By Tracy G. Cassels
Perhaps I’m simply becoming more aware of the growing divide between those who are pro-vax and those who are anti-vax, but lately the debates have fueled strong, both on EP and elsewhere. With the number of children not being immunized, people on both sides are jumping into the discussion full force. For those who are not getting their children immunized, they often speak of concerns about what is in the vaccines, side effects, and potential long-term consequences. The pro-vax side often counters this with statements suggesting either that the individuals are ignorant of the real danger of the diseases we immunize for or that anyone worried about vaccines are somehow stupid and should simply listen to the scientists saying research isn’t needed or their doctors (who they claim can understand this data better than any parent). The problem with this response is that it does nothing to help their goal of getting more kids vaccinated and in fact may have a harmful effect to that goal.
You catch more flies with honey than vinegar
First and foremost, I would like to remind the vaccine industry (and those out speaking on its behalf) that calling parents stupid for worrying about the health of their children is probably not going to instill positive feelings towards you. You’re even less likely to get them on your side. Considering how important some people feel the current set of vaccinations are for our children, imagine how you’d react if people told you that you were stupid for vaccinating? I imagine some of these responses come from extreme anti-vax groups stating things that people either believe or know not to be true, but the fact remains that if you want to convince people to listen to you, insulting them generally won’t work.
Research is ALWAYS necessary
Here’s where I have my biggest problem – well-conducted research is NEVER a bad idea. And if that research can assuage the fears of many parents, then why wouldn’t you do it? I’ve seen science blogs with scientists claiming research isn’t needed into the amount of aluminum associated with the current vaccination schedule. They have their reasons. But call me suspicious, I’ve never quite trusted anyone that says research isn’t necessary. Remember when formula was invented by scientists and they believed with all their hearts that they had made something way better than breastmilk. Fortified with everything! More fat! More protein! And if left up to them, I think they would have never researched whether it was better or not, but as we all know, it’s a pale comparison to what the female (and in rare cases, male) body produces.
In fact, science has many cases where someone studied the “obvious” only to discover it wasn’t so obvious after all (like the fact that infants experience pain or that the DARE program – created to keep kids off drugs – can actually increase drug use amongst teens). And many of our most amazing discoveries have come by accident while researching something else (and some of our more popular ones too – hello, Viagra). And of course, people study the obvious to help make policy changes. Dr. Charles Czeisler has studied the effect of sleep deprivation on performance in many fields, medicine included, to try and force the medical association to make changes to their current practices on how long shifts are for doctors only to be met time and again by resistance, although he was finally successful in implementing some change for interns in 2008 – but only interns because that’s who his research was originally on. But instead of saying “You’re being stupid and I won’t study residents” (though he certainly thought it), he went out and started studying residents so that he can provide the Institute of Medicine with data. It’s a lot harder (though obviously not impossible) to refute hard evidence in front of you than it is to refute something for which a person simply says “Trust Me”.
The other reason I believe we need more research on vaccines is that we currently don’t know why a small proportion of children have extremely negative reactions. Sometimes it’s allergies, but in many other cases, it’s not. Imagine if we could identify the risk factors ahead of time, and thus avoid the heartbreaking cases where a child had to go into anaphylactic shock or suffer seizures or even a coma before they realize vaccines aren’t for them? The fear of these effects keeps some parents from vaccinating and the more we understand why they happen, the better off we are to ensure parents can make a calculated and educated decision and not become furious at a parent whose child has several risk factors when he or she decides to forgo vaccinations. (I am happy to say that WHO is working on this a bit with their Global Vaccine Safety initiative with hopes of understanding the side effects associated with vaccines.)
Trust your doctors?
As someone who is a huge advocate for educating yourself and making decisions, I see vaccination as being no different. But when I propose this, I am often met with huge resistance because of the assumption that people are too stupid to understand the research behind vaccinations and so we should simply take the advice of our doctors who can break down this research better than we, right? Well, not necessarily. First, it depends on their own level of expertise in immunology. If your doctor didn’t do any training in it, or at least nothing recent, then they may not be able to understand any better than a well-educated individual. Second, I can’t help but wonder, if doctors are so good at understanding and breaking down data for their patients, why can’t they get it right on breastfeeding? If we accept the premise that doctors are great sources of information on the research on breastfeeding, most of us should also listen to doctors as they tell us to stop breastfeeding early and switch to formula well before a year per the recommendations of many doctors (especially in the United States). This makes me wonder what is it about breastfeeding data, which is frankly easier for a layperson to understand, that doctors have troubles with if we don’t accept that they are accurately sharing this information.
If you want to argue that the journal articles aren’t comprehensible, we should really be discussing a way to make this data more obtainable and comprehensible. Why not include a shortened lay person account in these articles for parents to read so that they can educate themselves and in turn, trust their decisions. Or have the researchers contribute lay articles for parents in parenting magazines? I know there are science blogs that purport to talk about the vaccine research, but generally all I see are blogs criticizing parents who want more information and implying they’re stupid for requesting such information. (Personally I find the WHO position papers to be pretty clear and far more informative than anything I’ve gotten from a doctor.)
Take a lesson from the breastfeeding movement
Breastfeeding rates in the United States hit an all-time low in 1971. Years of parents being told formula was superior coupled with short maternity leave times and abysmal support meant that only 24% of mothers even tried breastfeeding – far fewer continued with it and even fewer did it exclusively. And there were health problems associated with this. Because of these health problems, research had already started comparing breastmilk and formula—although the link between poor health outcomes and formula use was not obvious to many doctors for years—but rates continued to drop. However, no campaign told parents they were wrong, or stupid, or anything else. No. People just started doing more studies, gathering more data, and making such a convincing case for breastfeeding that we’re finally seeing improvements (though there’s obviously a far way to go, but when you battle a big industry in favour of something free that a mom produces herself… well, good luck). But we would not have gotten to where we are if it weren’t for the researchers who tirelessly study every aspect of breastfeeding so that mothers and policy-makers and educators and doctors have the most comprehensive information available. Does everyone listen to it? No. And so they keep working.
I pointed out in another article about things science doesn’t know that we don’t know the exact benefits of breastfeeding beyond a year. Does this mean I think there are none? Nope – quite to the contrary, I think the circumstantial evidence is quite in favour of it. In fact, I think it’s one of those “Duh” studies where the outcome just isn’t in doubt in my mind. But the reason I included it is because we need research on it. There are far too many parents who believe that breastfeeding an infant after the age of 1 is futile and has no long-term or even short-term benefits and may even have deleterious effects. Therefore it needs to be researched so we can get information out to parents so they can make the appropriate feeding decisions for their families. And for those who decide formula is not as good as breastmilk, they can also fight to make milk sharing and milk banks more prominent. I would also bet you that somewhere out there, someone has started research on this topic. Because taking it for granted helps no one.
Vaccine education and research should be absolutely no different. If you’re concerned about dropping rates of vaccination, then get in the lab, run research that addresses the questions and concerns of those not vaccinating and come prepared with an arsenal of research. When you want to make societal changes, especially when it comes to children and their parents, you have to have the answers to the questions they’re asking.
While I know some people disagree, I personally don’t think there’s much doubt that various vaccines have saved countless lives over the years. I do, however, think that, like anything, we need to be cautious about the degree to which we assume that changes to vaccination schedules, doses, etc. don’t affect their safety without conducting the appropriate research. If it’s a “Duh” experiment, so be it. Let it be one that puts countless parental minds to rest. Because every time there’s hesitancy to do the research, regardless of the reason, it just adds to speculation that they have something to hide which makes even more people question the safety of vaccines. For those of you who think it’s stupid to request that we research every aspect of vaccines, let me remind you that if the research is as clear-cut as you assume, then you should see this as a quick and easy way to potentially up vaccination rate, which I hope would be your biggest concern.