Asking Before They Play: How to Handle the Response
Jul 23, 2014

In the first part of this series, Ask Before They Play to Keep Chickenpox, Pertussis and Measles Away, Dr. Zibners explores why a parent might be concerned if their vaccinated child has unvaccinated playmates.  In the second part, Are Your Child’s Friends Vaccinated, she provides tips on how to pose the question to others.  In this final post she offers suggestions on how to respond when the answer isn’t exactly what you were hoping for.

 

Part Three: Handling the Response

By Dr. Lara Zibners

In parts one and two of this series, I’ve been equating a conversation about firearms in the home to one about immunization. Both can be awkward but both are very, very necessary. But suppose the answer isn’t the one you were hoping for.

You take a deep breath and spit it out: “Do you keep a loaded gun in the house?” If the answer is yes, there’s another conversation to be had: “Where are they kept? Are they secure? Where is the ammunition? I meant a revolver, not your staple gun!”

In the same way, you may want to open the conversational door about vaccines. What if the answer is

“Oh, no, we don’t vaccinate”

Do you panic? Jump to conclusions? Grab your child and run screaming?

No. Obviously not. My kids are numerous (3) and heavy (nearly 90 pounds combined). I can’t run anywhere. But besides that, it’s best not to start the conversation by assuming that every unvaccinated child has parents who are unwilling to vaccinate. If you find out that your child’s best friend hasn’t had his MMR vaccine, don’t turn away just yet. Take a deep breath and ask one simple question:

“May I ask why?”

If the reason a child isn’t vaccinated is actually a legitimate one (underlying illness, severe allergic reaction, or age), it’s easy.

“Oh, wow, that must be really difficult for you. I’m so pleased to let you know that mine are covered. I’m honestly thrilled that we can help protect your family as well as ours.”

Hey, not only was that easy, but you sound pretty heroic, eh?

But what if the other parent expresses concern, confusion or has been influenced by misinformation? When discussing vaccines with other parents, it’s best to try to remain as calm and as matter-of-fact as possible. You have armed yourself with knowledge, so why not share that with others? If you stick to the facts and leave the door open for questions, you’d be amazed at how many parents are just confused or fearful than hard-core anti-vaccine.

“What? Oh, no, I know what you mean. I used to think that too. Until I learned that chickenpox was killing more people than everything else we used to immunize for put together. Isn’t that shocking?”

“Gosh, I spoke with my child’s doctor about exactly that same thing. Did you know that so many studies have been done looking at that exact question and they just can’t find an association? In fact, the rate of autism has gone up after the removal of thimerosal from vaccines.”

Or take yourself out of the loop. After all, unless you are an expert in pediatrics, immunology or public health, why not bolster your credibility with a list of expert resources?

“Did you know that a huge percentage of what can be read on the Internet in regard to vaccines is not supported by science? Our pediatrician gave me some great resources that address those exact concerns. I’ve got a list of credible websites that I can share with you.  They’ve helped me to understand that immunizations are both safe and effective.”

But whatever you say, as hard as it is, it’s a good idea to try to remain nonjudgmental as well. And believe me, I find that really hard. I can’t even go to the grocery store without unconsciously registering an opinion on other shoppers’ hairstyles. Really hard. But if we want to keep this door open, we can’t come at them guns blazing, can we? Because the only appropriate response when being attacked is to either retreat or attack back. And neither of those responses is going to be helpful in getting our kids’ friends vaccinated, is it?

So I don’t back down from my belief that vaccines are a medical miracle, but I also take the time to listen, pinpoint the exact concern and address precisely that. My advice is to avoid broad sweeping statements which can sometimes sound like rhetoric and close down a conversation, rather than open it. Focus on specific concerns and conquer them with facts.

In other words, don’t just scream: “Are you nuts? Vaccines are awesome!”

Try this:

“Did you know that even though kids today get more vaccines than when we were young, it’s great to know they’re protect against far more diseases and all with far fewer antigens in the vaccines.  I’m so grateful that our kids and the vaccines they get are safer than ever before.”

Of course the flip side to that is when the answer you receive indicates that this parent’s view is not going to change over a few cups of coffee. When they say something patently anti-vaccine, such as, “I’ve done my research and vaccines are poison/don’t work/government conspiracies/tiny injectable bombs,” what are you to do then?

The reality is that there are people out there who are so deeply committed to their anti-vaccine position that it’s going to take more than a conversation on the playground to sway them. You might be surprised to learn that as pediatricians, we care for families who have lost, or nearly lost, a child to vaccine-preventable illness and yet some still refuse immunizations. That’s how deeply embedded these suspicions and beliefs may be.

My personal approach in that situation?

Take a breath and walk away, which still leaves the door for future, rational conversation open. I don’t waver on my stance. I don’t apologize for my beliefs. After all, I have years of scientific proof and a whole lot of really smart people backing me up. But I also don’t engage in something I can tell is going to be adversarial.

You might think this is cowardly of me, but I’ll beg to differ. In my job, I see some really horrible things. If I took every death personally, or if every seriously ill or injured child came home with me, I wouldn’t last very long at this, would I? If I got into an hour-long, emotionally draining and circuitous conversation with every parent who disagreed with me, no matter what the issue was, how long would it be before I went home and stuck my head in an oven? I will argue that being a pro-vaccine mom and doctor is the same kind of fight. One that I will work for on a larger scale, focusing my energy on doing the most good for the greatest number of people.

In the meantime, my kids don’t go play at homes with unvaccinated children.  That’s our right as parents. If the answer to the vaccinated question is one you aren’t comfortable with, you don’t have to send your children to their house, nor do you have to invite them to yours.

Of course, the good news is that these families are going to be the minority. Even if some parents are hesitant about vaccines, they may be vaccinating on a delayed or alternative schedule. While not ideal, it’s still some protection. By engaging in a conversation, you may soon find the door open to dispelling common myths and misunderstandings. And in that spirit, we’ll draw this topic to a close.

You should care if your children’s friends are vaccinated. You should ask about the immunization status of other families. And now you are ready to.  Simply remain calm, ask about their concerns, and then extend your hand and hopefully help another family make the right decision to vaccinate.

Here’s a list of awesome resources that Every Child By Two (ECBT) has compiled that address frequently asked questions and misconceptions about vaccines:

Familiarizing yourself with this information will ensure that you are ready to share these links or print these materials when you encounter someone who is questioning vaccines.

• Expert Responses to Frequently-Asked Questions about Vaccine Safety (Videos with transcripts that can be downloaded & printed)
• Strategies for Talking with Parents About Childhood Vaccines (Developed by CDC, AAP & AAFP)
• CHOP Vaccine Education Center Materials for Parents (Materials available in English & Spanish)
• Brochure Listing Websites and Books with Reliable Vaccine Safety Information
• Parents’ Guide to Immunizations (Resource can be printed & distributed)
• The Risks and Responsibilities of Not Vaccinating (CDC fact sheet)
• Ensuring the Safety of Vaccines in the U.S. (Fact sheet on vaccine safety systems & oversight)
• Understanding Thimerosal, Mercury and Vaccine Safety (CDC fact sheet)
• Childhood Immunization Flier (ECBT fact sheet developed for pregnant women)
• Understanding MMR Vaccine Safety (CDC fact sheet)
• Pertussis: Protect Your Loved Ones (ECBT fact sheet)
• Vaccines 101 and Media Training Webinar (Archived webinar w/ educational booklet that may be downloaded & printed)
• Bringing Immunity to Every Community (Online education course for nurses & advocates. CE credits for nurses available.)

The following resources allow vaccine advocates to share impactful stories that demonstrate the risk of vaccine preventable diseases to those who believe these diseases are not deadly or dangerous.   

• Stories of victims of vaccine-preventable diseases (Every Child By Two)
• Stories and videos of those affected by vaccine-preventable diseases (Shot by Shot)
• Videos of families affected by vaccine-preventable diseases (PKIDs)
• Vaccine-Preventable Disease – The Forgotten Story (Texas Children’s Hospital)
• Emotional stories of families impacted by flu (Families Fighting Flu)

Of course, feel free to add your comments and suggestions to each of the three posts in this series.  In sharing our experiences we can help one another to feel more comfortable in discussing vaccines with other parents.

 

Dr. Lara Zibners is board certified in both general pediatrics and pediatric emergency medicine.  As the author of the award-winning book “If Your Kid Eats This Book, Everything Will Still Be Okay,” and a hilarious blog, Dr. Zibners has been an avid and very public supporter of vaccination.

 

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