345 - A Pox on Fools - Thomas Levenson

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You Are Not So Smart Podcast

0:48Welcome to the You Are Not So Smart Podcast, episode... Episode 345.

1:19I know you're flustered now, and it is... I don't... I'm not flustered at all. I am frustrated. I've been honest with you. The reason I'm frustrated is because I... And you repeat things and the expert say yes. You are the HHS secretary, and you are talking about things that lead to vaccine hesitancy in this country.

Vaccine Hesitancy Interview

1:55That is CNN's Dana Bash on Sunday, August 2nd, 2026, attempting to conduct an interview with United States Secretary of Health and Human Services, Robert F. Kennedy Jr., about the state of vaccine hesitancy in the nation. And as Bash notes in the interview, RFK Jr. is considered by many to be the nation's most vocal, most powerful anti-vaxxer. So, as you might imagine, the interview did not go well.

2:31Do you see your job as ending vaccine hesitancy, or do you see your job as telling the truth to the American people? I see my job as telling the truth, and the truth is that there is study after study after study. It's one of the most studied things out there in science, and it is this... You're being like a parrot. Yeah. It goes on like this for about half an hour, and eventually both parties just get exhausted and give up.

RFK Jr and Vaccine Hesitancy

2:58What happens is Dana Bash keeps attempting to cite the science, the sources, the studies themselves, the experts who've attempted to summarize the research who they have consulted and put on the shows and said, hey, this is what the experts say. And RFK Jr. keeps suggesting that the science is a lie, and those scientists are liars. Her central accusation is RFK Jr. is outright lying to the American public, and his central accusation is that you can't trust the experts because they are liars.

3:37And, he says, the media blindly repeats what the majority of experts on vaccination tell them, while failing to also allow anti-vaxxers who don't trust those experts to have equal time. That's what you did during COVID. Now we know that Anthony Fauci, who was the expert, was lying about everything, about masks, about social distancing, about natural immunity, about the transmission from the vaccine, about the source of COVID.

4:07He was lying, and you were punishing people for not trusting the experts, and now you're rolling out the experts again. RFK Jr., who once again is the United States Secretary of Health and Human Services, boils over in anger over the very idea that the media would, quote, trust the experts. And he gets much angrier over the fact that the media would urge the non-experts of the United States, non-experts in vaccination, the people, the voters, to trust the vaccination experts.

4:43Yes, yes, and my job is to get as much information as I can. And what we were doing, what we were doing in COVID, and still, with regard to these vaccines, is getting the best information, the best science that we can, and putting it out there. And, sir, what you are doing is causing information to be out there that is not...

Levinson's Book on Vaccine Hesitancy

5:10For this episode, I was going to pull some audio from something in the last six months or so, but I didn't have to do that. This was today, the day I am recording this audio right now at this moment. This was today, this was just a few hours ago. And I honestly thought we were done with this sort of thing. So all of this is very surprising, very weird to me. I thought we were done with this kind of arguing when it came to vaccines.

5:43Not arguing in general, and not even specifically arguing over COVID. But after all of these years, I thought we had come to an agreement that vaccines were good. But the vaccine, that was a very good thing, right? That was an amazing thing, that we came up with the vaccine and saved millions of lives with it. But we are currently experiencing a resurgence of vaccine hesitancy.

6:14The president, the United States Secretary of Health and Human Services, both anti-vaxxers, who are making the rounds and being very vocal about their skepticism of expert opinions, while also spreading heaps of misinformation, often very easy to fact check misinformation. And Anthony Fauci, the immunologist during COVID, who served as the chief medical advisor to the president during the height of the pandemic, he's in the witness stand right now in front of Congress, getting yelled at by the anti-vaxxers in the United States government, of which I am surprised to learn there are many.

Expert Opinion on Vaccine Hesitancy

6:57So I thought this would be a good time to reach out to an expert, an expert on vaccines, on vaccine hesitancy, and to get his expert opinion on what is going on right now. It's been with us for a long time, you know, even in the sort of present moment, but you wouldn't have said at the turn of the 21st century, you know, in 2000, that it was anything but a fringe movement, right? Now it's not a fringe movement.

7:27It's at the center of power. That is the voice of Thomas Levinson. I'm Tom Levinson. My day job has me professing science writing at MIT. Yes, he teaches science writing at MIT. And if you are in his classes, you are truly fortunate because he has written several incredible books. They include So Very Small, which is about the history of humanity, figuring out how microbes work and how they changed medicine forever. He also wrote Money for Nothing, tracing the history of how money evolved, how it works, finance, economies, that sort of thing.

8:03He's also written a book about planetary astronomy.

History of Vaccine Hesitancy

8:06He wrote another one about Einstein's life and work while he was living in Berlin. And Levinson also wrote a book about the strange second life of Isaac Newton, while Newton was the master of the royal mint and was charged with battling counterfeiters. Levinson has also made 10 documentaries, including one about Einstein and another one that I love titled Origins, All About the Origins of Space, Time, Life, and so on.

8:37He's won a Peabody Award, an Emmy, a Westinghouse Award. He has a degree in history of science from Harvard. He's written for The Atlantic, the Boston Globe, Discover Magazine. And he told me a story while we were getting our microphones set up about how he once interviewed Carl Sagan whilst Sagan was getting a haircut. It was a great story. Speaking of the audio, that was messed up in some way. There was some sort of strange electronic interference while we were recording.

9:07So I cleaned that up as best as I could. But do please forgive the quality of the audio in some places while we discuss Levinson's latest obsession, which is based on all of his expertise and experience discussing and interviewing and researching these topics beforehand, but adding it to something new, the topic of his newest book titled A Pox on Fools. And the title comes right out and tells you how Levinson feels about this topic.

9:38The topic of the book is the history of vaccine hesitancy, the history of vaccine denial, of science denial when it comes to vaccines. It's the history of how often and how persistently people get to a point where they say they don't, quote, trust the experts. And in the book, he details the stark truth of the matter, which is that since the very first vaccines,

10:10there have been vocal and influential anti-vaxxers, some with political clout, some with a fan base, some that built that fan base into large movements that outright rejected the overwhelming evidence that vaccines work.

Polio and Vaccine Development

10:26And they're far less risky than, you know, getting the illness that the vaccine prevents that kills people. Well, the truth is, what we are seeing in the United States at the time of this recording, this resurgence of anti-vaxxers and vaccine hesitancy, a resurgence that has led to and is in part the result of anti-vaxxers taking the top positions in our government, including the portion of that government that oversees vaccination. This is not of our time.

10:58This is something that people just do. It's of all our times and all the times we've tried to create civilizations and deal with things. And it is manifested in vaccination stuff because it's a human nature, human psychology thing. It's what brains do in a very specific cognitive and social condition that is generated quite strongly by the advent of vaccination.

11:28We will explain all of that in a moment. But before we get into that, I want to note, as Levinson points out in the book, vaccines can and do have side effects. In the past, especially in the beginning, vaccines could cause harm. But it has always been rare and always been mild in comparison to dying from the virus in the thousands or millions. The potential harm vaccines may cause has always been far, far less than the harm the viruses combat.

12:02In short, potential vaccine harm is very small. Potential virus harm, very big. As in death or watching your child live out their entire life encased in an iron lung. That's what people faced as recently as the 1950s, especially in 1952 in the United States. The worst year of the polio pandemic. I don't know if you saw the John Wick movies, but they refer to Wick as Baba Yaga,

12:36the Russian boogeyman who comes and, you know, just out of nowhere wreaks havoc when he arrives. Well, polio is kind of the Baba Yaga of infectious diseases. And the summer of 52, as you said, is the worst outbreak in U.S. history. You know, many tens of thousands of cases, some deaths, paralysis. I mean, it was the iconic picture of, you know, a little tiny head, a child's head,

13:12poking out of this giant metal cylinder, the infamous iron lung that would breathe for patients who, for whom the paralysis had extended to the point where they couldn't breathe. The lungs, you know, the muscles would no longer contract the lungs. You know, one of the striking things is the last iron lung patient died just recently, you know, the last couple months. It's, you know, in one sense, polio is ancient history, and in another sense, you see, it's, you know, it lingers.

13:47Polio is a, it's a virus. It produces a number of effects on the nerves controlling muscles, and you can recover, you can be asymptomatic, you can recover from a bout of it with no lasting effects. You can have some transient weakness or difficulties, and then it progresses from there onto the much more dire consequences of increasing paralysis to the point of, let's say, requiring, you know, help in just the basic functions, bodily functions of living,

14:22or it can kill you. It became a regular sort of summer visitor. You would see the cases jump up in the summer. So by the time you get to the summer of 1952, the scale of the outbreaks in terms of both numbers and national extent had been growing. 1952 was catastrophically the worst. And, you know, if you were a parent then, in the summertime, and you had kids, you know, you want to be out, the kids want to be out there, right?

14:56You know, you go swimming, you go to movie theaters, you know, you go to a birthday party, right? So it's, it's, these are the ordinary daily life things that you do. And in the summertime, of course, with the lovely long days and the warm weather and everything, kids want to be outside, they definitely want to go swimming. And every time you got up in the morning and fed your kids breakfast and let them out into the world, it, for a lot of people, I think, started to feel like Russian roulette.

15:28You know, would they go to a friend's birthday party? Would they go to a party at a swimming pool or a swimming hole? And would they be okay? Or 10 days, two weeks later, would they suddenly start showing signs of a fever, some muscle weakness, what have you? And all of a sudden you realized that that entirely, you know, normal childhood activity had turned into a potentially life-changing and potentially life-ending scourge.

15:59You would send your kids out and there would be this real terror that, you know, something, something awful would happen to change your, your child's trajectory forever. It was genuinely terrifying. Any gathering was a potentially disastrous event. So one of the results was, you know, people, you know, for a few summers there in the United States, there was a kind of, you know, reluctance to be out there in the world.

16:31It wasn't just a disease. It was a, it was a something that, you know, attacked not just the muscles in your body, but the bonds between us in, you know, towns and cities. In 1952, polio infected 57,000 people, paralyzed 21,000 and killed 3,145.

17:07I mean, people really remembered that summer, the people who lived through that, but they also really remembered three years later, this mishap, this accident that took place in the vaccine manufacturing process. That mishap resulted in 40,000 people contracting polio from the vaccine. The virus hadn't been weakened and killed. It was given live to people accidentally. That error led to 164 cases of paralysis and 10 deaths.

17:42Even at this horrific scale, 164 versus 21,000 reveals a risk. 10 versus 3,145. It seems like it's a big difference, but it introduces the risk of the vaccine in a way that wasn't there before. And you could say something like, in that same year, 36,688 people died in automobile accidents in the United States alone.

18:13But that's not going to change minds. It's not going to change the fact that this very scary thing is in the world. And sometimes the vaccine that's meant to prevent it can itself sometimes be harmful. Not at the magnitude, but it changes the way you feel about what's going on around you. And yeah, sure, cars are far more dangerous. You're taking a much bigger risk than you would to take the polio vaccine.

18:44But people had gotten used to cars in a way they hadn't gotten used to this. And there are other factors at play. And we're going to talk about that in a second.

Vaccine Safety and Risks

18:56The biggest point, though, is Leveson says we have learned a lot about how to never let what happened with that single polio vaccine incident happen again. Not like that. In every year, we make huge leaps in vaccination science and technology and implementation. Vaccines are ridiculously safe. But if you were to argue the facts of the matter, as I just presented here, with someone who holds an anti-vaxxer attitude right now, it is highly unlikely you will sway them with statistics or appeals to authority and appeals to expertise of scientists who have devoted their lives,

19:37generations of scientists who have devoted their lives to this very thing. And that is because, just as with conspiracy theorists or political extremists, cult members, and any other group who gathers around beliefs and attitudes not supported by the evidence, facts, facts, science, and evidence, is not what's driving the debate for them. Their position on the issue is driven by other concerns, by different incentives, incentives that are not the pursuit of accuracy or the evidentiary truth.

20:11There are other motivations in our decision-making that can lead to motivated reasoning, which are far more powerful than the pursuit of logically sound, evidence-based conclusions. We will discuss all of that and much more with Thomas Levinson after this commercial break. Insurance isn't one-size-fits-all.

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24:12And now we return to our program. My name is David McCraney. This is the You Are Not So Smart podcast. And this is Thomas Levinson, the author of a book about vaccine hesitancy, the long history of vaccine hesitancy, titled A Pox on Fools. In the current, you know, 2026 and moving forward environment,

24:42the anti-vax arguments are essentially all bad. You know, they're, in some cases, outright lies. In some cases, they are, you know, drastic misunderstandings of the risk-benefit calculations. And in some cases, they're an argument over values where, you know, picking one value means that you are willing to tolerate a certain amount of suffering and death to achieve a rather more abstract end.

25:15So, you know, I've no patience for the anti-vaccine movement now. But it's important to understand that anti-vax, all the arguments being made now have a deep history, and they weren't always crazy. They weren't always wrong. They weren't always morally obtuse.

25:32And it's sort of understanding how once plausible and sometimes even very, you know, credible, reasonable objections became something else is, I think, both important for our understanding of the, you know, of why it is that vaccines induce such opposition, but also, I think, gives us a way to talk to people who are concerned about it, who are, you know, not necessarily committed anti-vaxxers, you know, people like RFK Jr., who's made a very good living off being an anti-vaxxer, among other things.

26:03But the people who, you know, hear that the Department, you know, the Health and Human Services Secretary is saying there's a problem and wonder, you know, that's an authoritative source. You know, just sort of on the face of it, is there something there? Well, again, the goal is to try and give some perspective on why what's being said sounds plausible, was once plausible, but is no longer. Levinson brings this up a lot in his book, the fact that we haven't collectively updated

26:35our priors, not just in one particular nation, across the whole species. We haven't updated our collective priors when it comes to just how great we are at vaccination now and how much we've learned just since the 1950s. The science is one of the most researched sciences we have, and it's at the level of being nearly miraculous to someone just a hundred years ago, what we're capable of doing.

27:05But we haven't really updated our emotional reaction to the idea of plague, of pandemic, of illness, and how human beings can attack that problem, reach goals, solve it, get it figured out, save people. We just haven't really collectively updated in a way, and there's lag there. And he has a lot of compassion for people who are stuck in the lag, because the fears are not wild and strange and bizarre. These are fears that you would have in a situation like this, especially like around smallpox,

27:40when the method of getting not quite dead smallpox into someone, it was bad. It was very risky. And people still remember what happened during polio, and just one rumor moving around that someone got this, someone got that. It's difficult to wrap your mind around. The thing that I really liked most about Levinson's book is that he cleanly identifies three major factors that lead to vaccine hesitancy.

28:10And each of these factors, depending on the person, depending on the in-group to which they identify, depending on their identity and how tight it is to in-group, depending on their nuanced personality traits and so on, these factors, they can blossom into a vehemence, a visceral form of pushback. And within that cloud of negative attitudes, within that emotional reaction, people search for others for validation. Am I crazy here? Am I too afraid, too anxious?

28:41And it's very easy now to find other people who say, no, I feel the same way. And a group can form around that. And you can form a new identity as a member of that group and become an anti-vaxxer that can become who you are, can become a part of you that you will defend because you're defending your identity. And now the entire motivated reasoning framework will change and adapt to that.

29:12So the primary motivation is to remain a good member of your in-group. And once again, none of these original hesitations are unreasonable. And all of them are aspects of human cognition and pattern recognition that come pre-installed in every human brain. And thus, vaccine hesitancy in 2026, in 1926, in 1826 has, in each era, been driven by the same factors. And this will be true for us for a very long time and are hopefully very long future.

29:47So what are these factors? Well, in Levinson's research, he found that the people who reject vaccines, who are most vaccine hesitant, most likely to become anti-vaxxers. They have the same three claims in every era in which people have felt this way, have become very frightened to the point that they have started anti-vaccine movements. Here are those claims. The first is vaccines are unnatural.

30:17They are artificial. They're human made. For some, that means not of God or not of nature. And for some people, that's the same thing. And in the end, depending on how you make sense of that kind of feeling, that revulsion, that anxiety, you will land on vaccines just seem wrong. The second hesitation is vaccines are scary. It's a mysterious chemical, a concoction, inside a syringe that will enter your body via

30:53a needle wielded by a stranger working on behalf of an institution to which you do not belong nor fully understand and perhaps, with good reason, don't fully trust. Add to that any rumors or old stories or myths or true accounts of people who have been harmed in some way by the process and the idea of getting vaccinated generates fear. And the third hesitation is, as psychologists would call it, agency threat, a threat to one's

31:23agency. And this will lead to what psychologists call reactants, an angry knee-jerk rebellion, an attempt to reassert one's autonomy. And people can be quite nuanced at the individual level and the cultural level in this regard, and those two things will interact. For some, the word mandatory is all it takes to choose the threat of the virus over submitting to the will of the person holding the needle on behalf of the state or of science or of medical

31:54authority or experts. If you trust the experts, this can seem nonsensical. If you don't, this one aspect, agency threat, for many, makes the very idea of vaccination, in Levinson's words, intolerable. Here is Thomas Levinson taking us through all three of these hesitations. I mean, I feel a response that, you know, a flash of recognition in the argument about it

32:28being wrong. Initially, when the very first sort of proto-vaccination procedure was brought into Western medicine in London and Boston in 1721, this technique of variolation where you actually give people a very mild, hopefully very mild case of smallpox to ward off the, you know, the wild version of the disease with its up to one-third death rate. So that starts happening in the early 18th century, and the instant immediate reaction

33:00is that the entire approach, the idea of doing this, of actually introducing a substance into a body that in some ways makes you ill, is a violation of God's order. You know, it's God's job to decide, you know, who suffers, who survives, who thrives, all that sort of stuff. And if you, you know, intervene in this way, it's a kind of blasphemy. Now there is, in that moment, in that same time, there's a powerful and again, to me, persuasive

33:33theological response, Cotton Mather, the witch burning, or witch killing, they didn't actually burn them at Salem, but the person associated with the Salem witch trials was also somebody who really thought of himself and wished to be a man of science, of natural philosophy. And he was the one who introduced this proto-vaccination into the new world. It was, had this guy's, this guy's instigation.

34:05And he responded that, you know, you violate the Sixth Amendment, thou shalt not kill, if you refuse to take action to preserve life. That you're not intervening in God's plan, you are executing, you know, the fundamental requirement that we're, we're asked to, you know, cherish life. It's fascinating. It's fascinating that he's like, thou shalt not kill, except witches. Witches were Satan's agent on earth. So they, they, they don't get, they don't get no love.

34:35But, but the, the idea that this is, you know, the, the underlying idea behind, you know, you dressed up in theological language is that, as you said, vaccines are unnatural. So they, you know, they're an attempt to engineer something in a human body. Whereas, you know, the right way to be in the world is to be in the world and allow the world to interact with you, sort of unmediated. And that's something, that idea, the idea that vaccines are unnatural because they upset

35:07our relationship to nature is something that really starts to take hold in the 19th century. It's a romantic ideal and you see it in, you know, people like Henry David Thoreau and John Muir, that the proper way to ensure health is not to attempt to manipulate the human body, but to bring it into, you know, to live right, to bring it into harmony with the natural world. And, you know, again, understandable, not entirely crazy.

35:38I mean, the horrific environment of 19th century, rapidly growing, rapidly industrializing cities with slums and terrible water and worse air and all that sort of stuff was unquestionably unhealthy. And, you know, one of the great movements of the 19th century was the sanitation movement, which made a major impact on improving, you know, quality of life and the sort of regime of disease in 19th century urban life. But even if it's a good thing to eat a good diet, breathe clean air, make sure your water

36:15supply is safe and pure, all those things are in themselves good, but they are insufficient if you encounter, you know, a measles virus or a smallpox virus or the typhoid or cholera. You know, when you actually come across that, the fact that you have touched grass that day is, you know, ain't going to help very much. So, again, but there's a lot, you know, I mean, you know, in my daily life, I realize it sometimes that, you know, I need to get out in nature for my mental and presumably physical

36:50well-being as well. So there's, you know, you can see what, this is not a, you know, it's not ridiculous. I think it is broadly a human thing, the sense that if you could, if you live right, if you do the things that keep your body and mind in the best possible framework, you will be healthy. Again, not entirely wrong and entirely reasonable. People, I mean, I think we can see why people would feel that. And, you know, you ask why we're in the terrible place we're in now.

37:27Part of it is, I think, that that argument and, you know, Robert F. Kennedy Jr. has made it is, you know, if you, when we were young, we all caught the measles and then we were permanently immune from the measles. And that was good. That was the natural way to acquire immunity, natural way to be in the world. You see this in, you know, the writings of naturopaths, you know, naturopathic medicine. You know, there was a quote from, like, somewhere in the book that says, you know, it's, you know, it's good to have a nice fever every now and then.

38:00You know, it's, your body needs that, your immune system needs that, all that sort of stuff. You can understand, particularly in a world that is alienating in lots of ways, why asserting that a connection to nature, a wellness, a, you know, meditative space, all this sort of stuff, is the proper response to problems of health and avoiding disease. And again, there's sort of nothing wrong with that on the face of it, except if you encounter a COVID virus, if you encounter, as we're now seeing with this still going on, still

38:33ongoing measles outbreak, as, you know, you know, pertussis, whooping cough is on the rise, all these kinds of things. Because the, the false agency that comes from asserting that there is an unnatural and a natural way of achieving wellness, and that the unnatural way is bad, and the natural way is right, doesn't actually accommodate the, both the scientific knowledge, the state of

39:04scientific knowledge today, and the reality that we live in a microbial world, we're guests in the world of bacteria and viruses. And we should remember that and, you know, do our best to, to accommodate ourselves to the fact that we will encounter pathogens. So that's, that's the wrong side of it. The bad side of it is the argument, again, there from very early on in the history of vaccines, certainly there at the very beginning of the first of the, you know, when the first true

39:37vaccine against smallpox was invented and disseminated at the very end of the, of the 18th century, beginning of the 19th century, people said, you know, it's bad, it, you know, produces all kinds of terrible, you know, it, it doesn't, it, it's not effective against smallpox and it causes other diseases, which is, you know, it's the same argument that's being made now, for example, about the measles vaccine and its alleged and nonexistent connection to autism.

40:07The idea is that vaccines are at, you know, at best ineffective and at worst genuinely and seriously harm causing. Again, in the early 19th century, you know, through the 19th century, there was some truth to the argument. One of the problems with basically the way they harvested and then spread the, the cowpox virus material that was the smallpox virus, a vaccine rather. You know, cowpox is a

40:42disease of cattle that is not threatening to human beings. The vaccine was discovered because it was noticed that dairy maids tended not to get smallpox and exposed to this disease of cattle when they milked, you know, in their daily life of milking lots of cows. So the question was, how do you get more cowpox when you aren't a dairy maid? And the way they did it in the beginning was, you know, they'd give somebody the cowpox vaccine. They would develop a mild reaction, including some sores. They'd harvest

41:18material from those sores and, you know, use that as the basis for the vaccine they give to somebody else. So-called arm to arm vaccination. The problem with it is two things. If you happen to get any blood along with the, the, the pus, um, you run the risk of transmitting an existing bloodborne disease. Um, and, uh, even worse, if you pick the wrong sore and the person you have, the person you're getting your vaccine material from

41:49has syphilis, you can just, you know, give somebody a loathsome, terrifying, and uniformly fatal disease. Um, and, you know, that's dreadful. Shouldn't happen to anyone. If it happens to you, you'd be really upset, um, and then dead. Um, and it's terrifying. And it's a, you know, it's a great argument against, uh, smallpox vaccination, except that the incidence of doing so was, was very, very low. It was a rare,

42:23it, it absolutely happened. There are documented cases, but, you know, something like 700 or so cases in Europe across a 20 or 30 year span. So even though, you know, 700 cases is, is enough to say, okay, this is really a problem against the, you know, population of Western Europe in those years, it's a very, very small fraction in which this terrible error was made. But you can, you know, see why there was reason to fear that smallpox vaccination, uh, which was the only vaccine

42:58available for essentially almost all of the 19th century. Um, why that might be something you should be afraid of. Now, again, uh, once the, the risks of arm to arm transmission were, were clearly identified, um, uh, the Italians and then the French and then around the world developed a technique of simply raising cowpox in cows, uh, never running any risk of, of, you know, tagging along a human

43:29disease in the vaccination. They basically farmed a vaccine. There were, there were, you know, herds of cattle that were used to develop the vaccine, which was then sold, um, you know, around, around whatever country was where the, uh, where the, the herd happened to be. Um, and that was, you know, quite safe to solve the problem. Smallpox vaccination, uh, proved to be useful. Um, more than useful. I mean, when, when it was first invented, the inventor, uh, Jenner, um, said it, it can be seen

44:02that the ultimate end of this practice will be the elimination of smallpox around the world. And he said that, you know, right around 1800, it took basically, uh, 170, 180 years, but he was right. Smallpox is, is extinct in the wild. There is none left circulating. No human being is at risk of catching a wild case of smallpox. So, um, yes, there is reason to fear sometimes. Um, but the

44:32scale, uh, you know, the, the response to actual problems has been to solve them. And the scale of the risk reward has always been in favor of vaccines and is now enormously more so. Vaccines do have side effects. There is some, and some of them have, uh, occasionally very serious side effects in very, very small numbers. As a society, we should address that because there's a whole social benefit to, to vaccination. Um, and if somebody suffers because of the, as we seek to achieve

45:03that social benefit, then we should probably do something about that. But it's not as if the, uh, the, uh, the problems were just ignored and it's not as if the, um, the scale of them, uh, was ever anything remotely like what people of those days and certainly not what people of these days suggest. There is no, you know, at the Fauci hearing just the other day, one of the Republicans was saying, you know, or, or maybe just after that millions of people were killed by the COVID vaccine.

45:34That's simply false. It's an, it's a, it's a blatant lie. This notion that, that vaccines are bad is deep. It has a long history. It is persistent. And it creates this perverse outcome where the people who are afraid of the vaccines put themselves more in harm's way, um, than they would otherwise be. You see that very much in the, in the changing patterns of measles vaccination as well right now. Uh, and the last issue in the anti-vaccine world is actually different from the first two.

46:10Uh, if you say vaccines are, are wrong, they're unnatural, you can say, well, in fact, they're not. We live in a world that is circumscribed by these microbes and this is a reasonable response. The so-called natural way is ineffective in the face of these challenges. And they're not bad in the sense that, that say an RFK junior would assert that they are, they are enormously effective and life-saving and so forth. Um, and those are empirical claims that can be tested, right? Um, the idea that,

46:43um, whether or not vaccines are effective, whether or not they work, um,

46:50it's still intolerable for anyone else, especially the state, uh, to tell me or whoever what to do. And again, there's, there's something you can understand there. Vaccination is a really intimate act, right? Some stranger walks along with some, some stuff that they claim produces an effect, uh, and says in order to take part in things like

47:21sending your kids to school or what have you, um, you have to, you, you or your children, everybody has to be vaccinated by order of, you know, where I am, the Commonwealth of Massachusetts or the United States government, whoever it may be. Um, that's kind of a big ask, right? You know, I, that I must by order of some, you know, distant power, uh, allow some stranger to actually change my body in some, you know, penetrating, you know, needle in my, in my shoulder kind of way. Um,

47:58so there's, uh, you know, the emotional power of the idea that no, you can't make me do this is, you know, again, I think it's a universal human thing. It's a scary thing. You don't want it. Kids don't like to get shots, all that sort of stuff. Um, but, you know, ultimately it's a question of, uh, fundamental values because the problem is, of course, when you don't vaccinate, um, you put yourself at risk or you put your children at risk, uh, by your own decision. Now, I think it's fair to put yourself, you know, in general,

48:34if you want to go bungee jumping or skydiving or what have you, that's your problem. And if the chute doesn't open, that's your last problem. Um, but, uh, but, uh, and, and you could sort of see vaccination that way. If I, if I refuse a COVID vaccine and I get COVID and I die, well, big won't. That's, you know, I made the choice. I, you know, I gambled that I got it wrong. But the problem is vaccines are not acts simply involving the individual.

49:06Uh, there are people in our society always who cannot be vaccinated. Infants, you know, at the age before their immune systems are developed enough to take vaccinations, right? So up to your, you know, you can be up to a year old and you, you won't be able to get your first measles vaccine. For example, transplant patients whose immune systems are suppressed, people with autoimmune disorders, uh, the elderly who may have been vaccinated, but their immune systems naturally weakened with age. There are a lot of vulnerable people out there.

49:37And some of them, you know, all of us are those people at one stage of our lives or another, right? You know, we're all infants at one point. We all get old if we're lucky. Um, uh, and, uh, uh, and these are the people for whom, you know, for whom vaccination isn't insufficient or unavailable, um, and who thus rely on society as a whole to keep a pathogen from finding them and harming them.

50:10And the way you do that is by something called herd immunity. You get enough people vaccinated so that a virus or a bacterium that causes an infection in one person has no one around them to infect, right? So, you know, somebody gets sick for whatever reason, but doesn't pass it on to their kids, doesn't pass it on to the, you know, the members of their bowling league, doesn't, you know, go to a restaurant and spread it to strangers at the next table, whatever it may be. Um, because enough people around them are vaccinated that the, this,

50:42the chain reaction of the virus spreading from person to person and more people and more people can't happen. There aren't enough available hosts for this, for this, um, event to take place. That's how you protect people who cannot protect themselves. So the question is,

51:02you know, first of all, you know, is that a moral imperative? Should you, should you take action to defend others, even strangers? Um, and then it's a question of, you know, how, what you feel is appropriate for state power? Is it, um, the right of government to make you take an action, uh, to keep the society as a whole, uh, safer than it would otherwise be? And in law, that question has been answered in the United States

51:32for a long time. You know, the Supreme Court case that settled the matter, uh, you know, up to now and hopefully continue, but we don't know, or what actually took place in 1905. The, the decision was rendered in 1905. And, um, the author of the opinion, Justice, uh, Harlan, who is nobody's idea of a woke liberal at all and quite the, quite the opposite made it very clear that, uh, somebody's liberty ends at the point that in infringes on somebody else's liberty.

52:08So if your action or your inaction causes harm or worse, a death to somebody else, the state has the power, you know, um, because there is no liberty in the grave, um, your choice not to vaccinate threatens to constrain the freedom, constrain the, the agency, uh, of others. And the state has the right to step in. There is, you know, in the, in the city, there's no liberty without limits. Liberty only exists if it exists within the, you know, at least the minimal constraint of you can't,

52:40you, you can't choose to act in a way that infringes on the, the, uh, you know, rights and agency of others. And for me, you know, again, that's not an empirical argument in the same way about, you know, are vaccines safe? Uh, are they more effective than, uh, you know, uh, sort of validating, you know, valorizing nature? Um, uh, are the, are vaccines more harmful than they do good? Those are empirical questions. Uh, but whether or not you think it's okay for the state to constrain your,

53:13your individual action because of the potential of that action to cause harm to people you may never meet or know, that is an easy judgment for me, but it's not an empirical one. It's a, one of values, one of a sense of, you know, am I, uh, simply an individual or am I an individual bound by ties to other individuals in this network that we call society?

53:51I want to land on one thing here. I think about myself and you and other people around me who I get presented with the, with, okay, yeah, sure. Here's the risk reward, la la la. And I'm like, yeah, of course, this makes sense to me. I'll get it. And then it, other people who I thought I understood all of a sudden seem like alien entities who they hear the same arguments and go,

54:22no way they get angry. They're, they're, they're cursing at Dr. Fauci as if he's the devil. And it seems so nonsensical and strange. I want to go to, well, these people are stupid, ignorant, evil, weird. Like I want to find some easy way to make sense of it, but I know it can't be that simple. What is your take on what is actually producing this current level of resistance that we're seeing

Current Resistance to Vaccines

54:48that has risen to the top of the news cycle? And what do we do about it as science communicators? What's the, what, how do we alleviate any of those? Your second question is, is difficult. Uh, the first one is, you know, I don't use the word evil very much. Uh, but I think there is an element of evil in, uh, one strain of the anti-vaccine movement. And that is the people who I think genuinely know better, but who find it useful to their own ends,

55:20uh, to, to sort of put themselves at the head of this, of this already moving train, right? Uh, I, I put RFK junior in that category. Um, during the COVID pandemic, uh, somebody identified 12 of the most effective anti-vaccine influencers. Kennedy was number two. Uh, but there were a bunch of people and it was a relatively small number of accounts on Facebook and places like that, that had enormous reach. And those are people who got power, they got money, they got clout. Um, they had a very good reason to be anti-vaccine advocates. And many of them were people who were

55:58at least absolutely capable of knowing better. And I think, you know, Kennedy vaccinated his own children. He said he regrets it, but you know, uh, Donald Trump got the COVID vaccine. I mean, it's, it's, it's not as if, um, uh, the people who are out front of this are in their own lives, obviously, uh, you know, uh, drinking their own, uh, drinking their own Kool-Aid. Then there's another group who I think are genuinely committed to the anti-vaccine stance and wrongly so that is

56:31they're making errors. Uh, but it's, uh, it's much more understandable. You know, it's, it's not just this sort of self-interest. Um, and those are people, you know, the whole vaccine autism thing comes out of a fraudulent story. I mean, literally it's been retracted. It's been exposed as fraud, uh, by Anthony Wakefield suggesting such a link in, um, uh, in the nineties, you know, the people who have kids who, who become diagnosed with autism, you know, severe autism, um, that diagnosis tends to

57:05happen, you know, sort of right in the middle of the vaccine schedule for child, childhood vaccine schedule. Um, and two things are happening there. One is, uh, the sheer sort of the idea that the universe is indifferent to us, that bad things can happen just because, you know, we're walking along the sidewalk that day. Um, that's, I mean, that seems to be the case, but it's really a hard thing emotionally for people to believe. There has to be a reason for both good outcomes and bad outcomes.

57:39Uh, the idea of looking for some distinct cause, something you can, you know, point to and say, that's the problem. Again, a deeply human response. It's, it's, you know, I can see where that comes from. Uh, uh, one of the things that happened is that impulse is now fed by an entire media and influence ecosystem where people can really benefit from, uh, trading on people's hopes, fears, desires,

58:11um, sadnesses, the scale with which these, uh, these falsehoods can get disseminated, the self-reinforcing nature of some of these networks. That's one of the reasons I think we're seeing such an enormous increase in the potency of the anti-vaccine movement, which, you know, it's been with us for a long time, you know, even in the, in the sort of present moment, but you wouldn't have said at the turn of the 21st century, you know, in 2000, that it was anything but a fringe movement, right? Now it's not a fringe movement. It's at the center of power.

58:45Now, the question is what can science communicators do about this? So first of all, I don't think that simply stating the facts is, is effective. Part of what I think is, is something that we've been saying in science communication for a long time, people don't remember facts, they do remember stories. And so if we can construct the critique of the anti-vaccine movement and the anti-vaccine argument, uh, through powerful and easily legible stories, that's, uh, that's, you know, we should do that. And we should do that as often as we can

59:20and in venues, um, uh, you know, in any venue we can, we can find to do it in. But I think the problem we're in now is that the anti-vaccine movement is not as it once was, uh, a movement, you know, focused on that one issue alone. Uh, it's become part of a broader critique against expertise. And that was the whole Fauci thing. How dare, you know, you have this senator

59:53from Ohio, Bernie Moreno, who's saying, you know, how did you, who the F is, do you think you are? You know, Moreno gave an interview after saying he's, you know, an arrogant, you know, et cetera, et cetera, et cetera. You know, Fauci's a, an expert. He's, you know, a MD who did further training and has worked in government service, uh, for, you know, decades and all that. Um, and he knows an enormous amount about infectious disease and responses to them. So, uh, you know, if you make as part of your

1:00:27political movement, the idea that that kind of expertise is non-existent or is, is not useful or is even that, you know, being an expert is somehow evidence that you are captured by, uh, you know, some, some ways of knowing or ways of being that are, that are just not, you know, not, not what the real world is like. Um, and you know, you see this, I think very much right now, uh, in our government, uh, and in our political life that, that expertise is, is no longer seen as trustworthy. Uh, you know,

1:01:04then the idea that, uh, the only proper role of government is, is, uh, you know, maybe the defense department and, uh, and redistributing money to, to friends of the administration. Um, uh, but not, you know, uh, doing anything that in any way sort of interferes with, with the, the,

1:01:32most capacious idea of personal autonomy. Um, vaccines in that case don't, aren't, aren't the problem in themselves. They're just another example of government overreach, right? Um, or if you see, if you, if you, if you make your political life around the idea that modern society is corrupt, right? And we need to somehow recover something that is, that is pure or clean or more honest. Well, you know, it's really easy to say big, you know, the only reason people want to give you

1:02:04vaccines is so big pharma can make some more money, leaving aside that vaccines are among the least profitable ends of the, uh, for good reason, um, of the, of the, uh, uh, of the drug business. Um, you know, you, I think you see where I'm going with this. There are lots of other political, um, ideas and ambitions, which add up in essence to a populist authoritarian view of how the U S and other nations should be run. Uh, and in that context, the anti-vaccine movement is, um, not the driver

1:02:42of it, but the logic of the larger political ambition essentially requires you to be anti-vaccine. The anti-vaccine movement with its themes of, you know, some kind of malign outside force government, big pharma experts, um, experimenting on taking advantage of doing harm to, uh, you know, honest, uh, simple folk. Um, it's a, you know, it's, it's, that's an old rhetorical move and it's always been effective. And I think it's effective now. And I don't think it's terribly surprising in the

1:03:17sense that we live, we're living in this very rapidly and for many people, traumatically changing world. But that understanding doesn't change the fact that, um, uh, making vaccines less available, uh, killing research into new vaccines, all that kind of stuff will lead directly to potentially enormous, you know, mass human harm, suffering. Uh, and that's why even though, um,

1:03:49there are a lot of people in the anti-vaccine movement with whom I have sympathy, with whom I think I can recognize some of the impulses that lead them to that end, it's still vital to counter it because the, the cost of, you know, the cost of that understanding and empathy shouldn't be the surrender of this enormous unprecedented and truly incredibly recent ability to, um, eliminate most of the threat of infectious disease. Remember, through almost all of human history, infectious

1:04:22disease, maybe throwing battlefield, you know, infections of battlefield wounds and so forth, with, you know, easily the leading cause of death. Uh, and there's no reason we need to go back to the age when, um, it was routine for parents to bury at least one of their children and often more. I think it's, I think it's a pragmatic, but also a moral imperative, um, not to go down that road again.

1:04:56That is it for this episode of the, you are not so smart podcast for links to everything we talked about head to you are not so smart.com or check the show notes right there in your podcast player. My name is David McCraney. I have been your host in those show notes. You can find my book,

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