Inoculating Against the Anti-Vaccine Meme

The debate over vaccination is raging (c.f. Wired article) and it smacks of one of those conundrums that is unlikely to get resolved by scientific inquiry.  I offer the following hypothesis and a way out of the dilemma.

Hypothesis: Vaccination is something that is good at the societal level but bad at the individual level.  That is, it is a tragedy of the commons.  You want all your neighbors to get vaccinated so they don’t pass on the germs to you, but there is enough risk from the vaccination process (at least for certain ones) that you’d rather not do it yourself.

The mathematics of the commons tragedies suggests that there are two ways out.   One is to change the payout/incentive structure, in other words, make the vaccine’s less risky to the individual, or at least change the perception of the individual risk (as the Wired article suggests).  The problem with manipulating perception is, what if you’re wrong?  The marketplace of ideas can be efficient, crowd wisdom can be greater than individual understanding.  And even in the cases it’s not, the market can remain irrational longer than you can remain alive.

The good news is there’s another way out.  Just as with the Prisoner’s Dilemma, you can iterate.

What would this mean in the case of vaccines?  It would mean that as a society we must recognize that if we “play the game” enough times we will find that not vaccinating as a whole leads to poorer outcomes to the the individual.  That means YOU.  And thus it becomes recognized that taking the “I’m not going to vaccinate” stance is immoral, or at least unacceptable.  Sure there will be “defectors”, just as there are people who don’t vote.  But those who don’t vaccinate — just like those who don’t vote — do so quietly.  They don’t shout it from the rooftops or let their neighbors know.  And sometimes they even lie and say that they did vote when they really didn’t….

The level of defection is inversely proportional to the level of transparency — the less your neighbor can find out about your behavior, the more likely you are to defect.  Thus, we solve the dilemma by making public the record of everyone who vaccinates, along with their address.  Those not on the record are assumed to be defectors.

  • Gene Lover

    Rafe, I think a better, more educated approach is to continue pursuing the science behind this. Believe me, there’s more to be done. Whenever there’s a needle in the haystack problem (like I suspect this is), it takes an inordinate amount of time and study to get to the bottom of it. Imagine that there is a very small fraction of kids who simply can’t handle the burden of these shots (they may not have the right “mix” of enzymes to chemically break everything down, which could be the result of a rare toss of the dice). It’s akin to pharmacogenetics, which looks to study why some of us do just fine on a drug, while others (usually a small fraction) have severe reactions. It’s an extremely hard problem to solve, but understandable that SOME parents aren’t willing to let it drop. Just like having personalized medicine, geared to our genetic propensities, maybe we can get to personalized vaccinations, with shot schedules based on tolerable chemical loads. This approach could engender trust on the part of parents and hopefully increase the vaccination rate. Denying there’s a problem, however small, simply won’t work.

  • Rafe Furst

    As I said, there will always be “defectors”. Parents know when their kids are being harmed better than any other adults. That’s why you can’t legislate it. If you lived in a world where your neighbors all vaccinated their kids, and you didn’t because you knew it was bad for your particular kid, and they knew that you felt this way, would you be able to handle the peer pressure for the better health of your child? Of course you would.

    I’m not denying anything, nor am I advocating stopping the science. Just suggesting a way forward until we have greater clarity.

  • Thomas goetz

    I’d just suggest modifying your hypothesis statement to “vaccination is PERCEIVED as something that is good at the societal level but harmful at the individual level.” in fact, the individual risks of not getting vaccinated – getting the disease- far outweigh the largely unmeasurable risk of vaccination.

    But I think yours is an intriguing idea – introducing shame into the moral calculation is an underutilized strategy.

    • Rafe Furst

      Yes, I think that’s a fair enough modification. The subtle difference though gets to a key feature of the iterated prisoner’s dilemma solution of iteration. I has to do with turning Mutual Knowledge (“vaccination is good for society”) into Common Knowledge (“we all know that vaccination is good for society, and we all know that we all know, and we all know that we all know that we all know…” and so on). The structure is inductive logic and iteration creates the recursion for the “proof” to work.

  • Alex Golubev

    greater transparency is needed in all aspects of our lives especially where agency problems reside. however, i don’t think shame is a good enough carrot and isn’t very quantifiable. with greater transparency insurance premiums ought to reflect the latest market beliefs. so greater transparency will align individual and common incentives through a market system where the collective is represented by a “taxing” organization. Of course it makes sense to have competing organizations as well. (applies to governments as well)