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“Anti-vaxxer” is a slang term for people who oppose vaccinations. It can be upsetting to encounter an anti-vaxxer, especially if you are afraid they are hurting other people (like by risking their children’s lives, or saying hurtful things about autistic people). Getting angry or starting an intellectual debate is unlikely to work, even if you are right. Here is how to handle an anti-vaxxer.
You can try a logical argument, although it’s unlikely to work.  X Research source Only try using logic if someone seems actually interested in a debate.
Senior Lecturer and Coordinator, Health and Medical Humanities, University of Sydney
Claire Hooker receives funding from the National Health and Medical Research Council. She works for the University of Sydney.
University of Sydney provides funding as a member of The Conversation AU.
The Conversation UK receives funding from these organisations
Dismissing people’s worries as baseless, whether that’s about the safety of mobile phones or fluoridated drinking water, is one of the least effective ways of communicating public health risks.
Yet it is common for people to “reassure” like this, both at home and in professional roles as experts, officials or corporate managers.
Another poor but common strategy is to try to debunk “alt-facts” (lies or misleading statements claimed as fact) like those circulating among anti-vaccination or anti-fluoridation groups.
If your role is to communicate public health risks, it is particularly hard to resist trying harder to help people understand the evidence. This is especially the case when a risk is low, and hence public fears are not only out of proportion but also costly to redress.
If an official’s or doctor’s response to a parent worried about fluoridated drinking water is to show them even more data about how safe and effective it is, they often won’t sound convincing. Instead, they’ll look incapable of unbiased discussion. Indeed, the more information they show, the more it can look like propaganda. This approach can even make the opponent’s argument more memorable.
Not only are reassuring people and countering misinformation ineffective, they can end up doing a lot of damage.
Ineffective communication, however well intentioned, can even boost “alt-facts” by amplifying, not diminishing, people’s worries.
So public health officials, clinicians and involved community members need to shift strategies when dealing with low risks, from communicating evidence to hosing down what has been called “outrage”, another name for public concern.
1. Hose down your own outrage first
The first step may well be to hose down your own outrage, or your fear about the consequences of public misinformation. Our own outrage stops us listening well to what’s driving public concern. We tend to correct or reassure when we’re motivated by our own worries, strategies that can worsen polarisation in a debate.
Addressing public outrage comes next. This is the type of response that focuses on your audience’s needs and stakes out a middle ground where there’s some room to manoeuvre.
2. Respect people’s fears
There are good, research-based strategies to manage this type of outrage, starting with the principles of care and fairness.
At minimum, this means acknowledging and respecting people’s fears. A fearful parent needs to know we care about their concerns on say, vaccine safety, and that we have heard and understood their worries. That’s before they will care about what we say.
3. Build trust
One of the strongest predictors of whether someone believes or acts on a public health message is trust; if we can’t trust the communicator, we won’t believe the message. Care, fairness, competence and openness are all aspects of trust.
Trust is essential for us to be able to communicate effectively over the life cycle of a public health issue, whether that’s about a mistake in public policy, or when new studies lead to new information or recommendations.
So if you are unsure about communication, always choose the strategy that builds trust, as we discuss in a new paper in the journal Public Health Research and Practice from the Sax Institute.
Competence means you need to stick unswervingly to the integrity of scientific method and data where you discuss it. But competence and openness together are best served by being upfront about uncertainty and complexity. It’s better to err on the side of communicating early and often, rather than to wait in the hopes of providing a more reliable and consistent message.
4. Don’t panic about panic
If you communicate early and the messages change or are confusing, won’t people over-react? Yes, and your job is to hose down your outrage and tolerate such early and usually short-lived over-reactions. People resume their usual habits and choices once they see for themselves they are safe.
Tolerating early over-reactions allows you to remain a trusted source people listen to, even if people don’t change their general views about the risk (and don’t expect them to).
Avoid telling people “don’t panic”. Even calling someone’s fears “panic” is a way of diminishing them. What is “panic” to you is simply “not doing as you think I should” to an anxious public.
5. Your actions communicate more than your words
Think about what your actions say to the public. For instance, the Australian government’s decision to cancel all temporary visas from West African countries affected by Ebola virus in 2014 signalled that Ebola was a real, terrifying threat. This message undermined consistent reassuring official public health messages that the risk of transmission within the community in Australia was extremely low.
Helping people become less fearful can be as simple as giving them back some control in the situation, for instance by giving people concrete actions they can take. In the case of Ebola, that might mean monitoring their temperature if they think they have been exposed.
Public health units can also work with community members to develop or co-design their own solutions. Deliberative processes such as these, where people can see their stake in the outcome, can be exceptionally strong ways of enhancing public trust in processes and institutions.
6. Play the long game
Effective risk communication means playing a long game of “getting to maybe”, the “maybe” being where officials can still engage a resistant public, one frightened and persuaded by “alt-facts”.
The aim is to maintain the relationships and the dialogue, not to correct all people’s false beliefs. Ironically this provides the best protection against polarisation and “alt-facts”, and hence our capacity as a society to confront the risks we collectively face.
The number of people against vaccinations – aka anti-vaxxers – seems to be growing with every year.
So, is there any truth to the widespread fear of vaccinations? Not really.
A new video from AsapSCIENCE has thoroughly debunked and deconstructed the most common anti-vaccination arguments.
Now, the next time you encounter an anti-vaxxer, you’ll be fully prepared and armed with the facts.
1. Vaccines contain “dangerous” chemicals like MSG, antifreeze, phenol, formaldehyde, aluminum and lead.
While it’s true that many vaccines contain chemicals like mercury aluminum and formaldehyde, the doses are so small that the substances are not considered toxic.
“The dose makes the poison, and the doses of the chemicals in vaccines are negligible,” the video explains.
For example, vaccines contain tiny amounts of aluminum to help make the shots more effective. In total, the aluminum present amounts to about 0.125 mg per dose, which is way less than the average 30 to 50 mg the average human consumes every day.
And even though the mercury used in vaccines is also negligible, it was removed from almost all childhood vaccines in 2001 after public outrage.
2. A child’s immune system doesn’t need to “develop naturally”.
Far from weakening your immune system, vaccines actually strengthen your immune system. Vaccines introduce a weakened form of virus into your body so that your system can learn to identify and defend against any future infections.
For young and old people, boosting your immune system with a vaccine is particularly important. For instance, children must be given vaccines for dangerous infections at a young age, because this is when their immune systems are most susceptible.
3. Vaccines can’t give you allergies.
In 1997, people began to question whether vaccines can give you allergies, but robust research shows vaccines have the exact opposite effect: They protect you from allergies.
4. “These diseases aren’t even all that dangerous. If you’ve got the measles what’s the worst that can happen?”
Vaccines have been so effective they have stopped millions of people from dying and prevented millions more from permanent physical disabilites.
For instance, in the 1960’s smallpox was responsible for millions of deaths, but just two decades later it was completely eradicated due to an aggressive vaccine campaign.
5. Vaccines can’t give you autism.
In the 1990’s, a paper was published that found a link between autism and the measles, mumps and rubella (MMR) vaccine. The study was later proven to be fraudulent by multiple comprehensive and long-term studies.
Plus, 10 out of 13 of the original paper’s authors have now refuted and retracted their original statements.
6. “People should have the choice to vaccinate because the choice only affects you.”
Wrong. Vaccines don’t just protect you, they also help other people stay healthy around you – especially old people, young people and people who can’t get vaccinated themselves, like those undergoing chemotherapy.
This is called herd immunity, and it effects the health of everybody – not just you.
7. “It’s all a conspiracy and big pharma is secretly trying to kill us.”
Of course pharmaceutical companies make money from vaccines, but that doesn’t mean the shots are bad for you. In the U.S., between 1994 and 2013, vaccines created a net savings of $295 billion in direct costs and US$1.3 trillion in societal costs.
And while it’s true some pharmaceutical treatments have been pulled off the market because of unforseen side effects, vaccines are some of the most highly regulated substances we can put in our bodies. In the US, it can take 10 to 25 years for just one vaccines to be approved, and even once it’s on the market it continues to be watched carefully.
In fact, the chances of you having a reaction to the MMR vaccine is one in a million, which is ten times less likely than being killed by lightning. The odds are clearly in your favor, so get your shots.
This article was originally published on our sister site, Science As Fact.
Professor of business ethics, NYU Stern
Sometimes it takes rebellious youth to help us see the error of our ways.
Consider Ethan Lindenberger, an 18-year-old from Ohio. His act of rebellion wasn’t staying out past curfew or avoiding his homework: It was getting vaccinated on his own, despite his mother’s protests.
Lindenberger’s mother opted her children out of vaccines and fed them messages about the dangers of immunizations. As he posted on Reddit, “My parents think vaccines are some kind of government scheme. It’s stupid and I’ve had countless arguments over the topic.”
So when he turned 18, he asked Reddit how he could get the shots he had been denied throughout his childhood: flu, pneumonia, chickenpox, hepatitis A, hepatitis B, HPV, meningitis, MMR, tetanus booster, and TDAP (whooping cough).
Redditors gave him guidance, and the thread went viral. The whole episode ended with Lindenberger testifying to Congress earlier this month. In New York, his testimony moved two state lawmakers so much that they’re proposing a bill in the state legislature allowing teenagers 14 and up to get vaccinated—even if doing so goes against their parents’ wishes.
Lindenberger’s testimony and this bill couldn’t come at a more important time. A measles outbreak recently hit the state of New York, with almost 200 confirmed cases state-wide. In Brooklyn alone, there have been 133 reported cases of measles since last October. And around the country in just the first three months of 2019, 12 states have reported cases of measles—the fastest infection rate on record.
This was not supposed to happen. In 2000, the Center for Disease Control declared measles eliminated in the United States. So what changed in the two intervening decades?
Simple: a misinformation campaign about vaccines fueled by social media that has led to many more unvaccinated people.
How people become anti-vaxxers
Lindenberger’s mother is a prime case. Her information about vaccines came from “anti-vaxx” groups on Facebook. As her son put it, “She thought vaccines were a conspiracy by the government to kill children.”
She is not alone. On Facebook and elsewhere online, hives of misinformation and pseudoscience push the view that vaccines are dangerous—that they lead to autism, that they are a government plot, or that they cause the diseases they are supposed to prevent.
Researchers and doctors have thoroughly debunked these claims again and again. But in the digital world, myths masquerade as truths. And well-intentioned people like Lindenberger’s mother make unsafe decisions as a result.
How we can stop anti-vaxxers
What can to be done? For one thing, laws can help. In the same way New York state lawmakers took action, we need federal action to allow young people to take their health and safety into their own hands when their parents won’t. We also need to strengthen and support legislation that blocks unvaccinated children from attending school. Specifically, lawmakers need to close “religious exemption” loopholes, or severely limit them with the input of medical and public-health professionals, as they allow parents to put other people’s children at risk.
A federal judge recently supported that view: When parents of unvaccinated children attempted to allow their children to return to a school recently struck by a measles outbreak, the judge blocked their entry. He’s not the only one. In Italy, a new law went into effect this month that barred unvaccinated children under six from school and fined parents of children older than six for not vaccinating their kids.
This is not, as some critics would suggest, government overreach. It is common sense, and these proposed measures resemble the many laws on the books that protect the public interest, even when they proscribe individual conduct. For example, driver’s license requirements, prohibitions on smoking on airplanes, restrictions on falsely yelling fire in a crowded theater—these widely accepted examples put the public interest ahead of private interests. Legislation on vaccines operates in the same spirit.
Laws, however, take time to enact. What we can do right away is take action on sources of misinformation. The public needs to stand up and tell Facebook, Twitter, and other social-media platforms that enough is enough. Facebook has begun to take small steps in this direction: They’re banning anti-vaccine information from being promoted through ads, and lowering its rank in search results. But they could go further. Pinterest, for example, has blocked searches on vaccinations, and Amazon pulled anti-vaxx documentaries from their catalog altogether. Facebook needs to ban anti-vaccine posts outright, and public pressure could get them to do just that.
Finally, we need to hold our leaders and influencers accountable. No matter how many laws we change or how many platforms we fix, a single stray comment from an authority figure can undo years of work. That goes double for politicians—people whom we entrust to make decisions in the public interest. So when someone like US congressman Mark Green questions the value of vaccines, it isn’t enough to move on. Even though he has now flipped his position and insists he vaccinates his kids, it’s too late: He gave his credibility—and by extension, Congressional credibility—to those peddling dangerous hoaxes. This isn’t a purely partisan issue: Both Democrats and Republicans have questioned vaccines in Congress, sometimes going so far as berating the director of the Center for Disease Control. There’s no place for conspiracy theorists and science deniers in leadership, and they should be voted out of office when the next election comes around.
Ethan Lindenberger’s decision to disobey his mother is a clarion call. We are well past the point of debate on vaccines, and our society runs grave risks by allowing the numbers of unvaccinated children to rise and allowing scientific falsehoods to spread. It is time for society-wide action on this issue—changes to our laws, improvements to our sources of information, and firm resistance to those who peddle pseudoscience. Few acts could be more urgent or more important.
The no-vaccine crowd has persuaded a lot of people. But public health can prevail.
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The World Health Organization has ranked vaccine hesitancy — the growing resistance to widely available lifesaving vaccines — as one of the top 10 health threats in the world for 2019. That news will not come as a surprise in New York City, where the worst measles outbreak in decades is now underway. Nor in California or Minnesota, where similar outbreaks unfolded in 2014 and 2017, respectively. Nor in Texas, where some 60,000 children remain wholly unvaccinated thanks in part to an aggressive anti-vaccine lobby.
Leading global health threats typically are caused by the plagues and perils of low-income countries — but vaccine hesitancy is as American as can be. According to the Centers for Disease Control and Prevention, the percentage of children who are unvaccinated has quadrupled since 2001, even though the overall utilization of most vaccines remains high. More than 100,000 American infants and toddlers have received no vaccines whatsoever, and millions more have received only some crucial shots.
It’s no mystery how we got here. On the internet, anti-vaccine propaganda has outpace d pro-vaccine public health information. The anti-vaxxers, as they are colloquially known, have hundreds of websites promoting their message, a roster of tech- and media-savvy influencers and an aggressive political arm that includes at least a dozen political action committees. Defense against this onslaught has been meager. The C.D.C., the nation’s leading public health agency, has a website with accurate information, but no loud public voice. The United States Surgeon General’s office has been mum. So has the White House — and not just under the current administration. That leaves just a handful of academics who get bombarded with vitriol, including outright threats, every time they try to counter pseudoscience with fact.
The consequences of this disparity are substantial: a surge in outbreaks of measles, mumps, pertussis and other diseases; an increase in influenza deaths; and dismal rates of HPV vaccination, which doctors say could effectively wipe out cervical cancer if it were better utilized. But infectious disease experts warn that things could get much worse. Trust in vaccines is being so thoroughly eroded, they say, that these prevention tools are in danger of becoming useless. The next major disease outbreak “will not be due to a lack of preventive technologies,” Heidi Larson, a professor at the London School of Hygiene and Tropical Medicine, writes in the journal Nature, but to an “emotional contagion, digitally enabled.”
Thwarting this danger will require a campaign as bold and aggressive as the one being waged by the anti-vaccination contingent. And to launch such a campaign would require overcoming strong inertia: a waning public health apparatus, countervailing politics and a collective amnesia over the havoc the diseases in question once wrought. But to succeed would be to rescue from oblivion one of the greatest triumphs of human ingenuity over disease — and to save countless lives.
Here’s how to get started.
Get tough. After the 2014 California measles outbreak, the state eliminated nonmedical exemptions for mandatory vaccinations. After a similar outbreak in Michigan, health officials there began requiring individuals to formally consult with their local health departments before opting out of otherwise-mandatory shots. In both cases, these tougher policies drove up vaccination rates. Other states ought to follow this lead, and the federal government should consider tightening restrictions around how much leeway states can grant families that want to skip essential vaccines.
Be savvy. The Vaccine Confidence Project is a London-based academic endeavor that monitors anti-vaccine websites for rumors and conspiracies and addresses them before the messages go viral. It also conducts regular surveys of attitudes and puts out a vaccine confidence index. Federal health officials would do well to implement a similar program, make it as public as possible and pair it with an aggressive and targeted social media campaign that makes as much use of celebrities as the anti-vaccine movement has.
Be clear. Vaccines, to some extent, are victims of their own success. In the United States especially, they’ve beaten so many infectious foes into oblivion that hardly any practicing doctors, let alone new parents, remember how terrible those diseases once were. An effective pro-vaccine campaign needs to remind us: Vaccines prevent two million to three million deaths globally each year. In developing countries, people line up for hours to get these shots. It’s also O.K. to get out of the gray zone. Scientists, especially, are uncomfortable with black-and-white statements, because science is all about nuance. But, in the case of vaccines, there are some hard truths that deserve to be trumpeted. Vaccines are not toxic, and they do not cause autism. Full stop.
Know the enemy. The arguments used by people driving the anti-vaccination movement have not changed in about a century. These arguments are effective because they are intuitively appealing — but they are also easily refutable. Instead of ignoring these arguments, an effective pro-vaccine campaign would confront them directly, over and over, for as long as it takes. Yes, there are chemicals in vaccines, but they are not toxic. No, vaccines can’t overwhelm your immune system, which already confronts countless pathogens every day.
Know the audience. Not every parent with concerns about vaccination is a rabid conspiracy theorist bent on resisting inoculation forever. In fact, studies suggest that less than 2 percent of all parents fall into this category. The rest of vaccine-hesitant families sit along a spectrum. Some reject all vaccines but are still open to receiving information. Others are only worried about one specific vaccine. And others still are merely anxious and looking for reliable information. Any successful campaign will need to mind this diversity and prioritize listening to concerns as much as dispelling myths.
Enlist the right support. Some doctors and scientists have referred to “uneventful vaccination” as “The Greatest Story Never Told.” Though they may not spread on the internet like the stories of terrible mishaps that anti-vaxxers traffic in, these far more common tales of inoculation without incident can be a powerful elixir for a nervous new parent. The best ambassadors of these stories are likely to be parents themselves. Surveys suggest that pro-vaccine families are often eager to help counter misinformation, but they don’t know where to start. If health officials corralled these families and trained them in the basics of vaccine science, they might succeed where official voices sometimes fail.
Image courtesy of the writer
Vaccine hesitancy—which is defined by the World Health Organization (WHO) as “the reluctance or refusal to vaccinate despite the availability of vaccines”—has been named one of the top 10 global health threats by the WHO. While vaccines currently prevent 2 to 3 million deaths a year globally, a subset of the U.S. population still refuses to vaccinate their children.
It’s called the anti-vaxx movement, and I used to be a part of it. I’m a “crunchy” mother of six. For my first four children, I actually did follow the standard immunization schedule set by the Centers for Disease Control and Prevention (CDC). But I stopped vaccinating my children altogether after the birth of my fifth child, around the same time I started hanging out with other parents who didn’t vaccinate their children.
Things started to change for me during the delivery of my fourth child. When I had my fourth I realized that the only people I truly trusted with my comfort and safety were myself and my husband. This was the beginning of my journey toward out-of-hospital birth.
I had a home birth with my fifth child, Parker James (we call him P.J.), and it was amazing, transcendental, and everything I ever wanted. It was a lot more empowering. I felt like I had had a baby for the first time, even though it was my fifth. I took him to the pediatrician when he was two days old and I think we started vaccines with him.
But when he was six months old, I started looking for a new pediatrician. We had some job transitions and for a time our family was uninsured. I was also talking to all these people who didn’t vaccinate their kids at the time. (It seems to me that when you go off the beaten path by having a home birth, you start to meet people who also prefer to approach health care differently. And within those circles, some people don’t vaccinate their kids.)
All of this led to my decision to stop vaccinating my children. I began to believe the notion from the fellow crunchy parents I was talking to that vaccines were driven by money more than by necessity and evidence. The thinking here—which I subscribed to—is that the medical industry and big pharma both profit from vaccines because they build in a need for multiple doctor’s visits, and that the vaccines mean more money for the pharmaceutical industry. From what I’ve seen, because many anti-vaxx parents believe that vaccines cause illnesses like autoimmune disorders and autism (which the CDC and several studies have refuted), they think that the medical industry and big pharma further benefit from vaccines by creating a need to treat these illnesses.
Plus I really didn’t want to have any dependence on the mainstream medical establishment. My exposure to moms who had the same parenting style as I had reinforced my hesitancy about doctors and vaccines. These confident, engaged mothers weren’t vaccinating, and they could articulate why. I started to agree with anti-vaxx sentiments that many modern ailments may be due to over-vaccination.
I started to postulate that many issues that I was seeing in my family could be related to vaccines—specifically obesity and autoimmune disorders, like arthritis and chronic pain. I really bought into the fallacy that we were generally better off living as naturally as possible and that this lifestyle would be protection enough against most diseases. The more I learned about birth and early childhood medical care, the more I thought I was seeing connections to the pharmaceutical or other industries whose main motives, I guessed, were profit.
When I got pregnant with my sixth, I was in the process of leaving the Mormon Church. The more I thought about it, the more I felt like I had repeatedly been burned by the institutions—whether religious, medical, or similar—I had trusted, and therefore I was distrustful of most institutions. Throwing away science was the collateral damage of my newfound commitment to listening to my own gut instincts. I felt like I had been doing things just because people told me to, including vaccinating my children, and I was done with it.
My sixth child was also born at home and I didn’t take her to a doctor afterward. She was a big, healthy girl, and though I wished I had a medical provider to take her to, I wasn’t overly concerned. I wasn’t looking to men in white coats anymore about what was best for me and my baby.
When I left the Mormon Church I lost a lot of my friends and social circle. I looked elsewhere for a new group of friends and peers, and because I’d gotten so interested in natural parenting, I joined some crunchy parenting communities online. But people there would talk up the benefits of things like essential oils to the point where I got skeptical. I remember thinking, You know this is bullshit, right? You can’t treat severe eczema with lavender. I started to question things again. I was on a roll of questioning things, being skeptical, and doing my own research, so I found myself questioning the things posted in these groups too.
Skeptic circles were so harsh on anti-vax parents and I wanted to be able to defend myself and do it well. The more I prepared for such arguments, the more I realized I had no solid defense. But that didn’t mean I trusted the system. I began to feel my children should be vaccinated but I still didn’t trust pediatricians. So I did my own research and started mapping out a plan for an altered vaccine schedule. I was trying to straddle the proverbial fence and find some middle ground I felt comfortable with.
I started bringing up what I had learned from my research in crunchy mom groups online and I felt like they could not tolerate it. I felt like they were shutting me down. Other parents who didn’t vaccinate their kids expressed fears that vaccinating would cause autism, behavioral issues, brain damage, or other unfounded claims, and they were staunch in their beliefs. But I knew stuff now. I had read things from a little bit of everywhere, including the Science-Based Medicine website from the creators of the Skeptics Guide to the Universe podcast by Steven Novella, a neurologist at the Yale University School of Medicine.
I was trying to be super logical about it. Still, every time I would bring up the subject of vaccines when it was clear that I wasn’t anti-vaccine, either the thread was deleted or we were told it couldn’t be discussed anymore. I felt like some people had made medicine and science the bad guys and nature into the good guys and that I was being ostracized for my views on vaccines. I would say things like this publicly and then privately I would get six to a dozen messages that would say things like “I’ve really been thinking about vaccinating” or “I feel the same way.” People were just scared to say it publicly and I wasn’t.
I had a very low tolerance for this dogmatic thinking because I had just left my religion. I needed people who could have hard conversations.
NEW YORK — It’s late on a Tuesday night during the worst measles outbreak in decades, and doctors, nurses and other health-care providers are gathered at a medical center to learn better ways of talking to parents who are reluctant to vaccinate their children.
Blima Marcus, an oncology nurse practitioner, leads the two-hour session on how to do a better job listening to and responding to parents’ questions — and, in the process, cultivating their trust. The key, she says, is hearing people’s questions about the science behind vaccines and addressing those directly.
To debunk the false claim that childhood illnesses strengthen the immune system, for instance, she said doctors can explain that the immune system is not a muscle that gets stronger with exercise.
“It’s not a great idea to deliberately expose your children to an illness any more than you would break their leg bone because you think it would grow back stronger,” she told the group at the Ezra Medical Center in Brooklyn’s Borough Park neighborhood.
Marcus, part of the Orthodox Jewish community in Brooklyn, helped form a volunteer group of health-care professionals this year to confront vaccine hesitancy and misinformation that officials blame for the measles outbreak — now in its 10th month — that is predominantly sickening Orthodox Jews in Brooklyn. Her group, the Vaccine Task Force, has written and distributed thousands of booklets to parents to counter fears and myths spread by anti-vaccination groups that have targeted the community.
Now, she and other nurses are tutoring the doctors about how to respond respectfully and effectively to such concerns.
Health officials in New York and throughout the country are increasingly trying new strategies to spread accurate information about vaccines. They are relying more on community groups instead of government agencies in an acknowledgment of a broad distrust of science and government, particularly in culturally isolated communities.
“We think if we just speak louder, people will just accept that,” said Jeremy Farrar, director of the Wellcome Trust, a global health foundation based in London. “We need to make a case for science and understand why people question it.”
Another recently formed group, the Jewish Orthodox Women’s Medical Association, runs a confidential hotline that families can call to request private, in-home vaccinations, so their children can be protected from measles without risking disapproval from anti-vaccine activists.
In Portland, Ore., where anti-vaccination sentiment is strong, Boost Oregon, a nonprofit organization, holds free workshops about vaccination for new and expecting parents. The workshops, taught by medical professionals, often run two hours or longer to allow parents to get all of their questions answered. The organization also provides seminars to doctors, nurses, midwives, naturopaths and others on how to address patients’ misunderstandings about vaccinations.
A recent global study of public attitudes about health and science by Wellcome Trust, conducted by Gallup World Poll, found that more than 8 in 10 people trust medical workers for health advice, and that the most trusted source of health advice is a doctor or nurse.
Nurses, in particular, can play a critical role.
“We’re the first and last person a patient sees before they make a final decision,” said Melody Butler, an infection specialist at Good Samaritan Hospital on Long Island who also heads a group called Nurses Who Vaccinate.
In New York, the inability to fully engage the Orthodox community on vaccination has “been really a lesson for us,” New York City Health Commissioner Oxiris Barbot said at a recent discussion at NYU Langone Medical Center’s Tisch Hospital. Given the community’s distrust of government, Jewish organizations are critical for providing information. “Public health doesn’t always have to be the messenger,” Barbot said.
At the recent session in Brooklyn, Marcus addressed the most common pieces of misinformation spread by anti-vaccination activists. Her presentation was succinct and packed with practical tips: Here’s how doctors can show parents how to find reputable studies online. Here are responses to 13 common concerns about vaccines, including ingredients and side effects.
If patients are worried about vaccine ingredients, Marcus told the providers as they snacked on pizza and potato chips, explain that aluminum hydroxide, for example, is used to improve the immune response and make the vaccine more effective. Half of the aluminum in a vaccine clears the body within 15 minutes, and 99 percent is excreted within two days, she said. Studies have found no correlation between infants who received aluminum-containing vaccines and cognitive development, she said.
The government can’t force people to get vaccinated, but businesses can bar people who are not. We just need a simple, reliable way to determine who’s had their shots.
Photo Illustration by The Daily Beast / Photos via Getty
Americans are about to enter a new phase of the pandemic, in which life-saving vaccines are, at last, a reality. The next several months will be confusing, with light visible at the end of the tunnel but the tunnel darker than ever, amidst thorny ethical questions of who should be prioritized.
But the months after that will be even more confusing, and we need to start preparing to answer those questions now.
By April or May, according to experts, most Americans who want vaccines will have gotten them. The trouble is that, as of last month anyway, 40 percent or so of Americans still need to be persuaded to get one.
For life, and the economy, to return to normal, we need most of these people to take part. So much is at stake: safe hospitals, stores, businesses, mass transit, schools, air travel, and cultural institutions, not to mention the economies that depend on them, our psychological well-being, and our entire way of life.
And yet, even with all the outreach that’s being planned now—to Black communities, rightly suspicious of the government; to conservatives poisoned by Trump’s and Fox News’s denialism; to left-wing anti-vaxxers—getting to “herd immunity” might take months. And in the meantime, a 95% effective vaccine is not good enough if you still have a 1 in 20 chance of catching a lethal disease at the grocery store.
Too much is at stake to wait for people who refuse to get vaccinated. We need a plan to move forward without them.
Let’s dismiss a few options out of hand. No, we won’t be locking anyone up for refusing to get a shot. Even if it would be constitutional, it’s un-American and would provoke massive resistance. In fact, no governmental compulsion to get vaccinated is consonant with our country’s values of liberty and freedom.
But freedom is a two-way street. You may have a right to get drunk and to drive however you like, but I have a right to be on the street and not be killed by you. No freedom is absolute, and your safety is where my freedom ends.
Likewise, just as I may have a right not to wear a mask or get a shot, you have a right to be able to walk down the street without me giving you a lethal disease. Choosing not to get vaccinated isn’t “freedom” any more than driving drunk is. It’s endangering other people. It is profoundly unethical. And it, too, is coercive; the anti-vaxxer is forcing me to swim in their viral discharge, anytime we share space in public.
So, what then? Anti-vaxxers are like drunk drivers, but we can’t force them to get vaccinated. Are we just stuck with a dangerous minority ruining life and endangering health for everyone else?
Ironically, given the politics of COVID-19, conservative American values point the way forward: we need to empower people to make their own decisions about safety. And we do that by empowering free enterprise.
Let’s imagine a world in June 2021, where everyone who wants a vaccination has gotten one, but where the virus is still spreading because of the large number of vaccine refusers. If I own a business, I may find it in my own interests to exclude those refusers. Maybe I want to protect my workers. Maybe I want to have a store, restaurant, bank, laundromat or school where people don’t have to wear masks, and where they can feel safe. And maybe I think that by doing that, I’ll get more customers.
So, just as today, I might put a “masks required” sign on the door, I might put a “vaccine required” sign on my door next June.
The trouble is that, unlike a mask, a vaccine is invisible. And that is why we must take action now.
We need written proof of vaccination that is as difficult to counterfeit or falsify as a hundred-dollar bill. We need it to be standardized and easy to show to others. And we need to start rolling it out in this phase of the pandemic, not the next one. Call them “vaccine passports”; simple, standardized documents, digital or printed, that enable society and the economy to get back to semi-normal without waiting for every anti-vaxxer to see the light.
This is what freedom looks like. Reliable proof of vaccination will enable individuals, businesses, churches, and other organizations to make these decisions for themselves—and for their customers and members to make their decisions as to whether or not to attend. For myself, if given a choice, I won’t set foot in a museum, go to a show, eat at a restaurant, shop in a grocery store, or pray at a synagogue with unvaccinated people either.
And the only ethical way forward is for me to have that choice. If anti-vaxxers can choose not to get vaccinated, I need to be able to choose to avoid them. Otherwise, we’re back to moral asymmetry. They can endanger my life, but I can’t do anything about it.
We’ve seen how this can work in the educational context. Fine, don’t get your kids their shots—but then, keep them out of school where they might endanger others. That way, everyone has freedom, both the anti-vaxxer and the large majority of people who understand the science and want to keep their kids safe.
All this depends on reliable proof of vaccination. Medical records may work for schools, but for every bar, movie theater, and restaurant, we need a simple document, in a standard form, with fraud protection, that will act as a kind of passport to living life in 2021. We need this to be free.
Again, in some totalitarian dystopia, the government could take choice out of the equation by requiring everyone to be vaccinated. But we don’t live in that world. In a free country, people get to choose. But all people get to choose. Both the unvaccinated, and the people who want to live our lives without fear of catching COVID-19.
And as a bonus, I suspect that when enough businesses and other public places go “vaxx-only,” that may incentivize some of the unvaccinated to change their behavior. If they can’t get into a baseball game, a graduation, a diner or a veterinarian’s office, they might find themselves re-examining their opinions about the vaccine.
Which, of course, they should anyway, because there is an objective truth to the novel coronavirus, and the truth is that it exists, it kills people, and it can be eradicated if enough people get a simple and safe vaccination against it. It may be someone’s constitutional right to be ignorant of science and reality, but the rest of us shouldn’t have to postpone our lives because of it.