Grifters, cynics, and true believers: The family tree of vaccine opponents
Grifters, cynics, and true believers: The family tree of vaccine opponents
骗子、愤世嫉俗者与狂热信徒：疫苗反对者的家族谱系
Stanley Plotkin, 93, was instrumental in developing a number of vaccines over the course of his career. He recently said that he’s “beginning to regret having lived so long—because we’re going downhill.” How could we possibly have gotten here? Maybe we’ve always been here. It turns out that the anti-vaccine arguments currently flooding the Internet have been around for as long as vaccines have. 93 岁的斯坦利·普洛特金（Stanley Plotkin）在其职业生涯中为多种疫苗的研发做出了重要贡献。他最近表示，他“开始后悔活得这么久了——因为我们正在走下坡路”。我们究竟是如何走到这一步的？也许我们一直都处于这种境地。事实证明，目前充斥互联网的反疫苗论调，自疫苗诞生之初就已存在。
In his new book A Pox on Fools, Thomas Levenson breaks them down into three categories, as made clear in the book’s subtitle: “The True Believers, Grifters, and Cynics Who Convinced Us to Reject Vaccines.” The accusations these people levy against vaccines can just as easily be used to categorize the arguments themselves: They are wrong, they are bad, and they are intolerable. 托马斯·莱文森（Thomas Levenson）在其新书《愚人瘟疫》（A Pox on Fools）中，将这些论调归纳为三大类，正如书名副标题所言：“说服我们拒绝疫苗的狂热信徒、骗子和愤世嫉俗者”。这些人对疫苗的指控，同样可以用来对这些论点本身进行分类：它们是错误的、有害的，且令人无法容忍的。
Wrong
错误的
As Levenson tells it, in the early 18th century, a couple of forward-thinking Westerners learned about inoculations against smallpox from Ottoman women and an enslaved African. At that point, infectious disease was by far the leading cause of death, as it had been forever. In the 19th century, roughly 40 percent of babies died of infection before they turned 5. (This is why the average lifespan back then was so low. It wasn’t that people didn’t live past their 30s; if they survived childhood, they largely did. It’s just that so, so many small children died that they dragged the average way down.) 据莱文森所述，18 世纪初，几位具有前瞻性思维的西方人从奥斯曼帝国的女性和一名被奴役的非洲人那里了解到了天花接种法。当时，传染病是导致死亡的首要原因，且这种情况由来已久。在 19 世纪，大约 40% 的婴儿在 5 岁前死于感染。（这就是当时平均寿命如此之低的原因。并非人们活不过 30 岁；如果他们能熬过童年，通常都能活得更久。只是因为有太多太多的幼童夭折，拉低了平均寿命。）
When smallpox epidemics broke out in London and Boston in 1721, Lady Mary Wortley Montagu and Cotton Mather initiated inoculation campaigns in their respective cities. Inoculation involved taking pus from a pock of someone with a not-very-severe case of smallpox, making a cut in the arm of the person to be inoculated, and rubbing the pus into the cut. There was an immediate backlash. It was morally wrong, some claimed, to interfere with the divine ordination of who would sicken and die and who would not. Only God had that ability, and to thwart it was to defy God’s will. It was hubris and blasphemy. 1721 年伦敦和波士顿爆发天花疫情时，玛丽·沃特利·蒙塔古夫人（Lady Mary Wortley Montagu）和科顿·马瑟（Cotton Mather）分别在各自的城市发起了接种运动。接种的方法是：从天花症状较轻者的脓疱中取出脓液，在接种者的手臂上划开一道口子，将脓液涂抹进去。这立即引发了强烈抵制。一些人声称，干预上帝对谁生病、谁死亡的安排在道德上是错误的。只有上帝才有这种能力，阻挠它就是违背上帝的旨意。这是傲慢，也是亵渎。
Levenson highlights how the subtext of this attitude was that contracting a highly infectious disease was divine punishment for sin and that the only way to avoid disease was to live a virtuous life. The Transcendentalists and Romantics substituted “nature” for “God” in the mid-19th century, but the argument has remained basically the same: vaccines are an affront to the “natural” world, and clean living is all you need to stay healthy. 莱文森强调，这种态度的潜台词是：感染高传染性疾病是对罪恶的神圣惩罚，避免疾病的唯一途径是过上道德高尚的生活。19 世纪中叶，超验主义者和浪漫主义者用“自然”取代了“上帝”，但论点基本保持不变：疫苗是对“自然”世界的冒犯，而纯净的生活方式才是保持健康的唯一要素。
The implicit moral judgment remains, even without God: if you get sick, it must be because you ate/drank/breathed/wore something that wasn’t pure enough. The immense strides in public hygiene and sanitation that preceded the heyday of vaccine development certainly did curb the spread of infection and increase lifespans, but clean living will not help you fight off an infection if you’re exposed to a pathogen as effectively as a vaccine will. 即便不再提及上帝，这种隐含的道德评判依然存在：如果你生病了，那一定是因为你吃、喝、呼吸或穿戴的东西不够纯净。在疫苗研发鼎盛时期之前，公共卫生和环境卫生方面的巨大进步确实遏制了感染的传播并延长了寿命，但如果你接触到病原体，纯净的生活方式在抵御感染方面绝不如疫苗有效。
Bad
有害的
Vaccines are unnecessary because our bodies can cure themselves, Robert F. Kennedy Jr. and his cronies claim. But they go beyond that and say they are actively harmful–and certainly more harmful than the diseases they are designed to prevent. This is an alluring argument to many, since the negative effects of vaccines are apparent (shots hurt for a moment, and you might get a sore arm or fever). In contrast, the lack of many small children dying from infectious diseases is harder to notice. Because of the spectacular success of vaccines, we take the lack of those deaths for granted. 小罗伯特·肯尼迪（Robert F. Kennedy Jr.）及其同伙声称，疫苗是不必要的，因为我们的身体可以自愈。但他们更进一步，称疫苗具有主动危害性——而且肯定比它们旨在预防的疾病危害更大。这对许多人来说是一个诱人的论点，因为疫苗的负面影响是显而易见的（注射时会疼一会儿，可能会手臂酸痛或发烧）。相比之下，幼童不再因传染病大量死亡的事实却很难被察觉。由于疫苗取得了巨大的成功，我们将这种死亡率的降低视为理所当然。
This argument, too, has been there since the outset, when there was no data yet to refute it. And in the intervening years, there definitely were some tragic missteps during vaccine development and administration. But 300 years later, it’s eminently clear that vaccines are safe. They are not completely risk-free, of course; nothing in life, certainly nothing valuable, is risk-free. Vaccines can and have caused serious adverse effects (but not autism) in specific populations. And certain vaccines are not safe for certain subsets of people—infants, the elderly, or the immunocompromised. But this is not an argument that healthy people shouldn’t get them; rather, it’s an argument precisely for why healthy people should get them. They keep circulating levels of pathogens low enough to protect those who cannot get vaccinated themselves, which brings us to the final argument. 这一论点自始至终都存在，当时还没有数据来反驳它。在随后的岁月里，疫苗的研发和接种过程中确实出现过一些悲剧性的失误。但 300 年后的今天，疫苗的安全性已毋庸置疑。当然，它们并非完全没有风险；生活中没有任何事物，尤其是任何有价值的事物，是完全没有风险的。疫苗确实可能在特定人群中引起严重的不良反应（但不会导致自闭症）。某些疫苗对特定群体（如婴儿、老年人或免疫功能低下者）来说并不安全。但这并不是健康人不应接种疫苗的理由；恰恰相反，这正是健康人应该接种疫苗的原因。它们能将病原体的传播水平保持在足够低的水平，从而保护那些无法接种疫苗的人，这就引出了最后一个论点。
Intolerable
无法容忍的
This last thread has nothing to do with whether or not vaccines are effective, necessary, or safe. It is not a biological argument but a visceral, philosophical one. Because it is not anti-vaccine; it is anti-vaccine mandates. It is about the responsibilities that our governments have to us and that we have to each other, and about the inevitable clash between an individual’s needs and wants and the good of society as a whole. 最后一个论点与疫苗是否有效、必要或安全无关。这不是一个生物学论点，而是一个发自内心的哲学论点。因为它不是反疫苗，而是反疫苗强制令。它关乎政府对我们、以及我们彼此之间应承担的责任，也关乎个人需求与愿望同整个社会利益之间不可避免的冲突。
The Supreme Court case of Jacobson v. Massachusetts lays out the two schools of thought. Boston and Cambridge enacted vaccine mandates during the smallpox epidemic of 1901, and Jacobson refused. He argued that “a compulsory vaccination law is… hostile to the inherent right of every freeman to care for his own body and health in such way as to him seems best.” But the majority ruled that our liberties are not absolute. The Constitution does not allow us to do whatever we want—it is there to protect everyone’s rights and freedoms, and that entails sometimes curtailing each person’s rights and freedoms. Associate Justice John Marshall Harlan summarized: “L…” 最高法院审理的“雅各布森诉马萨诸塞州案”（Jacobson v. Massachusetts）阐明了这两种思想流派。1901 年天花疫情期间，波士顿和剑桥市颁布了疫苗强制令，雅各布森拒绝接种。他辩称：“强制疫苗接种法……违背了每一位自由人以其认为最好的方式照料自身身体和健康的固有权利。”但多数派裁定，我们的自由并非绝对。宪法并不允许我们随心所欲——它的存在是为了保护每个人的权利和自由，而这有时需要限制个人的权利和自由。大法官约翰·马歇尔·哈兰（John Marshall Harlan）总结道：“L……”