Tag: autism studies

What Is Vaccine Injury Denial?

Few people deny that vaccine injury is real.

Vaccine injuries, while rare, are certainly real.

That’s why we have table injuries, the Vaccine Court, and the National Vaccine Injury Compensation Program.

What Is Vaccine Injury Denial?

Again though, vaccine injuries are rare.

“Vaccine Injury Denialism is rampant across the mainstream media, where child-abusing vaccine pushers like the New York Times, Washington Post and CNN deliberately contribute to the holocaust of vaccine injuries now devastating humanity’s children. Sadly, the same denialism about the alarming growth in medical injuries caused by vaccines is also endemic across universities, science journals and medical schools, where doctors are indoctrinated into a kind of “Flat Earth” denialism of vaccine injury reality.”

Mike Adams on Vaccine Injury Denialism is the denial of fundamental human dignity

Claims of vaccine injury denial come when we are skeptical or don’t believe that anything and everything is a vaccine injury.

Barbara Loe Fisher's NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.
Barbara Loe Fisher’s NVIC even claims that Shaken Baby Syndrome can be a vaccine injury.

For example, in some circles, if you point out that vaccines do not cause asthma, ADHD, autism, Celiac disease, diabetes, eczema, food allergies, infertility, multiple sclerosis, POTS, SIDS, or transverse myelitis, etc., then claims of vaccine injury denial begin to fly.

That shouldn’t be surprising, as these and other so-called vaccine induced diseases make up the bulk of the vaccine injury stories that scare many parents.

“IMAGINE YOU LIVE IN A COUNTRY in which a minority of people are taken in the middle of the night, and beaten, kicked, poisoned, half-drowned… they are crippled for life, maimed, and they are expected to accept a doctor’s or a judge’s view that “It wasn’t the Gestapo” or “It’s not even an injury”.

Imagine that minority amounted to tens of millions of people.

Now imagine that these victims are lured into traps by their own doctors with promises of medicine that will prevent illness – but in reality the doctors are paid for every patient they manage to convince to show up – and the doctors determine which injuries they caused and which were just “coincidences”.

Now imagine the media is primed to tell the world that no such injuries ever occur. Now your neighbors are denying it, calling you crazy for thinking there is a link…”

James Lyons-Weiler on Should Vaccine Risk/Injury Denial Be Prosecutable Offenses?

But doctors and the media, and your neighbors for that matter, don’t deny that claims of vaccine injury are real because of some grand conspiracy or simply because they want to.

It is because of research and science, understanding the difference between correlation and causation, and more research. And we understand that vaccines are both passively and actively monitored for side effects.

Vaccine injuries, although real, are rare.

The only denialism about vaccines that is important, is among those who deny that vaccines work and that they are safe and necessary.

What to Know About Vaccine Injury Denial

Anti-vaccine folks like to claim that anyone who doesn’t believe that vaccines cause all of their vaccine-induced diseases are part of a conspiracy of vaccine injury denial.

More on Vaccine Injury Denial

What Is the Evidence for Alternative Vaccine Schedules?

There is plenty of evidence that the standard immunization schedule is safe and effective.

What about the alternative vaccine schedules that some folks push?

Is there any evidence that is safe to delay or skip any of your child’s vaccines?

Alternative Vaccine Schedules

Many people think of Dr. Bob Sears when they think of alternative vaccine schedules.

Bob Sears appeared on Fox & Friends in 2010 for the segment
Bob Sears appeared on Fox & Friends for the segment “Vaccines: A Bad Combination?”

He created both:

  • Dr Bob’s Selective Vaccine Schedule
  • Dr Bob’s Alternative Vaccine Schedule

He didn’t invent the idea of the alternative vaccine schedule though.

Well before Dr. Bob appeared on the scene, Dr. Jay Gordon had been on Good Morning America with Cindy Crawford to discuss vaccines and how she had decided to delay vaccinating her baby.

Where did she get the idea?

After the segment, Dr. Jay stated:

“They edited the segment to make me sound like a vaccination proponent. We also have to understand the impact of a person as well-known as Cindy Crawford delaying vaccines for over six months.”

Jay Gordon

Dr. Jay has long talked about only giving infants one vaccine at a time and waiting until they are “developmentally solid” before vaccinating.

1983 historical immunization schedule
When Bob Sears came out with his vaccine book, Jenny McCarthy was also pushing the too many too soon myth and rallying folks to go back to the 1983 schedule that left kids at risk for meningitis, pneumonia, blood infections, severe dehydration, epiglottitis, and cancer from Hib, pneumococcal disease, rotavirus, hepatitis B, hepatitis A, chicken pox, HPV, and meningococcal disease.

Similarly, other folks have pushed ideas about delaying and skipping vaccines before Dr. Bob, including:

  • Donald Miller and his User-Friendly Vaccination Schedule – no vaccines until age two years and no live vaccines and when you begin vaccinating your child, give them one at a time, every six months (first published in 2004)
  • Stephanie Cave – starts at 4 months and delays many vaccines
  • homeopaths with immunization schedules that say to wait until six months and then start giving nosodes every five days
  • chiropractors with immunization plans that say to get regular chiropractic adjustments instead of vaccines
  • Paul Thomas‘ vaccine friendly plan
  • Jenny McCarthy and Generation Rescue’s Turn Back the Clock immunization plan which recommends substituting the latest schedule with the 1983 immunization schedule or a schedule from another country, like Denmark, Sweden, Finland, or Iceland.

Of course, Dr. Bob is the one who popularized the idea of the alternative vaccine schedule in 2007, when he published The Vaccine Book: Making the Right Decision for Your Child.

That’s when parents started to bring copies of his schedule into their pediatrician’s office, requesting to follow Dr. Bob’s schedule instead of the standard immunization schedule from the CDC.

What’s the Evidence for Alternative Vaccine Schedules?

There is no evidence that following an alternative vaccine schedule is safe for your kids.

“No alternative vaccine schedules have been evaluated and found to provide better safety or efficacy than the recommended schedule, supported by the Advisory Committee on Immunization Practices of the CDC and the Committee on Infectious Diseases of the AAP (the committee that produces the Red Book).

Pediatricians who routinely recommend limiting the numbers of vaccines administered at a single visit such that vaccines are administered late are providing care that deviates from the standard evidence-based schedule recommended by these bodies.”

American Academy of Pediatrics

What’s the first clue that these so-called alternative vaccine schedules have absolutely no evidence behind them?

They are all different!

Paul Thomas, for example, doesn’t even offer his patients the rotavirus vaccine. Dr. Bob, on the other hand, has it on his list of vaccines that “that could protect a baby from a very potentially life-threatening or very common serious illness” and is sure to give it at 2, 4, and 6 months.

How slow should you go?

Both Dr. Bob and Dr. Paul give two vaccines at a time with their schedules, but Dr. Jay and Dr. Miller say to give just one at a time.

“Would any scientist give SIX vaccines at once to a baby? Asking for trouble. One at a time makes so much more sense.”

Jay Gordon

And while some start their schedules at 2 or 4 months, others delay until 6 months or 2 years.

There is also the fact that the folks who create these schedules admit that there is no evidence for what they are doing…

“No one’s ever researched to see what happens if you delay vaccines. And do babies handle vaccines better when they’re older? This is really just a typical fear that parents have when their babies are young and small and more vulnerable. Since I don’t know one way or the other, I’m just happy to work with these parents, understand their fears and their worries, and agree to vaccinate them in a way that they feel is safer for their baby.”

Bob Sears on The Vaccine War

But there has been research on delaying vaccines.

Unvaccinated kids aren’t healthier – they just get more vaccine preventable diseases. Most of which are life-threatening, even in this age of modern medicine, with access to good nutrition and sanitation.

So whether you only get one or two vaccines at a time; delay until four months, six months, or two years before you get started; skip all live vaccines or just wait until your child is “developmentally solid” to give them;  or go with some other non-standard, parent-selected, delayed protection vaccine schedule, the only things that you can be sure of is that there is no evidence to support your decision and that you will leave your kids unprotected and at risk for getting a vaccine-preventable disease.

“…when I give your six-week-old seven different vaccines with two dozen antigens, I am supposed to try to convince you that the adverse reactions you have heard about are just coincidences.”

Jay Gordon

Better yet though. Find a pediatrician who will listen and answer your questions about vaccines, concerns about vaccine myths and misinformation, explain that no vaccine is optional, and not just simply pander to  your fears.

What to Know About the Evidence for Alternative Vaccine Schedules

There is no evidence that skipping or delaying any vaccines with an alternative vaccine schedules can keep your kids safe from vaccine preventable diseases.

More on the Evidence for Alternative Vaccine Schedules

Hierarchy of Evidence and Vaccine Papers

Evidence is evidence, right?

Nope.

There is a hierarchy of evidence, from weakest to strongest, that help folks make decisions about science and medicine.

That’s why you can’t just search Google or PubMed, read abstracts, and say that you have done your research.

Hierarchy of Evidence

For any study, you have to review and judge the quality of the evidence it provides.

A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield's retracted case series included only 12 children.
A meta-analysis with over 1.2 million kids found that vaccines were not associated with autism, while Wakefield’s retracted case series included only 12 children.

Is it a case report (a glorified anecdote), case series, or animal study (lowest quality evidence)?

Or a systemic review or meta-analyses (highest quality evidence)?

“The first and earliest principle of evidence-based medicine indicated that a hierarchy of evidence exists. Not all evidence is the same. This principle became well known in the early 1990s as practising physicians learnt basic clinical epidemiology skills and started to appraise and apply evidence to their practice. Since evidence was described as a hierarchy, a compelling rationale for a pyramid was made.”

Murad et al. on the New Evidence Pyramid

What about case control studies, cohort studies, and randomized controlled trials?

They lie somewhere in between on the hierarchy of evidence scale or pyramid.

And there are other factors to consider when judging the reliability of a study.

“Ultimately, the interpretation of the medical literature requires not only the understanding of the strengths and limitations of different study designs but also an appreciation for the circumstances in which the traditional hierarchy does not apply and integration of complementary information derived from various study designs is needed.”

Ho et al. on Evaluating the Evidence

For example, you might also have to take into account the sample size of the study.

A study can be underpowered if it doesn’t have enough subjects. Unfortunately, even an underpowered study will give you results. They likely won’t be statistically significant results, but folks don’t always realize that.

Even a meta-analysis, usually considered to be at the top of the hierarchy of evidence pyramid, can have problems that make their results less useful, such as not using appropriate inclusion criteria when selecting studies and leaving out important studies.

All in all, there are many factors to look at when reading a medical paper and considering if the results are valid and should influence what you do and how you think. This is especially true when looking at low quality vaccine papers, many of which the anti-vaccine movement uses to scare people, even though they are often poorly designed, and several of which have been retracted.

What to Know About the Hierarchy of Evidence

Learning about the hierarchy of evidence can help you better evaluate medical studies and vaccine papers and understand that there is more to doing your research about vaccines than searching PubMed and reading abstracts.

More on the Hierarchy of Evidence

 

Retracted Anti-Vaccine Studies

Everyone knows that Andy Wakefield‘s fraudulent MMR study was retracted.

Andrew Wakefield was the lead author on his retracted paper.
Andrew Wakefield was the lead author on his retracted paper.

That’s the study that got folks scared into thinking that vaccines are associated with autism.

Surprisingly, it’s not the only one…

Retracted Anti-Vaccine Studies

Actually, it shouldn’t be surprising at all.

Most studies that are touted by the anti-vaccine movement are poorly done and often flawed.

And they include these other papers and studies that have been retracted:

Is it a coincidence that all of the researchers who have had papers retracted seem to get funding from the CMSRI?

What else has been retracted?

The “Deadly Immunity” article by Robert F. Kennedy, Jr.

And the survey, “Vaccination and Health Outcomes: A Survey of 6- to 12-year-old Vaccinated and Unvaccinated Children based on Mothers’ Reports,” was originally retracted by Frontiers in Public Health before finding a home at another journal under a different name. That journal quickly retracted it too, but they then published the “fatally flawed” paper for some reason.

What to Know About Retracted Anti-Vaccine Studies

Many of the heroes of the anti-vaccine movement have published fatally-flawed studies that have been later retracted.

More on Retracted Anti-Vaccine Studies

Expert Statements on Vaccines and Autism

All of the organizations that help autistic people agree that there is no association between vaccines and autism.
All of the organizations that help autistic people agree that there is no association between vaccines and autism.

Some parents are still confused about who they should listen to for advice about vaccines and autism.

Is there any controversy or a real debate going on about whether vaccines are associated with autism?

What do the experts say?

They say that vaccines are not associated with autism.

More and more, experts are also stating that continuing to focus attention on vaccines is hurting autistic families.

And no, it’s not just one or two of them and it is not just your pediatrician…

Autism Science Foundation

“Multiple studies have been completed which investigated the measles, mumps and rubella vaccination in relation to autism. Researchers have also studied thimerosal, a mercury-based preservative, to see if it had any relation to autism. The results of studies are very clear; the data show no relationship between vaccines and autism.”

American Academy of Pediatrics

The American Academy of Pediatrics, an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists, has long advocated for the health and safety of our children.

“Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. Delaying vaccines only leaves a child at risk of disease. Vaccines keep communities healthy, and protect some of the most vulnerable in our society, including the elderly, and children who are too young to be vaccinated or have compromised immune systems.”

The AAP has consistently emphasized the safety and importance of vaccines to help reassure parents who are scared by anti-vaccine misinformation.

Autistic Self-Advocacy Network

“Vaccinations do not cause autism – but the use of autism as a means of scaring parents from safeguarding their children from life-threatening illness demonstrates the depths of prejudice and fear that still surrounds our disability. Autism is not caused by vaccines – and Autistic Americans deserve better than a political rhetoric that suggests that we would be better off dead than disabled.”

Autism Society of America

“There is no known single cause for autism spectrum disorder, but it is generally accepted that it is caused by abnormalities in brain structure or function. Brain scans show differences in the shape and structure of the brain in children with autism compared to in neurotypical children. Researchers do not know the exact cause of autism but are investigating a number of theories, including the links among heredity, genetics and medical problems.”

Autism Women’s Network

“Vaccines do not cause autism. Neither does thimerosal.”

National Autistic Society

“In the light of concern around the continuing activities of anti-vaccine campaigners, including promotion of the film ‘Vaxxed’, we feel it’s important to restate that research has comprehensively shown that there is no link between autism and vaccines…

We believe that no further attention or research funding should be unnecessarily directed towards examining a link that has already been so comprehensively discredited. Instead, we should be focusing our efforts on improving the lives of the 700,000 autistic people in the UK and their families.”

Autistica

“The biggest myth of all is that vaccines, specifically the MMR vaccine, cause autism. The safety of vaccinations has been repeatedly tested across large groups of people. High quality research studies involving hundreds of thousands of people have consistently shown that vaccinations do not cause autism.”

Thinking Person’s Guide to Autism

“So I want to ask you to be careful about how you make your pro-vaccine arguments when autism is involved — because when we use our many many mountains of evidence in statements such as “there is NO evidence linking vaccines to autism” without adding the statement “and fear of autism hurts autistic people,” then we’re actually contributing to negative stereotypes about autism and autistic people, rather than furthering autistic people’s acceptance and inclusion in our society.”

American Medical Association

The American Medical Association, which was founded in 1847, has just over 240,000 members.

“Each year vaccines prevent an estimated 2.5 million deaths among children under age 5, according to the World Health Organization. The AMA adopted policy this week continuing its efforts to promote public understanding and confidence in the safety of vaccines in order to prevent resurgence in vaccine-preventable illnesses and deaths. The new policy specifically supports the rigorous scientific process undertaken by the Advisory Committee on Immunization Practices and its development of recommended immunization schedules for the nation. The policy also recognizes the substantial body of scientific evidence that has disproven a link between vaccines and autism.”

Centers for Disease Control and Prevention

“There is no link between vaccines and autism.”

March of Dimes

“The implication that vaccinations cause autism is irresponsible and counter productive,’ said Michael Katz, M.D., senior vice president for Research and Global Programs for the March of Dimes…

Although several carefully performed scientific studies have searched for a link between autism and the use of thimerosal in vaccines, no such link has been found.”

Autism Speaks

“Each family has a unique experience with an autism diagnosis, and for some it corresponds with the timing of their child’s vaccinations. At the same time, scientists have conducted extensive research over the last two decades to determine whether there is any link between childhood vaccinations and autism. The results of this research is clear: Vaccines do not cause autism.”

National Association of Pediatric Nurse Practitioners

“Despite an abundance of evidence that there is no correlation between the vaccine and autism, the story noted in the movie has unfortunately made a lasting impact. It is the responsibility of pediatric-focused advanced practice registered nurses (APRNs) and colleagues to speak out against false information and educate patient families about vaccine safety and efficacy to prevent unnecessary and potentially fatal outbreaks.”

American Academy of Child and Adolescent Psychiatry

“Years ago, some people questioned whether the onset of characteristic symptoms of autism coincided with the timing of immunizations. Since then, multiple studies conducted in several different countries have demonstrated that there is no causal association between vaccines and autism. Neither vaccines nor their preservatives increase the rate of autism compared to unvaccinated children. Vaccines do not change the timing of autism symptoms, nor is there any effect on autism severity. Even in families at greater risk for autism, for example, where there is already a child with autism, there is no increase in the likelihood that the second child will have autism if he or she is vaccinated. Recent studies have also demonstrated that brain changes associated with autism risk most likely occur before birth and well before any immunizations are ever administered.”

World Health Organization

“Available epidemiological data show that there is no evidence of a link between measles-mumps-rubella (MMR) vaccine and autism spectrum disorders. Previous studies suggesting a causal link were found to be seriously flawed.

There is also no evidence to suggest that any other childhood vaccine may increase the risk of autism spectrum disorders. In addition, evidence reviews commissioned by WHO concluded that there was no association between the use of vaccine preservatives such as thiomersal and autism spectrum disorders.”

Institute of Medicine

“Based on a thorough review of clinical and epidemiological studies, neither the mercury-based vaccine preservative thimerosal nor the measles-mumps-rubella (MMR) vaccine are associated with autism… Furthermore, the hypotheses regarding how the MMR vaccine and thimerosal could trigger autism lack supporting evidence and are theoretical only .”

Child Neurology Foundation

“There are many myths linked to vaccines that this article hopes to have helped dispel. As discussed, any potential risk associated with vaccines administered to healthy children is small and outweighed by the risk of the naturally occurring disease. Maintenance of herd immunity and avoidance of vaccine exemptions are critical. Both of these practices disproportionately affect, at times with deadly consequences, our youngest and most vulnerable citizens.”

Canadian Paediatric Society

“Thus, the evidence is in, and the assessment of purported causality is clear. The MMR vaccine and immunization with thimerosal-containing vaccines are not causally associated with, nor are they a cause of, autism or ASD. There is mounting evidence that ASD has a strong genetic component – a very plausible cause for the disorder.”

European Centre for Disease Prevention and Control

“Autism is such a strong and emotive issue and something we all care about. However, the link made by one doctor to autism has been firmly discredited, and I can show you study after study that demonstrates that there is no link between the MMR vaccine and autism. Unfortunately, once a seed of doubt has been planted it tends to grow, and is fueled by sensational media and internet coverage that isn’t concerned with the facts. The real issue here is the very real risks from not being protected. I wish the voices of those who have been victims of not getting vaccinated could be heard more loudly and clearly.”

Robert Koch Institute

“There has been an ongoing debate in recent years whether autism, diabetes and even multiple sclerosis could be triggered by vaccinations. To date, there is no evidence for this and there are numerous studies that suggest that there is no link between vaccinations and these diseases.”

Hopefully it is clear that these position statements about vaccines and autism come from experts around the world, including many that directly take care of and support autistic families.

What to Know About Expert Statements on Vaccines and Autism

There is no debate and it is not a controversy – experts agree – vaccines are not associated with autism.

More on Expert Statements on Vaccines and Autism

 

Vaccines and Autism Redux

Is it true that only one ingredient (thimerosal) and one vaccine (MMR) has ever been looked at for its relationship to autism?

No, as you can probably guess, it is not.

“This meta-analysis of five case-control and five cohort studies has found no evidence for the link between vaccination and the subsequent risk of developing autism or autistic spectrum disorder. Subgroup analyses looking specifically at MMR vaccinations, cumulative mercury dosage, and thimerosal exposure individually were similarly negative, as were subgroup analyses looking specifically at development of autistic disorder versus other autistic spectrum disorder.”

Taylor et al on Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies

Since much of the original focus about vaccines and autism was on the MMR vaccine and thimerosal, that’s where a lot of the research to reassure parents went first.

Other research has been done though too, so it really is safe to say that vaccines are not associated with autism, even though some may continue to see a correlation.

“To try to isolate the effects of thimerosal from other vaccine constituents, we performed a subanalysis comparing risks associated with diphtheria-tetanus-whole cell pertussis vaccine or diphtheria-tetanus-acellular pertussis vaccine and Haemophilus influenzae type b vaccine given separately or combined.”

Verstraeten et al on Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization Databases

The great majority of parents know that:

  • it is not the MMR vaccine
  • it is not thimerosal or thimerosal containing vaccines
  • it is not the overall number of vaccines that are given to a child
  • it is not the timing of when the vaccines are given to children

And it hasn’t been just one or two studies that have shown that there is no association between vaccines and autism. There are dozens. There is also a comprehensive review by the Institute of Medicine and a very large meta-analysis that have come to the same conclusion.

Vaccines are not associated with autism.

Vaccines and Autism Redux

Could it be aluminum though?

Why aluminum? Because anti-vaccine experts cite some poorly done studies that try to say it is.

Bob Sears appeared on Fox & Friends in 2010 for the segment "Vaccines: A Bad Combination?"
Bob Sears appeared on Fox & Friends in 2010 for the segment “Vaccines: A Bad Combination?”

Aluminum has become the new formaldehyde, which used to be the new thimerosal. It is apparently where the goalposts have shifted when some folks talk about vaccines and autism now that every knows it is not the MMR vaccine, thimerosal, vaccine overload, or the timing of vaccines.

But if studies have shown that it is neither the number of vaccines nor the timing of vaccines, then how could it be aluminum, an adjuvant in many vaccines?

It isn’t.

Aluminum is not the smoking gun or the missing puzzle piece that anti-vaccine folks will continue to look for.

What other myths about vaccines and autism have been coming up lately?

Have you heard the one about the court ruling confirming a vaccine autism link? It didn’t.

Did you know that the FDA officially announced that vaccines are causing autism? They didn’t, but do you know why some folks are now saying they did? Because of the old package insert for the Tripedia vaccine, which lists autism as a possible adverse event (without evidence of causation). The vaccine was discontinued years ago, but it continues to pop up as ‘new’ evidence for some as an association between vaccines and autism.

Or maybe you have heard these other new theories from the anti-vaccine movement as they desperately try to prove an association between vaccines and autism:

  • vaccines block folate uptake
  • MTHFR gene mutations
  • maternal immune activation
  • cytokine storms
  • glutathione depletion
  • glyphosate
  • DNA fragments
  • microbiota alterations
  • GI barrier defects
  • blood brain barrier permeability problems

You don’t even have to pick just one theory anymore (the fact that the MMR vaccine doesn’t contain thimerosal or aluminum kind of puts these theories into opposition with each other, doesn’t it?). You can choose for any or all of them to be true if you want. Using synergistic toxicity, you pick a few of your favorite theories and make them 100 times more likely to damage your child! Not really, but that’s how some anti-vaccine folks think.

“Autism is not an immune-mediated disease. Unlike autoimmune diseases such as multiple sclerosis, there is no evidence of immune activation or inflammatory lesions in the CNS of people with autism. In fact, current data suggest that genetic variation in neuronal circuitry that affects synaptic development might in part account for autistic behavior. Thus, speculation that an exaggerated or inappropriate immune response to vaccination precipitates autism is at variance with current scientific data that address the pathogenesis of autism.”

Gerber et al on Vaccines and Autism: A Tale of Shifting Hypotheses

Of course, none of them are true.

Vaccines are still not associated with autism.

What to Know About Vaccines and Autism

Vaccines are still not associated with autism, even though anti-vaccine folks continue to come up with new ideas for how it might be, from glyphosate and DNA fragments in vaccines to MTHFR mutations and maternal immune activation.

More on Vaccines and Autism

10 Reasons You Aren’t Vaccinating Your Kids

Yes, we know.

It’s because you have done your research.

“Many would argue that we have become a culture characterized by intolerance of any risk (particularly of co-mission as opposed to omission), such that when harm does occur someone is to blame.”

Poland et al on Understanding those who do not understand: a brief review of the anti-vaccine movement

But that’s not really why you aren’t vaccinating your kids.

10 Reasons You Aren’t Vaccinating Your Kids

Research has explained the real reasons, most of which happen subconsciously, and they include the following  well known cognitive phenomena:

  1. ambiguity aversion – the idea is that people tend to prefer known risks rather than unknown risks and while you would think that would tend to widely favor getting vaccinated (known, very small risks of a vaccine) vs remaining unprotected (relatively unknown risk of getting a vaccine-preventable disease and coping with possible complications), that’s not how vaccine-hesitant people think. If you are skipping or delaying any vaccines, you are likely to overestimate the risks of vaccines, include ‘risks’ that are not even associated with vaccines, and make getting vaccinated seem like a much bigger and ambiguous risk than it really is. Also, some vaccine-hesitant parents see much more ambiguity in the whole getting vaccinated decision than there really is, mostly because of the false balance in media reporting. There is no ambiguity – experts agree that vaccines are safe and necessary.
  2. anticipatory regret – you might decide to skip or delay a vaccine because you “wouldn’t be able to forgive yourself” if your child had a severe reaction, explaining the anti-vaccine slogan that “You can always get Vaccinated, but you can never get Unvaccinated.” While it is a catchy slogan, it misses the fact that some parents do regret their decision to not vaccinate their kids because they did wait too long and their child did get a vaccine-preventable disease. You can’t always get vaccinated and severe reactions are very rare.
  3. availability heuristic – we think things are likely to happen if we can easily remember them and we are most likely to remember things like vaccine scare stories because we see them all of the time. That doesn’t make them true or mean that they really are common though. Have you seen many of those videos?
  4. bandwagoning – many of us like to jump on the bandwagon – doing what everyone else is doing. So how does bandwagoning fit into vaccine hesitancy, considering that most people vaccinate and protect their kids? Just consider that many of unvaccinated kids we see today are grouped together in “pockets of susceptibles” because their vaccine-hesitant parents are also clustered together in an echo chamber, making it seem like skipping or delaying vaccines is a more popular option than it really is. Also, so much of the vaccine sentiment online is negative, it is easy for it to seem like it is the same in the real world. For example, it has been found that 75% of the vaccine sentiment on Pinterest, 66% of the vaccine sentiment on YouTube, and 30-35% of the vaccine sentiment on Facebook and Twitter is negative! Do your friends and family members vaccinate their kids?
  5. cognitive dissonance – this is the anxiety you get from believing in two things that contradict each other, like if you are afraid to vaccinate your child, but you are just as afraid that if he isn’t vaccinated, then he will get measles. One belief eventually wins out and makes it easier for you to believe anything else that reinforces it, even things that aren’t logical and which are easily disproven. Even if you don’t realize it, and you probably won’t, this is when you begin to use cherry picking, confirmation bias, survivorship bias, etc., and become a Dunning Kruger master.
  6. control – most of us like to be in control, or at least feel like we are in control. Saying no to a vaccine, especially a vaccine that you feel is involuntary (your child needs it to attend daycare or school), may help you feel a little more in control of what may seem like a never ending bombardment of risks facing your child.
  7. explanatory attribution – people like, or even need, to find a meaning for things, such as why kids are autistic, and when you don’t have one, it becomes very easy to make one up or latch onto someone else’s idea of a vaccine injury or vaccine induced disease.
  8. free-riding – while some people are hiding in the herd out of necessity, including those who are too young to be vaccinated and those with medical exemptions, others are free-riders and are benefiting from the fact that most of the rest of us do get vaccinated and do vaccinate our kids.
  9. omission bias – when given the option, some people prefer doing nothing instead of doing something, even if it leads to something much worse happening in the future. Choosing to do nothing, like skipping or delaying your child’s shots, is still a decision though, and if your child or someone else’s child gets sick, your action (by omission) is still the cause and you would still be morally responsible.
  10. optimism bias – some parents are overly optimistic about their ability to protect their intentionally unvaccinated kids from getting a vaccine-preventable disease or even that they can treat them if they do get sick with essential oils, homeopathic remedies, a trip to the chiropractor, or other alternative type treatments. They can’t.

Of course, none of these things would be able to take hold so well without one other thing – fear.

Fear helps these cognitive biases, heuristics, and logical fallacies take hold and change your perception of risk into something that is much different from reality. That’s why some people think that the risks of vaccines are greater than the risks of catching a vaccine-preventable disease or even greater than the risks of having a vaccine-preventable disease.

They aren’t. Vaccines are safe.

immunization-program-stages
As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks. Photo by WHO

Again, some people fear vaccines more than they fear the complications of vaccine-preventable diseases. Surprisingly, this effect is well known and has been predicted. If you don’t know or have never seen anyone with a vaccine-preventable disease, like polio, measles, diphtheria, or tetanus, then it’s easy to believe that they really were mild diseases.

They weren’t. And they still aren’t. Vaccines are necessary.

Rotavirus vaccines are associated with a very small risk of intussusception, but that is not a good reason to miss the benefits of this vaccine.
My daughter getting all of her two month vaccines to make sure she was safe and  fully protected. Photo by Vincent Iannelli, MD

But why are some parents so afraid of vaccines that they have panic attacks if they even think about vaccinating their baby? It certainly doesn’t help if you believe one or more of the 100 myths about vaccines that you might see on Facebook, Twitter, Pinterest, and YouTube. Or that you are likely constantly being hit with vaccine scare videos that make it sound like every child has a vaccine injury.

All of that propaganda can make you more susceptible to the cognitive biases that we all have to deal with from time to time, even leading you to believe in the many anti-vaccine conspiracy theories that are always floating around.

But fear shouldn’t be what drives your decision making.

We shouldn’t have to wait for outbreaks for folks to start vaccinating their kids again.

Get educated and understand that vaccines are safe, with few risks and many benefits. Learn to think critically, be more skeptical about the things you see and read about vaccines, and overcome your biases.

What to Know About Why You Aren’t Vaccinating Your Kids

You aren’t vaccinating your kids because something or someone has scared you and a series of cognitive bias are making it hard for you to see the truth that vaccines are safe, necessary, and that they work.

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