Grifters, cynics, and true believers: The family tree of vaccine opponents

Stanley Plotkin, a pivotal figure in vaccine development, recently expressed his sorrow over the current state of public health, stating he regrets living long enough to witness the decline in trust towards vaccines. This sentiment raises a crucial question: How did society arrive at this point of skepticism? Thomas Levenson, in his new book "A Pox on Fools," delves into the origins of anti-vaccine sentiment, categorizing its proponents into three distinct groups: True Believers, Grifters, and Cynics. These categories reflect the nature of the arguments against vaccines, which he argues can be summarized as fundamentally flawed, harmful, and unacceptable. Tracing back to the early 18th century, Levenson recounts how the first inoculation efforts against smallpox were inspired by knowledge shared by Ottoman women and an enslaved African. At that time, infectious diseases were the leading cause of mortality, with around 40% of infants succumbing to infections before their fifth birthday. This dire situation dramatically lowered the average lifespan. During smallpox outbreaks in London and Boston in 1721, Lady Mary Wortley Montagu and Cotton Mather led the charge for inoculation. This procedure involved using material from a mild smallpox case to immunize others, but it was met with significant backlash. Critics argued that it was morally objectionable to disrupt what they saw as divine will regarding life and death. Some viewed the spread of infectious diseases as a form of divine retribution, suggesting the only way to avoid illness was through virtuous living. Levenson’s exploration highlights a long-standing conflict between scientific progress and deeply held beliefs, shedding light on the historical context of vaccine opposition that continues to resonate today.