I’m just following up on Julia Azari’s recent post on immunization politics. With some Republican presidential candidates now sounding out their concerns about immunizations (and getting some pushback for it), are we witnessing the early polarization of vaccinations? Are Republicans going to become the anti-immunization, anti-public health party, with only Democrats embracing the scientific consensus?
Obviously, this scenario is a potentially very dangerous one from a public health perspective. If only half the country is getting immunized, or if immunizations are being provided uniformly only during Democratic presidencies, that’s not much better than having no immunizations at all. But it also may prove difficult to reach that point, given the current makeup of the anti-vaccination (or anti-vaxxer) community.
There’s been some recent controversy over who precisely the anti-vaxxers are. Paul Waldman notes one study that suggests that, at least for now, there is no vaccine division along conventional ideological lines. Specifically, liberals appear no more likely than conservatives to believe that immunizations pose a threat. However, this finding does not necessarily mean that the anti-vaxxer belief system is unrelated to ideology. For one thing, while fears of vaccinations are certainly related to the refusal to vaccinate one’s children, they are not exactly the same thing. An anti-vaxxer may see no more risk in immunizations than one who regularly vaccinates her children, but may simply feel that there’s no need to expose her child to even a small risk if she can otherwise safely manage her child’s health. Second, even today, we are talking about a pretty small (if consequential) percentage of parents who are refusing to vaccinate. Liberals may not appear any more likely than conservatives to oppose vaccinations in aggregate studies, but the small number of anti-vaxxers may still be more likely to be liberal.
Perhaps the most comprehensive study of the anti-vaxxer community comes from sociologist Jennifer Reich. (Disclosure: Reich is a friend and former colleague of mine.) As she demonstrates in some of her recent work,
Children who are intentionally unvaccinated are more likely to be white, have a college-educated mother, and a higher family income.
Just demographically, that sounds like a Republican-leaning group. However,
Mothers in my study describe their efforts to protect their children’s health in ways they see as making vaccines unnecessary. They focus on organic foods, breastfeeding, health-promoting practices at home, and control of their children’s social exposure as ways they see themselves as mitigating disease risk.
In terms of lifestyle, this group sounds pretty liberal. And as Reich notes, these people tend to live in neighborhoods with poorer, under-vaccinated, medically fragile children. Reich describes the anti-vaxxers as “neoliberal,” noting that they’re neither crazy nor uninformed. Rather, they tend to view society as atomized rather than networked:
Mothers who reject vaccines are not “loons” as popular media would suggest. They spend considerable time and resources deciding what their children need and how to protect them. Yet they do so from a perspective that treats vaccines as a technology for individual consumption that mothers should assess and decide independently whether to use. This ethos—reflecting neoliberal goals that individuals behave as informed consumers responsible for their own health—lies in sharp contrast to the tenets of public health that expect individuals to accept minimal risk to protect those among them who are most vulnerable.
Could such an ethos spread to a more conservative group of Americans? Possibly. But from what we understand about social movements, they are very often driven by elites, whether those are cultural or political figures. That is, if enough Republican leaders or conservative cultural figures publicly question the importance of immunizations, and if such messages go unchallenged or even embraced by commentators on Fox and other conservative media outlets, that message could soon be adopted by conservative parents with only modest attachments to politics.
And in some ways, this argument meshes very well with the American conservative world view. The idea that I can make better judgments about my kids than the government can, that I should be concerned about me and my own rather than the larger social network, that I shouldn’t have to make sacrifices or face risks on behalf of strangers — it wouldn’t take much to fold that into the definition of modern conservatism. Resistance to vaccinations doesn’t have to mean embracing organic food or breastfeeding toddlers; that’s simply a liberal interpretation of it.
But we’re not quite there yet. The main cultural elites advocating avoiding or at least questioning vaccinations, from doctors with celebrity pretensions to celebrities with medical pretensions, are mostly on the left right now. Chris Christie has limited appeal, and Rand Paul has not quite yet demonstrated an ability to reach those outside his libertarian circles. But if we’re going to see the anti-vaxxer belief system mutate and spread to the right, this will be how it happens.
[Cross-posted at Mischiefs of Faction]