Rachel Hills has written a thought provoking piece for The New Republic, The Best Way to Combat Anti-Vaxxers Is to Understand Them.

Referencing the work of Jennifer Reich, a sociologist at the University of Colorado Denver, Hills claims:

It is not just anti-vaxxers, after all, who take pride in their ability to critically evaluate information, who do background research instead of trusting their doctor’s advice on faith, or who are skeptical of the motivations of government, pharmaceutical companies, or big business. Nor is it only anti-vaxxers who believe that every individual is unique, and that policies should be adapted to fit those idiosyncrasies, rather than applied one-size-fits-all. (As one mother Reich interview explained it in relation to vaccines: “Everyone has a different immune system. For some people, it may take three shots. [Others get] immunity that first time.”) In an era of high individualism, ideas like these aren’t outliers or aberrations. They are hallmarks of the liberal middle-classes—the kind of people, say, who might read The New Republic online. And I’ll be honest: they sound an awful lot like me.

In other words:

At its heart, the anti-vaccination movement isn’t a product of ignorance, selfishness, or even fear … although each of these play their part. It is the logical fallout of a society in which knowledge is relative, institutions are fallible, and the individual reigns supreme. In such an environment, the real surprise isn’t that there are people who doubt vaccines. It is that most of us don’t doubt them, even when every social force around us is urging us to do otherwise.

According to Hills, if that’s the case:

All of which begs the question of how we might better respond to anti-vaxxers. One solution might be to rebuild the trust between individuals and medical institutions. It is well established that parents who choose not to vaccinate their children are a privileged group, but the deep suspicion that lies at the heart of vaccine refusal reflects their distance from power, not just their proximity to it. It stems from the same impulse that leads people to believe that the U.S. government creates fake ISIS videos as propaganda tools, or that media barons dictate stories to their journalists over the phone…

She concludes:

Whatever approach we choose, one thing is for certain: Dismissing vaccine skeptics as crazies or idiots won’t solve the growing public health problem their choices present. To do that we need to go deeper; to examine not only the ways in which they are plainly wrong, but the beliefs they hold that are more equivocal—and the unwitting role we might all be playing in allowing those ideologies to thrive.

As much as I admire Hills’ writing and clear exposition of her claims, I disagree profoundly.

Hills is right to focus on parents’ attitudes, rather than their knowledge of science. That’s because anti-vax advocacy is not about vaccine and not about children. It’s about parents wanting to see themselves as educated, empowered and not submissive to authority … with an important caveat. They want to burnish their self-image without doing the hard work of learning immunology.

Yes, neo-liberals (and old fashioned liberals like myself) want to take pride in their ability to critically evaluate information, do background research instead of trusting their doctor’s advice on faith, and are skeptical of the motivations of government, pharmaceutical companies, or big business.” But it is IMPOSSIBLE to critically evaluate information about vaccines if you don’t have a firm grounding in basic immunology. It is IMPOSSIBLE to do research by reading websites written by laypeople for other laypeople. It is IMPOSSIBLE to be educated about vaccines without being thoroughly educated about immunology.

Hills claims that anti-vax isn’t a product of ignorance, selfishness, or even fear, Unfortunately, it is PRECISELY a product of ignorance, selfishness and fear; ignorance of basic immunology, microbiology and statistical analysis, selfishness in eliding the dangers vaccine rejection poses to others, and an absurd, overblown, unreasoning fear of autism.

Hills insists that anti-vaxxers aren’t idiots or crazies and likens them to people who believe the U.S. government creates fake ISIS videos as propaganda tools. But those people are also idiots and crazies. They have literally no idea what they are talking about and have an abiding fascination for conspiracy theories based on absolutely no evidence at all. If Hills was trying to make anti-vaxxers look reasonable, she used a strikingly poor analogy.

Hills concludes that dismissing vaccine skeptics as idiots or crazies won’t solve the growing public health problem their choices present.

I beg to differ.

Anti-vax activism is about parents and how they want to view themselves. It would be very hard for them to present themselves as educated and empowered if everyone else believed them to be ignorant and gullible. Indeed, the tide is turning at this very moment, as anti-vax advocacy is devolving in the public view from being simply one of many reasonable approaches to vaccination to the growing public belief that anti-vaxxers are crazy conspiracy theorists who have been 100% wrong about every claim they’ve ever made. The resurgence of pertussis, measles (and even the furor over Ebola), along with a continuing rise in autism prevalence have combined to make anti-vaxxers look like fools.

Hills is correct that anti-vax advocacy is not about science and is not going to be improved by improving science education, but she’s wrong to claim it is a manifestation of neo-liberalism. Neo-liberalism places great stock in real education, not pretending to be educated by surfing the internet. That’s just lazy boastfulness.

Neo-liberalism values skepticism, which actually means “requiring proof” and not “refusing to believe what experts say.” That’s just foolish.

Neo-liberalism questions government, pharmaceutical companies and big business, but it does not allege that government, pharmaceutical companies, and big business are engaged in conspiracies so massive that they involve all the doctors and public health officials in every country of the world, who are giving their own children vaccines that they supposedly know are toxic. That’s just totally crazy!

Obviously any attempt to increase vaccination rates will need to be multi-pronged, but I suspect that humiliating anti-vaxxers is going to be by far the most effective strategy. I would draw a parallel to racist and homophobic jokes. When they were acceptable, comedians told them and thought those jokes made them seem witty. When racist and homophobic jokes were finally acknowledged to be hateful, and comedians were humiliated for telling those jokes, most stopped telling them. They recognized that those jokes made them look bigoted, not witty.

When declaring yourself to be an anti-vaxxers brings only eye-rolls, condemnation and pity, neo-liberals will start vaccinating their children once again.