This past week, we took my two-month old baby for his first jabs (for Americans, that’s British for shots, i.e. immunizations.) At the same time, news outlets reported that there’s an epidemic of measles in the UK. A contributing factor to this outbreak has been many parents choosing not to have their children vaccinated because of a suspected link between the vaccine and autism, a link that has been thoroughly debunked. This false claim began with an article published by the Lancet in 1998—which was since retracted. In fact, in 2006, it came to light that the primary author behind the paper had been paid more than £400,000 by lawyers who hoped to reap fees from suing vaccine makers. Despite the weight of the scientific evidence against anti-vaccination and evidence that the idea was driven by ulterior agenda, belief in anti-vaccination and organizations promoting it persist.
At first glance, there appear to be many similarities between anti-vaccination movements and anti-evolution movements. Both are depicted as pseudosciences. Both invoke the rhetoric of parental rights over state control (in teaching children about evolution or in having children immunized.) Both have made similar use of rhetoric attacking the scientific community for being intolerant of their views: in ways that seek to undermine the cultural authority of science while also invoking that authority to validate their own scientific experts.
In terms of who these movement’s adherents or members are, there may not be very much overlap. It seems that scholarship on anti-vaccination tends to situate it within a broader trend of “alternative medicine” communities, rather than science skepticism. And some of the attacks on vaccination makes use of anti-corporate/industrial rhetoric against pharmaceutical companies that seems more aligned with the political left than anti-evolution’s typical association with the political right (in the US, at least). On the other hand, as Josh Rosenau on the NCSE pointed out on his blog earlier this month, offered an interpretation of polling data that suggests that the association with the political left is largely an attempt to create a false equivalence of pseudoscience across the political spectrum.
I find the question of alignment between issues to be an interesting sociological and historical question. In the nineteenth century, for example, there were perhaps good biological reasons why you might not find any pro-choice creationists (owing to the role embryology played in supporting evolutionary theory.) But the relative lack of people embracing that position today doesn’t seem to be on conceptual grounds, but cultural ones. So maybe antievolution and anti-vaccination are movements with very different origins, but who happen to act in some of the same ways. Or perhaps, as the anti-vaccination movement begins to invoke more anti-state/ant-government rhetoric, it gradually gains more traction among those who already use that rhetoric.
All of this is by way of introduction to the point of this post. I was left wondering whether any of the anti-vaccination organizations, or anyone influenced by them, had successfully affected (or even tried to influence) what American schools teach about vaccination in health education. After all, the antievolution movement has frequently made efforts to influence school curricula. And health education has frequently been a source of political controversy, most notably concerning the teaching of sexuality and sexual health (with accusations of errors and distortions in “abstinence only” versions of sex ed.) And there’s no question that activist groups on either end of the political spectrum attempt to influence school content.
You’ve got organizations unified by skepticism to a prevailing scientific theory, some of which have been involved in influencing legislation in the past, and a precedent that health education can be influenced by political or ideological agendas. And in the last couple years, several states have reopened debates about teaching antievolution or opposition to climate change, so you’ve also got state legislatures who are perhaps receptive to this kind of legislation.
So here’s the historical question. Has anti-vaccination actually influenced recent health education standards in the US? The quick answer seem to be no. There’s been no news stories about groups trying to take vaccination out, or writing anti-vaccination curricula. So at first glance, it seems a simple story.
But that’s begging the question of what schools already teach. For comparison’s sake, one reason that the school antievolution movement in American schools didn’t really begin until the early 1920s (well after Darwin) was the fact that evolution wasn’t really taught in schools until just a few years earlier. (This is one of the main reasons why I argue in my book that the antievolution movement needs to be seen more as a school movement invoking religion than a religious movement invoking education.)
So what do schools teach about vaccination? What I discovered in trying to research this is that there’s no single list that describes what every state requires to be taught about vaccination. So I’m going to try to compile that here.
Before: Ouch!
WARNING: This is only a preliminary list. I’m going to provide links to what I found, but I’m not about to claim that I found everything. (If you know of something I’m missing, please comment below and I’ll update it)
Methodology:
Basically I did a search for each state’s health education standards, and searched within them for any references to vaccination or immunization. If there was not an explicit reference to one of those two terms, I didn’t consider the state to be requiring the teaching of vaccination.
For example, in Connecticut’s standards, students are expected to “Comprehend concepts related to health promotion and disease prevention.” While the use of vaccinations and state vaccination requirements could be taught as part of this requirement, there’s nothing explicit that says so. Just because a state is listed as having no requirement doesn’t mean that schools do not teach about vaccines.
Some states don’t have official state standards, leaving curricula up to individual school districts. Others either echo the National Health Education Standards which are not themselves binding standards, but national recommendations., and which do NOT mention vaccination or immunization.
Herd Immunity
Anti-vaccination advocates often argue that it’s a personal right not to be subjected to state vaccination requirements (the U.S. Supreme Court rejected this claim in 1905.) The main reason that state interests are seen as superseding the individual is that the refusal to be immunized poses a risk to other people. That is, people who are not themselves immunized (by virtue of being too young or because of another mitigating health factor) are at a substantially reduced risk of catching a communicable disease when the surrounding population is immunized. This is called community immunity, or “herd immunity” (because some of the first places where this was demonstrated was with livestock, but the principle applies to humans as well.)
Some anti-vaccination groups and websites claim that herd immunity (they often emphasize this term instead of “community immunity” to make vaccination advocates appear dehumanizing) is not based in science, but has been proposed in order to encourage parents to police other parents’ vaccination decisions.
In order to shed light on the popular understanding of this, in the list that I’ve compiled, I also tried to point out the difference between those states which only included discussion of immunization as a matter of individual disease prevention, and those that also required teaching about immunization as a public health measure. If a state only requires teaching vaccination for one’s personal benefit, it’s not (necessarily) teaching students why the state claims the superseding right to compel vaccination. I want to distinguish between those states whose requirements teach that vaccination is a personal choice that people ought to make, and those states that teach that vaccination is a public good that is made as a community choice. I label each state “Personal” or “Public” to distinguish this. (If a state only required discussion of vaccination with respect to sexually transmitted diseases, I also label that separately)
AL – Personal disease prevention
AK – “describing the various effects of an innovation (e.g., snow machines, airplanes, immunizations) on the safety, health, and environment of the local community” in Scence, not health. NOTHING in health.
AZ – Personal disease prevention
AR (and here) – Personal disease prevention
CA – Personal disease prevention
CO – Personal disease prevention
CT – NOTHING
DC – Personal disease prevention
DE – NOTHING (appears to reference National standards)
FL (and here) – Personal disease prevention AND Public health
GA (and here) – Personal disease prevention AND Public health
HI – NOTHING
ID – NOTHING
IL – Personal disease prevention AND Public health
IN – Personal disease prevention AND Public health
IA (and here) – STD related mention only. Most curricula is reserved to local districts.
KS – Personal disease prevention (mentioned among “examples of teaching strategies and are not intended to endorse any one specific idea or concept.”)
KY – NOTHING (References national standards)
LA – NOTHING
ME – NOTHING
MD (and here) – Personal disease prevention
MA– Personal disease prevention
MN (and here) Personal disease prevention, but standards to be developed locally
MS – Mention of flu vaccine, and immunization and vaccine boh listed in Glossary, but otherwise no mention given
MO – Personal disease prevention
NE – NOTHING (Reference only to National standards
NV – NOTHING
NH – Personal disease prevention
NJ – STD only (2004 version of standards include Personal disease prevention)
NM – STD only
NY – NOTHING
NC – Personal disease prevention
ND – Public health ONLY
OH – No statewide health education standards.
OK – NOTHING
OR – NOTHING
PA – Personal disease prevention
RI – Personal disease prevention AND Public health
SC – Personal disease prevention
SD – Personal disease prevention AND public health
TN (and here) – Personal disease prevention
TX (and here) – Personal disease prevention
UT – Personal disease prevention
VA – Personal disease prevention
VT – Personal disease prevention
WA – Personal disease prevention
WV – Personal disease prevention
WI – “List ways to prevent communicable disease.” nothing specific to vaccination.
WY – NOTHING