The Needle and the Damage Undone? An Inoculation Celebration.

"You used my toothbrush and you have ebola".

Last week was a particularly busy week for Skeptical and Fortean events. Tuesday saw Al Robertson at The Miller talking about the occult roots of computing and that was followed, on Wednesday, in Greenwich with Pixie Turner and Brett Hermes' methodical dismantling of the cultish nature of the nutrition industry. But it all began in the Monarch on Monday when London Skeptics in the Pub hosted Richard Clarke whose talk, The Psychology of Vaccine Acceptance, Hesitancy and Refusal did exactly what it said on the tin.

In the last few years there has been a worryingly huge upsurge in measles across Europe. It's been most pronounced in Serbia and Ukraine, with Georgia and Greece also showing remarkable rises in the number of identified cases, and Clarke, a psychologist embedded in the epidemiology department at the London School of Hygiene and Tropical Medicine, was in Camden to talk about why he thinks that is and what we could do about. But first, he was keen to get across that his research was not funded by pharmaceutical companies.

Conspiracy theorists and the anti-pharma brigade are always keen to see financial motivation but Richard Clarke made it clear that both himself and the organisation he works for are motivated by a much more simple factor. They want children to grow up healthy and happy.

But he is also acutely aware that nobody should ever try to get between a mother and her child, that's not the way to change people's minds. Coming from a background that looks at the social science of vaccination rather than a strict medical one he was prepared to trust doctors and peer reviewed papers and felt the way to change people's minds was with evidence and gentle persuasion. Because a vaccine that stays in the vial is always 0% effective.

Vaccination uptake tends to be quite binary (you can't really half have an inoculation) but the beliefs that underpin decisions to vaccinate or not are anything but. Less than 2% of people decline all vaccinations and that's often for religious or deeply personal reasons but a diagram of a 'vaccine hesitancy continuum' (hey, I know how to have fun when I go to the pub) and a list of countries with high or low vaccination rates show just how difficult the data can sometimes be to interpret.

Ethiopia has very high vaccination rates and that's probably because people there have seen, in living memory, empirical evidence that vaccination works, that it saves lives. But did the take up in France and Italy (both now improving again) drop for the opposite reason? Had people become so confident that they wouldn't catch a potentially lethal disease they didn't even feel the need to take the prescribed precautions?

Is that why Poland is experiencing a huge move away from vaccination? Is vaccination a victim of its own success? When societies can no longer see the disease around them do they start to think the risks of vaccination are worse than the risks of the disease? To illustrate this Clarke showed the audience a photograph of an iron lung. Only those over 50, I'd say 60, were able to identify it. People no longer know much, or anything, about polio paralysis. They forget how dangerous that disease was. Yet, something relatively new and scary like ebola, has people very worried (see the quote that kicks off this piece).

Almost as if the 'vaccine hesitancy continuum' wasn't exciting enough we're treated to a graph showing severity/susceptibility quadrants and we consider some of the things people take into account when deciding whether or not to have their children vaccinated. Religion of course but also safety, effectiveness, and how important it actually is to have it done.

There's also the fear of autism. Clarke refused to even speak the name of the thoroughly discredited and struck off former doctor Andrew Wakefield who was responsible, back in 1998, for creating a huge backlash against vaccination by publishing a fraudulent report claiming there was a link between the MMR vaccine and autism. He chucked bowel disease in for good measure but that seems to be mostly forgotten about.

Despite both him and his research being widely debunked and denounced, the lies he promoted linger in the air like a bad fart and you'll often hear people, even twenty years later, trotting out the same old lines that he first put into the public sphere. It's that old thing about a lie travelling around the world before the truth can get its boots on.

Sometimes debunking rumours, frustratingly, only serves to spread them and, thus, reinforce them. It's why The Daily Mail print outrageously, and obviously, untrue stories about health scares. They know outraged but well meaning lefties will share them on social media sites and they'll get more 'views', their message will be spread by people who think they're countering it. The people who work for The Daily Mail may not be pleasant but they're not stupid. They're just pretending to be. It serves them well.

But how do those who prefer evidence to hearsay get their message across? The irrational among us are unlikely to study NHS leaflets, no matter how many there are, how well intentioned they are, or how true they are. Many choose to 'feel' risk as opposed to rationally assessing it. Critical thinking, in the days of Trump and Brexit, appears a dying art.

One of the final graphs of the evening shows how the action of one man (Wakefield, obviously) can still be seen on a graph two decades later. It shows the damage that can so easily be done and if that's not depressing enough we're left to ponder one thing we have too much of now and one thing we don't have enough of.

We have too much information (hey, TMI is even a recognised TLA). It comes at us from all angles, it's mostly unregulated (this blog certainly is so please verify facts before acting on anything I type - I AM NOT A DOCTOR), it often serves a shady agenda, and it sometimes seeks to simply disrupt. Information is good, of course it is, but we really need to up our fact checking game. Fake news does exist and it's mostly being propagated and disseminated by those who seem determined to make you believe that others are responsible.

What we haven't got enough of is trust. We don't trust the government, we don't trust the press, we don't trust the media, we don't trust doctors, and, ultimately it seems, we're losing trust in each other.

But I like to think I'm not alone when I say I do trust some politicians, I do trust some press/media, I do trust doctors, and I do trust my friends and family. Because without that trust, life would be almost unbearably sad.

I also trust London Skeptics in the Pub to provide me with an interesting, informative, and educational evening out and, once again, they'd not let me down. It was 5th November, bonfire night, and I could have been watching fireworks and drinking mulled wine. Instead I was listening to a bloke in a pub talking about meningitis B and I had no regrets about it whatsoever. But if I had kids, decided to not have them vaccinated, and they caught measles - which can be deadly, then that's something I definitely would regret.

Roll up your sleeves and look away. This won't hurt a bit.