Trump picking anti-vaccine Robert F. Kennedy to serve as the secretary of Health and Human Services has shone a spotlight on the anti-vax movement. This movement has been growing, leading to a decrease in vaccinations. One impact of this has been an increase is measles cases in the United States.

Critics of the anti-vaccination movement point to such cases as proof the movement is misinformed and dangerous.  Critics of the anti-vaxxers often deride them and see them as stupid because there is no evidence that vaccines cause the harms anti-vaxxers claims they do. For example, it is often claimed that vaccines cause autism, but this is clearly untrue. Vaccinations have also been conclusively shown to prevent diseases and reduce the severity of illnesses and this is evident to anyone who has a basic knowledge of the history of disease.  

It is tempting for critics to dismiss anti-vaxxers as stupid people who are too dumb to understand basic science. This, however, is a mistake.  One reason is purely pragmatic: those who are pro-vaccination want the anti-vaccination people to change their minds and calling them stupid, mocking and insulting them will cause them to entrench and double down on their view. Another reason is that the anti-vaccination people are not, in general, stupid. Interestingly there are grounds for both skepticism and concern about health and science. To show this, I will present some points of concern.

One point of rational concern is that scientific research has been plagued with corruption, fraud and errors. For example, the percentage of scientific articles retracted for fraud is ten times what it was in 1975. Once lauded studies and theories, such as those driving the pushing of antioxidants and omega-3, were riddled with inaccuracies. So, it is not stupid to worry that scientific research might not be accurate. Ironically, the study that started the belief that vaccines cause autism is a paradigm of bad science. So, it is not stupid to consider that studies that show vaccines are safe might also have flaws. That said, the fact that some research is flawed does not prove that any specific research is flawed. After all, the fact that some people are guilty of crimes does not therefore prove that you are guilty of a crime.

Another matter of concern is the influence of corporate lobbyists on health issue. For example, the dietary guidelines and recommendations set forth by the United States Government should be set based on the best science. However, these recommendations are influenced by industry lobbyists, such as the dairy industry. Given the influence of corporate lobbyists, it is not stupid to worry the recommendations and guidelines given by the state might not be the best but instead are aimed to increase profits for certain industries.

A third point of concern is that dietary and health guidelines and recommendations undergo what seems to be relentless and unwarranted change. For example, the government has warned us of the dangers of cholesterol for decades, but this recommendation has changed. It would, of course, be one thing if the changes were the result of steady improvements in knowledge. However, the recommendations often seem to lack a proper foundation. John P.A. Ioannidis, a professor of medicine and statistics at Stanford, has noted “Almost every single nutrient imaginable has peer reviewed publications associating it with almost any outcome. In this literature of epidemic proportions, how many results are correct?” Given such criticism from experts in the field, it hardly seems stupid of people to have doubts and concerns.

There is also the fact that people do suffer adverse drug reactions that can lead to serious medical issues and even death. While the reported numbers vary (one FDA page puts the number of deaths at 100,000 per year) this is certainly a matter of concern.  Everyone who has seen drug ads is familiar with the warnings. For example, consider Januvia, a diabetes drug. As required by law, the ads mention all the side effects of the drug and these include serious consequences including death. Given that the FDA has approved drugs with dangerous side effects, it is hardly stupid to be concerned about the potential side effects from any medicine or vaccine.

Given the above points, it is not stupid to be concerned about vaccines or any medication. At this point, the reader might suspect that I will defend an anti-vaccine position, bust despite all the points I raised I am pro-vaccination. This might seem surprising given the points made above, but my pro-vax position is consistent with my concerns.

The above points show there are rational grounds for a critical and skeptical approach to matters of health, medicine and science. However, this skepticism needs to be rational. That is, it should not be a rejection of science but the adoption of a critical approach in which one considers the best available evidence, assesses experts by the proper standards (those of a good argument from authority), and so on. Also, it is important to note that the general skepticism does not justify accepting or rejecting a specific claim. For example, the fact that there have been flawed studies does not prove that a specific study about vaccines is flawed. As another example, the fact that lobbyists influence government does not prove that all vaccines are harmful drugs pushed on Americans by greedy corporations. As a final example, the fact that some medicines have serious and dangerous side effects does not prove that the measles vaccine is dangerous or causes autism. Just as one should be rationally skeptical about pro-vaccination claims one should also be rationally skeptical about anti-vaccination claims.

To use an analogy, it is rational to have a general skepticism about the honesty and goodness of people. After all, people do lie and there are bad people. However, this general skepticism does not automatically prove that you are dishonest or evil—that is a matter that must be addressed on the individual level.

To use another analogy, it is rational to have a general concern about engineering. After all, there have been many engineering disasters. However, this general concern does not warrant believing that a specific engineering project is defective or that engineering itself is defective. The specific project would need to be examined, and engineering is, in general, the most rational approach to building stuff.

So, the people who are anti-vaccine are not, in general, stupid. However, they are not rationally assessing the specific vaccines and the evidence for their safety and efficacy. It is rational to be concerned about medicine in general, just as it is rational to be concerned about the honesty of people in general. However, just as one should not infer that a friend is a liar because there are people who lie, one should not infer that a vaccine must be bad because there is bad science and bad medicine.

Convincing anti-vaccination people to accept vaccination is challenging. One reason is that the issue is politicized and is a battle of values and identity. This is partially since the anti-vaccine people have been mocked and attacked, thus leading them to entrench and double down. Another reason is that, as argued above, they do have well-founded concerns about the trustworthiness of government, the accuracy of scientific studies, and the goodness of corporations. A third reason is that people tend to give more weight to the negative and tend to weigh potential loss more than potential gain. As such, people give more weight to negative reasons against vaccines and fear the alleged dangers of vaccines more than they value their benefits.

Given the importance of vaccinations, it is critical that the anti-vaccination movement be addressed rather than attacked. Calling people stupid, mocking them and attacking them are not effective ways of convincing people that vaccines are generally safe and effective. A more rational and more effective approach is to address their legitimate concerns and consider their fears. After all, the goal should be the health of people and not scoring points in a political battle