April 11, 2017
I went to a lecture last Thursday night, Lady Mary’s Legacy: Vaccine Advocacy from the Turkish Embassy Letters to Video Games, after being alerted by my friend Jennifer Margulis, who lives on the other side of the country, that it would be happening. Lisa Rosner, Ph.D., author of the new book Vaccination and Its Critics: A Documentary and Reference Guide, has apparently been traveling the country giving this lecture which was to cover approximately 300 years of “vaccine advocacy” in 30 minutes, after which Rosner would introduce us to the newest tool in the vaccine-advocacy arsenal: a video game. It was this video game that gave rise to Jennifer’s concern. After all, virtually anything can be made “cooler” if it comes with a video game, and is it really “coolness” we want determining, or at least influencing, our choices when it comes to such important health decisions as whether or not to vaccinate or how much to do so?
The lecture took place at the prestigious New York Academy of Medicine, so I was expecting a crowd intent on improving vaccine uptake. Imagine my surprise when, arriving a few minutes late due to over-packed rush hour trains, I was directed to a not-very-large room that was three-quarters empty. In fact, I counted only 11 people in the audience, including the woman who seemed to have organized the lecture. James Lyons-Weiler’s lecture on The Environmental and Genetic Causes of Autism at a New York University Law School building a few weeks ago drew a much larger crowd.
Could it be that despite ridiculous media frenzy every time someone comes down with measles (other than children who get it as a result of their vaccine, that is), few people are really all that worried about vaccine uptake? Of course, this is New York, and New York has some of the most draconian and unconstitutional practices with regard to vaccination in the entire country. So uptake here is rather high in the first place, despite large pockets of ulra-orthodox Jews who frequently choose not to vaccinate for religious reasons, and the “anti-science liberals,” as Paul Offit calls them, who have made the Park Slope Food Co-op famous.
The lecture was much as expected, starting with the letters of Lady Mary Wortley Montagu extolling the virtues of pox parties in Turkey, which sounded surprisingly like the chicken pox parties I’ve heard tell of in 1950s U.S. When someone got a mild case of smallpox, a local medicine woman would gather some matter from one of the pustules and open veins of all the children present, deliberately introducing the smallpox into their bodies. This supposedly resulted in a very mild case, with the children being ill a day or two and bouncing back quickly. Apart from being appalled at the generally unsanitary conditions (at least as described) with the potential to introduce all sorts of possible infections (in the days long before antibiotics), I was struck by the idea that, like all the “childhood diseases,” this one probably tended to be much less virulent in children than adults—which of course is the principle behind the chicken pox parties of the 1950s—and could have been endemic to Turkey already, making it generally much less lethal than it would be to a “naïve” population like the Native Americans who were so devastated by the spread of smallpox. This could be why Lady Mary was so utterly convinced of the safety of a procedure whose stats don’t really look that great in retrospect.
But, hey, who cares? Because Edward Jenner came along with his perfect solution: introduce cowpox instead! It was irritating to me that Rosner never mentioned any problems with Jenner’s vaccine. In fact, the only problem she ever acknowledged was that some people resisted the whiz-bang new technology that was going to save their lives, even if it sometimes killed them. Convincing the resisters is where the “vaccine advocate” comes in. According to Rosner, herd immunity requires that for highly infectious diseases a high percentage of people must be vaccinated to prevent outbreaks. In measles for instance, we are (now—the narrative has changed dramatically over the last 50 years) told requires 95% of the population to be vaccinated and revaccinated with regular boosters. Despite the fact that she is essentially a historian, I wondered if Rosner knew the origin of the concept of “herd immunity”: Arthur Hedrich discovered in the early 1900s that when more than 68% of the population of Boston had already had the measles (later, 55% in Baltimore), outbreaks didn’t happen. That’s a far cry from “we have to vaccinate the hell out of 95% of the population every ten years,” isn’t it?
It also irritated me that Rosner’s “advocacy” admitted no nuance into what is actually a very complex subject. Rosner fell into the trap that so many people do, implying that there were only two vantage points from which to view vaccines, as an unqualified good that everyone should receive as many of as possible as early as possible, or an unqualified evil with no other consequence than the destruction of health. The truth, of course, is that the vast majority of the population falls somewhere in between those two poles, with most understanding that vaccines have been instrumental in lowering levels of acute infectious illness, but also understanding that there is no medical procedure that is right for everyone, that risks vs. benefits can vary with time (witness the overuse of antibiotics and the rise of antibiotic-resistant bacteria which may be signaling the end of the antibiotic era), and that some caution is prudent with a procedure that has the potential to turn a very healthy child permanently into a very unhealthy child, or worse, cause the very death that we are seeking to avoid. Yet, vaccines are essentially all created equal in the eyes of the “vaccine advocate.” A vaccine for the very-contagious, almost-always-benign chicken pox or the very rare, not-at-all-contagious tetanus (which, by the way, has an effective non-vaccine-based intervention, TIG) deserves the same level of advocacy as a deadly, somewhat contagious illness like smallpox that we haven’t vaccinated for since the early 1970s. Frankly, I find that ridiculous, which is why people who brand themselves as “vaccine advocates” generally have very little credibility in my eyes. And I find it particularly tone deaf that they are now treating the very valid objections people have to the CDC-recommended vaccine schedule, especially when applied to virtually all children, as merely an obstacle to be gotten around in a game.
The fact that I have never had a flu shot places me firmly in the category of “anti-science” for most “advocates.” But does that make sense? I have lived on the planet for more than a half-century, and I have had the flu only twice—well, I think I’ve had it twice, anyway. Given that there are so many things that can cause “flu-like illness,” I can only assume that it was the actual flu, not prove it, and of course, the influenza virus itself is the only thing the flu vaccine is meant to protect against. I’m in that “high-risk” category, too, as I have asthma. Yet when my daughter was born, I remember my midwife telling me (at the age of 38) that when my milk came in I might feel like I had the flu. That made me mildly curious as I didn’t actually know what flu felt like. When, 24 hours later, I started to ache all over, I thought to myself, So that’s what the flu feels like! The first time I actually got the flu, I was 45 and had a new baby who didn’t sleep; I was completely exhausted. I recognized those aches right away from that previous episode. It was a miserable few days. Would I have preferred not to have had the flu? Oh yeah. But would it have been smart, prudent, or “scientific” to have had myself injected with Thimerosal every year of my life in order to ward that week off when it turns out that I have two copies of the C677T MTHFR gene, which means that I methylate (detoxify) at only about 30% the rate of most people? To that I answer a resounding oh, hell no!
The point of Rosner’s lecture seemed to be the introduction of the cool new video game that would teach high school and college students how to be effective vaccine advocates and save the world (or Philadelphia anyway). The game is called The Pox Hunter (really? “Hunting” smallpox is a good thing?), and is based on a historical incident of a smallpox outbreak in Philadelphia in the 1800s. While the creators took pains to be historically accurate and make it “pretty,” it’s pretty lame as video games go. It is a series of static pictures with extremely simplified decision making, along the lines of a mainframe computer game I used to play back in the early 1980s called Adventure. It’s not going to revolutionize vaccine advocacy, or even strike more than a handful of high school or college students as “cool.” The one thing I did appreciate about it, though, is its frank presentation of the strategies that vaccine advocates use to coerce you into using their products. They boiled down to “Flatter,” “Reason,” “Joke,” “Empathize,” “Scare,” and “Command” (which could as equally well be called “Bully.” I was happy that the audience resisted using it, until Rosner noted that college students tended to play “aggressively” and as a result tended to get “poor” results). I was actually impressed that a number of the characters in the game were programmed to see through the attempts at flattery, but then, like I said, they were going for accuracy. Rosner seemed to think that “Scare” was the most effective tactic. It certainly seemed to get you farther in the game. Not at all shocking, given the media frenzy when 111 people came down with measles after a visit to Disneyland. I think it’s a good idea for everyone to check this game out, at least long enough to be able to identify the manipulation techniques behind the messaging in mainstream media.
I think it’s particularly important to note what the game makers mean by “reason.” As I noted, the attitude comes down to either you’re for us, or you’re against us. “Reason” in the vaccine-advocate sense, unlike it’s real meaning, doesn’t mean looking at or understanding all the facts; it means simply presenting facts that are favorable to their side unemotionally. When a character points out, “reasonably,” that King Louis Phillippe of France died of smallpox at 64 despite having had it as a child, then asks the obvious question, “If smallpox can’t prevent smallpox, how can cowpox do so?” The game’s “Reason” response completely ignored the question and focused on something else altogether. In other words, even if someone appears to be using “reason” on you, that doesn’t mean they are at all interested in being reasonable. They are simply using reason as a tactic to manipulate you into doing what they want. If you continue to resist, that will become more apparent when the bully in them comes out.
By the way, despite Rosner’s claim that you weren’t allowed to lie in the game, at one point a character seeking reassurance asks if “The Pox Hunter” will swear on the Bible that nothing bad can happen. Given that the smallpox vaccine had at least as many adverse effects as any other vaccine, distinguishing such an oath from outright falsehood strikes me as a distinction without a difference.
During the question and answer session, I was further heartened to find that, in this crowd of 11, the man in the front row, right in front of the speaker, wanted to talk about what Suzanne Humphries, author of Dissolving Illusions, had to say and about the allegations in the movie Vaxxed. Another woman wanted to know what the answer to the question about Louis Phillippe was. After being “informed” that ethylmercury, “or methylmercury, I forget which” – the kind in vaccines – isn’t neurotoxic by a pediatrician (and, yes, I flatly contradicted him, but he wasn’t the slightest bit interested in learning something), I ended up having a long post-lecture conversation with the man from the front row, who turned out to be a retired science journalist, and the woman who’d questioned Louis Phillipe, who has common variable immune deficiency (CVID) and is open to learning all about the immune system and what happens when it doesn’t work according to plan. I told them about this website and gave them both my card.
So, overall, I was delighted with the evening’s information and outcome. The Pox Hunter is by no means a game-changer, but that doesn’t mean that the vaccine debate couldn’t become a hot video game item. Indeed, I kind of hope it can. My 18-year-old daughter has been working on an RPG game that pits me against the CDC. How cool would it be if kids all over the country were “virtually” cheering me on?
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P.S. If you have any ideas for events or plot lines for the game, leave us a comment!