A few weeks ago I wrote this letter to the editor here in Sitka, after going to a pro-vaccination talk given by a local pediatrician. I'd like to share it with all of you. It's not pro-vaccination and it's not anti-vaccination. It's about what I think is one thing that needs to happen in order for the pro and anti people to be able to really talk to each other.
Last night I attended by first “Doc Talk,” by pediatrician Dr. David Vastola, about childhood vaccinations. Few topics are as socially divisive as vaccinations! I appreciated Dr. Vastola’s thorough preparedness, and I learned a lot. He explained well what he (and the American Medical Association, and World Health Organization) views as an essential part of keeping not just one’s own children, but the whole world, safe.
However, there is one area in which I wish to quibble with Dr. Vastola, and that is in his explanation about why it is that the largest demographic (in the U.S.) currently refusing to vaccinate their children are educated, upper-middle class people. My memory is that he attributed this reality to that fact that that demographic is the portion of America that reads the most, and there is a huge amount of anti-vaccine literature available. The implication seemed to be that, although they read, they are not discriminating readers, and aren’t able to parse fact from snake oil.
As an educated, upper-middle class, white woman of child-bearing age(I don’t have children), I’d like to offer an alternate explanation. “Educated” means that most people in the demographic under discussion have gone to college, and many have attended graduate school. In college, particularly in the arts, humanities, and social sciences, one encounters implicit and explicit critiques of authority and the kind of hierarchical power structures that American medicine has historically enjoyed being at the top of. Every discipline from history to sociology to journalism is rife with stories of authority figures using their power for harm, or simply not knowing what the heck they were talking about (and so inadvertently causing harm). All of those disciplines, and a whole host of others, devote years worth of classes to deconstructing and criticizing the kind of authoritative, top-down worldview in which “experts” disseminate commands to the passive masses. And yet, that authoritative worldview is still the dominant one in the medical community. (Though I do not accuse Dr. Vastola or any other specific doctor of advancing that worldview.)
I think what we have is a deeper problem than what Dr. Vastola seemed to imply last night—that people don’t vaccinate their children because they read things, but don’t read critically. No doubt non-critical engagement with all kinds of media is a gigantic problem in America, and educated upper-middle class folks aren’t immune from sloppy thinking. But in the specific case of educated, upper-middle class people refusing to vaccinate their children, I believe there is a worldview clash taking place, in which one group of people are demanding the masses submit to the authority of science, statistics, and a medical worldview, and another group of people are resisting being (as they think of it) hornswaggled by the authorities (and hasn’t history given us limitless reasons to distrust authorities of every kind?). The situation isn’t helped, of course, when anti-vaccinators try to talk to doctors and are met with either derision or a gentle condescension, which only confirms their suspicions that doctors are operating within an antiquated and wrong-headed worldview. (Obviously these are generalizations; no doubt many doctors defy the norm, and quite plausibly Dr. Vastola is among them).
My point is this: until the American Medical Association and its members take seriously legitimate critiques of the power it has long enjoyed and assumed—until we can have a conversation about that—the vaccination conversation (a crucial converastion!) isn’t going to find its feet.
Thanks to Dr. Vastola, and to everyone who makes the “Doc Talks” possible.