What’s the hostility about not vaccinating all about?

On the ‘Arnica’ support group on Facebook this morning someone asked the question ‘why are people who are vaccinated worried about getting ill from non-vaccinated people?’. I have to say, this question has always puzzled me. If vaccination works, then they have nothing to fear. (I’m talking here about people who are actually vaccinated, not those who can’t be vaccinated because they are immune-compromised). This argument, that unvaccinated individuals are a threat to those who are vaccinated, is one I’ve heard repeatedly over the thirty years that I’ve been aware that there are differing perspectives on vaccination.

Fear is arguably the issue here. A branch of Social Psychology called ‘Terror Management Theory’ (TMT) throws light on this question.

Based on the work of existential theorists including Otto Rank and Ernst Becker, who proposed that human beings are driven by our innate fear of our mortality to produce belief systems that make us feel safe, TMT has been extensively researched for the past thirty years, accruing a significant body of data[i]. TMT has studied ‘mortality anxiety’ in a variety of contexts ranging from ageism to terrorism, sexuality to religion, materialism to sports affiliations.

The key ideas of TMT are that:

  • Human beings have a biological drive to survive, therefore we are naturally wary of our physical vulnerability and mortality.
  • Cultural worldviews are constructed to alleviate anxiety about human frailty and death.
  • Conformity to cultural worldviews bolsters self-esteem, in turn increasing our feelings of safety.
  • Human beings will respond with hostility and aggression to those individuals or groups who do not conform to the same cultural worldview.

It seems to me that the strong feelings people express about vaccination can be helpfully explained through the lens of Terror Management Theory, as each of the points above clearly come into play within the debate.

Fear of death or disability is the primary marketing tool of pharmaceutical companies and public health policy with respect to vaccination. This brings our innate mortality anxiety to the fore (in TMT terminology, it makes mortality salient), and when this fear is triggered in respect of our children (especially if we are new parents), we are all the more likely to comply with the expectations of health professionals and others.

So, we vaccinate, and in doing so, believe we are staving off illness and death. We’ve also boosted our kudos as parents. We’ve followed the expected path, acted appropriately within this dominant discourse of parental and social responsibility. Our anxiety subsides.

On the other hand, we do our research about natural immunity and vaccine damage, seek advice from a range of people, follow our parental instincts and, generally after a lot of thought and angst, make the decision not to vaccinate.

Both are valid positions. Both are personal choices.

The difference is that those who choose not to vaccinate are likely to be overtly criticised for failing to conform to the dominant worldview. They may be harangued by health professionals for not being responsible or even ‘fit’ parents. They may (as I did) have ‘mother refuses vaccination’ written in huge outraged letters across their child’s medical notes. They quite often, as has been noted, have the finger of blame pointed at them for exposing other people’s vaccinated children to risk. Certainly, in social media posts I’ve come across recently, they are exposed to a degree of aggression. ‘I hope your unvaccinated child gets measles and dies’ is one example.

The dominant worldview concerning childhood vaccination has shifted since I was a child. I still remember clearly standing in line at primary school holding hands with a child who was in the early stages of chicken pox. We both got ill. We both got better. Our mothers cheerfully swapped notes and support. That was it. There was no sense of blame, or fear, or ‘this shouldn’t be happening’. It was just a normal part of childhood. I do believe we were healthier for it.

Cultural worldviews shift, and fear is easily manipulated. Sadly, our innate mortality anxiety is a useful marketing tool.

[i]Tom Pyszczynski, Sheldon Solomon, Jeff Greenberg (2015) ‘Thirty Years of Terror Management Theory: From Genesis to Revelation’ in James M. Olson, Mark P. Zanna (Eds.)  Advances in Experimental Social Psychology, Academic Press, Volume 52, Pages 1-70.