An outbreak of measles in Clark county Washington has led to at least 36 confirmed cases, and quite possibly a dozen more. A recent Oregonian newspaper article by Molly Harbarger had the title “Vancouver-area measles outbreak costs county $187,000 so far.” While we now view measles as a childhood disease, some historians have suggested that it could have caused the Antonine plague that devastated ancient Rome (165-180 AD). Globally, in 1985 nearly 1.2 million people died from measles annually (see slide 3), and many more patients suffered from pneumonia or were left with damaged hearing. Of course, measles is easily preventable with a regularly administered vaccination. This vaccination not only protects the person who receives it, but also babies too young to receive the vaccine, or patients with weakened immune systems, such as people receiving chemotherapy or living with HIV/AIDS.
The outbreak in Clark county was entirely preventable. Too few people had received the vaccination for herd immunity to work. It’s a sign of a larger problem, which is people’s refusal to vaccinate their children against diseases such as Whooping Cough, which is making a come-back in the United States. Public health authorities suggest that one of major factors driving these outbreaks are the conspiracy theories regarding vaccines spread through social media, YouTube and the internet. Interestingly, outbreaks of these vaccine-preventable diseases are no longer primarily happening amongst the poor and marginalized, but rather amongst the educated and privileged.
I talk about conspiracy theories and public health frequently in this blog (perhaps too much), because of the extent to which they undermine public health efforts. In Brazil, my work has showed how a plethora of conspiracy theories emerged during the Zika epidemic, which had a terrible impact upon unborn babies. These theories attributed Zika to Bill Gates, the Illuminati, U.S. laboratories, pesticides and Monsanto. One point that I tried to make in my paper was that conspiracy theories were typically viewed far more often in alternative media sources than reliable sources of information, as other scholars have also found. While there was no vaccine for Zika, there were public health interventions that could work, such as wearing insect repellent, draining water where mosquitoes might hatch their eggs, and practicing safe sex for a period of time after infection. Public health measures -including Oxitec’s GMO mosquitos- might have also helped. But such measures were difficult for authorities to implement when conspiracy theorists blamed Oxitec for the outbreak. And why would an expectant mother put on insecticide if she believed that the true culprit was Monsanto, which had contaminated the water supply? Conspiracy theories are not harmless.
Every pandemic and outbreak of infectious disease has had its conspiracy theories, at least since the bubonic plague of the 14th century. The irony is that these theories have not dissipated with modern health care and state-provided education. Instead, they have morphed, evolved and grown. I’ve written an article that discussed how during the 2009 influenza pandemic conservative pundits in the United States blamed the outbreak on Mexican immigrants, while people in Latin America blamed it upon corporations in the United States. In Egypt the government slaughtered pigs owned by the Christian minority -with no public health rationale- while in Europe people questioned their ability to trust the pharmaceutical industry. In 2007 Indonesia for a time stopped sharing viral samples of avian influenza, which are used to create pre-pandemic vaccine strains. While there were many reasons for this decision, Indonesia’s health minister authored a book that suggested that the United States was creating bioweapons at a naval medical research center in Indonesia (Smallman, 2013, pp. 26-27). Nor are such conspiracy theories confined to public health. They emerge wherever political polarization has deepened, as has been the case in Argentina in 2015.
It may be easy to mock peoples’ fears in these cases. But measles is a far simpler outbreak to understand than Zika, avian influenza, or even the 2009 influenza pandemic. There can be few viruses as carefully studied, or for which a better vaccine exists. The outbreak took place in the United States, in an area with generally good health statistics. Yet conspiracy theories have immense power. I believe that these beliefs flourish in part because academics ignore them. Social science theory classes in sociology, anthropology and many other disciplines fail to even mention them. It is an interesting experiment at an academic conference to flip through theory textbooks in a search for even a brief mention of conspiracy theories. Nor are they typically discussed in public health textbooks either. At the same time that they proliferate, they are nearly invisible in academia.
Academics have certain expectations for theories. They are supposed to be articulated by well-educated individuals, who advance their ideas through books. Conspiracy theories instead come from the masses, and are spread without any gatekeeper, such as an academic press. But they are far too dangerous to ignore. We need to teach about conspiracy theories in our classes; to use case studies with conspiracy theories in our readings; and to ensure that information literacy is a core learning outcome in all our classes. The people who are turning from vaccines are often people with the resources to put their children into private schools, or to send their older children to private liberal arts colleges.
It’s true that it’s nearly impossible to fight conspiracy theories with arguments alone. I think that the work has to begin far earlier -in high schools if possible- and to begin not with conspiracy theories themselves, but rather the question of information literacy. What is fake news? How can we tell if a source is reliable? In a digital era, how should we sift our sources? Then we need to talk about conspiracy theories, and the literature regarding them, particularly from psychology. But educators can’t do it all. People in authority -and people from the same political or religious background as vaccine refusers- are crucial to addressing conspiracy theories. We need pastors to address this from the pulpit, political leaders to mention this in their speeches, and media figures to speak out. This will take everyone. Of course, this will not persuade dedicated conspiracy theorists. But we don’t have to. With measles a population needs a vaccination rate of perhaps 95% to achieve herd immunity.
Craft, S., Ashley, S., & Maksl, A. (2017). News media literacy and conspiracy theory endorsement. Communication and the Public, 2(4), 388-401.
Rodriguez, L. and Smallman, S. (2016). Political Polarization and Nisman’s Death: Competing Conspiracy Theories in Argentina. Journal of International and Global Studies Volume 8, Number 1, p. 20-39.
Smallman, S. (2018). Conspiracy Theories and the Zika Epidemic. Journal of International and Global Studies Volume 9, Number 2, p. 1-13.
Smallman, S. (2015). “Whom Do You Trust? Doubt and Conspiracy Theories in the 2009 Influenza Pandemic” Journal of International and Global Studies, Vol. 6, No. 2: pp. 1-24.
Smallman, S. (2013). Biopiracy and vaccines: Indonesia and the World Health Organization’s new Pandemic Influenza Plan. Journal Of International & Global Studies, 4(2), 20-36.