Alum, public health expert James Colgrove: compulsory vaccine laws essential to safety

San Francisco State University graduate James Colgrove researches one of the most divisive issues in the COVID-19 pandemic: the relationship between personal freedoms and public health policy. His books include “State of Immunity: The Politics of Vaccination in 20th-Century America, “Searching Eyes: Privacy, the State and Disease Surveillance in America” and “The Contested Boundaries of American Public Health.”

As dean of Columbia University’s postbaccalaureate premedical program, Colgrove presents a nuanced, sociological perspective to students. He graduated from the San Francisco State master’s program in Teaching English to Speakers of Other Languages (TESOL), but later switched to a career in public health while volunteering at the San Francisco AIDS Foundation.

Colgrove will give the closing keynote at SF State’s annual Constitution and Citizenship Day conference on Sept. 17. The two-day virtual event is open to SF State students, faculty and staff. Nine days before his keynote, the Sacramento native reflected on grad school, public health and anti-vaccination movements.

Do you recall any faculty members who had a significant impact on you from your time at SF State?

The [TESOL] program had a wonderful group of faculty. I remember them very vividly.

We were encouraged to have a meta-awareness of the classroom experience, since we were being trained to go in and lead that experience. I always felt I was watching the instructors on two levels: I was in the classroom to learn what they were teaching me, but I was also observing them as teachers and watching what they were doing to be effective.

All of the teaching that I do in public health is informed by everything that I learned at San Francisco State about being a good teacher.

As someone who studies public health as opposed to medicine, what do you feel are the most important values to impart to pre-medical students?

I definitely think that public health is complementary to medicine. What I try to convey to our pre-medical students is that understanding the societal context of their patients’ lives will make them better clinicians.

If they want to be effective at dealing with medical problems, they will approach that work with an appreciation of the messy complexity of their patients’ lives. And they understand the impact that social class, for example, and socioeconomic status have on health outcomes. [They just need to] have a broader and more perceptive view of what health means.

Vaccine hesitancy is not new. What has made this an issue?

Vaccination is unique among medical interventions. It is given to healthy people before they are ever sick — and on the assumption that it will somehow prevent them from getting sick in the future.

Getting anybody to take a vaccination actually is kind of asking a lot, if you think about it. In general, people don’t want to take medicine if they are not sick.

Really, the benefit of vaccination is more for other people in the community: vulnerable people who are particularly susceptible to disease and who can be harmed by diseases that unvaccinated people can spread in the community. So it’s not hard to understand why people would be reluctant to undergo vaccination.

One way that we have achieved high levels of vaccination in this country is through compulsory vaccination laws. And those laws are really essential to achieving high levels of protection and protecting us all. But we have a very strong libertarian strain in our history and political culture, and a lot of people really just don’t like that idea. It’s always been a challenge for public health folks.

How do today’s anti-vaccination movements compare to those in the past?

I think you see more continuity than change over time. If you read anti-vaccination pamphlets and literature from the 19th century, it sounds remarkably similar to the claims that are made today.

Particularly now, decisions around vaccination have become more an issue of identity. They’ve hardened onto partisan lines in a way we didn’t see so much in the past. Those kinds of identity-related beliefs tend to be very, very difficult to change.

How can the average citizen or SF State student do their part to protect public health?

Everybody should try to lead by example. Everybody should try to be a vaccine champion. Everybody should be posting their vaccination picture on whatever is their preferred social media platform. People should be making viral TikTok videos about that.

This is the problem: People who think vaccination is good don’t take the time to spread that news. The people who are really energized and motivated to act are the ones who want to feel like they’re against something.

Everyone in the SF State community, and everyone who is in favor of public health, should try to make their beliefs known in any way they can.