Vaccines? Safe. Parents? Dangerous.
Find a Conversation
|Wed, 12-17-2008 - 3:51pm|
Vaccines? Safe. Parents? Dangerous.
Lately I’ve been noticing an increasing number of journal articles, blog articles and opinion pieces on a terrible problem: Parents have questions about vaccines.
You would have to look far and wide to find anyone who thinks that these questions are valid and should be taken seriously. Common explanations are:
1) It is all about the parents who think they are really smart.
2) It is all about the parents who are very stupid and read stuff on the Internet.
3) It is all about the bad stuff on the Internet which is deceiving the parents who aren’t very smart and who think they are smarter than doctors. And infinite variations on this theme, which is really one argument…and the real argument is (drum roll)…vaccines are perfect and parents are the problem.
Being called stupid dupes hasn’t worked to shut up the parents with questions. Perhaps this is not a good strategy?
I’m sure you’ve noticed that many articles and blogs offer comment options to the public. If you are following the vaccine related discussions you’ll have noticed that there is a coterie of passionate vaccine defenders who pop up in every such public discussion. These vaccine defenders are fighting for the good of the vaccine program with everything they’ve got.
Oddly, however, the number of parents with questions seems to be increasing. Perhaps the vaccine defenders need to reconsider their approach.
Here are some suggestions, kindly meant, from an admirer of their efforts. These guys have put a lot of sweat equity into defending vaccines and they ought to be getting better results.
One argument which comes up over and over again is herd immunity. Any time a parent asks if they could perhaps delay or skip one vaccine or another, someone is sure to come out with this mantra: “If we stop vaccinating measles and polio will return and children will die!” But if a parent is wondering about the chickenpox vaccine, or the hepatitis B vaccine or Prevnar, or perhaps about the vaccine for hepatitis A, this isn’t actually a useful argument. They may start wondering, quite reasonably, why questions about an ever-expanding vaccine schedule are answered with rants about vaccines which were added to the schedule in the 1950s (polio) and the 1960s (measles). Does this mean that we don’t really need all of these new vaccines, they ask?
So, my first suggestion to the vaccine defenders is to customize their response to the concerns being raised. Parents have specific questions. The vaccine defense needs to have specific answers.
When it comes to herd immunity every vaccine is different. It turned out, for example, that the mumps vaccine provides excellent herd immunity in the absence of mumps…
In addition to the defenders acting as though all vaccines are identical in their efficacy, safety and relevance, they also tend to act as though all vaccine questioners are identical. Anyone who has a question, is, in the defenders view, anti-vaccine. And people who are anti-vaccine are bad people. As a result the defenders respond with sarcasm, rudeness and repetition.
My second suggestion to the vaccine defenders…is to customize their response to the concerns being raised. (I know, I already said that!) Some parents who raise concerns are just raising concerns. They haven’t gone over to the dark side. But with enough rudeness and sarcasm from the vaccine defenders they will definitely be moving in that direction.
Which leads me to the next problem. It is not, absolutely not, all about autism and vaccines. Parents who have questions about vaccines find all sorts of things to worry about in addition to or instead of autism.
I’m afraid my third suggestion is to customize their response to the concerns being raised. It really isn’t just autism. Parents are also worried about allergies, asthma, learning disabilities and generalized poor health. You need to have the research at your fingertips to answer all of these different concerns. If the research exists at all…if the research that exists supports the mantra “it isn’t the vaccines”…well good luck, anyway.
Honestly, at this point many people are concerned or on the fence about vaccines. The sarcasm and meanness pushes people away. It is not a convincing approach. Try being polite and sympathetic. I know this is tough and doesn’t come naturally, but it is absolutely essential if the vaccine defenders want to get anywhere in this battle. The articles on this blog provide good models for a sympathetic, thoughtful and scientifically oriented approach.
A few more points:
Vaccine defenders need to deal with the science. Saying that the science is all on the vaccine side, without actually presenting said science is a hollow argument. The defenders need to dig in, find the citations, seriously address the questions. And start tackling the increasing number of blogs and organizations which are tackling the science from the other side. Just calling them anti-vaccine and ignoring them isn’t working.
A sub-point on science: the scandals about faked science in medical journals are undermining people’s faith in doctors and science in general. If Merck did some bad stuff with Vioxx, is it unreasonable to have questions about their trustworthiness when it comes to Gardasil? The defenders need to be able to explain why vaccines are an exception to dirty dealing from the pharmaceutical companies. I’m wondering about this one myself and look forward to seeing what the vaccine defenders come up with.
Calling people anti-vaccine isn’t actually an argument. If someone says: “I didn’t vaccinate my child for chickenpox because I researched the illness and decided that the vaccine wasn’t worth it.” they aren’t necessarily anti-vaccine. They thought about a particular vaccine and decided against it. They probably thought about some other vaccines and decided those were okay. Looking at their position objectively, they are pro-vaccine but opposed to the CDC’s schedule recommendations. Defenders of vaccines have to figure out a way to respond to selective and delayed vaccinators which doesn’t include insulting them.
Selective and delayed vaccinators are potential allies who will fight for vaccines, but currently the vaccine defenders want nothing to do with them. Some of these parents are quite knowledgeable and have done extensive research into vaccines. They know more of the science than the defenders, frankly. But defenders want nothing to do with them, because in a black and white world you are either with us or against us and there is no middle ground. Pushing away allies is dumb.
Now comes a truly tough one: The vaccine defenders should be strongly, passionately, in favor of a philosophical exemption to vaccines. Why? Because it would increase the vaccine rates and provide accurate statistics about who is getting which vaccines. It would also increase trust in vaccines. The current system, in states without a philosophical exemption, forces parents to do all the vaccines or none of the vaccines or else to lie about their choices. Obviously, for parents with a really serious concern about a particular vaccine, being forced to do all or nothing is not a good option. It makes them feel bullied, harassed and victimized. It makes them think that the current system is all about power and control and not about the well-being of children. It makes them think that the government wants to invade their parenting choices. If the real concern about vaccines is herd immunity against polio and measles, then a philosophical exemption would, without a doubt, increase the number of children visibly vaccinated for polio and measles.
Favoring choice about vaccines is probably too much for the pro-vax team to stomach. It would require admitting that parents aren’t stupid, for one thing. And that they have a right to make decisions about their own children’s health care needs. No, I guess we’ll have to keep guessing about vaccine rates…
You know that old saying about dissatisfied customers making a lot of noise and happy customers making very little noise? It is especially true when it comes to vaccine injuries. A baby who dies or is seriously injured or even just spends a couple of weeks being very sick after receiving a set of vaccines will be all too visible. Parents, family, friends, coworkers, acquaintances–every person around will hear about the problems. This phenomena is increasing as vaccine concerns rise. Parent’s are less and less willing to consider a problem which occurs following vaccination as just a coincidence.
Now, listen carefully, because this is the most important point of all. Defenders should stop denying vaccine damage. When a parent testifies that their child was damaged by a vaccine they should fall all over themselves to acknowledge what happened, to agree that vaccines can, indeed cause injuries, to encourage the parent to report what happened to VAERS, to sympathize if they say the doctor denied the incident and refused to report it. I’ve only seen two responses to vaccine damage reports in these online debates from the pro-vaccine side: sometimes it is just ignored as though the parent hadn’t said anything, the rest of the time it is denied in one way or another. “Anecdotal evidence” is a popular response, for example.
Comment pages are widely read, which is why this coterie posts on comment pages to defend vaccines. Many people read (lurk) without ever posting. Each time a vaccine defender denies the existence of vaccine damage there is a pretty good chance that someone with direct experience of such damage is lurking and reading the denial. And feeling angry and disgusted.
But things get worse. Parents are concerned about the possibility of vaccine damage. They read stories about children who were damaged (true or not). They hear that the doctors denied that vaccines caused the problems. They see vaccine defenders either attacking or ignoring the parents of sick children. They even see, as I recently did, a vaccine defender proclaiming gleefully that the VAERS system is useless and cannot be used as a source of information about the risks of vaccines. What sort of message are vaccine defenders sending out to the public? Clear enough, unfortunately. If a parent is trusting enough to have their child vaccinated and something goes wrong they will have no recourse. The doctor will deny it. The system which is supposed to monitor vaccine injuries is useless and happily announced as useless. People who admire and support vaccines are so dedicated to their faith that they will attack the parents of chronically ill children. Ouch!
The official pro-vaccine position is that vaccines are safe. If this is true, a good system for tracking vaccine damage would confirm that safety. If vaccine defenders really believe that vaccines are completely safe and effective they should be fighting passionately for a system that tries to collect every vaccine reaction, no matter how minor. The current system obviously allows many thousands of reactions to pass unrecorded, perhaps, as the anti-vaccine critics claim, many millions. The only way to sort this out is to replace an ineffective system with an effective one. To replace bad statistics with good statistics. If pro-vaccine folks really, honestly, wholeheartedly believe in the safety of vaccines they should be fighting, hard, for an effective system of monitoring vaccine damage. We all need to end the confusion.
On the same note, a good study comparing vaccinated and unvaccinated populations will obviously prove that vaccines are safe, right? So why don’t the vaccine defenders fight for such a study? Vaccines make children healthier and the evidence should be easy enough to find. Yes?
I think vaccine defenders need some help because they are not convincing people and I think they know they are not convincing people.
I’ve shared these thoughts in an attempt to save the vaccine defenders from wasting their time and energy. Think about it. Start persuading and stop ranting.
Are they really fighting to defend vaccines or are they just out there to tell everyone how smart they are? Some of us are wondering.