September 17, 2012
On Puritans and the Whooping Cough
— Philippa Koch
A whooping cough epidemic has spread in my home state of Washington. Depending on where you turn, you can read about the shamefully high number of incidences caused by the anti-vaccine movement, or, alternatively, about doctors injecting innocent children with poison. The debate plays out in the national press and on Facebook walls. No longer should politics and religion alone be avoided in polite conversation: add vaccinations.
Both sides of this debate invoke an age-old story of the conflict between science and religion—with "religion" aligned variously with "popular irrationality" or "tyrannically imposed superstition."
For their part, vaccine supporters often portray "anti-vaxxers" as anti-science. A recent report on the whooping cough epidemic in Forbes, for example, opened by describing Washington as "a high-tech region with a highly educated public—not exactly the kind of place one would expect to fall for the anti-science rhetoric of the anti-vaccine movement." In this version, vaccination promoters represent science, and vaccines are a significant token of its triumph over irrationality.
In the anti-vaccinators' version of the science-versus-superstition story, however, they are the empiricists, the promoters of personal observation and self-education, who challenge the dangerous forces of establishment and authoritarianism. According to this account, modern medicine—with its connections to government and to profit-driven pharmaceutical corporations—is the new superstitious hegemony to be overthrown.
How can two such different communities inhabit the same role in the same story?
Perhaps the problem rests in the storyline itself. It might help to reconsider an historical event often portrayed as an exemplifying moment in the history of vaccinations and in the story of science versus superstition: the smallpox inoculation controversy in 1721 Boston.
In that incident, the Puritan minister Cotton Mather and a local physician, Zabdiel Boylston, decided to test inoculation, a new procedure reported from London's Royal Society and by Mather's slave Onesimus, who had observed its use in Africa. Inoculation was messy compared to today's vaccinations; it involved cutting patients' arms and inserting lint covered with matter taken from a smallpox sufferer's pustule. The inoculated became sick; the goal was not to avoid disease, but rather to suffer a lesser form.
Many Bostonians were frightened of a foreign procedure they had never witnessed and did not understand. They worried, further, that inoculation would spread disease, since inoculated people were not quarantined. As in the debate over vaccination today, however, the eighteenth-century anti-inoculators are often oversimplified in popular accounts as anti-science, clinging to superstition (in their case, believing God sent epidemics) rather than accepting scientific fact.
This synopsis is problematic for many reasons, not least because it ignores the fact that many of inoculation's staunchest supporters were clergy, and that inoculators themselves didn't actually understand—by today's scientific standards—how or why inoculation worked.
Science versus religion? It wasn't so simple. It still isn't so simple.
In the eighteenth century, both sides of the inoculation debate understood the human body and disease through the lens of their religious beliefs: they believed that sickness was a result of original sin and designed by God. But their religious perceptions of illness—and inoculation—and its effects on the body were also shaped by immediate, personal observations; the anti-inoculators emphasized these experiences in rejecting authorities' claims.
For their part, today's anti-vaccinators often claim the higher power of nature to provide humans with strong immune systems, a claim they gird with their own observations and interpretations of the human body and disease. Many stress, for example, gaining immunity through breast feeding or by actually contracting disease. And, as in 1721, authorities' efforts to urge vaccination are resisted. Anti-vaccinators exhort interested parents to read studies and to observe their own children. If comments on the Facebook page "Proud Parents of Unvaccinated Children"—a group with more than 22,000 "likes"—are representative, the mantra of the anti-vaccination movement could well be: "educate yourself."
The anti-vaccine movement is not "anti-science" (or at least not anti-empiricism, that foundational idea in the history of science), and such epithets do not help promote public discussion of vaccinations. Instead of lumping people into a tired storyline, we would do well to ask why such a storyline—so often disproven in scholarship—continues to frame public debate; why both sides are committed to claiming the same role in the story (the empiricist); and whether that commonality itself might offer a toehold for productive discussion.
Both sides share, after all, a desire to protect vulnerable populations as well as a confidence in the natural world and the promises of empiricism. In the end, we cannot rest with the narrative of science and progress versus ignorance; rather, we need to understand how and why different communities see "science and progress" so divergently.
Steven Salzberg, "Anti-Vaccine Movement Causes The Worst Whooping Cough Epidemic In 70 Years," Forbes, July 23, 2012.
Philippa Koch is a PhD candidate in the History of Christianity at the University of Chicago Divinity School. Her dissertation is entitled "Persistent Providence: Religion and Epidemics in Eighteenth-Century America."