Dr Liz Gordon: Vaccination and the loss of faith in the state
Around 20 years ago a British scientist named Wakefield led a study of twelve people that seemed to suggest a relationship between the MMR vaccine and autism. The study was soon shown to be flawed, and by itself was a mere blip in the ocean. It is, after all, well-established that systems of vaccination have had remarkable health effects on the human population over the past seventy years.
However, somehow the Wakefield study became entangled with a whole range of other discourses about the potential harm carried out by the state against the people. By the turn of the century, state dicta had lost much of their authority in some quarters. This is not surprising. The rise of the neoliberal state meant that the state withdrew (through disruption, loss of funding or privatisation) from many of the beneficial services previously offered to the people. Successive governments wrongly believed that the marketplace would, left to itself, more efficiently provide most things that people needed. As a result, there was an understandable loss of faith by the people in the reduced and diminished state sector.
Vaccination was not to be privatised, of course. Although privatisation has nibbled around the edges of the health system, the need for systematic coverage of vaccination – vax-equality, if you like – meant that it could not be left to the marketplace. Even in the US, with its privatised health system, free vaccinations are available for children who are not covered by other schemes.
But, first slowly and then faster, a lack of faith in state systems has grown among the people. Once trusted systems, especially health and education, have been supplemented by wealthier families with privatised elements – health insurance, private schools (or, more usually, large supplements paid to state schools as ‘donations’) and external providers (e.g. after-school tutors).
This has affected attitudes overall. The state is less trusted. This has reached its apogee in the USA, where the head of the state, President Trump, constantly snipes at the very state he heads, and urges the people not to trust their leaders. He might as well rant: “DON’T TRUST ME”.
The problem is, if you can’t get your messages from the leadership, where do you go to find out things? The rise of the internet is well-documented as a source of both excellent and terrible advice and information. There are plenty of anti-vax messages available on the internet if you want to read about those arguments. They are often compelling arguments of actual harm caused to children, allegedly, by vaccination. They are scary.
But most messages on the first several Google pages are the results of studies that show that such harm is not caused by vaccination. These are well-researched studies and well-written fact-sheets from organisations such as the World Health Organisation. While your judgement might be affected by loss of faith in organisations, the written material is still impressive.
I was interested to hear my friend Siouxsie Wiles on the radio yesterday talking about word of mouth. I have also been thinking about this a lot recently, and have written about it before. The reality is, a single message from another person – whether that person be a trusted friend or a casual acquaintance – can have more effect, at a sensitive time, than all the excellent public health messages in the world. And, moreover, this effect has been enhanced as the reputation of the state has been eroded by neo-liberalism.
The other important factor is that the threat from infectious diseases for which vaccines are available had dramatically reduced by the time the current generation of parents (Gens X and Y) had their children. Poliomyelitis, Tuberculosis and Measles in particular, which were all huge issues for previous generations, have all but disappeared due to public vaccination campaigns.
Thus, today’s parents are primed and programmed to listen to people say that there is doubt about immunization programmes, that they may be harmful to the children and information is being kept from them. Such messages are as, or more, likely to be circulated among well-educated people. In the current climate, it is not surprising that they have led to a reduction in immunization rates.
And so the inevitable has happened. It is lucky, certainly, that it is Measles and not Polio (which has also not been eradicated) that has broken out. Although lucky is not the word because sixty people have died in Samoa. Had we still had mass immunization in New Zealand, the epidemic of 2019 would not have happened in Auckland and someone would not have carried the disease to Samoa with such terrible results.
In her interview, Siouxsie concluded that if word of mouth is so crucial, that we all have a responsibility to spread the message as widely as possible that immunization is not only safe but crucial to our society and to the health of our children. It is important that a lesson is learned, today and for the future, from the tragic deaths and disabilities caused by Measles.
The underlying problem of a lack of faith in the state will take longer to fix.
Dr Liz Gordon is a researcher and a barrister, with interests in destroying neo-liberalism in all its forms and moving towards a socially just society. She usually blogs on justice, social welfare and education topics.
I think the word “faith” is the key one. Whether it’s a deep philosophical question about faith in the deep state, I doubt it — much more likely to be gullible people’s faith in faith healers weighed up against assessment of the skills of fellow members of the state, i.e. g.p.s with 6-8 years of scientific training.
Anecdotally I suspect complacency plays a large role in low vaccination rates. I’ve had a number of older people express bemusement at the NZ measles epidemic, claiming ‘we didn’t used to have this problem with measles”..so I looked it up..and its simply not true..people forget.
I had a young couple ask me what I thought about their child not getting the polio vaccination..and I said, well fine, just think how you’ll feel watching them hoble up the driveway in a leg brace..it was something they knew nothing about. And yes, they had their child vaccinated.
Siobhan: “I suspect complacency plays a large role in low vaccination rates.”
From conversations I’ve had with younger people, I agree. They are too young to have seen the epidemic diseases and their terrible consequences; they don’t understand the horrors from which they’re being protected.
“…older people express bemusement at the NZ measles epidemic, claiming ‘we didn’t used to have this problem with measles”…”
I was a bit surprised at this. I’m older and I surely remember those epidemics all too well: the children who died, or were left disabled.
“….just think how you’ll feel watching them hoble up the driveway in a leg brace..it was something they knew nothing about.”
Indeed. And that wasn’t the worst that could happen, either. I was born just before the run of post-war polio epidemics, which were brought to an end by the arrival of the Salk vaccine in, I think, 1956. I know that I was among the first cohort of children to receive it. I went to school with children who wore leg-irons; others were paralysed and spent time in iron lungs, still others died. A friend contracted a mild form of the disease, was quarantined for quite a long while in hospital, with all the other children so affected.
Unless they’ve done a bit of reading, the young have no idea that until about the early 50s, nobody actually knew what was causing the disease. My late mother told me about the resulting terror: how do you protect your kids if you don’t know how to protect them? The fear and sense of helplessness permeated the community.
In truth, it’s polio in particular which still scares the shit out of me. We were all vaccinated: firstly with the Salk vaccine, then a few years later the Sabin oral dose. But even so, immunity probably isn’t lifelong; all of us depend for protection on herd immunity. The absolute last thing we need here is an outbreak of the wild virus, and for as long as it hasn’t been completely eradicated worldwide, there’s a risk of an outbreak, such as we now have with measles.
People of my age and older, who had polio when young, can, as they age, experience post-polio syndrome, and many do. So polio is a particularly cruel disease.
My personal preference nowadays is a hard line against parents who either refuse to vaccinate their kids, or just don’t get around to it. None of us owns our children: they are the next generation and we have them only for the rearing of them, as my grandmother used to say. Nobody has any business visiting the consequences of their prejudices and ignorance upon their kids, who don’t get a say in it.
Giving them the best chances in life includes protecting them by vaccination from the awful epidemic diseases which ravaged populations when I was very young.
And beyond that, we all have a responsibility to each other to create that herd immunity. I’m infuriated by some of the solipsism I’ve heard from people who refuse to vaccinate their children; such people are quick enough, I notice, to take advantage of the socialised healthcare and education services offered here.
Were I still working in the health sector, or serving on a school BoT, I’d be pushing for the exclusion of unvaccinated children from services. The rest of us have a right to be protected from other people’s stupidity.
D’Esterre, an excellent post spelling out the dangers of anti-vax. I particularly like your comment “none of us own our children”. In this neo-liberal world I suspect some parents do think they own their children and are the sole arbiters of what happens to them, with little regard for the impact on others. John Donne once said no man is an island, entire of himself…
Janio: “John Donne once said no man is an island, entire of himself…”
Indeed.
“Therefore, send not to know
For whom the bell tolls,
It tolls for thee.”
Wise words from the 17th century; we humans are the same as in Donne’s time. Everyone should take note. Especially the anti-vaxxers.
I think it is important to acknowledge that vaccines do have adverse reactions. Looking at the official data it is around 3-4 children per 10000 in the case of the MMR vaccine. MMR with other vaccines is indicated to double that risk. The risk involved here is that of febrile seizure, which is described as non-serious, although I would imaging very concerning for the parents. On medical advice we delayed MMR for our child by six months as my partner has adverse effects to many antibiotics. Our child has a milder form of this. This is mentioned in the adverse reaction data.
I bring this up, as many medical professionals when interviewed on this imply that vaccines are entirely risk free, which is not the case. This may be in their mind to avoid clouding the issue, but unfortunately I think it gives ammunition to anti vaccine activists. Our child did not have any problems with vaccines and having met people who have had polio I cannot see any justification for not vaccinating where the risk is a deadly illness.
Alan: “The risk involved here is that of febrile seizure, which is described as non-serious, although I would imaging very concerning for the parents.”
That it is. But febrile seizures are more frequently a risk, I believe, when a child has a high temperature from whatever cause. I’ve certainly seen that.
We had a child who had a serious localised reaction to the triple vaccine (no MMR in those days). Fortunately, it was short-lived; but even so, we’d not have refused further vaccinations because of it. We’re old enough to have seen the damage caused by the diseases that vaccination covered off.
Anti-vaxxers smear vaccines as a “Big Pharma” conspiracy to reap vast profits from a “dubious/dangerous product”.
What they conveniently overlook is that the former Soviet Union also produced its own vaccines from its pharmaceutical manufacturers. Profit was not a motive for Soviet vaccine manufacturers: they were state-owned.
I am not an “anti-vaxxer”. I am concerned with the ingredients now contained in the MMR vaccine.
I have done my homework. Vatican/Rockefeller/Bilderberg. Have you done yours, Frank?
Helena: “I have done my homework. Vatican/Rockefeller/Bilderberg. Have you done yours, Frank?”
In fairness to Frank, that’s not the point he was making.
In any event, I agree with him.
Liz Gordon, your comment on the measles tragedy in Samoa does not include the botch up by 2 Samoan nurses which caused the death of 2 children. Unsurprisingly, this put people off getting vaccinations and there was an anti-vax mindset throughout Samoa. Thank goodness, government have stepped in with their vaccination drive. I agree with you that NZ/A has the largest responsibility for the outbreak.
How is it known that someone from NZ/Auckland carried measles to Samoa? There were 10 million measles cases worldwide quoted in one year, and only a few thousand of these at most (apparently) were from NZ.
Garbonza: “How is it known that someone from NZ/Auckland carried measles to Samoa?”
Given the significant Samoan population here – and given also that I understand vaccination rates are low in the NZ population – I suspect that it may be an assumption, based on the fact that there’s a fair bit of to-ing and fro-ing between here and Samoa.
Or it may be the case that testing has revealed that the same strain of the disease is circulating there. When we had the meningococcal epidemic here, the strain circulating was different from that in Australia, for instance. Although, if I remember rightly, it was the same strain as in Cuba. And that country managed to control it a very long time before we managed to do it here. Socialised medical system in Cuba, of course: you gotta love it! See this:
https://scielosp.org/article/medicc/2019.v21n4/19-27/