Vaccination Debate: Historical Context Rough Draft

Sydney Moody

Dr. Stephanie Brown

ENG 306

6 April 2016

The History and Rhetoric Behind the OngoingVaccine Controversy

Historical Context

     Although overwhelming, an alarming truth has come to light. Human fears of carnivorous beasts that make us feel small and vulnerable pale in comparison to the microscopic beasts that have plagued humanity for thousands of years (Riedel). One of the most infamous microscopic beasts is the Variola virus that causes smallpox, a deadly disease characterized by skin rashes and fever (WebMD). Fortunately, those who witnessed the devastation of this disease came to realize that “survivors of smallpox became immune to the disease,” which eventually led to the practice of inoculation (Riedel). Inoculation is the unsettling practice of injecting “fresh matter taken from a ripe pustule of some person who suffered from smallpox” (Riedel) into the skin of a healthy individual. This preventative measure was a predecessor to what is now known as vaccination (Riedel). The idea behind vaccination is to prevent a disease or illness from occurring by intentionally introducing “dead or weakened forms of infectious microbes” (Williams, 8) into the body of a relatively healthy individual promoting the development of immunity (Williams, 8).

     The practice of vaccination was widely successful in the past with such achievements as the abolishment of smallpox and highly reduced rates of other diseases “such as diphtheria, whooping cough, and tetanus” (Williams, 8). Vaccinations may have even gone so far as to influence the outcome of the Revolutionary War in the United States, with both sides of the war protecting their troops with vaccines (Jana). There is no doubt that the scope of survival from infectious diseases was heavily influenced by the faithful use of vaccinations. Global history has proven that previously deadly diseases such as smallpox have been completely overcome by the use of vaccines (Williams, 8). However, faith in vaccines became questionable as vaccinations became more common. To this day, individuals rally both against and in favor of the use of vaccinations.

      The complicated history of vaccinations has shown us that “public fear of disease is often replaced by fear of preventative intervention as soon as the disease itself begins to fade from collective memory” (Jana et al.). Great controversy has been evoked in the United States with the implementation of mandatory vaccination laws. In the 1905 Supreme Court case Jacobson v. Massachusetts, the Court ruled that “the board of health of a city or town” may “require and enforce the vaccination and revaccination of all the inhabitants thereof” in the interest of “public health or safety” (Justia). The defendant, Jacobson, was ruled against by the Court after declining to be vaccinated and was forced to pay a five dollar fine (Justia). The Court did implement exceptions, but the results of this case have continued to cause controversy in cities throughout the United States.

     Continuing such controversy, the state of California enacted Senate Bill 277 in February of 2015, making interesting changes to an existing vaccination law. This purpose of the bill was to “eliminate the exemption from immunization based on personal beliefs” (California Senate, 2015). As a result, “…hundreds of parents have attended public hearings to protest the measure, arguing that the state should not interfere with their decisions about what medical treatment to provide their children” (McGreevy). The new law has also created dispute amongst proponents of the bill and religious institutions, such as the Nation of Islam (McGreevy).

     Laws such as Senate Bill 277 stir up emotions on behalf of two types of protestors: those who oppose the bill because it violates their personal beliefs and those who oppose the bill because they disapprove of vaccines altogether. The latter, often referred to as “anti-vaxxers” (Khazan), have developed an entire movement in opposition to mandatory vaccinations. This anti-vaccination movement, is a “rhetorical attempt…to arouse public opinion to the destruction or rejection…” (Griffin, 11) of vaccinations. Some of the credit for this movement can be given to former physician and current film director, Andrew Wakefield who published a paper in 1998 that provided false evidence of a link between autism and the MMR vaccine. Although the paper was discredited, the association between the disorder and the vaccine lingers eighteen years later (Lipkin).

     The goal of the anti-vaccination movement is to maintain the right to deny mandatory vaccinations based on personal beliefs as well as to inform those who currently consent to vaccinations about the associated dangers. Their collective protest has developed from “a period of inception” to “a period of rhetorical crisis” (Griffin, 10). During the former period, Andrew Wakefield was spreading the message of the movement throughout the United Kingdom and the United States, causing panic amongst the parents of vaccinated children. The movement has since breached “rhetorical crisis” (Griffin, 10) because an unyielding conflict has arose between those who support the movement and those who support vaccinations. There is evidence to support that vaccines are safe, but there is also evidence circulating that vaccines have adverse effects. The protest will only reach what Leland Griffin calls, “a period of consummation” when the protestors accept defeat or vaccine supporters concede to the protestor's wishes.

      With angry parents, disgruntled religious institutions, and Andrew Wakefield in opposition to mandatory vaccination laws, those who support vaccinations have their hands full with misinformation to overcome. These vaccine supporters include, “…public health officials, the CDC, the American Academy of Pediatrics, the Food and Drug Administration and child health advocates…” (Williams, 11).

     A strong divide remains to this day between those in support of vaccinations and those in opposition to vaccinations. While this feud continues, more people choose not to vaccinate their children. Just two years ago,a few Los Angeles schools had “up to 60 to 70 percent of parents” refusing to vaccinate their children using a personal belief exemption (Khazan). To the dismay of the remaining 30 to 40 percent of parents who did have their children vaccinated, “A community can only be protected when 92 percent or more of a population is immunized” (Khazan). Therefore, as the anti-vaccination movement continues to grow, protection from infectious diseases through vaccination becomes less and less effective. Consequently, the outcome of this debate will have a profound outcome on the spread of communicable diseases and the health of American citizens.

Rhetorical Context

     The anti-vaccination movement emerged amidst newfound information about the side effects of vaccines. It has been widely known that vaccinations may cause “…soreness at the injection site, fever, aches, and fatigue” (Williams, 8). However, “Severe adverse effects, such as allergic reactions, convulsions, shock, and death are also possible but are reported to be statistically rare” (Williams, 8). These risks, on top of Andrew Wakefield’s false evidence of an association between autism and the MMR vaccine, can perplex any concerned parent hoping to make the right decision for their child. With extensive evidence fueling the support of vaccinations as well as the elaborate warnings by anti-vaccination protestors, the decision to vaccinate or not to vaccinate can be difficult.

      This debate between anti-vaccine and pro-vaccine has brought into question aspects of the American identity. As polarizing as this issue is, the core aspects of the American identity are represented on either side. Those who are anti-vaccine represent the right to have freedom over one’s body, and as a country we have agreed to respect personal beliefs regarding medical issues. For example, when a religious tradition calls for circumcision, or a Jehovah’s Witness patient denies a life-saving blood transfusion, we allow it. Both of these examples represent medically controversial issues in which we have ruled in favor of the individual’s rights whether they are asking for or refusing a particular treatment or procedure. From the perspective of anti-vaccination protestors, does it not seem fit to also allow Americans concerned about vaccine safety to deny a vaccine?

     It is also a distinctly American characteristic to intervene in medical affairs for the greater good, as was displayed in 2014 with America’s involvement in the African Ebola crisis. By September of 2014, the United States had donated “more than $100 million” (Kaplan) to the cause on top of caring for four Ebola patients in U.S. hospitals (Kaplan). In the case of vaccines, the more individuals who are vaccinated, the more protected we are as a country. With this information in mind, we know that the is more than an individual issue. It is a national issue. In the first chapter of the book Vaccinations, Gretchen Flanders included the following “four-way stop sign” metaphor by Dr. Bruce Gellin, “‘A person who decides to ignore the stop sign knows he has less risk of an accident if others obey it. However, if two drivers make a similar decision, assuming that the other will stop, the outcome becomes much more risky for everyone in the intersection.’” (Flanders, 14). As more and more people make the decision to refuse vaccination, the risk for developing an infectious disease increases. Michelle Meadows noted in her essay Vaccines Are Safe and Effective, “…even immunized individuals can be at risk because no vaccine is ever 100 percent effective for everyone” (Meadows, 19).

     The anti-vaccination movement has contributed to many protests in California regarding the passage of Senate Bill 277. On May 16, 2015, protestors rallied at the doorstep of an event for the Democratic Party in Anaheim criticizing governor Jerry Brown for the bill’s passing (Jamison). Later that year, a Santa Monica ABC news station reported on an anti-vaccination protest labeled the Health Freedom Rally. Reporter Denise Dador claimed that “hundreds of parents and activists” were present at the event, as was Andrew Wakefield, an infamous promoter of the movement (Dador).

     Images of these protests and related protests amplify the movement’s key terms and phrases: informed consent, autism, and my child, my choice. According to the U.S. Department of Health and Human Services, informed consent is a participant’s agreement to participant in research once informed of all possible risks (hhs.gov). By using this phrase, protestors are eliciting their right to know all possible side effects of vaccines as well as their right to refuse them.

     The second key term used in anti-vaccination protests is autism. Despite evidence disproving the association between autism and vaccination, protestors continue to use this word as a rhetorical strategy. By putting the word “autism” on their posters, protestors use pathos, persuasion through emotion, to persuade other parents to avoid vaccines. Jenny McCarthy, a celebrity representative of the anti-vaccination movement, has used this word continuously to criticize vaccinations. As she personally has a child with autism, McCarthy is essential to the effective use of pathos in this movement (Coombes).

     Finally, the phrase “my child, my choice” is seen all over anti-vaccine posters. This phrase suggests that the new law revokes a parent’s choice to not vaccinate their children. In actuality, parents still have the right to refuse to vaccinate their children. The penalty of this choice, however, is that their child will no longer be able to attend daycare, public, or private school facilities (SB 277). This penalty, therefore, puts many parents in a situation where vaccination is the only choice.

     A 2005 study by Allison Kennedy, Cedric Brown, and Deborah A. Gust, explains why this negative reaction to the bill was expected. According the authors, “Residence in a state that offers philosophical exemption to vaccination…was significantly associated with opposition to mandatory vaccines” (Kennedy, et al.) Since California had previously accepted personal belief exemptions, it makes sense that many individuals would be opposed to the new senate bill. The study went even further to prove that the anti-vaccination movement and the protests it has elicited is associated with more than just the American identity. The study found that “parents who reported lower household income were more likely to be opposed to compulsory vaccination…” (Kennedy, et al.). Therefore, the vaccination debate has incorporated a more specific piece of the American identity, the lower class. Making vaccinations mandatory may have significant drawbacks other than the side effects of the vaccines. According to the study, these individuals face more “experience barriers, such as transportation or access to health care services” (Kennedy et al.). These results present interesting questions to those in favor of vaccinations. Are vaccines easy enough to receive? With the passing of Senate Bill 277 in California, questions like this need to be thoroughly investigated.

     The rhetorical goal of the anti-vaccination movement is to affect a change in the national opinion on vaccines through the rhetorical strategies pathos and ethos. The key phrase, “my child, my choice” previously discussed is a testament to pathos. It’s clear that parents on both sides of the issue have their children’s safety at heart, but the anti-vaccination protestors center their argument on pulling heartstrings while pro-vaccine activists rely mostly on science. The movement also relies heavily on ethos with Jenny McCarthy and Andrew Wakefield as the head celebrity and medical endorsements, respectively. With these individuals speaking at protests and rallies, the movement seems more substantial and attracts bigger crowds.

      The rhetorical goals of the movement build on top of the movements existing legislative and political goals. Members of the movement seek to repeal mandatory vaccination laws such as California Senate Bill 277 to ensure that personal belief exemptions remain a legal loophole to refuse vaccinations. Politically speaking, these protestors also want to limit government control in medical affairs, therefore increasing autonomy in their own medical decisions.  

      The individuals involved in the ant-vaccination movement are each speaking on behalf of an identity they feel connected to, including low-income families with limited medical access, concerned parents, or American patriots protesting for individual liberties. Each of these identities and several others are represented in the images of anti-vaccination protests. Andrew Wakefield, whose reputation has been tarnished and whose science has been disproven, continues to advocate for individuals belonging to these identities through the anti-vaccination movement. Most recently, Wakefield has expanded the scope of the movement with his new documentary  “Vaxxed: From Cover-Up to Catastrophe.” The film was scheduled to debut at the Tribeca Film Festival this year, but was removed due to the perceived negative message of the film (Lipkin). The controversy over this film is a sign that the anti-vaccine movement continues to be firmly rooted in a “rhetorical crisis” (Griffin, 11). 

Works Cited

Primary Sources:

“Jacobson v. Massachusetts.” US Supreme Court, Justia (1905). Web. 5 April 2016

“California Senate Bill 277.” leginfo.ca.gov. 19 February 2015. Web. 5 April 2016.

Secondary Sources:

Coombes, Rebecca. "VACCINE DISPUTES." BMJ: Britsih Medical Journal 338.7710 (2009): 1528-1531. Web. 04 April 2016. (Peer Reviewed Article) 

Dador, Denise. “Hundreds Protest California Vaccine Bill In Santa Monica.” abc7.com. 03 July 2015. Web. 07 April 2016.

Flanders, Gretchen. “Vaccinations Under Scrutiny: An Overview.” Vaccinations. Ed. Mary E. Williams. Farmington Hills: Greenhaven Press, 2003. pgs. 12-17. Print. 07 April 2016.

“Frequently Asked Questions About Human Research.” HHS.gov. Web. 07 April 2016.

Griffin, Leland M. “The Rhetoric of Historical Movements.” Readings on the Rhetoric of Social Protest. By Chlares E. Morris III and Stephen H. Brown. 3^rd ed. 183-203. Desire 2 Learn. Web. 07 April 2016.

Jana, Laura A. June E. Osborn. “The History of Vaccine Challenges: Conquering Diseases, Plagued by Controversy.” Vaccinophobia and Vaccine Controversies of the 21^st Century. pgs. 1-13. 27 May 2013. Web. 7 April 2016.

Jamison, Peter. “Vaccinatio protestors at Democratic convention compare California to Nazi Germany.” The Los Angeles Times. 16 May 2015. Web. 07 April 2016.

McGreevy, Patrick. “Nation of Islam Opposes California Vaccine Mandate Bill.” The Los Angeles Times. 22 June 2015. 9 March 2016.

Meadows, Michelle. “Vaccines Are Safe and Effective.” Vaccinations. Ed. Mary E. Williams. Farmington Hills: Greenhaven Press, 2003. pgs. 18-25. Print. 07 April 2016.

Kaplan, Rebecca. “Obama to boost U.S. involvement in fight against Ebola.” CBS News. 15 September 2014. Web. 07 April 2016.

Kennedy, Allison M., Cedric J. Brown, and Deborah A. Gust. “Vaccine beliefs of parents who oppose compulsory vaccination.” Public Health Reports 120.3 (2005): 252-258. Web. 03 April 2016. (Peer Reviewed Article)

Khazan, Olga. “Wealthy L.A. Schools’ vaccination Rates Are as Low as South Sudan’s.” theatlantic.com. 16 September 2014. Web. 5 April 2016. (Popular Source)

Lipkin, W. Ian. “Anti-Vaccination Lunacy Won’t Stop.” The Wall Street Journal. 3 April 2016. Web. 07 April 2016.

Riedel, Stefan. “Edward Jenner and the History of Smallpox and Vaccination.” Proceedings (Baylor University. Medical Center) 18.1 (2005): 21–25. Print.

“Smallpox.” WebMD. 23 April 2015. Web. 6 April 2016.

Williams, Mary E., ed. Vaccinations. Farmington Hills: Greenhaven Press, 2003. Print. 4 April 2016. (Historical Context)