Over the years, I have noticed a steady increase in anti-vaccine misinformation circulating on social media. I find it troubling, but I am somewhat reassured because for every anti-vaccine click-bait article posted, there are 20 other posts urging parents to follow their pediatrician’s vaccine schedule. So when I read that there was a confirmed case of the measles in Baltimore recently, I was alarmed but not surprised.
My first reaction is anger: How could anyone deny the indisputable evidence from hundreds of studies that prove the safety and efficacy of childhood immunizations? My second reaction is fear — not only for the unvaccinated children, but also for the babies too young to be immunized and immunocompromised adults. Scrolling through hundreds of Facebook comments, I see that I am not alone in my fear and outrage. “Vaccinate your damn kids!” one angry father writes. “I’m never leaving the house again,” an 8-week-old infant’s mother laments. Their feelings are understandable; it’s hard to understand the logic behind refusing to vaccinate children, and it’s easy to blame their parents.
Still, I wonder how this blame-game will play out: Will the mountains of scientific evidence behind vaccines convince vaccine-hesitant parents, or will it push them farther into the depths of internet conspiracy black holes insisting that vaccines cause autism? I’d put money on the latter.
In my health communications class in college, vaccines were a monthlong topic of discussion. But rather than focusing on the debate itself, we learned how to communicate with vaccine-hesitant parents. We learned about confirmation bias: the tendency to seek out information that confirms what we already believe. We learned that bombarding vaccine-hesitant parents with research and data would likely never change their minds, because being an “anti-vaxxer” is more than just a belief; it’s an identity. We learned that calling parents who are opposed to, or hesitant of vaccinating their children “anti-vaxxers” only feeds into this identity and pushes them farther away.
My perspective on how we should communicate with parents who express concerns or hesitations about vaccines changed. I discovered that more often than not, their decisions were based on the best information they have at the time.
I have a 9-month-old baby with a severe breathing disorder. I noticed that her breathing was off when she was just 2 days old. When I asked her pediatrician, he flippantly said, “Oh, not to worry. Babies just make a lot of noise.” He dismissed my concerns, even when I insisted that there was something clearly wrong with her. A few days later she was projectile vomiting and gasping for air, so we rushed to the emergency department where she was admitted and diagnosed her with severe laryngomalacia, a condition that would require surgery to correct.
I was outraged. Why had her pediatrician not taken just a few minutes more to hear me out? The experience left me angry and distrustful, but it gave me a new perspective. Vaccine-hesitant parents want what I wanted: their fears and concerns to be addressed, not disregarded. They want to be a part of the decision-making when it comes to their child’s health care, and above all, they want what’s best for their children.
It’s challenging for pediatricians, nurses and other public health professionals to interact with these parents because we see the imminent danger in their misinformed decision. But instead of turning them away, what if we made more of an effort to bring them in?
A 2005 study on immunization attitudes and beliefs among parents found that their views on vaccines are not as black and white as they may seem. In fact, five clusters of parents were identified. Their beliefs ranged from immunization advocates to parents who were worried that vaccines would harm their children. Another national survey in 2000 found that a substantial number of parents believe that their child’s immune system could be weakened by vaccines and that children get more vaccines than are good for them. Both studies came to the same conclusion: Children’s health care providers are the most important source of information on immunizations.
Vaccines are one of the most important public health advances of our time, but we still have a long way to go in addressing common misconceptions to ensure informed decision-making. Pediatricians, primary care doctors and public health workers have the opportunity to contribute to this educational effort through respectful, well-informed and compassionate dialogue with parents. We all want what’s best for our children. We just need to right information to get there.
Meredith Alston works for the Anne Arundel County, Maryland, Department of Health. This column was originally published in The Baltimore Sun.