The Reverend Cotton Mather was an exceptionally influential minister among New England Puritans. I recently discussed his role in spreading the fame of the enigmatic Dighton Rock, and his influence on the witch-hunters of Salem is widely known. Few, however, are aware of his role in popularizing early smallpox immunization efforts in America. In 1706, Mather was gifted a slave named Onesimus. Upon receipt, he looked this gift man in the mouth, as it were, searching his body for the telltale scars of a former smallpox infection and asking Onesimus if he had already had the disease. Onesimus showed Mather a small scar where he had been inoculated against the disease in Libya, the country of his birth. Mather afterward questioned numerous slaves in the area and found that the practice, which had come to be called variolation after the Latin name of smallpox, variola, was quite common and appeared very successful. Indeed, there was a long history to the practice of variolation against smallpox, a rudimentary form of immunization that involved purposely introducing biological material from an infected person—preferably one with a mild case of the disease—into the system of an uninfected person. The method goes as far back as 1000 CE in China, where they ground up infected scabs and blew them up people’s noses like snuff. By Mather’s day, the practice typically consisted of extracting pus from a smallpox sore and placing it under an uninfected person’s skin through a small incision on the arm. A variolated patient did develop a case of smallpox, but a milder and less deadly form, afterward developing immunity against the brutal “Speckled Monster” that had ravaged mankind for thousands of years and had spread the world over through trade routes, exploratory contact, and war. The more Mather learned about it, the more he supported the practice in Boston, and during a terrible smallpox outbreak in the 1720s, he convinced a local physician in his congregation to inoculate almost 300 Bostonians. While about 14% of those who contracted smallpox during this outbreak died from it, only six people, or about 2%, of those variolated died. But nevertheless, some did die, and this resulted in one of the first major backlashes against immunization efforts. Some declared that it was bad medicine, as it purposely caused a wound and an infection, while others saw it as a “devilish invention,” suggesting that some contracted smallpox as a punishment from God, and protecting them from God’s wrath was wrong. The debate was so fiery that one anti-variolater lobbed an improvised bomb into Cotton Mather’s house through a window. On it was a note that read, “Mather, you dog, Damn you, I’ll inoculate you with this.” Ironically, the only reason Mather was even able to read the note was that the poorly-made bomb failed to detonate. This furor over smallpox variolation would last for some time, but it would eventually subside, and the practice of variolation would become widespread, even among the nation’s Founding Fathers, like Thomas Jefferson, who traveled from Virginia to Pennsylvania to be variolated; John Adams, whose whose wife and children were variolated; and George Washington, who made variolation a requirement for all American soldiers. But of course, this was by no means the end of resistance to immunization science. And today, as we try desperately to get the Covid-19 pandemic under control in order to preserve lives and salvage our economies, it’s more important than ever to understand the history of anti-immunization rhetoric in order to refute its current iterations and encourage widespread vaccination.

As some of you may recall, I touched on historical anti-vaccination claims before, in an episode about Alfred Russel Wallace, whose contribution to anti-vaccinationist rhetoric will be discussed here again, but there is far more to the topic, and I’ve long wanted to talk about it. Now, with the push to vaccinate here in America and the corresponding push against vaccination by the practice’s critics, it seems like the best time to talk about this. When considering vaccination coverage generally, the fact that it remains very high in America, with about 95% of children receiving the doses of vaccines recommended, indicates that resistance to vaccination is not as widespread as one may think. Anti-vaxxers would like us to think that they are a massive movement, and with the amount of news coverage they get, one might assume they are. However, recent efforts by Facebook to curb anti-vaccination misinformation have uncovered that two thirds of all the anti-vax content on social media appears to come from only a dozen online sources, called the “Disinformation Dozen.” This does not mean that such misinformation should be allowed to spread unchecked, though, and when it comes to the Covid vaccine, this science denial becomes even more dangerous. Many adults, even those who are susceptible to anti-vaccine pseudoscience and conspiracy theory, still get their children vaccinated because of the vaccination requirements of schools, and beyond this, they only espouse anti-vaccination claims in an abstract way, the same way they’ll share conjecture that 9/11 was an inside job, or that JFK’s murder was actually the result of a shadowy government conspiracy. “You know what I heard…” they’ll tell friends over beers, but the idea never affects their behavior beyond their yearly decision of whether or not to get a flu shot, because they had all their vaccinations as a child. But the Covid vaccine is new, admittedly rushed, and must be administered to adults, who are far more susceptible to severe cases of Covid-19 than children, in order for us to reach herd immunity. So now these adults who fancy themselves “free-thinkers” and already have the seeds of anti-vax misinformation in their minds are making the decision not to be vaccinated. Even if they are not swayed by the absurd fringe claims that Bill Gates is putting microchips in us through the vaccine, or that, as Congress’s resident lunatic Marjorie Taylor Greene has asserted, Covid-19 vaccination records are the Mark of the Beast prophesied in Revelation, they remain hesitant due to distrust of the pharmaceutical industry or the government, or because of an imperfect understanding of the science behind this vaccine and vaccination in general. Before I was vaccinated, a family member told me that I didn’t need to get the shot because people were reaching herd immunity against Covid-19, which of course is false and fails to understand the basic fact that herd immunity to infectious diseases like Covid-19 is only achieved through widespread vaccination. So to start this history of anti-vaccinationism, we need to lay a foundation of basic understanding by discussing immunization science.

Rev. Cotton Mather’s house, scene of a failed bombing by someone who opposed Mather’s support of smallpox inoculation. Public Domain.

Most of the credit for the development of vaccination science goes to Edward Jenner, an English doctor who accepted the efficacy of inoculation, having been variolated himself as a child. In the 1790s, Jenner noticed that, in a given population suffering a smallpox outbreak, milkmaids seemed to rarely catch the disease. His hypothesis was that these milkmaids had developed immunity because of their exposure to cows that were infected with a similar disease, cowpox. More specifically, when these milkmaids came into physical contact with the cowpox pustules on udders, they were exposed to a pox that created only mild symptoms in humans and conferred immunity against the far more virulent and deadly smallpox. To understand how deadly and how virulent full-blown smallpox was, consider its symptoms. After a couple days of fever and body aches, a rash appeared inside the mouth and then spread over the entire body, becoming pustules, which might break, creating bloody sores. The most severe form had a fatality rate of up to 33%, with victims dying because of blood toxicity, infection, and blood loss. Those who survived typically suffered terrible scarring, sometimes over their entire body, and often blindness as well. In 18th century Europe, the death toll reached about 400,000 a year. After a year of Covid-19 that saw nearly 1 million deaths across Europe (and 1.3 million deaths across the Americas), this may seem tame, but with differences in population density, the comparison isn’t so simple. Suffice to say that the Speckled Monster was a violent, global scourge. Therefore, Jenner’s discovery was a medical miracle. He took pus from a cowpox pustule on the hand of a milkmaid and applied it to the arm of his gardener’s 9-year-old son using the variolation method, and months later, when he exposed the boy to smallpox several times, the boy never contracted the disease. Thus, the vaccine was born, named after the Latin word for cow, vaccus. Jenner wrote a book on the topic in 1798, and within five years, it had been translated into 5 languages and vaccination programs were underway in developed nations and colonies all over the world. There actually remains some mystery over whether early vaccinations were all derived from cowpox, as some early samples have been tested and shown to have been taken from a similar animal disease, horsepox. Regardless, the principle had been established, and through vaccination, the disease smallpox has been virtually eradicated. Because of this and how the science has been used to combat the spread of other diseases, the development of this immunization technique is considered the foremost medical breakthrough in the history of mankind.

At the time that Jenner developed the vaccine, the medical community’s understanding of how and why it worked was imperfect. After all, this was before the widespread acceptance of germ theory. Today, we know that vaccines work by activating the body’s immune system and relying on its memory. Amazingly, when it is exposed to the bacteria and viruses that cause disease, it is afterward able to remember certain features of them, like surface proteins, so that it will be better able to fight them off again in the future. This is called adaptive immunity. Vaccines have come a long way since the dangerous days of cutting open an arm and inserting infected pus into the wound, but the idea remains the same—the human body was better able to resist cowpox, and remembering features of that virus made it easier for the body to defeat the smallpox virus. Since then, vaccines became less dangerous, using weakened viruses or bacteria, or even rendering them incapable or replicating by killing them using formaldehyde or other chemicals. Some just introduced parts of a pathogen for the immune system to remember, or just toxins that a pathogen produces. Regardless, the central mechanism is the same. Think of antibody response as a bloodhound ready to track down and neutralize an intruder; the vaccine is just giving our bodies’ bloodhounds the scent to help them find and attack the invader. Now some of the Covid vaccines, the Pfizer and Moderna shots, use a brand-new method of exposing us to the viral proteins we want our immune system to remember: mRNA or messenger RNA. By injecting designer mRNA, our own body’s cells are directed to build the virus surface proteins that make Covid-19 so virulent. Therefore, no part of the virus is ever introduced into a vaccinated person’s system. Rather, cells are programmed to teach our immune systems how to battle the virus, should it ever enter our bodies. While this technology is new for vaccines against viruses, which may cause some vaccine-hesitance, it’s actually not as new as some believe. Scientists have been studying mRNA’s use in the creation of cells that mimic stem cells and in the development of a vaccine for cancer for more than 30 years, with hundreds of scientific papers published and dozens of longstanding clinical trials. So to suggest that this technology, which essentially programs the body’s immune response in the same way as traditional vaccines except through a different mechanism, was only developed in a rush during the last year, is inaccurate.

Dr. Jenner performing his first vaccination. Public Domain.

As the example of backlash against variolation efforts in colonial America shows, anti-vaccination sentiment is also not a new development and has been around since the dawn of immunization science. Many years after the development of Jenner’s smallpox vaccine, a variety of laws in 19th century England made vaccination compulsory. The Vaccination Act of 1840 outlawed the outmoded and far more dangerous technique of variolation and provided free vaccination to the poor, but by 1853, with vaccination rates not improving, a new act was passed making vaccination of infants required by law, with parents liable to be fined or imprisoned if they did not comply. This compulsory vaccination program was expanded by the Vaccination Act of 1867, which required all children under 14 to be vaccinated and began levying fines on doctors that failed to report families that resisted vaccination. In 1871, punitive measures against the poor who failed to comply included the confiscation of property and placement in a workhouse. It was in response to these draconian laws, which were actually pretty typical of laws governing the poor in the Victorian Age, that robust anti-vaccination activism emerged. As one might expect, a central complaint among these first organized anti-vaccinationists was the power of the state over personal liberty and its persecution of those who refused or were hesitant to be vaccinated. There were also, though, critics who complained that vaccination science was unproven, that it caused other diseases such as syphilis, or that disease actually emanated from decaying organic matter—the miasma theory of disease—and thus injecting oneself with what was essentially poison could not actually prevent disease. Rather, these “sanitarians” or “anti-contagionists” asserted that keeping city streets clean was the only way to prevent disease. Alternatively, there was again, as in Mather’s day, religious opposition on the grounds that immunization interfered in God’s plans, but with a new spin. 19th century critics like John Gibbs claimed that death by disease was foreordained. Therefore, if vaccination reduced death by smallpox, there would just be more death by consumption, whooping-cough, or measles, for divine providence could not be thwarted.

In 1867, John Gibbs’s cousin founded the Anti-Compulsory Vaccination League, and throughout the 1870s, the cause became popular among the working class and the poor in provincial organizations. It was among these small northern town associations that the most extreme justifications for resistance were prominent, and it was among them that it became a movement of civil disobedience, with organized refusal to comply with the law resulting in some leaders of the movement being imprisoned for their beliefs. Meanwhile, among middle-class intellectuals in London, the London Society for the Abolition of Compulsory Vaccination was organized. Among these was Lord Alfred Russel Wallace, the co-discoverer with Darwin of the scientific principle of Natural Selection, who like other vaccine critics took a more holistic view of health and likewise distrusted the growth of state power and medical authoritarianism. He also took a sanitarian view by attributing reductions in smallpox infection rates to general improvements in sanitation. Wallace further argued, much as some have about today’s Covid vaccines, that more study and experiment was necessary to prove the efficacy of the smallpox vaccine. At the time, Wallace was working with imperfect statistical evidence, and of course, the systematic tests he proposed have since been completed, and then some. Therefore, it’s hard to characterize Wallace, whose heroic refutation of flat-earthers I have previously discussed, as anti-scientific, even despite his obsession with seances and spiritualism. This demonstrates, though, that 19th century anti-vaccination rhetoric was not solely the domain of anti-intellectual denialists. Eventually, in 1896, all of these organizations combined into one National Anti-Vaccination League concentrated on parliamentary change. In 1898, they achieved victory when a new law was passed allowing abstention from vaccination on the grounds of “conscientious objection” (the first time the phrase was used before its later use in the context of the refusal of military service). However, by this time, vaccination had so reduced rates of smallpox infection that compulsion was no longer a necessity, making this victory more of a pacifying concession.

Wood engraving depicting fears over a compulsory vaccination act. By E.L. Sambourne, courtesy Wellcome Images (CC BY 4.0)

This would not be the end of anti-vaccination activism against compulsory smallpox vaccination, however. The formation of anti-vaccination leagues had spread to New England in the mid-1880s, and the compulsory vaccination of children being made a pre-requisite of enrollment in schools precipitated a surge of anti-vaccination rhetoric through the Progressive Era of the 20th century. Much of the resistance originated at first from farming families, who complained that the transient fevers that often resulted from vaccination kept their kids out of the fields and prevented them from bringing in the crop before the beginning of the school year. Some religious opposition was present here as well, though from a somewhat unorthodox source. I am referring to the Swedenborgian Church, which believes in the unusual mystical prophecies of Emanuel Swedenborg, who claimed to have had transportive visions that allowed him to talk with angels and demons. Swedenborg claimed the Last Judgment began in the mid-18th century, and that the Second Coming of Christ had actually happened, through the revelation of his own teachings. In 1906, the Swedenborgian Church in Bryn Athyn, Pennsylvania, or the General Church of New Jerusalem, resisted vaccination against smallpox during an outbreak because of their devotion to homeopathic medicine, and from among the members of this church emerged John Pitcairn, anti-vaccination giant and founder of the Anti-Vaccination League of America. However, the majority of the opposition to compulsory vaccination in early 20th century America came from parents who believed their children had been injured by a vaccine. In 1914, a New York state Republican committee delegate named James Loyster lost his son to infantile paralysis. As it happened three weeks after a vaccination, he came to believe that it had been caused by the vaccination—the old post hoc ergo propter hoc logical fallacy. This prompted him to undertake a crusade against vaccination. He surveyed many residents of upstate New York, and he believed that he had discovered some fifty cases of injury and death caused by vaccination, which he argued far outweighed the mere three deaths by smallpox during the same period, apparently never considering that the smallpox death rate had become so small precisely because of vaccination. Among the bereaved parents who lobbied against compulsory vaccination was one illustrator whose daughter, some time after vaccination, had become paralyzed and died due to a heart defect. The limp-limbed ragdoll this illustrator designed, Raggedy Ann, which he said reminded him of his late daughter, would many years later become something of a symbol for anti-vaccinationists. James Loyster took the anecdotes he had gathered from people like the Raggedy Ann doll creator, and he made pamphlets, which he distributed to New York legislators. Eventually, he succeeded in getting the state’s compulsory vaccination law altered. The Jones-Tallett amendment rescinded the requirement in rural areas and towns with populations of less than fifty thousand, except in cases of an outbreak, when compulsory vaccination could be enforced once again. However, Loyster rejected the law, seeing it as a defeat, since in cities of more than fifty thousand, the amendment actually expanded vaccination requirements.

As with anti-vaccinationism in 19th-century England, it’s clear that it would be unfair to characterize the philosophy of compulsory vaccination objectors as uniform. Beyond objections to the temporary loss of child labor or because of perceived dangers, there was objection to the laboratory experimentation on animals that took place to develop vaccines. These vaccine critics were early animal rights activists called anti-vivisectionists, who protested, as the name implies, surgical experimentation on live animals. Though they may seem like odd bedfellows with animal rights activists today, there was also a strain of libertarian ideology present among anti-vaccinationists. The two sons of John Pitcairn, the Swedenborgian founder of the Anti-Vaccination League of America, inherited the organization and likewise were leaders in the movement, and they also funded the Sentinels of the Republic, a conservative political organization that opposed federal overreach and socialism in any form, rejecting any social reforms of the day, including New Deal legislation, limitations on child labor, and even the establishment of the Department of Education. Among many anti-vaxxers of the Progressive Era, a government that compelled citizens to do anything, even for reasons of public health, looked a lot like Bolshevism. Then there were those who saw it as a matter of personal liberty, believing their control over the kind of medical care they received to be as sacrosanct as the freedom of religion. Among these were religious groups like the Swedenborgians, whose doctrines included a philosophy on health. Christian Scientists emerged as a similar group. They believed that illness was not actually physical and could best be overcome by appealing for recovery through prayer. The group was widely criticized around the turn of the century after some cases of children dying because they had only been “treated” by practitioners of Christian Science rather than by actual doctors. Charges were made that followers of Christian Science were unlawfully presenting themselves as medical practitioners, and this was another common thread among anti-vaccinationists. There were a variety of alternative medicine movements that positioned themselves in opposition to vaccination. Naturopathy was one, with its emphasis on natural therapeutics. Physical Culture was a movement emphasizing natural foods, exercise, and fresh air that also engaged in germ theory denialism, contending that disease resulted only from unclean living and poor fitness. Then there was chiropracty… that’s right, chiropractors. Now don’t get me wrong. I have benefitted from spinal adjustments myself, or at least I believe I have, but chiropracty started as a form of absolute quackery. True believer chiropractors claimed that people only became ill because of spinal misalignment, which disrupted the body’s flow of energy. One can almost hear a low voice out of the past moaning: woo… woooo….

Anti-compulsory vaccination rally, 1919. Image credit: Wikimedia Commons User Cavernia (CC BY 2.0)

In the 1930s, anti-vaccinationism in America declined. First, a series of Supreme Court decisions found that compulsory vaccination laws were perfectly constitutional, and then the figures who had spearheaded major anti-vaccinationist organizations passed away. By the end of the 1970s, smallpox had been eradicated because of vaccination, and numerous other diseases, including measles, diphtheria, pertussis, and polio are now kept under control, also through immunization. Modern anti-vaccinationism didn’t really show up until 1998, when a British physician named Andrew Wakefield published a paper in The Lancet in their Early Report feature titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children.” The paper speculated that the vaccine for the measles, mumps, and rubella, or MMR, might cause gastrointestinal inflammation, which in turn could be the cause of autism, a development disorder diagnosis that had become and continues to be more and more common in children. When it came out that Wakefield had falsified data and acted unethically in subjecting children to unnecessary spinal taps, his paper was retracted, he was disgraced, and his license to practice medicine revoked. Nevertheless, it has become a common claim among anti-vaccinationists today that vaccines cause autism. Wakefield has since made a pseudoscience career for himself by further fanning the flames of this disinformation, claiming that children who receive too many vaccines too quickly or receive them while unwell or on other medication are susceptible to being turned autistic. Other claims have to do with the presence of thimerosal in vaccines, used as a preservative, because it contained mercury, which is a known neurotoxin. Everyone seems to know that mercury was used by milliners in hat making, and that it drove them insane, thus the term “mad as a hatter.” However, the thimerosal in vaccines used ethyl mercury, which does not cross the blood-brain barrier like its counterpart, methyl mercury does, so this concern was groundless, and regardless, the chemical was removed from vaccines by the CDC in 2001 simply to pacify anti-vaxxers. While it’s true that we don’t really know why autism incidence has risen so dramatically since the 1970s, the fact that we can now more clearly recognize and more accurately screen for signs of being on the autism spectrum might account for the much of the increase in diagnoses. The fact is that no vaccine-autism connection has ever been found despite numerous scientific studies being conducted specifically to determine whether one exists. Studies that found zero association between the MMR vaccine and autism have been published in the scholarly journal Pediatrics, the similarly titled Journal of Pedatrics, The Lancet, the Journal of Child Psychology and Psychiatry, and the New England Journal of Medicine, to name a few. But anti-vaxxers don’t let a little thing like empirical evidence get in the way of their convictions.

Again, though, as in the past, modern anti-vaccinationists do not all approach the subject with the same philosophy and motivation. Objections predicated on religious doctrine remain, though with some variations. As with those who long ago objected to interfering with Providence, some anti-vaxxers, like Suzanne Humphries of the International Medical Council on Vaccination, will say that the pharmaceutical industry has set itself up to replace God, striking fear into humanity that they will be struck down by pestilence if they do not accept this peculiar communion in a syringe. Then there is the streak of environmentalism among anti-vaxxers, among hippies who object to the animal products in them or to what they deem to be toxic chemical ingredients, even though any chemical component that might be harmful in larger amounts exists in vaccines only in such a negligible quantity that the body can easily eliminate it. Environmentalist objection to vaccines sometimes blends with religious objection, arguing that the body’s natural defenses are better equipped to fight disease without technological aid because that is how God designed it in His infinite wisdom. The view that the fight against vaccination is a fight for personal liberty remains, but it has blended in an interesting way with feminism. Specifically, Second Wave Feminism introduced the idea that medical paternalism was a key element of the patriarchy, and that women must fight to reclaim control of their healthcare from the male-dominated medical industry. This view that women know their bodies best translated into anti-vaccination rhetoric in the form of mothers insisting that their maternal instincts were far more trustworthy than professional medical advice. This notion of the superiority of personal instincts over expert opinion would not be reserved only for women or mothers, though. Since the 1970s, while second-wave feminism was encouraging women to wrest away the reins of their healthcare from the patriarchy, the notion of respect for patient autonomy was spreading as a core principle of medical ethics. This was in response to some terrible ethical violations, some of which were indeed perpetrated by vaccine researchers who tested their vaccines on children with developmental disabilities. With the advent of the Internet, patient autonomy took on new meaning, for suddenly patients could easily self-diagnose, and doctors, who depended on positive online reviews and satisfaction scores to run a successful practice and maintain Medicare reimbursement, were under pressure to give patients what they wanted. Add to this the spread of misinformation online, and you have a recipe for quackery and anti-intellectualism. All of these undercurrents can be observed in the remarks of minor celebrity and prominent anti-vaccinationist Jenny McCarthy during her television appearance on Oprah. “The University of Google is where I got my degree,” she explained in defense of her claims that her son Evan became autistic because of a vaccine, adding, “my science is named Evan, and he’s at home. That’s my science.” When pushed to clarify how she could be so certain, she credited her own “mommy instinct” for letting her “know what’s going on in his body.”

Father of modern anti-vaccinationism Andrew Wakefield, doubling down. Image credit: Wikimedia Commons user Bladość (CC BY 4.0)

But clearly the most common thread in all anti-vaccination rhetoric is the belief that vaccines cause harm or injury, especially to children. The fact is, though the risk of harm from vaccines may be minimal today, there have historically been cases of serious damage done by vaccines. As mentioned, the early practice of variolation was almost barbarous by comparison with vaccination, involving crude purposeful infection that often still resulted in death. Then after Jenner’s breakthrough using material from people infected with cowpox, it turned out that the donors of infected material sometimes were also infected with other diseases that were then passed right along to the person being vaccinated. There were cases in which numerous children caught syphilis and died because of this cross contamination through vaccination. Even in the late 19th and early 20th centuries, when vaccination had become more sterile, episodes still occurred with bacteria-contaminated needles or vaccination solutions that were contaminated with other diseases. In the 1950s, when Jonas Salk’s polio vaccine went to market through numerous pharmaceutical companies, one incident saw batches shipped with live instead of dead viruses, resulting in a manmade polio outbreak that saw 200 people paralyzed and ten killed, many of them children. But these were contained events, which were discovered and corrected. Much anti-vaccination rhetoric, as with most science denialism, relies on baseless conspiracy theory, claiming that the government and the pharmaceutical industry collude to cover up the harms of vaccines in order to make money. However, the simple fact that harms have been identified, admitted, and addressed disproves this. The fact that vaccine manufacturers are shielded from liability by legislation certainly contributes to this conspiracy theory. For example, in America, when Republican President Ronald Reagan signed a law creating the National Vaccine Injury Compensation Program, he set up a mechanism for reviewing claims of vaccine harm and compensating plaintiffs that demonstrate some probability that an injury was suffered due to vaccination. This program encourages manufacturers to continue making vaccines by removing the threat of lawsuits. Some might argue that this means manufacturers no longer need to worry about safety, but this is not accurate, as there is tremendous government oversight of vaccine safety. The CDC and FDA have their Vaccine Adverse Event Reporting System, to which anyone can contribute reports, and the CDC has their own separate program as well, the Vaccine Safety Datalink, which collects safety data directly from health care providers. As for the big government conspiracy theorists’ claims that all of these government agencies are in on it, the fact is that vaccination requirements are decided by local and state governments, not some shadowy federal monolith. While it’s true that vaccination recommendations are passed from these federal agencies, these recommendations are made by technical advisory groups that hold meetings that are open to the public. As usual, conspiracy theories like these break down under simple, clear logic.

The victory of immunization science over diseases has always been relative. While variolation against smallpox carried a 1-2% chance of death, this is vastly preferable to the 10-33% chance of death from smallpox. The idea has always been that the benefits justify the risks. The risks today are minimal, but they are still present. For example, the MMR vaccine comes with some small risk of febrile seizure, but then again, these convulsions also occur naturally in a small percentage of children, are typically short and mostly harmless, and vaccines can in some cases prevent febrile seizures by protecting against diseases that cause them. To be considered medically vital, we only need to determine that the potential benefits of vaccination outweigh the risk of side effects, and that can easily be demonstrated by the elimination of smallpox and polio by vaccination, as well as the initial elimination of measles before flagging vaccination rates allowed for its recent resurgence. This resurgence of measles also demonstrates that this decision of whether benefits outweigh risks is not a matter of individual preference. Vaccination against infectious disease is a matter of public health that requires collective action. This is the case for compulsory vaccination. Many today don’t understand the concept of herd immunity. It was touted last year as a kind of laissez-faire solution to the Covid-19 pandemic, as if it would be over with more quickly if we all ran out and purposely infected ourselves like one big chicken pox party. The fact is that herd immunity is only achieved through mass vaccination. The more people are immune to a disease, the less it will spread, which confers safety even on those who aren’t immune, but the rates of immunity required to achieve herd immunity vary depending on how contagious the disease might be. For the flu, a vaccination rate of 50-75% of the population confers herd immunity, but for measles, 83-94% immunity is needed, and for whooping-cough, 92-94% immunity must be achieved. Numbers like that don’t tend to occur without mass vaccination. We may not yet know what percentage of the populace that must be vaccinated to achieve herd immunity against Covid-19, but considering how contagious it is, we should assume that we will need something like 94% of the populace to be immunized. So if you are considering not getting vaccinated, or if you know someone who is hesitant, urge them, convince them, explain to them that we need to take action. If they are leery of the mRNA technology in the Pfizer and Moderna vaccines, encourage them to get the Johnson & Johnson vaccine, which instead uses a disabled adenovirus that contains some genetic material from the novel coronavirus in order to instruct the immune system on how to combat it. If they are disappointed that the Johnson & Johnson vaccine only has a 66% efficacy, let them know that this is likely just an aberration based on the fact that the clinical trials were held during the pandemic’s surge, and remind them that many flu vaccines also have a 60% efficacy but remain effective. We have a chance to take some control over this virus and to seize some form of normalcy that may pave the way for an economic recovery, but we all have to trust science and do our part. We’ve done it before, and we can do it again.

Until next time … remember… there’s denialism and then there’s post-denialism. True denialism disguises itself as logical and even scholarly, and because of that is very insidious. If it is not countered, it evolves to become post-denialism, the obtuse, purposeful opposition to reason that requires no evidence, just the desire to undermine. It’s the difference between a pseudo-academic denialist manifesto and a tweet that just says Covid-19 is a hoax. We must address the first to in order to prevent the second.

Anti-Vaccinationism, a Historical Hindrance to Herd Immunity

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