Should we be honest about vaccines? That is a serious question. Common sense says that “honesty is the best policy,” and I maintain that topics related to vaccination are not exceptional in this regard. However, some serious and well-intentioned people apparently disagree. They reason that there are overwhelming competing considerations—mainly, the risk of bad consequences. After all, any admission of inadequacy regarding vaccination, or acknowledgement of a significant risk/benefit tradeoff, however minimal, would give ammunition to the enemy, the so-called “anti-vax crowd.” And that could negatively impact vaccination rates. Thus, from this point of view, it seems we simply cannot afford to be nuanced, if that is what being intellectually honest would require. By this same reasoning, we cannot even openly discuss tangentially related topics, if that might be taken, rightly or wrongly, as reflecting negatively on vaccines … [please read below the rest of the article].

Image credit: Diverse Stock Photos via Flickr / Creative Commons

Many people, in various ways, have suggested something like this. That is, epistemic authorities shouldn’t be forthright about the facts relevant to the evaluation of vaccine safety if broader awareness of those facts might lead to vaccine hesitancy. Here are some representative examples of how this view has been expressed:

The U.S. FDA, in justifying a change in regulation that may have been perfectly reasonable, wrote: “[A]ny possible doubts, whether or not well founded, about the safety of the [oral polio] vaccine cannot be allowed to exist in view of the need to assure that the vaccine will continue to be used to the maximum extent consistent with the nation’s public health objectives” (FDA 1984, 23007).

Regarding the vaccine injury compensation program doing a better job at protecting pharmaceutical industry than helping victims of vaccine injury, an LA Times article mentions, “Some see this as a natural result of federal health officials’ fierce devotion to the immunization program—and their fear that if enough injuries were acknowledged, people would be afraid to get their shots” (Levin 2004).

Similarly, and more recently: “The CDC has admitted it is withholding large portions of COVID-19 data—including on vaccine boosters—from the public because it fears the information could be misinterpreted” (Crane 2022).

Below I consider the idea that scholars should self-censor when intellectual honesty might negatively impact vaccination uptake as this idea was expressed by Adam Riggio (2022) here on SERRC. I address this in the context of other contributions to SERRC by Brian Martin (2022, 2021, 2016), Lee Basham (2022a, 2022b), and Mitchell Liester (2022). I maintain that the case for intellectual dishonesty is not sufficiently convincing. And thus, honesty remains the best policy.

Martin’s Contribution on the Covid Vaccination Paradigm

Applying a Kuhnian analysis of the response to COVID-19, according to which reigning paradigms shape both the scientific interpretation of evidence and the direction of research, Martin suggests that the response to COVID-19 may have been influenced by social factors. In this case, the paradigmatic assumption is that vaccines are so safe and effective that they must be the solution to our COVID predicament. In this context, Martin asks, “[W]hy were billions of dollars invested in vaccine research, development and manufacturing but no equivalently funded social research undertaken into other measures to ameliorate damage from the pandemic?” (2022, 47).

When social factors influence science, there are real-world implications. We might get away with ignoring extra-epistemic influences on science if we are lucky: the reigning paradigm and the biases it engenders may lead us to emphasize precisely the most efficient solution. After all, presumably, there are some good reasons supporting the reigning paradigm. However, if we are not lucky, failure to fully interrogate the dominant paradigm may lead to policies that are inefficient or even destructive, while hampering our ability to even recognize the mistakes that are made. In other words, unquestioned biases can lead to serious negative consequences. And yet Martin is criticized for raising this issue precisely on consequentialist grounds. Specifically, as we will see, Riggio seems to assume that a general vaccine-centered paradigm is correct, and thus raising concerns about vaccination is uniquely dangerous. However, in reality, the danger cuts in both directions. We can’t have truly justified confidence in a position if potential challenges to it are self-censored.

Basham’s Contribution on the Origin of HIV

Basham’s article addresses a heterodox theory of the origin of HIV. According to this theory, Hilary Koprowski’s polio vaccine trials in Africa may have inadvertently led to HIV and thus AIDS. This theory, Basham writes, “is credible on the evidence” (Basham 2022a, 32). In a subsequent article, Basham seems to make an even stronger claim, suggesting that the theory is likely. He writes, “Hilary Koprosky’s Oral Polio Vaccine … likely led to the deaths of tens of millions by HIV and its resulting AIDS” (Basham 2022b, 77). This idea is sometimes referred to as the OPV theory. Since I’m not steeped in the relevant evidence, I remain agnostic about it, if cautiously skeptical. Still, I am persuaded that not all was fair and proper in the way that theory was historically adjudicated (see Martin 2010), even if the correct answer was reached. If the evaluation process was not epistemically sound, then it seems we were just lucky to adopt the true position (if we in fact did). And we may not always be so lucky. If this is how things work more generally, then awareness of this may diminish our trust in (ostensible) epistemic authorities, and thus weaken confidence in the safety of vaccines. Though the connections here are tenuous, such reasoning may nonetheless influence the decisions of some people, with potentially unfortunate effects. Notice that such general critiques of science, regardless of their validity, are vulnerable to the same criticism that Riggio makes of Basham’s remarks about the OPV theory regarding the origin of HIV, discussed below. It will follow that we should not inquire critically about the history of science, because it may indirectly cause some people to make decisions that have bad consequences.

Basham suggest that we need not worry about being forthright about the OPV Theory. We need not remain silent out of a concern that it may negatively impact vaccination rates. He writes, “[Some people] fear the terrified blow back against vaccination in general. But in a rational polis, and I contend in large measure we are, as partisans of democracy, this terror of terror is misplaced” (Basham 2022a, 30). That is, we live in a (sufficiently) rational polis that such honesty would not trigger irrational blowback against vaccines in general. In support of this, one might argue that honesty about the Cutter incident did not seriously undermine vaccination programs overall and in the long run, despite the fact that the incident involved a defective vaccine that caused 40,000 cases of polio and many cases of paralysis and death (see Basham 2022a, 26). And, although the particular vaccination program was halted, that was precisely what should have happened under those circumstances.

Riggio’s Response to Basham

Riggio responds to Basham in an article titled, “The Dangers of Intellectual Honesty in a World of Lies: A Reply to Lee Basham” (Riggio 2022). Riggio worries, “Someone could share Basham’s article on Telegram channels that promote anti-vaccination propaganda, and guide conversations about it to make people further distrust any vaccines” (62). And that might lead to people not taking a vaccine that could save their lives. Anyone who contributes to a bad outcome, even if unintentionally, bears some responsibility—or so Riggio’s way of thinking seems to suggest. He writes, “[I]f one or more of those children contracts a virus and dies or suffers injury, Basham and SERRC bear some share of the responsibility” (62). That is a heavy burden. And Riggio implicitly suggests that this responsibility implies that one should self-censor regarding this issue. But it seems this would apply to any thought tangential to vaccine safety that could be used to lead people to choose not to vaccinate. To be fair in tallying consequences, however, we should not forget the dangers of such self-censorship, discussed below.

Much of Riggio’s response to Basham involved the fact that Basham seemed to base his optimism about intellectual honesty on the notion that, “as partisans of democracy,” we are “in a rational polis,” and thus the fear of “blow back against vaccination in general” is misplaced (Basham 2022a, 30). I think Basham overstates his case here, if he is taken to mean that our society exhibits an exceptionally high level of rationality. And I largely agree with Riggio’s critique of this notion, especially regarding the reliability of the mainstream media. However, I don’t think the case for intellectual honesty depends upon this. For one thing, Basham seems to be thinking less about the reliability of our institutions and more about the ability of the people, on the whole, to be reasonable. In other words, Basham believes we live in a society suitable for democracy; Riggio’s critique seems to imply that we do not.

I would suggest that the society we live in, despite its epistemic imperfections, is nevertheless one in which intellectual honesty is still the best policy. It is rational enough, and in the required way. Indeed, it is partly because our society is not rational in certain ways, some emphasized by Riggio, that the best policy is to have open, honest, and frank discussion of all perspectives, even if that will risk some negative consequences. Because our institutions are not perfectly reliable and (ostensible) epistemic authorities within them often have conflicts of interest, individuals do and should attempt to think for themselves to the degree that they can, and to interact with each other as well as, to the degree possible, with experts. Sources that deceive or conceal will ultimately be exposed and lose influence. One could argue that that is happening broadly right now: Politicians lost credibility a long time ago. The credibility of the mainstream media has been eroding meaningfully in recent years and decades. More recently, medical authorities have been losing credibility in the minds of many (Shore 2007). Academics could well be next. What is the best way for academics to avoid losing credibility? Is it doubling down in defense of noble lies? I doubt it.

Let’s look at Riggio’s position more closely. He writes, “I argue that we do not, at a society-wide level, have the capacity to be rational enough to discuss the possibility that mistakes in vaccine development caused an immense harm, without that discussion being exploited to spread greater harm” (62). After all, “‘just raising questions’ has been weaponized by extremists” (61). The worry is that, even if we are both intellectually honest and careful, other people may nevertheless “use our speech to manipulate others in dangerous ways” (62).

This is a consequentialist argument that assumes that bad results will predictably follow from being completely honest about vaccination, and certain tangentially related topics. This may indeed be true. However, dishonesty, or even lack of honesty through silence, can also lead to bad consequences. These bad consequences can be of two very different varieties. First, lack of honesty can lead to error. And error can lead to harm. Sometimes, for example, vaccines have been problematic. We want to be honest enough to catch problems early and thus be able to remedy them before too much damage is done. Put more generally: Science only flourishes with the free flow of ideas, when consensus can be openly challenged and judged on the quality of its responses to challenges. This is far from a new idea. Bertrand Russell’s critique of totalitarian science is that it cannot successfully compete with democratic science precisely because the former lacks the open and honest exchange of ideas and mutual critique that is characteristic of the latter (Russell 1953).

Second, even if there is no genuine problem to be uncovered and remedied, dishonesty may itself lead to precisely the bad results that it was meant to prevent, if it is detected. That is, it may backfire. Consider the remarks of John Ziman (2000):

In the eyes of the public, the major virtue of academic scientists and their institutions is that, even when they do disagree, they can be trusted to present what they know ‘without fear or favour’. Whether or not this high level of credibility is really justified, it is what gives science its authority in society at large. Without it, not only would the scientific enterprise lose much of its public support: many of the established conventions of a pluralistic, democratic society would be seriously threatened (175).

Assuming Ziman is right, a lot more than confidence in vaccines is at stake if scientists and academics more generally follow the path of well-intentioned dishonesty. People will become distrustful, and less likely to follow science-based guidelines and suggestions. They may be less likely to vaccinate, not because they have well-grounded reasons to think a vaccine is unsafe, but because they have reasons to be unsure of its safety, since they can’t trust the honesty and integrity of stated evaluations. And this will be a rational response. The only way that deception would avoid this outcome is if it could go undetected. But that is not likely. To maintain sufficient secrecy would probably require a regime so repressive as to unacceptably increase the risk of the first kind—that errors would go undetected, or unaddressed, and that scientific debacles historically associated with totalitarian regimes would follow.

A recent example of propagandistic messaging reveals that such messaging is not hard to see through, suggesting that such propagandistic dishonesty is likely to be detected and rightly mocked on social media, as in this case. The U.S. department of Health and Human Services (HHS) tweeted a short video featuring Dr. Amy Edwards explaining that the mRNA vaccines for COVID-19 simply contain “mRNA … wrapped in a lipid envelope.” Regarding the lipid envelope, she says, “all it is is fat molecules.” She concludes, “So you’re looking at messenger RNA, which is something that’s naturally occurring inside of our cells, wrapped in fat, which is something that’s naturally occurring inside our cells. So the ingredient list is very short and very easy” (HHS 2022). This is a form of intellectual dishonesty that could be called “mis-simplification.” It is a misleadingly reassuring simplification. First, though perhaps least importantly, it is not actually a complete list of the ingredients. Second, the lipid envelope is not the same as the fats naturally occurring in our bodies. One of the lipids that the Moderna and Pfizer vaccines include is polyethylene glycol, “PEG,” (CT.gov 2022), which is suspected of causing anaphylactic reaction in some people (Turk 2021). And, third, the particular mRNA in these vaccines produces a version of the SARS-CoV-2 spike protein, which is not something that would ordinarily occur in our bodies (absent a SARS-CoV-2 infection).

To appreciate the significance of this point, note that it would be possible to design an mRNA product that would produce just about any protein, including highly toxic ones. And yet Dr. Edwards’s soothing tone, as she explains how natural and simple this is, suggests that there would be no reason to worry about any potentially dangerous effects. After all, (very different) mRNA is already something we have “naturally occurring in our cells.” Perhaps these vaccines truly are safe for most people. But the statements offered to engender this impression, if properly understood, give us no good reason at all for confidence. That is the sense in which it is misleading. And the recognition of this gives us reason for concern. For it suggests that we cannot trust the HHS. This further supports Riggio’s claim that we do not live in a (fully) rational polis. But it undermines his conclusion, for it suggests that more honesty, not less, is needed.

Basham’s Reply to Riggio on Consequentialism  

Basham argues that “Political epistemic paternalism is contrary to functional representative democracy” (Basham 2022b, 86). That seems right to me. Yet it might nevertheless be asked, “But is it good?” While I think the answer is probably “No,” I accept that it is a fair question. But Basham seems to reject the implicit consequentialism underlying it. Basham notices that Riggo’s argument is consequentialist, and he rejects it on that account: “Such consequentialist moral arguments have little place in epistemology” (79). Well, they may have little place in epistemology, but they may nevertheless be, in imaginable cases, overwhelmingly compelling from a practical perspective. Riggio doesn’t need to show that a consequentialist argument would be compelling in all cases, and thus Basham’s counterexample does not refute the suggestion that a consequentialist argument might be compelling in this case.

Thus, in contrast to Basham (2022b), I am inclined to offer a different critique of Riggio. Yes, Riggio’s position is consequentialist. But, as suggested above, not all consequentialist arguments are bad ones. After all, consequences do matter. They matter a lot. Nevertheless, (1) they are not the only things that matter, and (2) figuring out all the relevant consequences is not easy. As the saying goes, “Predictions are hard, especially about the future.”

The problem is not that Riggio’s position is consequentialist; it is that consequentialist arguments need to be sufficiently empirically supported so as to justify confidence in the relevant predictions. And, from a broader perspective, non-consequentialist factors also need to be considered, such as the implications regarding rights and virtues. Riggio’s argument is not adequately developed in these respects. While I doubt it would ultimately be convincing if it were more developed, that is not in principle impossible. To find out, the relevant arguments and evidence for both sides would have to be put forward and considered. But that raises a problem: Riggio’s position does not allow for this process to take place. His position is not defensible in the sense that it prohibits what is necessary to defend it. A full defense of the idea that vaccine honesty would result in worse consequences than a policy of self-censorship and noble lies would require not just arguments favoring the latter, but a full hearing of all the relevant evidence. After all, a trial in which the defense is not allowed to present its case proves nothing.

Further, for intellectual dishonesty to be justified, the harms of honesty must be clearly and substantially worse, not just marginally or “probably” worse, than the harms of intellectual honesty. This is because these harms must outweigh the non-consequentialist factors which tend to weigh against dishonesty. Honesty is a virtue, after all. And being less than fully honest about the relevant costs and benefits risks running afoul of moral and legal requirements involved in securing informed consent. Indeed, some might argue that even if there is a substantial consequentialist benefit, concealing information that may make someone circumspect about accepting a medical intervention inherently compromises their ability to give informed consent, and thus constitutes a serious abuse of human rights.

Liester Contribution on Dissent Suppression 

Riggio’s implied suggestion that certain topics and themes ought not be discussed can be considered a form of suppression of dissent. Mitchell Liester’s recent contribution to SERRC, “The Suppression of Dissent During the COVID-19 Pandemic” (2022), provides many examples of dissent suppression, both historical and current, along with an analysis of the tradeoffs they involve. Taken as a whole, the article seems to recommend caution against the sometimes-understandable desire to suppress certain points of view. Notably, Liester points out that suppressing dissent can (1) hamper scientific progress, (2) backfire, thereby “increasing the visibility and support for the dissidents,” as well as (3) cause a backlash such as protests (63).

Martin’s Contributions on Weaponization and Vaccination Gatekeepers

Martin responds to Riggio’s framing of raising doubts as wielding a weapon in an information war. Almost any cognitive move can be analogized in this way. And, as Martin points out, weapons can be used defensively as well as offensively. In both cases, they can be used justly as well as unjustly. So, although the language of “weaponizing” is pejorative, the real issue is not whether a certain action, such as discussing the OPV theory, is analogous to using a weapon, or can be so used by others; it is whether that use is appropriate. And that is a judgement that is not always easy to make.

Martin makes the following observations: “If the OPV theory was weaponised against vaccination, as Riggio suggests, it was a remarkably silent and ineffectual weapon” (2022, 93). And, “opponents of the OPV theory were the ones who used knowledge claims as a means of attack” (93). While these points are worth noting, I’m not sure that the degree of effectiveness, or the strength of the “attack,” is really the important issue. What is important, again, is whether any particular use of a weapon was an appropriate one. Many of the considerations discussed in Martin’s response suggests that those opposing the OPV theory engaged in inappropriate suppression of dissent. In contrast, it is not clear that raising questions about scientific orthodoxies is inappropriate so long as the questioning is intellectually honest. But what of those who would use such an inquiry to discourage vaccination? It is not even clear that that is necessarily inappropriate either, even if it is misguided and even if it results in some bad circumstances. After all, taking the high road, by supporting the free exchange of ideas, may well end up producing the best consequences overall. Considering the long run, open inquiry seems the wisest course.

In a 2016 article on SERRC entitled “An Experience with Vaccination Gatekeepers,” Martin articulates one potentially approvable response to seemingly problematic views about vaccination: “respectfully address concerns raised by parents and others on a case-by-case basis, depending on their level of opposition to vaccination, countering vaccine criticisms with relevant information” (30). This resonates with the “particularist” approach to conspiracy theories, according to which each particular theory ought to be judged fairly and judiciously according to its own particular merits and faults. This may involve respectful engagement with an intent to provide relevant information that counters the conspiratorial perspective. It is an approach recommended and exemplified by Mick West and Chris Mohr, both conspiracy skeptics.^[1] However, to be genuinely fair, this engagement should be openminded. Everyone will have their own biases but should nevertheless endeavor to maintain an appropriate degree of modesty in recognition of their fallibility.

This strategy contrasts with two alternative approaches that Martin mentions in reference to the vaccine issue: ignoring vaccine critics or “trying to discredit and censor” them. Riggio’s essay involves a tactic that is something in-between simply passively ignoring and actively trying to discredit and censor. Riggio acts, by writing his article, with a goal of curbing certain discourse (i.e., censoring), but in a subtle way, by advocating self-censorship, inviting others to ignore criticism and avoid explorations that might lead to “dangerous” questions. For the reasons discussed above, this is a dubious strategy both in terms of maintaining credibility and of decerning truth.

Conclusion

Even if it is rare that vaccine critics are right about a supposed danger, it could be disastrous if the danger is genuine and the alarm bells are ignored, muffled, and shouted over. Perhaps more importantly, it is likely that skepticism, given greater credibility by the recognition of intellectual dishonesty employed to counter it, will result in more resistance to public health initiatives than would pursuing a policy of rigorous honesty.

In addition, although consequences are quite important, there are other important considerations. Rights, autonomy, fairness, and, yes, honesty, are important. When there is serious doubt about how the consequences will play themselves out, norms of prima facie morality should be adhered to. Being intellectually honest is generally the right thing to do. In order to justify overriding this norm based on consequentialist predictions, one needs ample evidence that benefits far outweigh costs. Although a superficially plausible case can be made against being honest about vaccine safety, further consideration suggests that such a strategy is not likely to be best in the long run.^[2]

References

Basham, Lee. 2022b. “Vaccination Disasters: The People v. Adam Riggio, A Reply.” Social Epistemology Review and Reply Collective 11 (4): 77-89.

Basham, Lee. 2022a. “An Autopsy of the Origins of HIV/AIDS.” Social Epistemology Review and Reply Collective 11 (1): 26-32

Crane, Emily. 2022. “CDC Withholding COVID Data Over Fears of Misinterpretation.” New York Post. February 22. https://nypost.com/2022/02/22/cdc-withholding-covid-data-over-fears-of-misinterpretation/.

CT.gov. 2022. “What are the Ingredients of the COVID-19 Vaccines? What is in Them?” Connecticut’s Official State Website. https://portal.ct.gov/Coronavirus/Covid-19-Knowledge-Base/Vaccine-Ingredients

Erdeljic Turk, Viktorija. 2021. “Anaphylaxis Associated with the mRNA COVID-19 Vaccines: Approach to Allergy Investigation.” Clinical immunology 227 108748. https://doi.org/10.1016/j.clim.2021.108748.

FDA. 1984. “Additional Standards for Viral Vaccines; Poliovirus Vaccine, Live, Oral.” Federal Register 49.107: 23004-23007. June 1. Rules and Regulations.

Hagen, Kurtis. forthcoming. Conspiracy Theories and the Failure of Intellectual Critique. Ann Arbor, MI: University of Michigan Press.

HHS.gov [@HHSGov] 2022. “COVID Vaccines for Children are Made Up of Ingredients that Naturally Occur Inside of our Bodies’ Cells. Hear More From Dr. Amy Edwards.” Twitter. April 23.  Accessed on May 2, 2022. https://twitter.com/HHSGov/status/1517896142226403329.

Institute of Medicine. 2012. Adverse Effects of Vaccines: Evidence and Causality. Washington, DC: The National Academies Press. https://doi.org/10.17226/13164.

Myron Levin. 2004. “Vaccine Injury Claims Face Grueling Fight.” Los Angeles Times. November 2.

Liester, Mitchell B. 2022. “The Suppression of Dissent During the COVID-19 Pandemic.” Social Epistemology Review and Reply Collective 11 (4): 53-76.

Martin, Brian. 2022. “Knowledge as a Weapon?” Social Epistemology Review and Reply Collective 11 (4): 90-96.

Martin, Brian. 2021. “A Covid Paradigm?” Social Epistemology Review and Reply Collective 10 (9): 44-50.

Martin, Brian. 2016. “An Experience with Vaccination Gatekeepers.” Social Epistemology Review and Reply Collective 5 (10): 27-33.

Martin, Brian. 2010. “How to Attack a Scientific Theory and Get Away with It (Usually): The Attempt to Destroy an Origin-of-AIDS Hypothesis.” Science as Culture 19.2: 215-239.

Riggio, Adam. 2022. “The Dangers of Intellectual Honesty in a World of Lies: A Reply to Lee Basham.” Social Epistemology Review and Reply Collective 11 (3): 61-69.

Russell, Bertrand. 1953. The Impact of Science on Society. New York: Simon and Schuster.

Shore, David A., ed. 2007. The Trust Crisis in Healthcare: Causes, Consequences, and Cures. New York: Oxford University Press.

Ziman, John. 2000. Real Science: What it is, and What it Means. New York: Cambridge University Press.

^[1] See Hagen, forthcoming, 259-260, and 313n20, for examples of how West and Mohr effectively bring relevant evidence to bear on an aspect of many 9/11 conspiracy theories, and my endorsement of their approach in a particularist context.

^[2] I thank Brian Martin and Lee Basham for helpful comments on a draft of this article. Also, especially given that the topic is intellectual honesty, perhaps “full disclosure” requires that I indicate that, while I have not done an exhaustive study of vaccination science, I have found some of the science cited to support strong general claims about vaccine safety to be unconvincing, at best. There seems to me to be a bias in the way the science is conducted and how findings are framed. In addition, many potential problems have not been adequately studied (see Institute of Medicine 2012). Regarding the mRNA vaccines for COVID-19 in particular, the situation appears even worse. From my perspective, therefore, it seems that there is ample dishonesty in this area already. To convince people like me to be more trusting, there needs to be less dishonesty, not more.

Categories: Articles, Critical Replies

Tags: Adam Riggio, Brian Martin, consequentialism, dissent, epistemology, honesty, Kurtis Hagen, Lee Basham, Mitchell B. Liester, self-censorship, vaccination