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.
A lot of the vaccine research that folks do is on PubMed.
Using PubMed to Do Research About Vaccines
And that’s not necessarily a bad thing.
“PubMed comprises more than 27 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.”
Just like anyone can put up a website or Facebook page and say whatever they want, almost anyone can get a study or article published in a journal and get it indexed in PubMed.
While PubMed is an index with over 27 million citations, it doesn’t do anything to evaluate those citations to see if they include studies with design flaws, conflicts of interest, or are simply fraudulent.
That means that you need to know that a study does not get a badge of legitimacy for simply being in PubMed!
And it does not automatically mean that the evidence and conclusions from the article are of high quality just because it is listed in PubMed.
So use PubMed to find articles to help you do research about vaccines, but then read the article from beginning to end, not just the abstract, and make sure it is an article you can trust:
Was it published in a legitimate journal, like Vaccine or Pediatrics, and some of these high-impact journals? (good)
That’s great, but PubMed shouldn’t be your first stop, or your only stop.
As you do your research or get bombarded with a list of links or abstracts from PubMed, remember that there is a hierarchy of evidence to consider before deciding if a paper or study is really evidence of anything. And finding a case report, study on rats, or an invitro study won’t win you an argument about vaccines when there are randomized control trials and systemic reviews on the other side.
What to Know About Using PubMed to Do Research About Vaccines
PubMed is a giant index of journal articles, but simply being in PubMed doesn’t mean that an article or study is reliable or of high quality, whether it is about vaccines, a vaccine-preventable disease, or any other medical topic.
More on Using PubMed to Do Research About Vaccines
Having disagreements about getting kids vaccinated and protected are not rare these days.
“Many parents have questions about their children’s vaccines, and answering their questions can help parents feel confident in choosing to immunize their child according to the CDC’s recommended immunization schedule.”
They understand that terminating the physician-patient relationship over vaccines truly is a last resort for “when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists.”
Whether you find yourself on opposite sides about immunizations with a friend, your spouse, an ex, or your pediatrician, agree to get educated about vaccines using these recommended and reliable sources of information and then talk about it some more.
“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:
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.
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.
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?
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?
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.
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.
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.
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.
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.
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.
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.
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.
“anxiety that results from simultaneously holding contradictory or otherwise incompatible attitudes, beliefs, or the like, as when one likes a person but disapproves strongly of one of his or her habits.”
So for example, if you are scared to vaccinate your child, then also thinking that your intentionally unvaccinated child could catch measles and get very sick might cause some cognitive dissonance. This leads you down the road to also start to believe in much of the pseudoscience of the anti-vaccine movement, including that:
vaccines don’t work anyway (they do)
vaccine-preventable diseases, like measles, aren’t that bad (they are)
it is actually good to get a vaccine-preventable disease (it isn’t)
everyone else is vaccinated, so it doesn’t matter if my kids aren’t (it does)
bacteria and viruses don’t even cause disease (they do)