How do you avoid fighting with friends and family when you get together at the holidays?
Some say to talk about whatever you want, but just have empathy for others when you talk about controversial topics.
Other experts say to simply avoid talking about things like politics, religion, and sex.
Going that route, it is easy to imagine that the list of things that you can’t talk about can get pretty long in some families.
Topics Too Dangerous To Avoid
Are some topics too dangerous to avoid talking about?
I’m not talking about in the long-term, what’s going to happen to our world kind of dangerous, but short term dangers to your kids and the rest of your family.
For example, what if you instinctively think that you should avoid talking about guns when visiting your uncle’s house, because you remember seeing all of his Facebook posts about the NRA. But you want to make sure there aren’t any unsecured guns lying around the house that your toddler could find. Do you ASK about guns in the house?
It should be clear that they are not all fully vaccinated. At least one of the grandchildren is just 6-months-old, so is too young to be fully vaccinated. She will not get her first dose of MMR and chicken pox vaccine, for example, until she is at least 12 months old.
But she isn’t the only one at risk. The other children and adults could be at risk because no vaccine is 100% effective. Vaccines work and they work very well. They just aren’t perfect.
What Ask Amy Gets Right and Wrong
Ask Amy was smart to turn to a pediatrician for help on this question.
And Dr. Thoele is right, this intentionally unvaccinated child is getting away with hiding in herd (at least so far) and won’t get anyone else sick unless he is exposed first and gets sick himself.
“If you choose to delay some vaccines or reject some vaccines entirely, there can be risks. Please follow these steps to protect your child, your family, and others.”
CDC on If You Choose Not to Vaccinate Your Child, Understand the Risk and Responsibilities
Many of us would take exception to the part that it is “highly unlikely” that this child could get a vaccine-preventable disease though. There are usually one or more outbreaks of chicken pox, mumps, pertussis, and measles, etc., going on in different parts of the United States throughout the year. And because parents who don’t vaccinate their children often cluster together in groups, it increases the chances that their kids will catch something.
Have they traveled out of the country? Have they been exposed to someone who has? That increases their risk too.
“(Dr) Thoele and I both hope that everyone attends the family get-together and that all family members should try their best to be nice to one another. There is, fortunately, no vaccine preventing that.”
So should this intentionally unvaccinated toddler come to the holiday party?
Should other kids come if the unvaccinated child will be there?
While no one wants a family to be split over such a matter or for grandparents to be put in the middle, it is a much more complicated issue than wishing that everyone play nice.
Not surprisingly, pediatricians get asked about these kinds of situation all of the time:
Should new parents allow family members to visit if they won’t get a flu shot?
When can they allow a family member to see their new baby if they won’t get a Tdap booster?
What do they do about the family members who don’t get vaccinated and don’t even take their kids to the doctor for regular checkups?
And what’s the answer?
Understand that kids aren’t at least partially protected against:
pertussis until after the third dose of DTaP at six months
the flu until after getting a first flu shot at six months, keeping in mind that they are actually going to need a second flu shot for full protection, since it is the first time that they are being vaccinated against influenza
measles, mumps, and chicken pox until they get their first dose of MMR and the chicken pox vaccine when they are 12 months old
And that’s why many parents would not, if they had a choice, expose their children to an intentionally unvaccinated child until after they had at least had their 12 to 15 month vaccines. By this time, they have also gotten 3-4 doses of Hib and Prevnar, and have completed their rotavirus vaccines.
Of course, if the child, or any of the adults, had an immune system problem, were getting treated for cancer, or had any other condition that would put them at higher risk for getting a vaccine-preventable disease, then they would likely never voluntarily expose themselves to someone who was intentionally unvaccinated.
We often have to remind people that the anti-vaccine movement didn’t start with Bob Sears, or Jenny McCarthy, or even with Andy Wakefield.
Did you know that the Reverend Cotton Mather’s house was bombed in Boston in 1721? Well, someone through a bomb through his window. Fortunately, it didn’t go off.
That’s 77 years before Jenner developed his smallpox vaccine!
What was Mather doing?
He had started a smallpox variolation program. He was trying to protect people in Boston from smallpox during one of the most deadly epidemics of the time.
So essentially, the anti-vaccine movement started before we even had real vaccines…
Is the Anti-Vaccine Movement Growing?
You see reports of more and more outbreaks of vaccine-preventable diseases, hear about new vaccine laws and mandates, and depending on who your friends are, may see a lot of anti-vaccine articles and vaccine injury stories getting shared on Facebook.
You have probably even heard about pediatricians firing families who refuse to vaccinate their kids.
So what’s the story?
Is the anti-vaccine movement growing?
Is there a growing resistance among parents to getting their kids vaccinated?
“Parents are taking back the truth. It is my expectation that this crack in the dam will serve to sound an alarm. To wake women up. To show them that they have relinquished their maternal wisdom, and that it is time to wrest it back.”
Kelly Brogan, MD
Is the world finally “waking up to the dangers of vaccines,” like many anti-vaccine experts have been claiming for years and years?
The Anti-Vaccine Movement is not Growing
Many people will likely tell you that the anti-vaccine is in fact growing.
You can read it in their headlines:
The worrying rise of the anti-vaccination movement
Will 2017 be the year the anti-vaccination movement goes mainstream?
Pediatricians calling anti-vaccine movement a growing problem
There’s Good Evidence That The Anti-Vaccine Movement Is Growing
I was skeptical that the anti-vaccine movement was gaining traction. Not anymore.
But the anti-vaccine movement is not necessarily growing.
The overwhelming majority of parents and adults are fully vaccinated.
Most parents do their research though, don’t jump on the anti-vaccine bandwagon, and know that vaccines work, vaccines are safe, and vaccines are necessary.
The Anti-Vaccine Movement is Changing
A lot about the anti-vaccine movement hasn’t changed over the last 100 plus years.
Many early critics of vaccines were alternative medicine providers, including homeopaths and chiropractors, just like we see today. And like they do today, they argued that vaccines didn’t work, vaccines were dangerous, and that vaccines weren’t even necessary.
The big difference?
Unlike when Lora Little, at the end of the 19th century, had to travel around the country to distribute her anti-vaccine pamphlet, Crimes of the Cowpox Ring, anti-vaccine folks can now just tweet or post messages on Facebook. It is also relatively easy to self-publish an anti-vaccine book and sell it on Amazon, put up your own anti-vaccine website, post videos on YouTube, or even make movies.
“Whatever you think about Andrew Wakefield, the real villains of the MMR scandal are the media.”
Ben Goldacre on The MMR story that wasn’t
Fortunately, all of that is balanced by something they don’t have anymore.
No, it’s not science. That was never on their side.
It’s that the media has caught on to the damage they were doing and isn’t as likely to push vaccine scare stories anymore.
Explaining the Popularity of the Anti-Vaccine Movement
The anti-vaccine movement has always been around and they are likely not going anywhere, whether or not they are growing.
“By the 1930s… with the improvements in medical practice and the popular acceptance of the state and federal governments’ role in public health, the anti-vaccinationists slowly faded from view, and the movement collapsed.”
Martin Kaufman The American Anti-Vaccinations and Their Arguments
Why so many ups and downs?
It is easily explained once you understand the evolution of our immunization programs, which generally occurs in five stages:
pre-vaccine era or stage
increasing coverage stage – as more and more people get vaccinated and protected, you pass a crossover point, where people begin to forget just how bad the diseases really were, and you start to hear stories about “mild measles” and about how polio wasn’t that bad (it usually wasn’t if you didn’t get paralytic polio…)
loss of confidence stage – although vaccine side effects are about the same as they always were, they become a much bigger focus because you don’t see any of the mortality or morbidity from the diseases the vaccines are preventing. It is at this point that the anti-vaccine movement is able to be the most effective.
resumption of confidence stage – after the loss of confidence in stage three leads to a drop in vaccine coverage and more outbreaks of a vaccine-preventable disease, not surprisingly, more people understand that vaccines are in fact necessary and they get vaccinated again. It is at this point that the anti-vaccine movement is the least effective, as we saw after outbreaks of pertussis in the UK in the 1970s and measles more recently. You also see it when there is a report of an outbreak of meningococcal disease on a college campus or a child dying of the flu on the local news, etc.
eradication stage – until we get here, like we did when smallpox was eradicated, the anti-vaccine movement is able to cycle through stages two to four, with ups and downs in their popularity,
So the anti-vaccine movement is able to grow when they have the easiest time convincing you that the risks of vaccines (which are very small) are worse than the risks of the diseases they prevent (which are only small now, in most cases, because we vaccinate to keep these diseases away, but were life-threatening in the pre-vaccine era).
“As vaccine use increases and the incidence of vaccine-preventable diseases is reduced, vaccine-related adverse events become more prominent in vaccination decisions. Even unfounded safety concerns can lead to decreased vaccine acceptance and resurgence of vaccine-preventable diseases, as occurred in the 1970s and 1980s as a public reaction to allegations that the whole-cell pertussis vaccine caused encephalopathy and brain damage. Recent outbreaks of measles, mumps, and pertussis in the United States are important reminders of how immunization delays and refusals can result in resurgences of vaccine-preventable diseases.”
Paul Offit, MD on Vaccine Safety
Fortunately, most parents don’t buy into the propaganda of the anti-vaccine movement and don’t wait for an outbreak to get their kids vaccinated and protected. They understand that you can wait too long.
The bottom line – except for pockets of susceptibles and clusters of unvaccinated kids and adults, most people are vaccinated. If the anti-vaccine does grow, it eventually gets pulled back as more kids get sick.
What to Know about the Growing Anti-Vaccine Movement
Although they may have an easier time reaching more people on Twitter, Facebook, YouTube, and with Amazon, the overwhelming majority of parents vaccinate their kids and aren’t influenced by what some people think is a growing anti-vaccine movement.