This is where antivaccination beliefs lead you.

This is where antivaccination beliefs lead you.

There is a good reason that the regular contributors at Science-Based Medicine, which is about examining and promoting the highest standards of science within health care, are also all skeptics. Effectively promoting science requires a working knowledge of pseudoscience in all its forms. If anything, this is getting more true in the era of alternative facts and fake news.

The anti-vaccine movement is an excellent example. You cannot address the harm of this movement without understanding pseudoscience, denialism, conspiracy thinking, and motivated reasoning. It is common for scientists naïve of pseudoscience to approach all such issues with the assumption that they are due mostly to a deficit of information. Under this paradigm all you have to do is give people the information they are missing, and they will change their mind and do the rational thing.

Such an approach only works for issues about which the target audience does not already have any emotional investment. For questions about which we are essentially neutral, people do take a natural Bayesian approach and update our beliefs with the new information. However, the more we are invested in one conclusion, the more immune we become to facts and logic. On such issues facts may even provoke a backfire effect in which people dig in their heels, and become even more certain of their original position. They may even begin to doubt all of science in order to render their position immune to scientific facts.

This unfortunate phenomenon is exacerbated by orders of magnitude when people band together to reinforce each other’s motivated reasoning. People are also social creatures, and social reinforcement of a specific narrative can be powerful. The way in which social media makes forming such groups so easy has been dubbed the “echo chamber” effect.

Motivated reasoning, confirmation bias, cherry-picking, conspiracy thinking, and the echo chamber effect conspire together to create a self-reinforcing narrative, one that can ensnare the unwary. Level of education and general intelligence do not appear to protect one against being ensnared – in fact, being intelligent just makes one better at motivated reasoning. Critical thinking skills, self-awareness, and the highest level of science education appear to be necessary to inoculate against being trapped by pseudoscientific narratives.

The anti-vaccine narrative

We have been dealing with the anti-vaccine movement for years, and it is clear that they are operating under this paradigm. They have a clear narrative, which is based largely in conspiracy thinking. Conspiracy theories are a particularly pernicious form of pseudoscience because they so effectively cut one off from any path to reason. They also tend to get more and more extreme, and dark, over time. They have to, in order to maintain themselves against reality.

A recent article by longtime anti-vaccine crank Kent Heckenlively nicely demonstrates this process.

The anti-vaccine conspiracy theory holds that vaccines cause a long list of ills. This is taken as a given, an article of faith. Everything else necessarily flows from that premise. If vaccines cause disease, then the pharmaceutical industry must know it. They have done the research. One does not have to be a conspiracy theorist to assume that corporations are hiding inconvenient information to protect their profits.

But then the narrative necessarily gets darker. Not only must pharmaceutical executive know that vaccines are causing harm, it must also be true that the medical profession knows as well. Who do you think is conducting that research? They review the data, and they make recommendations for treatment. The government must be involved as well, because they regulate vaccines. The Center for Disease Control (CDC) reviews the published science and makes recommendations for the vaccine schedule. So they must be in on it.

Think about what a scary world anti-vaxxers live in. The institutions of health that profess to protect and serve the public, in their view, are actually poisoning them, all to protect the profits (and a tiny slice of those profits) of one industry. The situation is all the more emotional because this alleged harm is being done to children.

But then it gets worse – science communicators look at the data, and the official reviews, and talk to relevant experts and conclude that vaccines are safe and effective. The arguments of the anti-vaccine community all collapse under objective examination. They communicate their findings to the public. This just makes anti-vaxxers feel as if they are under fire. In their view, science communicators must all be shills for “Big Pharma.” They “know” this is true, because it must be.

That is the nature of conspiracy theories – the conspiracy collapses unless more and more people are in on the conspiracy. Before too long you have a world-wide dark and evil conspiracy. It’s enough to make one paranoid.

Read Heckenlively’s account of his own journey down this disturbing path. First, the premise:

We know that vaccines are causing MASSIVE DAMAGE to the health of our young and contributing to the massive epidemics of chronic diseases among those of working age and the dementias of the elderly. Don’t believe me? Just read the vaccine safety inserts.

As an aside, Heckenlively seems to comply with the general rule that the level of one’s paranoia is directly proportional to the use of all caps. The package inserts contain every observed side effect of a drug, even if they were reported in 1% or less or those using it, and even if they were not caused by the drug (see here for more context on those packaging inserts). There are rare adverse reactions to vaccines. No one denies that.

The question, as it always is with medical interventions, is what are the relative risks vs benefits. The risks of vaccines are rare, the benefits are massive. This is the consensus opinion of the world’s scientists, doctors, scientific and health organizations. Heckenlively thinks he knows better because he can read a packaging insert.

This also brings up another aspect of conspiracy theories – the “army of light” (as the theorists see themselves) are always able to easily see through their imagined conspiracy. Everyone else is either an ignorant dupe, or part of the conspiracy. They also easily dismiss counter evidence. The very fact that FDA regulations require listing all possible side effects on the package insert for public disclosure is not exactly consistent with there being a conspiracy of silence. In Heckenlively’s world, those are the effects they “admit” to – so there must be even more and worse effects. Got it.

Armed with basic English literacy, Heckenlively believed he would change the world:

But I thought when people like me raised our voices and claimed vaccines were harming the human species, that somebody in a position of authority in government or science would do some proper investigation. However, as I researched my book, INOCULATED: How Science Lost its Soul I had to confront some dark truths about the corruption of the American body politic.

This is the difference between engaging with the scientific and medical communities, and thinking that you know better than the experts. I don’t blame parents and citizens for having concerns about the safety of such a widespread public health measure. If you do, engage with experts, find out what they known and how. Most experts are happy to talk about the topic of their expertise.

Antivaxxers like Heckenlively did not do serious journalistic or science journalism investigation. They simply confirmed their beliefs, and blamed anyone who would not buy into their seriously flawed narrative. He found a disconnect between his conclusions and the conclusions of experts, and from that he concluded that the experts were not only wrong, they were evil and corrupt. That is a dark path that only gets darker.

No matter how cynical I was about whether people in our government cared about children with autism, and the wholesale destruction of our species by vaccines, I wasn’t cynical enough.

We tried to work with our health authorities. They turned a deaf ear.

That’s right, people like Heckenlively have to believe that the government (and medical profession) literally do not care about the “wholesale destruction of our species.” He would rather believe this than maybe, just maybe, his interpretation of the science is flawed or incomplete. The notion that experts who have dedicated their lives to studying vaccines might have a more reliable opinion about their safety than a non-scientist like Heckenlively is apparently inconceivable. The notion that the governments and health authorities of the world are standing by while our species is destroyed – that makes sense.

If you had any doubts about the fact that the anti-vaccine narrative thrives within its own echochamber, and among general conspiracy theorists…:

I hear Alex Jones and InfoWars are going to be doing their own series of special reports on THE VACCINE SIDE EFFECTS LISTED ON THE INSERTS. (That’s just the things the pharmaceutical companies admit!) I’m looking forward to that.

Heckenlively apparently thinks that Alex Jones is a more reliable source of information than the CDC. The conspiracy theorists are their own references.

It is an almost universal element of apocalyptic conspiracy theories that there is a coming reckoning (it is one of the many cult-like attributes of such groups):

I wish I could say I felt sorry for those who will suffer the wrath of an enraged public when all of this is revealed. But I don’t. When the Nazis lost World War II, many of them used a ratline to escape to South America. For these criminals, there will be no place in the world which will accept them.

I do feel sympathy for Heckenlively and others like him. In my opinion he has fallen victim to a flaw in the programming of the human brain. He is trapped in a feedback loop of confirmation bias, and he is in way too deep to have any reasonable hope of ever digging himself out. To him there is no reasonable disagreement, and no discussion to be had. Those who disagree with him are “criminals” guilty of genocide like the Nazis. He imagines a day, with hope in his heart, that he and his anti-vaccine colleagues can stand gloating and grinning over those who disagree with them while angry mobs they incited tear their enemies apart.

It is a sick vision, but it is the inevitable destination of the dark path the anti-vaccine conspiracy theorists travel.


Posted by Steven Novella

Founder and currently Executive Editor of Science-Based Medicine Steven Novella, MD is an academic clinical neurologist at the Yale University School of Medicine. He is also the host and producer of the popular weekly science podcast, The Skeptics’ Guide to the Universe, and the author of the NeuroLogicaBlog, a daily blog that covers news and issues in neuroscience, but also general science, scientific skepticism, philosophy of science, critical thinking, and the intersection of science with the media and society. Dr. Novella also has produced two courses with The Great Courses, and published a book on critical thinking - also called The Skeptics Guide to the Universe.