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Wednesday
Jan112017

Donald Trump: Science Communication Environment Polluter-in-Chief

So, what to say about Trump’s despicable stance on vaccines?  Well, how about this:

1. Despite the regularity of empirically uniformed assertions to the contrary, the policy of universal vaccination, carried out by means of school-enrollment mandates, is not a politically contentious policy.  On the contrary, the vast majority of the public --including Democrats and Republicans climate change skeptics and nonskeptics, evolution believers and evolution nonbelieversall support this policy.

The universal-vaccination pubic consensus can be, and has been, measured by public opinion polls. But the best evidence is just how high vaccination rates are in the U.S. today, and have been for more than a decade.

Yes, this policy is opposed by a fringe, which various narcissistic public figures and a gaggle of professional conflict entrepreneurs jockey to lead.  But the fringe is a fringe; “anti-vaxers”—people who really are committed to rolling back universal childhood vaccinations, the most successful public health policy ever devised—are definitely outliers In whatever culturally identifiable group they come from.

2. This doesn’t mean, though, that the policy of universal childhood vaccinations is immune to political polarization.  For proof, consider the HPV vaccine.  Designed to protect against most of the strains of the human papilloma virus that cause cervical cancer, the proposal to add HVP to the universal-vaccine schedule splintered the American pubic along familiar political and cultural lines. As a result, this vaccine, even some ten years after the political battle abated, continues to bear a stigma that inhibits states from adding it to the mandatory list, and parents from assenting to the administration of it to their sons and daughters (Gollust et al. 2010; Gollust et al. 2015a, 2015b; Kahan et al. 2010).

3.  The key to protecting public confidence in and support for universal childhood vaccinations is the quality of the “vaccine science communication environment.”  Consider the HBV vaccine. Like the HPV vaccine, the HBV one is designed to confer immunity to a cancer-causing pathogen, hepatitis-b.  Only a few years before its recommendation on the HPV vaccine, the CDC identified it, too, as appropriate for inclusion in schedule of mandatory vaccines (for infants now but initially for adolescents).  At the time that the HPV vaccine was an object of intense, and intensely politicized, issue (roughly 2007-2010), the rate for HBV vaccines was between 90% and 95% on a national basis.

The difference in public reactions reflected the difference in the science communication environments in which they learned of these respective vaccines (Kahan 2013, 2016). 

Unable (understandably, inevitably) to determine on the basis of personal research and experience all the science that they must accept in order for them to flourish in their lives, ordinary members of the public sensibly become experts on identifying who really knows what about what.

When they applied that form of rational perception to the HBV vaccine, all the cues—from the recommendations of their own pediatricians to the actions of their peers—vouched for the good sense of getting the shot.

But when they first encountered the HPV vaccine, the situation was quite different: they were bombarded with information that emphasized partisan division  mirroring the divide over already polarized issues, including climate change, evolution, etc.

The reason for the difference was a risky marketing decision by the manufacturer of the HPV vaccine (Kahan 2013). Keen to accelerate the addition of its own HPV vaccination to the universal-childhood vaccination schedules, and to lock up its control of the market for supplying the vaccine for use in the public-school enrollment programs before approval of a rival firm’s competing vaccination was approved, the manufacturer orchestrated a poorly disguised political marketing campaign, one that included adoption of vaccine mandates in state legislatures.  The process attracted the usual conflict entrepreneurs—right and left.

In sum, the company recklessly pushed the HPV vaccine into the political arena, which is ripe with cues that attached a partisan brand to the vaccine.  Such cues—ones that make a contested science issue a symbolic test of who one is culturally, and whose side one is on—predictably displace and erode the habits of mind that diverse members of the public use to identify who knows what about what.

The HBV vaccine, in contrast, avoided this dynamic. Like other childhood vaccines, it travelled a depoliticized administrative route to adoption, in which public health authorities insulated from politics added the vaccine to the states’ universal-vaccination schedules.  As a result, parents learned of the HBV vaccine  from their pediatricians, people the trust, in a normal, unpolluted science communication environment that enabled rather than enfeebled their rational power to discern what is known to science (Kahan 2016).

With the HBV vaccine, they never had to make a choice, in sum, between knowing what science knows and being who they are as members of diverse cultural meanings (Fowler et al. 2015).

But with the HPV one, they did.  When they are put in that situation, bet consistently that they will choose to “be who they are” (Kahan 2015), and you will become a very rich person (as conflict entrepreneurs well know).

4. Trump as science communication environment polluter.  That’s what makes Trump’s actions—his appointment of the crank Robert Kennedy Jr. --to head up an absurd “vaccines & autism” commission so dangerous.  From his bully(bull shit) pulpit, he has a unique power to enmesh the facts on the safety childhood vaccines in the toxic memes (Kahan et al. 2016) that transform a science issue into a cultural-identity one.  

His actions also create a condition ideal to the flourishing of conflict entrepreneurs, who profit from the anxieties that cultural conflicts over science provoke,  and who until now have floundered about without drawing large followings (CCP 2014).

Fighting back w/ true factual information – while certainly appropriate—is unlikely to do be sufficient once positions on vaccine risks have become fused with personal identity (Nyhan et al. 2014; Nyhan, 2016).

5. To public’s confidence in universal vaccination, we—all the people who aren’t part of the existing anti-vax fringe—need to resist Trump’s toxic stratagems.  There’s only one effective remedy for Trump’s vile behavior: to refuse to take the bait. Aside from the HPV disaster, politicians on both the right and the left have for the most part refused to make mandatory childhood-vaccination into a partisan issue.  They must do the same now.  Indeed, they must band together, across party lines, to condemn Trump for the threat to public health that his actions pose.

And the same goes for those outside the government.  Media and interest groups must be discouraged from using Trump’s behavior as an occasion to assimilate childhood-vaccines into the set of toxic issues that put ordinary people to the choice of being who they are or knowing what science knows about how to  protect their well-being. 

Of course, such groups can be expected to do what is in their interest. So citizens, too, must show that polluting the science communication environment around vaccines is something they won’t tolerate from those whose job it is to inform them.

6. This is the biggest test yet of our society’s science communication literacy.   I’m aware, of course, about how empty, how naïve an injunction like the one I just propounded can be.  We know a lot more about how and why certain issues become entangled in toxic, science-communication-environment degrading memes than we know about how to stifle that process.

But we must use all we know, and seek to add to it through experience as well as research (Pemberton 2013; Mnookin 2011), to block Trump’s effort to pollute the science communication environment on vaccines, and hope we can learn more from the experience.

The alternative to not even trying is to put at risk what is likely the greatest public-health asset—the broad level of U.S. general public confidence in childhood vaccines—that we possess. . . .

References

Cultural Cognition Project. Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Experimental Investigation.

Fowler, E.F. & Gollust, S.E. The content and effect of politicized health controversies. The ANNALS of the American Academy of Political and Social Science 658, 155-171 (2015).

Gollust, S.E., Attanasio, L., Dempsey, A., Benson, A.M. & Fowler, E.F. Political and news media factors shaping public awareness of the HPV vaccine. Women's Health Issues 23, e143-e151 (2013).

Gollust, S.E., Dempsey, A.F., Lantz, P.M., Ubel, P.A. & Fowler, E.F. Controversy undermines support for state mandates on the human papillomavirus vaccine. Health Affair 29, 2041-2046 (2010).

Gollust, S.E., LoRusso, S.M., Nagler, R.H. & Fowler, E.F. Understanding the role of the news media in HPV vaccine uptake in the United States: Synthesis and commentary. Human vaccines & immunotherapeutics, 1-5 (2015).

Kahan, D., Braman, D., Cohen, G., Gastil, J. & Slovic, P. Who Fears the HPV Vaccine, Who Doesn’t, and Why? An Experimental Study of the Mechanisms of Cultural Cognition. Law Human Behav 34, 501-516 (2010).

Kahan, D.M. A Risky Science Communication Environment for Vaccines. Science 342, 53-54 (2013).

Kahan, D.M. Climate-Science Communication and the Measurement Problem. Advances in Political Psychology 36, 1-43 (2015).

Kahan, D.M. Protecting the Science Communication Environment: The Case of Childhood vaccines. (2016), working paper.

Kahan, D.M., Jamieson, K.H., Landrum, A. & Winneg, K. Culturally antagonistic memes and the Zika virus: an experimental test. J Risk Res, (2016), advance on line.

Nyhan, B. The Challenges of False Beliefs: Understanding and countering misperceptions in politics and health care (2016), working paper.

Nyhan, B., Reifler, J., Richey, S. & Freed, G.L. Effective Messages in Vaccine Promotion: A Randomized Trial. Pediatrics  (2014).

Mnookin, S. The panic virus : a true story of medicine, science, and fear (Simon & Schuster, New York, 2011).

Pemberton. Jabbed: Love, Fear and Vaccines (2013).

 

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Reader Comments (19)

Dan -

==> And the same goes for those outside the government. Media and interest groups must be discouraged from using Trump’s behavior as an occasion to assimilate childhood-vaccines into the set of toxic issues that put ordinary people to the choice of being who they are or knowing what science knows about how to protect their well-being. ==>

I assume that you're aware that the closing the stable door at this point is rather pointless.

But at any rate, I don't see how what you're suggesting might be achieved even if the horse hadn't already done bolted.

Would it work for people to simply not voice objection or react to Trump's exploitation of vaccine science for the sake of political expediency? I doubt it. And I doubt that's what you're suggesting.

So how do you think people should respond without assimilating vaccine science into the ideology wars? I mean yes, explicitly linking vaccine policy to the "war on science" would clearly be avoidable, and deliberately avoiding making any such linkage might feel good for people who want to stay above the fray, but the realpolitik world dictates that any reaction to anything Trump does on this issue will be leveraged by Trump and his supporters for political advantage. IMO, w/r/t climate science, you overestimate the differential impact of politicized rhetoric on the part of "realists," as "skeptics" will necessarily be outraged no matter what rhetoric "realists" use (they have to be, because the overriding, if unconscious "motivation" behind what takes place in the climate wars is identity-protection/identity-aggression). I wonder if I would come to a similar conclusion here about your view on causality for polarization.

Keep in mind, that Trump was willing to fear-monger about Ebola by advocating policies that were widely rejected by people knowledgeable about public health policy. He seems to feel no constraints for using science-associated issues for the sake of political expediency, and certainly doesn't need politicized rhetoric from the other side on issues (which didn't exist on Ebola) to use fear-mongering for his advantage.

January 11, 2017 | Unregistered CommenterJoshua

@joshual--

What horse are you talkinhg about? This issue isn't poloiticized now. It should stay that way.

I don't recommend doing/saying nothing. I am recommending that people avoid responding in a manner that evinces that positions correlate w/ political orientation. I say those on left & right should denounce his program. Indeed, Congress hould reafuse to fund the envisioned agency or working group or whatever it is that Trump has appointed RFK2 to lead.

January 11, 2017 | Registered CommenterDan Kahan

Dan -

http://www.dailykos.com/story/2017/1/10/1618988/-Donald-Trump-appoints-Robert-F-Kennedy-Jr-to-chair-panel-on-vaccine-safety-wing-nuts-rule

http://www.huffingtonpost.com/entry/trump-vaccines-autism_us_58750d8ce4b02b5f858b3810

I have no idea how much attention this issue will attract amidst the sexier hearings on Trump's cabinet appointments and the whole golden showers tornado. But I have little doubt that some on the left will continue to connect this with climate change, the "war on science," etc., to prosecute their ideological battle with Trump. And I would be very surprised if Trump diverge away from his politicization of the science of vaccines.

That doesn't mean that it will become a more widely polarized issue, however, And then it would be an interesting question, if it doesn't, what distinguishes it from other politicized science issues such as climate change.

==> I am recommending that people avoid responding in a manner that evinces that positions correlate w/ political orientation. ==>

Agreed, but how does someone do that, exactly? Certainly, connecting it with the "Republican war on science" won't fit the bill, but what other form of reaction would not evince positions correlated with political affiliation? I can't think of any. Seems to me that pretty much any opposition to Trump will, necessarily, evince positions correlated with political orientation - because people are looking for issues to vindicate their identity protective cognition.

==> I say those on left & right should denounce his program. ==>

The left has begun to do so already. What will the response be on the right if Trump continues to politicize the issue? I would imagine the response will be to attack the left.

I don't think, however, that this issue will catch fire on a wide scale, and I think that the reason won't be because of what people on the left do in response to Trump. I think that there is more to the calculus of what issues get hitched more widely to ideological bandwagons than the more simple equation that you seem to be suggesting (i.e., at least as I understand your position, that there is nothing inherent about individual issues that grease the track towards politicization, but rather singularly, the politicization originates in some particular act or rhetoric by some particular actor(s)).

January 11, 2017 | Unregistered CommenterJoshua

He who knows only his own side of the case, knows little of that. His reasons may be good, and no one may have been able to refute them. But if he is equally unable to refute the reasons on the opposite side; if he does not so much as know what they are, he has no ground for preferring either opinion. The rational position for him would be suspension of judgment, and unless he contents himself with that, he is either led by authority, or adopts, like the generality of the world, the side to which he feels most inclination. Nor is it enough that he should hear the arguments of adversaries from his own teachers, presented as they state them, and accompanied by what they offer as refutations. That is not the way to do justice to the arguments, or bring them into real contact with his own mind. He must be able to hear them from persons who actually believe them; who defend them in earnest, and do their very utmost for them. He must know them in their most plausible and persuasive form; he must feel the whole force of the difficulty which the true view of the subject has to encounter and dispose of; else he will never really possess himself of the portion of truth which meets and removes that difficulty. Ninety-nine in a hundred of what are called educated men are in this condition; even of those who can argue fluently for their opinions. Their conclusion may be true, but it might be false for anything they know: they have never thrown themselves into the mental position of those who think differently from them, and considered what such persons may have to say; and consequently they do not, in any proper sense of the word, know the doctrine which they themselves profess.

So, to play devil's advocate...

1) The debate is already polarised/polluted, and everyone knows it. Nobody believes for one second that because Donald Trump has appointed him that he's any more likely to be right. (Half the population will think that that mere fact itself means Kennedy's more likely to be wrong!) Donald, as a politician, has no scientific authority. It's obviously entirely a political appointment, and you shouldn't be giving the impression that who gets such jobs says anything at all about the science by fighting it on science grounds!

2) Opposition to people's views on the basis of them being a member of the anti-vaxxer group is therefore already associated with taking political sides. Objecting to the appointment doesn't do anything to persuade people he's wrong, it just tells them which side your on, and taints you with the politically partisan pollution in their eyes. Anything you say thereafter is judged accordingly - you have an uphill struggle gaining credibility because other participants assume you're only saying what you say because of your declared group allegiance.

3) The same effect deprives Kennedy of any special authority or credibility with those who are not already supporters. The potential harm is therefore greatly reduced.

4) You can't hold a debate if one side is not invited. If you try to exclude people from the debate, you never actually get to thrash out the reasons they're wrong, and more dangerously, you give the impression you're refusing to debate them because you know you'd lose.

And you don't convince anyone to think again by treating them as an idiot and excluding them from the public square. They take it as hostility, and respond emotionally to that accordingly.

5) Running a foot race after carefully hobbling all of your opposition and then crowing about how your triumphant victory at the finish line shows the superiority of your position is unlikely to convince anybody. You have to win the race even after handing your opponent every advantage, and thereby depriving them of every excuse for having lost.

6) If the policy-making process is evidence-based, rather than authority-based, then it should make no difference who is running it. The fact you're worried about the wrong guy running it tells us that you at least think it's too authority-based for our comfort. You can't rely on giving authority only to people with the right opinions to ensure the right policy. You have to build it into the process.

This is therefore an excellent opportunity to change things. And to teach people why they need to be changed, and precisely why arguments from authority need to be rejected. (i.e. that sometimes the wrong people get into authority.)

You can fake authority, you can't fake a valid scientific argument.

7) If you suddenly notice the political bias of candidates for government science positions only when an opponent gets into office, and knowing that everyone is blind to their own cognitive biases, and also knowing (via the symmetry thesis) that everyone has biases, including you, you ought to be wondering around about now whether maybe Obama's appointees looked exactly like this to the other side of the political aisle?

How do you like the view in *that* mirror?

If you think political appointments are so bad, why the hell did you tolerate presidents appointing them in the first place?! (As opposed to a competitive technical exam, say...) Obama's had the power for the past 8 years to stop doing it. Only objecting to the other side doing it is rank hypocrisy. As is suddenly only doing something about when you're not in position to take advantage of it yourself.

8) You should never give any power to government that you would not want to see your ideological enemies wielding, because one day they will. That's an important principle and safeguard of liberty. You build the limits into the system when you're in power yourself, so that you're protected when you're not.

Authoritarians want power over others, but don't want those others to have power over themselves, and call themselves "liberals" because of the latter. Real liberals don't want anyone to have power over anyone else. This ought to count as a major "teachable moment" for all of you as to why that is! Pay attention!

9) Science has always argued patiently with cranks. Those with bad arguments are easy to knock down. Those with better arguments are an invaluable resource for testing your own understanding. I've had some fascinating discussions with people who think Einstein's relativity is wrong, with perpetual motion machine and reactionless drive advocates. (Not to mention global warming believers!) Even if you know they're wrong, it's sometimes surprisingly difficult to explain clearly why. And besides the learning experience in better understanding the science itself, it's a humbling and educational experience just because of that fact.

Indeed, it's a statement of strong scientific principle to seek out an opponent who does genuinely disagree, and is strongly motivated to find flaws in your position - just as Mill said. It's what scientists ought to be doing anyway.

It should make no difference to the scientific method that they're in a position of political power. You present the arguments and evidence in such a way that there is no possible chink or hole in the argument for anyone watching to doubt. The obvious and well-known determination of your opponent to do so is the most convincing argument possible of the absence of any such flaws when they fail. You should teach people to reject arguments from authority, and to demand arguments from evidence. The arguments either convince or don't convince on their own merits. And for the partisans, the arguments make no difference anyway.

January 11, 2017 | Unregistered CommenterNiV

BTW -

Kennedy's statements seemed awfully vague to begin with. Now there's this:

http://www.cnn.com/2017/01/10/politics/robert-f-kennedy-jr-donald-trump-vaccine-commission/index.html

January 11, 2017 | Unregistered CommenterJoshua

Dan, you say partisans must ban together across party lines to condemn Trump's stance. But it seems that if liberals/Dems speak out, that may make conservatives find the anti-vaxx stance more attractive, because if liberals are mad about it (or anything else Trump does), it must be good.
So it seems that the best (only?) way for liberals to "speak out" on this issue, without moving it into the partisan sphere, is to publicize/retweet/promote statements by conservatives. Like posting this article from the Resurgent: http://theresurgent.com/stop-it-anti-vaxxing-is-one-conspiracy-too-far-for-trump/
That seems doable to me, but one problem is that I cannot get on board 100% with this article because of what it says about climate change.
What do you think is the best way for liberals to condemn Trump (short of finding a conservative partner to issue a joint statement, which seems impracticable because coordinating is hard)

January 11, 2017 | Unregistered CommenterRoseanna

@Joshua-- I had a feeling that Kennedy was making "fake" news.... But apparently Trump is genuinely ruminating about, if not planning for, a "commission." Hard, bi-partisan denunciation -- and indication from Congress it will not appropriate funds for such a comm'n--would help innoculate vaccines against entanglement in antagonistic meanings

January 12, 2017 | Registered CommenterDan Kahan

@Roseanna--

It's not the pol/cultural identity of the critic that is decisive; it is the use vel non of arguments that simultaneously associate position being challenged w/ *a particular* identity & invite contempt for those holding such an identity.

Take a look at experiments in "feral risk communication" report & in Zika paper & tell me if they affect your critique

January 12, 2017 | Registered CommenterDan Kahan

@NiV

But the premise that vaccination is polarized issue already is false. In this circumstance, the goal of protecting science communication environment involves keeping it free of toxic memes. Arguing w/ cranks is fine-- so long as one avoids identifying cranks w/ entire cultural group

January 12, 2017 | Registered CommenterDan Kahan

"But the premise that vaccination is polarized issue already is false."

It's not politically polarised. But politics is not the only axis along which people can vary, culturally.

I was talking about the tendency, once something has become a group belief, for the belief to become an identifying badge of the group, for group membership to cause members to generally credit or discredit members/non-members respectively, and for these effects to become self-reinforcing, irrespective of the evidence. It shows all the problematic characteristics of political polarisation without being correlated to politics.

January 12, 2017 | Unregistered CommenterNiV

@NiV--

I agree with you that cutural polarization is not completely captured by political divisions. We considered this most rencently in the Supplemental INformation (I hate these) part of our paper Zika & toxic memes; indeed we used cultural measures there precisely b/c it was more discerning of systematic individual differences than was political orientation.

What we must be disagreeing on, then, is eithe where we are in the cultural-polarization career of childhood vaccines or how fragile its state of nonpolarization is right now.

January 14, 2017 | Registered CommenterDan Kahan

I think that the political process, in our two party system is inherently partisan. I share the concerns of Roseanna and other commenters above.

We already have considerable experience with what does not work in vaccine communication. What does not work is jousting, giving the other side a platform by simply coming out loudly in opposition to that side.

This mechanism not only worked well for Wakefield, a broader based version of the same sorts of tactics has worked well for Trump in his Presidential campaign. And overall, the media is doing a poor job of using standards of journalism to counter these methods: https://www.theguardian.com/us-news/2017/jan/14/donald-trump-press-conference-twitter-media.

Opposing Trump as a tactic is inherently partisan, and one he relishes fostering. Which is what he is doing in his appointment of Kennedy. Very clever, in that in crossing party lines he can make what is really a a highly partisan appointment appear as "non partisan".

We are over a decade on now from the introduction of the HPV vaccine. Andrew Wakefield's paper that purported to link the MMR vaccine with autism was published in 1998, with refutations starting almost immediately afterwards, but was not completely retracted by the journal Lancet until 2010, with allegations of fraud following that. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/. We now have two deeply embedded sides who are still making careers out of jousting in this debate.

Despite the successive waves of communication pollution on the subject, in general, most children are getting vaccinated. That is due to the hard work of pediatricians and public health professionals. These people are forging ahead with tactics that work. Pediatricians have been mproving the hand off from obstetrician to pediatrician and focusing on parent communication. Public health officials have been effectively doing their jobs. This includes: Outreach to medically undeserved communities with programs such as "cocoon of safety" that emphasize that parents and other adult caregivers for infants need to be immunized. Mechanisms that allow parents who are members of vaccine opposing religious groups ( some Amish and Dutch Reformed Church for example) get to clinics with protections for privacy and lack of recrimination for not getting their children vaccinated sooner. Public Education programs that let people know that in many instances adults that think that they are vaccinated may need boosters (the whooping cough "Big Bad wolf" ads aimed at Grandma and Grandpa are examples of this http://www.fiercepharma.com/dtc-advertising/gsk-s-big-bad-whooping-cough-vaccination-campaign-bares-its-teeth). Laboriously tracking outbreaks when they do occur and attempting to assure that those that are exposed get immunized. Using the generally widespread support for vaccines to aid in these efforts. This work has been highly effective.

We also need to highlight the need for further vaccine development and better precautions.

For measles, infants are quite vulnerable, as are people on immune suppressing drugs. Older adults who did not get the booster initiated in the 1980s may also have lesser resistance. This is an old vaccine. Perhaps we could now do better. Measles is highly contagious since it can be transmitted by air. We have a medical system that in many instances is not set up to safely handle these sorts of cases well without exposing other patients and medical staff. This could put the public at risk in future epidemics. We have a global society, one in which travel is common. The exposure rates at a place like airports or Disneyland far exceeds the statistical limits of provisions of herd immunity. We may need to adjust such things as our handling of infants, and requirements for travelers and workers in high public exposure venues to accommodate for that.

For HPV, we have demonstrated that Big Pharma is more than eager to introduce a vaccine that can be placed on the large scale customer base and liability protections of the childhood vaccine program. But now, with the threat of Zika, there has been less action by the major pharmaceutical companies themselves. Policy measures that increase public funding for vaccine development or that conversely, focus on privatization by increase the liability umbrella might help.

Following the lead of the public health community, dangers can be highlighted, without emphasizing the positions of those that have not yet gotten vaccinated. We should also keep in mind that in the general scheme of things, what matters is public health overall. Non-vaccinated children may be lacking in other forms of much needed health care, with ramifications far more serious than a case of measles is actually likely to be. One of the major ultimate goals of the HPV vaccine is reduction of cervical cancer rates. For which older women need access to women's health clinics and Pap smears today. At which time they could also get such things as mammograms and or birth control advice.

What to do about Kennedy? or Trump? That is harder. But in as much as possible, IMHO, we should focus on advocating for science without letting ideas that are not supported by science becoming center stage. That means not providing the other half of a "tell both sides" debate. Figuring out ways to access the public via the media without mentioning Kennedy or autism. Put the public health officials front and center. Put those who have actually made a profession out of highlighting the controversy on notice that the science community is not with them.

I think that this is the important part of #5 above. Refuse to take the bait.

January 14, 2017 | Unregistered CommenterGaythia Weis

"What we must be disagreeing on, then, is eithe where we are in the cultural-polarization career of childhood vaccines or how fragile its state of nonpolarization is right now."

Thinking about it a bit more, I'm wondering if we're talking across purposes, using different definitions of "polarisation".

I've been involved in many different sorts of discussions and debates on the internet, and there is a distinct difference in feeling between those in which people's passions are or are not aroused. A discussion about the size of electrons with respect to atoms, say, has a very different 'feel' to one on evolution, GMOs, environmentalism, the economics and morality of free market globalisation, religion, Israel-Palestine relations, or climate change. People take sides. They're emotionally involved, and see it as a Manichean moral struggle against 'the enemy'. I've been in a few debates on vaccines and they all had the same feel.

What I'm thinking of as "polarisation" might better be called "tribalism" - the division into "sides" in which each group holds beliefs about the other group separate from their beliefs about the subject of the argument, and where people tend to get pushed into one group or the other. There's no agnostic middle ground; you're either for it or against it.

I'm looking at a characteristic of the debate itself. You, on the other hand, seem to be looking at how it interacts with other, pre-existing polarised debates: so it's when the pre-existing polarised debate between left and right, or between individualists and communitarians gets tangled up in it, and one entire tribe gets sucked in to supporting one side of the argument, forcing the other side to take the other side of the argument.

That's also an interesting phenomenon, but it's different to the one I was talking about.

I think my point still stands. I don't think "toxic memes" are specific only to political arguments. I think that if you take a stand on the side of the pro-vaxxers, the participants in the fight won't see that as settling the argument, but as simply taking sides. It's true that if political establishments on both left and right take the same side, it's less likely to get entangled with politics, but it won't do anything to resolve the vaxxer debate. And according to your bar chart, anti-vaxxers constitute 20-25% of the population!

I'm inclined to agree that preventing entanglement with political sides would be good - it could only serve to further entrench viewpoints. Nevertheless, I'm not sure that simply taking a side (or being seen to) is necessarily the best way forward, for all the reasons discussed above. Nor do I think it would be so easy - given that something like 20-25% of both political parties hold the contrary view, if you all suddenly and loudly stake a position in the debate, I'm sure they would want to speak up for their own beliefs too. Both parties would find themselves at war internally, and if those wars came out differently in each case, you could end up triggering exactly the sort of political division you was hoping to prevent.

If you want to have any hope of persuading the anti-vaxxers that they're wrong, you need someone from their own tribe involved in the investigation. Otherwise they will simply dismiss it as an establishment whitewash with no credibility. (I speak from as position of knowledge, here, having watched the effect when they appointed strong pro-warmer figures to all the official investigations on Climategate.) If we want to make an attempt to attempt to fix the damage caused by the anti-vaccine arguments, it needs to be something like this. But there is a valid argument as to whether we really want to open that particular can of worms at all. And I would quite agree that the fact that it is Trump doing this, with the reflexive opposition to anything he says or does that evokes in half the population, it's probably going to cause trouble.

January 14, 2017 | Unregistered CommenterNiV

RFK JR walks out of a meeting with Trump and manages to generate massive headlines for himself. Straight out of Trump's playbook. This is a game that effective science communicators should not be getting sucked into.

The issues to focus on revolve around public health, for which vaccines can be an effective solution. But the bottom line is public health.

As I've pointed out in comments on other posts, public health officials have been very effective in getting parents to immunize against measles once they realize the seriousness of the need and are provided with mechanisms for doing so that don't force them to publicly deny other affiliations. One example I am familiar with was a measles outbreak among Dutch Reformed Church members on the British Columbia/Washington State border. The key was to studiously refuse to respond to the minister with an anti-vaccine stance, and to provide a high degree of privacy to parents bringing children in to be vaccinated.

On the subject of the HPV vaccine, WHO has a newly published guide for the introduction of this vaccine in national immunization programs: http://apps.who.int/iris/bitstream/10665/253123/1/9789241549769-eng.pdf?ua=1

"Because HPV vaccines do not protect against all HPV types that cause cervical cancer, vaccine
introduction should be part of a coordinated and comprehensive approach to cervical cancer control
that includes:
• Prevention primarily through vaccination of 9-14 year old girls prior to exposure and acquisition
of HPV infection;
• Secondary prevention through screening and treatment of adult women for pre-cancerous lesions,
and
• Tertiary and palliative care for women affected by cervical cancer."

If I were writing this, I'd include more information and screening and treatment focus on other forms of HPV related cancers, but I think that the broad approach, one in which vaccines are only one component of achieving a pro-health objective, is the right way to communicate.

With this structure it ought to be obvious, IMHO that the issue of vaccines is hardly the " biggest test yet of our society’s science communication literacy", even if that was limited to public health issues. Trump has already called for repeal of Obamacare, without offering a clear alternative. Access is central to good public health. While big fusses have been made regarding low vaccine rates in upscale American communities, deaths due to vaccine preventable diseases have occurred in communities that lack public health access: http://www.nytimes.com/2010/06/24/us/24cough.html. And if cervical cancer rates are to be reduced, access to pap smears and thus women's health clinics is crucial. Reductions in funding for Planned Parenthood ought to be of serious concern.

Key to effective science communication here is denying RFK Jr the publicity he craves, or at least not accentuating his efforts.

January 14, 2017 | Unregistered CommenterGaythia Weis

"Key to effective science communication here is denying RFK Jr the publicity he craves, or at least not accentuating his efforts."

It depends what effect you want.

If nobody has ever heard of the controversy, you might indeed prevent people ever hearing about it.

If people *have* heard of the controversy - and I think launching a public campaign to tell the ultra-controversial and combative US President Trump not to do what he's just announced he's doing can't help but raise visibility even further - you hand Kennedy the best possible stick to beat you with he could ever want.

He will simply claim that the medical/regulatory establishment supports vaccination simply because anyone who doesn't is excluded from it. He will claim that the medical industry wants to exclude him because they want to avoid scrutiny. Because they know if they had to provide proof of their claims in a venue where all opposition hadn't been excluded, they know they'd lose. And best of all, he'd avoid any necessity to prove any of his claims himself - if he's not invited to the debate, nobody can say for sure he didn't have a valid argument. Some people will assume he did.

You ought to already know this. The dynamics is exactly the same as in the fracking debate. The industry experts and scientists all say its safe. The protestors say it's dangerous. If the regulatory body that decided whether fracking was to go ahead was made up entirely of industry-appointed supporters of fracking, with anyone who opposed it being excluded from having a voice because they were an "unscientific crank", what would you think?

As it happens, I think the arguments of the fracking protestors are just as scientifically spurious as those of the anti-vaxxers (because I've looked at them), but I also think it's extremely dangerous to exclude people who disagree with a 'scientific consensus' from the public debate and political decision-making process. The reasons for that I've set out at length many times before.

You ought to have anti-frackers on the panel that decides whether to do fracking. You ought to have environmentalists on the panel that regulates industry to prevent pollution. You ought to have anti-vaxxers on the panel to decide whether vaccines are safe. They're 20% of the population! Democracy demands they be represented.

But you ought to insist that whoever is on the panel, they have to adhere to strict scientific standards of quality and transparency, and have all their work checked by all sides, with those criticisms and challenges published too.

January 15, 2017 | Unregistered CommenterNiV

I agree with NiV's conclusions.

And while I'd agree with Dan's headline above (Trump as science communication polluter in chief), I think that is a foregone conclusion by now. The question is, how should science informed public communicators deal with that? The answer, I believe, is to not continue to give center stage to the media circus. As the NCSE (National Center for Science Education) advises on evolution: "Don't Teach the Controversy".

Googling RFK Jr right now reveals that a number of professional science communicators are falling into a Trump style trap, as initiated by RFK Jr when he came out of a meeting with Trump and announced that he would head up a vaccine and autism commission. (At this point, Trump himself is being vague, typical for him, IMHO, maintaining deniability that such an invitation ever even occurred). Trump is going to continue to be himself. RFK Jr. appears to be similarly opportunistic. The question is how we deal with it. In my opinion, while the media plays lip service to the idea that they will not allow Trump to set the media publicity agenda, the media can't seem to resist continuing to do so. Immediately following Kennedy's announcement there was a firestorm of headlines, all featuring Kennedy and his anti-vaxxer ideas. As with Trump's Presidential campaign, this gives failed ideas way more publicity than they deserve. Every headline mentioning vaccines and autism extends the life of this myth. Unfortunately, as the CEO of CBS News pointed out, Trump's style may not be good for the nation, but it is good for media money making. http://www.mediaite.com/online/cbs-ceo-on-trump-campaign-it-may-not-be-good-for-america-but-its-damn-good-for-cbs/

Science Communicators ought to start from a position of strength in the science. And the facts, as demonstrated by Dan's research, that the public in general, and especially the key demographic of parents with small children, largely supports vaccines. And are utilizing them. I think that highlighting recent progress (an Ebola vaccine) and urgent needs (Zika, the obsolescence due to mismanagement of many antibiotics) can foster public understanding for the need for future R&D funding as well as work on improvements in existing vaccines.

Vaccines are sometimes a partial victim of their own success. Few people have seen a case of measles. (It might raise feelings of "disgust" if they had). But diligent work by public health officials to track down cases and highlight gaps in coverage can stem the spread of outbreaks. And, while vaccines provide an easy fix, measles at the level currently experienced is far from the biggest public health issue facing the nation.

Quite a bit of the problem needs to be addressed by working on mechanisms not directly related to anti-vaxxers.
Instead, focus on good science based public health care more generally:

The societal need to maintain access to good health insurance as something that makes all of us healthier.

Making clinics and hospitals more hygienic, and resistant to the spread of microbes, including airborne ones.

Ensuring that workers in high people contact professions are fully immunized and have the sick leave provisions needed to stay away from the public when ill.

Education on the potential for harm from diseases, whether it be measles or polio, and the need for immunization, until like smallpox, they are eliminated as a global threat. And thus that our concerns about vaccines should extend worldwide.

The need to use our current knowledge of the immune system to develop improved vaccines with less side effects, and to identify those (few) who might be most in danger of suffering from side effects. And to support research funding into greater knowledge.

In the case of some diseases such as measles it might be advisable to look more closely at residual maternal immunity in infants, and whether or not re-vaccinating women with low immunity prior to pregnancy might be a viable mechanism for protecting subsequent babies.

The urgent need for mechanisms that focus on the threats of emerging diseases and research into vaccines that may help prevent their spread.

Broadening our focus beyond the childhood immunization program to adults, with established routine booster programs ensuring that there is not a base of such diseases as whooping cough in the adult population.

I think that we need to base our approaches with the knowledge that there are considerable forces out there wanting to gain publicity for their ideas (notably the antivaxxers) as well as those that have based journalistic careers on exposing and supposedly combating those ideas but have instead, inappropriately highlighted and fostered their spread, ( but benefited their own careers in doing so). Additionally, there are other forces with vested interests in limiting conversations to topics that deflect further scrutiny of their own operations with regards to vaccine development and expense (Big Pharma).

We can use the science of science communication to come up with much better public outreach methods.

January 15, 2017 | Unregistered CommenterGaythia Weis

In my opinion, we ought to entertain the concept that these issues are interrelated.

A "Marin County" stereotypical antivaxxer and fossil fuel CEOs are operating from analogous positions of personal and corporate privilege and elitist lack of concern for the common social good.

January 16, 2017 | Unregistered CommenterGaythia Weis

The science communication problems certainly did not start with Trump. Our political arena is not the only area polluted by the effects of Big Money.

"“The very way we all think about disease—and the best ways to research, define, prevent, and treat it—is being subtly distorted because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices,” "

https://www.propublica.org/article/pharma-money-reaches-guideline-writers-patient-groups-doctors-on-twitter?utm_source=pardot&utm_medium=email&utm_campaign=dailynewsletter

January 17, 2017 | Unregistered CommenterGaythia Weis

"because so many of the ostensibly independent players, including patient advocacy groups, are largely singing tunes acceptable to companies seeking to maximize markets for drugs and devices"

'Appeal to Motive'.

If you stick to strict standards of scientific quality, then motive is irrelevant because they would have to publish the evidence and the evidence stands on its own. The sceptical opponents checking it would quickly highlight any trickery or distortion.

If someone claims to have produced a new drug to cure cancer, you don't test it by checking who funded the research, and dismissing it if they have a financial interest in lying about it. You check it by giving it to people with cancer and seeing how often they survive. The difference between the two approaches is fundamental to the philosophy of science. Financial conflicts are (perhaps) a good reason to check things more carefully, but not to reject things.

There are many alternative explanations for funded groups giving different answers to unfunded ones. Perhaps the simplest is that companies might choose to fund only those groups who are the most knowledgeable about the subject. (Well, wouldn't they?) Or maybe they're more knowledgeable because they're funded. Note, I'm not saying they are, or that's the true explanation. Bribery and bias is certainly a common motivator, too. The point is that given several hypotheses predicting the same outcome, we can't tell from this evidence which (if any) of them is true. We don't know.

Fake news works because people are not trained in how to recognise fallacious arguments. On the contrary - since most of the arguments presented by the media are based on fallacies of one sort or another (like Argument from Authority), people are actually being trained to accept them as valid. If it *looks* like a professional media publication, with the right fonts, typesetting, visual style, vocabulary, and so on, people learn to pick up on those cues as signs the source is trustworthy. But fallacies are fallacies precisely because they can be faked. You can arrive at false conclusions using these methods of argument. And so can anyone else.

Even if you only use them 'honestly', always using them to present true conclusions based on longer, non-fallacious reasoning, and only use them to "keep things simple" for an uneducated public, you're still storing up trouble for society. Besides the possibly of falling victim yourself to unconscious bias, you're leaving tools around that can be picked up by anyone. Eventually, someone will. Someone you don't agree with.

'Fake news' happens because we don't teach people how to use the scientific method. There's no known alternative to it. Any solutions we propose to that one are going to be hard.

January 18, 2017 | Unregistered CommenterNiV

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