Sunday, February 15, 2015

What will make them vaccinate?

Many of us are baffled by those who won’t vaccinate their children. We can’t believe there are people who can ignore the statistics that show that where children are vaccinated, disease rates go down. We think such people are stupid, selfish and destructive. I know I’ve looked at anti-vaxxers as idiots whose grandparents probably thought the earth was flat. But after communicating with some anti-vaxxers on Facebook, and reading articles on what motivates parents, I’m cutting the anti-vaccine movement some slack. There is a method to their madness.

Vaccines are a difficult topic because few people can discuss the welfare of children without emotion. Parents of babies and school-age children struggle with dozens of decisions a day (how to dress the kid, what to feed it, how much TV to allow, etc.). And the fact is, some children do have a bad reaction to vaccines. Only a small minority react badly, and an even smaller minority have the mitochondrial disorder that can be triggered by vaccination (among other things!), but the anecdotes abound. The numbers show that far more children are at risk of catching a disease than are at risk of having an adverse reaction to a vaccine, but personal stories very effectively raise doubt about the safety of vaccines.

A recent NPR article (Psychological Biases Play A Part In Vaccination Decisions) reveals part of what influences parents’ opinions about vaccines. When making decisions about their children, a parent’s goal is to make a decision they won’t regret. When researchers presented parents with two risks (to their children) to choose between, many people chose the path that didn’t require them to do anything. The researchers theorize that lack of action relieves some of the remorse parents might feel later if their child suffers from their decision. For example, if a woman has her child vaccinated against the flu and complications arise from that injection, she might feel worse than if she hadn’t had her child vaccinated and the child caught a serious case of the flu. It’s as if we associate action with guilt, and inaction with freedom from guilt. The article uses the phrase "doing harm versus merely allowing harm."

The article theorizes that we might increase vaccination rates if we change things so that not vaccinating a child requires more action than vaccinating. If it takes lengthy paperwork and focused effort to get an exemption from vaccination, then keeping your child unvaccinated would become the path of action, opening yourself up to more regret if that decision leads to a negative outcome. (We might already be heading in that direction as more schools make vaccination a requirement for attendance.)

Given all the uncertainty that anti-vaxxers have created about vaccines, it makes sense that many parents lean towards not vaccinating, which feels like not taking a direct action that might harm their child. It’s an emotional decision driven by parents’ need to not do anything they’ll later feel guilty about. This bias also explains how people can ignore the scientific evidence showing that vaccines don’t cause autism. It no longer matters that Andrew Wakefield -- the person who said he’d found a possible link between vaccines and autism -- falsified his data. Anti-vaxxers have heard enough stories about children with suspicious reactions to vaccines to make Wakefield’s debunked research irrelevant.

No one wants to do anything that might hurt their child. Many people would rather do nothing and take their chances with those consequences. What we pro-vaxxers are battling is parents' emotional need to believe they have not taken any action that could damage their child. That's an extremely powerful emotional need that won't be touched by statistics and scientific facts, so let's stop yelling and put down the bar graphs and scientific studies. One of my dad's favorite sayings is "If you can't make them see the light, make them feel the heat." What we need to do is make those exemptions much harder to get so that keeping your kid unvaccinated requires deliberate action that you can't pretend you're not taking. I imagine a future in which you either get your children vaccinated or home school them through the post-graduate level. At any rate, we're not going to convince anti-vaxxers of the importance of vaccination, so we might as well stop trying. The best path is to allow them their fears and anxieties while we change the environment until not vaccinating becomes too uncomfortable a position to maintain.


Monica W. said...

You are more thoughtful and generous than I am.

I don't really care about flu or chicken pox vaccines, but the ones that inoculate against diseases that kill or permanently disable people are the ones where I get more irate at anti-vaxxers.

Regina Rodríguez-Martin said...

Monica, did this post not make you any more sympathetic to parents who live in terror of hurting their children? Parents are in a terrible position every single day as they try to raise children in a world where anything can kill you at any moment. They're doing the best they can, which is why I say people should stop having kids because even the best parenting is never good enough. Everyone grows up damaged. Time to give up, people.

Matt said...

I all for vaccinations and it is fortunate that illnesses like Measles, Mumps and Rubella have had vaccines for some years now. I can't understand these parents who won't have their children vaccinated.