The Death of Expertise Doesn't Have to Mean a Return of Vaccine-Preventable Diseases

In The Death of Expertise, author Tom Nichols (and the world), explaining the many factors leading to mistrust of experts or the rise in people who believe themselves to be experts when all they are are influencers. We humans are interesting when it comes to whose advice we follow and why we do so. As children, we are inclined to follow the lead of our parents and teachers, but . Later on in life, popular culture and social media conspire (knowingly or not) to place certain people on pedestals or in positions where what they say is the ultimate authority on the subject.

But what makes an expert? Is someone with a doctoral degree from an accredited institution of higher learning an expert? There are plenty of examples of people with medical degrees, doctoral degrees, and master’s degrees who get things wrong. During the early days of the COVID-19 pandemic, there was no shortage of “Dr. This” and “Dr. That” who told us via social media, podcasts, or as talking heads on television that we should take this or that medication to prevent COVID-19... All without evidence. There were physical fights over physicians not prescribing ivermectin or hydroxychloroquine. People flocked to black markets to obtain those drugs on the advice of “experts” who gave baseless recommendations, or recommendations based on . 

Identifying an expert is difficult, . Even courts sometimes find it difficult to define expert witnesses, because the prosecution or defense may put forth a person as an expert, but the court fails to recognize them as such due to a limited understanding from the court on the subject being discussed. This has been the case in . Each side will bring expert opinions (or witnesses), and those experts will have conflicting views or opinions on vaccination. It is then left up to the judge and/or the jury to make sense of what they were told. And, if the comments section of the videos and news on these cases is any indicator, justice might not be carried out, because the comprehension of difficult scientific concepts may not be there.

At the end of the day, listening to experts -- and following their recommendations -- is a cultural issue. When cultures and their members move away from listening to experts, the experts are no longer experts. That is, expertise is a subjective cultural norm. A person can go to school for decades, graduate at the top of their class, make breakthroughs in their field, and then account for nothing if they lack credibility or the listening ear of the public.

It’s the same way with vaccination. In epidemiology, . First, the organism must be found only in one species (humans, in our case). An organism that can go from species to species can’t be eradicated, because it will find a species to hide in before making a comeback. Second, the organism must trigger immunity, or the vaccine for it must trigger immunity. That immunity must be long-lasting, long enough to ensure that no dormant or asymptomatic cases are out there, waiting to allow the organism to return. And, third, there has to be a vaccine.

That vaccine can’t be just any vaccine. As stated in the second point above, it must be a highly effective vaccine: one conferring long-lasting immunity to the highest proportion of people who get it. The vaccine must be affordable and available to everyone. Otherwise, those who cannot afford it or don’t have access to it could be reservoirs of the organism. Most importantly, the vaccine must be accepted by nearly 100% of the public. Anything less than that, and there could be pockets of the unvaccinated where the disease could thrive and make a comeback.

We have seen this last effect in recent years with measles. Humans are the only reservoir of the measles virus, and . In the United States, the vaccine is available to all children and paid for by insurance companies, , or a combination of different programs to deliver the vaccine at little to no cost. Nevertheless, there are pockets of unvaccinated children and adults. In 2018 and 2019, . In 1991, members of a church in Philadelphia who did not believe in modern medicine left their children unvaccinated, . In those, and many other instances, the vaccine was highly effective, it was available, and it was just the hesitancy of parents to vaccinate their children that caused disease and even some deaths.

Unfortunately, public health and popular opinion are tied together in the United States. In other countries where , public opinion matters only to the extent that the government imposing those orders will listen. In the United States, the public is free (in almost all instances) to refuse medical care, including vaccines. If they don’t see a vaccine as beneficial, , then they’re not getting the vaccine. Or worse, they might not give their children the vaccines needed to keep childhood diseases at bay.

The “death” of expertise we have experienced during the culture wars on the COVID-19 vaccines does not have to mean the death of vaccine programs and the reemergence of vaccine-preventable diseases. It could, but only if it is allowed to continue. This “death” can be quickly averted through the sensible use of communications strategies and a robust response to vaccine misinformation and disinformation. Parents listen to parents, so parents could share stories of vaccination and why they chose to vaccinate their children. Parents will also listen to their children’s pediatricians, so pediatricians need to be given the resources to have more meaningful conversations with parents.

As for the robust response to misinformation and disinformation, here are some resources:

• is a consortium of journalists and fact-checkers from around the world who check and double-check claims made by public and private figures in public. Most notably, they take the time to track different instances of the same social media posting to see the progress of misinformation and who is more likely to be affected by it.
• focuses more on political statements and proclamations, separating the myths from the facts. Lately, vaccination has become a political issue, so PolitiFact keeps up with social media (and traditional media) postings to debunk false claims.
• Like the other above, , also looks at what is circulating on the internet and debunks false claims. They even have a page to look specifically at misinformation and disinformation related to the pandemic.
• works with other academics to look at false claims related to public health and national security. She posts almost daily on false claims she finds on the internet, analyzing them in detail and explaining the origin of those claims.

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