How To Argue Against Anti-Vaxxers

Look, this is an old-school argument by now. The reality is that there is only one study that ever linked vaccines to autism, and it's since been thoroughly discredited, not because of an all-powerful pharmaceutical lobby, but because the science was poor, has been contradicted by a huge range of other studies, and was conducted by a doctor who has since had his medical license revoked for several reasons, some unrelated. Andrew Wakefield's methodology for the 1998 study published in The Lancet was deemed in 2010 to be both uncorroborated and unethical, he was forbidden from practicing medicine, and The Lancet formally apologized.

Wakefield's unintentional legacy has been, fortunately enough, a lot of studies that tried to replicate his findings, and failed. A meta-study from 2014, for instance, looked at a total of 1.2 million children and found no vaccine-autism link whatsoever; and that's not even scratching the surface. Anti-vaxx people need to be assured that scientists really did take Wakefield's claims seriously, and have investigated them back to front, in a way that can be deemed free of outside influence from people trying to skew the evidence.

Interestingly enough, this may be the argument that really changes the minds of anti-vaxxers. A 2015 study found that while rational arguments may work well enough, anti-vaxxers change their minds most readily when they're faced with the realities of what happens when vaccination doesn't occur. And let's make no mistake, the realities can be as truly horrific as the vaccinations themselves can be beneficial. It's not an equal choice in the slightest.

Vaccinating children against measles, for instance, protects them against seriously horrible risks. In 1986, author Roald Dahl wrote to parents considering not vaccinating their children:

"Olivia, my eldest daughter, caught measles when she was seven years old.... In an hour, she was unconscious. In twelve hours she was dead. The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her. That was twenty-four years ago in 1962, but even now, if a child with measles happens to develop the same deadly reaction from measles as Olivia did, there would still be nothing the doctors could do to help her."

Even with modern medicine, the side effects can still be deadly: encephalitis will occur in around one child in 1,000 with measles, pneumonia in 1 in 20, and 2 in 1,000 will die. Rubella in small children is often quite inconsequential, but if caught by pregnant women it will cause birth defects in 85 percent of fetuses. Babies and small children who catch whooping cough are highly vulnerable, at risk of seizures, kidney issues, brain damage and pneumonia. Pneumococcal illnesses, which are immunized against using the pneumococcal vaccine, can cause meningitis, septicaemia, and meningococcal, a particularly deadly virus. (A cousin of mine died of meningococcal at three weeks old.)

We'll get onto the supposed costs of vaccinations in a second, but their benefits are gigantic. Smallpox has been entirely eradicated, and that was a disease so common that everybody, including Elizabeth I, had scars from it. Polio, which once caused millions of deaths and disabilities worldwide, is 99 percent eradicated. Measles has been almost eliminated in the Americas since 2002. Get your head around that for a second: diseases that utterly terrorized our ancestors, even our grandparents, are now disappearing or gone. Vaccinations have saved millions upon millions of lives, and continue to do so every day.

A common anti-vaxx argument is that vaccines are inherently unsafe. One of the major arguments for this is the fact that, in the U.S., the National Vaccine Injury Compensation Program has given $3.18 billion in compensation to people bringing forth claims since 1988. Surely this means that there's something inherently wrong?

Not so fast. TIME crunched the numbers, and came up with the startling observation that the number of claimants compared to the number of vaccinations actually given over the time period meant vaccines have less than a million-to-one chance of doing harm. They also pointed out that the compensation is done on a no-fault basis, so the court doesn't require concrete proof that the problem was caused by the vaccine. A minute number of claims (around three per year) are about lifetime injury, and those make up for most of the compensation. They make up around 90 of the 2.5 billion or so vaccinations given in America during the period. The math shows the risk is incredibly miniscule.

It's intuitive that there are some risks to vaccines; after all, it does involve placing a small amount of a problem into the body. However, as histories of vaccination make clear, a lot of very intense work has gone into making sure that they are as close to 100 percent safe as possible, and they've come damn close. Many people experience mild side effects after vaccines as their immune systems kick in (tenderness, a touch of cold); the most severe reactions are usually in people who have an allergy to some component of the vaccine. And our understanding of how allergies interact is always better-safe-than-sorry. For instance, the CDC recommended for a while that people with severe egg allergies be observed for 30 minutes after getting a flu shot, but they've since determined that allergic reactions are unlikely.

The idea that "natural immunity" will somehow be a better alternative to vaccinations is a common part of vaxxer arguments; they note that a small dose of measles as a child will develop the immunity in their kids without the necessity of getting "chemicals" via vaccinations. There are a few problems with this. One, it requires that the child actually get ill, and take the significant risks of doing so, which I've talked about above. But two, it fundamentally misconstrues what the "chemicals" in vaccines actually do.

Natural isn't always better. Arsenic is naturally produced, for instance. But the chemicals in vaccines (which have been thoroughly and rigorously tested before being given to the majority of a population, including very young children, because governments have no wish to kill off their citizens) are designed to be low-dose and are only present because of absolute necessity. The preservative thimerosal, for instance, was attacked as potentially problematic because it contains a variety of mercury (less toxic than the kind that made hatters mad), but it's only around to make sure that multiple doses don't go off. It's now been removed from most vaccines or is only present in trace amounts. They did it as a precautionary measure, not because it's been found to be harmful, but because the evidence that it did or did not cause any issues was "inadequate" either way, and it was better scientific practice to pull the preservative and do more tests than leave it in. They issued a final report in 2004 exonerating thimerosal from causing autism.

This is the big one for many anti-vaxxers: that compulsory vaccination represents government overreach and that the personal choice of parents is paramount. The problem is that vaccination needs to be done en masse to be fully effective. The phenomenon of "herd immunity" is a key part of vaccination: if you vaccinate the vast majority of a community, they protect people who can't get vaccinated or are more vulnerable, like infants, pregnant women, and people with severely compromised immune systems, like those on chemotherapy. Nineteen out of every 20 people need to be vaccinated for this protection to work. If you don't vaccinate your kid, you're placing children with cancer, for instance, in severe danger.

Targeted vaccination is also important: for particular illnesses, certain groups are more liable to get and spread them than others, and so need to be a focus of vaccination. "Selective vaccination of groups that are important in transmission," vaccine developer Dr. Stanley Plotkin explains in his guide to herd immunity, "can slow transmission in general populations or reduce incidence among population segments that may be at risk of severe consequences of infection." One of the big targeted populations? Small kids who might get flu.

Vaccination is not an opt-in, opt-out thing, unfortunately. If you live in the middle of nowhere and will never have exposure to other humans, ever, feel free not to vaccinate. Vaccination mandated by the government is fundamentally designed for the greatest possible protection; it's rather like FDA rules on, say, food producers. They can't just let food companies opt out of listing their ingredients or obeying rules on use-by-dates and food storage. Contamination can spread, and the laws exist to make sure everybody remains safe. Your child, like every other child and adult, has a fundamental right to grow up healthy. That is a right worth protecting with a jab in the arm.