked idea could stand between us and a decisive end to the Covid-19 pandemic. Here, I explore how we got here - the checkered 200+ year history of vaccine skepticism that has culminated in the Covid-19 anti-vax movement, why debunked ideas don’t ever seem to fully go away and what it is about the human psyche that makes us continually drawn to conspiracy theories.
How did we get here? The 200+ year history of the anti-vax movement
{1796} Vaccines are invented, skepticism is born
Last time, I wrote about how the first vaccines were developed in the late 18th century by British physician, Edward Jenner, who discovered that smallpox could be prevented by infecting individuals with the much milder disease, cowpox. Despite the massive public health benefit of this breakthrough, opposition to Jenner’s vaccines came straight away, on scientific, sanitary, religious and political grounds. Some objectors, including the local clergy, felt that vaccination was “unchristian” as they claimed that the vaccines had an “animal origin”. Some fearful parents objected to the vaccination procedure, which included scoring the flesh of a child’s arm and introducing infected material from a previously vaccinated person.
For many others, the science behind the vaccine was outlandish. At the time, most still subscribed to the so-called “miasma theory”, which suggested that disease was spread through “bad air” which emanated from rotting material. It would still be roughly 100 years before germ theory - the idea that disease was spread through tiny organisms or “germs” - would be fully accepted, and longer still before we had a grasp of the human immune system, explaining how vaccines actually worked.
{1800s} Skeptics get organised...and creative
During the 19th century, several organised anti-vaccination leagues arose, usually associated with vaccination drives and the introduction of mandatory vaccination laws, with citizens decrying these laws as an infringement of their rights. Also, during this time, self-styled “saviours” emerged claiming to know “the truth” about vaccines and circulated their messages widely. One colourful example in late 19th century Canada, was a Dr Ross, who during a smallpox outbreak, authored a widely-distributed pamphlet claiming that the vaccine did not prevent smallpox, but rather caused it, along with other nasty diseases like syphilis, killing children “outright”. In fact, there wasn’t a smallpox epidemic at all, and as evidence he produced testimonies of impressive sounding individuals whose names were prefixed by “Dr '', “Prof '', or “Sir”.
Despite these claims, the public health benefits of vaccines were irrefutable. In Sweden, the country with the longest running data on smallpox deaths, the number of deaths from smallpox plummeted after vaccines were introduced in 1801, corresponding to a steady rise in life expectancy:
{Early to mid 1900s} Things get quiet for a while
Around the start of the 20th century, sanitation and medical care was improving, and governments began placing less emphasis on compulsory vaccinations. The resistance to vaccinations eased, and the public welcomed advances in vaccine science, which around this time gave us vaccines for other deadly diseases like polio, whooping cough and tetanus.
{1980s-90s} The Wakefield Conspiracy
Fast forward to the 1980s. The horrors of smallpox and other infectious diseases were becoming an ever-fading memory in Europe and vaccine skepticism was on the rise again. A claim that DTP vaccines were associated with very rare, but serious brain injury, was stoking new fears about vaccines. Despite this claim being debunked - the brain injuries in question turned out to be misdiagnosed cases of infantile epilepsy with no link to the vaccine - the media coverage and fear-mongering around the issue galvanised fears about vaccines and several organised groups of anti-vax activists formed.
It was in this context of rising fear and suspicion that in 1998, another British physician, Andrew Wakefield and his colleagues published a paper in the prestigious medical journal, The Lancet, claiming that the widely administered MMR vaccine was associated with autism. Immediately after this, serious flaws in Wakefield’s work were highlighted- the small sample size of only 12 children, the uncontrolled experimental design and speculative conclusions, as well as an undisclosed conflict of interest for Wakefield- his work was being funded by the lawyers of parents suing vaccine manufacturers. Follow up studies were conducted on large samples of children, refuting the link. The Lancet quietly retracted the paper, and eventually it was determined that Wakefield and his colleagues had participated in deliberate fraud, picking and choosing data to suit their case and falsifying the facts, apparently for financial gain. Wakefield was struck from the medical register but continued his crusade against vaccines. This episode breathed new life into the anti-vax movement, this time in the internet age, and the ideas wouldn’t go away as quickly.
{2000s- 2021} - The launch of a thousand Facebook pages
Fast-forward again to 2020. The modern anti-vax movement, reinvigorated by Wakefield’s claims, has been slowly building momentum for years, but a global health crisis and talk of a brand new vaccine has propelled anti-vax sentiment into the mainstream. Theories range from the understandable, such as concerns over the possible side effects of the vaccines to the bizarre - that the vaccine is a covert means of population control or a false-premise to microchip us. {Stay tuned for the next installment in this saga delving into these specific Covid conspiracies.}
Why bad ideas don’t go away- the psychology of conspiracy theories on the internet
So, we’ve covered why the anti-vax movement exists in the first place, but why do these debunked ideas have such staying power? The sad truth is that, in the age of social media, the most visible ideas aren’t the ones backed by the most evidence or logic, but the ones that are the most clickable, controversial, shouted the loudest, and with the most conviction. While tech companies have made efforts to counteract disinformation online, many have been slow to respond. Critics point out that platforms like Facebook have been quietly benefitting from controversial ideas for years, as more controversy means more clicks, shares, comments and profits for their advertisers.
Once an idea gets momentum online, it takes on a life of its own- embedding itself in our brains even if at first we know it doesn’t gel with logic or our understanding of the world. On some level we think “this must have something to it because the idea is floating around out there and lots of people believe it and are really sure about it!” Even if we aren’t won over, the seed of doubt is planted, and we start to see the issue as a debate between two sides, even if the premise of one side is entirely false.
When it comes to conspiracy theories, psychologists warn that there is something uniquely appealing about these kinds of ideas to the human psyche, specifically our need to understand and feel secure in our surroundings and community. They offer a simple explanation for complex and scary phenomena, helping individuals feel they have a tidy answer to large scale global issues, and therefore some sense of control due to what they perceive as their superior understanding of the issue. Further, if the conspiracy theory is the dominant belief in one’s social group, a desire to have good standing within the group can also make people predisposed to the belief.
Psychologists believe that we evaluate ideas based on certain criteria, including whether the idea is consistent with our understanding of the world around us, personal biases, mood, what other people in our social group make of the idea, and whether we find the person sharing the idea to be convincing, which in turn could be influenced by whether they communicate with authority and confidence. For many of us, without access to all the data and inundated by the vast number of opinions online, we are left feeling overwhelmed and confused. For others, these ideas don’t appear illogical at first blush, but instead are entirely consistent with their worldview- one consisting of paranoia and mistrust of scientists, politicians and official narratives, and the belief in vast secret networks of change-makers across industries, bent on misleading the public to further their shadowy agenda. The people predisposed to these ideas are the ones that become the loudest champions of the conspiracy, becoming more and more convinced with each new piece of information and through support from other like-minded individuals.
Where does this leave us?
Based on this, we can see that the way we process ideas isn’t as logical as we might like to think, and that the nature of the social media discourse and human psychology create the perfect storm for the survival and spread of false information. While people with extreme anti-vax opinions may be in the minority, the very presence of these ideas in our information landscape leaves many more of us - who don’t have firsthand knowledge of the medical field - unsure how to proceed, leading to inaction. In practical terms, within the current pandemic this means fewer needles in arms, and a longer, more painful route to herd immunity.
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