- I wanted to understand antivaxer arguments, so I debated them on the Huffington Post.
- They repeatedly made assertions linked to articles that didn’t support them.
- When I challenged their assertions, they did not engage with discussion on them.
I’m a pontificator by nature, not a brawler, but pontificators rarely change opinions. People that read pontifications are usually predisposed to agree with them. I like to think that among the tiny number of people who stumbled across my post on the mythology behind measles vaccination was someone who didn’t know what to make of the issue and was reading around it. Someone who came away persuaded to vaccinate their children. If that person existed, they didn’t tell me about it. They remain a hopeful fantasy of mine.
So I decided to get off my soapbox. I picked a fight with the antivax brigade.
Why the antivaxers?
I picked that particular debate because I know enough about to engage with it. It’s also one where the stakes are high enough to be worth an argument or two. Misinformation about vaccination is dangerous. Parents deciding not to vaccinate their children have caused a number of measles outbreaks in countries that have the resources to fully eradicate measles and in spite of the way it’s commonly perceived, measles is a serious illness.When vaccination rates in the USA dropped in 1989, around on in five of more than 55,000 infected children were hospitalised and 166 died. I haven’t been able to find figures on how many were brain damaged, but it usually happens in 0.025% of cases, so we’d expect it to have happened to 15-20 more children. Even if the children recovered completely, hospitalisation is no fun. 11,000 sets of anxious parents sat by their child’s hospital bed, wishing they’d had their child vaccinated. Even if the child skipped happily out of the hospital, some families must have been paying off the bills for years.
The MMR vaccine is safe and extremely effective against not only measles, but also mumps and rubella (German measles), it’s easy to understand why some parents are confused by the sheer volume of misinformation. I laid out the facts in my earlier post, but I don’t fool myself that it was a light in the darkness that confused parents are groping their way around in. It was more a whisper in the cacophony that is the internet.
When I ran across an article on the Huffington Post by self-professed silly mummy Lucy Gaskin, I knew it wouldn’t be long before the antivaxers descended on it. It looked like a good place to test drive my debating skills. The Huffington post looked like a good intro to internet debating, as the pace of comments is slow enough to keep up with and the tone isn’t as aggressive as on most mainstream news sites.
Assume the best, address the worst
I set myself certain rules before I started. I resolved to approach the debate with an open mind, and to assume that my opponents were debating in good faith. That was slightly scary as it meant opening myself to the possibility of being wrong, but I didn’t see there was no point in engaging unless I was willing to explore the issue in full. I was also determined not to resort to either ad hominem attacks or what we in Britain call ‘taking the piss’.While Lucy and I were on the same side in the ongoing debate, I couldn’t agree with her argument that vaccination should be compulsory because an unvaccinated child is an infection risk. It wasn’t her interpretation of the science that I disagreed with. No vaccine is perfect, so some vaccinated children will always remain vulnerable to being infected while others cannot be vaccinated because of problems with their immune system.
I did, however, disagree with her solution that vaccination should be mandatory. My view is that it is not ethical to give even a harmless treatment to one person for another’s benefit, and that the focus should be on the primary purpose of vaccination: to protect the child who receives the vaccine.
I’m also concerned about the message it sends to parents who want the best for their child. To a parent having trouble sorting the information from the misinformation, it begs the question of why their child must be vaccinated for someone else’s sake. It wouldn’t be necessary if the vaccine was good for their own child.
I see no reason to make it any more complicated than it needs to be. Parents have a simple and very good reason for having their child vaccinated: it protects their child from a very dangerous disease.
In all honesty, I couldn’t argue with the antivaxers without stating my objection, which felt rather churlish. Lucy and I were both working from the same facts, even if we disagreed on how they should be used to make policy. By the time the antivaxers had descended to deny the facts, Lucy and I agreed on far more than we disagreed on.
Lucy had the grace to join the debate below the line and took my argument in good part. I don’t think she agreed with me, but that’s up to her. We could probably have discussed it further if we didn’t find ourselves standing back to back against the antivax assault.
I didn’t expect to come up with anything the antivaxers hadn’t heard before, so I didn’t expect to convince any of them. I was aiming my arguments at people who were trying to decide what was best for their own children, and were trying to sift the facts from the misinformation. I assumed undecided parents would be reasonable people who would find evidence more persuasive than flights of rhetorical obnoxiousness. The catch was that they wouldn’t be likely to actually post. I’d have no evidence of their existence. I’d just have to assume that the Huffington Post is a popular enough site that there would be a silent majority out there.
I won’t give a blow-by-blow account of the debate here, as it’s below the article if you’re interested.
Playing the man and shifting the goalposts
I learned my opponents’ tactics very quickly: they only had two patterns. The first was to make an ad hominem attack against either ‘scientists’ in general, or one scientist in particular. The second was to assert their position and link to an article. Sometimes it was an article in a scientific journal, sometimes an article about it.I didn’t address the ad hominem attacks. I saw the question of who said what about whom as a distraction. There’s plenty of solid data, so I kept to it. As I did, it became increasingly obvious that the people posting the articles had either not read them or not understood them.
At one point, I was told: ‘there has only been one measles death in the US in the past 10 years you cannot claim that there has been a 75% reduction of measles in the US in that time period’. He linked to a paper that described the 1989-1991 outbreak in the USA and directly attributing it to measles vaccination falling below the critical threshhold. Even more confusingly, this was in response to my statement that ‘the WHO reports a 75% reduction in measles mortality between 2000 and 2013’. I hadn’t specified that the WHO was quoting worldwide figures, but then I hadn’t said it was specifically referring to the USA either.
I imagined a groan drifting across the Atlantic. Most Americans I know are tired of the stereotype of Americans who forget there’s a whole world beyond their borders, and would be embarrassed by my opponent’s determination to conform to it.
I forced myself to remember my starting resolutions and determined to respond according to them rather than the collective facepalm I was imagining. Were my own cognitive biases were getting in the way of my understanding his point?His statement that there hadn’t been a measles death in the USA in the last 10 years was factually true. The problem was his citing it as evidence that the MMR vaccine doesn’t protect against measles. MMR has been used almost universally in the USA for the last 10 years, so no deaths would be exactly what we’d expect to see if it works. The paper he quoted described the 1989-1991 outbreak as an illustration of what happens without vaccination, but the 166 deaths in that outbreak had been before his 10 year cutoff.
I reread the paper and I still could see the evidence against vaccination that he was seeing. His inability to distinguish between the USA and the entire world made it even easier to conclude that he’d only skimmed the figures rather than reading the paper.
As I continued to engage, I came to see this sort of thing was fairly typical among the antivaxers. I was beginning to wonder if they assumed no one read the articles they linked to.
They were also fond of category errors, such as not understanding the difference between data from the USA and data from the entire world. My opponent followed his failure to distinguish between the USA and the entire world with a failure to distinguish between cases and fatalities. He stated, correctly, that the number of measles deaths in the USA dropped before the measles vaccine was introduced. Where he went wrong was in assuming that meant the
vaccine was ineffective. The same paper showed very clearly that the number of cases – that is, the number of children who were infected with measles – dropped sharply when the vaccine was introduced in 1962. He argued, again correctly, that healthcare had been getting better and more
widely available throughout the 20th century, so a child with severe measles had a much better chance of surviving in 1960 than 1920. He didn’t seem to have noticed that the authors of the paper he was quoting still regarded measles as a serious problem:
Nevertheless, in the late 1950s, serious complications due to measles remained frequent and costly. As a result of measles virus infections, an average of 150,000 patients
had respiratory complications and 4000 patients had encephalitis each year; the latter was associated with a high risk of neurological sequelae and death. These complications and others resulted in an estimated 48,000 persons with measles being hospitalized every year.
Lose on measles, argue pertussis
It didn’t take me long to stop worrying that I’d have to reassess my views. Whenever I contradicted one of my opponents’ points, they didn’t respond but rather made another assertion with another misunderstood link. I felt I was winning the argument because they had no response to me, but I was also aware that they probably thought they were winning the argument as long as they didn’t run out of stuff to link to. You can’t lose an argument you don’t engage with.
After a while, the antivaxers ran out of papers on measles to misquote. At least, I assume that was why they moved on to talking about the pertussis vaccine for whooping cough. I was initially reluctant to get sidetracked. I was spending a lot of time reading their linked articles without broadening the argument, and pertussis was not the subject of Lucy’s original article.However, I soon realised that the antivaxers were simply not making a distinction between different vaccines. To them, a vaccine was a vaccine and to discredit one is to discredit all of them. They did not bring the BCG vaccine against tuberculosis into the discussion, which was discontinued for adolescents some years ago when it was found that it doesn’t protect adults. It’s a much better example of a vaccine not working as it was thought to than anything they were talking about, though the fact that it was withdrawn undermines the idea that vaccinologists are fundamentally dishonest and are forcing vaccines into children for nefarious reasons of their own.
As they ran out of arguments against MMR, I decided I may as well follow the argument over to pertussis. Much of it revolved around the finding that some people may be infected and transmit pertussis even after they were vaccinated. The argument then seemed to be that this made herd immunity impossible so there was no point in giving children vaccines.
Herd immunity is a secondary benefit of vaccination: if enough people in a community are immune to an infection and unable to pass it on, then a small number of people who are not immune will still be protected because they will never be infected. It protects children whose immune system is not fully functional so cannot be vaccinated. As no vaccine is 100% effective, there are also a small number of healthy people who are vaccinated are still vulnerable to infection and need herd immunity to protect them. The number of people who must be vaccinated to achieve herd immunity depends on the how effective the vaccine is and how infectious the disease is.Herd immunity is particularly relevant to MMR as it explains why we’re seeing outbreaks of measles but not mumps and rubella, even though the vaccine contains all three. Measles is much more infectious, so it requires 92-95% vaccine coverage to achieve herd immunity. Rubella and mumps only require 86% or lower. MMR has fallen far enough to allow measles outbreaks in some areas, but not so far as to allow mumps and rubella.
Returning to pertussis, my opponents were correct in reading the research as saying that vaccinated people could transmit pertussis, but once again I found myself wondering how they saw that as evidence against vaccination. People who could infect others with pertussis did not become ill themselves. The vaccine succeeded in its primary purpose of protecting the individual and if you can’t rely on herd immunity, that’s all the more reason to get yourself and your children vaccinated.
I could understand the discussion of herd immunity as it was the focus of Lucy’s original article, but I couldn’t understand why they seemed to think that a possibility that vaccination against pertussis might not – and the research is no more definitive than that – induce herd immunity was a strong argument against the MMR vaccine.
I found my resolution to be polite challenged by my growing conviction that the antivaxers couldn’t make basic distinctions. I found my responses becoming a little acerbic and as I did so, I realised I was constantly on the defensive. I felt like I was playing whack-a-mole against a barrage of misunderstandings.
So how could I go on the offensive without actually being offensive?
No one had dismissed the scientific method. In fact, they had claimed to be defending it and quoted scientific literature to back up their position. So I couched my counter-attack in terms of the scientific method. At the end of a response to my most persistent opponent, I challenged her to either state what evidence she would need to believe MMR is safe and effective, or admit that she was basing her position on ideology rather than evidence?Her response?
I didn’t get one. She started a new thread and told me, ‘the science shows it is not possible with the present ineffective vaccines – get over it’.
If she was resorted to ‘get over it’ as an argument, she was running out of them. I repeated the question.
She started another thread.
I repeated my question.
No answer. Silence rained for a week. I sat down to write this post and opened the discussion.
She was back!
Now she was talking about the pneumococcus vaccine and a study on virus transmission in battery chickens (no, me either). I answered her points and repeated the question.
Three weeks later, no answer. I decided I’d won the argument, though I’m sure she would disagree.
What did I learn?
Frustrating as it was at times, I had learned a few things. I’d read about several measles outbreaks I hadn’t known about, and read some research on pertussis that was more recent than I’d looked at before.
More to the point of the exercise, I’d learned more about the antivax position than I ever could have done without engaging with it. The only time I seriously doubted my opponents’ good faith was when someone posted a one line comment and a link to a thinly-disguised advertisement for a homeopathy practice. While my main opponents were peddling misinformation, I have no reason to doubt that they believed it themselves. What I don’t know is how they came to believe it, and I would be fascinated to find out.
Deities and hemp oil
I’d also discovered the limits of my resolution to be polite and respectful of my opponents. Part of that was feeling I was playing the killjoy academic who answered everything with rather dull, fact-orientated prose. It was precise but
it wasn’t exactly fun. After a few days, I surprised myself by the amount of sarcasm I was editing out of my posts before I sent them.
Simply putting it I don’t trust doctors or scientists who puts profit over my child’s health if you research what is actually in the injections the body already naturally has it in it but these foolish dictators want to put their man made stuff inside my child!!!! I don’t think so!!!!!! I trust God be4 any doctor what will be will be. Hemp oil!!!!!
It saw it when I came in from an evening with friends. It made me laugh. I was still grinning when I went to bed. Next morning, I couldn’t resist it: I took the piss.