I'm a hard line, strong supporter of vaccinating children. I wrote about it here on Daily Kos ten years ago ("The War On Science: When Mob Rule Prevails." and see the comments), and I'm certain and unequivocal that the science and data are on the side of vaccination.
I'm a pediatrician. I'm also interested in politics, and politics is the art of persuasion. This leads to the inevitable observation that the importance of persuasion, whether for votes or for advice on vaccination, is worth spending time thinking about.
What's also worth thinking about is the difference between castigating parents and persuading them, and importantly, the difference between how you approach parents and how you approach the fools, hucksters, mountebanks and politicians who lead them on.
Can you claim that public health is nonpartisan but still pick on politicians? I think you can. Can you tell parents (or voters) that they are stupid and then expect to persuade them? I think not.
Head below the fold for more on this story.
If you want the science and research behind vaccination, there's many good places to go on the internet, including CDC.gov and
History of Vaccines. And here are two excellent vax myth debunkers:
"Vaccines: Facts vs. Myths" by Liz Szabo, and
"Misconceptions about Vaccines." (The article does a great job demolishing the hygiene theory that improvement in disease is due to hygiene and not vaccination. That would not explain chicken pox.)
However, for today, I want to focus on beliefs and persuasion.
Brendan Nyhan, a political scientist who writes for the New York Times, has a large body of important work on persuasion. I recommend "Vaccine Opponents Can Be Immune to Education" to start:
The problem in this case wasn’t getting parents to believe the facts. Our results indicate that parents who saw the corrective information were less likely to believe in the vaccines-autism myth than those who didn’t. It seems that raising the topic may have instead prompted skeptical parents to think of other concerns or hesitations they have about vaccines to defend their views on the topic.
In addition, our results show that other types of messages used by public health agencies — information about disease risks, a dramatic narrative and images of sick children — were also ineffective.
Another good read is
"Debunking vaccine junk science won't change people's minds. Here's what will.":
Julia Belluz: If I had to briefly sum up your research findings, I'd say: it's near impossible to change peoples' minds. Are vaccine beliefs any different from other types of beliefs?
Brendan Nyhan: Vaccine beliefs are a lot like the political beliefs my co-author [Jason Reifler] and I study. People feel passionately, they are not inclined to hear contradictory messages, and there are all sorts of myths circulating. The way people reason about vaccines, it's the same as the way people reason about other controversial topics.
So, think of it this way. How would you, as a deep blue liberal, structure a talk in deep red Mississippi, about politics and policy? Probably not by yelling at your audience. You might want to understand who they are, even, before you speak.
Now, some of the research suggests the best "persuaders" are the healthcare professionals who directly work with the families, but i can tell you from experience that it's not so easy, and it often takes years to see change.
With that in mind, there were a trio of articles I highly recommend reading to understand where people are coming from on the vax issue. It won't apply to everyone. It won't help you with every case. But it will help you talk to the persuadable where at least there's a chance of conversation. And it makes the case that sometimes parents themselves are the best persuaders. Between the pediatrician and the moms at the bus stop, the doc doesn't always win.
"How one vaccine skeptic became a vaccine supporter" is an absolute must read.
LN: One thing that really struck me about your book was how much empathy you had for people who disagree with you. How can we introduce more empathy into the conversation?
EB: I’m not sure that we have a good understanding of why people don’t vaccinate. And I think that could produce more empathy. When I’ve talked to people in a really sustained and in-depth way about why they’re not vaccinating, it’s often complicated and multifaceted and has a lot to do with their personal history and their relationships sometimes to the government, or sometimes to past experience with medicine.
In the book I wrote about a friend whose parents are Vietnam refugees and who were exposed to Agent Orange. She’s just one example of many, but it’s not hard to see how someone who had very dangerous chemical exposure as an infant would be wary around things that are chemicals or pharmaceuticals. It’s also not hard to understand that someone whose family and whose homeland was so deeply affected by the policies of our government and the actions of our government would have a problematic relationship with that government. And I don’t think that’s actually an outlying case. I think there’s a lot of people who have complicated backstories, and they’re either around politics or sexism or medicine, and those things are feeding into why they’re not vaccinating.
LN: What other factors might be driving this?
EB: We live in at least, I, live and participate in a parenting culture, an upper middle class, usually white, well-educated parenting culture, that really encourages and supports fear and fearfulness.
Fear is understood as a sort of intelligence in this culture. Promoting fear in another parent or mother is seen as a kind of favor. If you don’t think somebody’s feeling afraid enough, your job is to scare them. I think the other way into empathy is to look at how scared people are, and to think about why they’re scared, and what’s happening culturally to support and encourage that fear.
Eula Biss, the essayist also delves into how the anger from other parents has to do with skipping out on communitarian responsibilities. That's something you can tap into in a constructive way during conversation.
"I used to be a vaccine skeptic. Now I’m a believer." is another good essay:
When we made our decisions about vaccines the first time, it was all abstract. My child couldn’t die from measles, I told myself. My mom had had measles, and she was just fine. I hadn’t yet spent those weeks in the NICU, praying over my child that the fluid in her lungs wouldn’t become full-blown pneumonia. I hadn’t seen all of the other sick babies around her. I hadn’t heard from other bereaved parents about all the ways babies can die.
People change. Give them the chance to.
I Asked My Mom Why She Didn’t Vaccinate Me and partly, it was on the advice of the doctor. Yeah, we have those.
Bob Sears.
Jay Gordon (Jenny McCarthy's doc).
Jack Wolfson. On behalf of my profession, I apologize.
In any case we have an opportunity (alas) to have a lot of people who, for various reasons, are vaccine hesitant pay attention to the news. There's nothing like babies with measles to get your attention and theirs. Assume they are trying to do right by their kids. Assume they're worried or downright scared. Don't yell at them. Save that for Christie and Paul, and the doctors they get their information from. They deserve every slam you can think of, not the parents.