Do vaccine sceptics deserve a voice?

Anti-vaxxers cannot be dismissed as simply stupid or malicious: it is not always easy to “follow the science”.

Message from above: the stars of Netflix's Don't Look Up, which satirises our “shrug it off" approach to the climate crisis

The big Netflix hit over Christmas was Don’t Look Up, starring Leonardo DiCaprio and Jennifer Lawrence as astronomers who discover that a comet is on track to destroy the Earth. A Trumpian US president, played by Meryl Streep, refuses to take their warnings seriously, a disregard shared by a media class obsessed with celebrity trivia and a population stupefied into inaction.

Few viewers will have missed the film’s political message. The comet, of course, represents climate change. And, suggests the film-maker Adam McKay, the flailing response of the Don’t Look Up characters is similar to our collective flailing right now, when confronted with an emerging global catastrophe.

What I disliked about this otherwise engaging film is its representation of scientific and political disagreement. It understands the failure to act on the climate crisis to be a result not of genuine difficulty but of malicious stupidity. The Trumpian president’s supporters are portrayed as bovine, refusing to acknowledge the threat of the comet, even when it becomes visible in the sky. “Don’t look up” is the slogan they mindlessly chant, while the good guys respond with “listen to the goddamn qualified scientists”.

The problem is the “goddamn qualified scientists” do not all agree with one another. Some are in denial for personal reasons, while others are in the pocket of big business. Those warning against the comet form a minority within this fictional scientific community.

On this point, the Don’t Look Up narrative diverges from the reality of climate science: Nasa calculates 97 per cent of publishing climate scientists agree the planet is warming as a consequence of human behaviour. But on other questions, there is significantly more debate within the scientific community, and the facile directive to “follow the science” – popular among politicians during the Covid-19 pandemic – cannot help us.

What “follow the science” really means is “follow the current scientific consensus”. But the consensus often changes. This will be apparent to any parent who pays attention to public health messaging. The infamous example is the guidance on thalidomide – the morning sickness drug that caused defects in an estimated 10,000 babies born in the 1950s and 1960s – but there are many other instances of inconsistent messaging: should babies be laid to sleep on their backs or their fronts? Should peanuts be fed to infants before the age of one, or should they be withheld until the age of three? The answers to both of these questions have varied within my lifetime, as the scientific consensus has shifted and with it official policy.

Which brings me to the confrontation on 7 January between the Health Secretary Sajid Javid and Steve James, a consultant anaesthetist at King’s College Hospital (KCH) in London. Javid asked staff on the ward how they felt about new rules, which come into effect in April, that will require all front-line NHS workers in England to have a Covid vaccination or else be moved to another role. Ten per cent of KCH staff are unvaccinated and thus risk losing their jobs. While his colleagues shuffled their feet and Javid glowered at him, James expressed his objections to the policy: “I’ve had Covid at some point. I’ve got antibodies. I’ve been working on a Covid ICU since the beginning. I’ve not had a vaccination. I do not want to have a vaccination.”

Is James too stupid to understand “the science”? That seems unlikely, given his medical expertise. Rather, he disputes the evidential basis of the policy, pointing out to Javid that the vaccines do seem to cut the risk of transmission, but not for long. What’s more, some studies suggest natural immunity is as effective as vaccination in protecting against both transmission and severe illness. Vaccines are highly effective, but the scientific community is not agreed on the necessity of jabbing the young and healthy, or those who have recovered from the disease. And although James and his fellow sceptics may prove to be mistaken, they cannot be dismissed as simply stupid or malicious.

Official policy on mask-wearing has been reversed since the start of the pandemic, when we were advised masks were unnecessary. We now know there is little need to decontaminate surfaces, as we were once told to, since Covid rarely spreads through them. The scientific consensus on the virus and its transmission has changed, and it will almost certainly change again.

Sometimes “the science” gets it terribly wrong. In a devastating essay published last year in the US online magazine Tablet, the novelist and essayist Ann Bauer described the torment suffered by her autistic son Andrew, who died aged 28, apparently by suicide, having grown “tired of being controlled by the fickle tzars of autism”. From the mid-1950s, the “refrigerator-mother” theory of autism was popularised, which understood the condition to be caused by a lack of maternal affection. Some autistic children were removed from the care of loving families and placed in foster homes, despite the screaming protestations of mothers condemned as “refrigerators”. Then the scientific consensus around the causes of autism shifted; it shifted again, and again. As Bauer writes:

Each new wave was certain: the approaches to autism that had come before were barbaric and uninformed, but this most recent breakthrough was the one clear truth. Science had spoken.

Having witnessed the sometimes cruel treatment of autistic individuals and their families in the name of “science”, Bauer admits to a certain cynicism. “I have been through this before,” she writes of the medical merry-go-round we are all now on. The scientific method demands debate, dissent and revision; “follow the science” implies certainty. Until it changes.