Home > Expert Insights, Parent Perspective, Vaccine Myths > Asking Before They Play: How to Handle the Response

Asking Before They Play: How to Handle the Response

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.

 

DrZibnersPart 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.

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.   

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.

 

  1. July 23, 2014 at 5:26 pm

    Thank you for writing this series. It’s a different story for us, as we live in our nation’s region of lowest vaccination uptake.which means just over half the kids are not vaccinated. Which means it’s harder to limit our kids exposure to unvaccinated children. It would be akin to punishing our children if we didn’t allow them to go to any birthday parties, or play with their friends. They would be like social pariahs here if we strictly enforced them not playing with unvaccinated kids. Having said that, we are vocal about our pro vaccination stance and hope to start conversations with people in order to slowly turn this situation around.

    Like

  2. Tim
    July 23, 2014 at 11:18 pm

    Chickenpox used to kill an average of 100 people a year, out of four million, who got it, about fifty children and fifty adults. Why would you say that’s more than all the other VPDs put together? More than all the cases of the three vaccine-preventable types of meningitis put together?

    Like

  3. July 24, 2014 at 2:57 am

    Tim, thanks for catching what I knew would be flagged up. If you look at the statistics for 1995 and what we routinely vaccinated for, the comment holds. DPT: 12, OPV: 1, MMR: 5 HIB: 12. These were deaths across ALL age groups, so the pediatric portion was a segment of this. Varicella was responsible pediatric deaths at a rate of 13 to 16 a year, over 100 including all age groups. The numbers are impressive and varicella clearly dominated. Also impressive that most varicella deaths occurred in otherwise healthy individuals. You are correct, that in today’s terms, it’s not true. But we didn’t routinely vaccinate for meningoccus then. I also excluded Hepatitis B deaths (if you are going to call me on that) because it doesn’t kill children, nor does it kill acutely. So YES, to the point, thank heavens we have the meningitis vaccines NOW!

    Like

  4. David
    July 24, 2014 at 10:19 am

    This is a fantastic article. I always have a hard time staying perfectly calm during the conversations where the other parents are quoting Jenny McCarthy and youtube videos as easily as I may quote WHO findings and information from the CDC. You are very correct: it is wise to maintain the bridge lest a rational conversation could exist in the future. A lesson I hope I have learned as my brother and his wife have chosen not to vaccinate their now one-year-old and things have gotten tense to say the least.

    Like

  5. JGC56
    July 25, 2014 at 11:06 am

    I note whenever the benefits of varicella vaccination comes up both pro- and anti-vavers focus all but exclusively on mortality. Those who support vaccination note “In the USA chicken pox used to kill as many as 100 people a year!” while those who oppose it argue “We’re vaccinating millions of people to prevent a measly 100 deaths a year!”

    But we’re not in fact “vaccinating everyone to prevent 100 deaths a year”: although there may have only been 100 deaths a year there also were on average four million infections, mostly in children, resulting in 10 to 13 thousand hospitalizations. We’re instead vaccinating everyone to prevent millions of people (again, mostly children) from the suffering and costs associated with contracting a serious illness.

    I think it’s important to step back and see that larger picture.

    Like

  6. Tim
    July 25, 2014 at 1:30 pm

    But stepping even further back shows us that it’s good to get chickenpox as a child when it’s nearly always mild. You get permanent immunity and don’t have to worry about it as an adult, when it can be more dangerous. You can get shingles later either way, from the shot or the disease, but lack of chicknpox virus in the environment to give natural “boosters” to everyone who had chickenpox in the past has resulted in a lot more cases of shingles than ever before. Very few countries give this vaccine, for those reasons.

    Like

  7. Chris
    July 25, 2014 at 1:45 pm

    Tim: “But stepping even further back shows us that it’s good to get chickenpox as a child when it’s nearly always mild. You get permanent immunity and don’t have to worry about it as an adult, when it can be more dangerous.”

    That is a lie. Shingles is not pleasant, and making children suffer for up to two weeks with dozens of itchy open sores that could become infected with bacteria is cruel and sadistic. Instead of wanting kids to get sick, you can avoid shingles by getting zoster vaccine.

    Only a person who hates kids and wants to see them suffer would suggest they are better off with the disease than the vaccine.

    Like

  8. Lawrence
    July 25, 2014 at 2:43 pm

    @Tim – can you please cite any source that shows that disease is “beneficial?”

    Like

  9. thirdwarning
    July 25, 2014 at 5:14 pm

    When antivaccine parents often object to their children being asked to ‘take one for the team’ in response to comments about the breakdown of community immunity, I have no idea why Tim would want children to suffer and risk more and greater suffering later so that some few adults might avoid shingles.
    Tim, do you have evidence that varicella vaccination has resulted in ‘a lot more’ cases of shingles?

    Like

  10. July 26, 2014 at 3:37 am

    The evidence is that having the varicella vaccine potentially decreases the risk of shingles. And then we have a shingles vaccine. The reasons some other countries (the UK where I live and work) don’t give it routinely is money, not benefit. Which is why I paid for my kids to get it.

    Like

  11. July 26, 2014 at 3:37 am

    And agree! Big picture!

    Like

  12. Tim Harley
    July 27, 2014 at 2:18 pm

    Thirdwarning,
    Those children who get chickenpox as children, when it is nearly always mild, are then protected from getting it as adults, when it can be more dangerous. The booster effect of kids getting chickenpox all around us is just an added benefit for adults.

    Like

  13. Chris
    July 27, 2014 at 2:22 pm

    Mr. Harley, how is getting chicken pox better than preventing it with the varicella vaccine? Provide some actual verifiable studies to show that the vaccine is worse than the disease.

    The adults who worry about shingles can get a zoster vaccine instead of hoping some nearby kid gets to suffer for over a week with itchy open sores (pox).

    Like

  14. Shay
    July 28, 2014 at 1:28 pm

    “We’re vaccinating millions of people to prevent a measly 100 deaths a year!” And to prevent millions of parents from suffering the same kind of mental anguish my mother went through when three of us came down with it at once (1960). She resorted to duct-taping mittens to our hands to keep us from scratching, and I’m surprised she didn’t have a nervous breakdown.

    Only someone who has never had the chickenpox would think that it is a mild and harmless disease.

    Like

  15. Shay
    July 28, 2014 at 1:30 pm

    Oh, and Tim? I’ve had shingles. Twice. I can’t wait until next year when I’m old enough for the vaccine.

    Like

  16. Chris
    July 28, 2014 at 7:10 pm

    Shay: “She resorted to duct-taping mittens to our hands to keep us from scratching, and I’m surprised she didn’t have a nervous breakdown.”

    Which is why I think anyone who wants kids to get chicken pox just so he as a full grown adult does not need to get the shingles vaccine is a sadistic child hater.

    Like

  17. Tim Harley
    July 29, 2014 at 11:51 am

    Shay,
    I’ve had shingles too, but it wasn’t a bad case, and I’ll never get the shingles vaccine. I’d rather get shingles every year.
    Chris,
    Were you the one talking about helicopter parents not long ago, scoffing at their overprotectiveness? You probably realize that it’s a tough world out there. Most of us let our children ride bikes, play soccer or football, take baths by themselves when they’re old enough, some people make their children hold still while a painful needle is pushed into their flesh and held there for a few seconds, and so many other things that kill or disable a few people. We make them get cavities filled at some discomfort, even pain, for themselves. We make them study and do homework regularly even when it is hard and boring, keeping them from doing more enjoyable things, and we make them suffer the anxiety, boredom, humiliation, and fear of going through the education gauntlet. The immune system won’t work well if it doesn’t get real life practice, sort of like school work and sports. A few days of itching really isn’t a big deal, especially when it has so many longterm benefits.

    Like

  18. Chris
    July 29, 2014 at 12:15 pm

    ” I’ll never get the shingles vaccine. I’d rather get shingles every year.”

    and (added emphasis):

    “Most of us let our children ride bikes, play soccer or football, take baths by themselves when they’re old enough, some people make their children hold still while a painful needle is pushed into their flesh and held there for a few seconds, and so many other things that kill or disable a few people.”

    Wow, you want kids to suffer from chicken pox just because you have a needle phobia. Nice. And still very sadistic.

    A person who has decided that chicken pox is preferable to a “painful needle” and that it is “held there for a few seconds” does not have a clue. The needles are very small and not painful, and definitely not as painful as a fever and dozens of itch painful pox.

    Getting a possibly disfiguring disease is not a reliable nor desirable “growth experience.” The up to two weeks of being sick and in pain would be better spent playing and getting to actually attend school.

    Mr. Harley your next comment better contain the PubMed indexed studies by reputable qualified researchers (Gary Goldman does not count) that shows there is greater risk from the varicella vaccine than actually getting chicken pox.

    Like

  19. Lawrence
    July 29, 2014 at 6:52 pm

    Chicken Pox was a combined 8 week hell in my house (I got it, then my sister got it, then my brother got it), each case worse than the last.

    I know we would have preferred the vaccine over the disease, hands-down.

    Like

  20. Tim Harley
    July 29, 2014 at 7:20 pm

    Well, Lawrence, I’m all about free and informed choice.

    Like

  21. Lawrence
    July 29, 2014 at 7:30 pm

    A choice we didn’t have, since the vaccine was still years away. Luckily, my kids won’t suffer the same agony or possibility of severe side effects from the disease….now, if I was only old enough for the shingles vaccine….

    Like

  22. July 29, 2014 at 7:32 pm

    @tim – so, what are the benefits of Chicken Pox, except for the joy of getting Shingles later in life?

    Like

  23. July 29, 2014 at 7:37 pm

    Tim, are you aware that chickenpox has potential complications including death?complications range from bacterial infections of the skin and tissues under the skin
    (including group A streptococcal infections),dehydration from vomiting or
    diarrhea, pneumonia and Encephalitis. Vaccines are not made for trivial diseases and while the majority will come out unscathed (albeit having suffered horribly for having the disease) these complications can’t be ignored. According to the CDC, between 10,500 and 13,000 people were hospitalised per annum due to chicken pox complications prior to the vaccine, and 100 to 150 people would die as a result of chickenpox.

    Like

  24. July 29, 2014 at 7:41 pm

    May I also add that there are plenty of opportunities for our immune systems to get a workout, and it doesn’t have to include potentially deadly diseases in order to be strong. On average it is estimated that a baby will encounter between 2000-6000 immune challenges every day. So subjecting your children to dreadful diseases instead of just getting them vaccinated doesn’t make sense.

    Like

  25. July 29, 2014 at 7:46 pm

    @Heidi – perhaps if one is a sadist and enjoys watching children suffer…..

    Like

  26. Chris
    July 29, 2014 at 8:39 pm

    Mr. Harley: “Well, Lawrence, I’m all about free and informed choice.”

    So make us informed by providing the the PubMed indexed studies by reputable qualified researchers that shows there is a greater risk from the varicella vaccine than actually getting chicken pox.

    Like

  27. novalox
    July 29, 2014 at 11:00 pm

    @tim

    Tell that to the patient I saw who had scarring across his body because of chicken pox. I’m sure they’ll tell you how nice chicken pox really was.

    Like

  28. Tim Harley
    August 2, 2014 at 2:49 pm

    I believe people should be allowed to make their own decisions as to what, if any, vaccines they will get for themselves or their children. It is impossible to get accurate statistics one way or the other, for one thing. Everyone with any kind of an financial interest in vaccines, direct or indirect, cannot be trusted to publish or tell you the truth. It’s always going to come down to personal philosophy and the experience of the individual person and his family, friends, and those he hears or reads about. Four million people, most of them children, used to get chickenpox every year, and very very few of them had a bad case or died of it. I had it, everyone I knew had it. I’ve had experience with vaccine damage, and I just don’t want the shot. And it’s my right to refuse it.

    Like

  29. Chris
    August 2, 2014 at 9:25 pm

    “Everyone with any kind of an financial interest in vaccines, direct or indirect, cannot be trusted to publish or tell you the truth.”

    Why should we believe you? And have you ever had to choose between not going to work to paying someone to come to your house to watch your sick child so you could go to work? I knew people who had to make that choice. Some were even impacted when my kids got chicken pox because one was getting language therapy from student clinicians, and his not being able to go to four sessions impacted the required hours the student required to graduate and be certified. That is an economic impact you are ignoring.

    I should also mention during a chicken pox outbreak the school nurse was not very happy with a parent who sent the child with a fever to school with a bottle of Tylenol.

    “Four million people, most of them children, used to get chickenpox every year, and very very few of them had a bad case or died of it.”

    So what? At least a hundred died per year, and many suffered permanent injuries and scarring. So exactly how many people have to die from a vaccine preventable disease per year for you to care? Obviously it needs to be more than a hundred. Is it two hundred? Or is it four hundred? Do tell us.

    Oh, wait, you want kids to suffer between a week to two weeks with fever and dozens of open itchy sores because you have a needle phobia. Or are just sadistic.

    And again, give us the the the PubMed indexed studies by reputable qualified researchers that shows there is a greater risk from the varicella vaccine than actually getting chicken pox.

    Like

  30. Gray Falcon
    August 3, 2014 at 6:54 am

    Tim, how can you call the deaths of a hundred children a year acceptable losses?

    Like

  31. Chris
    August 3, 2014 at 11:49 am

    It seems odd that he would think claiming “only a hundred deaths from chicken pox” is evidence that the vaccine is unsafe and useless.

    Like

  32. JGC56
    August 4, 2014 at 10:52 am

    “I believe people should be allowed to make their own decisions as to what, if any, vaccines they will get for themselves or their children.”

    And you know what? They do. They’re simply not free of all consequences which follow up their decision: if they elect not to have their children vaccinated, those children may not be eligible for enrollment in a public school. If they elect not to vaccinate themselves, they may not be eligible for employment as a health care professional where they would place their clients at risk.

    “ It is impossible to get accurate statistics one way or the other, for one thing.”

    Why not?

    “Everyone with any kind of an financial interest in vaccines, direct or indirect, cannot be trusted to publish or tell you the truth.”

    Why not?

    “It’s always going to come down to personal philosophy and the experience of the individual person and his family, friends, and those he hears or reads about.”

    I’m sorry, you’re wrong. It comes down to evidence—not personal philosophy, not anecdote.

    “Four million people, most of them children, used to get chickenpox every year, and very very few of them had a bad case or died of it.”

    Why the narrow focus on deaths due to chicken pox? Isn’t safely and effectively preventing four million people (mostly children) from illness and suffering a reasonable end of itself?

    I’ll also note that chicken pox resulted in 10 ,000 to 13,000 hospitalizations each year, which I would say qualified as “bad cases”, and is a number that no rational person would characterize as “very, very few”.

    “I had it, everyone I knew had it.”

    Which attests to how well routine vaccination works: it’s no longer the case that everyone will experience infection.

    “I’ve had experience with vaccine damage, and I just don’t want the shot.”

    What damage are you attributing to vaccination, and how have you factually established that damage actually was caused by a vaccine? It is on some basis other than a post hoc ergo procter hoc logical fallacy, I trust.

    Like

  33. Tim
    August 4, 2014 at 3:21 pm

    But children in 48 states can get a religious exemption to attend public school, and the state can’t question the nature of the religious beliefs. And no, I don’t think preventing everyone from getting usually mild diseases is a valid end in and of itself. I think it’s less dangerous to just go ahead and get the diseases. Others can decide as they like. You are saying that I have to reason the same way you do and make the same decisions you have, but I am saying that I don’t have to and am not going to.

    Like

  34. Chris
    August 4, 2014 at 3:43 pm

    Tim: “I think it’s less dangerous to just go ahead and get the diseases ”

    Prove it. Provide the PubMed indexed studies by reputable qualified researchers that shows there is a greater risk from the varicella vaccine than actually getting chicken pox.

    Otherwise we will still believe your reasons are because you have a needle phobia and like to see kids suffer from a preventable illness.

    Like

  35. Gray Falcon
    August 4, 2014 at 7:13 pm

    Tim, imagine watching a film, and hearing someone say “A hundred people will die, mostly children. We consider that an acceptable loss.” Is that a hero, or a villain?

    Like

  36. JGC56
    August 5, 2014 at 10:08 am

    “I think it’s less dangerous to just go ahead and get the diseases.”

    But WHY do you think this, Tim? Do have any actual evidence demonstrating that the risks associated with routine childhood vaccination exceed the risks associated with remaining vulnerable to the diseases they protect against?

    Take your example of chicken pox. Before vaccination, in the US, there were 4 million cases (mostly children) every year, requiring 10 to 13 thousand hospitalizations and causing 100 to 150 deaths.

    Does routine childhood vaccination against chicken pox cause more than 4 million people to become ill every year?

    Does routine childhood vaccination against chicken pox cause more than 10 to 13 thousand people to require hospitalization every year?

    Does routine childhood vaccination against chicken pox cause more than 100 to 150 deaths every year?

    For your claim “it’s less dangerous to go ahead and get the diseases” to be true he answer to all of the above must be “Yes”–and quite frankly, I think we’d all have heard if this were happening.

    Like

  37. January 28, 2017 at 10:02 pm

    Reblogged this on autisticagainstantivaxxers.

    Like

  1. July 24, 2014 at 11:21 am

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