Guest post by Mark A. Largent
Last week the daytime talk show The View announced that it had hired Jenny McCarthy as a co-host for the show. The show has never shied away from hiring strong-willed, opinionated women. But, unlike any of the previous hires, McCarthy has drawn fire from the public health and medical communities because of her outspoken position on compulsory vaccines. Her views are vehemently rejected by public health officials, science enthusiasts, and health care providers even as they are encouraged by some who occupy an even more extreme position against vaccines. Yet, McCarthy represents a large segment of parents who are not actually eager to move to either extreme, and it is a mistake to cast and recast her message as more extreme than it really is.
McCarthy’s ascent up the Hollywood ladder has caused great consternation among her critics. As Phil Plait, a long-time critic of McCarthy, wrote on Slate, “So McCarthy will now get a seat on a TV show, where her charm and good humor will no doubt serve her and her cause well. And in the meantime, her frankly dangerous ideas about health issues will get that much more mainstream attention.” Others have been even more pointed in their criticism. James Poniewozik of Time wrote that the decision “to legitimize McCarthy’s dangerous anti-science” is “irresponsible and shameful.” Michael Specter wrote in the New Yorker that McCarthy’s “dangerous views on childhood vaccination may—if only indirectly—have contributed to the sickness and death of people throughout the Western world.”
I wrote a lot about McCarthy in Vaccine: The Debate in Modern America. She is undoubtedly one of the most visible figures in the modern vaccine debate, and she had drawn a great deal of attention from both vaccine advocates and their detractors. She is an easy figure to demonize, and in the book I describe how McCarthy wrote two books on motherhood that vaulted her “potty humor into the mainstream in a way that a half-dozen B movies and hundreds of celebrity appearances never could.” In 2006, she published Life Laughs: The Naked Truth about Motherhood, Marriage, and Moving On, which detailed the difficult year when she divorced her husband and learned that her son, Evan, was diagnosed with autism.
In her 2008 book, Louder Than Words, McCarthy described the day Evan’s symptoms of autism first appeared. She had found her two-year-old in his crib, limp and struggling to breathe through a seizure. Earlier that day he had received several vaccines, and his seizures may have been induced by a fever, which sometimes follows vaccinations. An ambulance took Evan to the hospital, where he was given a series of tests and released a day later unable to walk, barely speaking, and acting oddly. Shortly thereafter he was diagnosed on the autism spectrum. McCarthy’s story is laced with small details that foreshadow her eventual disgust with medical professionals who were unable to find solutions to, or even adequate explanations for, Evan’s seizures or the radical changes to his physical and cognitive abilities. Like many other Americans, McCarthy turned to the Internet to learn more about her son’s condition and find treatments. Eventually her self-guided research led her to the kind of information that I describe in my book: “accusations about vaccine-induced ailments, concerns about the contents of vaccines, and assertions that—somehow—vaccines cause the symptoms of autism.” McCarthy came to believe that Evan’s seizures and accompanying changes in his behavior and cognitive abilities were the result of insults that his body had endured, which included a series of ear infections and their treatment with several courses of antibiotics, a severe case of eczema, and his routine childhood vaccines. Evan’s body, she believes, could not handle the combined effects of these illnesses and treatments, and his immune system went “haywire.” McCarthy believes that her son’s digestive system stopped being able to process certain foods, and this change led to a toxification of his system, which caused his symptoms. In an interview with a parenting magazine, McCarthy explained, “Looking back, I’d say, ‘God, if a kid is having more than seven ear infections in a year and he’s got eczema, there are some issues here—his immune system is obviously under attack, and we need to put him in the sensitive category. Let’s just delay some of his shots.’ ”
McCarthy gives voice to a large – and apparently growing – segment of American parents who are increasingly uncomfortable about the modern vaccine schedule. Published polls typically report that about 40% of American parents have refused or delayed a recommended vaccine for their children. Vaccine advocates routinely portray McCarthy as “anti-vaccine,” but we should take her case as an opportunity to think about how we define someone as “anti-vaccine.” An anti-vaccinator is someone who believes that vaccines are not effective at preventing diseases or that vaccines somehow pollute the body and are thus inherently bad and will refuse any and all vaccines. The percentage of anti-vaccinators in the U.S. has held steady throughout the least 100 years at about 3% of the population and is dominated by a few religious sects (like Christian scientists and Jehovah’s Witnesses), a couple of ethnic or cultural groups (like the Amish), and some alternative health care providers who eschew many aspects of modern medicine (including a large number of naturopaths and chiropractors).
By this traditional definition, McCarthy is not an anti-vaccinator. She apparently does not believe the vaccines are inherently bad or ineffective at preventing diseases. Instead, McCarthy believes that the one-size-fits-most approach taken by the modern vaccine schedule is problematic because it does not adequately protect the handful of apparently otherwise healthy children who might be susceptible to damage from vaccines. In an interview with the PBS show Frontline, McCarthy said, “We’re not an anti-vaccine movement. We’re pro-safe-vaccine schedule. Until we have that conversation, people are going to think it’s an anti- and pro- side.” She has called for an aggressive campaign to investigate all of the contents of all childhood vaccines to insure that they are free of potentially harmful preservatives and adjuvants (this, by the way, has already been done), and she would like to see physicians routinely screen children to determine if they might be somehow susceptible to adverse reactions from vaccines. She is also anxious about the large number of vaccines routinely administered to children at a young age. Under the current vaccine schedule, children typically receive about three dozen vaccinations before they start kindergarten, and most of these vaccinations occur within the first 18 months of a child’s life. McCarthy’s position is that, for some children, vaccinations ought to be delayed until age 2, rather than begin at birth.
McCarthy’s argument about vaccines is much more attractive to most American parents than have been the arguments offered by traditional anti-vaccinators, and thus she is much more dangerous in the minds of vaccine advocates. She has a powerful, if at times problematic, personal story about her child’s adverse reaction to vaccines, and she tells it with brutal honestly. She bluntly expresses the frustrations that many of us have felt with the modern medicine’s inefficiencies and strained bureaucracy. Moreover, she very effectively taps into the fears that many parents feel about vaccines. For parents of healthy children, the fear that a vaccine will induce serious, permanent damage is both real and very effective at altering their health care decisions. As I explain in Vaccine, “Guilt by omission—failing to administer a vaccine and as a result a child contracts a communicable disease—seems preferable to guilt by commission—making a child sick as a result of an adverse reaction to a vaccine.”
So, in light of McCarthy’s new, high-profile gig, what should vaccine advocates be doing about her? If vaccine advocates are interested in seeing as many children as possible vaccinated, what should they do about McCarthy?
First, stop calling her an anti-vaccinator. Her views are broadly appreciated by parents, especially mothers (who research tells us make about 85% of the health care decisions for their families). By labeling McCarthy an anti-vaccinator, public health officials and their proponents are effectively telling anyone who shares McCarthy’s concerns that they, too, are anti-vaccinators. Doing so drives millions of moderate parents into the warm embrace of alternative care providers, many of whom are truly anti-vaccine. McCarthy and parents like her are vaccine anxious. Vaccine-anxious parents recognize the potential value of vaccines in preventing disease—even if they sometimes discount their efficacy—but they weigh vaccines’ benefits against a host of unknown potential adverse side effects. The best way to address vaccine anxious parents is not to marginalize them as anti-vaccinators, but to address their root concerns about vaccine safety, efficacy, and continued importance in light of the decreasing incidence of most vaccine-preventable diseases.
Second, stop trying to recast and condemn McCarthy’s message. Doing so, even in the most aggressive and dismissive way, validates her as an authority of sorts and it provides her a great deal of free advertising. Millions of vaccine-anxious parents in the U.S. see public health officials and science enthusiasts focusing intense attention on the attractive and charismatic McCarthy, who has a story that can solicit empathy from even the most callous reader. Attacking her is ineffective at maintaining the trust of the 40% of American parents who admit to being anxious about the modern vaccine schedule.
Finally, directly address McCarthy’s concerns (and the concerns many parents share with her). Instead of demonizing and marginalizing McCarthy, use that same space to explain why we are confident that childhood vaccines are safe and free from harmful preservatives and adjuvants. Explain how and why public health officials are confident that modern vaccine schedule is appropriate for most children.
Public health officials have a strong urge to view McCarthy as the cause of much of the anxiety that many parents feel about vaccines today. She is merely a symptom—a very visible one—of deeper and much more vexing problem. As I explain in Vaccine, the process of vaccinating children today raises a large number of “serious problems—some inherent to the vaccines themselves and some unintentionally generated over the last several decades—that animate parents’ anxieties about vaccines. The entire process is conducted under substantial time and financial pressures, and so many shots are given at such a young age against so many obscure diseases without parents’ having a clear understanding of why we are vaccinating against certain diseases and not others. No reasonable person ought to be surprised that the process has created apprehension among thoughtful parents.” Directly addressing these problems in a calm and reasoned fashion is the best way to ensure that McCarthy’s new job will not undermine health officials’ efforts to protect as many children as possible against as many vaccine-preventable diseases as possible.
Mark A. Largent is a historian of science, technology, and medicine and the author of Vaccine: The Debate in Modern America. He is an associate professor of history and the director of the Science, Technology, Environment, and Public Policy Specialization at Michigan State University.