Tahlil Wehlie speaks with his son Luqman, 3, at their apartment in Hopkins, Minn., April 27. Luqman and his sister got the measles during the current outbreak in Minneapolis and are now recovering at home. (Courtney Perry/For The Washington Post)

It’s extremely contagious, and can lead to hospitalization, pneumonia, deafness and death. And though it was eradicated in the United States in 2000, it’s back with an increasing number of virulent outbreaks — most recently in Minnesota, where the number of documented cases recently rose to 69 and spread to a fourth Minnesota county.

The disease, of course, is measles — and it’s spreading again because of anti-vaccination myths. In Minnesota, 65 of the cases are among people who haven’t been vaccinated. And 59 are among Somali immigrants, a group that in 2014 had a vaccination rate of only 42 percent, having been targeted with anti-vaccination propaganda.

That’s a public health problem, and not just for the unvaccinated. When a critical percentage of the community has been vaccinated, everyone’s more protected from that disease.

The problem is what we would now call “fake news”: the myth that vaccines cause autism. Unfortunately, that myth can get stronger after someone’s been educated about the facts. Let’s be clear here: The measles vaccine is undeniably safe. Scientific evidence overwhelmingly shows that the benefits of vaccines far outweigh the risks. Vaccines have no relationship at all to autism. And yet this remarkably persistent, even contagious, myth continues to endanger children’s health.

We examined who supports school vaccination requirements.

Here’s the traditional public health approach to preventing the spread of measles and similar childhood diseases: State and local governments have required children to be vaccinated before they can enter public school.

About three-fourths of the country supports that approach, according to data from the 2016 American National Election Studies (ANES). So who does, and who doesn’t?

1. More education leads to more support for vaccinations — mostly

Our research finds that education is a key variable in whether someone supports vaccine use and policies. The higher the degree someone has received, the less likely they are to believe the myth that vaccines and autism are linked. Those with more education are also more likely to support requiring parents to vaccinate their children.

Why? Many academic studies show that education strengthens the ability to consider several sources of information, search out and possess factual information, and counter dubious information.

According to the 2016 ANES data, nearly 88 percent of people with a graduate degree support school vaccination requirements. That figure was 81 percent for people with bachelor’s degrees, 73 percent for people with some college, and 73 percent among those with only a high school degree or who did not graduate from high school.

2. But there are plenty of vaccine skeptics

And yet a significant proportion of Americans remain skeptical about vaccines. Consider the responses to this question: Do the health benefits of vaccinations generally outweigh the risks; do the risks outweigh the benefits; or is there no difference?

Nearly a third of respondents answered skeptically. Fully 12 percent said that the risks of vaccinations outweigh the benefits. And 17 percent said that the risks and benefits are equal.

Among these vaccine skeptics, only 48 percent favored vaccination requirements for school attendance.

Even more remarkable, this skepticism changes the relationship between someone’s level of education and their support for vaccination requirements.



3. Education hardens the skeptics’ opposition to school vaccination requirements

Among vaccine supporters — those who say the health benefits outweigh the risks — more education increases the likelihood of favoring school vaccination requirements.

But among vaccine skeptics, that pattern reverses. In this group, the most highly educated are most opposed to school vaccine requirements. Consider that, among those skeptics who have a high school diploma or less, 58 percent favor vaccine school requirements — but among the skeptics with graduate degrees, that figure drops to 38 percent.

Education isn’t infallible

Overall, education increases political knowledge and factual understanding. But it can also help people justify their most firmly held views, whether factually based or not. Research shows that politically knowledgeable people, compared with less knowledgeable, may reject facts inconsistent with their own partisan views. When confronted with a variety of evidence, some of which supports and some of which undermines their beliefs, these knowledgeable citizens succumb to confirmation bias, remembering only the information that supports their existing views. It’s no wonder that the most educated citizens can disagree significantly on hot-button political facts and policies.

To that list, we can now add school vaccine policy. Highly educated vaccine skeptics are likely to feel confident about challenging scientific evidence. And they’re probably motivated to seek information that confirms their worries about vaccines. According to Brendan Nyhan’s recent study, when given information disproving the mythical vaccine-autism link, vaccine-skeptical parents actually became less likely to say they would vaccinate a child.

People often resist information that challenges their beliefs. Ironically, when it comes to vaccines, education can bolster false beliefs. All of which suggests that the United States can expect more dangerous outbreaks of measles, the preventable disease that hasn’t been eradicated after all.

Mark Joslyn is a professor and graduate director of political science at the University of Kansas.