In This Episode
We almost eradicated measles in the U.S., but anti-vaxxers had to go and ruin it for everyone. WTF? Dr. Abdul El-Sayed walks us through the history and science of vaccines and the growing anti-vax movement. We meet the people affected, like Ethan Lindenberger, an 18-year-old who defied his anti-vax mom to get vaccinated.
[SOUND DESIGN here and throughout: 1850s London… lots of British accents, people shouting in the streets; “Extra! Extra! Hear ye! Hear ye!” … carriages moving past; the footsteps of a woman quickly walking… the sound of a water pump being pumped, and water hitting a bucket… ]
ABDUL: It’s London –1853. The city has just been transformed by the Industrial Revolution… Life is changing fast.
It’s summer in the city, and it’s unusually hot. It’s crowded. People are doing everything they can to escape their tiny tenements.
And there’s something else. Death in the air. There’s an outbreak of cholera.
[PAUSE FOR SOUND DESIGN]
Here’s what you need to know about cholera. It’s brutal. Your body loses almost all of its water in a matter of days, like it’s wringing itself dry.
The epidemic is spreading fast. Just this week, the 83rd person was declared dead.
Enter John fucking Snow…
[Game of Thrones theme song] overlay with “The King in the North!”
ABDUL: Yeah, not that John Snow. We’re talking about the OG *Doctor* John Snow.
He wasn’t King in the North, but he did take care of the Queen when she gave birth. And nobody knows it yet, but he’s about to become king…of Public Health.
But back to this epidemic. The big question on everyone’s mind is how it’s spreading. Because then, maybe someone could do something about it.
There are two competing camps. First, there are the supporters of the Miasma theory. Basically, team-Miasma thinks that a low-lying cloud of foul gases emanating from the soil is somehow killing people when they breathe it in.
That may sound absurd, but it’s actually the going theory at the moment.
Then there’s the other camp, John Snow’s camp. They are the contagionists. They think there is some substance transmitting the disease. A bunch of tiny particles maybe. Probably in the water people are drinking.
See, at this point, Londoners get their water from a system of shared public water pumps.
So, John Snow realizes that this moment may be a chance to prove his theory right–stop the epidemic, and save a bunch of lives. He starts talking to folks. Remember those 83 people who died? He maps where they lived. And he finds that 73 of them happened to all live closest to the same pump. The Broad Street Pump.
He interviews the next of kin of the other 10 that died. And it turns out that eight of them drank from the pump on Broad Street! Whiiiich also happens to be downstream from where people have been dumping their cesspits.
He couldn’t prove it yet under a microscope, but John Snow and his evidence helped lead to a discovery that today is so commonplace you probably take it for granted. It may be the most important discovery in human history.
Formally, it’s called the Germ Theory of Disease. That microscopic organisms, tiny particles or germs, cause diseases in humans.
But what Snow did next is why I’m telling you this story.
He doesn’t just go publish his neat little map in a journal and call it a day. No, John Snow takes his evidence to the Board of Guardians…that’s seriously what they called the town council…and convinces them to take the handle off the pump. No more handle, no more water.
Down goes Cholera. [Boxing bell sound design].
And that’s how public health was born…and how John Snow became the King . He used science.. to move government.. to act… to save people’s lives. And in the alternative ending to Game of Thrones, John Snow ascends to the iron throne..and proceeds to build fantastic sanitation systems for the people of Westeros, Essos, and Sotheryos.
TYRION: Grand Maester, it is my theory based on years of work on the Casterly Rock sewers that clean water leads to a healthier population… Find the best builders and set them to the task…
But for real… Soon after Snow, early health departments began popping up all over Europe and the US, mandating sanitation and hygienic water treatment, reducing overcrowding, passing and enforcing food and worker safety laws.
And it worked. People got way healthier, pretty quickly.
And as science yielded new discoveries — like vaccines or antibiotics — government was right there to put them into action.
That dynamic duo: science and government, working together, trusting each other it’s brought us some of the greatest health achievements in human history. At the turn of the 20th century, life expectancy in the U.S. was 47. By 1950, it had jumped by more than 20 years to 68.
Science. And government.
Two things Americans… LOVE to hate.
[ARCHIVAL CACOPHONY OF BULLSHIT FADES INTO SHOW THEME] [Clips 0.1]
ABDUL: I’m your host, Dr. Abdul El-Sayed, and this is America Dissected – a podcast about the important relationship between science and government – and what it means for the health of our nation.
I’m a doctor and epidemiologist, and I served the city of Detroit as its Health Commissioner. As a public health official, I was on the frontlines of protecting our health. AND I had a front row seat as this crucial partnership that John Snow helped usher in – between science and government – has started to falter.
I watched media spin get in the way of sound science…
[ARCHIVAL: Media clips] [Clips 0.2]
ABDUL: … and petty politics get in the way of sound government …
[ARCHIVAL: politics clips] [Clips 0.3]
ABDUL: … And I watched as people suffered the consequences.
With The Vitals, I’m bringing you stories from those frontlines. Together, we’ll cut through the bullshit to get back to what matters in our health: understanding how lucky we are to be alive today, the threats we face, and what we have to do to address them.
In this first episode, we’re cutting right into the belly of the beast: fucking anti-vaxxers.
ACT 1 – WHO GETS SICK
ARCHIVAL: Anti-vaxxer celebrities spouting nonsense on YouTube etc., news reports of bogus anti-vaxxer claims, etc. — get a sense of the kind of celebrity culture around anti-vaxx movement, as well as “serious journalism” trying and failing to talk about the subject…
ABDUL VO: Here’s the thing – right now, there’s plenty of attention being paid to the small minority of people – celebrity or otherwise – spewing nonsense about vaccines. And that’s the issue – that attention – it’s exacerbating the problem.
And they’re not the ones who deserve our attention, anyway.The people who really deserve our attention in all of this have a very different story to tell…
INTV – LAWSON: [00:14] I’m 27 weeks today.
INTV – ABDUL: [00:21] Are you gonna find out the sex or are you going to wait?
INTV – LAWSON: [00:27] I’m too ahead of the game for that. We’re having another girl.
[BEAT – or music in]
INTV – LAWSON: [2:00 – 3:00] I got an email… along with a whole bunch of social media posts that there had been a measles exposure… And of course the social media was not very helpful, but the email was directly from the YMCA and I also got emails from a couple other locations in my city that if you were in these areas you may have been exposed to measles because there was a baby with measles in these areas.
ABDUL VO: This is Dana. What happened to her could have happened to anybody. She’s pregnant, and her 4 year-old daughter goes to a pre-school at their local YMCA in Massachusetts. And during pick-up time, a parent had brought a baby who had been carrying measles. The contamination was in a very specific area — through the lobby, at a certain door — and Dana had been right there.
Thankfully, her 4 year-old daughter had been vaccinated, but Dana worried about her unborn child, so she decided to take some extra precautions…
INTV – LAWSON: [3:41] I went to my doctor and had a blood draw for the measles antibodies. And it came back that I had the antibodies for rubella, but not for measles and even though I had received the vaccine when I was a kid, it was the 80s.
So, I found out that I only got one shot instead of 2 and the second booster would probably put me over the edge and made me immune to measles but at that point I was considered not immune to measles.
ABDUL VO: Dana grew up in the 80s. Her parents did what they were supposed to do and got her vaccinated. But sometimes, as you get older, you need what’s called a “booster” to keep you up to date. An extra dose to remind your immune system what it’s up against. But Dana couldn’t get a booster now because she was pregnant–and it could hurt the baby.
INTV – LAWSON: [3:42] My doctor, right away, said, “I think this is okay…” called me back… I have to report this to the Department of public Health… I felt totally healthy… she called me back about I don’t know 10 minutes later and said I’m so sorry. I spoke to the Department of Public Health… to report this and you actually have to go on quarantine for 21 days in your home.
ABDUL VO: You might wonder why 21 days. That seems like an awful long time to keep someone cooped up. The thing about measles is that it starts to be contagious even before the symptoms start. And it can take 21 days for the symptoms to start. 21 days is the longest possible period between when someone could be giving people the disease and when they would know they had it. That period is the most dangerous time for spreading the disease. And quarantine makes sure that they’re not spreading it all that time.
INTV – LAWSON: [4:51] the first thing I thought of was what’s going on? Oh my god. Did I just give all these people… the measles?
[7:01] I never had a fever or a rash or anything, but I’ve been in my office so I had to call my human resources department on a Friday afternoon and they had to call the city of Boston and they had to go through lots of Hoops to make sure that the rest of our staff which is about five to six hundred people were okay, and there wasn’t something, you know, cause for alarm or we needed to send a letter out in that way too.
INTV-ABDUL: [14:35] Did you fear that something might happen to the pregnancy if you came down with a fever or a rash?
INTV – LAWSON: [14:41] Yeah absolutely the pregnancy was the number one thing on my mind. It was actually me getting the measles was the least of my worries in the sense of if I knew that if I were to get sick, I’d be in a full Panic about measles in the womb or what’s going to happen.
[15:20] It was very scary because I lived in fear of getting this fever and you know what you don’t even want to get like a sniffle when you’re pregnant. You don’t want to get anything because you know, you’re carrying another being inside your body.
ABDUL VO: A pregnant woman forced to spend 21 days under quarantine, worried sick about what might happen if her unborn child were to contract one of the most contagious diseases known to humankind.
And then there was the outright bizarre — Like when her daughter got strep in the middle of her quarantine, and she wasn’t allowed inside the doctor’s office.
INTV – LAWSON: They said well just park in the parking lot and we’ll come down to you. So we’re in the parking lot, my daughter and I, she’s coloring and these two nurses come down in full hazmat suits with their strep culture and they come in and they’re like my daughter’s terrified and everyone – I don’t know how this didn’t end up on the Internet because everyone had their phones out and they’re like taking pictures.They’re also like what is this service this car side service you are getting? But they did her throat swab… Yeah they were like what’s going on? And I was like, oh my God, this is so embarrassing, you know, and it’s hard enough to just get a throat culture on a kid anyways.
ABDUL VO: Yeah, so what Dana’s story reminds us is that while those nurses in hazmat suits were trying to protect themselves in a protective hazmat bubble – the point is, none of us live in one. What we do – or don’t do – affects the people we share this place with. Sometimes with frightening consequences.
And this is why Dana’s story is the story we should be hearing – What did she do wrong? Nothing. She was the unlucky consequence of someone else’s misinformed decision.
Dana and her unborn child would have been protected if everyone else had been, too. But you may be asking yourself – how exactly? And also – seriously, what is going on with the breakdown in people’s trust of vaccination? Fear not, we’re gonna get into it.
But first, let’s talk about the science behind vaccines – which could not have happened without the science kicked off by John Snow and the germ theory of disease it helped establish.
A lot of you might already know this, but bare with me on the problematic policing metaphor.
[SOUND DESIGN OVER THE FOLLOWING:]
Our bodies have this incredible immune system. Think about it like a distributed police force that exists all over the body – specialized cells doing specialized things, all with one goal: keeping you healthy. Let’s call it the immune force. Scientists actually estimate that if you were to take the whole immune force dispersed all over the body and put it in one place, it would be an organ the size of your brain.
Immune cells, they’re really good at attacking things that they’ve seen before. Once they recognize a bad guy, they target and destroy it quickly. Matter of hours. It’s like targeting a repeat offender – somebody who’s already in the system. But they’re not as good at identifying a first-timer – and so the whole response can take a week or more.
But a week is a long time. You can imagine that a really deadly disease can wreak havoc before the immune system even has a chance to get started. And that’s where vaccines come in. They introduce our body’s immune systems to a weakened – or sometimes dead – version of that offending agent. It’s like a massive “WANTED” poster or “be on the lookout” call over the wires. So when our immune system cells do catch sight of the real thing, if you’re ever exposed to it, they know just what to do.
[END SOUND DESIGN]
In the last century, vaccines have been incredibly effective at reducing and sometimes completely eradicating diseases. Notice how you don’t hear about anyone getting smallpox anymore? Yeah, vaccines. In fact, vaccines are right up there alongside the ranks of John Snow in our public health history book – a tool in our kickass arsenal, ensuring we all live longer lives than our predecessors.
What’s crazy is that they haven’t been around that long. Our modern sense of mass-produced vaccinations that have the power to eradicate disease is barely two generations old. The vaccine for pertussis was created in 1914, diphtheria in 1926, and tetanus in 1938. Polio? Not until 1952.
Now, I was born in 1984. The only vaccine-preventable illness I got was the chicken pox, because we didn’t have a vaccine for it yet. But with measles on the rise, I was curious: what was it like to live in a time before vaccines, when the diseases they prevent were just–common? So I called some folks who could fill me in…
INTV – ABDUL: [1:33] Grandma I distinctly remember going to the doctor to get vaccinated with you.
INTV – JUDY: you were terrible.
INTV – JAN: He was awful. Oh God, that’s right. I forgot. He was awful.
INTV – JUDY: You were completely terrified of needles and you had a very loud voice and you were very strong. Oh my gosh, no wonder your mom wouldn’t go with you.
ABDUL VO: If you haven’t guessed it already, that’s my Grandma Judy and my Grandpa Jan. Exposing all my secrets. Grandma’s a nurse, who worked in the health system for decades. She and my grandpa are retired now, they’re in their 70s; which means they were born in the 1940s, before the advent of the polio vaccine…
INTV – JAN: [6:35] I remember we would go to somebody’s house when they found out they were having polio is like going to a house like a funeral. I mean it was I remember as a little child just being uncomfortable, but I had oh. There were two little girls that died and I [00:07:22] can just physically remember four or five people that that got polio. Janet Dalta, they just lived close to us and Jeff Arnold was was from town.
INTV – JUDY: [8:25] I know everybody was afraid of it. I lived in Ann Arbor and I didn’t know any children that got it but you heard about it all the time and everybody was really scared of it because you know, they end up in Iron lungs and some of them died and some of them were in wheelchairs the rest of their lives.
ABDUL VO: Polio is scary. It infects the part of your spinal cord that controls your movement, taking away your ability to move some parts of your body. Sometimes it affects your diaphragm, the muscle that helps you breathe. And that’s how people ended up in the iron lung. Sometimes the symptoms go away. Sometimes they’re permanent–like FDR, who was paralyzed from the waste down after he got it as an adult. Thousands of people, often kids, died.
Thankfully, my grandparents only caught the tail end of that polio outbreak. At the time they were children, the trials for a polio vaccine were being conducted at the University of Michigan — right in my grandmother’s hometown. By 1955 the famous Salk vaccine was released to the public.
ARCHIVAL: NEWSREEL OF SALK VACCINE DISCOVERY [Clip 1.1]
Following its release, a group called the March of Dimes, which was named after FDR— clever, right? — launched a massive pro-vaccine campaign. Informational campaigns, free vaccinations, celebrity endorsements. Elvis — the biggest star of the day — got his polio vaccination LIVE on the Ed Sullivan show — the most watched show of the day.
ARCHIVAL: ELVIS ED SULLIVAN CLIP IF WE CAN FIND IT [Clip 1.2]
Back in Michigan, my grandmother was one of the first to get vaccinated.
INTV – JUDY: [8:58] Well, I don’t remember if it was experimental or if they had released it when I got it, but everybody got it as soon as they could. And then I don’t remember but exactly why but when the oral vaccine came out everybody got again. I mean people were lined up outside at different places where they were giving the vaccine and getting it whole families.
[8:45] Everybody wanted it. They didn’t want their children to die.
INTV – ABDUL: [24:34] How much do you think vaccines have become a victim of their own success?
INTV – JAN: Oh, there’s no question. I mean you don’t have the diseases so why get the why get the vaccine?
INTV – JUDY: Well, I remember when they were going to stop giving the smallpox vaccine and my kids have had it, but I said I I think Jeff wouldn’t have had to get it, but I said I don’t want my kid to be the first ones not to have a vaccine because what if it doesn’t work. And I certainly didn’t want them getting smallpox.That was our first success. I think but I don’t even know how much smallpox there is in the world now.
INTV – ABDUL: They eradicated it 40 years ago.
But yeah, I mean that’s that’s the truth of what vaccines that’s the ideal, right? The ideal is that there is no more of the disease in the world and then nobody has to get vaccinated.
INTV – JUDY: So really what we should be doing is trying to get the whole world vaccinated for a while and then eradicate the disease.
INTV – ABDUL: That would be the goal.
INTV – JUDY: That would be great. [25:34]
ABDUL VO: Grandma’s right – the ideal would be to get everybody vaccinated and therefore, eradicate these diseases. And the frustrating thing is – we were so close with measles! At least in this country.
Of course, the truth is – not everyone can get vaccinated. And there lies one of the most important functions of vaccines: they don’t just protect people who get them – they protect the very people who can’t. Pregnant people like Dana; people whose immune systems are still developing – like babies – or folks with immune disorders.
That protection happens because of a process called herd immunity – or collective immunity.
Think of it this way: if you’re one of those people who can’t get vaccinated, your likelihood of getting one of those vaccine-preventable infectious diseases depends on your likelihood of coming into contact with somebody who has the disease. And those with the disease could only have gotten it if they weren’t vaccinated in the first place. It follows that if more people get vaccinated, those who can’t for some medical reason are less likely to come into contact with somebody who could give them the disease. And there’s less disease.
But when fewer and fewer people choose to vaccinate, more people carry the disease, and the likelihood that people who can’t get vaccinated come in contact with them and get the disease goes up.
Choosing not to vaccinate is more like drinking and driving than it is like choosing not to wear a seatbelt. Collective immunity is why. You don’t wear a seatbelt? You’re making an awful decision–but you’re only jeopardizing yourself. But if you drink and drive, your recklessness can kill other people.
In short: you vaccinate to protect yourself–AND to protect everyone around you.
Like my grandma told you, I hate shots. But as a father, I get my flu shot for my baby girl.
As more and more people are choosing not to vaccinate, our collective immunity – it’s breaking down. It’s like there are more drunk drivers on the road. More of us are at risk–like Dana. And more of us are getting sick…
[possible archival of measles outbreaks][Clips 1.3]
These outbreaks shouldn’t be happening. We have an incredibly safe, incredibly affordable, and incredibly effective vaccine. In fact, we were on the cusp of eradicating measles because
[Archival of headlines about eradicating measles, early 2000s].
So, with this rock solid vaccine backed by rock-solid science, WHY ARE PEOPLE NOT VACCINATING THEIR KIDS? For that, my friends, stick around.
AD BREAK – MIDROLL
ACT 2 – MEET AN ANTI VAXXER
[ARCHIVAL: Waterfall of stories about anti-vaxxers and “vaccine hesitancy”][Clips 1.4]
ABDUL VO: Okay, so the media has paid so much attention to this small group of people who refuse to vaccinate their children that they’ve even crafted a new term to describe their behavior: vaccine hesitancy. Let’s throw that into the growing column of unhelpful euphemisms that have the side effect of legitimacy.
With the help of a hapless media and exploitative politicians, these anti-vaxx groups have had great success in growing the numbers of the so-called hesitant. And as we’ve talked about, that’s had some very real consequences for public health. The first half of 2019 had almost three times as many measles cases as ALL of 2018.
Like my Grandma said, in many ways, the success we had in almost eradicating measles through the vaccine, has kinda backfired. People don’t realize how dangerous it can be. People don’t think their kid will be the one to actually get it. Kinda like drunk drivers never think they’ll be the one to get into an accident.
Thing is – we outlawed drunk driving. Period. You do it, you get caught, you get in trouble. But vaccines? While there are mandatory vaccination laws on the books in all 50 states, there are, of course, also loopholes in almost every state–in fact, because of ceaseless misinformation campaigns and bullshit arguments about “government overreach”, anti-vaxx dogma has almost become mainstream in Republican thinking. Thank you politics.
Those holes are called exemptions. Like for a war draft, an exemption is a waiver that allows you to do something different from what the government is telling you to do. So vaccine exemptions are waivers for parents that them to send their kids to school even though they haven’t been vaccinated.
Those waivers were originally created for kids who have medical reasons why they can’t be vaccinated. But because of the way misinformation has mixed with politics, today, 15 states allow for a philosophical exemption – meaning you don’t have to justify your anti-vaxxer beliefs to anyone. You just get to choose not to vaccinate your kids. My home state, Michigan, is one of those states.
[ARCHIVAL: Video parents have to watch if they want their kids not to be vaccinated…]
ABDUL: If you’re a parent who wants an exemption, all you have to do is go to a local health department, watch a cheesy ass PSA about the risk of not vaccinating,
[ARCHIVAL: Video parents have to watch if they want their kids not to be vaccinated…]
ABDUL: talk to one of the staff, and you’re good to go – on your way to the vaccine equivalent of drunk driving.
These waivers are leading to the breakdown in collective immunity that we talked about earlier, leading to the outbreaks you’ve been hearing so much about.
But honestly, I think we’re talking about the wrong outbreak. The contagion we should be concerned with isn’t measles–but the contagion of misinformation that is making the spread of measles possible.
To learn more about this spreading mindset, we turn to a young man who grew up in an environment teeming with it.
INTV – ETHAN: [4.11_Ethan] So growing up it was a very hostile environment to vaccines.
ABDUL VO: That’s Ethan Lindberger. He grew up unvaccinated in the state of Ohio, another state with a philosophical exemption on the books. Today, Ethan, now 18 years old, is a rising voice in the anti-anti-vaccine movement, recently testifying before Congress on the dangers of vaccine misinformation.
INTV – ETHAN: [4.16_Ethan] It was an environment where my mom would talk openly about how vaccines were dangerous, how they were unhealthy, how they cause autism and brain damage, and didn’t help anybody’s health and safety — didn’t contribute to the health and safety of society. You know growing up that was the environment that I associated with vaccines, but I didn’t really think about it too much because it wasn’t this big deal that was important to me. We were just the healthy kids who weren’t vaccinated.
[10:47/12.06_Ethan] No, I mean like yeah think you’re as a kid as a nine-year-old ten-year-old 12 year old kid like you’re talking about how you don’t know anything about health and science and medicine. You you don’t ever speak to the doctor when you go in for an appointment — your parents make all decisions for you. And so…
[11:45/13.07_Ethan] my perspective growing up, I just was avoiding these needles that would probably hurt and that’s kind of convenient for my thirteen year old self going to public school.
ABDUL VO: Ethan’s mother didn’t form her anti-vax stance independently. She was a victim of the contagion of misinformation.
INTV – ABDUL [8:38_Abdul] I mean, where did she get this research?
INTV – ETHAN: [9:04/10.25_Ethan] it was partially a lack of education and also a surplus of misinformation. She originally started from like misinformed books or articles or probably also friends and family members who would like give these secondhand accounts of people getting vaccinated and being injured or some such story that wasn’t accurate.
[9:24/10.50_Ethan] You know, as that progressed she latched on to social media. And so I know even if she wasn’t just partially hesitant, I know for sure that once social media kind of came into the picture, that she was surrounded by all these other people that shared her these opinions and encouraged them. I think social media is where it turned into like this passion rather than a curiosity.
INTV – ABDUL: [9:48] So she found an online community that really justified and validated her thoughts and then that sort of reinforced her position outside of the internet.
INTV – ETHAN: [9:58/11.20_Ethan] Yeah, absolutely.
[10:24/11.47_Ethan] That social space online became a big focal point for her to share those opinions, get more information, and feel encouraged for this ignorance that was kind of growing.
ABDUL VO: The Internet is a veritable cesspool of anti-vax propaganda, where people turn to learn all sorts of lies… vaccines are dangerous for their children, the dangerous lie that they cause autism, or that there is a conspiracy facilitated by the CDC, WHO, and podcast hosts like me.
But it’s also a two-way street. And as Ethan turned 16, he started to see anti-anti-vaxxer content, memes and discussion boards, and realized that what he was hearing at the dinner table wasn’t just wrong–it was dangerous.
INTV – ABDUL [12:27] when did you start to form your own position on this?
INTV – ETHAN: [12:30/13.50_Ethan] I don’t really know the exact moment because it was like a slow progression of outside information.
[14:33/16.03_Ethan] Like I’d see a meme about vaccines and I’d see an article shared about it. You know there’d be something on Facebook or Reddit.
[14:33/15.55_Ethan] the first time where I was like here’s some other information and we compared notes
[13:29/14.54_Ethan] my mom was having like this big conversation about vaccines and saying that her friend was pro-vaccine how dumb that was, of course they cause autism and she doesn’t even know.
I just like got on my phone and I looked on the cdc’s website, there was an article in the very large headline was “vaccines do not cause autism. I showed it to her and said well, you know the CDC disagree. Is there any you have any reason why they may be wrong? She was just like well, that’s what they want you to think.
ABDUL VO: Ethan’s research eventually led him to reject his mother’s beliefs. At first that was no big deal — a disagreement between parent and child, something as old as time. But as colleges began to ask Ethan for vaccination records, he was forced to ask himself if it was finally time that he got vaccinated. So when Ethan turned 18, he made his decision.
INTV – ABDUL: [18:09] What was her response when you said I’m going to get vaccinated?
INTV ETHAN: [18:14/19.35_Ethan] Absolute absolute fear I mean she freaked out. Because you gotta think like it makes sense we even though it absolutely is outlandish to think that vaccines cause autism and brain damage and there’s no science behind it if you really do believe the stuff and if somehow you fallen into this trap and your child comes up to you and says I’m going to get my vaccines. Well, how do you how else would you respond other than losing your mind? You know, like if my my came up to me and said I’m going to take a bath in radioactive waste I’d be like, no absolutely not.
INTV – ABDUL: [19:28] What was your response to her fear?
INTV – ETHAN: [19:33/20.50_Ethan] Just understanding.
[19:54/21.17_Ethan] I understood going in that this was going to be a situation where she would not respond well.
[20:22/21.42_Ethan] Instead of just going and getting my vaccines one day — and then coming home with bandaid on my arm and saying like too late — I made an appointment with a doctor and spoke to her. And so I made every decision I could to lay out a foundation of respect and trust.
INTV – ABDUL: [20:42] Your response captures a level of empathy and respect even in the face of deeply irrational behavior. right? You could have easily just pointed to every other kid who got their vaccines in their school and said they’re all fine, I’m going to be fine too. But you appreciated the space of mind that your mother occupies and you assented to it. You said, you know, this is where she is emotionally and I’m going to have to calibrate my response. In tow, what does that say about the way we should be approaching anti-vaxxers generally?
INTV – ETHAN: [21:18/22.44_Ethan] You can’t control the way people think so you have to best handle the way you think and the way you behave.
[22:00] When it comes like individuals your family your friends people that have suffered and are victims of misinformation, I think that approaching them with the same mindset of like empathy kindness respect. That’s so important and we’re missing that because we’re falsely identifying the problem with them rather than the people that are leading the movement that are spreading the lies.
INTV – ABDUL: [22:24} the way you’ve laid it out is that they are perpetrators and then there are victims of this virus of misinformation and that we ought to be treated them differently, right?
INTV – ETHAN: [31:30/32.51] People who are anti-vaccine aren’t bad people… I think they’re people that have seen bad information having reached with poor information, that is telling them that they are a bad mom, they’re a bad dad, they are a horrible parent that is putting their kids in danger if they vaccinate — which is exactly the opposite of what’s true.
ABDUL VO: Ethan’s right. You and I have good reason to fear anti-vaxxers, but at their core anti-vaxxers are scared too.
Like Ethan was getting at — in the context of the contagion of misinformation, Anti-vaxxers are just the victims who have been infected. And like any virus, we can’t just treat the symptoms. We’ve got to fight the source.
The anti-vax movement didn’t sprout up on its own. It was manufactured.
INTV – ETHAN: [22:47] There are people that are actively taking roles as anti-vaccine leaders who understand the gravity of the situation and that understand the real truth behind the situation and are vocally taking stances that are amassing them such large community.
INTV – ABDUL: [32:37] What do you think these leaders of the anti-vaccine movement gain out of it?
INTV – ETHAN: [32:46] There’s money, there’s Fame, there’s being part of a movement. There’s so much to it. You get you gain so much by becoming a vocal leader in the anti-vaccine community… You can sell supplements, You can sell alternative medicine…
[33:22] you look on a half the anti-vaccine websites that are like the largest sources of misinformation… They’re covered with advertisements and they’re selling their also marketing their own information.
INTV – ABDUL: [23:44] How should we be dealing with these perpetrators when Justin Timberlake or Jessica Biel come out and say I’m worried about this and they now become pushers of this very dangerous mindset?
INTV – ETHAN: [24:02] It’s such a hard problem to address because there’s so many ways you could approach it and there’s so many consequences with the way you approach the situation.
[25:09] I think it’s a level of not reaching those people but reaching the people that are still recruitable to reality — people that are still on the fence.
[25:38] I don’t think my mom will ever change her opinion. I don’t think there’s anything you can do any information you can present her. You could sit her down in front of someone dying from measles and show them show her the vaccine. Give it to a different kid move them in that room and I could find and she would still say no.
INTV – ABDUL: [26:12] So we’ve got to be thinking about making sure that the right information is given to folks who are susceptible. It’s almost like we’re vaccinating against anti-vaccines.
INTV – ETHAN: [26:22] Young people are a fantastic demographic to reach with better information.
Having schools have better education towards vaccines and vaccine hesitancy, these are solutions that work and we need to focus on because you’re reaching people that are more susceptible rather than have, you know fallen to this like, It’s like just this pit of lies that they’ll never climb out.
ABDUL VO: So we treat this anti-vax contagion two ways: we fight the perpetrators at the source, and we try to get people the information they need before they ever hear the anti-vaxxer propaganda. But when it comes to vaccines, the people who most of us trust to tell us what’s good for us and our children–our doctors–may need to rethink how they do it.
INTV – ETHAN: [28:17] Doctors honestly should be trained to be better storytellers.
[29:02] We didn’t Express the dangers of polio in medical terms. It was why do people would sit around at dinner tables and say well, why do we vaccinate against polio? And you know, the mom or dad in the house would say the reason we vaccinate is because little Timmy down the street didn’t and he’s dead now, right?
[29:16] Those are the stories that convince people to vaccinate.
INTV – ABDUL: [39:50]. What do you think we need to do with respect to public policy on this issue. Do you believe that religious or philosophical exemptions are justified?
INTV – ETHAN: [40:36/41.57] You’re talking about the government setting up a public environment in a school system where they’re allowing people to be put at risk for diseases they can prevent and that doesn’t make any sense.
[41:03] It makes no sense that we have the ability to put kids at risk and the government facilitates an environment.
INTV – ABDUL: [41:21] And yet that would mean that you and your siblings would have been barred from public school.
INTV – ETHAN: [41:26] Absolutely.
[41:46] and that’s the point. When you talk about states that take away these exemptions the inoculation rate goes up to almost 90% 95%. It works because for my mom she would not be able to fund and properly put the time and effort into private school or home school. So she’d only she’d be only she’d be left with one option which is to vaccinate her children and put them in public school.
[43:06] It shouldn’t be permissible for the government to put people in… dangerous circumstances. So the government is making this ignorance an encouranged and accepted idea.
INTV- ABDUL [48:09] Thank you for taking the time. I really appreciate it.
INTV – ETHAN: Yeah, absolutely. Thank you!
ABDUL VO: So Ethan’s given us a lot to think about.
First of all, this whole “Why the fuck don’t people vaccinate their kids?” approach? It’s not working. Like Ethan said, we have to differentiate between the perpetrators and the victims.
While the perpetrators may be driving this anti-vaxxer ideology for personal gain, their victims are usually just afraid. One of the things I learned in medical school and then again as a politician, is that yelling at people who are scared doesn’t make them less scared. Especially if you’re speaking on behalf of one of the institutions they don’t trust in the first place.
Second, we haven’t done a good job of communicating with language that people understand. People don’t change their minds by hearing statistics or the results of some empirical study. No, for most of human history, the most effective means of communication has been telling stories.
And then we really need to rethink our policy…
ARCHIVAL: New York blanket ban on exemptions, etc. [Clips 1.6]
ABDUL VO: Though there’s good science to back up why we should force everyone who medically can to vaccinate, forcing people to do things they don’t want to do doesn’t usually work out very well.
And here, I’ve got a new idea. What if, instead of calling for a blanket ban on exemptions, we created a quota system. If we know that collective immunity requires a certain proportion of people to be vaccinated, what if we offered a limited number of exemptions below that number to protect collective immunity and then offered them in a lottery system.
That does a few things First, it assures that we maintain the collective immunity in public institutions where diseases are most likely to spread, like schools.
Second, and more importantly, if the spread of this mindset is what we want to counteract, it disincentivizes people from spreading their ideology, because by doing that, they’ll just increase the number of people in their communities who will apply for the lottery, which decreases the likelihood that they will get an exemption.
But I also agree with Ethan, that maybe we just can’t give this contagion any more room to spread:
This week, we talked about what happens when people ignore clear scientific information in a matter of life or death. Next week, we explore the space where science hasn’t really given us answers.
[ARCHIVAL: New evidence suggests coffee is both good and bad headlines…] [Clips 1.7]
And the people who exploit it
[ARCHIVAL: Goopcast ridiculousness] [Clip 1.8]
America Dissected is a production of Crooked Media. Our producers are Austin Fisher, Cary Junior II, and Katie Long. Andrea B. Scott is our story editor. Our sound designer is Daniel Ramirez. Production support from Alison Falzetta (Fall-ZET-ta), Elisa (AY-lisa) Gutierrez, Kara (CARE-ah) Hart, Daniel Porcerelli (PORE-sir-el-ee), and Tara Terpstra. Fact-checking by Dr. Nicole Aiello (aye-YELL-low). The theme song is by Taka Yasuzawa (TAAK-ah Yaas-oo-ZAH-wah) and Alex Sugiura (SOO-ghee-er-ah). Our executive producers are Sarah Geismer (GUISE-mer) and Mukta Mohan (MO-haan). Special thanks to Jon Favreau, Jon Lovett, Tanya Somanader (SOW-men-ay-der) and Tommy Vietor. And I’m your host Dr Abdul El-Sayed. Thanks for listening.