In Professionals We Trust—Or Do We?

In a recent New York Times opinion piece, science journalist Melinda Wenner Moyer bemoans the fact that vaccine researchers are getting paranoid about publishing scientific papers that contain anything negative about vaccines, out of fear that the anti-vaccine movement will weaponize such results.  This problem has important implications for public trust in professionals generally, including engineers.

First, a little background.  Life before vaccines was shorter and riskier.  Smallpox, diphtheria, tetanus, and the lesser but still potentially fatal childhood diseases of measles and mumps killed millions and left survivors scarred for life or otherwise disabled.  That is why the world’s most advanced thinkers, including the New England minister and Princeton president Jonathan Edwards, embraced the idea of vaccinations against smallpox when Edward Jenner popularized it in the 1700s.  Unfortunately, when Edwards was vaccinated during an outbreak of the disease in 1758, it led to full-blown smallpox that killed him. 

Vaccination methods were crude back then, and over the following decades, the smallpox vaccine was refined to the point that in 1980, the World Health Organization declared that smallpox had been eradicated.  But Edwards’ death is a reminder that progress isn’t uniform, and bad news as well as good news has to be shared among professional practitioners if progress in any technology is to be made.

Up to about the year 2000, the attitude of the public in most industrialized nations toward vaccines was almost uniformly positive, and not controversial.  Each new and more effective vaccine, such as the Salk and Sabin vaccines against polio in the 1950s, was hailed as one more example of science’s triumph over disease.  Then in 1998, a gastroenterologist named Andrew Wakefield published the results of a small study based on 12 cases that seemed to indicate a link between autism and the very small amount of mercury used as a preservative in the mumps-measles-rubella (MMR) vaccine that was routinely given to millions of small children every year. 

Wakefield’s paper was published in the respected medical journal Lancet, and created a huge controversy.  Parents of autistic children now had something to blame on which to blame the mysterious syndrome, and as time went on, activist groups of parents formed and made Wakefield a hero.  The nascent Internet became a powerful tool in the hands of these groups, as it bypassed the usual peer-review process that scientists must adhere to and enabled isolated parents of autistic children to band together.  The failure of any subsequent scientific studies to confirm Wakefield’s findings didn’t slow down the anti-vaccine movement significantly.

It wasn’t until 2004 that serious questions were raised about Wakefield’s integrity.  It turned out that he was being paid by attorneys who wanted to sue vaccine manufacturers, and after further investigation revealed that Wakefield had fabricated some data, Lancet withdrew the paper and Wakefield had his British medical license revoked.  But the horse had left the barn long before that.  Currently, many well-educated and otherwise rational people refuse to have their children vaccinated for what are generally termed “philosophical reasons.”  As epidemiologists know, there is a threshold for the percent of unvaccinated people in a given population above which the risk of epidemics increases rapidly, and widespread refusal to vaccinate is partly blamed for recent outbreaks such as the 147 cases of measles centered at Disneyland in California in 2015. 

This story of the anti-vaccination trend is perhaps one of the clearest examples of what is a relatively new thing in Western civilization: widespread distrust of expert authority.  Back when everyone knew someone who had died of smallpox and many survivors bore scars, the promise of being able to immunize yourself and your offspring against such a terrible disease was so attractive that intelligent people such as Jonathan Edwards took the risks of what was by modern standards a very dangerous vaccination. 

Today, when the chances of anything bad happening from a vaccination well known and down in the fifth decimal place (a few per 100,000), and the ill effects of not getting vaccinated are also well known and clearly worse than taking the vaccine, why would anybody refuse, especially on behalf of their innocent children?  Clearly, because they believe in something or someone other than the conventional scientific wisdom represented by institutions such as the medical profession, government and private research organizations, and even people as supposedly trustworthy as their own family doctor.   

The problem with all this is that some professionals really do know more about a subject than non-professionals, and when experts talk about their own fields, they are generally more worth listening to than some random website you find with Google.  The paranoia among vaccine researchers that Moyer discusses is a sad result of ignoring this basic fact of life. 

It’s like a child who is repeatedly accused falsely of stealing from the cookie jar.  If he’s punished often enough for something he didn’t do, he may go ahead and steal anyway, figuring he’s going to get blamed for it whether or not he’s done it, so he might as well enjoy the ill-gotten gains of stealing, because the negative consequences will be the same.

In embracing bogus and disproved theories of harm from vaccines, anti-vaccine groups appear to be creating the very behavior they suspected was already happening among scientists:  namely, a reluctance to report negative aspects of vaccine use.  Of course, this will cripple any efforts to improve vaccines, because you have to know what went wrong before you can fix it. 

Let’s hope that engineers keep their collective noses clean in this regard.  Few polls of trust in the professions even ask the public about engineers.  I had to dig for a while before I came up with a global poll from 2015 that lumped engineers in with technicians, and that combined group came in on the trust scale about in the middle, just below pilots and just above soldiers.  Firefighters were the most trusted profession, and bankers the least.

Things could be worse, certainly.  In this fishbowl Internet age when anybody who says anything eye-catching, whether true or not, is liable to become world-famous overnight, engineers need to be especially careful in their public pronouncements.  It’s good to let the public know your considered expert opinion about something.  But first, be sure you’re right.  Lying about a matter of expert opinion that’s of vital interest can create harmful effects that go on for decades, as the anti-vaccine movement has shown.

Sources:  Melinda Wenner Moyer’s opinion piece entitled “Anti-Vaccine Activists Have Taken Vaccine Science Hostage” appeared on the New York Times website on Aug. 4, 2018 at https://www.nytimes.com/2018/08/04/opinion/sunday/anti-vaccine-activists-have-taken-vaccine-science-hostage.html.  I referred to the website https://www.historyofvaccines.org/content/articles/do-vaccines-cause-autism for information about the Wakefield controversy, to https://blogs.cdc.gov/publichealthmatters/2015/12/year-in-review-measles-linked-to-disneyland/ about the Disneyland measles outbreak, and to https://www.gfk-verein.org/en/compact/focustopics/worldwide-ranking-trust-professions for the global survey of trust in various professions.  Jonathan Edwards’ death as the result of a smallpox vaccination is well known and reported in numerous sources.