One thing I've seen a lot of in recent writing on vaccine policy has been the critique against harsh or demonizing language against parents who are opposed to vaccines, with suggestions about more sensibly converting the unconverted. Dan Kahan, professor of law and psychology at Yale, has been especially adamant on this point, and outlets like The Atlantic, Bloomberg, and NPR have published thinkpieces on why shaming and other negative approaches, in their words, "don't work."
Not everything in these pieces is wrong, and there's definite worry about issues as fully consensus-based as vaccinations becoming embroiled in political partisanship. I can also, to some extent, respect Kahan's warnings about the rightness of accusations like "anti-science", which is admittedly a problematic label.
But what none of these pieces touch on, except for brief mention in the Bloomberg article, is we do have also have a history of eradicating or nearly eradicating a set of vaccine-preventable diseases, and we can look to that history to see how it was done: i.e., our successes had nothing to do with trying to convince the skeptics:
The opposition to compulsory vaccinations in its early years makes our current debate look quaint. Anti-vaccination societies that sprung up near the end of the 19th century recruited broadly, and had full access to airing their concerns in major newspapers. The Christian Science church used the judicial system to fight compulsory vaccination, even winning an occasional victory. But most importantly, there were concerned parents:
Concerned parents formed the largest recruitment pool for antivaccination societies. Many American parents, including those who would never formally join a society, viewed school vaccination requirements as an unwarranted usurpation of their domestic authority, and an unconstitutional violation of every child's "right" to public education. More viscerally, many parents feared that vaccination would harm their children. Behind almost every antivaccination leader lay a family horror story.
As Willrich points outs, anti-vaccination rhetoric actually precedes the practice in this country: it was a cottage industry unto itself, with its own bestselling books, celebrity spokespeople, and institutional backing. Newspapers told stories of children ripped from their parents and dying in vaccine-induced agony. Compulsory vaccination was compared to the recently-abolished practice of slavery, as an anti-progressive denial of individual freedom, etc. Protests involving hundreds of people, legislative successes, civil disobedience: much of the rhetoric and behavior we thankfully consider fringe today was
part of mainstream American discourse. And in fairness, this backlash was likely rendered more intense by the aggressive behavior of Z. Taylor Emery, Brooklyn's commissioner of health, whose execution of mandatory vaccination made headlines as needlessly aggressive to the point of cruelty, and who became the bogeyman of antivaccination societies. Vaccines were also unregulated (until 1902, and then only somewhat) and considerably less safe than they are now: not all the tales of horror were invented.
And yet, compulsory vaccination eventually won the day, not through a careful consideration of the feelings of concerned parents or through a balanced assessment of rhetoric, but through public policy decisions that ignored them. While it's clear that a Emery-style approach is counterproductive, the eventual alignment of AMA recommendations, legislative power, and judicial blessing rendered the discussion moot. Antivaccination societies dwindled with time, though like all things in American life, the values of these movements resurface periodically in response to changes in circumstances. It is not possible to contain these sentiments through Enlightenment-style rational discourse - we know for a fact that that doesn't work - but we can ensure that public policy is strong enough to withstand it.
Maybe the circumstances a hundred years ago don't map well onto our own, internet-fueled age, but I do have to ask why we're spilling so much ink on the proper and respectful way to argue with people who represent a fringe minority, when history has shown that we can better solve these problems by strengthening public policy (a post on Forbes weighted various strategies and eventually sided with this point) without their input and without having to appeal to them for support or permission. But I would take it a step further: marginalizing and mocking the people who are putting forth marginal and mock-worthy arguments may be the best way of keeping those arguments from gaining access to serious debate. I wouldn't maintain a pretense of respectful debate when arguing evolution or earth-is-roundness, either. When comments by Christie and Paul are carefully weighed instead of dismissed outright, we run the risk of pretending that these are real, substantive issues, and the buffering of public policy law becomes even harder.
(I had a similar reaction to the debate over same-sex marriage: I couldn't care less if my neighbor is homophobic, only that the law isn't. Fight your battles.)
Anyway... Just some quick thoughts. I've glossed over much of this, so if there are big issues with the history involved, please let me know in the comments, and I can correct as necessary.
3:22 PM PT: Garrett offers a fair critique of the "evidence doesn't work" claim above.