The Vaccination Divide: Where Pathogens Meet Politics

The following article is an opinion piece written by Michael S. Kinch. The views and opinions expressed in this article are those of the author and do not necessarily reflect the official position of Technology Networks.

Anti-vaccine sentiments were deeply entrenched in society before the first vaccine was discovered in the late eighteenth century. This skepticism mutated from concerns about variolation, a procedure whereby smallpox virus was intentionally inoculated into a small cut in the forearm. The anxieties over variolation were understandable since even subcutaneous infection with smallpox would cause considerable misery and occasional death. Yet this procedure was embraced by many since the risks from variolation paled in comparison with the death and disfigurement arising from smallpox, which had periodically blighted humans from time immemorial.

In the early 1800s, a far more safe and effective approach was announced: the use of cowpox (Variola minor) to prevent infection by its far more deadly cousin (Variola major). While the smallpox vaccine saved countless lives and ultimately led to the elimination of a deadly pathogen (which is supposed to exist only in deep freezers in Atlanta and Moscow), resistance from a subset of anti-vaxxers to the smallpox vaccine was merely a preview of novel forms of vaccine skepticism, paranoia and rumormongering to come.

Cowpox, as the name suggests, is derived from a bovine virus (hence the protective procedure became known as vaccination based upon vacca, the Latin term for cow). Due to its bovine origin, rumors quickly spread throughout skeptics, who maintained that vaccinated individuals would sprout horns and transform into minotaur-like beasts. In what would be recognizable to current society, views of vaccination were intimately linked with politics.

We might look back at such bygone notions with a dismissive shake of the head based on present-day rationalism as contrasted by the absurdity of such arcane views. Yet each and every vaccine introduced since that time has triggered its own unique variation on the theme of irrationality. In the latter half of the twentieth century and despite exposure of duplicitous motives and data meant to stir up anti-vaccine notions, the DPT (diphtheria, pertussis and tetanus) and later the MMR (measles, mumps and rubella) vaccines each were claimed to cause developmental disorders such as autism. Both claims were shown definitively to be frauds foisted by hucksters motivated by greed…and yet persist to this day. Later still, the HPV vaccine (which prevents several sexually-transmitted forms of cancer) was discredited by a belief it would trigger a wave of teenage promiscuity, rumors that again were not based upon fact.

Until now, such irrationality has largely been focused upon a particular vaccine. While ignorance has been the source of isolated and unnecessary disease and death, the situation may soon become considerably worse and widespread.

A newly published study suggests evidence of a far more troubling outcome with a dire potential to amplify the suffering. In a recent edition of The New England Journal of Medicine, a team of researchers from the University of California, Los Angeles revealed that changes in the uptake of the influenza vaccine were aligned with political views in general and skepticism of COVID vaccines in particular.

It is generally recognized that individuals in blue-trending states were more likely to embrace COVID vaccines while the populations of red-leaning states were more skeptical. A remarkable and troubling outcome is that these same views were soon applied to influenza vaccines. By comparing the rates of influenza immunization before versus after both the onset of the pandemic and the introduction of the first COVID vaccines in early 2021, the investigators measured the rates of influenza vaccination.

Whereas recognition of the COVID-19 pandemic in 2020 itself did not alter rates of influenza vaccination in the following autumn, the introduction of the COVID vaccines in early 2021 had a profound impact on adult vaccination rates. Those in red states became less likely to be vaccinated for influenza (than before the introduction of the COVID vaccines) whereas younger adult populations of blue states increased their vaccination rates. Thankfully, these diverging trends in influenza vaccination were not observed with older adults (age 65 and older), who are most susceptible to influenza morbidity and mortality.

As recently reported in The New York Times, anecdotal evidence suggests that COVID vaccine-skeptical parents are contributing to a further erosion of adherence to pediatric vaccination. Such irrationality is not particularly new given that the rates of MMR vaccination had been declining in the years before the pandemic. Indeed as I recounted in Between Hope and Fear, declining rates of vaccination have been contributing to a resurgence of measles in the United States. This trend is ironic and problematic given early evidence that recent vaccination with the MMR vaccine might confer a protective effect against COVID-19.

These results are not merely troubling in terms of irrationalism trumping objective evidence. If such trends in vaccination persist and expand, it could contribute to a growing divide not merely in the political views, but for public health. It logically follows that the future might portend regional plagues and increasing pressure upon the need for public services. A further challenge is that red states are generally characterized as conveying fewer public services and thus may be particularly unprepared for the implications of the reported trends in vaccination.

Beyond the sheer human tragedy arising from unnecessary death and suffering, such trends might be both self-defeating and self-correcting. Paradoxically, it can be reasonably presumed that wholesale declines in vaccination could have profound demographic impacts in the balance of red and blue political views. The nation might experience higher rates of avoidable diseases and death amongst those with the most strident political views. The misfortune is compounded by the fact that were younger adults to remain adherent to these misguided views and fail to protect future generations, our society will remain endangered for years to come.