Barry Gilheany tackles the fake news in the realm of vaccination discourse. 

As vaccination programmes are being steadily rolled out and taken with various degrees of effectiveness across the UK, Europe, and the US (but regrettably much less so in Africa and other parts of the developing world), it is incumbent upon medical practitioners and public health policy experts and administrators to counteract the conspiracy myths about Covid vaccines which are widely disseminated online by disinformation sources such as the Plandemic video. 

But it is also incumbent to address the vaccine hesitancy felt by individuals and communities who have had lived experiences of the unethical behaviour of pharmaceutical giants and of coercive intervention by statutory medical authorities in their lives. Strategies to do so should therefore seek to maximise informed consent amongst the largest critical mass of the public to ensure the greatest possible "herd immunity" in the population. Understanding the history of anti-vaccine sentiment and empowering the public with the fact checking resources to rebut anti-vaccine false claims are thus essential components of the toolkit needed to overcome the spread and prevalence of vaccine misinformation.

Vaccine Hesitancy: The Spectrum

Vaccine "hesitancy" covers a spectrum from those with very narrow and specific doubts - or sometimes just questions - to the extreme and immutable anti-vaxxer and understanding that is vital to cognition about how hesitancy forms people's behaviour. Some optimists believe that much hesitancy will just dissipate. Speaking before the onset of the current vaccination programmes, in August 2020, Paul Offit, the head of the Vaccine Education Centre at the Children's Hospital of Philadelphia, counselled against taking surveys then showing worryingly low levels of willingness to get vaccinated too seriously, as no vaccine then existed, and in a data vacuum, scepticism was to be expected. And indeed, recent survey evidence has showed that the proportion of French people willing to get vaccinated jumped from 39% in December to 51% in January - a pattern repeated in other countries (Spinney, 2021: p.2).

However, others detect the development of a different trend. Bernice Hausman, cultural theorist, and the author of Anti/Vax, asserts that "The pandemic has increased empathy for those who are hesitant." This is partly, she believes, because the pandemic has illuminated racial, classed, and other structural inequalities in healthcare and their historical roots. A particularly painful legacy for African Americans was the notorious Tuskegee syphilis study running from 1932 to 1972 which unethically tracked the course of syphilis in African American sharecroppers without ever offering them effective treatments. She observes "a huge shift" in public perceptions of the vaccine-hesitant from "victims of misinformation, to seeing them as mistrustful for valid social and historical reasons." (Spinney: p.2)
 
History of Anti-Vaccine Sentiment

Those who promote anti-vaccination have throughout the history of vaccines consistently used a standard set of strategies (Larsson,2020: p.2). They dispute the effectiveness of the vaccines being administered. They claim that vaccines cause diseases from the comprehensively demolished claim at the turn of the 21st century that the MMR vaccine causes autism to the claims of the anti-vaxxers of the past that vaccination was responsible for a full spectrum of diseases, from smallpox to syphilis, typhoid, cholera and "blood poisoning" (These claims were not always baseless, but their risks were constantly exaggerated. They claim that the disease being vaccinated against cause little harm or are best treated "naturally" through alternative medicine, better nutrition, and sanitary improvements etc. (Cleaner water and sanitation and better food undoubtedly help but anti-vaxxers simply refuse to recognise the medicinal and epidemiological benefits of vaccines). They depict public health measures as assaults on personal liberties and abuses of government power. Lastly, they cite authorities to legitimise their anti-vaccination arguments with the most totemic example being the discredited former physician Andrew Wakefield the author of the notorious study linking MMR to autism. (Larsson: pp.1-5).

For at least a century after Edward Jenner's discovery of the first vaccine in 1796 against smallpox, vaccination carried much greater risks than today although the protection it afforded still far outweighed any possible harms. Since vaccination would not always have been carried out in the sanitary conditions which we are accustomed to today, then it sometimes caused secondary infections with lingering and unpleasant side-effects resulting in loss of income for workers forced to take time off work. These were legitimate concerns throughout the 19th century since the smallpox vaccine was the only one most people were offered, and they were revived when health authorities tried to increase vaccine coverage (Spinney: p.3)

What also surfaced in epidemics were what Larsson terms "white knights"; figures who used popular concerns to power their own agenda and portray themselves as heroes. One self-styled knight in white armour was Dr. Alexander Ross who rose to prominence as the author of a popular pamphlet published during the Montreal smallpox epidemic of 1885. Just like Andrew Wakefield, Dr Ross in his "heroic" narrative, styled himself as "the only doctor, who had dared to doubt the fetish" of vaccination. Despite this, it was revealed that he had recently been vaccinated during the epidemic; a fact which major newspapers of the time gleefully reported on. (Larsson: p.3).

Ross decried the "senseless panic" caused by health officials and medics over the epidemic, and that the city had "very few cases” One section of his pamphlet made the following four claims:

"1 - Vaccination has been weighed in the balance and found wanting.

2. - Vaccination does not prevent Small-pox in any cases.

3 - Vaccination does cause loathsome and often fatal diseases.

Many children are killed outright, and thousands have their health ruined by it.

4. Vaccination does not lessen the severity or the fatality of Smallpox. The proportion of Vaccinated persons who have Small-pox has steadily increased as Vaccination has been extended - and the number of deaths in proportion to the cases is the same as ever. In the last epidemic of Smallpox in London, 92 per cent were persons have been Vaccinated or Re-vaccinated." (p.3)

In fact, official numbers for the epidemic would eventually rise to 9,600 reported cases with nearly 3,234 deaths – nearly two per cent of Montreal’s population at the time. An additional 10,000 cases were recorded in the province of Quebec, but historians believe the number is much higher.[*]

As with today’s Covid sceptics, Ross’s pamphlet fulminated about the role of the press and medical profession in stirring up fears over infection as part of a “mad” campaign for financial enrichment. Then as now, epidemics created opportunities or both employment and research around medicine. Yet this employment was decried as an unethical exploitation of the poor, worth “one million pounds sterling” to the profession, rather than an effort to combat the suffering and death of thousands (p.4)

In addition, public health measures were framed as an assault on individual rights and an unwarranted extension of government power. “Talk no longer of Russian Tyranny”, Ross proclaimed, for there was “none so formidable” as the city health officials. (p.4).

The anti-vaccination movement has had a long tradition of promoting the words of “experts” who back their narrative. In the 19th century, vaccination debates often brought in small circles of medical men who condemned vaccination as a “filthy” and “evil” practice, (p.5)

The founders of the first anti-vaccine movement, the Anti-Compulsory Vaccination League (ACVL) formed in Britain1866, the brothers Richard Butler and George Gibbs urged citizens to protest vaccination as an act of patriotism. “Stay the hand of the vaccinator, Richard Butler Gibbs wrote … “Let Britannia put her foot on this iniquitous destroying, death-producing interference and crush it out.” (Offit, 2012). The ACVL’s publication the Vaccination Vampire conjured up apocalyptic images when it declared that vaccination” offer[ed] up annually an indefinite number of human sacrifices to propitiate an imaginary Devil,” and anti-vaccine activists compared it to “some savage African tribe that every week sacrificed to an idol two children to guard against smallpox. (Offit: p.109) ".

Expressing concern about the bovine contents of Jenner’s vaccine a speaker at a meeting of the British Medical Association in 1890, produced a child whom he claimed was “covered with horn-like excrescences, which had resulted from vaccination. (Offit: p.114). Likewise, other anti-vaccine activists claimed that its contents the “poison of adders, the blood, entrails and excretions of bats, toads and suckling whelps” and that it transformed a healthy child into “a scrofulous, idiotic ape, a hideous foul-skinned cripple: a diseased burlesque on mankind”. Using gothic images, propagandists distributed pictures of vaccinated children turning into minotaurs, hydra-headed monsters, dragons, the incubus, and Frankenstein.” (Offit: p.110)

Although not couched in the flagrantly racist, imperialist, and disablist language of Victoriana, modern images summoned by modern anti-vaxxers can be no less offensive. On 14th October 1999, Jane Orient, a prominent anti-vaccine spokesperson, compared likening vaccines to scientific experiments in Nazi Germany on ABC’s Nightline with Ted Koppel. In refusing to back down from what Koppel called “a horrible analogy”, Orient proceeded to claim that if parents wanted to reduce consent for their children to be vaccinated (against Hepatitis B), “they may be threatened with having their children taken away from them.” On being told by another guest on the shop, Dr. Sam Katz, a professor of paediatrics and infectious diseases, that no such event had ever been recorded nor had he ever heard of such, Ms Orient simply said that she had heard of cases but would not elaborate. (Koppel: pp.113-14). The art of supposition really is a stock-in-trade of anti-vaxxers.

Although claims such as MMR causes autism have been cast in more scientific and sophisticated language than those of the 19th century which said that the smallpox vaccine turns children into cows, they are both equally nonsensical. During the Omnibus Autism Proceeding in the USA which ran throughout the 2000s, fringe doctors and scientists claimed that thimerosal weakened the immune system, allowing measles vaccine virus to damage the intestine. Because the intestine was now leaky, brain-damaging proteins could enter the bloodstream and cause autism. These hypotheses look quite feasible; as feasible as a claim that since smallpox is made from the fluid of cow blisters that invariably contain cow DNA; injection of cow DNA into children could possibly cause the DNA to incorporate itself into the nucleus of a small group of genetically susceptible children. Cow DNA, which contains the blueprint for making cows, could according to such theoretical explanation take over the cellular machinery, causing small, but noticeable, cow-like features. As Offit points out, given the number of cow DNA consumed every day in hamburgers and the fact that small fragments enter the body every day, were this Frankensteinian scenario possible, then we would all be cows by now (Offit: p.113)

Anti-vaxxers and Free Speech

The imperative to restrict free speech to counteract the influence of anti-vaccination falsehoods is argued powerfully by the Guardian/Observer columnists Nick Cohen and George Monbiot. Imploring us to “always ask the hard questions”, Cohen opines that “the hardest one to ask about Covid and free speech is why does the law tolerate anti-vaccine propaganda?”[1] For John Stuart Mill’s harm principle holding that free societies must tolerate unpopular and offensive speech provided it does not incite the physical harm of others does not apply in this situation because “anti-vaxxers are inciting physical harm.”[2] George Monbiot points to the collision between the right to speak freely and the right to life when malicious disinformation about medicine and vaccines are allowed to spread unchecked. Because of the incompatibility of both rights in the Covid world; he asserts that “when governments fail to ban outright lies that endanger people’s lives, I believe they make the wrong choice”[3]

Monbiot deconstructs the “marketplace of ideas” vista so beloved of free-speech zealots by pointing out that in a marketplace it is forbidden to make false claims about a product. So therefore, outlandish, and dangerous falsehoods such as ‘coronavirus doesn’t exist’, ‘it’s not the virus that makes people ill but 5G’, or ‘vaccines are used to inject us with microchips’ should be subject to a time-limited ban of up to six months using the template of the Cancer Act which bans people from advertising cures or treatments for cancer. He proposes an expert committee along the lines of the Scientific Advisory Group for Emergencies, identifying claims that present a genuine danger to life and proposing their temporary prohibition to parliament.[4]

Monbiot removes the populist, ‘anti-elite’, anti-establishment’ veil behind anti-vaccine sentiment to reveal the plutocratic and corporate vested interests that they serve. For example, the launch of the Great Barrington Declaration that champions herd immunity through mass infection with the help of discredited claims, was hosted by the American Institute for Economic Research which receives money from the Charles Koch Foundation, and takes a wide range of anti-environmental positions.[5]

For Cohen, the corporate villains of the piece are Big Tech. He cites an investigation by the Centre for Countering Digital Hate (CCDH) which has found that leading Covid deniers had boosted their social media presence by millions during the pandemic. The CCDH reported last year that Facebook, Instagram, and Twitter were failing to act against more than nine in ten posts reported for containing misinformation. Acknowledging that Covid has made him “less confident” in his view “that the power of the censor is more frightening than the menace posed by the censored”; he says that free societies need to decide on what lines they need to draw. For they “cannot leave profit-hungry social media sites, with near monopolistic control of the public square, to decide for us”. He argues for legislation to regulate what can or cannot be said and impartial judges and juries should administer them. For the major lesson of Covid is that, for him, “we cannot continue to have our speech controlled by the whims of Californian tech conglomerates.”[6]

The “Ministry of Truth”

George Monbiot’s call for a time-limited veto on the most palpably false Covid claims met with a response in the UnHerd ezine from a professed ‘lockdown hardliner’ who ridicules his call for expert committee to adjudicate on likely misinformation by sarcastically musing about setting up “a Ministry of Truth to provide and ongoing means of suppressing dangerous information on the grounds that “if lives are at risk, then isn’t that all that matters.””[7] They argue that suppression of such obvious nonsense as “vaccines are used to inject us with microchips” is unnecessary as it will never inform government policy.[8]

They counter Monbiot’s proposal by posing a ‘risk to life’ conundrum around the closure of Germany’s nuclear power plants in the aftermath of the Fukushima disaster in Japan in 2011. They make a “compelling case” that Germany’s move unnecessarily prolonged Germany’s dependence on coal-fired power-stations, thereby exposing people and the planet to life-threatening pollution.”[9] A far-fetched argument maybe; only one that George Monbiot has made on a number of occasions they point out.[10] While agreeing with the proposition that there is no absolute right to free speech, the columnist concludes by warning of the “chilling effect” on public discourse and of the possibilities of failure to expose future public policy mistakes.[11]

Accentuate the Positive

Effective strategies to counteract the voluminous amounts of Covid misinformation should focus on positive means of empowering people with the tools to rebut the conspiracy myths and the falsehoods of the deniers. One such initiative is the website Anti-Virus: The Covid-19 FAQ launched in January this year as “a source reliable information devoted to demolishing the claims of sceptics and holding them to account.”[12] Founded by Stuart Ritchie, lecturer at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London received 30,000 views in its first two days and has been praised by Stan Westlake, CEO of the Royal Statistical Society. Among the false claims that it has refuted are that ‘91% of Covid cases are false positives’[13]; there are no excess deaths[14] and that ‘Danish study shows masks don’t stop the spread[15].

The history of vaccination conflicts should remind us that the reasons for vaccine hesitancy are diverse, complex and are framed by social and political context. During the Montreal outbreak, for example, resistance was accentuated by pre-existing tensions between the city’s francophone and anglophone populations with resentment by the French workers towards “the upper-class English doctors who wanted to stick needles into them’ (Spinney p.4). It didn’t help that a contaminated batch caused some cases of the skin infection erysipelas early on.

Historically, anti-vaccine sentiment was often provoked by mandates, in part because of reasonably grounded fears of brutal and discriminatory fashion. Ethnic minorities were vaccinated at gunpoint and medically vulnerable populations were forcibly given experimental concoctions in the manner of the Tuskegee syphilis episode. The 1905 Supreme Court ruling in Jacobson v Massachusetts upholding US states’ right to vaccinate galvanised “conscientious objectors”[16] and in 1908 the Anti-Vaccination League of America was set up. (Spinney: pp.4-5).

Brazil had a similar rite of passage. An obligatory vaccination law, passed by the national assembly in October 1904, led to the week long mass insurrection in the streets of Rio de Janeiro known as the “Revolta Contra Vacina. This revolt was as much a statement of ideological opposition, rather than merely fear of medical treatment. For many of its combatants it was a fight of the poor against state interference in their lives. (Deer, 2020).

The afore-mentioned Montreal resistance only turned violent after vaccination was made compulsory. Echoing these voices from history, Hausman cautions against “characterising all vaccine dissent as wrongheaded and antiscience. Referring to the measles outbreaks that occurred in the US in early 2019, she questions whether measures, like the emergency declared in New York’s Rockland County in March 2019 blocking children and teenagers not vaccinated against measles from public places “will quell the concerns of vaccine sceptics or improve this country’s excellent vaccination rates.”[17]. She opines that “arguments that treat scientific evidence as the only basis for healthy civic behaviour” permit “no room for an acknowledgment of alternative experiences or belief systems, nor for a conversation about what we owe one another as citizens in modern societies”. She then goes on to say that “if scientific data were somehow always absolutely correct and appropriate to each situation, we would not need science and health policies to help us to decide how to deploy those facts for the public good." (Hausman, 2019).

The latter point that Hausman make does not, however, appear to acknowledge that scientific theories and evidence are always subject to the test of falsifiability and are always open to revision if new knowledge emerges. Having said that, there is much to commend for the storytelling approach which Spinney advocates in order to win around vaccine sceptics. For people do not experience vaccine injury at the population level; they experience it personally. In the words of the Australian epidemiologist Stephen Leeder “Facts are not rejected because they are seen as wrong, but because they are seen as being irrelevant”. Vaccine educators, aware of just how successful anti-vaxxers have utilised storytelling as opposed to statistics, are now “getting” this. Hence, they will respond to stories about somebody who had a bad reaction from a jab by telling them about “a couple last week, your age, who got the vaccine and are doing fine” may also help that different kinds of people from Anthony Fauci and Chris Whitty say these things (Spinney: p.6)

Ultimately the success of vaccination relies on a strong social contract which has been fraying across the Western world. The development of strong social solidarity at the start of the pandemic does augur well for vaccination programmes but this solidarity has likely been weakened by the inconsistent messaging that has come from the UK government and the breach of coronavirus regulations by key decision makers such as the former Special Adviser to Prime Minister Boris Johnson, Dominic Cummings. Looking at what history can teach us about vaccine scares and the empowerment of citizens through accurate information about the pandemic and vaccination can form a two-pronged strategy to refute the disinformation tactics of Covid denialists.

Bibliography

(1) Deer, Brian (2020) The Doctor Who Fooled the World. Andrew Wakefield’s War on Vaccines London: Scribe

(2) Hauseman, Bernice Stop Telling Anti-Vaxxers they’re Insane for Questioning Vaccines/ Opinion The Inquirer 28 March 2019

(3) Larsson, Paula COVID-19 Anti-Vaxxers Use the Same Arguments from 135 Years Ago The Conversation 5th October 2020 https: //www.history.ox.ac.uk/article/covid-19-anti-vaxxers-use-the-same-arguments-from-135-years-ago

(4) Offit, Paul A., MD (2012) Deadly Choices, How the Anti-Vaccine Movement Threatens Us All New York: Basic Books

(5) Spinney, Laura. Vaccines and Immunisation. Could Understanding the History of Anti-Vaccine Sentiment Help Us to Overcome it Guardian 26th January 2021 https://www.theguardain.com/society/2021/jan/26/could-understanding-the-history-of-anti-vaccine-sentiment-help-us-to-overcome-it

[1] Nick Cohen. Anti-vaxxers posing as victims has a history. Look at Andrew Wakefield. Observer 31 January 2021 p.52

[2] Ibid

[3] George Monbiot. Misinformation kills and we have a duty to suppress it. Guardian 27 January 2021

[4] Ibid

[5] Ibid

[6] Nick Cohen, op cit

[7] George Monbiot’s ‘Ministry of Truth’ is a dangerous idea’. Unherd 27th January 2021

[8] Ibid

[9] Ibid

[10] Ibid

[11] Ibid

[12] Fighting back. New website that is holding Covid sceptics to account. Guardian 25th January 2021

[13] Theory is based on a statistical misunderstanding, ands since during the summer (when cases were low) only 0.3% of tests were positive, it cannot be that a much greater proportion of positive tests are now “false”. The huge rise in deaths disproves the idea that people aren’t getting sick. (Ibid)

[14] The Office for National Statistics recently estimated that there were 14% more deaths in the previous year than the baseline from the previous five years – even though in the latter part of the year deaths from causes other than Covid-19 actually fell. (Ibid)

[15] The study was only testing protection for the wearer, not others in the vicinity. Problems with its design were pointed out before it was conducted, and there is lots of evidence from around the world that mask-wearing is associated with a lower rate of increase in the spread of the virus.

[16] It was only during the First World War that the term came to refer to people who objected to taking up arms.

[17] For example, in 2016 national coverage for vaccines against polio, MMR, Hep B and diphtheria, tetanus, and acellular pertussis (DTaP) were over 90 percent for children aged 10 to 35 months. In Pennsylvania, vaccines for DTaP, polio, MMR, Hep B, and varicella are required for school entry, with follow-ups in later grades for certain illnesses. Pennsylvania is one of 17 states that grant philosophical exemptions, along with the religious exemptions in 47 states.

(*) These numbers and the story of this epidemic have been narrated by historian Michael Bliss in his non-fiction account, Plague: A Story of Smallpox in Montreal.

Barry Gilheany is a freelance writer, qualified counsellor and aspirant artist resident in Colchester where he took his PhD at the University of Essex. He is also a lifelong Leeds United supporter. 

Covid, Vaccine Misinformation And How To Overcome It

Barry Gilheany tackles the fake news in the realm of vaccination discourse. 

As vaccination programmes are being steadily rolled out and taken with various degrees of effectiveness across the UK, Europe, and the US (but regrettably much less so in Africa and other parts of the developing world), it is incumbent upon medical practitioners and public health policy experts and administrators to counteract the conspiracy myths about Covid vaccines which are widely disseminated online by disinformation sources such as the Plandemic video. 

But it is also incumbent to address the vaccine hesitancy felt by individuals and communities who have had lived experiences of the unethical behaviour of pharmaceutical giants and of coercive intervention by statutory medical authorities in their lives. Strategies to do so should therefore seek to maximise informed consent amongst the largest critical mass of the public to ensure the greatest possible "herd immunity" in the population. Understanding the history of anti-vaccine sentiment and empowering the public with the fact checking resources to rebut anti-vaccine false claims are thus essential components of the toolkit needed to overcome the spread and prevalence of vaccine misinformation.

Vaccine Hesitancy: The Spectrum

Vaccine "hesitancy" covers a spectrum from those with very narrow and specific doubts - or sometimes just questions - to the extreme and immutable anti-vaxxer and understanding that is vital to cognition about how hesitancy forms people's behaviour. Some optimists believe that much hesitancy will just dissipate. Speaking before the onset of the current vaccination programmes, in August 2020, Paul Offit, the head of the Vaccine Education Centre at the Children's Hospital of Philadelphia, counselled against taking surveys then showing worryingly low levels of willingness to get vaccinated too seriously, as no vaccine then existed, and in a data vacuum, scepticism was to be expected. And indeed, recent survey evidence has showed that the proportion of French people willing to get vaccinated jumped from 39% in December to 51% in January - a pattern repeated in other countries (Spinney, 2021: p.2).

However, others detect the development of a different trend. Bernice Hausman, cultural theorist, and the author of Anti/Vax, asserts that "The pandemic has increased empathy for those who are hesitant." This is partly, she believes, because the pandemic has illuminated racial, classed, and other structural inequalities in healthcare and their historical roots. A particularly painful legacy for African Americans was the notorious Tuskegee syphilis study running from 1932 to 1972 which unethically tracked the course of syphilis in African American sharecroppers without ever offering them effective treatments. She observes "a huge shift" in public perceptions of the vaccine-hesitant from "victims of misinformation, to seeing them as mistrustful for valid social and historical reasons." (Spinney: p.2)
 
History of Anti-Vaccine Sentiment

Those who promote anti-vaccination have throughout the history of vaccines consistently used a standard set of strategies (Larsson,2020: p.2). They dispute the effectiveness of the vaccines being administered. They claim that vaccines cause diseases from the comprehensively demolished claim at the turn of the 21st century that the MMR vaccine causes autism to the claims of the anti-vaxxers of the past that vaccination was responsible for a full spectrum of diseases, from smallpox to syphilis, typhoid, cholera and "blood poisoning" (These claims were not always baseless, but their risks were constantly exaggerated. They claim that the disease being vaccinated against cause little harm or are best treated "naturally" through alternative medicine, better nutrition, and sanitary improvements etc. (Cleaner water and sanitation and better food undoubtedly help but anti-vaxxers simply refuse to recognise the medicinal and epidemiological benefits of vaccines). They depict public health measures as assaults on personal liberties and abuses of government power. Lastly, they cite authorities to legitimise their anti-vaccination arguments with the most totemic example being the discredited former physician Andrew Wakefield the author of the notorious study linking MMR to autism. (Larsson: pp.1-5).

For at least a century after Edward Jenner's discovery of the first vaccine in 1796 against smallpox, vaccination carried much greater risks than today although the protection it afforded still far outweighed any possible harms. Since vaccination would not always have been carried out in the sanitary conditions which we are accustomed to today, then it sometimes caused secondary infections with lingering and unpleasant side-effects resulting in loss of income for workers forced to take time off work. These were legitimate concerns throughout the 19th century since the smallpox vaccine was the only one most people were offered, and they were revived when health authorities tried to increase vaccine coverage (Spinney: p.3)

What also surfaced in epidemics were what Larsson terms "white knights"; figures who used popular concerns to power their own agenda and portray themselves as heroes. One self-styled knight in white armour was Dr. Alexander Ross who rose to prominence as the author of a popular pamphlet published during the Montreal smallpox epidemic of 1885. Just like Andrew Wakefield, Dr Ross in his "heroic" narrative, styled himself as "the only doctor, who had dared to doubt the fetish" of vaccination. Despite this, it was revealed that he had recently been vaccinated during the epidemic; a fact which major newspapers of the time gleefully reported on. (Larsson: p.3).

Ross decried the "senseless panic" caused by health officials and medics over the epidemic, and that the city had "very few cases” One section of his pamphlet made the following four claims:

"1 - Vaccination has been weighed in the balance and found wanting.

2. - Vaccination does not prevent Small-pox in any cases.

3 - Vaccination does cause loathsome and often fatal diseases.

Many children are killed outright, and thousands have their health ruined by it.

4. Vaccination does not lessen the severity or the fatality of Smallpox. The proportion of Vaccinated persons who have Small-pox has steadily increased as Vaccination has been extended - and the number of deaths in proportion to the cases is the same as ever. In the last epidemic of Smallpox in London, 92 per cent were persons have been Vaccinated or Re-vaccinated." (p.3)

In fact, official numbers for the epidemic would eventually rise to 9,600 reported cases with nearly 3,234 deaths – nearly two per cent of Montreal’s population at the time. An additional 10,000 cases were recorded in the province of Quebec, but historians believe the number is much higher.[*]

As with today’s Covid sceptics, Ross’s pamphlet fulminated about the role of the press and medical profession in stirring up fears over infection as part of a “mad” campaign for financial enrichment. Then as now, epidemics created opportunities or both employment and research around medicine. Yet this employment was decried as an unethical exploitation of the poor, worth “one million pounds sterling” to the profession, rather than an effort to combat the suffering and death of thousands (p.4)

In addition, public health measures were framed as an assault on individual rights and an unwarranted extension of government power. “Talk no longer of Russian Tyranny”, Ross proclaimed, for there was “none so formidable” as the city health officials. (p.4).

The anti-vaccination movement has had a long tradition of promoting the words of “experts” who back their narrative. In the 19th century, vaccination debates often brought in small circles of medical men who condemned vaccination as a “filthy” and “evil” practice, (p.5)

The founders of the first anti-vaccine movement, the Anti-Compulsory Vaccination League (ACVL) formed in Britain1866, the brothers Richard Butler and George Gibbs urged citizens to protest vaccination as an act of patriotism. “Stay the hand of the vaccinator, Richard Butler Gibbs wrote … “Let Britannia put her foot on this iniquitous destroying, death-producing interference and crush it out.” (Offit, 2012). The ACVL’s publication the Vaccination Vampire conjured up apocalyptic images when it declared that vaccination” offer[ed] up annually an indefinite number of human sacrifices to propitiate an imaginary Devil,” and anti-vaccine activists compared it to “some savage African tribe that every week sacrificed to an idol two children to guard against smallpox. (Offit: p.109) ".

Expressing concern about the bovine contents of Jenner’s vaccine a speaker at a meeting of the British Medical Association in 1890, produced a child whom he claimed was “covered with horn-like excrescences, which had resulted from vaccination. (Offit: p.114). Likewise, other anti-vaccine activists claimed that its contents the “poison of adders, the blood, entrails and excretions of bats, toads and suckling whelps” and that it transformed a healthy child into “a scrofulous, idiotic ape, a hideous foul-skinned cripple: a diseased burlesque on mankind”. Using gothic images, propagandists distributed pictures of vaccinated children turning into minotaurs, hydra-headed monsters, dragons, the incubus, and Frankenstein.” (Offit: p.110)

Although not couched in the flagrantly racist, imperialist, and disablist language of Victoriana, modern images summoned by modern anti-vaxxers can be no less offensive. On 14th October 1999, Jane Orient, a prominent anti-vaccine spokesperson, compared likening vaccines to scientific experiments in Nazi Germany on ABC’s Nightline with Ted Koppel. In refusing to back down from what Koppel called “a horrible analogy”, Orient proceeded to claim that if parents wanted to reduce consent for their children to be vaccinated (against Hepatitis B), “they may be threatened with having their children taken away from them.” On being told by another guest on the shop, Dr. Sam Katz, a professor of paediatrics and infectious diseases, that no such event had ever been recorded nor had he ever heard of such, Ms Orient simply said that she had heard of cases but would not elaborate. (Koppel: pp.113-14). The art of supposition really is a stock-in-trade of anti-vaxxers.

Although claims such as MMR causes autism have been cast in more scientific and sophisticated language than those of the 19th century which said that the smallpox vaccine turns children into cows, they are both equally nonsensical. During the Omnibus Autism Proceeding in the USA which ran throughout the 2000s, fringe doctors and scientists claimed that thimerosal weakened the immune system, allowing measles vaccine virus to damage the intestine. Because the intestine was now leaky, brain-damaging proteins could enter the bloodstream and cause autism. These hypotheses look quite feasible; as feasible as a claim that since smallpox is made from the fluid of cow blisters that invariably contain cow DNA; injection of cow DNA into children could possibly cause the DNA to incorporate itself into the nucleus of a small group of genetically susceptible children. Cow DNA, which contains the blueprint for making cows, could according to such theoretical explanation take over the cellular machinery, causing small, but noticeable, cow-like features. As Offit points out, given the number of cow DNA consumed every day in hamburgers and the fact that small fragments enter the body every day, were this Frankensteinian scenario possible, then we would all be cows by now (Offit: p.113)

Anti-vaxxers and Free Speech

The imperative to restrict free speech to counteract the influence of anti-vaccination falsehoods is argued powerfully by the Guardian/Observer columnists Nick Cohen and George Monbiot. Imploring us to “always ask the hard questions”, Cohen opines that “the hardest one to ask about Covid and free speech is why does the law tolerate anti-vaccine propaganda?”[1] For John Stuart Mill’s harm principle holding that free societies must tolerate unpopular and offensive speech provided it does not incite the physical harm of others does not apply in this situation because “anti-vaxxers are inciting physical harm.”[2] George Monbiot points to the collision between the right to speak freely and the right to life when malicious disinformation about medicine and vaccines are allowed to spread unchecked. Because of the incompatibility of both rights in the Covid world; he asserts that “when governments fail to ban outright lies that endanger people’s lives, I believe they make the wrong choice”[3]

Monbiot deconstructs the “marketplace of ideas” vista so beloved of free-speech zealots by pointing out that in a marketplace it is forbidden to make false claims about a product. So therefore, outlandish, and dangerous falsehoods such as ‘coronavirus doesn’t exist’, ‘it’s not the virus that makes people ill but 5G’, or ‘vaccines are used to inject us with microchips’ should be subject to a time-limited ban of up to six months using the template of the Cancer Act which bans people from advertising cures or treatments for cancer. He proposes an expert committee along the lines of the Scientific Advisory Group for Emergencies, identifying claims that present a genuine danger to life and proposing their temporary prohibition to parliament.[4]

Monbiot removes the populist, ‘anti-elite’, anti-establishment’ veil behind anti-vaccine sentiment to reveal the plutocratic and corporate vested interests that they serve. For example, the launch of the Great Barrington Declaration that champions herd immunity through mass infection with the help of discredited claims, was hosted by the American Institute for Economic Research which receives money from the Charles Koch Foundation, and takes a wide range of anti-environmental positions.[5]

For Cohen, the corporate villains of the piece are Big Tech. He cites an investigation by the Centre for Countering Digital Hate (CCDH) which has found that leading Covid deniers had boosted their social media presence by millions during the pandemic. The CCDH reported last year that Facebook, Instagram, and Twitter were failing to act against more than nine in ten posts reported for containing misinformation. Acknowledging that Covid has made him “less confident” in his view “that the power of the censor is more frightening than the menace posed by the censored”; he says that free societies need to decide on what lines they need to draw. For they “cannot leave profit-hungry social media sites, with near monopolistic control of the public square, to decide for us”. He argues for legislation to regulate what can or cannot be said and impartial judges and juries should administer them. For the major lesson of Covid is that, for him, “we cannot continue to have our speech controlled by the whims of Californian tech conglomerates.”[6]

The “Ministry of Truth”

George Monbiot’s call for a time-limited veto on the most palpably false Covid claims met with a response in the UnHerd ezine from a professed ‘lockdown hardliner’ who ridicules his call for expert committee to adjudicate on likely misinformation by sarcastically musing about setting up “a Ministry of Truth to provide and ongoing means of suppressing dangerous information on the grounds that “if lives are at risk, then isn’t that all that matters.””[7] They argue that suppression of such obvious nonsense as “vaccines are used to inject us with microchips” is unnecessary as it will never inform government policy.[8]

They counter Monbiot’s proposal by posing a ‘risk to life’ conundrum around the closure of Germany’s nuclear power plants in the aftermath of the Fukushima disaster in Japan in 2011. They make a “compelling case” that Germany’s move unnecessarily prolonged Germany’s dependence on coal-fired power-stations, thereby exposing people and the planet to life-threatening pollution.”[9] A far-fetched argument maybe; only one that George Monbiot has made on a number of occasions they point out.[10] While agreeing with the proposition that there is no absolute right to free speech, the columnist concludes by warning of the “chilling effect” on public discourse and of the possibilities of failure to expose future public policy mistakes.[11]

Accentuate the Positive

Effective strategies to counteract the voluminous amounts of Covid misinformation should focus on positive means of empowering people with the tools to rebut the conspiracy myths and the falsehoods of the deniers. One such initiative is the website Anti-Virus: The Covid-19 FAQ launched in January this year as “a source reliable information devoted to demolishing the claims of sceptics and holding them to account.”[12] Founded by Stuart Ritchie, lecturer at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London received 30,000 views in its first two days and has been praised by Stan Westlake, CEO of the Royal Statistical Society. Among the false claims that it has refuted are that ‘91% of Covid cases are false positives’[13]; there are no excess deaths[14] and that ‘Danish study shows masks don’t stop the spread[15].

The history of vaccination conflicts should remind us that the reasons for vaccine hesitancy are diverse, complex and are framed by social and political context. During the Montreal outbreak, for example, resistance was accentuated by pre-existing tensions between the city’s francophone and anglophone populations with resentment by the French workers towards “the upper-class English doctors who wanted to stick needles into them’ (Spinney p.4). It didn’t help that a contaminated batch caused some cases of the skin infection erysipelas early on.

Historically, anti-vaccine sentiment was often provoked by mandates, in part because of reasonably grounded fears of brutal and discriminatory fashion. Ethnic minorities were vaccinated at gunpoint and medically vulnerable populations were forcibly given experimental concoctions in the manner of the Tuskegee syphilis episode. The 1905 Supreme Court ruling in Jacobson v Massachusetts upholding US states’ right to vaccinate galvanised “conscientious objectors”[16] and in 1908 the Anti-Vaccination League of America was set up. (Spinney: pp.4-5).

Brazil had a similar rite of passage. An obligatory vaccination law, passed by the national assembly in October 1904, led to the week long mass insurrection in the streets of Rio de Janeiro known as the “Revolta Contra Vacina. This revolt was as much a statement of ideological opposition, rather than merely fear of medical treatment. For many of its combatants it was a fight of the poor against state interference in their lives. (Deer, 2020).

The afore-mentioned Montreal resistance only turned violent after vaccination was made compulsory. Echoing these voices from history, Hausman cautions against “characterising all vaccine dissent as wrongheaded and antiscience. Referring to the measles outbreaks that occurred in the US in early 2019, she questions whether measures, like the emergency declared in New York’s Rockland County in March 2019 blocking children and teenagers not vaccinated against measles from public places “will quell the concerns of vaccine sceptics or improve this country’s excellent vaccination rates.”[17]. She opines that “arguments that treat scientific evidence as the only basis for healthy civic behaviour” permit “no room for an acknowledgment of alternative experiences or belief systems, nor for a conversation about what we owe one another as citizens in modern societies”. She then goes on to say that “if scientific data were somehow always absolutely correct and appropriate to each situation, we would not need science and health policies to help us to decide how to deploy those facts for the public good." (Hausman, 2019).

The latter point that Hausman make does not, however, appear to acknowledge that scientific theories and evidence are always subject to the test of falsifiability and are always open to revision if new knowledge emerges. Having said that, there is much to commend for the storytelling approach which Spinney advocates in order to win around vaccine sceptics. For people do not experience vaccine injury at the population level; they experience it personally. In the words of the Australian epidemiologist Stephen Leeder “Facts are not rejected because they are seen as wrong, but because they are seen as being irrelevant”. Vaccine educators, aware of just how successful anti-vaxxers have utilised storytelling as opposed to statistics, are now “getting” this. Hence, they will respond to stories about somebody who had a bad reaction from a jab by telling them about “a couple last week, your age, who got the vaccine and are doing fine” may also help that different kinds of people from Anthony Fauci and Chris Whitty say these things (Spinney: p.6)

Ultimately the success of vaccination relies on a strong social contract which has been fraying across the Western world. The development of strong social solidarity at the start of the pandemic does augur well for vaccination programmes but this solidarity has likely been weakened by the inconsistent messaging that has come from the UK government and the breach of coronavirus regulations by key decision makers such as the former Special Adviser to Prime Minister Boris Johnson, Dominic Cummings. Looking at what history can teach us about vaccine scares and the empowerment of citizens through accurate information about the pandemic and vaccination can form a two-pronged strategy to refute the disinformation tactics of Covid denialists.

Bibliography

(1) Deer, Brian (2020) The Doctor Who Fooled the World. Andrew Wakefield’s War on Vaccines London: Scribe

(2) Hauseman, Bernice Stop Telling Anti-Vaxxers they’re Insane for Questioning Vaccines/ Opinion The Inquirer 28 March 2019

(3) Larsson, Paula COVID-19 Anti-Vaxxers Use the Same Arguments from 135 Years Ago The Conversation 5th October 2020 https: //www.history.ox.ac.uk/article/covid-19-anti-vaxxers-use-the-same-arguments-from-135-years-ago

(4) Offit, Paul A., MD (2012) Deadly Choices, How the Anti-Vaccine Movement Threatens Us All New York: Basic Books

(5) Spinney, Laura. Vaccines and Immunisation. Could Understanding the History of Anti-Vaccine Sentiment Help Us to Overcome it Guardian 26th January 2021 https://www.theguardain.com/society/2021/jan/26/could-understanding-the-history-of-anti-vaccine-sentiment-help-us-to-overcome-it

[1] Nick Cohen. Anti-vaxxers posing as victims has a history. Look at Andrew Wakefield. Observer 31 January 2021 p.52

[2] Ibid

[3] George Monbiot. Misinformation kills and we have a duty to suppress it. Guardian 27 January 2021

[4] Ibid

[5] Ibid

[6] Nick Cohen, op cit

[7] George Monbiot’s ‘Ministry of Truth’ is a dangerous idea’. Unherd 27th January 2021

[8] Ibid

[9] Ibid

[10] Ibid

[11] Ibid

[12] Fighting back. New website that is holding Covid sceptics to account. Guardian 25th January 2021

[13] Theory is based on a statistical misunderstanding, ands since during the summer (when cases were low) only 0.3% of tests were positive, it cannot be that a much greater proportion of positive tests are now “false”. The huge rise in deaths disproves the idea that people aren’t getting sick. (Ibid)

[14] The Office for National Statistics recently estimated that there were 14% more deaths in the previous year than the baseline from the previous five years – even though in the latter part of the year deaths from causes other than Covid-19 actually fell. (Ibid)

[15] The study was only testing protection for the wearer, not others in the vicinity. Problems with its design were pointed out before it was conducted, and there is lots of evidence from around the world that mask-wearing is associated with a lower rate of increase in the spread of the virus.

[16] It was only during the First World War that the term came to refer to people who objected to taking up arms.

[17] For example, in 2016 national coverage for vaccines against polio, MMR, Hep B and diphtheria, tetanus, and acellular pertussis (DTaP) were over 90 percent for children aged 10 to 35 months. In Pennsylvania, vaccines for DTaP, polio, MMR, Hep B, and varicella are required for school entry, with follow-ups in later grades for certain illnesses. Pennsylvania is one of 17 states that grant philosophical exemptions, along with the religious exemptions in 47 states.

(*) These numbers and the story of this epidemic have been narrated by historian Michael Bliss in his non-fiction account, Plague: A Story of Smallpox in Montreal.

Barry Gilheany is a freelance writer, qualified counsellor and aspirant artist resident in Colchester where he took his PhD at the University of Essex. He is also a lifelong Leeds United supporter. 

21 comments:

  1. Loada pish. Whoever wrote this article knows zero history about vaccines. Just a repeater of what they are told. Pathetic.

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    1. Who am I with my Grade C O-level in Chemistry as my sole science qualification to question the expertise of the scientists that cite?

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    2. Had my first Astra-Zeneca shot this week. Felt full of beans afterwards. Get vaxxed, Quillers!

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    3. I agree. Have you started mooing yet or turned into a cow? !!!
      I think expertise can always be questioned. That is the very principle which science is based on - as Brian Cox said, it is the enemy of certainty.
      Science is testable so why not ask questions of the expertise and force them to up their game either in terms of improving their method or improving their explanation? And if the flat earthers and young earthers want to make their point, let them. It does not mean you have to take them seriously or that they be allowed to teach in the school science class.

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  2. Very informative piece Barry and a lot of work put in. Anti-Vaccination is like anti-evolution to me.

    Unlike the Young Earth anti evolutionists, not everybody suspicious of vaccines is a crank or a crackpot but there are far too many of them who are to allow me to be comfortable with their case. They can often sound like the Christian Science Movement that told people to avoid medicine in place of prayer. The result was kids dying agonising deaths in front of their religiously unhinged parents when they could have been saved or at least had their suffering greatly alleviated.

    I am very concerned about the suggestions made by people like Cohen and Monbiot to curb free inquiry. Cohen's quote in particular sets alarm bells going “that the power of the censor is more frightening than the menace posed by the censored.” That plays straight into the authoritarian handbook and upends everything people like me have valued for decades.

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    1. AM

      Thanks for your feedback.

      The two things that I would counsel are that compulsory vaccination must be avoided at all times because of the racialised and classed history of medical mandates and not to engage in argumentation with online anti-vaxxers as this is precisely the oxygen of publicity they crave.

      Gentle but persistent persuasion at all times!

      I think what Nick Cohen is getting at is that we should not allow Big Tech to redefine the meanings of free speech and censorship.

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    2. Barry - no more reason to engage with the anti-Vaxxers than there is to engage with the young earthers but my point is more about free inquiry. I just sense that Nick Cohen is using Big Tech to mask a more censorial impulse that has always lurked behind the free speech veneer put up by liberals and the Left. People have a right to hear and not have what they hear be determined by Nick Cohen or others no matter how well meaning.

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  3. Every single source linked...all open up to a blank page. SO very little can be fact checked. Quillers, open the links yourselves .And then there is total misinformation such as....

    A particularly painful legacy for African Americans was the notorious Tuskegee syphilis study running from 1932 to 1972 which unethically tracked the course of syphilis in African American sharecroppers without ever offering them effective treatments.

    What happened was they infected black Americans with STI's...Which is very different to what you claim Michael....




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    1. Frankie - they are references rather than links. A formatting problem at our end.

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  4. AM

    I think the point that Cohen is making is that social media behemoths profit greatly from the misinformation spread by anti-vaxxers and other extremists and that the algorithms used by Big Tech puts can lead to such misinformation being promoted to the top of so many users' newsfeeds.

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    1. Barry - fake news and disinformation has been on the go since time began. The Holy books have caused as much dissemination of false info as any bit tech company but Nick Cohen is not looking them banned. I always mistrust the censorial impulse no matter what the motive.

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  5. What do you expect from a Leeds fan? Seriously, we have been fed a load of misleading, at best, info by so-called experts, little wonder people are becoming less trusting. As Professor Luke O'Neil said the Irish Government should be "kicking" on the door of the Kremlin for the Russian vaccine which has a 92% efficiancy rating. Not bad by any standard.
    K.M

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  6. Myself, my Sister, my Mother and stepfather have just finished isolating after covid, without being disparaging to people who have suffered but for us there was nothing to it. My Mother is high risk so she's barely been out the door in the last year and now she's saying 'is that it?' I can't believe I spent a year apprehensive about catching this, I've had worse colds.

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    1. David,

      She was one of the lucky ones.

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    2. Why did you isolate for something that doesn't exist David?

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  7. Good article Barry thanks. Says a lot for vacinations when the Taleban forbid the populace under their control to recieve the shot for Polio and quickly reversed their decision when Polio reared up it's head again!

    Anti-vaxxers are in the same group as flat-earthers.

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  8. Steve,
    Hahaha. I knew you you would reply to that. It's an easy illness to get over unless you're a wimp

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    1. David,

      Unfortunately a lot of the population have co-morbidities which makes it so much harder for them to get over it, and it's this groupd that puts the pressure on the health system.

      But you already know this!

      Glad your mum is ok though.

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  9. Steve,
    Thanks. I realise the damage it can do, I'm done having serious debates on this, it's done. A year ago they were valid, it's done now for better or worse this is the road we went down. We've just to look to the plus side, it's getting rid of the old team with their stupid theories like two genders and personal responsibility and all that shite. Barry said it's killing minorities in the NHS that can only be good news, who do they think they are? Coming from all over the world to Britain to steal Irish jobs, outrageous! I mean think of the narcotics we could pilfer if it wasn't for these fucking dogooders.

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    1. Ha! Something seriously wrong if a immigrant is stealing a shit job from a toothless gormless local, outrageous and just not cricket!

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  10. Covid, Vaccine Misinformation And How To Overcome It


    To over come the misinformation ...Stop taking MSN the Gov narratives as gospel. Do your own research. I did and short version Quillers, someone is trying to sell me a pup that I don't want to buy..

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