Vaccination, Deniers and Religion

Some people say that vaccination is responsible for the near eradication of dangerous diseases, and that those who do not vaccinate themselves or their children are a threat to society (and should be forcibly vaccinated). Others argue that vaccination is not a sure thing, is not exclusively responsible for the eradication of disease (if at all), poses long term problems for the species, and may have acute, immediate risks. Some people also object to some or all vaccinations on a variety of moral or religious grounds.

And some people just hate needles.

One of the immediate difficulties encountered in discussions of this and similar matters is the average person's inability to remain focused, be precise, and reason deeply (or speak charitably and respectfully with others). Most claims simultaneously (and erroneously) cover multiple issues, and involve little more than an assertion coupled with an ad hominem smear against anyone who holds a different position. For example, the following post was brought to my attention. It was written by a popular Catholic author, Mark Shea:

"We are now in the situation of Catholics who consider themselves the gold standard for orthodoxy trusting neither the Magisterium nor reason and listening only to tribal echo chambers and themselves as they cobble together personal philosophy from crap on the web. It will not end well and is about as far from the Catholic intellectual tradition as you can get. It's a form of Protestantism that has not yet been given a formal name."

I had no idea what he was ranting about, but was intrigued because a lot of people were affirming him -- about 150 at last count, including one of my former theology professors. Not wanting to be left out of the party, I asked for clarification:

"Mark, I'm not sure to whom you are referring when you speak of Catholics who portray themselves as the 'gold standard' of orthodoxy yet trust neither the Magisterium nor reason. Even if such people do exist, why does it matter to you? There are always crazies among us, and there is no sense trying to reason with or expect much from them. I'm also not clear on what you mean by 'Catholic intellectual tradition' (as if there is only a single, monolithic-like one). Perhaps you could clarify these comments."

Mark later replied:

"Seth: It matters in this case because Catholics who think they are smarter than the Church and every medical authority on earth are helping to encourage behaviors that place my grand-daughters' lives at risk with their foolish vaccine denialism."

Ah, so this is about vaccination. Okay. That narrows it a bit, but it is still quite ambiguous. About whom is he writing? About which vaccine(s)? About which vaccination issue? And what does the Catholic Church have to do with this? I could only guess.

But notice how the topic is framed. Mark opens by attacking the character of those who differ with his position (whatever that is). They are frauds. They think they are smart, but they are stupid. "Every medical authority on earth" agrees with Mark, and these "deniers" are dangerous to society. Doing a little more research, I discovered that this is unfortunately how Mark typically interacts with those who don't share his opinions. As disappointing as that is, we must remember that such behavior is by no means unique to Mark or to Catholics. One need only watch a political talk show for about five minutes (or scan almost any Internet discussion) to find similar attitudes expressed. This is something about which we all must be cautious. 

Further, as we frequently do, Mark is engaging in the very behavior which he decries in others. He is presenting his own position (whatever that actually is) as the moral one, the orthodox one, the reasonable one, and pretends that everyone else somehow has dirty (germy) hands. Yet nowhere in this series of assertions does one find the presentation of any evidence, of any facts. Further, there is a great deal of ambiguity. The ranting is not about any person in particular, any vaccine in particular, or any manifestation thereof. In this way, he is simultaneously writing about everything and nothing. His position is, for all practical purposes, untouchable... almost.

Trying to discern the rationale -- the reasoning -- behind a
belief is a little like trying to separate and trace cords in
a tangled mess. Once separated, each cord can then
be examined and tested to see if it "works."

We frequently don't know what reasoning led to or is implied by our beliefs, words, emotional responses and choices. Indeed, more often than not, little or no reasoning was involved; we were just reacting or "running on autopilot," acting habitually. It is among the fundamental practices of philosophy (and especially philosophical counseling) to discern or tease out what reasoning actually led to a particular state, or, if no reasoning was actually employed, the reasoning that was implied -- the reasoning that would have been employed to arrive at the same destination. We can then examine that reasoning for strengths, weaknesses, fallacies, etc. Still uncertain about what had Mark so exercised, I pointed out that Mark's assertions thus far imply a certain set of beliefs:

1. That the Catholic Church -- the "Magisterium," specifically -- has made some kind of definitive proclamation on vaccination.
2. That the Church is an authority and expert in matters of vaccination.
3. That the Church's proclamation in this issue is binding upon the faithful.
4. That all issues of vaccination (as believed by Mark) are uniformly held by medical professionals, are self-evident truths, etc.
5. That anyone who doubts or questions this or might point to counter-evidence is a "foolish denier" and Catholic fraud.

There are a couple issues here that are unique to Catholicism, which I will briefly explain for the non-Catholic reader. First, the "Magisterium" refers to the teaching office or authority of the Church. This is not a particular person or physical office (though it does refer to some, exceedingly rare pronouncements by the Pope), but refers to the action of teaching the Catholic faith as entrusted, collectively, to the bishops, of which there are presently about 5100 worldwide. Specifically, the Church asserts that it has expertise and authority in matters of morals and faith. That is, if the Church says that it is wrong to murder someone, then Catholics are obligated to believe (and act) that it is wrong to murder. If the Church teaches that God exists eternally, then Catholics are obligated to believe, as a matter of faith, that God exists eternally. However, the Church is not an expert and has no binding authority in other matters. If the Church (or some individual bishop) says that the sun revolves around the earth, that plumbing should be performed only with iron pipes, that the ideal tax rate is 39%, or that the proper way to treat rabies is with leeches and soy sauce, then Catholics are (obviously) free to smile sweetly, say "thank you for expressing your valued opinion," and then go on and believe and do what we know to be correct.

Some Catholics collapse this boundary and attempt to set the stage as if theirs is the only moral, Catholic one by asserting that all human actions are moral actions... when it suits their purposes. In this they are (usually unwittingly) paraphrasing Thomas Aquinas, and rightly observing that all human acts have, in a sense, a moral dimension, or at least moral implications. In making this leap, though, such persons are attempting to impose what they believe to be a Church teaching on others by distorting the Church's teachings beyond recognition. It doesn't really work.

In any event, this is roughly the reasoning and attitude under-girding Mark's statements. The problem is that none of these things are actually true: The Magisterium has not made a definitive statement regarding vaccinations, and even if it did, it has no expertise or authority in that science. Further, his claim that "every medical authority on earth" agrees with him is demonstrably false (though he would simply dismiss anyone who does not agree as a non-authoritative quack). And since his assertions have no grounding, they can be rightly dismissed with little more effort than, "well, that is merely your opinion."

But I didn't do that. Rather, I requested that he please be more specific, and provide some evidence to justify his claims so that I could better understand the issue. There is always a chance that I'm wrong, that I've missed some important piece of the puzzle that someone else can see. I also expressed concern that he seemed to be manifesting the very behavior and attitudes that he criticized in others. At that point he dismissed me by writing that I don't know what I'm talking about.

I hear that a lot. Perhaps he was correct.

Truth Should Be Proposed, Never Imposed

One of the many ways that people have attempted
to impose their beliefs on others.

This is important to recognize in any contentious matter. If you ask for evidence or the rationale behind a position, and the person dismisses or attacks you, you can know that you've probably just touched upon a matter that the person may believe sincerely and passionately, but probably not for rational reasons. We don't have a great deal of solid justification for many of the things we believe, and for the most part that is okay. It doesn't mean that we are wrong. But when someone questions or challenges us on one of these beliefs, and our response is instinctively aggressive or defensive, that suggests something is amiss.

Further, it is one thing to say "I believe X." It is quite another to say, "You should believe X, and if you don't, you are a moron." Once we go from "I believe" to "you must believe or you are stupid," then it is imperative that we have some very, very solid evidence to back up what we are saying, and be willing to provide it.

Philosophy, knowledge, debate and the like are ideally not about assertions, opinions and personal smears. They are about the ability to inquire into and demonstrate the truth of a matter in a way that others can understand. In the best of cases, a debate is not an attempt to win, but a mutual effort to find the truth. This is incredibly freeing! When you can make an issue into an honest, shared search for truth rather than an attempt to defend or impose your own personal beliefs, wonderful things can happen! To that end, if it is at all possible, when in a disagreement, do whatever you can to approach the matter with the attitude of wanting to detect the truth, even if it turns out that it is inconvenient or differs from what you currently believe.

As I have mentioned before, most immanent differences ultimately reduce down to more fundamental differences, usually having to do with epistemology (how we can say that we know something) along with other basic premises. With a little more research it became clear(er) that Mark's agitation had to do with people who object to certain vaccinations on moral grounds. The issue is that the genesis of some current vaccines can be traced back to aborted fetuses, and some people feel that it is immoral to use such vaccines -- that to do so is, in a way, a kind of participation in and support of the abortive action. This is actually a reasonable position, whether from the perspective of (secular) philosophical ethics, Catholic tradition or even the Bible (Romans 14, et. al.). However, Mark believes otherwise, and he and his supporters assert that people who disagree are dangerous "jackasses," to quote one of his devotes.

To justify their position, they could (and do) reference a 2005 letter and study generated via the Pontifical Academy for Life that (1) strongly affirms the immorality of products resulting from actions like abortion and an obligation to avoid participation therein, but (2) argues that some people could use the vaccines if there were no alternatives and the immanent use was necessary to save lives. (There is a second document from 2008, Dignitatis Personae, that provides additional general guidance.) The letter and related report identify several vaccines developed from aborted fetuses, including vaccines for measles, mumps, rubella, chicken pox, polio, smallpox, rabies and hepatitis A. According to some sources, there are not presently alternative vaccines in the USA for rubella, chicken pox or hepatitis A. None of these are generally serious or fatal, except to the unborn or otherwise infirm. Rubella tends to come in waves, but hasn't been seen in the USA in awhile. However, its last wave appears to have been a factor in nearly 30,000 stillborn deaths, and another 20,000 deformities (it is estimated that 50-90% of unborn children are seriously affected if the pregnant mother contracts rubella). Chicken pox kills a few thousand people worldwide annually (representing a mortality rate of under 0.01%). Hepatitis A is prevalent in less sanitary countries, and kills an estimated 100,000 people annually, out of ~1.4 million infections worldwide via liver failure and related complications (representing a substantial mortality rate of about 7%).

The position taken by the Pontifical Academy for Life is a highly nuanced position. 

1. It is not, as Mark asserted, something from the Magisterium in the sense of an articulation from the body of bishops or that would otherwise be binding upon Catholics.
2. It is not the only or exclusive reasonable position... though it is quite reasonable. 
3. With respect to "Catholic Intellectual Tradition," the reality is that there isn't a single, historical approach to any or all questions. However, the Thomistic/Aristotelian virtue-ethics model is predominant over the last millennium, and the way that the report is articulated manifests such an approach. At first I suspected that the underlying reasoning was an actual or implied appeal to the moral dynamic of secondary or unintended (but foreseeable) consequences -- this is often appealed to in the Catholic tradition, though it has its own serious problems -- but closer examinations reveals that it is simply an appeal to practical expediency; that is, in the absence of other means of protecting life, this will have to do until something better comes along. To make this comprehensible, consider this analogy: Suppose a ship was made by slave traders many years ago for the very purpose of transporting captive slaves. They actually built it with their bones and skulls molded right into parts of the ship (to push the point). The slavery was eventually ended, and even the original makers and owners of the ship have since died. No one wanted anything to do with the ship, and there was talk of burning it. However, before that could be done, the volcanic island on which you live began to crumble into the ocean, and the only remaining ship that can save you and your family is that slave ship. Assuming there is no other realistic chance of survival, do you use it and save your life even though it has a tainted origin and disgusts you? Or do you stand on principle and risk almost-certain death for yourself or family? The stand of the report's authors is, basically, that it is reasonable to use the ship to save your life if you have no alternative.
4. The letter does not obligate the reader to go and receive vaccines derived from aborted fetuses -- it merely asserts that, in some cases, a person who does so is not guilty of formally (intentionally and knowingly) engaging in evil. The difficult part is the statement (clarified in a footnote of the letter) that parents who voluntarily refuse to vaccinate themselves or their children are morally culpable for any harm that results from that decision. For example, a child might contract rubella and, before showing symptoms, transmit it to a pregnant mother. This places some people in a difficult place: Receive a vaccine derived from aborted fetuses, or (possibly) risk viral infection for one's self, one's children, or others. The error in thinking here is the assumption that a vaccinated person could not also transmit the disease. 

This is a problem for which there is not an easy, clean answer. The primary error is to pretend that there is one, and that mine is it, and that everyone else is an idiot in need of forced re-education. This is a frequent error made by those who dabble in philosophy or theology -- the presumption that either field provides clear concise answers to difficult questions, or that whatever answer I've arrived at is the only reasonable one.

And that is how it goes, especially when we begin tampering with stuff. This isn't to say that we shouldn't tamper -- tampering can be fun and lead to amazing things -- but merely to acknowledge that our ability to tamper can lead to tough situations, and frequently outstrips our ability to comprehend and work out the moral implications of our actions.

Try to Be Likable

Don't be this guy. No one cares
what he has to say.

Before moving on, there is a relevant dynamic worth noting. Even if you are right, few people will listen to you if they don't like you. For example, if you and I are having a discussion about a topic on which we differ, and in the process of the discussion I insult you, am rude, or otherwise come off offensively, chances are that my position is going to be rejected on that basis alone... even if I was right... even if it could save your life.

In all honesty, this is something with which I've struggled for, well, forever. No one likes to hear that he is wrong, and if that is accompanied by implications that he is stupid, evil or some other simultaneous innuendo, it increases the chances of the message being rejected along with the messenger.

We turn now to briefly address some of the questions raised in the first paragraph.

1. Is vaccination responsible for the eradication of diseases?

Many studies of disease-related mortality rates show ongoing and dramatic declines long before a related vaccine was developed and implemented. But the mortality rate doesn't measure how many people are infected by or carry a disease -- it measures how many people die from it. Because the decline in mortality rate came before the vaccine even existed, it clearly had nothing to due with the vaccine. The decline could be the result of many influences; general population health, increased cleanliness and sanitation, better water supply, improved medical services, etc.

The morbidity or infection rate attempts to measure the number of people showing symptoms associated with actual infection. If a group of people are exposed to a disease, and half of them become infected and show symptoms, the disease would be said to have a 50% morbidity or infection rate. Though vaccination does not appear to have much of an influence on the death (mortality) rate of those who are infected, for some diseases it does appear to reduce the rate of infection. So, if the mortality rate from a disease drops from 10% to 0.1%, this means that, of those infected, the death rate dropped from 100 per 1000 to 1 per 1000. That is a great thing, but probably had little to do with vaccination. However, if the infection rate drops from 50% to 10% shortly after the introduction of vaccination (and nothing else significant changed), then it is reasonable to presume that change was due to vaccination. Though this is not a direct change to mortality rates, the change in infection rate is naturally going to iterate through to cause a change in the gross mortality to the population.

Imagine a moderately-sized city of 100,000 people. Suppose that, over a year, roughly all 100,000 of them are exposed to a particular disease. If 50% of them become infected by a disease, and there is a 0.1% mortality rate, then it can be expected that roughly 50 people are going to die from the disease or related complications (100,000 x 50% x 0.1%). After vaccination, the infection rate decreases from 50% to 10%, and the actual deaths due to the disease could be reduced to as few as 10 persons (100,000 x 10% x 0.1%). Though the vaccination doesn't affect the death rate due to infection, it does decrease the total number of deaths by reducing the number of infected persons.

It also appears that, once the prevalence of infection becomes low enough, usually due to sanitation and other efforts, widespread vaccination can be effective at finishing the job and helping keep certain strains of particular diseases from re-establishing a foothold in the population. However, several factors make it nearly impossible to completely eliminate a disease:

• Even if no one is presently infected, the germs are still present in the environment, and are transmitted by both the vaccinated and non-vaccinated.
• Vaccinated people can often still become infected at varying rates. (For example, in a recent mumps outbreak, research indicated that as many as 84% of the 6700 infected people had been vaccinated, indicating almost zero effectiveness against the disease.)
• Other strains of the disease may appear to which vaccination provides little or no resistance.
• And, obviously, non-vaccinated people can become infected.

This suggests that vaccination alone is not enough to eliminate a disease that has become established in a population, but that several factors, including vaccination, can work together to dramatically decrease its presence.

2. Are those who do not vaccinate a danger to others?

Anyone who carries a dangerous virus or bacteria is a hazard to others, irrespective of whether he is vaccinated, showing symptoms, otherwise immune, etc.

Proponents of blanket, compulsory vaccination argue that non-vaccinated people are a danger to society. This argument appears to correspond to our experience, which is that being around sick people -- especially if there is any close contact -- often results in transmission of the virus or bacteria to the formerly-healthy person. It is then up to the healthy person's immune system to deal with the invader.

The problem, of course, is that if vaccination was actually as robust as people seem to believe, then non-vaccinated people would only be a danger to themselves, which leads to the second form of this argument: Some assert that voluntary-non-vaccinators are a danger to those who cannot be vaccinated due to age, being in the womb, allergy or other condition.

Let us grant that, in general and for the average person, vaccination appears to reduce the chances of developing symptoms related to specific viruses and bacteria with varying degrees of effectiveness and duration. However, vaccination is not a guarantee of immunity, nor does it prevent transmission. Many vaccines fail to provide much protection for a variety of reasons. Second, even if someone is immune, whether due to vaccine or nature, he can still carry and transmit a disease to others by a variety of mechanisms, often with few or no symptoms (granted, symptomatic people generally seem to be more contagious than asymptomatic). Indeed, in the recent measles outbreak in California and elsewhere, some research indicated that the source was actually vaccinated, and that the infection spread through many vaccinated persons (as well as non-vaccinated).

So the real issue here is that, in general, both vaccinated and non-vaccinated persons can carry and transmit diseases, though symptomatic persons are probably more heavily infected and are more likely to spread disease to others (including caretakers) via contact or proximity. However, the twist here is that it is the very issue of being symptomatic that makes one more likely to take precautions and segregate himself from others, thereby protecting others from infection (granted, it may be spread anyway, especially if it is transmissible prior to becoming symptomatic, or if the symptoms aren't recognized immediately). And, somewhat anti-intuitively, it is the asymptomatic -- even vaccinated or otherwise immune -- person, who might be a carrier and transmitting the disease to others, including those who cannot be vaccinated for a variety of reasons.

Overall, vaccination appears to be a contributor to the reduction and near-elimination of some diseases, along with a variety of efforts. It also reduces the chances of the vaccinated person contracting a particular disease and becoming symptomatic. However, even a vaccinated person can carry and spread germs. Consequently, the arguments that vaccination alone is responsible for the eradication of disease, or that vaccination prevents the spread of disease do not appear to be true. Nonetheless, this does seem to indicate that vaccination is, on the whole, a beneficial practice.

Let us look now at the arguments against vaccination, which are generally of two kinds:

1. The benefits of vaccination do not outweigh the risks.
2. Some kinds of vaccination are immoral due to their genesis.

We'll also briefly introduce another, controversial argument on the matter.

3. Do the dangers of vaccination outweigh the benefits?

The actual dangers (and severity) posed by vaccines are also, unfortunately, unclear. The CDC and similar organizations argue that vaccines are among the safest products available and refer to a variety of reports to confirm this, but one could argue that this is a little like the frequent police statements that they investigated their actions and found them to be completely justified. Somehow, that almost always seems to be the case when organizations investigate themselves -- they generally turn up as pure as the "wind driven snow." And we don't need to go very far before stumbling upon a list of government-approved foods, chemicals and drugs that were later learned to be terrible for you.

For the sake of discussion, let us just grant that, with respect to society as a whole in the near-term, the dangers of vaccinations seem to be lesser than the dangers of non-vaccination. For some individuals in certain circumstances, however, it is true that vaccination is more dangerous. That is, it is true that some people have adverse, debilitating, even deadly reactions to vaccination. The causes of such reactions are many, and often unclear. Perhaps there was something wrong with the batch of vaccine. Perhaps the person had a reaction to the active agent or transport chemicals. Perhaps one or both of these interacted with something else (e.g., another vaccine, medicine or drug) in the person's system. Many doctors raise concerns about the necessity, effectiveness and safety of vaccination, especially for babies, children and those who are unwell or taking other medications. These concerns seem reasonable.

With regard to the benefits, the efficacy and necessity of some vaccines is rightly questioned. There is little point in being inoculated against a disease to which you are not likely to be exposed, or which you can easily survive, especially if that inoculation carries with it the possibility of various unwanted side-effects. A similar argument could be raised against vaccines that, for the most part, constitute protection from the consequences of voluntary, avoidable behaviors. For example, there was recently a push to have all young females injected with Gardasil, which is believed to prevent the establishment of a virus responsible for genital warts and many cancers. That seems, at first glance, to be an obviously-right choice to make. No one wants his daughter to die of cancer -- cervical or any other kind. However, it turns out, upon a closer read, that the treatment is specifically (and only) for sexually transmitted diseases. Again, no one wants his children to become infected by any disease, sexually transmitted or not, but when we begin to inoculate children against sexually transmitted diseases, we are entering a new ethical realm, and one for which we don't really have any pre-existing framework from which to reason. The difference between this and handing them condoms is murky at best, and complicated by the fact that adverse reactions to Gardasil have been reported. In this we begin moving in the direction of lifestyle- and choice-related vaccination, as opposed to vaccination against diseases that one is likely to contract innocently. This is not to say or imply that such vaccinations are wrong, but merely that the topic is far from clear, clean and easily resolved.

Apart from voluntary, behavior-related vaccinations, the argument here is really rooted in statistical risk-avoidance. According to the Centers for Disease Control, adverse reactions to vaccination range from one per thousand injections to one per millions. As such it is arguable and demonstrable that the risks of not being vaccinated in the presence of a deadly illness outweigh the risks associated with vaccination. Consider, for example, chicken pox vaccination. Chicken pox is highly contagious, but the chances of dying due to chicken pox appear to run about 0.001% for children, or one in 100,000 infections. If the chances of a deadly or serious reaction to vaccination approached this, that would be a good argument for avoiding vaccination. On the other hand, consider rabies. The death rate for rabies is ~100% if one is not vaccinated prior to the appearance of symptoms. In such a case, the chances of serious adverse reaction to vaccination would have to also approach 100% in order to justify rational rejection of vaccination on the basis of possible bad reaction. This is clearly not the case for most vaccinations.

We intuitively make these kinds of comparisons and calculations frequently and imprecisely... especially once emotions come into play.

There is a subjective difference, however, in that if someone catches a disease and dies from that disease, we generally do not perceive in that something immoral, something wrong. It is certainly a tragedy, but not one that we can (generally) attribute to an individual choice or act. On the other hand, if someone gets a shot and then has an adverse reaction, perhaps leading to permanent disability or death, then we feel a kind of responsibility, as it was the result of a positive action. These feelings of responsibility and remorse are understandable, even if not completely rational (in the sense of being statistically justifiable), and probably play a part in one's mental calculations.

4. Are some vaccinations immoral?

This was covered to some extent in the introductory paragraphs. To the degree that the way in which a vaccine is developed (or used) violates someone's moral compass, it seems that he should have the freedom to reject the vaccine, simultaneously accepting the responsibility for his choice. However, this needs to be weighed against any obligation he has to protect other people's lives, especially those of his children. For example, let us imagine that your child is bitten by a dog that turns out to have rabies, and the only treatment -- the only way to save your child's life -- is to receive a vaccine that is derived from the pituitary glands harvested from 3 year old children from a small tribe in Africa. The question is, is the parent who rejects such a treatment for his child doing something evil or immoral?

The answer in that and similar cases seems fairly clear, but things become cloudy as we move from hyperbolic, extreme examples to reality, and to circumstances that merely involve animal testing or similar.

5. Is vaccination harmful to the species in the long-term?

It is a little ironic, but the position that appeals to the long term, natural robustness and health of the species as a whole -- that appeals to the good of society in general -- it seems would need to be against artificial vaccination. While vaccination tends to reduce the chance of infection for a particular unit, and therefore might extend individual lives, it does little or nothing to aid the long-term natural immunity of "the herd." The evolutionary process has a natural tendency of making it so that the stronger, the healthier, the more fit survive and pass on their genes to others. Vaccination circumvents this, allowing those who are not immune and less healthy to pass on their genes just as well as those who are healthy.

I'm not suggesting or implying that we should therefore go without vaccines or just let people die when they get sick. Far from it! I merely bring it up because those who argue for vaccination frequently reference the health of society, the herd, the species, etc. They argue from the good of the whole to impose an obligation upon the individual. However, their argument is very shortsighted, and actually, from a scientific point of view, undermines the very value they claim to be championing. (As a counter-argument to this, it could be asserted that various viruses and such change so rapidly that such long-term natural immunity is actually impossible. But it would be interesting to see some studies of both perspectives here.)

6. Is correlation the same as causation?

Hardcore-proponents of vaccination generally disregard mortality data and instead point to morbidity as evidence of the effectiveness of vaccines. For example, consider the apparent-decrease in infection rates around the introduction of vaccines in this chart from an article at Vaccine Impact:

The darker line indicates a substantial drop in infection rates after the introduction of the vaccine. Though susceptible to the correct criticism that correlation is not causation -- it is possible that something else or some combination of factors caused the decline -- repeated examples of the same dynamic at different times, with different populations, different geographies and different vaccines/diseases would make for a very persuasive case.

However, if we are going conflate correlation with causation when it comes to a reduction in incidence of one dynamic, we don't get a free pass to ignore simultaneous, similar changes in other dynamics. For example, according to a variety of sources (including the CDC), the incidence of autism has increased since about 1970 to now from about 1 in 2000-5000 children to about 1 in 70-100. And if the entire spectrum of various neurological disorders are included, that figure jumps to as many as 1 in 6.

The causes for this are unclear. There may be a connection to vaccination... or there might not. It could be aliens... or proximity to computer hardware... or unleaded gasoline. What is clear is that the same reasoning that people say proves that vaccination eliminated disease -- the correlation between introduction, vaccination rate and incidence -- also indicates that vaccination caused the increase in autism rates (as well as other disorders having a similar incidence pattern).

The curve is a little too pretty and neat. It is obviously not to scale.

Now, I'm not saying that vaccination is responsible for this. I simply don't know. Causation is a much more difficult issue in real life than people tend to presume. Specifically, we tend to assume that, just because event Y came after X, that X caused Y, when that might not be the case. There is even a logical fallacy named just for this common thinking error, post hoc ergo propter hoc ("after this therefore because of this").

If someone is going to use incidence and vaccination rates as "proof" of effectiveness, it is inconsistent -- and disingenuous -- to then just ignore those statistics when they don't play in his favor.

7. Are arguments by analogy valid?

Something that has been prevalent in the whole vaccination debate is an attempt to condescendingly "prove" one's position by arguing via analogy. This has ranged from comparing not vaccinating to letting zombies into your home, to taking the brakes off of your car, etc. This isn't unique to this topic, but because vaccination is complex and the issues are hard to comprehend directly, people often appeal to analogies to make their points.

Let me say this very clearly:

ANALOGIES PROVE ABSOLUTELY NOTHING

Because most people have almost no training whatsoever in logic, they get away with this nonsense, but it really is just that: nonsense. For example, it does not follow from the fact that it might be foolish to take the brakes off of your car that you are a dangerous fool if you don't receive every vaccine in existence. One could just as easily argue that not putting breaks on your car is like not eating peanut butter. There is no logical, rational connection whatsoever between a car's brake system, and injecting chemicals and germs into your body in an attempt to avoid disease. It is a horrible analogy, about as relevant as the infamous Chewbacca Defense. Even if it was a good, tighter one, it still wouldn't prove anything.

Analogies can be useful when it comes to helping people understand something new. Via analogy, the new thing can be related to something the person already knows, creating a kind of bridge. For example, basic electronics is often explained to beginners via water plumbing analogy wherein water pressure is like voltage, water flow is like amperage, a line blockage is resistance, etc. But beyond instructive purposes, analogies need to be used with great caution. If one is being employed in an argument, then there is very likely something wrong with the argument, itself.

Concluding Remarks

Some vaccinations, along with general sanitation, food quality and medical services, do appear to contribute positively to overall public health, longevity and quality of life. Vaccination also appears to reduce the overall chance of contracting certain strains of diseases. However, vaccinated or not, it is still possible to spread germs to others, or even contract the disease, though clearly those who have a serious infection and are symptomatic are likely to be a greater source of germs than others. To the degree that the chance of adverse reaction approach the chance of serious complication due to infection -- and this may vary from person to person and depend on many factors -- it is rational to avoid vaccination. It also isn't clear that the array of vaccinations given to newborns is necessary, or that the benefits outweigh the risks. There are also understandable moral arguments against certain vaccinations, insofar as the genesis of those vaccines seems immoral or the exclusive purpose of the vaccination is to enable immoral behaviors. In the very long term, it is possible that vaccination might be an impediment to the robustness of the species, but that is a particularly-controversial argument, and seems to disregard the value of currently-living persons.

This is a complex problem. The rational, moral choice in common human circumstances isn't always as obvious as people make it out to be. We can (and frequently do) get ourselves into situations where there isn't a single, clear moral option, but a variety of choices, each with its own complications. In the end, one thing to be wary of in matters such as these is really anyone who claims that his position is the only, self-evident, sensible one.

So where do I stand personally in all of this? I generally avoid medications unless an illness is so bad that I can't sleep. I don't think I've had any vaccinations since I was about 8 -- at least I don't remember any. If there was a deadly disease ripping through the population, if I got a nasty puncture wound, or was bitten by an animal, I'd go get vaccinated. Otherwise, for diseases where there is little chance of infection, or if the consequences are generally mild, I avoid vaccination. I would not attempt to impose my opinions or choices on anyone else, especially via the threat of force (via the state).

Of course, I'll probably be dead next week from a unique combination of yellow fever, malaria and emotional constipation, at which point Mark Shea can triumphantly declare, "I told you so!" No doubt the epitaph will read, "And this is why you should get your shots."