With the increase in outbreaks of vaccine preventable diseases like measles and whooping cough in the U.S., many are asking how to stop the current outbreaks, and how to increase vaccination among children to avoid further outbreaks. Proffered answers to these questions include increasing patient understanding about the safety of vaccines and dispelling concerns that vaccine skeptics express through better clinical communication (Ross D. Silverman and Lindsay F. Wiley, “Shaming Vaccine Refusal,” The Journal of Law, Medicine, and Ethics 45, (2017): 573). Public health officials and physicians have also suggested several deontological (Paul J. Carson, Anthony T. Flood, “Catholic Social Teaching and the Duty to Vaccinate,” The American Journal of Bioethics 17 no. 4 (2017): 36–43) or utilitarian (James Colgrove, “Immunization and Ethics: Beneficence, Coercion, Public Health, and the State,” in The Oxford Handbook of Public Health Ethics, ed. by Anna C. Mastroianni, Jefferey P. Khan, and Nancy E. Kass, Oxford: Oxford University Press, 2019, 438–39) arguments to encourage or mandate vaccines, yet, their solutions are only focused on convincing “the other” that science is right and their previously held beliefs are wrong. This pitting science versus an objection, be it religious or some other concern, fails to build common ground with vaccine skeptics, and undercuts important arguments, acknowledgements, and conversations that both sides of the debate need to consider. With an eye to building common ground with vaccine skeptics, I suggest that a phenomenological re-narration of the vaccine debate through a prophetic framework offers a way to see where both sides of the debate have shared concerns, and this will help build a more productive conversation in the long run.
The Current State of the Debate
Currently the vaccine debate in the U.S. is polarized. People are either vaccine supporters or vaccine skeptics, and both sides lob serious accusations at the other. Vaccine supporters understand vaccine skeptics to value their own autonomy to make medical decisions above the needs of the community, putting in danger or at least great risk, people for whom vaccination is not possible. They are also characterized as religious fanatics who value misinformation over the objectivity of science, and thus, really do not understand what they are talking about. Vaccine skeptics see vaccine supporters as asking them to trust science when science has not always been accurate or right, like with the inclusion of thimerosal in vaccines (Arthur Allen, Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver, New York: W.W. Norton and Company, 2007: 375-383). They also see vaccine supporters as not being interested in their concerns about safety. While the link between autism and vaccines has been shown to be entirely false, some vaccine skeptics focus on issues of informed consent and understand vaccine supporters as not caring about how informed consent ought to manifest in the clinic.
Why a Re-narration is Needed
While I am fully in support of vaccines, the previous paragraph describes a debate that has become so passionately fueled, that both the vaccine skeptics and supporters have some merit in their accusations, but much is missed through the rhetorical shouting. In order to build common ground, we need to take this debate out of the realm of medicine, epidemics, and preventing terrible diseases to see where we can unite forces and work together to build a safe and healthy community. One way this can be accomplished, is recasting the vaccine supporters and skeptics as prophets. To do this, I will use Abraham Heschel’s The Prophets to list a couple characteristics of a prophet.
Turn to the Prophetic
First, the prophets of the Old Testament are not just predictors of the future, but their prophecies look past, present, and future (Abraham Joshua Heschel, The Prophets, New York: Harper Perennial, 1962, xxv). They are divine messengers (Ibid., xxii), and yet the content of the message is not the only important point, but Heschel writes, “The significance of Israel’s prophets lies not only in what they said but also in what they were” (Ibid., xxi). In the case of the vaccine debate, the god that the prophets serve is Phobos, fear. As diving messengers of fear, the vaccine prophets show that fear is the motivator of this conversation: for the vaccine supporter, there is a fear of epidemics and for the vaccine skeptic, whether justified or not, there is a fear of making a decision that could negatively impact the rest of a child’s life.
Heschel also describes prophets as wounded, “The prophets must have been shattered by some cataclysmic experience in order to be able to shatter others” (Ibid., 14). In informal discussions, I have heard doctors express with deep sorrow the fate of children in different countries who do not have access to vaccines against diseases like polio and measles and who end up terribly affected both physically and socially. The idea that people would willingly refuse such vaccines for their children is the utter definition of privilege. Yet, I suspect many skeptics would say that even one child who is adversely affected by a vaccine is one too many and too big a price to avoid a disease. They have both witnessed devastation, whether actual or perceived, and both wish to stop that devastation in society on whatever scale.
Additionally, the key to recognizing prophets and understanding their prophecies: prophets are less concerned with details and more concerned with the meaning of the details; that is that their descriptions may contain some inaccuracies, but the overall picture they paint is the main point and focus of their commentary (Ibid., 16). This is obvious in much of the vaccine debate: the vaccine supporters tend to ignore the fact that a very small percentage of humans have adverse reactions to vaccines (for more information on this, cf. Louis Conte and Tony Lyons, Vaccine Injuries: Documented Adverse Reactions to Vaccines 2014–2015, New York, Skyhorse Publishing; 2014). The vaccine skeptics tend to dismiss all scientific information in favor of observational and experiential data from a small group of people. The facts about the vaccine debate have long been lost, but because the facts are not central, does not mean that both sides of this debate do not have something important to say.
Questions for Further Consideration
By viewing the vaccine debate through the lens of prophethood, we can see that there are many similarities between the prophetic vaccine supporters and the prophetic vaccine skeptics. Both approach the problem from a different vantage point, and both have important things to say. One question we need to ask ourselves as a society is: do we want to serve the god of fear in this debate, or would another god be less of a task-master? Vaccine supporters fear epidemics and suffering and vaccine skeptics fear suffering and being taken advantage of. The god of fear rules with a heavy hand of tyranny. But I wonder if this is the only god that can be worshiped in this debate. Could a god of charity, or a god of cooperation, or a god of love prove to be a less demanding deity to serve?
There is also a commonality in sharing stories of devastation, both from the perspective of people who have experienced or witnessed those who have experienced devastating disease and those who think that vaccines have harmed their child. Regardless of the science of whether a vaccine hurt a child or not, there is certainly room for empathizing with patient narratives and a coming alongside those who suffer.
This is but a taste of how a phenomenological approach, which allows for observation qua observation, can help change aspects of the debate, or at least deescalate the passion and allow for productive conversations moving forward about how we, as a society, ought to approach the multiplicity of concerns around vaccines.