Tag: cognitive bias

How To Counter Vaccine Hesitancy

There is nothing wrong with having questions about vaccines. And there is certainly nothing wrong with doing a little, or even a lot of research about vaccines.

“We are not against vaccines. Just because we have hesitancies and valid concerns about injecting our baby with specific chemicals and toxins does not mean we are anti anything…

As a soon-to-be-parent [and especially as a first-time-mom] I do feel it my responsibility to have questions, and to listen to my motherly instinct to question things, and do my research.”

Kat Von D

The problem comes when the answers folks get come from misinformation, and it leads them to skip or delay their child’s vaccines, leaving them unprotected.

What is Vaccine Hesitancy?

To counter vaccine hesitancy, you likely first need to understand what it means.

“Vaccine hesitancy refers to delay in acceptance or refusal of vaccines despite availability of vaccination services. Vaccine hesitancy is complex and context specific varying across time, place and vaccines. It includes factors such as complacency, convenience and confidence.”

SAGE Vaccine Hesitancy Working Group

So it means someone who is anti-vaccine, right?

Not exactly.

“Although many may characterize all individuals who eschew vaccines as “anti-vaccine” or “vaccine deniers,” in reality there is a broad spectrum of individuals who choose not to have themselves or their children vaccinated.”

Tara C Smith on Vaccine Rejection and Hesitancy: A Review and Call to Action

Many of the folks who are vaccine hesitant aren’t truly anti-vaccine. They are likely being misled by anti-vaccine myths and propaganda, but at least they aren’t the ones spreading it across Facebook or on their own blogs and anti-vaccine websites.

How To Counter Vaccine Hesitancy

How do you counter vaccine hesitancy?

“It’s unfair for anyone to expect me [or any parent] to take the word of the pharmaceutical companies who have much to gain from and industry worth billions without question – and then have to dismiss any concerns of my own.”

Kat Von D

You learn to answer all of the questions and concerns that these parents might have about vaccines and vaccine-preventable diseases, including the risks and benefits of vaccines and the risks of being unvaccinated.

“Well, if you’re going to inform yourself about vaccines, I think anybody who’s truly informed will realize that getting a vaccine is much better than not getting one. If you’re choosing not to vaccinate your child, it’s because you’re getting, frankly, bad information about vaccines.”

Paul Offit, MD

You also make sure that parents, teachers, nurses, doctors, pharmacists, reporters, and everyone else gets good information about vaccines.

And you call out the misinformation and out-right lies of the anti-vaccine movement, especially when they say that vaccines never work, are always dangerous and full of toxins, or aren’t necessary.

You don’t let parents get manipulated by the anti-vaccine industry, which has gotten very good at selling fear – literally.

Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain because they are all an illusion.
Like the card trick in My Cousin Vinny, anti-vaccine talking points are easy to explain away, because they are all an illusion.

Remember, there is not one anti-vaccine argument or talking point that ever holds water.

Why not?

Because unless you go cherry picking, the evidence overwhelmingly shows that vaccines work, vaccines are safe, and vaccines are necessary.

What to Know About Countering Vaccine Hesitancy

If you are on the fence or scared to vaccinate your kids, let us help you learn why vaccines are safe and necessary and arguments against vaccines never hold water.

More on Countering Vaccine Hesitancy

Comparing Lightning Strikes to Measles Deaths

Have you ever heard that your child has more of a chance of getting hit by lightning than getting measles?

Since getting struck by lightning is rare, folks like to use it in comparisons to other things that they also think are low risk when trying to make a point.

There are problems with this type of argument though.

Understanding Risk Perception

In an age when many folks are overly anxious about things, it is important to understand the difference between real and perceived risks. Unfortunately, our biases often lead us to worry about the wrong things, sometimes with tragic consequences.

“No intervention is absolutely risk free. Even the journey to a physician’s office with the intention to receive a vaccination carries the risk of getting injured in an accident. With regards to risks of vaccination per se, one has to distinguish between real and perceived or alleged risks.”

Heininger on A risk–benefit analysis of vaccination

Vaccines have risks, but they are small risks, as we know that vaccines are safe and necessary and the decision to skip or delay your child’s vaccines carries with it a much greater risk.

Comparing Lightning Strikes to Vaccine Preventable Diseases

How common or rare do you think it is to get hit by lightning?

  • odds of being hit by lightning – 1 in 1,171,000 (each year)
  • odds of ever being hit by lightning – 1 in 14,600 (lifetime risk)
  • on average, 26 people die after being struck by lightning each year (since 2007), which is down from a recent historical average of 45 deaths per year (30 year average) and way down from when we used to see 400 lightning strike deaths each year before 1950
  • on average, 252 people are injured after being struck by lightning each year
Actually, just since 2000, at least 5 people have died of measles in Canada.
Actually, just since 2000, at least 6 people have died of measles in Canada.

Although 26 people dying after lightning strikes sounds like way too many to me, especially since one recent death was a 7-year-old boy in Tennessee playing under a tree, with 1 in 1,171,000 odds of getting hit, it sounds like we are pretty safe.

But is it fair to use those odds to justify your decision to keep your kids unvaccinated?

Of course not!

Why is our risk of getting struck by lightning so low?

What happens when we hear thunder or see lightning?

When Thunder Roars, Go Indoors!

What happens when a thunder storm approaches and you are at your kids soccer or baseball game?

“Postpone or suspend activity if a thunderstorm appears imminent before or during an activity or contest (irrespective of whether lightning is seen or thunder heard) until the hazard has passed. Signs of imminent thunderstorm activity are darkening clouds, high winds, and thunder or lightning activity.”

UIL on Lightning Safety

Many ball fields now have lightning detectors to alert officials of nearby storms. And just about everyone has access to weather apps on a smart phone that can alert them to an approaching thunder storm or nearby lightning strikes.

The point is that most of us understand that lightning is dangerous, so we go far out of our away to avoid getting hit. The risk of getting hit by lightning isn’t 1 in 1,171,000 with folks running around outside waving golf clubs in the air during thunder storms or sitting on their roofs under an umbrella watching the storm.

The risk of getting hit by lightning is 1 in 1,171,000 because most of us go inside once we know lightning is nearby.

“Based on the media reports of the fatal incidents, many victims were either headed to safety at the time of the fatal strike or were just steps away from safety. Continued efforts are needed to convince people to get inside a safe place before the lightning threat becomes significant. For many activities, situational awareness and proper planning are essential to safety.”

A Detailed Analysis of Lightning Deaths in the United States from 2006 through 2017

And the same is true with measles and other vaccine-preventable diseases. They aren’t as common as they once were because most of us are vaccinated and protected.

If you skip or delay your child’s vaccines, you will increase the risk that they will get one of these vaccine-preventable diseases. And you will increase the risk that they will get someone else sick.

“I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the diseases increase significantly.”

Dr. Bob Sears in The Vaccine Book

And if enough people don’t get vaccinated, herd immunity fails, and we will see a return of pre-vaccine era levels of disease.

What to Know About Vaccines and Risk Perception

Folks often misuse lightning strikes when they think about risks, not understanding that the risk of getting hit by lightning is low because we take a lot of precautions to avoid getting hit by lightning.

More on Vaccines and Risk Perception

8 Myths About Pediatricians Who Fire Families Who Don’t Vaccinate Their Kids

What actually happens when a pediatrician has a vaccine policy that requires parents to vaccinate their kids or face dismissal from the practice?

Not surprisingly, there are a lot of myths about the controversial issue of pediatricians dismissing families who don’t vaccinate their kids.

1 ) It is a myth that the American Academy of Pediatrics has a policy encouraging pediatricians to dismiss families who don’t vaccinate their kids.

There is no such policy.

Instead, in 2016, about 400 leaders from AAP chapters, committees, councils, and sections voted on a resolution at the 2016 AAP Annual Leadership Forum (ALF) to support pediatricians who dismissed families who didn’t vaccinate their kids.

RESOLVED, that the Academy support, in their policy statements and clinical guidelines about immunizations, pediatricians who decide to discharge patients after a reasonable, finite amount of time working with parents who refuse to immunize their children according to the recommended schedule or who fail to abide by an agreed-upon, recommended catch-up schedule, and be it further RESOLVED, that the Academy continue to support pediatricians who continue to provide health care to children of parents who refuse to immunize their children.

Resolution #80.81SB Supporting Pediatricians Who Discharge Families Who Refuse to Immunize

The resolution also voiced support for pediatricians who didn’t dismiss these patients.

2)  It is a myth that pediatricians dismissing families who don’t vaccinate their kids is a new thing.

Although it is getting a lot more attention now, since that 2016 resolution and a report on Countering Vaccine Hesitancy that soon followed, dismissing or firing families who don’t vaccinate their kids is not new.

A 2005 AAP report, Responding to Parental Refusals of Immunization of Children, discusses the issue.

“In general, pediatricians should avoid discharging patients from their practices solely because a parent refuses to immunize his or her child. However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice.”

Responding to Parental Refusals of Immunization of Children

And a study, Dismissing the Family Who Refuses Vaccines, also published in 2005, made it clear that many pediatricians “would discontinue care for families refusing some or all vaccines.”

3)  It is a myth that dismissing families who don’t vaccinate their kids is an evidence based policy.

There is nothing beyond anecdotal evidence that families, when faced with the decision of getting vaccinated or getting dismissed from an office, will choose to get vaccinated.

Again, the latest resolution supporting the idea of dismissing families came because it was voted on and became an official Annual Leadership Forum resolution. In general, only the top 10 ALF resolutions are acted upon urgently by the AAP.

At the time, many pediatricians felt constrained by the previous statements from the AAP that discouraged dismissing these families.

4)  It is a myth that pediatricians dismiss families who don’t vaccinate their kids because they don’t want to be bothered talking about vaccine safety.

Although few pediatricians would want to talk to a parent who is arguing that vaccines are poison, aren’t necessary, and never work, fortunately, most vaccine-hesitant parents don’t actually talk like that. They are usually on the fence or simply scared because of all of the anti-vaccine propaganda they are exposed to and need a little extra time to understand that vaccines are safe and necessary.

A typical vaccine policy gives a parent plenty of time to get their child caught up on vaccines before they might be dismissed from the office.
A typical vaccine policy gives a parent plenty of time to get their child caught up on vaccines before they might be dismissed from the office.

And most pediatricians give them that extra time and do talk to them about their concerns. Despite the perception from some of the headlines you might see, families typically don’t get fired after one visit because they refused one or more vaccines.

5) Pediatricians who don’t dismiss unvaccinated families are supporting the use of alternative vaccine schedules.

While this is certainly true for some providers who actually advertise that they are “vaccine-friendly” and encourage parents to follow a non-standard, parent-selected, delayed protection vaccine schedule, most others understand that there is no evidence to support these alternative schedules and they are simply tolerated until the child can get caught-up with all of his vaccines.

6) It is illegal to dismiss a family who doesn’t want to vaccinate their kids.

While some pediatricians think that it is a bit of an ethical dilemma, the legal issues are very clear.

Physicians can’t simply abandon a patient so that they go without care, but they are typically free to end the physician-patient relationship after giving them formal, written notification, and continuing to provide care (at least in emergency situations) for a reasonable amount of time, giving the family time to find a new physician.

Of course, state and federal civil rights laws protect families from being terminated because of sex, color, creed, race, religion, disability, ethnic origin, national origin, or sexual orientation.

7)  It is a myth that dismissing families who don’t vaccinate their kids will protect those families who do vaccinate and protect their kids.

This is often the main reason that pediatricians use to justify dismissing families who don’t vaccinate their kids. After all, it isn’t fair to the families who come to your office, those who do get vaccinated and protected, if someone who is intentionally not vaccinated gets measles and exposes them all, right?

There seem to be several problems with this idea though:

  • relatively few exposures during outbreaks actually occur in a pediatrician’s office. Looking at most recent measles outbreaks, for example, exposures were more likely to occur while traveling out of the country, in an urgent care center, emergency room, somewhere in the community, or in their own home.
  • infants who get pertussis are usually exposed by a family member
  • while measles is very contagious and the virus can linger in an exam room for hours, other vaccine-preventable diseases are far less contagious. Mumps, for example, typically requires prolonged, close contact, which is why you are unlikely to get mumps at your pediatrician’s office.
  • when dismissed by their pediatrician, there is a concern that families might cluster together in the offices of a vaccine-friendly doctor or holistic pediatrician, making it more likely for outbreaks to erupt in their community if any of them get sick

And that’s the key point. Just because families get dismissed from a pediatrician’s office, it doesn’t mean that they leave the community. Your patients might still see them at daycare, school, at the grocery store, or walking down their street.

Pediatricians who don’t dismiss families who don’t vaccinate their kids often feel that it is better to keep working to help them understand that vaccines are safe and necessary, so that they eventually do get vaccinated and protected.

What about the extra risk in their own offices?

With RSV, strep, cold viruses, and everything else that kids have in the average pediatrician’s office, it is best to take steps to reduce the chances that kids are exposed to all of them. How do you do that? Don’t have a waiting room full of kids that are exposing each other to germs!

8) Most families don’t vaccinate their kids because they don’t trust their pediatrician.

While this is likely true for some, those families who want to see a pediatrician and don’t refuse any other treatments, like their newborn’s vitamin K shot and eye ointment, likely do trust their pediatrician.

Then why don’t they vaccinate and protect their kids?

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

They are likely afraid.

What are they afraid of?

More and more these day, if you ask them, they will likely tell you that they don’t know. It would be much easier if they were afraid of something specific, like the myth that a baby’s immune system is too immature to handle any vaccines, that there are hidden ingredients in vaccines, or that vaccines are somehow associated with autism.

You can answer specific questions about vaccines, but it is harder when they are afraid because they see anecdotal vaccine scare videos or because friends and family members are feeding them misinformation.

“With all the challenges acknowledged, the single most important factor in getting parents to accept vaccines remains the one-on-one contact with an informed, caring, and concerned pediatrician.”

“…nearly half of parents who were initially vaccine hesitant ultimately accepted vaccines after practitioners provided a rationale for vaccine administration.”

“Developing a trusting relationship with parents is key to influencing parental decision-making around vaccines.”

“Pediatricians should keep in mind that many, if not most, vaccine-hesitant parents are not opposed to vaccinating their children; rather, they are seeking guidance about the issues involved, beginning with the complexity of the schedule and the number of vaccines proposed.”

“Because most parents agree to vaccinate their children, this dialogue, which can be started as early as the prenatal interview visit if possible, should be an ongoing process.”

AAP on Countering Vaccine Hesitancy

Whatever their vaccine policy, pediatricians should all work to counter vaccine misinformation and propaganda, so that our families get vaccinated and protected and our communities are safe.

It is also clear that we need new ways to talk about vaccines.

And we definitely new more ways to help everyone learn to think critically, be more skeptical about the things they see and read, and overcome their biases.

What to Know About Pediatricians Who Discharge Families Who Refuse to Immunize Their Kids

Whether they have a vaccine policy that dismisses families who don’t vaccinate their kids or they continue seeing them, pediatricians want to do what is best for their kids.

More on Pediatricians Who Discharge Families Who Refuse to Immunize Their Kids

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

For the overwhelming majority of us, it seems like a simple decision – get your kids vaccinated and protected and avoid all of the risks of vaccine-preventable diseases.

After all, we understand that vaccines are safe and necessary.

But folks who choose to skip or delay vaccines want to do what is best for their kids too, even as they come to the exact opposite decision, so who is making the smarter choice?

Are Anti-Vaccine Folks Smarter Than the Rest of Us?

Not surprisingly, anti-vaccine folks think they are smarter.

Why?

“In the end we are left with a powerful sense of knowledge – false knowledge. Confirmation bias leads to a high level of confidence, we feel we are right in our gut. And when confronted with someone saying we are wrong, or promoting an alternate view, some people become hostile.

The Dunning-Kruger effect is not just a curiosity of psychology, it touches on a critical aspect of the default mode of human thought, and a major flaw in our thinking. It also applies to everyone – we are all at various places on that curve with respect to different areas of knowledge. You may be an expert in some things, and competent in others, but will also be toward the bottom of the curve in some areas of knowledge.”

Steven Novella on Lessons from Dunning-Kruger

While it is easy to blame it on the Dunning-Kruger effect, a study that appeared in the July 2004 issue of Pediatrics, Children who have received no vaccines: who are they and where do they live?, is often used by anti-vaccine folks to reinforce the idea that they are smarter.

“Undervaccinated children tended to be black, to have a younger mother who was not married and did not have a college degree, to live in a household near the poverty level, and to live in a central city. Unvaccinated children tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding 75,000 dollars, and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children”

Children who have received no vaccines: who are they and where do they live?

But the part of the study that is often quoted is comparing unvaccinated vs undervaccinated.

In the same study, the education level of unvaccinated vs vaccinated is virtually the same.

And the differences for the unvaccinated vs undervaccinated kids was about their living near the poverty level. If these families grew up with less money, they likely had less opportunities to go to school, and unfortunately, had less opportunities to keep their kids up-to-date on their vaccines.

One study, Maternal characteristics and hospital policies as risk factors for nonreceipt of hepatitis B vaccine in the newborn nursery, did seem to associate a higher education level with refusing the newborn hepatitis B vaccine, but an even bigger factor was being born in a facility that actually had a policy that offered the vaccine.

“Likewise, vaccine refusal now appears to be less a function of socioeconomic status than it once was. Previously, maternal education was strongly associated with vaccine refusal, but now mothers without a high school diploma are even more likely than college graduates to have unvaccinated children . Also, unvaccinated children are no longer found primarily in the highest income households (perhaps a function of income data being top-coded at $50,000), but now are equally likely to live in households with more moderate (or even below poverty) incomes.”

Laura Blakeslee on Trends and Characteristics of Unvaccinated Children in the United States : The National Immunization Survey, 2002 − 2010

Other studies have either showed a higher level of college graduates for those who vaccinated their kids or no difference.

What about all of the experts in the anti-vaccine movement? Remember that the heroes and so called experts of the the anti-vaccine movement mostly includes celebrities, some doctors and scientists who are practicing way out of their field of expertise when they talk about vaccines, and others whose work is not supported by the great majority of experts in their field.

That’s not necessarily the end of the story though.

Yet another study (a small survey), Parental Delay or Refusal of Vaccine Doses, Childhood Vaccination Coverage at 24 Months of Age, and the Health Belief Model, found that as compared to parents who vaccinated their kids, those who delayed or refused vaccines:

  • were less likely to think that vaccines were necessary
  • were less likely to think that their kids would get a disease if they weren’t vaccinated
  • were less likely to believe that vaccines are safe
  • were more likely to believe that vaccines caused serious side effects
  • were more likely to believe that children get too many vaccines

And surprisingly, considering that the above things are basically anti-vaccine talking points that are easily disproven, they were actually more likely to have gone to college and to be a college graduate. It is not a surprise that they were less likely to have a good relationship with their doctor and were less likely to believe that their doctor had their child’s best interest at heart.

Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning.
Parents unknowingly gave their infants teething powder made with mercury, causing pink disease or mercury poisoning. Ironically, a decrease in illiteracy levels might have been the cause.

So maybe some anti-vaccine parents are indeed well-educated about some things, but that just gets us back to the Dunning-Kruger effect, as they certainly aren’t making smart decisions about vaccines.

Fortunately, this is still a very small, although very vocal, minority of people, as most parents vaccinate and protect their kids.

What to Know About Anti-Vaccine Intelligence and Education

Parents who choose to skip or delay their child’s vaccines are not making smart decisions about vaccines.

More on Anti-Vaccine Intelligence and Education

Dear Anti-Vaxxers,

As someone who has always understood that vaccines are safe and necessary, who vaccinates his children, I’m asking you to hear me out.

Dear anti-vaxxers. Vaccinate your kids.

I don’t think that you are either stupid, uneducated, crazy, or that questioning vaccine safety is always associated with  believing in conspiracy theories.

I understand and appreciate that you do care about your children, that you care about their health, and that you want what’s best for your family.

I actually do get that. I really do.

But I know that while you believe that you have done years of research and investigation to help you decide that the potential benefits of vaccines don’t outweigh their risks, going out of your way to find information to support your decision and ignoring all of the rest that says you are wrong, isn’t really doing research.

Whether you have never set foot on a college campus, you have a PhD in immunology, or you are a toxicologist, I know that you are still vulnerable to the same cognitive biases, heuristics, and logical fallacies as everyone else, and those can keep you from coming to a truly informed decision.

And I know that you are mostly motivated by fear, anger, and mistaken ideas of vaccine injury, vaccine induced disease, and unexplained illness and sudden deaths.

We all care about our children and families. The difference between us is that you still believe that there are two sides to the vaccination debate.

There isn’t.

Vaccines are safe, necessary, and they work well to protect our kids from life-threatening vaccine-preventable diseases.

No, vaccines are not 100% safe and they don’t work 100% of the time, but neither are they responsible for all of the things you see in vaccine scare stories or all of the so-called vaccine induced diseases we hear about.

“What if doctors never actually learn about vaccines, their ingredients, or adverse events, in medical school? What if the medical textbooks are written with an enormous amount of funding from the pharmaceutical industry? What if the CDC owns patents on vaccines? What if the pharmaceutical industry is corrupt and funds studies which conveniently stop monitoring test subjects before adverse effects begin to manifest? What if vaccines contain toxic substances at levels which can cause chronic illness when children are repeatedly injected with them? What if we are trading temporary illness for the development of autoimmune and neurological disease later in life? What if the threat and danger of these “preventable” diseases has been inflated to push more vaccines? What if these vaccines are not even truly effective as we have been led to believe and we will always need more booster shots to try to make up for that fact? What if there is evidence for all of the above, you just haven’t seen it yet?”

Ashley Everly Cates

Listen.

If you don’t want to vaccinate your kids, then don’t.

But don’t be influenced by folks who say they have done their research and don’t believe in conspiracy theories, but use a book by Neil Z Miller as a reference and push every major anti-vaccine conspiracy theory.

And don’t expect that your vaccine choice will be consequence free, including that your child will be at increased risk to get a vaccine-preventable disease, you will be putting others at risk to get a vaccine-preventable disease if your intentionally unvaccinated child gets sick, and you may be kept out of daycare or school if you live in a state that doesn’t allow non-medical exemptions.

I hope that you will keep an open mind and genuinely take time to look into this for yourself, beyond the myths and claims of anti-vaccine heroes who ignore or are unaware of the massive amount of evidence that contradict their claims.

Please take caution and know that I don’t do this to be popular. I don’t do this to make friends, get likes on my Facebook page, or sell vitamins and supplements in an online store.

Truly. The only reason I speak out is to protect my children and your children from unnecessary harm.

After all, is it really so hard to believe that the great majority of pediatricians, infectious disease specialists, immunologists, toxicologists, and public health experts in the world and throughout history are right about vaccines?

More for Anti-Vaxxers

Are You Too Scared to Vaccinate Your Kids?

These days, if a parent suggests to their pediatrician that they might want to skip or delay their child’s vaccines, it is typically not because they are afraid of any association with autism, or because they have been influenced by Jenny McCarthy or Andrew Wakefield, or even because they have done a lot of research.

It is mostly because they are scared.

Are You Too Scared to Vaccinate Your Kids?

What are they scared of specifically?

“In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines.”

Marian Siddiqui et al on the Epidemiology of vaccine hesitancy in the United States

Surprisingly, there often isn’t anything specific that they are scared of. That’s unfortunate, as it makes it harder to offer reassurance when they don’t have specific questions or concerns.

Still, something is scaring these parents, sometimes to the point that they have panic attacks if they even think about vaccinating their kids.

“…many parents are inundated with horror stories of vaccine dangers, all designed to eat away at them emotionally while the medical and scientific communities have mounted their characteristic response by sharing the facts, the data, and all of the reliable peer-reviewed and well-cited research to show that vaccines are safe and effective.”

Federman on Understanding Vaccines: A Public Imperative

What has them so scared?

Could it be:

Whatever it is, it builds up to the point to where these parents fear the risks of vaccines more than they fear the risks and complications of vaccine-preventable diseases.

As more people are vaccinated and diseases disappear, they forget how bad those diseases are, skip or delay getting their vaccines, and trigger outbreaks.
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

That’s not surprising.

After all, why fear polio, measles, diphtheria, or tetanus, etc., if you have never had or known anyone that has had one of these now vaccine-preventable diseases? Why fear them, if you have never known anyone who has died with one of these now vaccine-preventable diseases?

And why trust that you should vaccinate your kids when you are likely inundated with messages about vaccines being poison, a Big Pharma conspiracy, or that you can just heal your child with some garlic and essential oils if they get sick?

Reducing Anxiety from Vaccinations

Have any ideas on how to get over your anxiety about vaccinations?

To start, learn that vaccines are safe, necessary, and they work to protect your kids and that all of the messages you are hearing about vaccines that have been scaring you aren’t true. You have probably already realized that on some level, but there are cognitive biases, heuristics, and logical fallacies that work together to change our perception of risk, keep us believing things aren’t true, and in this case, can keep you from vaccinating and protecting your kids.

It can also help to learn to think critically and be more skeptical about the things you see and read about vaccines, especially if you aren’t sure about the source of the information.

“The Internet has been identified as an important source for parents to seek and share vaccine information. There are concerns that parental fears or hesitancy on childhood immunizations are increasing due to the popularity of social media and exposure to online antivaccination sentiment.”

Tustin et al on Internet Exposure Associated With Canadian Parents’ Perception of Risk on Childhood Immunization: Cross-Sectional Study

Don’t let a small, yet vocal anti-vaccine minority scare you into a poor decision about your child’s vaccines.

What to Know About Being Too Scared to Vaccinate Your Kids

Parents who are inundated with anti-vaccine messages and misinformation sometimes get too scared to vaccinate their kids, fearing vaccines more than they fear the diseases they prevent.

More on Being Too Scared to Vaccinate Your Kids

Grave Reminders of Life Before Vaccines

Need a reminder of just how serious vaccine preventable diseases can be?

Don’t remember the pre-vaccine era?

That could be why some folks are so quick to think that skipping or delaying vaccines is a safe option for their kids.

Vaccines are necessary.

Without them, we will see even more outbreaks of measles, mumps, and pertussis and kids will continue to die of rabies, tetanus, and other now vaccine-preventable diseases.

The South Park Cemetary was begun in 1891 during a diphtheria epidemic.
A diphtheria cemetery in Wyoming.

Isolation hospitals and pest houses were commonly used to quarantine folks with smallpox.
Isolation hospitals and pest houses were commonly used to quarantine folks with smallpox and other now vaccine-preventable diseases.

Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over...
Even mild smallpox, as depicted on this WHO Smallpox Recognition Card, included flu like symptoms, a few weeks of pustules, and then waiting for the lesions to scab over…

People continued to die of smallpox well into the 20th century, even though an effective vaccine was developed in 1796.
People continued to die of smallpox well into the 20th century, even though an effective vaccine was developed in 1796.

In the pre-vaccine era, we had outbreaks of polio, and other, now vaccine-preventable diseases.
Outbreaks of polio would once isolate entire towns, as parents feared their kids would get sick too.

Fight Polio Poster
When was the last time you saw a child with polio?

Before wide use of the Hib and Prevnar vaccines, infants with fever would routinely get spinal taps and you would hope for clear fluid (cloudy fluid could be a sign of a bacterial infection).
Before wide use of the Hib and Prevnar vaccines, younger infants with fever would routinely need spinal taps and you would hope for clear fluid (cloudy fluid could be a sign of a Hib or Strep pneumo infection).

In the pre-vaccine era, Hib caused epiglottitis, meningitis, and pneumonia - all life-threatening diseases that are now prevented by the Hib vaccine.
In the pre-vaccine era, Hib caused epiglottitis, meningitis, and pneumonia – all life-threatening diseases that are now prevented by the Hib vaccine.

Before the 1990s, when the Hib vaccine available, hospitals had an epiglottitis team on call and always available.
Before the 1990s, when the Hib vaccine available, hospitals had an epiglottitis team on call and always available.

News of the Newark kids going to Paris to get Pasteur's rabies vaccine made the front page of the New York Times.
In 1885, several boys from Newark went all of the way to Paris to get Pasteur’s new rabies vaccine, as the disease had always been fatal up until that time.

Even if they survive, kids can lose fingers, toes, or even arms and legs to meningococcemia.
Even if they survive, kids can lose fingers, toes, or even arms and legs to meningococcemia.

Roald Dahl's daughter died of measles in 1962, the year before the development of the first measles vaccine.
Roald Dahl’s daughter died of measles in 1962, the year before the development of the first measles vaccine.

Nationwide, at least 123 people died in the United States during a large measles epidemic from 1989 to 1991, during a time that we had good sanitation, nutrition, and medical care.
Nationwide, at least 123 people died in the United States during large measles epidemics from 1989 to 1991, a time when we had good sanitation, nutrition, and medical care, but some folks weren’t vaccinated and we weren’t yet giving a second dose of MMR.

A papilloma caused by HPV on the vocal cords of a child with recurrent respiratory papillomatosis.
A papilloma caused by HPV on the vocal cords of a child with recurrent respiratory papillomatosis. (CC BY 4.0)

You don't have to go back to the pre-vaccine era to know that pertussis kills.
You don’t have to go back to the pre-vaccine era to know that pertussis kills. Ten infants died in 2010 in California from pertussis infections.

We should never forget what life was like before vaccines.

We should know that vaccine-preventable diseases were rarely mild, natural immunity comes at a cost, and that those who died from smallpox, diphtheria, measles, and polio aren’t around to talk about their experiences on Facebook (survivorship bias).

We should never forget that vaccine-preventable diseases were once big killers, and the only reason some folks have grown to fear the side effects of vaccines more than the diseases they prevent, is because we don’t see those diseases very much any more. If more people skip or delay getting vaccinated, we will though.

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

Vaccines are safe and vaccines work.

Get vaccinated and protected.

Outbreaks of vaccine-preventable diseases belong in the past.

What to Know About Life Before Vaccines

Forgetting the pre-vaccine era and the benefits of vaccines makes folks susceptible to anti-vaccine talking points and scares them away from vaccinating and protecting their kids.

More on Remembering Life Before Vaccines