Vaccines have saved millions of lives. The scourge of smallpox is gone from this planet, except for stockpiles kept in Siberia and Atlanta, and polio has almost been eradicated. Dangerous and burdensome diseases have been tamed, and child survival improved due to vaccines. Refusal of vaccination denies these historical and medical truths and puts all people at risk of infectious disease.

That’s one way to start a story about vaccine skepticism. Here’s another:

Ever since there have been vaccines, there has been vaccine dissent. Themes in antivaccination protest are remarkably cohesive: impure vaccine ingredients, physician and corporate greed, potential ill effects, and threats to bodily integrity animate historical and contemporary concerns. While significant majorities accept vaccination regimes across the globe, determined minorities rely on a variety of belief systems and evidence to support their claims that vaccines are damaging to individuals, populations, and the planet.

The first narrative initiates a story that only flows one way—toward excoriation of those who cannot, for whatever reason, see the truth. The next sentence in the story is some version of this one: Vaccine dissent is essentially selfish, foolish, and irrational.

The second narrative offers a more open-ended opportunity, but currently, in the United States and elsewhere, only the first is allowable. Try to argue that beliefs about vaccination are complex and socially contextual, or even that people’s individual beliefs matter when it comes to vaccination, and you will be targeted as an antivaxxer. Vaccine hesitant parents are vilified and ridiculed in the media; well-founded concerns about the political impact of strict vaccine mandates are automatically criticized; and any suggestion that vaccination policies and requirements could be adjusted in response to public concerns is labeled science denial.

What is going on? In the 1990s, major news outlets in the U.S. reported evenhandedly about parental worries about thimerosal, a mercury-containing vaccine preservative in use since the 1930s. In the 2000s, though, as mainstream consensus coalesced around the lack of a connection between vaccines and autism, reporting on vaccination shifted to a more critical stance toward those who still questioned vaccine safety. After 2006 and the roll-out of Gardasil, an HPV vaccine marketed to prevent cervical cancer (whose maker, Merck, lobbied for state-level mandates, angering Christian conservatives who objected to a school-entry mandate for a vaccine against a sexually-transmitted disease), it became commonplace to see inflammatory news reporting in traditionally reliable outlets like the New York Times and the Washington Post.

Anti/Vax: Reframing the Vaccination Controversy tries to reorient public debate around vaccination by reminding us that there are numerous currents in American culture that share the concerns of vaccine skeptics. In the book I try to change the way we tell the story of vaccine dissent, much like a recent New York Times article that identifies poverty, political and social unrest, international travel, and geographical barriers as significant deterrents to comprehensive measles vaccination coverage globally.

Vaccine dissent is only one factor affecting current measles outbreaks in the U.S., and probably not the most important one. Balanced reporting about vaccination and infectious disease can illuminate the highly complex context in which modern medical efforts often conflict with local traditions, personal and community beliefs, and political realities in the context of globalization.

The way we tell stories matter. Storytelling can open up or shut down meaningful conversation. We are at a time in American history when talking across barriers of belief, ideology, and cultural identification are more important than ever. Vaccination controversy, and the contentious public debate that envelops it, is just one element in an increasingly polarized cultural conversation about what binds us and divides us as a nation.

We need to craft vaccination stories that differ from the inflammatory, accusatory, and vilifying narratives that we have created across social media and more traditional news platforms. Understanding vaccination controversy more deeply, with more attention to the features it shares with other cultural concerns, is one way to start.

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Bernice L. Hausman is professor of humanities and public health sciences and chair of humanities at Penn State College of Medicine. The author of four single-author studies of medical controversies (including Anti/Vax), she has a background in women’s studies, literary and critical theory, and the medical humanities. 

You can purchase Anti/Vax: Reframing the Vaccination Controversy, here. 

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Featured blog post image: ‘The Public Vaccinator’ by Lance Calkin. Credit: Wellcome Collection. CC BY