Opinion: Talking with the vaccine-hesitant and vaccine-deniers

Recently I wrote an op-ed describing the sometimes dire consequences of avoiding the immunizations that can prevent diseases that have been virtually eliminated, only to reappear due to misinformation about vaccines. How to reach the misinformed or merely concerned?

No parent wants their child unprotected from serious illness and every parent obviously wants the best for their child, which makes them vulnerable to information that questions any approach that purports to protect their child, especially when endorsed by celebrities promoting their own products claiming to solve a problem.

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Deniers are not a homogeneous group. Vaccine-deniers are composed of a mix of those who have had very negative experiences with medicine or medical authority figures – and those who may simply be misinformed or need more information.

The problem is that the medical and pharmaceutical industries have been guilty of some serious mistakes in the past – enough to sow seeds of doubt among some. For example, there was the medical catastrophe of the thalidomide misadventure of the mid 20th century, or the overuse of oxygen causing blindness in premature infants. A particular denier might be aware of one of the extraordinarily rare adverse vaccination events resulting in temporary or permanent severe illnesses. Or a child or close family member may have appeared to experience an association between receiving a particular vaccine and a deterioration in the individual’s psychoneurological state. While association is not causation, individuals who have personally seen the temporal linkage between these two events are usually “immune” to scientific evidence.

The full-blown conspiracy theorists represent only about four per cent of deniers; they are so fixed in their views that they see conspiracies everywhere. They bring their views into action by delving deeply only into the “research” that supports their views. Their very lives have been captured by the unending search for studies that confirm their beliefs. The studies or casual associations unearthed by the vaccine-deniers include a variety of speeches, testimonials, celebrity blogs and questionable or fraudulent research that can be found on the websites of conspiracy theorists.

Serious vaccine-deniers regularly cite research long ago retracted by reputable journals like the Lancet, which first published a small amount of made-up data, purporting to show a link between autism and the measles-mumps-rubella (MMR) vaccine. The author of that study had his medical licence revoked, and makes his living talking to “anti-vaxers.” Top of the list of “scientific” studies that support the relationship of vaccination to autism relates to aluminum stabilizers/enhancers used in vaccines. Aluminum compounds have been present in some vaccines since 1926 – but the major focus of deniers, MMR, does not even employ aluminum.

Recently, research in mice carried out at UBC by Dr. Chris Shaw, purporting to show neurocognitive deterioration after aluminum exposure, was retracted when it was found that the results were “doctored.” Another ingredient of concern for some is mercury, which in the past was used as a stabilizer. MMR never contained mercury. Since 2001, mercury was removed from all vaccines. Finally antibiotics, mainly neomycin in minuscule doses, is added to a number of vaccines, including MMR, to preserve sterility. No adverse events have been associated with such low levels.

The most credible research shows that autism is a genetic, environmental, and developmental condition that has indeed increased sharply in recent years, but well after MMR began to be available in the early 1960s. It makes more sense to look deeply into the massive increase in the use of neurotoxic herbicides and pesticides and the increase in a variety of neurological diseases like multiple sclerosis, Parkinsonism, Alzheimer’s and autism.

The vaccine-hesitant. This group of people is much larger than the deniers. They aren’t strongly opposed to vaccines. They are just nervous enough about the vaccine or vaccine additives that they decide not to get their children vaccinated. Some have become concerned when exposed to the fraudulent studies on social media and influenced by the many slick anti-vax tracts readily available on the Internet. They have genuine concerns based on this avalanche of negative information. Yet, few parents are in a position to deconstruct the materials, and talking to them about the complex issues is very time-consuming. Yet talking with such folks is precisely what we must do. Canvax.ca is a reliable source of vaccine information.

What to do. Rare practitioners have been known to discharge vaccine-hesitant and vaccine-deniers from their practice. While this might save the practitioner time and effort, it will do little to solve the current problem. Unfortunately, the only way to go is to listen attentively to the reasons behind people’s concerns. Most vaccine-hesitant will be grateful to have the needed information and a framework for evaluation of what is out there in social media. But it will often take more than one visit to explore vaccine decisions. Having a respectful conversation between a health professional and patient about complex issues can help to build the kind of trust that will be needed when, inevitably, serious illnesses arise in the life of any family.

 Dr. Michael C. Klein, author of Dissident Doctor: Catching Babies and Challenging the Medical Status Quo (Douglas and McIntyre, 2018), lives in Roberts Creek.

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