To examine this issue, it’s useful to look at the role of expertise in public scientific controversies. Vaccination proponents sometimes say that in order to have any credibility, it’s necessary to have appropriate credentials and expertise, for example in immunology or epidemiology. This sounds plausible but on closer scrutiny does not make sense. Expertise in immunology is relevant to debates about immunology, but it may have only limited relevance to vaccination policy. Within immunology, expertise can be quite narrow. For example, studying the immune system of the frog does not automatically make one an expert on the human immune system. Studying polio immunity does not automatically make one an expert on infectious disease immunity in general. Most scientific research is highly specialised, more so than most people realise.
What happens in public debates is that the transition from specialist knowledge to more general authority is skimmed over, without justification, so that having a PhD or an MD is taken as a proxy for authority on policy-related issues.
The next step is to assert that anyone without specialist scientific knowledge, for example in immunology or epidemiology, or at least a PhD in a scientific field, therefore has no credibility to comment on vaccination. This is another step without a solid logical foundation, because it assumes incorrectly that having specialist knowledge makes a person an authority in related areas and then goes on to assume, again incorrectly, that lack of this specialist knowledge precludes a person from having any credibility.
The shortcoming of these assumptions is most easily seen by rebuttals to the specialist argument, in the form of questions with obvious answers. Does knowledge of tree-ring dating techniques give special authority to comment on climate change policy? Does knowledge of radioisotope scattering cross-sections give special authority to comment about energy policy? Does knowledge about road-building give special authority to comment about transport policy? In every case, it is obvious that specialist knowledge is inadequate for dealing with the wider issues that are typically debated, all of which have to do with policy, namely decisions about social arrangements.
If specialist knowledge is not enough to justify special authority to comment, there are several possible ways to proceed. One is for policy to be developed and implemented by the groups with the most power. This is an authoritarian approach. A different approach is to accept that many people are capable of having an input into decision-making about policy matters, because lots of people are affected and can understand something relevant to the issues. This provides a rationale for involvement in policy-making by a wide range of individuals, representing different demographics and perspectives. This can be accomplished in various ways, for example via referendums or citizens’ juries. In a less systematic way, involvement occurs through the efforts of campaigners who try to influence politicians.
In a number of countries, formal citizen participation in decision-making is encouraged, most commonly by local governments, government agencies, private groups and researchers. However, so far the vaccination issue seems to have been exempt from such efforts. It remains an issue in which recruitment of citizens into deliberative mechanisms is off the agenda: decision-making remains dominated by health authorities [Mark A. Largent, Vaccine: The Debate in Modern America (Baltimore, MD: Johns Hopkins University Press, 2012), pp. 155–156, makes the point that vaccination proponents, despite their talk of education and “open dialogue,” do not want citizens to participate in decision-making]. Expertise remains the justification for excluding citizens from formal roles even though, on closer examination, typical forms of narrow expertise do not justify having a special authority to pass judgement on policy matters.
The view that expertise is necessary to be involved in decision-making is seldom articulated and systematically defended; it is more commonly simply assumed. In the Australian vaccination debate, though, this view received an eloquent expression.
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The history of science is full of examples of standard beliefs being overthrown or modified by new information, such as the discovery of prions and their role in mad cow disease. There is much that remains unknown about immunity and indeed about how vaccines work. Much of mainstream science operates on the basis of paradigms, which are packages of beliefs, frameworks and practices that guide thinking and research. However, paradigms are constantly being modified, and occasionally they are overthrown and replaced by alternatives.
Also relevant is the experience of “citizen scientists”: people without formal credentials or institutional affiliations who undertake research […]. For example, in the case of Minamata disease in Japan, citizen researchers discovered the cause — mercury pollution in the ocean — while teams of conventional scientists with ample funding, using computer models and sophisticated ocean sampling, did not […]. [Patrick] Stokes [author of articles named “No, you’re not entitled to your opinion” and “The undeserved doubt of the antivaxxer”] ignores the existence of citizen science.
One of the problems with relying on certified experts is that they are especially susceptible to influence by employers, funders and professional status. Pharmaceutical companies, medical professions and governments are not neutral pursuers of the truth, but have their own interests in profit, status and legitimacy. When vested interests are present, special efforts are needed to scrutinise both research carried out, because it is likely to be affected by various forms of bias and misrepresentation, and research that might be carried out but is not [Sheldon Krimsky, Science in the Private Interest: Has the Lure of Profits Corrupted Biomedical Research? (Lanham, MD: Rowman & Littlefield, 2003)]. It is also important to look at how safe it is to voice scientific dissent.
That most vaccination research is carried out or supported by pharmaceutical companies is an important consideration. This doesn’t mean the findings are necessarily wrong, incomplete or one-sided, but it is important that they be subject to scrutiny by independent experts. However, there are few well-funded independent vaccination specialists. Furthermore, some scientists and doctors critical of vaccines have come under attack in various ways […]. The result is a large potential for distortion of the research field. Stokes does not raise any of these issues.
There is a considerable body of research about public scientific controversies, namely those directly affecting the public, such as climate change, nuclear power and pesticides [I’ve outlined ideas from this body of research relevant to campaigners in The Controversy Manual (Sparsnäs, Sweden: Irene Publishing, 2014), http://www.bmartin.cc/pubs/14cm/]. The view of most controversy researchers is that these controversies involve both scientific and social components; many further argue that separating these components is artificial. In practice, disputes over scientific matters are laced with social influences, and vice versa. The implication is that it is legitimate for non-scientists to question scientific orthodoxy. For example, activists have pointed to areas of research that should be studied but are not, thus questioning positions based on research that is carried out [David J. Hess, Undone Science: Social Movements, Mobilized Publics, and Industrial Transitions (Cambridge, MA: MIT Press, 2016)].
– Vaccination Panic in Australia (2018), pp. 293-9