Isabella Farrington is a first year politics and international relations major, whose experiences in the program are the focus of this spring’s segment of the series.

This post is the second of our spring segment.  If you have not yet done so, please read this introduction for some brief context.

In the current COVID-19 era, every other click-bait headline screams “mandatory jabs,” “anti-vaxxers this” or “anti-vaxxers that.” The issue on mandatory vaccinations has been brought to the forefront as government and school-mandated COVID-19 vaccinations persist. The debate tensions between state power and obligations to public health, religious and philosophical freedom of belief, and parental choice are conflictions both ethically and emotionally involved. Complex matters such as this stress the importance of debate principles in creating a constructive discussion. John Stuart Mill’s (2011) debate ethics outlines the dangers of “…argu[ing] sophistically…suppress[ing] facts or arguments…misstat[ing] the elements of the case…or misrepresent[ing] the opposite opinion,” (99). The ignorance of misinformation, the sociopsychological facets of the debate, and the validity of opposition opinion contradict Mill’s debate principles. By recognizing the presence of these factors, the mandatory vaccine debate paradox can be better understood and more effectively approached to promote constructive, respectful, and inclusive debate.

In 1905, the Supreme Court ruled on the issue in Jacobson v Massachusetts, where state powers over public health allowed required vaccinations for students “Twenty-First Century Jacobson V. Massachusetts” 2008, 1820). Despite the conclusions of Jacobson v Massachusetts, the controversial debate on mandatory vaccinations for children continues as popular opinion contradicts medical science. The vaccine debate phenomenon is largely due to persistent misinformation and perceptions of opposing views. Most detrimental to the vaccine debate, however, has been the disregard of truth within opposing views, from both positions. One exemplification of these conflictions is the passing of Senate Bill No. 277 in June of 2015 by California’s governor Jerry Brown. The bill eliminated the opportunity for individuals to file religious or philosophical exemptions from required student vaccinations (Allen and Pan). As one could guess, the bill was met with an abundance of both supportive and antagonistic responses.

Anti-vax arguments have shown to survive off a sort of “scientific denialism” and, in extreme cases, conspiracies that stem from and further stimulate distrust for major corporations and government intentions. We’ve all heard the idea of “Big Pharma” – the global industry of manufacturers and companies that hold manipulative, for-profit monopolies on medical products (d’Ancona as cited in Numerato et al. 2019, 84; Cheng 2022). And, while this description may be accurate in some ways, it is also generalizing and often used flippantly. The social media age has contributed largely to the formation of illogical positions, providing platforms to create “echo chambers” that strengthen confirmation bias (confirm the beliefs individuals already have) and raise concerns over the quality, accuracy, and credibility of shared knowledge on vaccines (Numerato et al. 2019, 83, 87). Misinformation, of course, is more than correctable inaccuracies, but emotion-driven persuasion that can deliver crutches of (mis)information to sustain vaccine uncertainty and institutional distrust.

While there is a high saturation of misinformation within the mandatory vaccine debate, there still poses a great need for recognizing the value and truth in opposing opinions in order to ethically and responsibly approach debate and action. First, there is the stake of personal freedoms, whether that be religious and philosophical freedoms or autonomy rights. For instance, some anti-vax positions may claim rights to parental authority, while others refuse vaccination based on the unnatural ingredients within that do not align with their religious beliefs. This sort of autonomy, or the right to self-government, is a foundational principle to medical ethics (Cheng 2022).

In terms of the mandatory vaccine debate, most states have allowed religious and even philosophical, in addition to medical, exemptions up until the passing of S.B. 277. Since the bill abolishes the acceptance of religious or philosophical vaccine exemptions, opponents critique its passing on ethical grounds as it conflicts with freedoms of religion and expression. Recognizing the value of opposition does not require discarding empirical evidence but can inform decisions in ways that expand the capacities, applicability, and effectiveness of action. The immediate judgement of unvaccinated individuals, circulation of blame, and unwillingness to understand, however, has directly inhibited the advantages of constructive debate between opposite views.

With the extremely binary nature of the vaccine debate, misrepresentation of the opposite opinion comes hand-in-hand with disrespectful debate. For instance, in response to the signing of S.B. 277, news reports intentionally included language emphasizing the “heated” debate, spotlighting interviews that blamed Governor Brown for “single-handedly screw[ing] California” and “fail[ing] California’s children” (“Gov. Brown Signs Vaccination Bill” 2015). This dysfunctional “intemperate discussion, namely invective, sarcasm, personality…” as Mill (2011) would say, is incredibly ineffective and detrimental to debate (100). Insulting use of language illustrates a lack of respect, preventing effective communication of what can be done and what needs to be done, instead only stimulating emotions and abetting distrust. It is easier to place blame on parents, vaccine manufacturers, legislators, or the government rather than reconcile differences, but this impulse inherently makes assumptions and generalizations that misrepresent the opposite opinion and discourages any form of productive debate, cooperation, or collaboration.

Personal biases have influenced the policy surrounding the mandatory vaccine debate for children, restricting the applicable nature, and in turn value, of the laws. A significant facet of the mandatory vaccine debate is the psychological construction of risk. Essentially, each individual’s personal perceptions of the world and others can influence their perceptions on the importance of vaccinations or of being unvaccinated. These unconscious biases can also “shape the views of legal decisionmakers who act with broad discretion,” such as the legislature involved in deliberation and passing of S.B. 277 (Fentiman 2017, 247). Thus, it is important to hear diverse perspectives and voices, as co-author of the bill Senator Ben Allen claims was achieved as the bill was processed through three committees (“Gov. Brown Signs Vaccination Bill” 2015). Hearing different perspectives can alter world views in ways that create opportunity for better decision and policy making on the vaccine debate.

It is necessary that both debate positions not only avoid invective language and production of misinformation but recognize the sociopsychological dimensions of emotionally involved debate that dissuade productive debate as outlines by Mill’s principles. Doing so requires mutual respect and a willingness to understand by encouraging open-mindedness. Medical professionals have a responsibility to approach vaccine uncertainty or anxiety with respect and empathy, relating to the desire of parents to keep their children healthy, operating from a patient, relationship-building standpoint (Hilton 2019). Legislators have a different role, though a responsibility still. One proposed institution that legislatures could enact is the distinguishment of vaccination requirements between “medically necessary,” those that are vital to prevention of disease, and “practically necessary,” vaccines to which there are alternatives, though these alternatives are mainly insignificant in practice (“Twenty-First Century Jacobson V. Massachusetts” 2008, 1820). Additionally, specific to S.B. 277, due to the manipulation of emotion by misinformation within the larger debate, the bill could benefit from a clause that allocates funds towards providing education resources on vaccinations with purposefully patient, respectful, and empathetic delivery. Pursuing these methods of debate may pose challenges of frustration and dissociation. Nevertheless, to make progress in reaching a common consensus on vaccine mandates and public health goals, intentionality and debate awareness is the first and most important step.

 

References

Allen, S, and S Pan. 2015. “SB-277 Public Health: Vaccinations.” California Legislation Information. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520160SB277.

Cheng, FK. 2022. “Debate on Mandatory COVID-19 Vaccination.” Ethics Med Public Health 21: 100761. doi:10.1016/j.jemep.2022.100761. Accessed at Debate on mandatory COVID-19 vaccination – PMC (nih.gov)

Fentiman, Linda C. 2017. Blaming Mothers: American Law and the Risks to Children’s Health. New York: New York University Press. muse.jhu.edu/book/56535.

“Gov. Jerry Brown Signs Vaccination Bill Removing Personal Belief Exemption.” 2015. CBS News. CBS Broadcasting Inc.Gov. Jerry Brown Signs Vaccination Bill Removing Personal Belief Exemption – CBS Sacramento (cbsnews.com).

Hilton, Lisette. 2019. “Navigating The Antivax Movement.” Contemporary Pediatrics. Contemporary Pediatrics. July 23. https://www.contemporarypediatrics.com/view/navigating-antivax-movement.

Mill, John Stuart. 2011. “On Liberty.” The Project Gutenberg. https://gutenberg.org/files/34901/34901-h/34901-h.htm.

Numerato, Dino, Lenka Vochocová, Václav Štětka, and Alena Macková. 2019. “The Vaccination Debate in the ‘post‐truth’ Era: Social Media as Sites of Multi‐layered Reflexivity.” Sociology of Health & Illness 41 (S1): 82–97. https://doi.org/10.1111/1467-9566.12873

“Toward a Twenty-First-Century Jacobson V. Massachusetts.” 2008. Harvard Law Review 121 (7): 1820–41. Toward a Twenty-First-Century Jacobson v. Massachusetts – Harvard Law Review

Vedantam, Shankar, Maggie Penman, Camila Vargas Restrepo, Laura Kwerel, and Tara Boyle. 2019. “Facts Aren’t Enough: The Psychology of False Beliefs.” NPR. https://www.npr.org/2019/07/18/743195213/facts-arent-enough-the-psychology-of-falsebeliefs.

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