How we create vaccine hesitancy

We have responsibility in the rising tide of vaccine hesitancy. Granted, most of the responsibility belongs to the charlatans and the grifters in the anti-vaccine community. But all of us have created a world where being afraid of vaccines only makes sense.

How did we do this? It was not our tone, and it wasn’t our failure to talk about the science. Instead, all of us agreed to view healthcare as a consumer commodity and took the expert opinion away from our doctors and gave it to the patients.

What do I mean? Take a look:

Screen Shot 2017-06-15 at 4.36.36 PM
Facebook post from Minnesota Star Tribune captioned with: “Armed with the right questions, you, too, can become an empowered patient ready to make informed decisions.”

I found that post while scrolling through my Facebook feed, and the caption caught my eye more than the article. For the record, the ten questions the article suggests you ask your doctor are very good and would have you relying on your doctor’s expertise.

The caption is problematic because it alludes to “empowered patients” and “informed decisions.” (People who dwell in the vaccine advocacy world likely instinctively bristle at the term informed decisions.) For far too many parents, such statements translate into a belief that they need to inform themselves ahead of time in order to get the medical care they want, and that the power and responsibility over their children’s medical care is solely the parent’s.

Dr. Jennifer Reich, in an article titled “Of natural bodies and antibodies: Parents’ vaccine refusal and the dichotomies of natural and artificial,” makes this point perfectly:

In fact, vaccine resistance lies at the intersection of two ideologies: one that expects parents to intensively invest in their children and the other that calls for individuals to become savvy consumers of technology and health interventions.

Oftentimes mothers, who make the majority of vaccination decisions, feel the duty to demonstrate their love for their children by learning all they can about healthcare choices, from feeding to sleep safety products to vaccines. They stand in sharp contrast to their grandmothers, who for too many years acquiesced to all medical advice and didn’t presume to demand more information from their doctors. In fact, many of us spent a lot of energy cajoling our grandmothers to ask their doctors why they were being prescribed Xanax in lieu of allergy medication or to ask for more testing of their heart health.

As I grow older, and the generation just behind me is wading through the too much pediatric information readily available to them, I see how the lessons we tried to teach our grandmothers needed to be titrated for the next generations–the generation of girls growing up under Title IX who were not accused of attending college only for an MRS degree. Even as we still live in an era of rampant sexism, 20- and 30-something women may not recognize how much more empowered they are than the Greatest Generation of women.

And when you do not see the path that was trod behind you, a doctor who tells you that he is not comfortable with your decision to eschew vaccines might seem paternalistic, which is why so many anti-vaccine parents accuse doctors of bullying. After all, aren’t you informed, just as society tells you to be in order to prove your skills as a decent parent? Isn’t it your commission to seek out empowerment in all things parenting, but in especially healthcare?

Perhaps you already noticed that the way doctors try to empower patients differs from the way parents think they are supposed to become empowered. It is true that information is power, but only good information is good power. And the best place to find good information? The experts. In other words, empowered patients know how to get the best information from their doctors.

Anti-vaccine charlatans wedge themselves into that tiny sliver of space that exists between informing yourself and getting information from your doctor. They convince parents that doctors are untrustworthy, bought, uninformed, and all manner of negative adjectives. Once parents are convinced, empowerment becomes a struggle between parent and doctor.

But empowerment ought to ease a parent’s mind rather than ramp up anxiety about becoming informed and understanding immunology. Empowerment ought to be a collaboration between doctor and patient, where patient feels free to ask questions at will and trusts that the doctor will give the best medical answers available at that time.

If we want parents to be vaccine confident, we need to assure them that they don’t need to know everything. We need to talk less about informed decisions and more about asking good questions and finding a trustworthy doctor.

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One thought on “How we create vaccine hesitancy

  1. In my experience, some parents come in to the office armed with anti-vaccine information and they’re ready for a fight. They’re angry before they enter an exam room and they’ve left no wiggle room for the doctor to even open a discussion with them. It’s time consuming and disheartening at some level. Some don’t want to hear what we have to say, at all! Thankfully, they are few and far between!

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