Running the Vaccine Gauntlet

I had a wonderful tour last week of the state capitol of Virginia at Richmond. It was conducted by my old friend Mark Greenough, the chief of interpretation, and someone who occasionally portrays John Marshall, the chief justice of the Supreme Court. As we entered the capitol, we walked the gauntlet of about 100 women, many of them with children, holding up hand-painted signs denouncing vaccination. I stopped to engage with several of them. “Why are you doing this?” I asked. A thirty-five-year-old woman said, “We love our children.” Unable to stop myself, I said, “Oh, so those who vaccinate their children don’t?” She was displeased, to put it mildly.

Later, sitting in my airport hotel room, swabbing down the nightstand, the lamp, the remote, and the doorknob with sterile wipes—a fastidiousness which has little to do with the coronavirus, by the way—I thought about human irrationality. We know that the smallpox vaccine developed by Edward Jenner in the Age of Jefferson has saved the lives of hundreds of millions of human beings. When Jenner made the great medical breakthrough—realizing that kinepox, a cousin to smallpox, can immunize against the much more devastating smallpox, and from which we get the word vaccine, which comes from the Latin vaccus for cow—he was denounced and opposed by people who thought, What, you are giving people a disease—cowpox—and pretending that that will immunize them from smallpox. No way. And people who believed that smallpox is God’s way of fulfilling his vow in the book of Genesis to punish mankind for its sinfulness. Jenner persisted and changed the world. About how many individuals can you say that?

We would all be so much better off if we listened to science. Science is not invariably right. The development of the chemical Thalidomide in Britain in the 1960s as a cancer drug wound up causing thousands of profound birth defects. DDT was thought to be a miracle weed killer until we realized that it travels all the way up the food chain until it kills eagles. The men who built the atomic bomb at Los Alamos did not stop to think about radioactive fallout until just a few weeks before the first test at Alamogordo, New Mexico. We get it, not only that science and engineering can make terrible mistakes, but, worse, we are often surprised long after the fact by the law of unintended consequences.

Still, science is self-correcting, transparent, peer reviewed, and committed to the amelioration of the condition of mankind. In his wonderful book Homo Deus, the intellectual historian Yuval Harari argues that the triumph of science means that one of the four historic scourges of humankind—epidemic disease—has essentially been eliminated by science, and that it is only a matter of time before science plus all the data that is now routinely collected from every corner of the planet and sorted by hordes of supercomputers and artificial intelligence will cure virtually all, maybe all, diseases, from Parkinson’s and Alzheimer’s to Cancer and Lou Gehrig’s Disease. This sounds a little optimistic to me, and I would love to hear a Sixty Minutes interview with Professor Harari right now, as the coronavirus spreads like wildfire, but I am guessing he would say this: within a year this will be a distant memory. Science, as long as it is joined by intelligent public policy decisions, will get on top of the coronavirus much sooner than you think, because we have created the epidemiology infrastructure—the World Health Organization the Centers for Disease Control, government funding of medical research, the magnificent global research university matrix—that coordinates a global response to the outbreaks of disease.

I trust science. I do not particularly trust government, because any administration anywhere, whether it is Angela Merkel’s Christian Democratic Union party in Germany or chairman Xi Jinping of China, is going to try to cover its backside, even if that means withholding the truth the whole truth and nothing but the truth, and governments must often talk in reassuring bromides to keep whole populations from panicking. And panic, as we have already seen, only compounds the root problem. If you read Daniel Defoe’s Journal of the Plague Year, published in 1722, or Stephen King’s The Stand, published in 1976, you will see how quickly concern tips over into panic, which leads to spasms of violence, inhumanity, and social breakdown; and how thin is the veneer of human civilization. We think we are orderly, law-abiding, compliant, respectful of others, generous, tolerant, and understanding, but even in the minor oil crisis of 1979 people where ramming each other’s cars and whipping out guns in lines at America’s gas stations. If all the food disappeared from the grocery stores in your community, it would not take two weeks before people who roving the streets with clubs and guns in search of food and pummeling anyone who seemed to be hoarding whatever is left.

We think we are civilized but that is only because we have civilized manners, laws, and institutions. When they begin to break down, humans begin to resemble Jonathan Swift’s yahoos—excrement hurling primates with no self-control of violence or sexual predation. Among other things this explains My Lai and Abu Ghraib. We always act surprised when our inner Yahoo bursts through the thin layer of civility, but any serious study of human history proves that we are at least as much yahoo as hero of a Jane Austen novel.

As I took my usual sponge bath with rubbing alcohol in my airport hotel room in Richmond, Virginia (I’m joking but you get the idea), I thought about those stern and righteous women in the gauntlet at the capitol. They have every right to feel as they do about the vaccine protocols of the American public-school system, but they do not have the right to increase the vulnerability of our social structure. Trying to find the right balance in that issue proves to be very difficult, but I err on the side of vaccination. Why?  Because I have read about the bubonic plague of the 14th century, which killed approximately one in four in all of Europe; I have read about the history of smallpox, including the smallpox holocaust that destroyed millions of American Indians from the moment Columbus bumped into the Bahamas in 1492 until it was declared eradicated in 1980. I have read the story of the Yellow Fever epidemic in Philadelphia in 1793, when one in ten innocent people of the city died of a disease nobody even knew the transmission of. And because my mother, like so many others, including Franklin Delano Roosevelt, contracted polio, until most of its strains were finally eradicated in 1999.

I wish to make two points about the anti-vaccine crowd.

First, the people in that protest line at the Virginia State Capitol have the luxury of standing there because science and public policy together have eradicated most of the infectious diseases that have carried off billions of people over the last thousand years. In other words, because we have used vaccines to eradicate all of the major infectious diseases, it is possible to get worked up around the fringes. They would not talk that way if measles were killing three out of every hundred public school students, including perhaps their own child.

Second, if the coronavirus explodes across the globe exponentially and let’s say gets much more deadly, killing hundreds of thousands or even millions, and the scientific community develops a vaccine, you can bet those same mothers would be clawing their way to the front of the lines to demand that their children be the first to be vaccinated. An ungenerous person would say they should have to sign a form saying they do not expect to be saved so they can remain consistent with their anti-vaccination philosophy. I wish to be more generous than that. But if that moment comes, I hope they will be asked to reconsider their irrational antagonism to the healing arts

That same anti-scientific narcissism, by the way, is what is endangering the whole planet as climate begins to spin out of control.

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