A new book about fear of vaccination reminds me of a piece I wrote nearly 5 years ago on toxicophobia.

The book is On Immunity: An Inoculation by Eula Biss. As a review in the New York Times Review of Books, characterizes the person most likely to be afraid of vaccines:

white, educated, relatively wealthy — a woman drawn to doing things “naturally,” who tells us she gave birth without pain medication, medical intervention or an IV. That “naturally” is key. Our anxieties about industrialization, at how we’ve polluted the world and presumably each other, have given the word its particular luster: “Where the word filth once suggested, with its moralist air, the evils of the flesh, the word toxic now condemns the chemical evils of our industrial world.” Biss reports from deep inside the panic. “My son’s birth brought with it an exaggerated sense of both my own power and my own powerlessness,” she writes. The world became suddenly forbidding: There is the lead paint in the wall to fear, the hexavalent chromium in the water. Even stagnant air, she was told, can kill her child. “It is both a luxury and a hazard to feel threatened by the invisible,” she says.

Biss is talking about toxicophobia, the fear of toxins, which underlies a variety of “natural” movements from natural childbirth to anti-vaccination to natural parenting. Aficionados of these movements suffer from a pervasive fear of being poisoned. And not poisoned accidentally, either. They fear being poisoned surreptitiously, deliberately, and as part of a giant conspiracy perpetrated by Big Pharma and Big Farma and Big Medicine.

It is axiomatic among quacktivists — anti-vax activists, organic food devotees, homebirth midwives, natural parenting advocates — that conventionally grown food and the water supply are filled with “toxins.” Sometimes these toxins are named; often they are not. In all cases, though, there is no evidence that anyone is actually being harmed by “toxins,” but, of course, proof is not a requirement in the fantasy world inhabited by devotees of quacktivism.

Vaccines supposedly contain “toxins” that cause autism. (N.B. Toxins always and only cause diseases and syndromes whose etiology is still unknown. No one ever claims that toxins cause strep throat, or sickle cell anemia, or gallstones.) Our food supply is purportedly contaminated by toxins too numerous to even bother mentioning by name. Our water supply is supposedly contaminated by the toxins in pesticides. And, of course, all medications produced by Big Pharma have myriad secret and toxic side effects.

Big Pharma deliberately adds toxins to its vaccines. AND vaccine manufacturers know all about this and do it to make more money. AND the government knows all about it, too, and insists that we take more and more vaccines every year. AND the government pays for it. AND the government has granted vaccine makers indemnity from prosecution. It is a wicked world.

Big Farma covers our fruits and vegetables with toxins, and, if that weren’t enough, adds toxins in the guise of preservatives to everything else. And these toxins cause cancer! What kind? Don’t ask, no one knows, and why would that matter anyway? Cancer is cancer. And if all that weren’t bad enough, Big Farma now wants to flood our food supply with … genetically modified food. Horror of horrors, genetically modified foods (they modified the GENES, for chrissakes) are sure to be filled with unnamed toxins of all sorts. And if that weren’t bad enough, Big Farma wants to irradiate our food to kill harmful bacteria (they’re going to expose our food to RADIATION, for chrissakes). Next thing you know we’ll all be gigantic and super-powerful. Oh, wait, maybe we’ll all be stunted and weak. It doesn’t matter; regardless of what they do you can be sure it will “weaken” our immune systems.

We are facing a big problem. Contrary to what the food and medicine toxicophobes believe, it is not the deliberate contamination of our food and pharmaceutical systems. The problem is a sociological problem. Large segments of the populations are suffering from the delusion that industry and the government are colluding to deliberately poison them.

To be clear, I’m not suggesting that medications don’t have side effects or that pesticides or preservatives are theoretically incapable of being harmful. Everything has potential side effects, but there’s a big difference between “potential” and “real.” Vaccines, for example, are known to cause brain damage and death in a tiny proportion of children who are vaccinated. That is real. But vaccines don’t cause autism. That’s fantasy.

What is the source of this toxicophobia? In part it stems for Americans’ apparent inability to understand risk. Americans are so obsessed with side effects that they forget about effects. They vastly overestimate the risk of side effects and vastly underestimate the life saving benefits of the treatments in question. That tendency to overestimate side effects is directly related to the sense of control that Americans do or do not feel. Just as Americans routinely underestimate the risks of driving, they routinely overestimate the risk of plane flight. They believe themselves to be in control while driving, yet they develop irrational fears about the risk of an unforeseen and unforeseeable plane crash.

So Americans obsess over the risk of side effects from medication and the theoretical risk of side effects from agricultural methods that have made the food supply larger and safer. They are consumed with anxiety by the belief that they are secretly being poisoned. This obsession is magnified by the belief that Big Pharma and Big Farma know about all these side effects and are hiding them. Do large corporations hide damaging information from the public? Yes, unfortunately, they do. But Big Pharma and Big Farma are no different from other large corporations. Yet no one has stopped driving because they fear the auto industry has designed cars that will blow up at the slightest provocation (even though that actually happened with the Ford Pinto) and no one has stopped crossing bridges for fear that shoddy construction will lead them to collapse (even though that has actually happened, too).

Simply put, there is no basis in reality for this pervasive toxicophobia, suggesting that it may be serving a psychological function. Americans are not being poisoned, but they imagine they are because, I suspect, it is a way to channel their anger at being so easily manipulated by large corporate entities like banks and other special interests, and their frustration at their perceived powerlessness. Toxicophobia projects this fear, anger and frustration onto medications, food, and, most importantly, vaccines. Unfortunately, rather than being protective, toxicophobia diverts attention from the real problems onto imaginary ones. And, paradoxically, toxicophobia doesn’t improve health, it kills people, generally babies, small children and the immuno-compromised.

Anti-vax activism is toxicophobia writ large. And as Biss points out, toxicophobia, like most quacktism is a luxury of the privileged.