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How to deal with anti-vaxxers

It’s a big problem.

Certain that they are right, struggling to find ways to get their message across, public health officials are exasperated by their inability to convince more U.S. parents to vaccinate their children.

“I think we’re all kind of frustrated,” said Stephen Morse, a Columbia University infectious disease expert. “As scientists, we’re probably the least equipped to know how to do this.”

They say they are contending with a small minority of parents who are misinformed — or merely obstinate — about the risks of inoculations. The parents say they have done their own research and they believe the risks are greater than health authorities acknowledge; they are merely making their own medical choices, they say.

Most parents do bring their children for shots, and national vaccination rates for kindergarteners remain comfortably above 90 percent. Experts aren’t even sure the ranks of families who don’t vaccinate are growing to any significant degree.

But in some states, the number of parents seeking exemptions from school attendance vaccination requirements has been inching up. In some communities, large proportions of household skip or delay shots. The rise has come despite unsettling outbreaks of some vaccine-preventable diseases that had nearly disappeared from the United States.

“Part of the reason everyone is so concerned about this is because they don’t know whether things will get worse,” said Dr. Walter Orenstein of Emory University, considered one of the nation’s leading experts on vaccines.

[…]

Experts see the cooperation of physicians as a key to prodding families to get old and new vaccines. They believe too many family physicians and pediatricians have been lax. Some doctors perhaps see themselves as too busy to spend time debating the value of vaccines with resistant families. Some have complained about the cost and hassle of stocking the shots. A smaller contingent may have their own questions about vaccine, and indulge families that want to postpone or skip shots.

ACIP has been looking at the problem. So has another national panel — the National Vaccine Advisory Committee, chaired by Orenstein — which two years ago convened a Vaccine Confidence Working Group to study the issue. In a draft set of recommendations presented this month, the group said there’s not enough good information on where clusters of unvaccinated people are, to what extent they are growing, and why they exist.

The workgroup is recommending more study, and better training of physicians so that they will work harder to present childhood vaccination as the sensible way to go.

Another strategy is to simply make more parents vaccinate, through a concerted effort to eliminate philosophical exemptions to vaccinations or to make the exemption application process more demanding. Several experts interviewed believed reducing exemptions is the most practical approach, in a country where individual freedoms are sometimes celebrated at the expense of the communal good.

I’m on record as being in favor of severely limiting personal exemptions for vaccinations, and taking a punitive approach as needed to compel the obstinate holdouts to comply. If you want to call this a matter of freedom, I say it’s my freedom to live a healthy life that’s at stake. Be that as it may, it would be much better if people were more willing to comply on their own. Ruth Graham, writing in Slate, makes an important point about this.

“There is a history of paternalism in medicine,” said Jordynn Jack, an associate professor of English at the University of North Carolina at Chapel Hill whose 2014 book Autism and Gender explores how ideas about gender have affected debates about autism, including the vaccine controversy. “The language that’s used by the scientific community to communicate that vaccines are safe sometimes falls into that paternalistic model. ‘I’m telling you what’s right, and I’m telling you as a scientific authority,’ ” Jack said. “For some people that’s persuasive, but for others it’s not.” In her book, Jack dissects how contemporary mothers often think of themselves as “warriors” on behalf of their sick children, fighting first for a diagnosis and then for treatment. If procuring basic care for a sick child feels like a battle, then why trust the enemy’s propaganda?

Concern about not being taken seriously by medical professionals causes other problems for women as well. Surely by now we have learned that a successful outreach program depends on being able to speak to people in a way they will relate to. Seems to me that’s a good place to begin here as well. Of course, as this AusChron post points out, people have to be willing to listen, and to understand what they’re being told, too.

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