Are Vaccines the Real Microcephaly Culprit?

No. They are not. Vaccines are not causing microcephaly in Brazil.

If you have no idea what I am talking about, count yourself lucky and thank your friends for not bringing crazy to your social media feed. But since you are probably curious, here is a sample:

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Dr. Tenpenny, the Ohio anti-vaccine activists behind sites like All About Breast Health and TruthKings has joined the conspiracy bandwagon in insisting that the Tdap vaccine given in pregnancy to prevent pertussis in mothers and their newborn babies, is the real cause of microcephaly, and not the Zika virus.

Their overly simplistic thought process is not new. These are the people who brought us “vaccines cause autism” and “the HPV vaccine causes ovarian failure,” which require the same “We did X and Y happened” thinking. Post hoc ergo propter hoc.

Except that the connection between Zika virus and microcephaly is established, unlike the uncertain causes of autism. Yet, organizations like the poorly-named National Vaccine Information Center and Natural News continue to promote this obviously wrong and crazy theory.

And like autism, there isn’t even a correlation. If there were a correlation between the Tdap vaccine given in pregnancy and microcephaly, we would see an epidemic of microcephaly in the United States, where the recommendation for this maternal vaccine has been in place since 2013 (one year before the Brazilian recommendation), and in Australia where a similar recommendation is in place. In other words, there isn’t a propter hoc to connect the post hoc to. There are simply conspiracy theorists throwing their darts at the vaccine target to see what sticks.

Let’s hope this dart doesn’t stick. While I would love to believe that pregnant women will shake their heads in disbelief over how outrageous these claims are, I know how vulnerable a woman can be to bad information while she is expecting a baby. And so we remind people that pertussis in an infant is terrifying, and the Tdap in pregnancy is safe.

And then file this post under “Things I can’t even believe I have to write.”

 

Tetanus Vaccines Encourage Walking on Rusty Nails

Parents all over the country are submitting their children for one vaccine that protects against a disease they know nothing about. If you ask the average parent “What is tetanus?”, they are unlikely to provide a complete answer. They probably have only heard of tetanus from the vaccine and not from family stories about ancestors who contracted tetanus.

In fact, these parents are submitting their children for vaccination against a disease well before they will even encounter this disease. One of the most common ways tetanus is contracted is through puncture wounds, such as you might get from stepping on a nail. When was the last time a 2-month old (yes, that’s the age of the first tetanus vaccine) stepped on a nail? And even when they start walking, can’t you just teach them not to step on nails? Isn’t giving a vaccine against tetanus just giving a child permission to walk through construction sites and step on as many nails as they’d like?

What’s more, even though the vaccine is often mandated for school entry, tetanus is not spread to innocent victims. You can’t catch it by breathing, the way you might catch measles or chickenpox. It’s not that we want our children getting lockjaw, but can’t we just parent them really well away from getting it?

What’s that? Tetanus is a horrible and cruel way to die and spreads in multiple ways beyond rusty nails? Tetanus killed 580 people per year in the U.S. before the vaccine? The vaccine could in no way encourage promiscuous walking behavior? You can’t parent a child better as an alternative to vaccination?

I’ll make a deal with you. I will accept that the tetanus vaccine is important for the above reasons if you accept that the HPV vaccine is important for those same reasons. (You knew I was going this direction, didn’t you?)

  • HPV can spread in more ways than simple vaginal or anal intercourse. There is evidence that it can be spread through deep kissing, oral sex, and other ways.
  • HPV-related cervical cancer kills 4,000 women in the U.S. every year today. (Yikes! That’s more than tetanus!)
  • The HPV vaccine does not encourage promiscuity. When deciding whether or not to have sex, it is highly unlikely a young adult is considering their immunization record in the same way toddlers do not consider their tetanus vaccine when walking around.
  • Your lovely tween or teen may have promised not to engage in any sexual activity before marriage. However, their virginity is not a guarantee of protection because you are not parenting their future spouse (who could have multiple partners) and because not all sexual activity is consensual. Right now, 79 million Americans have HPV. Some of them were virgins when they got married.

Parents get squeamish thinking about their children’s future sexual activity in ways that they don’t get squeamish thinking about their children’s future walking activity. But we should no more tell parents to forego the tetanus vaccine and just make their children wear shoes outside than we should tell parents to teach their children to use condoms (or make purity promises) in lieu of the HPV vaccine. When it comes down to it, it’s not about walking or sex–it’s about preventing real and deadly diseases. And maybe the tetanus vaccine doesn’t encourage kids to walk on rusty nails after all.

I’m pro-vaccine, but that HPV vaccine…

Somewhere along the line, it became acceptable for parents who happily vaccinate their children against pertussis and measles and diphtheria and rotavirus to fear the HPV vaccine. Parents who shun the notion that the MMR causes autism or the the Tdap causes SIDS gobble up willingly blog posts about beautiful teenage girls who developed neurological problems or ovarian issues after the vaccine. That the websites they read are connected to the most notorious in the anti-vaccine world doesn’t register with these otherwise pro-vaccine parents. They are certain that this vaccine is not safe and that, while they can trust the CDC on every other vaccine, the HPV vaccine information has been obscured and sullied.

Parents fear vaccines for lots of reasons, and I’ve always held that fear of the HPV vaccine is one gateway into the anti-vaccine world. (Another prominent gateway is our birth culture, but that’s a different post.) Those pretty teenage girls had so much to hope for. And now their dreams are dashed–even if all evidence points away from the HPV vaccine.

I could go on about how safe this vaccine truly is, but I’ve done that before.

Instead, I’m going to insist today that parents who readily fall prey to misinformation about this vaccine do not understand what is at stake. I was fortunate enough to host a conference call last week featuring Dr. Nathan Boonstra on the topic of HPV vaccine uptake. While you should listen to the whole thing, I was most struck by what he said about the burden of HPV disease:

When we talk about the burden of this disease, I think it is underestimated by a lot of people…We are looking at 80 million Americans currently infected with HPV, 14 million new infections a year in the United States. And it’s most common in people in their teens and their early twenties…We are talking about 4,000 deaths from cervical cancer alone every year. We are talking about 12,000 cases of cervical cancer a year. And when we start looking beyond that, we are looking at something on the order of 25-26,000 cases of cancer in the United States from these [HPV] viruses. And then we can go even bigger and talk about the hundreds of thousands of cases of genital warts and hundreds of thousands of cases of precancerous lesions that have to be removed and that have their own set of complications and their own burden by bleeding or infection or even cervical incompetence…When we talk about males and females, a lot of people think we are trying to protect females. But when you really break down the numbers out of all of these 25,000 cases of cancer that are happening in the United States, a good third of them are in males…Most of these are your oropharyngeal cancers, which can be reduced by widespread use of the vaccine.

What Dr. Boonstra pointed out is that the burden of HPV disease actually outpaces some of the other diseases we vaccinate against. If we consider only cervical cancer deaths (even though HPV causes a number of cancers) and compare those to the deaths of other diseases, the harm caused by HPV disease is obvious:

  • 4,000 HPV-related cervical cancer deaths in the U.S. today.
  • 1,904 polio deaths in the U.S. in 1950 (near the height of the epidemic).
  • 450 measles deaths every year in the U.S. before the vaccine.
  • ~500 tetanus deaths each year before widespread use of the vaccine in the U.S.
  • 100 chickenpox deaths every year in the U.S. before the vaccine.

And so on. You’ll notice that with the diseases we most fear for our children, we readily accept vaccinations. Except that HPV-related cancers kill more people every year than polio, measles, tetanus, and chickenpox combined did before we had vaccines for those diseases.

Parents who feel that they can let this vaccine hang or opt out of it because it doesn’t seem important are playing a dangerous game with their children’s health. HPV is a real threat, and preventing cancer when we can is an obligation. I would never say that one vaccine is more important than another, but the HPV vaccine is certainly crucial, even when it has the reputation of being optional.

While the burden of the disease may not hit their children until they are adults, the chance to protect their children happens when they are still children and parents have the obligations to make the choice to protect.

 

You Can Stop Vaccine Hesitancy

Yesterday, while waiting to get his baby’s vaccines at the doctor’s office, Mark Zuckerberg did the one thing we should all be doing to combat vaccine hesitancy:

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And, no, I’m not suggesting you start your own social media empire. That’s not what you need to do.

You need to tell people that you are (or have been) vaccinating your children. You need to tell people publicly. Because if everyone who did vaccinate their children simply posted a photo like this on social media, the anti-vaccine movement would look like that tiny less-than-one-percent that they are instead of a loud, social media enterprise.

It’s called social norming, and it might be more effective than debating other people about vaccines and debunking their misinformation. A simple I VACCINATE statement, when made by everyone, shows just how ubiquitous this decision is, and also just how safe the decision to do so is. Imagine being a new parent and seeing photo after photo of friends saying “Time for vaccines!” on the internet (or heck–in person!). All those babies that you know who are vaccinated and are fine show just how safe immunizing can be.

Because I am so passionate about social norming, I am willing to insist that your duty speak up about vaccinating is just as important as your duty to vaccinate your children. If you truly want to protect your child and your community, it is your responsibility to help stem the tide of vaccine hesitancy. I bolded that because it is important.

In fact, there is evidence that your advice about vaccinating makes a difference. According to research by Dr. Emily Brunson out of Texas State University, “the variable most predictive of parents’ vaccination decisions was the percent of parents’ people networks recommending nonconformity” to the immunization schedule. In other words, the more people who recommend you not vaccinate on-time, the more likely you are not to vaccinate on time. Conversely, if everyone you know recommends you vaccinate on-time, you are unlikely to deviate from the vaccine schedule.

So get out there and tell your friends and family members and FarmVille collaborators that you vaccinate your children, end of story.

The Cancer Kids are Taking Over

I frequent Dr. Tenpenny’s Facebook page because it is amusing but also because it helps me understand the marketing being used to make parents afraid of vaccines. Because I keep tabs on Tenpenny, I’ve also taken note of the revolving websites she has attached herself to, from Vaxxter to All About Breast Health. That’s where I found TruthKings.

It sounded promising but also slightly frightening. We all know the spurious ways people like Tenpenny use the term truth, after all. But today I noticed a post about why it is okay to endanger the health of vulnerable children undergoing chemotherapy.

Of course, that’s not how my new favorite truthers framed it, though. They titled their post, “Your Child Having Cancer Doesn’t Mean My Child Should Be Forced Dangerous Vaccines.” The title alone is poppycock. Let’s review in bulleted points:

  • No one is forcing vaccines upon anyone. To force a vaccine would mean to hold a child down and physically inject it into a child. Instead, reasonable safeguards are put on schools, including the safeguard against infectious disease. If you don’t want to participate in helping schools be safe from infectious diseases, you bear the consequences.
  • Vaccines are not dangerous. Millions of vaccines are given every day. 95% of parents choose to fully vaccinate their children. If vaccines were dangerous, pretty much every child in this country would be worse off for being vaccinated. Instead, they are free of diphtheria, polio, Hib, measles, and so forth.
  • Of course it is your responsibility to take reasonable precautions to help other children. That’s why you can’t drive drunk or text while driving. In fact, the law books are filled with things you can’t do because it would endanger others. And Laura Bredesen, mother of a cancer patient exposed to measles, will tell you that leaving your child unvaccinated is a direct threat to the children around him/her who are cancer patients.

Why are these TruthKings taking on the ever threatening pediatric cancer patient? What did these cancer kids ever do to them?

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Don’t worry, cancer kids; you aren’t the only threat. It seems that fluoride, GMOs, education, and the Islamics are all taking over. Or at least the Islamics are.

Fear of the other is the most common cause of bigotry and prejudice. For a TruthKing, you are a threat if you are a Muslim or if you are receiving chemotherapy because your existence means that their freedom might be curtailed. Both cancer patients and Muslims are turned into the enemy by refusing to actually get to know anyone who fits those categories.

After all, Ben Bredesen can’t be your enemy once you get to know him because he’s a sweet kid. And he’s a child. How can a kid be an enemy, and on what planet to you refuse to protect a child?

And that’s just my reaction to the headline. In fact, the entire post is a deep conspiracy about how the government is using pediatric cancer patients to take away our freedom. And you and I are apparently part of the conspiracy:

The Government has pulled at the very fibers which inspire you, cause you to be passionate, make you laugh and make you enraged. They’ve convinced you that myself and my child are here on earth to do harm to your child. And they’ve done this as a way to recruit an army of mothers and fathers to take the helm and become soldiers in a way to fight against parental rights.

In this battle, of course, the rights of the parent trump the rights of the child. People who use terms like “truth” and “parental rights” believe that they own their children, that their decisions are paramount whether or not these decisions are wise. They give no consideration to how children have been historically used by those who believe they own them, children who have worked in sweatshops and have been physically abused. The history of children’s rights is expunged in favor of a new liberty for parent/owners of children.

Of course, you ask, the war metaphor is just a metaphor right? (Okay, maybe you didn’t ask that, but you should.) No. Not at all. Remember these are people who think we are on the brink of an Islamic takeover. Their fears are about something sadistic and nefarious:

When you take the bait by the Government to diminish these very basic human, parental rights, you allow the Government to play to your sadness and despair. They have you at your weakest moment, compromised in your soul. When you really consider what they are doing, using your sick child as bait for your impassioned plea to support the army who is going to go door to door and remove rights, you begin to see how disturbing and disingenuous it all really is.

Going door to door to remove your rights. Sounds frightening doesn’t it?

But again, nothing of the sort is happening or is going to happen. At worst, you might be required to homeschool your child, as is now the case in California. Ironically, of course, asking that you opt for homeschooling instead of government-funded schooling is really the opposite of the foot soldiers coming to your door to remove your rights. It is keeping children closer to the adults who have bought into the fear mongering of the anti-vaccine movement.

Of course someone like Tenpenny shares the heck out of TruthKings on her page. This fear-based marketing, stirring distrust in the government and asking people to cloister against some imaginary army. The purpose of this marketing scheme is to sell her own wares. But real people are being harmed with this marketing strategy, whether these people are Ben Bredesen or our Muslim friends and neighbors. It’s unconscionable that a grifter like Tenpenny make them into the enemies in order to turn a profit. She will never change, but we can make sure our friends and family do not fall prey to these cynical strategies.

Vaccine Safety Advocate

It is interesting that hundreds of researchers and scientists work every day to monitor and study the safety of our vaccine program to ensure that it is safe, but “vaccine safety advocate” gets used, without irony, by anti-vaccine activists in order to obscure their true purpose of frightening parents away from vaccines by falsely connecting them to autism.

Words matter, and they matter especially in journalism. Casting people who form coalitions in order to slow the uptake of vaccines and promote misinformation about them as anything other than anti-vaccine is playing into their own public relations and feeding the anti-vaccine delusion.

So why does the Star Tribune keep changing articles and headlines to accommodate the public relations of Minnesota’s wealthiest and most politically connected anti-vaxxer?

On the heels of the Disneyland measles outbreak, Strib reporter wrote this terrible and falsely balanced article discussing how anti-vaccine activists were on the defense (since they were, you know, bringing back measles). Originally, the article began:

Jennifer Larson’s conversion to anti-vaccine started after her infant son got his measles shot in October 2001. Within minutes, she said, he passed out, within hours he stopped making eye contact, within weeks he lost a sense of touch and within months he was found to have severe autism.

The first line, that she was converted to anti-vaccine, is accurate. That the vaccine caused her child’s autism is, of course, refuted by science. But to the point: Jennifer Larson is anti-vaccine. It is her anti-vaccine stance that has led her to bring to Minnesota hearings doctors like Dr. Toni Bark, who is also anti-vaccine and who has a whole movie about the pretend dangers of vaccines. The bill they were testifying against would not have mandated vaccines; it simply would have required parents speak to a doctor before opting their children out of vaccines. Who is against people talking to their doctors about the risks of opting out of vaccines? People who are anti-vaccine.

But Jeremy Olson (or his editors) changed that first line of that awful article so that it read: “Jennifer Larson’s conversion to vaccine skeptic started after her infant son got his measles shot in October 2001″ (emphasis mine). Jennifer Larson, no doubt, did not like being called anti-vaccine because who wants to be against vaccines? Not someone who spreads misinformation about vaccines or keeps parents who have hesitation about them from their doctors. Oh wait.

In any case, the Star Tribune slipped up and called her anti-vaccine again, to report that she was planning, along with her anti-vaccine political party, a local fundraiser for anti-vaccine Libertarian presidential almost-candidate Rand Paul. The article was originally titled, “Head of anti-vaccination group to host Rand Paul fundraiser.” As far as headlines go, it was completely fair. Yet, months later, the headline has changed, and a correction now accompanies the article:

An earlier headline and photo caption with this article did not identify the Canary Party and its president, Jennifer Larson, correctly. Neither she nor the group oppose all vaccinations. Rather, they are raising questions about vaccine safety and federal vaccine research.

Oh really? She’s raising questions about vaccine safety? I know she has contributed tens of thousands of dollars to politicians in hopes of getting anti-vaccine misinformation about autism into the congressional record, but has she ever funded research about vaccine safety since she is so concerned about the federal research being done? (And can someone please point out how ridiculous it is to be concerned about “federal vaccine research” when vaccines are researched by governments and universities and non-profits and, yes, corporations across the globe, in lots of countries with lots of government structures?)

But the Star Tribune knows all this. I know they do because I have told them. So the real question remains: why do they keep capitulating to the absurd and inaccurate request by one anti-vaccine activists to be labeled as a “vaccine safety advocate.” Vaccine safety advocates do exist. They are the reason we have safe vaccines that prevent us from getting polio and diphtheria. They aren’t the lone voices repeating snippets of fraudulent, retracted studies.

Doublespeak: A Dr. Bob Special

Dr. Bob Sears is the author of a bunch of books, the salesman of supplements, a Fellow of the American Academy of Pediatrics, and a master of doublespeak about vaccines. According to Dr. Bob, he gives vaccines in his office every day. Why, then, does he work so hard to frighten parents about vaccines and downplay the effects of the diseases they prevent?

His newest venture, a supposed non-profit organization called Immunity Education Group (Do Not Link hyperlink), is a case in point. The website itself says almost nothing useful to anyone, but it appears that the real meat of his work is on the associated Facebook page, co-adminned by self-proclaimed data analyst Melissa Floyd.

The past few weeks, I have been ignoring Dr. Bob’s new Facebook page because sometimes ignoring them makes them wither and fade away. But one post last week drew in my attention (and some of my precious time and efforts):

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Since Dr. Bob is so long-winded, I didn’t screen capture the entire post. But this is the part that caught my attention:

Do you see it now? This press conference wasn’t about disease information; it’s the beginning of a hunt for pockets of vulnerability. And, I gotta hand it to them, the CDC’s answer was sheer brilliance. “No, we’re not the bad guys. We won’t share the data. School vaccine laws and sharing exemption information is a STATE and local matter. We’re are staying out of that.” The quotes are my paraphrase of the CDC answer. But the CDC wrapped it up this this statement (my quotes again, but it’s almost word for word):

“We encourage parents to find out their local vaccine exemption levels so that they can work together to help everyone do what’s good for their community.” Yes, they actually said that. It sounded so righteous, useful, and proper yesterday. But when you look at the whole picture, I worry that it’s a portend of what’s to come.

This is why we must work hard to come together, understand one another, start having conversations, accept one another’s varying medical beliefs, and learn to live together in peace and harmony. The current system is working well; diseases are under control, and we have very high vaccination rates. Less than 1% of families make the medical decision to forego vaccines. Coercion is unnecessary and divisive. The alternative, as laid out by the Centers for Disease Control and Propaganda, almost seems like the beginnings of a which hunt: which kids are unvaccinated in YOUR neighborhood, and what are YOU going to do about it?

– Dr. Bob Sears, Immunity Education Group

In other words, Dr. Bob doesn’t want vaccination rates at the school level (or district level, county level, whatever level) shared because he is afraid that it will turn into a “which hunt” for his patients. Or unvaccinated patients in general.

So much about this caught my attention since I was on that same CDC media call. Here’s a screen grab of my less-alarming notes:

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Yes, I cannot use less than symbols properly when typing quickly.

You’ll note the lack of CDC intimating that parents should go out and harass the parents of their children’s unvaccinated classmates. Since 21 states now offer this information, you would think the anti-vaxxers would be recounting these incidents if they were happening. But they aren’t. In fact, most parents I know who seek out this information want to know their child’s chances of being exposed to measles or chickenpox. Others want their children going to schools with high science literacy.

In fact, I’d venture to guess that most parents looking up immunization rates for their schools are using them far more legitimately than those looking up free and reduced lunch rates at schools. All sorts of data is available to parents in ways that preserves the privacy of students.

At one point on Facebook, Melissa Floyd, who is not a doctor, took over the reins of moderating the thread. And things went downhill.

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At that point, I asked Melissa for a citation showing that the CDC claims that immunity against measles lasts for a maximum of 15 years after MMR. I also pointed out that a woman in Washington died from measles. My comment asking for a citation seems to have disappeared, and Melissa moved on claiming that no school district with high PBEs was part of the measles outbreak and other such fabricated bologna. Fortunately, others asked her for a citation, and Dr. Bob jumped in to correct this piece of misinformation, right?

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Oh dang.

So we know that Dr. Bob isn’t very good at math (by his own admission) or at getting information about vaccines correct. He’s not good at social media, and he’s not good at choosing which side has the larger market base (hint: it’s the side with the 95% of parents who vaccinate).

But he’s great at doublespeak.

See, it’s not that measles lasts a lifetime. It’s that the package insert shows antibodies after 11-13 years. Dr. Bob still has antibodies from his MMR. But some adults might not have antibodies. How many adults? Not important. But the vaccine wears off and the CDC recommends boosters for people like pregnant women because of their rubella immunity. Oh, and if you spread misinformation, he will ban you.

It’s almost magnificent, the amount of obfuscation. In fact, he’s saying almost nothing. He is saying both that immunity from measles lasts 13 years, and that it lasts for much longer. He is saying that immunity from the MMR wanes and that it doesn’t for most people. And he is using pregnant women and their need to be immune to rubella as proof that measles immunity…something.

He might as well have posted a William Carlos Williams poem and told people to interpret it as they see fit.

His comment regarding the woman who died in Washington, though, was much clearer. He says we cannot know if she died from measles, and his actions show that he would prefer to believe that she didn’t because then he can’t lull people into believing that protection against death from measles is a matter of nutrition.

But here’s the thing. The coroner and the state department of health think she died from measles:

The death of a Clallam County woman this spring was due to an undetected measles infection that was discovered at autopsy.

The woman was most likely exposed to measles at a local medical facility during a recent outbreak in Clallam County. She was there at the same time as a person who later developed a rash and was contagious for measles. The woman had several other health conditions and was on medications that contributed to a suppressed immune system. She didn’t have some of the common symptoms of measles such as a rash, so the infection wasn’t discovered until after her death. The cause of death was pneumonia due to measles.

Dr. Bob can dissemble and juggle with the truth all he likes, but had this woman not been exposed to measles because of unvaccinated people, she wouldn’t have died.

That one fact, that someone in the United States in the year 2015 has died from an illness we can easily and safely prevent, is not something to ploy coy with. And because of her senseless death, parents want to make sure that their children are in places where such diseases are not spread. And I think that it’s every parent’s right to know how vulnerable their schools are to the spread of preventable disease.

Stop the Reduction of Science into Shouting Matches

When news becomes entertainment, it often devolves into shouting matches, and I don’t know about ratings or advertisers, but I suspect that these shouting matches are good for both. Bring together two people who staunchly support opposing positions, and–bam!–shouting match entertainment. But you know what they aren’t good for? Facts, and scientific facts in particular.

So inviting both Dr. Corey Hebert from Louisiana State University and Christina Hildebrand of A Voice for Choice on The Ed Show on MSNBC last month did absolutely nothing to further science. The discussion, which was supposed to center on Carly Fiorina’s statements about so-called parental choice and vaccines quickly devolved into hashtag-driven accusations about the horrors of vaccines and the impossible task of trying to refute these simplistic falsehoods by explaining complex science in mere seconds. Take a look:

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Of course, something that could have been a discussion about the balancing of rights when it comes to vaccine mandates became a discussion about vaccines and autism. When you invite an anti-vaccine activist onto your show, be aware that they only have two rabbits in their hat: vaccines cause autism (they don’t) and the CDC is evil (because evil).

The media is culpable, of course, because being salacious rather than sticking with the facts leads to outbreaks and perpetuates myths. And false balance is a real problem when it comes to science reporting, but especially journalism concerned about vaccines.

There is no clearer way to say it then this: vaccines do not cause autism, and there is no debate about concerning it. There are not two sides to vaccines and the science is not a political issue. The media need to keep this in mind when framing their stories.

One could make the case about the validity of discussing public policy and how best to require vaccines for school. However, that discussion is never going to happen meaningfully with an anti-vaccine activist because of those two rabbits I mentioned earlier. They only agree to media interviews so that they can perpetuate their long-disproven myths. They aren’t there for policy discussions. They are there to scare parents away from vaccines.

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And this is where everyone else in the world comes in. There are too many new journalists always coming into the industry who have immunization stories thrust at them even though they have no background in science reporting. False balance will always be an issue unless we do something.

I know how much we feel pulled to answer interview requests because we want to explain how safe and effective vaccines are to the public. It is a public service to go on television and make sure the news gets it right. But if we share space on the page or on TV with an anti-vaccine activist, we are only helping to give them the opportunity to sell their myths and we legitimize them by making their ideas seem equivalent with the science we are presenting. I put that in bold because if you read nothing else, I want you to understand that.

We need to stop agreeing to interviews when anti-vaxxers are being interviewed for the same story.

And I have done this. I am minor and easily replaceable, but it is a matter of principle. A minor cable news channel called and asked me for an on-camera interview. I asked immediately who else was being interviewed and found out they were also interviewing an anti-vaccine activist. So I said no. As luck would have it, they immediately called a friend of mine who told me about the request, and I was able to share with her what I’d learned. She, too, turned down the interview. What did they do? After watching the interview, it appears they stopped some random person in the parking lot and asked his opinion. Instead of the anti-vaxxer being given equal weight with a non-profit director, she was given the weight of a random guy from the parking lot. I wasn’t thrilled she was interviewed, but she didn’t seem as legitimate as she might have.

No matter who you are: a doctor, a public health official, a parent, etc., if someone calls and asks to interview you for a media story, the first words out of your mouth should be, “Who else are you interviewing?” If they are interviewing an anti-vaxxer, just say no. They might find someone else to interview, unless we all agree to stop being complicit in perpetuating false balance. But I hope, over time, they will just stop calling the anti-vaxxers and realize that the real battle is against preventable disease and not a cage match involving opposing sets of facts.

Menses, Vaccines, and Slacktivism

Reading about the woman who ran an entire marathon menstruating without a tampon made me think of vaccine advocacy. I recognize it is an odd leap, but advocacy shares commonalities no matter the cause.

In case you missed it, People magazine reported that Kiran Gandhi ran a marathon in London last April while blood soaked her pants:

Gandhi let her blood flow freely to raise awareness about women who have no access to feminine products and to encourage women to not be embarrassed about their periods.

The value of what might seem like an odd stunt was debated all over social media. Some felt that it highlighted a real issue while others felt that it solved nothing and amounted to slacktivism. Slacktivism is a form of activism that requires very little effort on the part of the activist and often leads to no real involvement in the issue at hand.

Gandhi being accused of slackvitism hit me. Granted, I work day in and day out trying really, really hard to get people to engage their friends, neighbors, and school administrators in order to raise immunization rates in their communities. For all my work, I have found that people are most comfortable with far lesser forms of activism: sharing Jimmy Kimmel videos on Facebook, wearing a pro-vaccine t-shirt, or Tweeting at Jenny McCarthy. Are their efforts (and mine) worthwhile?

To answer that question, I really need to unpack what the cause is. Even though we bill ourselves as the pro-vaccine movement, we are really, at our heart, anti. We could see ourselves as anti-disease or as anti-vaccine hesitancy. In either instance, we are doing battle against things contagious that threaten public health.

If we are simply anti-disease, so-called slacktivism is not actually slacking off. The first course of action against preventable disease, after all, is to get your child (and yourself) vaccinated, since vaccines do battle against the diseases directly. The next step is simply to make vaccinating normal so that others will do it, too. Sharing that Jimmy Kimmel video certainly gives an air of “Normal people vaccinate” and might also remind people to check on their immunization status.

Vaccine hesitancy is a different monster, though. Jimmy Kimmel is not going to make a parent who has concerns about vaccines laugh those concerns away. As I wrote earlier, turning the tides of vaccine hesitancy requires people who care about the hesitant addressing concerns with them and sharing stories about why we vaccinate. This person-to-person, retail advocacy is the exact opposite of slacktivism. It is more akin to building a Habitat for Humanity house, except that no one will ever drive past the house and look at it because you cannot drive past outbreaks that never happened and note their lack of existence.

The pro-vaxxers who have vaccine hesitant friends whom they engage are the ones getting their hands dirty with activism. But they aren’t alone. The Washington Post reviewed a study on slacktivism and how to engage activists more deeply:

[T]hose whose initial act of support is done more privately (for example, writing to a member of Congress) are more likely to engage in deeper, more costly forms of engagement later on. Those whose initial support is public (i.e. through posting to Facebook or Twitter) are less likely to engage more deeply. Moreover, the researchers find that most appeals for token engagement “promote slacktivism among all but those highly connected to the cause.”

In other words, those who are engaging in pro-vaccine advocacy primarily through social media might be the people who appear to be the face of the pro-vaccine movement, but they may not be the ones moving the needle (pun intended) on vaccine advocacy. People who are writing legislators, engaging the media, talking to their school administrators, requesting pro-science books added to library collections, and a hundred other mundane, private tasks are pushing their neighbors to confront fears about vaccines in order to raise immunization rates. Their work is both anti-disease and anti-vaccine hesitancy.

Which is not to say that being pro-vaccine primarily on social media is inferior. Of course, there are ways that social media activism can effect real change concerning vaccine hesitancy and the grip the anti-vaccine movement has on Facebook and Twitter. For example, it was through social media that Chili’s was convinced to drop their support of an anti-vaccine organization. I’ve also used social media to prompt pro-vaxxers into private forms of advocacy, writing letters to congress and asking them to cancel a anti-vaccine hearing, for example.

Thus, being engaged in awareness raising does not preclude a person from making a real difference. However, the leap from sharing a funny pro-vaccine meme on Facebook to writing a company or a policymaker is wide, and often people engaging on social media are not ready to make that leap. My past personal experience has shown that in order for pro-vaxxers to take on get-your-hands-dirty activism, they have to be alerted to an immediate need that requires specific, short-term action (such as writing to have a hearing canceled or posting on Chili’s social media page). Between those actions, then, a little so-called slacktivism or awareness raising is necessary to keep people interested.

If you are waiting for me to rule on Kiran Gandhi, you may have waited in vain. While I don’t consider her cause one of those that drives me, I do donate feminine hygiene products to the local food shelf. And I hope that someone reading today’s post might write a letter to a school administrator and ask how the vaccine rates are and what might be done to raise them.

And why not. Here’s Jimmy Kimmel again.

No, There Isn’t a Simple Way to Get Anti-Vaccine Parents to Vaccinate

Everywhere you look, the media is telling you that you can scare anti-vaccine parents into vaccinating by showing them photos of sick kids and telling them stories about diseases. Article after article after article lately is telling us that we can win vaccine debate and change minds–simply! Why didn’t we all think of this before? (Seriously. Click that hyperlink.)

The buzz in the media is based on a new study published in PNAS looking at ways of countering anti-vaccine beliefs. The study looked at over 300 people with varying degrees of vaccine acceptance and hesitancy and presented them with one of three forms of vaccine information: a mother’s story about her child’s measles, facts debunking vaccine myths, or information about birds. The stories, it turns out, had the greatest effect on attitudes about vaccines. As Tara Haelle at Forbes points out:

So, presenting individuals with the dangers of not vaccinating, both in words and in images, seemed to help them think more positively about vaccines. In fact, the effect was most dramatic in those who had the lowest scores – the poorest attitudes toward vaccines – at the start.

Let’s be very clear that this study absolutely did not measure whether or not parents of unvaccinated children then went out to vaccinate their children. Their attitudes simply shifted because the risks associated with not vaccinating were reframed for them in a way that was both relatable and memorable. (In fact, I’m quoted in Haelle’s article saying that.)

I mention this limitation because I do not want pro-vaccine advocates to be lulled into thinking that the way to win debates or get people to vaccinate is to bombard them with pictures of sick kids and stories about suffering children. I can imagine social media arguments where anti-vaxxers make their same tired assertions only to be answered by a well-meaning pro-vaxxer who thinks she can solve it all by posting a photo of an ill child. I’ve been to the rodeo a few times, and while that might get some attention, we aren’t going to solve the issue of vaccine hesitancy that way.

In fact, I have witnessed in person that very technique not working. I was at a screening of the film Invisible Threat, which contains two stories of disease and its awful effects. Afterward, during the Q&A, one woman wanted to talk about how Vaccine Court proves that vaccines are unsafe. See how easy it is to set aside a story in favor of your own entrenched beliefs?

Do you know what actually makes people deconvert from the anti-vaccine movement? Other people who care about them.

I have spoken to and worked with and met many, many people who used to be anti-vaccine and many more who had some degree of fear about vaccines. Understanding the risk of disease through story was vital to them understanding why we prevent those diseases, but it wasn’t the end of their deconversion. Every one of these people I have met has had someone in their life–a doctor, a friend, a new acquaintance, a family member–who cares enough to keep a civil conversation going. And the conversation was not grounded in winning a debate. The conversation was grounded in a sincere and deep concern about protecting children.

So go ahead and tell your stories about your encounters with disease. They are critically important because they remind us that we don’t do all of this for nothing. But ground this conversation in kindness and goodwill, and plan on sticking around for a while. Telling the stories is just the first step. Showing we care enough to keep talking is crucial. And no, it’s not easy.