His reputation will never recover from that unfortunate business in Salem, but Cotton Mather deserves some recognition for his place in American medical history. He was the anti-vaccination movement’s first target.
The scene was Boston in 1721. Beginning in April, a smallpox epidemic spread from a ship anchored in the harbor; over the course of a year, it killed more than 840 people. (Here I’m drawing on Kenneth Silverman’s excellent The Life and Times of Cotton Mather, winner of the Pulitzer Prize for biography in 1985.) In the course of his pastoral duties, Mather preached the necessary funeral sermons, but he was also a corresponding member of the Royal Society of London for Improving Natural Knowledge. The Puritan cleric had been keenly interested in medical issues for many years before the epidemic hit. He knew of a treatment, discussed in the Society’s journal, in which a little of the juice from an infected person’s pustule was scratched into the skin of someone healthy. It warded off the disease itself, somehow. The patient might fall ill for a short while, but would be spared the more virulent sort of infection.
Two months into the epidemic, Mather prepared a memorandum on the technique to circulate among area doctors, one of whom decided to go ahead with a trial run on three human guinea pigs. All survived the experiment, and in a remarkable show of confidence Mather had his son Samuel inoculated. (Mather himself had contracted smallpox in 1678, so was already immune.)
News of the procedure and its success became public just as the epidemic was going from worrying to critical, but not many Bostonians found the developments encouraging. The whole idea seemed absurd and dangerous. One newspaper mocked the few supporters of inoculation for giving in to something “like the Infatuation Thirty Years ago, after several had fallen Victims to the mistaken notions of Dr. M____r and other clerics concerning Witchcraft.”
Still more unkind was the person or persons responsible for trying to bomb Mather’s house. It failed to go off, but the accompanying note made the motive clear: “You dog, damn you, I’ll inoculate you with this….”
The colonial era falls outside the purview of Vaccine Nation: America’s Changing Relationship with Vaccination (University of Chicago Press) by Elena Conis, an assistant professor of history at Emory University, who focuses mainly on the 20th century, especially its last four decades. The scene changed drastically since Mather's day. Knowledge lagged behind technique: pioneering though early vaccination advocates were, they had no sound basis for understanding how inoculation worked. And the “natural philosophy” of Mather’s era was nowhere near as institutionalized or authoritative as its successor, the sciences, grew in the 19th century.
By the point at which Vaccine Nation picks up the story -- with John F. Kennedy announcing what would become the Vaccination Assistance Act of 1962 – both the nation-state and the field of biomedical research were enormous and powerful, and linked up in ways that Conis charts in detail. “If the stories herein reveal just one thing,” she writes, “it is that we have never vaccinated for strictly medical reasons. Vaccination was, and is, thoroughly infused with our politics, our social values, and our cultural norms.”
Be that as it may, the strictly medical reasons were compelling enough. The Act of 1962 was a push to make the Salk vaccine -- which between 1955 and 1961 had reduced the number of new polio cases from 30,000 to under 900 – available to all children. This seems like progress of a straightforward and verifiable sort, with the legislation being simply the next step toward eradicating the disease entirely. (As, indeed, it effectively did.)
But in Conis’s account, the fact that JFK announced his support for a vaccination program on the anniversary of Franklin Delano Roosevelt’s death was more than a savvy bit of framing. The reference to FDR, “the nation’s most famous polio victim and survivor,” also “invoked the kind of bold, progressive Democrat [JFK] intended to be.” It positioned his administration as sharing something with “the nation’s impressive biomedical enterprise and its recent victory against a disease that had gripped Americans with fear in the 1940s and 1950s.”
It was technocratic liberalism at its most confident -- a peak moment for the belief that scientific expertise might be combined with far-sighted government to generate change for the common good. And it’s all pretty much downhill from there: Vaccine Nation is, in large part, the story of an unraveling idea of progress. True, scientists developed new vaccines against measles, diphtheria, rubella, and other diseases. But at the same time, the role of federal power in generating “public awareness and acknowledgement of a set of health threats worth avoiding” came into question. So did public trust in the authority of medical science and practice.
The erosion was, in either case, a drawn-out process. A couple of instances from Conis’s narrative will have to suffice as examples. One was the campaign against mumps. The military lost billions of man-hours to the highly contagious disease in the course of the two world wars. But a vaccine against mumps developed in the 1940s was left on the shelf when peace came. Mumps went back to being treated as a childhood ailment, rather than a disease with an associated cost.
But the postwar baby boom created a new market of parents susceptible to warnings about the possible (if very rare) long-term side-effects of getting mumps in childhood. Messages about the responsibility to immunize the kids were targeted at mothers in particular, stressing that the possible danger from contracting mumps made prevention more urgent than statistics could ever measure.
The logic of that appeal – “Why risk a danger that you can actively avoid?" – applied in principle to any disease for which a vaccine could be manufactured, and by the 1970s, early childhood meant having a cocktail of them shot into the arm on a regular basis. Then came the great swine flu scare of ’76. The government warned of an impending crisis, stockpiled a vaccine for it, and began immunizing people – especially the elderly, who faced the greatest risk.
The epidemic never hit, but the vaccine itself proved fatal to a number of people and may have been the cause of serious medical problems for many more. All of this occurred during the last months of Gerald Ford’s administration, though it has somehow become associated with the Carter years. There is no historical basis for the link, but it has the ring of truthiness. The whole debacle seemed to refute JFK’s vision of science and the state leading the march to a safer and healthier future.
The largely unquestioned confidence in vaccination was perhaps a victim of its own success. Insofar as nearly everyone was immunized against several diseases, any number of people suffering from a medical problem could well believe that the shots had somehow caused it or made them susceptible. And in some cases there were grounds for the suspicion. There were also cases of inoculation inducing the disease it was supposed to prevent, as well as allergic reactions to substances in the vaccine.
But Colis sees the rise of an anti-vaccination mood less as direct response to specific problems than as a byproduct of countercultural movements. Feminists challenged the medical profession’s unilateral claim of authority, and some women took the injunction to protect children by immunizing them and turned it on its head. If they were responsible for avoiding the risk, however slight, of preventable childhood illnesses, then they were equally responsible for avoiding the dangers, however unlikely, posed by vaccines.
Another strain of anti-vaccinationist thinking was an offshoot of environmental awareness. While industrial society polluted the air and water, heedless of the effects, medicine was pumping chemicals and biological agents into the smaller ecosystem of the human body.
Similar concerns had been expressed by opponents of vaccination in the late 19th and early 20th centuries -- though without much long-term effect, particularly given the effectiveness of immunization in preventing (even obliterating) once-terrifying diseases. Conis depicts anti-vaccinationists of more recent times as more effective and better-established.
Besides the feminist and ecological critiques, there is the confluence of anti-government politics and new media. Supporters of vaccination once downplayed the issue of side effects, but it’s an area that demands – and is receiving – serious medical investigation.
In places, Vaccine Nation suggests that the critics and opponents have made points worthy of debate, or at least raised serious concerns. And that may be true. It would almost have to be, the real question being one of degree.
But even with that conceded, many of the arguments the author cites are … well, to be nice about it, unpersuasive. “DISEASE IS NOT SOMETHING TO BE CURED,” says one vintage anti-vaccinationist tract revived in the 1980s. “IT IS A CURE.” The cause for illness? “Excess poisons, waste matters, and incompatible food” – but not, most emphatically, germs.
“Did you know,” asks another figure Conis quotes, “that when immunity to disease is acquired naturally, the possibility of reinfection is only 3.2 percent? If the immunity comes from a vaccination, the chance of reinfection is 80 percent.” In a footnote, Conis indicates that the source of these fascinating statistics “is unclear.” That much, I bet, is true.
Poor old Cotton Mather’s thinking combined superstition and enlightened reason. They can and do mix. But not in a statement such as “DISEASE IS NOT SOMETHING TO BE CURED. IT IS A CURE." The good reverend would dismiss that as little more than ignorance and magical thinking -- and rightly so.
“The Top 10 Retractions of 2014” appeared on the website of the life-sciences magazine The Scientist a couple of weeks back, garnering a little attention (mostly of the social-media, “Hey, look at this!” variety) but without making much of an impact. Comments were few and far between.
That seems unfortunate, given the stakes. Physicians, it has been said, bury their mistakes -- a grim joke that very nearly applies to some of the researchers whose work made the Hall of Shame. But most of the inductees are charged with committing malfeasance rather than error. (A number of them were covered here at Inside Higher Ed over the past year.)
The most egregious case? That would have to be the paper that the journal Retrovirology retracted, by a researcher who "spiked rabbit blood samples with human blood to make it look as though his HIV vaccine was working.” The runner-up is probably the situation that forced the Journal of Vibration and Control to retract 60 articles, which had been accepted for publication after receiving fraudulent “peer review” by scientists who manipulated the online submission system using up to 130 fake email accounts.
The good news is that the paper reporting on HIV vaccine work that had been tampered with seems not to have made much of an impression: it hadn’t been cited by other researchers. As for the phony peer-review gang, its leader was the identical twin brother of Taiwan’s minister of education, whose name appeared as a coauthor of some of the papers. Not long after the scandal broke, the minister resigned, while insisting that he had no idea of what his evil twin had been up to. (And you thought your family gatherings were awkward,)
The annual list (first compiled in 2013) is the work of the good people at Retraction Watch, who monitor and investigate the embarrassed announcements that publishers would rather not have to issue. Most of the stories they cover are from the sciences (chiefly natural, some social) although there is the occasional case from the humanities, where the main ground for retraction seems to be plagiarism. Or rather, problems of involving "mistaken punctuation" and "misreferencing," since euphemism prevails. (One author charged with plagiarism admitted to "misconduct in text," which is my new favorite expression.)
Besides fraudulent labwork and efforts to game the peer-review system, RW covers breaches of ethical norms in research -- the notorious "Facebook mood experiment" made the list for 2014 -- while also keeping an eye on predators lurking in the shadows around scholarly publishing. While unscrupulous academic publishers deserve all the bad press they get, they are often so brazen that it's hard to think of them as a menace. Consider the most widely noticed example in recent months: the story of a couple of computer scientists who wrote a "paper" consisting of an obscene seven-word sentence, repeated a few hundred times and incorporated into graphs and flowcharts. They submitted it to one of the sketchier journals in their field, where it appeared once the authors paid a fee. After all, the anonymous reviewer considered the paper "excellent.”
Which, in its own way, it was, though the paper is not on the top 10 list. Using the carelessness and greed of worthless journals to embarrass them may be an entertaining way to blow a few hundred bucks, but much less amusing is the thought that there must be academic libraries paying for subscriptions to said journals.
One of the year's top 10 items involved a French computer scientist who, the Retraction Watch says, “catalogued computer-generated papers that made it into more than 30 published conference proceedings between 2008 and 2013. Sixteen appeared in publications by Springer, and more than 100 were published by the Institute of Electrical and Electronic Engineers (IEEE).” The fact that the papers were computer-generated does not mean they were gibberish, since there are programs that can perform a database search and "write" a credible literature review. Still, that seems like streamlining the production of knowledge just a little too far.
The Retraction Watch site is littered with the wreckage of numerous careers, but it serves an important purpose apart from the dubious pleasures of Schadenfreude. In a recent column I wrote about Ben Goldacre's book I Think You'll Find It's a Bit More Complicated Than That (Fourth Estate), which includes a shrewd assessment of the strengths and weaknesses of the peer-review system that seems germane:
"[Peer-review] is often represented as some kind of policing system for truth, but in reality some dreadful nonsense gets published, and mercifully so: shaky material of some small value can be published into the buyer-beware professional literature of academic science; then the academic readers, who are trained to appraise critically a scientific case, can make their own judgments. And it is this second stage of review by your peers -- after publication -- that is so important in science. If there are flaws in your case, responses can be written, as letters to the academic journal, or even whole new papers. If there is merit in your work, then new ideas and research will be triggered. That is the real process of science."
I am a five-foot-tall female physicist. You hear a lot about the challenges facing women in physics. These are real, and the percentage of physics bachelor’s degrees earned by women has stagnated at just over 20 percent for more than a decade. Being a woman in physics can be hard, but being a short physicist seems even harder to me. Why don’t we ever talk about the challenges of being short?
Gender is the most prominent feature that we use to categorize ourselves, beginning from the first question asked after we are born: Is it a boy or a girl? The hypothesis that women are less intelligent or less cognitively capable of certain tasks has been around for a long time. For a while it was attributed to brain size, then the Y chromosome, then hormones circulating in the body, and now prenatal hormone exposure.
For some reason, our society wants to believe that women aren’t as smart as men. When a woman feels out of place in a male-dominated environment, she is understandably tempted to attribute it to her gender -- and she may be right.
But when I find myself feeling out of place and not quite knowing why, I tend to blame it on my height. Whether on the athletic field, in an elevator, or in the lab, I am generally the shortest person present. At my height, 19 out of every 20 women I meet are taller than I am. The average man soars 10 inches above me. High heels cannot make up 10 inches.
As kids, we all wait to grow into the world around us, and the average 12-year-old is close to my height. It wasn’t until I was an undergraduate at Yale University that I had to admit the world would never be designed for me. I was somehow happily oblivious in college to the challenges faced by women, but the challenges faced by short people were obvious to me, every day. I could not reach things on high shelves in the labs and libraries. I could not sit with my feet flat on the floor with my back supported in many classroom chairs.
The challenges continued in my graduate research lab at Harvard University. I wasn’t large enough to flip the dewar that held our cryogenic microscope. I wasn’t strong enough to loosen a bolt. When I couldn’t find where my peers had put something, I learned to get on the step stool and look at their eye level.
I looked ridiculous using all my body weight at an awkward angle to pull a liquid helium tank down the hall. The cleanroom ran out of the small sizes of “bunny suits” that are required to enter the cleanroom fabrication facilities. Small people were expected to wear larger ones, since big people cannot physically fit into smaller ones.
The biggest safety hazard was the location of a hot plate in a fume hood. The point of a fume hood, a structure that allows you to put your hands into a space that has its own ventilation, is to keep toxic fumes on the inside, away from the air you breathe. Short people simply took a deep breath before sticking their heads into the fume hood.
My six-foot-tall female labmate didn’t have these problems.
I now work at a women’s college. The environment is eye-opening.
The brightest student in the class is a woman. The most studious student is a woman. The struggling student is a woman. The slacker is a woman. The geek is a woman. The most aggressive and most outgoing students are women. Even the student who talks the most in class is a woman.
When I need help reaching the screen at the front of the room to pull it down, it’s a 5’6’’ woman who comes to my rescue. Prizewinners are always women, and leadership positions always go to women. We may still categorize the people we meet, but it’s no longer based on gender.
I received the Presidential Early Career Award for Scientists and Engineers in 2010, considered one of the most prestigious awards bestowed upon young scientists. There were two things that statistically increased the chances of receiving the PECASE that year through the National Science Foundation: being a woman; and being named Ben. You are unlikely to hear the accusation that you won “just because your name is Ben,” yet women are told that they receive awards because of their gender, not their qualifications.
A women’s college naturally provides many female role models, but predicting effective role models is not straightforward. For some, identifying with a role model is critical to pursuing an unusual path, but a good match is not as straightforward as being the same gender, race, or sexuality.
I never needed or wanted female role models in physics. But I do need short role models in sports. Watching someone much larger than you excel on the field is not helpful. Seeing someone your size outcompete a larger person is motivating, and educational. One striking part of my interview at Mount Holyoke was how short the (male) dean of faculty was. I more recently met the (short, female) director of the American Association of Physics Teachers. I didn’t think I was looking for five-foot-tall role models in leadership, but maybe that’s because I hadn’t met any.
While I intellectually recognize that being a woman in physics has presented challenges, I viscerally know that being short is difficult. That I haven’t volunteered my race or sexuality suggests I’m white (which is true) and heterosexual (also true).
When someone speaks over me in a meeting or repeats my idea more loudly as their own, I assume it’s due to my physical stature, not because I’m a woman. And for all of you who are ever in a meeting and notice this happening, it’s your cue to say, “Thank you for reinforcing the point made by... .” That’s all it takes to change a frustrating environment into an affirming one, in a noncontroversial way.
If we all make an effort to do small things like that more often — to recognize that the categories by which we sort people are limited, and that talent comes in all shapes and colors and follows many different trajectories through life — then perhaps an essay like this will someday simply start with the statement: “I am a physicist.”
Katherine Aidala is an associate professor of physics at Mount Holyoke College.