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How (Not) to Talk About Vaccines

by Miriam Axel-Lute on October 9, 2014 · 4 comments

 

There are two topics about which people who otherwise tend to agree with each other tend to figuratively rip each other’s throats out about. Since I wrote about Israel and Palestine in my last column, I figured I’d go whole hog and write about vaccines this week.

Now I’m not going to actually make an argument directly about vaccinations. What I do want to do is propose a bit of a theory about the current tone of the discussion:

I think that it’s quite possible that at the moment the biggest thing fueling anti-vax sentiment is the pro-vax movement.

As far as I can tell, the major tactics of people who want to stem the increase in vaccine opt-outs are shame and ridicule. I am particularly concerned with variants that go roughly like this: “Vaccines are science! How could you be so superstitious and anti-science??!! Um, science, bitches?”

Now, it’s understandable that if the sum total you know about people concerned about vaccines are those clinging to a study that claimed to prove a link with autism and has since turned out to be fabricated, you’d be pretty frustrated. There are definitely those who are not taking rational positions.

However, if you take the universe of people who have concerns about the current vaccine recommendations for children, you find the issues are far more subtle and varied than “someone says it causes autism!” (and the decisions being made often far more subtle than no vaccinations at all ever). Again, I am not making a claim one way or the other about these points, but for example, there are concerns about aluminum levels, about the sudden and untested increase in combination shots and their potential to cause the immune system to overreact, about losing natural immunity to chicken pox and increasing the risk of the disease in adults when it is much more dangerous, etc. These may all be factually wrong if you can get down to hard data, or not proportional to the benefits of having herd immunity, but they are not being argued on the basis of God’s word, and they aren’t mere laziness. The sheer amount of information to assess if you try to do so from scratch is positively monumental.

One article I read was particularly bemoaning all the highly educated parents who were anti-vaccine and wondering how that could be. Even people who were scientists! The author concluded that it was a mixture of competitive “natural” parenting and cross applying their perceived sense of themselves as experts to fields they are not qualified to judge.

I have a different theory. It has two parts: First, highly educated parents are aware of the medical profession’s record of telling us what’s good for us. And it isn’t good. They know the history of doctor recommendations on smoking to thalidomide to countless recalled drugs.

At the time they have vaccination aged children, they are likely to have just had a big dose of experience with a medical system that is woefully ignorant about the actual science and best practices behind birth, from laboring positions to eating during labor to episiotomy to breast milk supply. So they are not going to take a pronouncement by the medical establishment as necessarily reliable, and that’s reasonable.

Second, most of them do understand how science works: science is complicated and iterative. It is by its very nature about questioning received wisdom. It gets stuff wrong from time to time. It is generally better than its alternatives, of course, and many of its conclusions, replicated in multiple different ways by different people are rock solid, even some about health. But scientific findings are not infallible and it’s insulting to scientists to suggest that they should be treated that way. There many sad examples of science illiteracy around the country,

Someone who knows that they don’t have the expertise or resources to actually assess the evidence from scratch is going to have to assess other people’s claims about that evidence. Guess how likely they are to listen to people making fun of them for asking the questions?

If the pro-vaccine advocates want to get anywhere they need to stop wrestling with the few they will never convince, and instead speak to everyone else: cut the attitude, take the concerns seriously enough to know what they actually are, and present clear arguments on the state of the underlying science addressing those concerns.

Take Dr. Sears, who by actually taking concerns about aluminum concentrations seriously and proposing an alternative schedule that addresses it, has probably prevented 100 times more vaccine opt-outs than all the self-righteous shaming screeds on the Internet combined.

For those concerned with actual effects and not blowing off steam, that’s a much better model.

mjoy

{ 4 comments… read them below or add one }

Dorit Reiss October 10, 2014 at 12:52 am

I agree with your point about how to address the dialogue, but not with your example. By overstating vaccine risks and understating diseases risks, by legitimizing alternative schedules, I think Dr. Sears’ book has done a lot of harm.

I would also point out that the internet dialogue is harsh, and many of the anti-vaccine commentators use very harsh language, and it’s hard for even patient people never to rise to the bait. On the other hand, there is a lot of good information out there which takes vaccine concerns seriously and addresses them in depth.

The problem is that many anti-vaccine activists claim all of those sources are “industry sponsored”. Incorrectly.

I’d appreciate – and I’m saying that seriously – some thoughts on how to respond to that and help people make use of the credible information out there (and protect them against falling for inaccurate claims, like Sears’ claims about aluminum, or like those promoted by the misleadingly named National Vaccine Information Center, an anti-vaccine organization).

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Twyla October 10, 2014 at 11:21 am

Keep in mind that Dorit thinks pretty much every criticism of vaccines is inaccurate, and every reported vaccine injury is either delusion or coincidence – except for acknowledging supposedly one-in-a-million serious adverse reactions, and more common supposedly harmless reactions such as fainting after Gardasil (but no brain injury), “febrile” seizures (but no seizure disorders), and swelling at the injection site (but no chronic inflammatory issues).

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Dorit Reiss October 10, 2014 at 1:25 pm

Actually, I think that evidence-based criticism of vaccines – like criticizing the pertussis vaccine’s effectiveness, for example – is perfectly fine. Similarly, injuries that are causally related to vaccines with evidence should be acknowledged – for example, severe allergic reactions to a vaccine, and so forth. I do think that when people make claims of injuries that go against the evidence, like for seizure disorder, and criticisms of vaccines that go against the evidence, the fact that they are against the evidence should be highlighted. Letting inaccurate information stand is misleading.

I would also suggest that trying to delegitimize – unfairly – another commentator is not a good contribution to the discussion of the topic, and that maybe the speaker should address the content of the article.

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Jay Knable October 12, 2014 at 1:05 pm

“Letting inaccurate information stand is misleading.”

I agree. So when worldwide studies consistently raise concerns over vaccine safety and effectiveness, we should take them seriously despite the unchanging positions taken by the healthcare industry and corporate interests in this country who benefit from continual blind faith in vaccines. We would not even be having this discussion if it were up to them…

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