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Posts Tagged ‘vaccine hesitancy’

Concerned Parents Duped by Deceptive Sound Bites and Junk Science

December 1, 2016 2 comments

One of our priorities on Shot of Prevention blog is to provide accurate, evidence-based immunization information so that people can make educated decisions for themselves and their families.  Unfortunately, people are sometimes duped into believing things that are inaccurate, causing them to question the safety, efficacy or importance of vaccines.  If we are to improve vaccine confidence, than we must work to understand why anti-vaccine messages resonate with people.  In this guest post, we learn more about the research being conducted to help us change the trajectory of the anti-vaccine movement.

Concerned Parents Duped by Deceptive Sound Bites and Junk Science

by Meghan Bridgid Moran, Assistant Professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health

Any parent voicing even the slightest concern about vaccinating a child is lumped in as a member of an inglorious club: “the anti-vaxx movement.” The news media castigates them, other parents shun them and the medical community can’t understand them.

The reality is more complex.

Sure, a very small percentage of parents refuse all vaccines for their children. And there are people and organizations that flatly and loudly assert, falsely, that vaccines are dangerous. But most parents are simply trying to do what’s best for their children in a world saturated with information and misinformation. They just want to protect their families. These are the people who deserve our sympathy, not our ire.

istock_000045885926_xxxlargeAnti-vaccine messaging—however misguided, however misleading—resonates with them. As a result, an increasingly alarming number of parents are opting out of routine vaccinations for their children. Every day, more kids are being exposed to once-tamed vaccine-preventable diseases like measles and whooping cough.

To understand how concerned parents could be persuaded not to vaccinate their children, a team of researchers at San Diego State University and I conducted a deep dive into 480 anti-vaccine websites to analyze their tactics and assess their methods. The picture that emerged from these sites—from Natural News to Mercola to Think Twice—is at once bracing and informative: Anti-vaccine websites leverage an arsenal of powerful and persuasive tactics to manipulate people into believing vaccines are dangerous.

Predictably, these sites appeal directly to people who are interested in choice, personal freedom and the ability to make their own informed decisions — all valiant ideals. “Natural treatments” and “homeopathic remedies” are held high and offered up as bona fide vaccine alternatives. Yet in the end, these sites betray those who visit them.

Here are a few key findings from our research

Read more…

Physicians Can Help Influence Vaccine Opinions By Engaging Patients on Social Media

September 8, 2016 6 comments

posterDr. John Merrill-Steskal has spent 22 years as a Family Medicine Physician.  He believes that doctors can help promote healthy behaviors by becoming more engaged on social media. Throughout the past year, in an effort to help shape public perception on a variety of medical topics such as vaccines, Dr. Merrill-Steskal has begun hosting a monthly radio show,  blogging at Triple Espresso MD, and contributing guest posts on other blogs such as KevinMD.  We welcome his latest contribution:

Vaccine hesitancy: It’s time to go on offense

by John Merrill-Steskal, MD

The term “vaccine hesitancy” is a relatively recent term in medicine, a term used to describe patients who are worried about the safety, efficacy, or necessity of receiving immunizations. Vaccines are safe and have a proven track record of saving lives. As a result, doctors have been caught somewhat off guard by the notion that anyone would have second thoughts about the benefits of immunization.

Recommendations commonly publicized on how to respond to the vaccine hesitant patient are admirable, and have a calm, respectful tone.  For example, doctors are encouraged to engage patients and respond to their concerns, while giving a clear message to recommend vaccination. Since treating patients disrespectfully or with disdain will only serve to alienate them further, being respectful, calm, and clear in our communication is our best chance at tipping the scales in favor of vaccination

The problem with this approach, however, is that physicians are on the defensive before a discussion even begins. And as in sports, a good defense without an offense will not win the game. Because of where we talk to patients, doctors are at a critical disadvantage: the physical place in which physicians engage patients about vaccines is typically the exam room, and by the time patients have arrived to the clinic they may well have already formed their opinions about vaccines.

As a result, physicians are forced to respond and react to concerns, and must attempt to reclaim ground that has already been lost. In other words, because of the nature of where physicians physically interact with and engage patients, we are by default always on the defensive as we work to dispel myths and misinformation regarding vaccine safety or efficacy.

To make a true difference on vaccine hesitancy, I think doctors must engage patients where the dialog is happening in real time: in the world of social media.

Every day patients acquire information, discuss concerns, and formulate opinions within the realm of social media.  By the time a patient enters the exam room, their mind may already be made up about vaccines. While our discussions with individual patients in exam rooms will always be important, it is becoming equally important for physicians to enter the dialog where it is being created, before the patient arrives at the clinic. Physicians need to pay attention to what patients are talking about on social media, and need to be a part of that dialog.  If we don’t, we will always be on the defensive.

If we are to advance vaccination, physicians must leave the safety of the exam room and meet patients where their opinions are being created.  Start a blog, tweet an opinion grounded in science, or engage patients online; by having a stronger voice in social media, doctors have the opportunity to be more influential in shaping opinions before our patients have become “hesitant“.

It is time to go on the offensive, and is the only way we will win the game.

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Dr. Merrill-Steskal is joined by a guest on his monthly radio show.

 

Dr. John Merrill-Steskal has recently been accepted to the 2016 American Academy of Family Physicians Vaccine Science Fellowship, an elite fellowship program which only accepts two providers per year.  We look forward to learning more about his work in the area of immunization education and we suggest readers also check out his other immunization related blog posts such as Past and Present: Rubella and Zika and Can the anti-vaccine movement be convinced with more positive messages?  

You can follow him on Twitter @MerrillSteskal.


Every Child By Two (host of the Shot of Prevention blog) welcomes guest blog posts on a variety of vaccine related issues.  The views and opinions expressed in these guest posts do not necessarily represent the views of the Every Child By Two organization.

A Physician’s Plea to Those Who Don’t Vaccinate

July 14, 2016 14 comments

What value do vaccines have in your life?

Throughout July and August, Shot of Prevention is encouraging people to address this question.  Today’s guest post, by clinical cardiologist Dharmaraj Karthikesan, provides a personal perspective from someone who is genuinely concerned about the health and well-being of people who choose not to vaccinate themselves or their children.  

Photo Of RajHere’s what Dr. Karthikesan has to say:

I’ve heard people say that deaths from preventable diseases are the will of God.  Indeed all men must die, but not all have to die stupid.  I believe ignorance is deadly.  Sadly, it can also be contagious.

My issue resides with people who are opposed to vaccination and recently this issue became very personal. 

See, I have a new nephew in the family.  He lives in another country and so I only get to see him on Skype.  However, his parents were considering a visit and I was really looking forward to seeing him.   But due to the outbreak of diphtheria in Malaysia, where I live, I advised his parents to postpone their visit.  See my nephew hasn’t completed his vaccination schedule and I feared for his health.

My fears are not unfounded. This is the reality we are living in; where our lives are dictated by the decision of others. And every decision not to vaccinate affects the health of others in our community and in our world.

As a doctor, I try to appeal to people’s sense and reason when they tell me that they have decided against vaccinating.  Sometimes that communication fails and so I’ve decided to try to employ one other method.

Instinct.

I ask,

Do you instinctively feel that your child is safe without vaccination? 

Do you instinctively feel secure knowing that your child will recover regardless of the infectious disease that they may contract?

Do you instinctively feel impervious to all manner of infectious disease, even those which are airborne, just because you eat a certain diet or take certain homeopathic remedies?  

If it is difficult to honestly answer these questions affirmatively, then I beg you to consider what I have to say. 

Vaccines are safe.

I state the obvious first. I understand and empathize with those who feel that vaccines are dangerous and those who believe vaccines can be harmful or detrimental to health. Let’s assume that this is true. For a moment, let’s assume they are worse than death, or worse than the defects and disabilities they cause.

Let’s start with polio, which can cause disability and even suffocation if it involves the breathing muscles. Assuming your child recovers from polio, he may never run or play like a normal child. Are you prepared to accept that?

How about diphtheria, which affects your child’s breathing. In severe forms, it can affect the heart and nerves leading to death. Are you willing to take that chance? 

Now how about pertussis, which is known to cause violent, uncontrollable coughing making it extremely difficult for a child to get air into their lungs.  About half of babies who get pertussis need care in the hospital, and 1 out of 100 babies will die.  Is this the kind of suffering you want for your child?

There are serious dangers with all vaccine preventable diseases.  However, vaccines work to prevent infection by developing an immunity that imitates the infection.  This imitation spares one from suffering with severe illness.   Instead, vaccination allows the immune system to develop an arsenal of weapons in the form of’ ‘antibodies’. If your child should ever be exposed to these infections in the future, these antibodies will prevent the infection from spreading to your child by eliminating the threat early and preventing your child from getting sick. It’s quite simple actually.  Once the body knows the ‘enemy’, it is better able to defeat it.

So the question that begs for an answer is this;

Do you want your child to be facing these diseases alone, or do you want a strong arsenal of vaccines helping to form a protective shield?

The choice is yours.  But that’s the problem actually.  Vaccines are a choice and people’s choices are sometimes influenced by inaccurate information.

Doctors don’t make money from selling vaccines.

Read more…

History Is Destined To Repeat Itself With More Measles Outbreaks

March 31, 2016 2 comments

What Have We Learned From Last Year’s Measles Outbreak?

8QgmhZV.jpgLast year the United States experienced a large, multi-state measles outbreak that was largely responsible for 189 measles cases that spread across 24 states and the District of Columbia.  It’s believed that the outbreak started from a traveler who contracted measles overseas and then visited the Disneyland amusement park in California while infectious.  Widespread media coverage of the outbreak helped elevate public concerns related to the dangers of measles infection, the consequences of a growing number of school vaccine exemptions and the risks of disease among those who were too young or medically unable to be vaccinated.

At this time last year, it seemed as though we were experiencing a tipping point; a growing number of people were beginning to realize that vaccine refusal had consequences that could threaten our nation’s public health.  The fact that the personal decisions of a select few people was able to threaten herd immunity and the health of many unsuspecting families and communities was worrisome.

It was believed that more parents (including some who had previously refused vaccines) were seeking and accepting vaccination for their children as a direct result of the outbreak.  However, to determine whether clinicians were experiencing any real or lasting changes in vaccine acceptance, Medscape conducted a survey of vaccine providers to find out.

The survey, conducted in July of 2015, included 1577 physicians, nurse practitioners and physician assistants who worked in pediatrics, family medicine and public health.  Responses confirmed that the measles outbreaks induced more acceptance of the measles vaccine and vaccines in general.  The survey also indicated that, for some parents, a greater acceptance of vaccines was directly related to the fear of the disease, the consequence of being denied admission to schools, daycares or camps, and a greater knowledge about vaccines as a result of more reading on the subject.  However, in some cases there was no change.

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Results of Medscape Survey Conducted in July, 2015

 

Every Child By Two also experienced a heightened amount of interest in the months during and immediately following the outbreak with a record number of inquiries from parents.  Most were asking for information about the dangers of measles infection and for clarification of the MMR (measles, mumps and rubella) vaccine schedule.  There were many parents who were specifically inquiring as to the possiblity of vaccinating their children before the recommended age in order to protect them during the outbreak.  Shot of Prevention blog posts that included content specific to measles infection and MMR vaccination had record numbers of views in the early months of 2015, and personal stories relating to the outbreak, were widely shared on social media.

One story that drew a lot of attention was an open letter by Dr. Tim Jacks, whose two children had to be quarantined after they were both exposed to measles at a Phoenix Children’s Hospital clinic.  His 3-year-old daughter Maggie had a compromised immune system as a result of fighting acute lymphoblastic leukemia (blood cancer), while his 10 month old son Eli had received all his recommended vaccines, but was still too young for his first dose of MMR vaccine.  While neither of his children ended up contracting measles, the frustration he expressed in his letter entitled “To the parent of the unvaccinated child who exposed my family to measles” hit a nerve with a lot of people.

The Focus of Immunization Rates Fades as Cases Dwindle

In reaching out to Dr. Jacks this week, it appears that the attention on vaccinations that was raised during last year’s outbreak appears to have been rather short-lived.  He explained,

“As a pediatrician, I regularly discuss vaccines, exemptions, and last year’s outbreak.  The cold facts and data only reach so many, so my family’s story adds a personal angle to the issue that questioning parents rarely consider.  After the media exposure, many families were aware of our situation.  However today, the measles issue is not on as many people’s minds.  Vaccine exemption is however a hot issue in Arizona.  The Arizona political arena is considering avenues to encourage vaccination and I am hopeful that the coming year will produce progress in that regard.”

Today, a little over a year since the outbreaks began, the good news is that there have only been two reported measles cases so far in 2016.  However, it also appears that history may be destined to repeat itself.

Consider, for example, the reports out just this week about a California charter school student who tested positive for measles after returning home from traveling overseas.  With just 43% of kindergarteners at the Yuba River Charter School being up-to-date on their MMR vaccine, the California Department of Public Health has attempted to prevent a measles outbreak by first closing the school to all students, and then remaining closed to those without a measles vaccine until April 8 as long as no new cases are documented.

Despite overwhelmingly high vaccination rates across the country, with a mere 1.7% national vaccine exemption rate among kindergartener’s for the 2014-2015 school year, and a 90%+ coverage of MMR vaccine among 19-35 month old children, these small pockets of unvaccinated children continue to present a risk of future measles outbreaks. Read more…

Outbreaks Remind Us of Dangers of Disease and Benefits of Vaccines

January 30, 2015 16 comments

Rafiki, the wise old mandrill in Disney’s Lion King movie, made a profound statement that is extremely relevant to the current U.S. measles outbreak that began in Disneyland in December, 2014:

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Yes, the past can hurt.  Infectious diseases have a history of being dangerous and deadly.

All you have to do is look at history to see how many millions of lives have been lost, or how many people have been permanently disabled, by infectious diseases. It’s no small number.  And, there’s a long list of diseases that we can now prevent that have been leading killers in the past.  Today, vaccination greatly reduces disease, disability, death and inequity worldwide.  Vaccines given to infants and young children in the U.S. over the past two decades will prevent 322 million illnesses, 21 million hospitalizations and 732,000 deaths over the course of their lifetimes.  While it’s hard to see what doesn’t occur, the fact remains that vaccines save lives and prevent suffering.

Some people will choose to run from the past.  They’re called vaccine refusers.

No matter how much scientific evidence there is to prove vaccines are responsible for the incredible reduction of disease worldwide, there will always be some people who will run from the truth.  They either debate it, or simply ignore it.  These are the people who purposely refuse vaccines.  Sometimes they focus their efforts on trying to pin every possible ailment known to man (from SIDS, asthma, allergies, autism, etc.) on vaccines.  Other times they focus on the risk associated with vaccines.  In the case of the MMR vaccine, they prefer to focus on the less than a one in one million chance of a serious adverse reaction rather than the fact that one or two of every 1,000 children who have measles will likely die.  What is particularly frustrating is their tendency to ignore the present reality as well as the past.   In cases when the scientific community has investigated their concerns, they ignore the findings because they fail to support their previously held beliefs.

Most people have learned from the past, but remain at risk from those who haven’t.  

Thankfully, the overwhelming majority of people vaccinate.  These are the people who actively try to protect themselves, their families, and others in their community, by contributing to the benefits of herd immunity and trying to reduce the transmission of vaccine preventable diseases.  Unfortunately, the minority can sometimes jeopardize the herd.

Take the Van Tornhout family for instance.  Today mark’s the fifth anniversary of their daughter Callie’s death.  Callie was exposed to pertussis before she was old enough to begin her DTaP (diphtheria, tetanus and pertussis) vaccination series.  Her story was featured on CNN last week, as an example of how concerning the current measles outbreak is.  Unfortunately, there are many children under the age of one who are too young to receive the regularly scheduled MMR (measles, mumps, rubella) vaccine who are at increased risk of complications of measles as a direct result of this outbreak.

Katie and Craig Van Tornhout with their newborn daughter Callie

Katie and Craig Van Tornhout lost their newborn daughter Callie to pertussis.  She was only 38 days old and too young to be vaccinated.

Sadly, the Van Tornhout’s can’t run from the past.  Every day without their daughter Callie is a reminder of why they must continue to educate people on the importance of vaccines.

Stories like Callie’s are shared repeatedly.  On the national news.  On various social media sites.  On websites and blogs.  And even around the family dinner table.  We share these stories so people will realize that these diseases still pose a threat to our children, especially those too young to be fully vaccinated.  Unfortunately, some people remain conflicted about the lessons of the past.  On the one hand, they consider vaccinating to protect themselves and their children from these preventable diseases because they hear stories about children like Callie.  But on the other hand, they’re frightened by prolific misinformation that reinforces their suspicions that vaccines may be harmful.  For fear of making the wrong decision, they fail to make the responsible decision to vaccinate, which then results in a decision which jeopardizes the health of everyone else in their communities.

Today, in honor of Callie’s fifth angel-versary, I urge everyone to do what you can to help ensure no other child dies as a result of a vaccine preventable disease.  Don’t be reluctant to engage in a conversation about vaccines with friends or family.  Don’t refrain from sharing scientifically accurate vaccine information on social media.  Don’t be afraid to ask a non-vaccinator what their objections are.  And please don’t let the past repeat itself.  Sign up to receive notifications from Every Child By Two so you can stay informed of relevant immunization news, now and into the future.  

Providers Are Most Persuasive On Vaccinations When Speaking with Confidence and Conviction

November 6, 2013 2 comments

Doctors have been using science to evaluate the safety and efficacy of vaccines for decades.  Yet, we’re only just beginning to explore how the science of communication can help doctors to improve parental vaccine acceptance. A new study published in Pediatrics this week explains that it’s all in the “architecture” of the provider-parent conversation.

The study, entitled The Architecture of the Provider-Parent Vaccine Discussions At Health Supervision Visits examined the way in which providers discussed vaccine recommendations with parents and how varying techniques may have impacted vaccine acceptance.  The emphasis was not on what the provider was saying about vaccines, but more specifically on how the conversation was both initiated and pursued by the provider.   The study determined that if a provider initiates a vaccine recommendation by using a presumptive method, (such as “Well, we have to do some shots”) rather than a more participatory initiation (such as “What do you want to do about shots?”), parents were more likely to accept the provider’s recommendations.

The full report elaborates on how the provider-parent conversations were captured, analyzed and recorded, and then notes the following observations:

  •  The majority of providers (74%) initiated vaccine recommendations by using presumptive formats, but significantly more providers used participatory initiation formats with vaccine hesitant parents than with non-vaccine hesitant parents (41% vs 11%).
  • Among all parents, a larger proportion resisted vaccine recommendations when providers used a participatory rather than presumptive initiation format (83% vs 26%)
  • Analysis showed that provider use of participatory initiation formats for their vaccine recommendations was associated with a significantly increased odd of parental resistance.   
  • Nearly half of initially resistant parents accepted the provider’s original vaccine recommendation if the provider continued to pursue it. These findings seem especially important given that only 50% of providers pursued their original recommendation after initial parent resistance.

As a parent, my initial reaction to this “presumptive” and “persistent” language was one of concern.

Don’t parents want providers to address their vaccine related concerns?  Won’t they be turned off by providers who are perceived to be telling them what to do or pressuring them to vaccinate?   Read more…

When it Comes To Vaccination, We Have 99% To Thank

October 3, 2013 17 comments

hugmeslothWhen I began writing on this blog three and a half years ago, I had never had a face-to-face conversation with someone who I would’ve described as “anti-vaccine”.  That’s not surprising really, since about 99% of people vaccinate.  The odds of me knowing someone who didn’t vaccinate was fairly low, and the odds of me speaking to them about their opinions would likely be even lower.  While I had never walked around wearing a sign that said “I vaccinate”, I had never hid the fact that I vaccinate either.  Each of my five children wore their band-aid badges of honor after their scheduled well-visits and it was not uncommon for me to tell others that “my kids had shots today”.

But today – knowing what I know now – I think about the hundreds of people who I’ve associated with over the years.  It’s entirely likely I’ve known people who were selective vaccinators, delayed vaccinators, or parents who followed an alternative schedule.  But anti-vaccine? Could it be?  Other than one acquaintance I’ve had, I can’t think of anyone I’ve ever known, in real life, that has refused vaccinations entirely.  And even though this one acquaintance believed her child’s developmental delays were in some way a result of her child’s immunizations, she never once tried to persuade me not to vaccinate or even suggest that she believed vaccines to be dangerous.

Unfortunately, since I began writing about immunization issues, I’ve been shocked and appalled at the people who ridicule, threaten and personally harass me day after day – all because they reject the scientific views that I base my vaccination decisions on.  AntivaxersMakeMeSickShirtAnd while there are still less than 1% of people nationwide who refuse vaccines entirely, I’ve seen how a very small minority of that 1% can be extremely persistent, vocal and downright rude.  These are the people I would label as “anti-vaccine”.

Which brings me to the interesting popularity of a recent article entitled “I’m Coming Out…As Pro Vaccine“.  The author’s views have been articulated by many before.  But for some reason, this particular post has gone viral.  I’ve seen lots of acquaintances discussing it on social media and it’s encouraging to see how the popularity of this piece may be helping the 99% of parents who vaccinate to make their views known publicly.

At the beginning of the article the author, JJ Keith, admits, Read more…