Why Parents Don’t Vaccinate Their Children—And What We Can Do
August 2, 2013It's a horrific, heartbreaking sight and sound: Whooping cough victims wracked with prolonged coughing spasms so violent that they may break their ribs. It often creates a strange, sickening "whooping" sound as patients struggle to inhale air after such coughing. If left untreated the coughing fits can last months and interfere with eating and sleeping-and can be fatal. Though adults can catch whooping cough, it is most often found in children. It sounds like something from the Middle Ages akin to the black plague, and there is an effective vaccine against it. Still, whooping cough is making a scary comeback-and partly because of people like celebrity anti-vaccination activist Jenny McCarthy.
There are several reasons why some parents choose not to vaccinate their children, though most of them come down to misinformation from anti-vaccine advocates. With the recent addition of Jenny McCarthy to the popular ABC television show The View, many people are wondering what effect, if any, this will have on vaccination rates.
Much of the current fear and doubt about the safety of vaccines and autism can be traced back to Dr. Andrew Wakefield, the lead author of a small 1998 case report suggesting a link between vaccines and the onset of childhood autism. The British General Medical Council found he had acted unethically in his research, and his paper, which was championed by several celebrities including McCarthy, was retracted by its publisher, the Lancet.
It is true that there are risks involved in vaccinations, as there are with any drug or medical intervention. The risks are not hidden but instead well-known and easily available from your doctor or online. The risks of side effects, however, are far less dangerous than the risks of catching the disease.
One way to encourage vaccination is to counter obvious examples of anti-vaccine misinformation. For example many people claim that it is not the deactivated measles-mumps-rubella (MMR) vaccine itself that causes autism but instead a preservative used in the mix called thimerosal, which contains potentially toxic organic mercury. However as science journalists (including Seth Mnookin, author of The Panic Virus: A True Story of Medicine, Science, and Fear) noted on the PLoS blogs, the MMR vaccine "does not and never did contain thimerosal." Furthermore, thimerosal hasn't been in any American vaccines for nearly fifteen years.
There has been some research examining why anti-vaccine information is persuasive to many people. One of the most compelling factors is the availability of vivid, personal stories highlighted by anti-vaccination activists such as those seen on television and featured at personal appearances. It's a classic case of science versus anecdote: Statistics and authoritative, impersonal medical information will never be as compelling as an emotional, tearful story told by a mother holding the daughter whose autism she blames on the MMR vaccine. All the facts, data, and research fades away under the glare of human anger and suffering-whether the target of that anger is justified or not.
One article in Human Vaccination and Immunotherapy by A. Shelby and K. Ernst examined the issue and concluded that "Utilizing some of the storytelling strategies used by the anti-vaccine movement, in addition to evidence-based vaccine information, could potentially offer providers, public health officials, and pro-vaccine parents an opportunity to mount a much stronger defense against anti-vaccine messaging." Perhaps tearful stories and personal anecdotes from parents who failed to vaccinate their children (and who were injured or died as a result) might be an effective counter-measure.
Putting the fear of vaccines in historical perspective may also help allay parent's fears. Fear of vaccination is nothing new; it's been around for centuries. There was vehement resistance to the very first vaccine, created for smallpox in the late 1700s. When the public learned that the smallpox vaccine was created by taking pus from the wounds of infected cows and giving it to humans, they were disgusted by the idea; some even believed that the vaccination could turn children into cows!
In England, vaccination deniers formed an Anti-Vaccination League in 1853. Echoing many of today's anti-vaccination claims, this and other groups claimed that the smallpox vaccine was not only ineffective and dangerous, but represented an infringement on personal rights by the government and medical establishment. If concerned parents understand that early fears over smallpox vaccination (as well as polio, diphtheria, and others) are unfounded, they may accept that current fears over childhood vaccinations are as well.
There is truth to the idea that celebrities can influence the opinions and beliefs of their audiences, and it is certainly possible that as long as McCarthy continues to actively sow doubt about the safety of vaccines, her audiences will refuse to vaccinate their children. But there are ways we can counter this misinformation and save children's lives.
Healy M. Jenny McCarthy on 'View': A new forum for discredited autism theories. The Los Angeles Times. 2013 Jul 15. Available at https://www.latimes.com/news/science/sciencenow/la-sci-jenny-mccarthy--view-autism-20130715,0,6008429.story.
Holler K, Scalzo A. "I've heard some things that scare me". Responding with empathy to parents' fears of vaccinations. Mo Med. 2012 Jan-Feb;109(1):10-3, 16-8. PubMed PMID: 22428439.
Mnookin, S. "A PSA to journalists writing about vaccines: Thimerosal was never used in the MMR vaccine". PLoS blogs. 2013 Jul 16. Available at https://blogs.plos.org/thepanicvirus/2013/07/16/a-psa-to-journalists-writing-about-vaccines-thimerosal-was-never-used-in-the-mmr-vaccine/
Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013 Jul 13. doi:pii: S0264-410X(13)00935-3. 10.1016/j.vaccine.2013.07.013. [Epub ahead of print] PubMed PMID: 23859839.
Shelby A, Ernst K. Story and science: How providers and parents can utilize storytelling to combat anti-vaccine misinformation. Hum Vaccin Immunother. 2013 Jun 28;9(8). [Epub ahead of print] PubMed PMID: 23811786.