High risk: anti-vaxxers in the delivery ward.
February 22, 2019 2:16 AM   Subscribe

“Tell me more,” I say, because I sense that the mother is holding something back. She looks down into the baby’s face as she replies, so softly I almost don’t catch it. “I don’t believe it is right to pierce his holy body with a needle,” she says. At that, my heart softens, because this is the kind of objection I feel for. It is not based on risks that science has proven are imaginary, or on false notions of “toxins”, or fear of chemicals that occur naturally in foods and the soil and are added to medicines. This mother’s child is holy, and his body is perfect and we ought to leave it be.

A nuanced and empathetic account of working with vaccine hesitant mothers in neonatal wards. I thought the author, Dr. Rachel Pearson, humanely conveyed the challenges of reassuring new mothers about the safety of modern medical interventions.

This piece was adapted from a publication in the New York Review of Books and overlaps with her book, No Apparent Distress.

(I feel like the use of anti-vaxxer was probably added by the editor. It implies that the piece is much more strident than it actually is. Organizations are gradually adopting the term "vaccine hesitancy" as it might create less of a blowback effect.)
posted by Telf (116 comments total) 27 users marked this as a favorite
 
Call it what you will, it won’t change their ideas, and it won’t end well for them and others. But what you gonna do?
posted by unliteral at 3:11 AM on February 22 [10 favorites]


I wonder when we will start to see the long term repercussion of these parents’ choices. Refusing vaccinations is a fairly new concept. I mean short term, yes, we can definitely see that some kids will die from lack of the whooping cough vaccination.

But I’m talking about the adult children years later who come storming back in to their parents, screaming that thanks to them, they’re infertile because they caught mumps or deaf because they had measles simply because their parents thought they knew better and it was all entirely preventable. I think for an unlucky few, that day is coming and I don’t know how any parent could formulate an adequate response.
posted by Jubey at 3:26 AM on February 22 [54 favorites]


Ah well, if they're religious idiots that's cool. What's a little child-endangerment between friends?
posted by pompomtom at 3:27 AM on February 22 [30 favorites]


Do read the whole thing, the quote above is somewhat misleading.
posted by hat_eater at 4:01 AM on February 22 [6 favorites]


"...parents are allowed to make choices that put their children in unnecessary danger. They are allowed to weigh risk and benefit on their own scales. They can see an injection as harm. Research has shown that parents who decline vitamin K are likely to go on to decline vaccination. Like those who refuse vaccines, they tend to be college-educated, white and born in the US – people like me, whose social privilege insulates them somewhat from ill-health."

The insulation of social privilege. Yes. This makes so much sense.

posted by evelvenin at 4:05 AM on February 22 [31 favorites]


(I really recommend reading the article, it’s thoughtful and beautifully written and not actually as much about antivax as the title suggests at all.)

I did not think twice about getting the Vitamin K shot when my daughter was born. Still, I can see where people like the newborn boy’s mother in the article are coming from, on some deeply primitive and instinctual level. I also agreed to two other needle-involved things around birth: foetal blood samples taken from her scalp during labour and a blood sample taken to determine treatment for jaundice when she was one day old. Both of these were absolutely the right call to make and both had potentially awful consequences if I’d refused and therefore we hadn’t had the information they gave us. I knew this. I still felt terrible when I was holding my screaming newborn as the neonatologist drew blood from her heel, or as I stroked her head and saw the scabs and scratches on her scalp, like no matter my reasoning I had done something deeply terribly wrong by allowing someone to harm my perfect baby.

So many of these decisions feel like weighing up fears in the same way, and it’s not (only) about the evidence base behind the fears at all.

The first times I was pregnant I was an academic working on historical medical correspondence, and that massively informed what I was scared of, in a way that generally worked out fine with modern medical care. I was very scared of measles, and no amount of antivax talking points that measles is rarely dangerous or fatal in the developed world would have persuaded me to refuse MMR for my child. (I mean, even if I hadn’t been that afraid of measles I’d have got her the vaccine because i rationally know the measles risk is still higher than the immunisation-for-measles risk. But I wasn’t only weighing up this figure against that figure, I was also thinking of all those suffering children in the archive papers I’d read, and all their parents who were terrified of measles for good reason.)

Other times it left me with fears that overlapped less usefully with the modern world. For two years I was scared of my daughter getting smallpox, for example, even though smallpox is effectively gone from the world and I not only knew that but could give you a long and detailed explanation of how it was eradicated. She wasn’t going to get smallpox. Didn’t stop me thinking “but maybe, but maybe...” with every fever or rash she did get, because I’d read so many accounts from parents watching their children suffer and die of it that it blotted out all other thinking.

I’m no longer scared of her getting smallpox specifically, but I also know that if smallpox ever did come back I’d very happily throw out all my convictions about public health programmes and civil liberties if martial law and forced vaccinations is what it took to stop it. This is hypocritical of me, very likely, but there we are.

I don’t know how you deal with fears like the fear of vitamin K injections. It does sound like the author of the article was able to meet the parents halfway and gain their trust, to a degree, and hopefully that’ll help their decisions in future. Still: at the end of the day, both babies left the hospital without it.
posted by Catseye at 4:38 AM on February 22 [40 favorites]


> But what you gonna do?

Teeny tiny baby coffins.
posted by cjorgensen at 4:56 AM on February 22 [17 favorites]


"vaccine hesitance" sounds to me like a type of rebranding meant to try and make something unreasonable sound reasonable, like turning trans-exclusionary feminism into "gender critical feminism" or racism into "race realism"

it's still the same anti-vaccine talking points and beliefs.
posted by anem0ne at 5:22 AM on February 22 [70 favorites]


I do like the anegdote about the anesthesiologist snorting “well that’s a bad decision” and that being more effective in changing a mind than all the careful reasoning and negotiation.

Maybe they should just play out entire fake emergencies or “good-cop/bad-cop” routines with idiot patients to make them make the right choice instead.
¯\_(ಠ_ಠ)_/¯
posted by mit5urugi at 5:28 AM on February 22 [27 favorites]



"vaccine hesitance" sounds to me like a type of rebranding meant to try and make something unreasonable sound reasonable, like turning trans-exclusionary feminism into "gender critical feminism" or racism into "race realism"


Do you want to be right or do you want to be effective?

If the goal here is to Tell Truth to the Sheeple, then labeling everyone with these views as an "antivaxer" - go ahead.

If you want to win people over and help your cause - I'm not talking about the peddlers of this filth, but the well-meaning who have been influenced by this rot..... maybe a different approach is required.

Maybe some respond to mockery and derision, others don't. Perhaps we should be scientific about this to obtain our results, even if it means not Talking Science and Statistics always
posted by lalochezia at 5:28 AM on February 22 [52 favorites]


I refused circumcision for my son because I felt like this. But I would never never ever refuse a vaccination for this reason - vaccinations aren't just about your child, vaccinations are about every single other child, the elderly and anyone with a compromised immune system. This is very empathetic piece but honestly I think the parents who don't vaccinate their children are the epitome of selfishness.
posted by bluesky43 at 5:40 AM on February 22 [19 favorites]


Like those who refuse vaccines, they tend to be college-educated, white and born in the US – people like me, whose social privilege insulates them somewhat from ill-health."

I think this has a lot more to do with bogus credentialing. College has gotten too easy and grades too inflated. People with basic degrees have massively inflated perceptions of their own abilities and knowledge because they have been told they are really really smart. The smartest.

The anti-vax crowd is exactly this demographic. College grads with basic degrees. They are not the ones with advanced degrees and they are not the ones who flunked out or couldn't get in.

They are the "a little knowledge is a dangerous thing" crowd. The climbed the mountain of their degree and didn't really look around so didn't realize it was just a foothill. So now they think they are Sir Edmund Hillary.
posted by srboisvert at 5:43 AM on February 22 [25 favorites]


Nice to see this article on the blue! I wanted to post it here when it come out but I know Dr. Pearson so it would have been too close to a self-link. Anyway, she is extremely brilliant and thoughtful and it’s great to see this article getting broad circulation. It is a real problem for medical providers— how do you deal with vaccine-hesitant parents in a way that is most likely to actually change their minds?
posted by aka burlap at 5:56 AM on February 22 [12 favorites]


It would be nice if we could have conversations about new parents and medical choices and misinformation without so angrily adding our voices to the deafening roar of personal criticism already directed at them from all sides, for all kinds of reasons, specifically at mothers. I know this one is really obviously a good thing, and has serious societal effects, and we're all pretty low on emotional energy, but can we try and engage this problem and not just dunk on people who made bad choices? There are deeper reasons they made those bad choices, and if we can work on those, maybe we can make some progress. This isn't an article about the rest of the world and vaccines, it's about the people whose job it is to actually try and deal with it on the ground, where things are not so easy.

I know actual doctors have better stories about this kind of thing, but even my very nominal medical work runs into this problem in other ways. Some obvious medical things scare some people, and if there is a more comforting viewpoint they can settle into, they will. The one I know is glasses. Lots of people, most commonly older men, can be very resistant to getting glasses, and sometimes will do so to the point where their resistance starts to cause greater decay than if they just wore the glasses. These people are making an obviously bad medical choice, and one that endangers the rest of society (they drive), and sometimes it is our job to try and convince them to make the right one. There's a lot of things we say, and a lot of reasons why these guys mistrust us from the start (glasses are expensive, and many of them rightfully sense a racket. sometimes they hate the fashion element), but I can assure that none of them involve telling these guys what we actually think of them, which is that they are macho-fueled idiots who think glasses will make them look weak or old because they bought into some bullshit, and they need to listen to the doctor and wear glasses so they don't run me down in the parking lot. We use more compassionate approaches that involve listening and explaining, part because we can't be mean to patients, and part because it actually works. Yelling makes us feel better, doesn't do squat to solve the problem. Entrenches it, I find. For us we have the luck of there being an obvious experiential benefit if we can get them to wear glasses, and sometimes the will later thank us. I feel for everyone in preventative medicine, because when they do their jobs well, the patient should hopefully not notice anything.

This obviously isn't as serious as vaccines, but I hope it can serve as an example of the kind of struggle this is on the ground. You can't just be angry, no matter how angry it makes you. Sometimes to bring someone back you have to build bridges to bad places, but it works better than throwing stones.
posted by neonrev at 6:13 AM on February 22 [50 favorites]


"vaccine hesitance" sounds to me like a type of rebranding meant to try and make something unreasonable sound reasonable,

I think that would have been "vaccine skepticism" or something. But the way "hesitance" softens the stance is by implying that it's temporary, and you'll come around soon, once you fully appreciate how necessary it is.

"Anti-vax" is a position. "Vaccine hesitance" is a passing phase.
posted by RobotHero at 6:24 AM on February 22 [23 favorites]


Us scientific rationalist people who believe in science believe in magic just as much as the woo people.

Doing harm to another person is hard and we have strong inhibitions against it. Poking someone with a needle, even yourself is hard, and some people never overcome their reflex that makes it impossible. It is so hard that we have developed magic rituals to overcome this inhibition. The common magic ritual when doing something that violates the skin is to perform an unnecessary act of care taking. This magic ritual is the standard purification and cleansing ritual, where a specially sanctified piece of material is moistened with a special solution that kills evil, and the victim is anointed.

Swabbing before injection is unnecessary. I read somewhere that the first study to come up with these findings was in Scandinavia and after the study conclusively proved it was unnecessary the doctors and nurses who participated in the study promptly went right back to swabbing. "Better safe than sorry, right?" and "Oh, it makes the patients feel better." They really didn't want to change their habit. This despite the fact that achieving hand-washing compliance which does make a difference is so difficult that the medical community has pretty much given up and is going with allowing hand sanitizer use instead, despite the fact that it doesn't make nearly the same difference as the hand-washing.


Medicine which is 'good' for us is hard enough to inject, but 'poison' like attenuated live viruses are much more daunting. I am glad I read this article. It has given me a new vocabulary to use with anti-vaxxers. For me they are now the vaccine-hesitant. I should have realised that the pile-on from the pro-vaxxers that I keep seeing and have joined on line was a symptom of outrage filter and tribalism.

And as for the part that the child - the person - is holy, ah, she and I share a spiritual belief. This was a lovely, lovely article.
posted by Jane the Brown at 6:39 AM on February 22 [20 favorites]


CNN.com opinion piece by a woman born with Congenital Rubella Syndrome because her mother had measles while she was pregnant. (Disclaimer: I went to high school with the author.)
posted by skycrashesdown at 6:54 AM on February 22 [15 favorites]


If you want to win people over and help your cause - I'm not talking about the peddlers of this filth, but the well-meaning who have been influenced by this rot..... maybe a different approach is required.

I don't want to win these people over. I want them ostracized and shunned. I do not give the faintest hint of a damn about the feelings of "well-meaning" folks who have chosen to ignore centuries of data and literal reams of scientific evidence, in favor of their own blinkered magical thinking based on literally the dumbest and most easily disproven crap ever vomited up by mankind, which is creating a massive public health crisis. It's equivalent to asking us to think about the delicate sensibilities of folks dumping mercury into the drinking water, or firing a gun randomly into the air. After a certain point, people's idiotic and reckless behavior disqualifies them from the sort of good-faith compassion you're talking about, because they are not operating in good faith. If it were up to me, we'd load MMR vaccines into dart guns and shoot them at anti-vaxxers headed into the NICU. It is literally unfathomable to me that anyone would exert the emotional labor spoken of in this article.
posted by Mayor West at 7:09 AM on February 22 [42 favorites]


You know what, people make stupid medical decisions all the time. Maybe not ones as ethically bad as refusing to vaccinate one's children. But we would never, for instance, say that if a diabetic person was eating too much sugar, their doctor should berate them and call them an idiot. We recognize that a good doctor comes from a place of compassion, even if they keep educating the patient, even if they are blunt about consequences. Since this doctor cannot legally compel this woman to get her child vaccinated, she must be persuasive. And let's also point out that she is a woman, and thus probably less likely to get a good response if she says bluntly "That's a bad decision" like the male anaesthetist.
posted by Hypatia at 7:23 AM on February 22 [18 favorites]


After a certain point, people's idiotic and reckless behavior disqualifies them from the sort of good-faith compassion you're talking about, because they are not operating in good faith.

I find it more useful to think of this as a public health crisis along the same lines as, say, air pollution. (WHO lists both in its identified top threats to global health in 2019.)

My typical morning commute involves walking my kid to school along roads full of cars, mostly driven by other parents dropping their kids off, usually crawling along in gridlock, usually engines running even when they're stopped so they don't get parking tickets. After I've done that, I carry on to my office, which involves a walk along the most polluted street in my country.

All this pollution is caused by vehicle traffic, and therefore by individual people making individual decisions. The added effect of one more person driving isn't what's tipping it to 'dangerous'; likewise, the added effect of one more person refusing whooping cough vaccine isn't what's going to destroy herd immunity. Both individuals are only contributing a tiny, tiny part of the problem by themselves, but the combined effects of many other people making that same decision are causing illness and death.

People who don't vaccinate are making bad and dangerous decisions. I just don't see how making this public health issue about individual moral failing while that one is a structural issue where nobody's really to blame is consistent, or helpful, or likely to improve things for the rest of us.
posted by Catseye at 7:30 AM on February 22 [23 favorites]


okay but the diabetic is endangering themselves, like someone who skips their meds and drinks too much.

the injection-refusing parent endangers their child and the general public, like someone who steals their roommate's meds or drives drunk.

I don't want to shun a person who refuses vaccinations for their kids any more than I want to shun a person who swipes other people's Ativan. I want to compel that person to stop doing that thing, by force if no other option is available.
posted by bagel at 7:31 AM on February 22 [9 favorites]


can i be a non-binary vaccer? fluid in my support/distrust?
this "you're with us or against us" shit is never a good sign. the world is a subtle variable place.

i believe in scientific method/evolution/climate change/etc but unlike gravity(i drop an apple, you drop an apple), many of these things are difficult to experience directly. vaccines are similar, you can't really have a scientific method moment with them and you're given a black/white yes/no choice. i believe scientifically vaccination is a real thing, but if i had a kid, it would seriously give me pause to see all those needles. i'm damn distrustful of mega-corps of any sort. the track record of mega-corps in any industry is not good. also, as a phd dropout, i have seen the way research institutions work and it ain't pretty.

if you go in for a flu vaccine they tell you straight up it's got mercury as adjuvent. a small dose surely but do i really need to take a small dose of mercury?? how would i know? i know i don't want mercury in my water or fish or tooth fillings. maybe it does nothing or maybe it does mess with my particular chemistry and history of exposure?? i'd rather have the flu for a few days.

here's a person in science (who i have actually had lunch with) who believes simply that vaccine benefit is overrated and vaccine dangers are underrated. (but i do know people in the past have lambasted this woman on mefi)
https://www.youtube.com/watch?v=9_a2FueONBU&feature=youtu.be
i'm not endorsing all her conclusions but she has a bunch of super interesting points in this talk. number of vaccines for grandparents generation vs todays babies etc. combinatoric effects with increased pesticides of today, mercury and aluminum as adjuvents, and on and on...
posted by danjo at 7:33 AM on February 22 [3 favorites]


I don't want to win these people over. I want them ostracized and shunned.
The problem with that is, they control their children. So you're going to ostracize and shun the children, too. And the ostracized, shunned children won't presumably be ostracized and shunned all the way off the continent, so they'll be endangering herd immunity right along.

I do not give the faintest hint of a damn about the feelings of "well-meaning" folks who have chosen to ignore centuries of data and literal reams of scientific evidence, in favor of their own blinkered magical thinking based on literally the dumbest and most easily disproven crap ever vomited up by mankind, which is creating a massive public health crisis.
If achieving your goal is possible by catering to their feelings, then catering to their feelings is the means necessary to achieve the goal.

It's equivalent to asking us to think about the delicate sensibilities of folks dumping mercury into the drinking water, or firing a gun randomly into the air. After a certain point, people's idiotic and reckless behavior disqualifies them from the sort of good-faith compassion you're talking about, because they are not operating in good faith. If it were up to me, we'd load MMR vaccines into dart guns and shoot them at anti-vaxxers headed into the NICU.
Isn't it pretty to imagine? But that is an imaginary world similar to the one the antivax crew lives in.

It is literally unfathomable to me that anyone would exert the emotional labor spoken of in this article.

If it works, we best start to fathom it. If it works but it's too much hassle and it's beneath us to try to fathom, then we're risking the children's lives and health and the lives and health of vulnerable people and herd immunity, all because we find magical thinking irritating.

This attitude reminds me of the right-to-life theory that they should make abortion illegal and close all the clinics. Of course that keeps people from being able to access birth control, which leads to more abortions. Closing Planned Parenthoods across the land = more unwanted pregnancies and more abortions. Violent rage at antivax parents = fewer kids get vaccinated.
posted by Don Pepino at 7:35 AM on February 22 [17 favorites]


Maybe some respond to mockery and derision, others don't

I responded to mockery and derision, and it was instrumental in guiding me away from some very toxic fundamentalist beliefs. In the world of antivax maybe some people need the kid gloves, but others don't. I'm going to continue to play to my strengths.
posted by traveler_ at 7:37 AM on February 22 [7 favorites]


if you go in for a flu vaccine they tell you straight up it's got mercury as adjuvent. a small dose surely but do i really need to take a small dose of mercury?? how would i know?

The CDC tells you that the mercury containing preservative (not adjuvant) in multi-dose flu vaccine vials is safe, and they are experts who have studied this way more than some person who has a youtube. They also tell you that "I'd rather have the flu for a few days" ignores the benefits of the flu vaccine, including avoiding risk of health complications to you and all the other people you will expose.
posted by hydropsyche at 7:39 AM on February 22 [42 favorites]


Also, that person with a youtube is a computer scientist, so her expertise on vaccination safety is highly questionable.
posted by hydropsyche at 7:40 AM on February 22 [23 favorites]


It's equivalent to asking us to think about the delicate sensibilities of folks dumping mercury into the drinking water, or firing a gun randomly into the air. After a certain point, people's idiotic and reckless behavior disqualifies them from the sort of good-faith compassion you're talking about, because they are not operating in good faith. If it were up to me, we'd load MMR vaccines into dart guns and shoot them at anti-vaxxers headed into the NICU. It is literally unfathomable to me that anyone would exert the emotional labor spoken of in this article.

My partner is immunocompromised, and was from a young age. I want every single living human stuck full of needles containing whatever the doctors tell me is useful to keeping her and the rest of people like her alive if they can have them, cause she can't. I am scared a lot of the time from it. If it were up to me, the choice to not vaccinate a kid would come with an invitation for everyone in a 1000 mile radius to beat you in turn. That's why it's good that I'm not in charge of how actual doctors with an actual job to do communicate these things to patients. It's good that I'm given directives on how to deal with patients at my own work. There are people who work their whole lives on this problem. One wrote an article, handily linked at the top.

It's not unfathomable, it's some people's job. Lots of people, actually. Most people aren't internet folks like us with this kind of community. Most people get screaming hell from all sides on social media and in public and from their bosses and coworkers and family and friends and TV and ads and anything else, and sometimes make bad choices. Lots of people have to try and contain and deal with this bad advice. Yelling more does not help. Listen to the ones who actually do it.
posted by neonrev at 7:41 AM on February 22 [18 favorites]


can i be a non-binary vaccer? fluid in my support/distrust?
this "you're with us or against us" shit is never a good sign. the world is a subtle variable place.


I vote absolutely not, yikes, we are talking about a choice that kills innocent people, not a gender identity. I had the flu this year despite the vaccine, and it sucked, but I was much less likely to be hospitalized or to give it to anyone else due to the vaccine.

If you don't want a shot so badly you're fine with hospitalizing infants or cancer patients over it, comparing that to being non-binary is wildly insulting on like twelve hundred levels.
posted by bagel at 7:43 AM on February 22 [62 favorites]


If I thought for a red hot minute that more people would go for vaccines if they were rebranded as BabyMagic LifeSyrum and colored purple, I would suggest that we do that.

I know that vaccines work. Vaccines work WELL. They are startlingly effective.

However, the US, as a nation, is not willing to FORCE people to vaccinate their children. The world as a whole benefits from herd immunity, but we as a nation value personal autonomy and belief systems more than herd immunity.

Since we're not willing to do it by force, then we need to do it by persuasion. By marketing. By selling people on the stuff. For some of the not-vaccinating crowd, science and reason may win the day. And that's great. By all means, let us change the minds of those whose minds are open to change.

However, some folks are not going to be convinced by science and reason. Some folks do not believe or understand that they are coasting on the Herd Immunity generated by Other Parents vaccinating, that they are getting a free ride, that they are getting the benefit of thousands upon thousands of vaccinated people around them.

Some folks are CONVINCED that the reason there are so few cases of polio nowadays is that the "disease has weakened considerably since the 1950's" and it's not as dangerous now. Like that's a thing they honestly, truly believe. Same for why we don't see the great reaper diptheria, the disease that took 1 in 5 of children under five that caught it... it's "not as strong now".

Some folks post facebook memes about "immigrants with smallpox on the border of the US RIGHT NOW" and believe, firmly and truly, that this is A REAL THING. (Image is from, like, 2004. Person has scabies, not smallpox. Smallpox has been eradicated in the wild since about 1978.)

For this group of people, and there are a bunch of them, it's an uphill battle for Science and Reason to win the day. And then the question is "Do we value the right of these people to be totally and stupidly wrong MORE than we value the health of their minor children, the health of medically-fragile people everywhere, and the power of Herd Immunity for the rest of our population?"

Apparently, we do.
posted by which_chick at 7:43 AM on February 22 [6 favorites]


It is a real problem for medical providers— how do you deal with vaccine-hesitant parents in a way that is most likely to actually change their minds?

I think this is where the public health community need to talk to psychologists, communication and marketing experts. I don't know that they've solved the problem, but they may have a lot to contribute.
posted by jb at 7:44 AM on February 22 [4 favorites]


Oh, I’ve thought about this a lot lately. I’m all in on vaccines, which seems to be lost on people as I make this argument. But here is the problem I see, in short:

Women, who seem to be the primary on the ground proponents of anti-vax, are behaving entirely rationally when they don’t trust a medical system that rountinely abuses them and has for centuries. Is their any wonder that some of them refuse to believe the authority figures that tell them to “trust us, this vaccine is safe.”?

The intersection here with society at large constantly telling women how they’re parenting wrong, not being good mothers because x, y, and z, that strangers think it’s okay to walk up to mothers and criticize how they’re doing pregnancy or parenting... a lot of anti-vax scorn comes from this exact place.

These women, for the most part, are acting rationally within the confines of what they know and the information they have available. The science and hard data they have is often wrong. But the rest, the distrust, the long history of the medical establishment mistreating women, the resistance to paternal badgering; that’s all real and valid.

Stop telling women they’re dumb for believing what they believe, and maybe we can turn this around.
posted by [insert clever name here] at 7:45 AM on February 22 [39 favorites]


The anti-vax crowd is exactly this demographic. College grads with basic degrees. They are not the ones with advanced degrees and they are not the ones who flunked out or couldn't get in.

It doesn't take an advanced degree to understand that vaccines work. This is a ridiculous assertion. It doesn't even take ANY degree, just an acceptance that science is real. That's what's been undermined these last 30 years, along with a mentality that nobody is ever actually wrong as though facts are malleable.

We don't need to "accept" these people, or convince them, or be nice to them. We could quarantine them, though, just like society used to do for people who were disease vectors. They can have a vaccine and their freedom, or their beliefs and walls, pick one.
posted by Autumnheart at 7:54 AM on February 22 [15 favorites]


Adding to my point, I listened to an episode of Hidden Brain last night on Eugenics and Forced Sterilizations of women, never having realized the tie in here of eugenics being more “control the bodies of women”. Here, science was used to justify some truly awful behavior. And yes, it was the 1920s, but science continues to be more mallible when there is an agenda, even today. I suspect we’re going to look back in the same number of years at how science was used to disenfranchise women in other ways. I don’t think that’s going to be the vaccine front, but I do think the rejection of vaccines is a symptom of a system that has done women wrong.

As for why it’s primarily college-educated women? Well, my guess is that they know enough history to see this bigger picture of systemic mistreatment of women that their distrust of the medical industry is born of historical knowledge. (That is a hunch, but I think it’s going to bear out.)
posted by [insert clever name here] at 7:58 AM on February 22 [7 favorites]


Maybe it's the rampant socialization that Being A Mom makes you an expert on everything.
posted by Autumnheart at 8:01 AM on February 22 [16 favorites]


i'm damn distrustful of mega-corps of any sort. the track record of mega-corps in any industry is not good. also, as a phd dropout, i have seen the way research institutions work and it ain't pretty.

The WHO and the CDC and PHAC (Public Health Agency of Canada) are not mega-corps.

I work with epidemiologists and public health experts. Of all the medical fields, this is one with some of the least involvement of large corporations. People are primarily employed by governments and non-profit institutions, like universities. They have no motivation to promote unnecessary care - far from it, in the case of governments in countries which provide health care. They want to save money. If they are promoting vaccines (which are covered under universal health care), it's because they see it as saving money from dealing with illness, disability and possible death.
posted by jb at 8:04 AM on February 22 [34 favorites]


Could medical insurance plans mandate that newborns get vitamin K injections and vaccinations as a condition for continued insurance? Treat refusal of standard medical care like a preexisting condition? Do they already and parents just shrug and say, "Corporations, whaddaya gonna do?" and pick up their adorable little pox vectors and trudge out into the big world? Forgive my ignorance, but I never had kids because I didn't want to orphan them when my heart stopped from the intense unremitting terror of and rage at other people. Not to mention remorse at having contributed to the growth of this dismal and accursed species.
posted by Don Pepino at 8:06 AM on February 22 [3 favorites]


These people are making an obviously bad medical choice, and one that endangers the rest of society (they drive)...they need to listen to the doctor and wear glasses so they don't run me down in the parking lot.

Then the solution is to tighten legal requirements so that they either have glasses or they don't drive. Who gives a shit what they think or feel about it? If they want to drive, get glasses. If they want to be macho, they can walk. The solution isn't holding their hand and working through their stupidity, it's forcing them to comply or face the consequences.

But we would never, for instance, say that if a diabetic person was eating too much sugar, their doctor should berate them and call them an idiot.

People can choose to harm themselves. They don't get to choose to harm others, especially children.

Since this doctor cannot legally compel this woman to get her child vaccinated, she must be persuasive.

and

The problem with that is, they control their children.

No, they don't. Children aren't the property of their parents. We place all sorts of limits on what a parent can do to their child or what they can choose for them. Parents can't choose to neglect or abuse their children no matter how they feel about it, and our solution to those problems isn't to gently walk them to the light. Our solution is use the law to stop the behavior. Same here: vaccines shouldn't be a choice. Legally mandated.
posted by Sangermaine at 8:06 AM on February 22 [17 favorites]


My kid is alive and thriving because of newborn screening (heel prick blood test), and so we were on board for all vaccinations and shots as early as possible. We were lucky. His last inpatient hospitalization occurred coincidentally during an active measles outbreak in Minneapolis, in which we spent 4 days in isolation in his room on the unit designated for kids with cancer, genetic disorders, and other rare diseases. These are the kids that herd immunity is supposed to protect, and while I don’t wish the heartbreak of being a frequent flyer to this unit upon any child or family, I wish that these parents could see what it is like to be in the vector of other people’s privileged, deliberate ignorance.

Also, the vibe of a children’s hospital during a measles outbreak is unlike any hospital vibe I have ever experienced. It’s like an eerie tomb of doom.
posted by Maarika at 8:07 AM on February 22 [19 favorites]


If I thought for a red hot minute that more people would go for vaccines if they were rebranded as BabyMagic LifeSyrum and colored purple, I would suggest that we do that.

My SO thinks vaccines should be marketed as "special preventative germs" to convince the hippies to vaccinate. They are derived from natural things (viruses).
posted by jb at 8:08 AM on February 22 [10 favorites]


Women, who seem to be the primary on the ground proponents of anti-vax, are behaving entirely rationally when they don’t trust a medical system that rountinely abuses them and has for centuries. Is their any wonder that some of them refuse to believe the authority figures that tell them to “trust us, this vaccine is safe.”?

There may be some truth to this (women are still treated badly, especially when it comes to issues like chronic pain).

But at the same time, in terms of recent residencies in the US, women dominate pediatrics (about 75 percent) and obstetrics/gynecology (about 85 percent). So a lot of these arguments happening today are not happening between mothers and male doctors, but between female doctors (or nurses) and parents.

I don't know the gender breakdown on who makes vaccination decisions, but I have found the anti-vax movement to feel (to this afab but non-binary person) very female-oriented, and wrapped up with a lot of the "natural motherhood" culture. I feel more like it's an argument between women than between women and male-dominated institutions.
posted by jb at 8:19 AM on February 22 [8 favorites]


The problem with that is, they control their children.

No, they don't.

What? Yes! In this, they do! That's the whole entire problem!

Children aren't the property of their parents. We place all sorts of limits on what a parent can do to their child or what they can choose for them. Parents can't choose to neglect or abuse their children no matter how they feel about it, and our solution to those problems isn't to gently walk them to the light. Our solution is use the law to stop the behavior.

If the parent is not putting the child in a carseat, the parent will be subject to the law. But if the parent wants to deny the child recommended medical care because of Jehovah or Nature, the law smiles and nods. And if the parent wants to homeschool the child and teach it that God is a winged horse that made the world fifty years ago and the best way to avoid dying of plague is to wear copper and not have sex until marriage, that's fine with the law.

Same here: vaccines shouldn't be a choice.
Certainly they shouldn't. Obviously. But they are. That is the real actual world, not the magical dream world. We have to operate from within the real world.

Legally mandated.
Absolutely. Let's work for that. Meanwhile! How do we get people to choose to give their poor kids vitamin K so they don't stroke out and die before they can even walk?
posted by Don Pepino at 8:21 AM on February 22 [4 favorites]


I'm terrified that the woman in this article was resisting a VITAMIN K SHOT, simple vitamins that greatly reduce her baby's risk of hemmorage, and she still refused. Vitamins. That's truly insane.
posted by agregoli at 8:21 AM on February 22 [9 favorites]


I mean, this is a woman taking advantage of a fully modern hospital system of care, and she disagrees that vitamins are ok to give her baby. I don't understand that kind of selective trust in science.
posted by agregoli at 8:24 AM on February 22 [15 favorites]


neonrev: It would be nice if we could have conversations about new parents and medical choices and misinformation without so angrily adding our voices to the deafening roar of personal criticism already directed at them from all sides, for all kinds of reasons, specifically at mothers.

It's been more than a decade since our youngest child was born, but I still remember the combination of emotional overload & fragility from the whole delivery experience, combined with the flood of information about feeding and safety and schedules and whatnot. It really isn't fair!

New parents -- especially the moms who delivered the baby -- are not at their best, and yet they are expected to make decisions (the name! circumcision! vaccines! breast or bottle!) and absorb information at a furious pace. Pre-natal educational classes do not and cannot prepare you for it all. If you haven't had the conversations and planned things out ahead of time, it's possible to commit to things that you later regret.
posted by wenestvedt at 8:26 AM on February 22 [10 favorites]


wenestvedt, yes! Reading the article I was like, "Why have they not discussed the shots ages ago, why'd they wait 'til she was in labor to do this crucial education about all this stuff she has to decide?" And THEN I read on and find out that the education happened, it was just that it was miseducation. The midwife apparently warned the expectant mother specifically that the doctor was going to offer vitamin K and to reject it. What the hell? Are midwives somehow immune from malpractice lawsuits? What in the actual hellll. The last couple of paragraphs of this made me want to rip out every single hair on my head.
posted by Don Pepino at 8:32 AM on February 22 [23 favorites]


I would think you could still know that vitamins cannot harm a baby...especially when they are recommended by the same doctor you trusted you and your baby's care to in the first place.
posted by agregoli at 8:32 AM on February 22


But I’m talking about the adult children years later who come storming back in to their parents, screaming that thanks to them, they’re infertile because they caught mumps or deaf because they had measles simply because their parents thought they knew better and it was all entirely preventable. I think for an unlucky few, that day is coming and I don’t know how any parent could formulate an adequate response.

When my stupid state was huffing and puffing and freaking out about kids getting HPV vaccines, I had similar thoughts. Hey Parent, how are you going to feel about not vaccinating your kid because you want to control their sexuality, then they get actual fatal cancer thanks to you? How is your kid going to think about you as they die?

As a parent, I couldn't really imagine anything worse than knowing I COULD have protected my kid, but didn't, for extremely stupid reasons, and now they're dead. I would be an utter failure of a parent, the literal worst.

I hated hearing my baby scream when they gave him his initial vaccines, it was unpleasant, but it sure as hell beat watching him die of a preventable disease.
posted by emjaybee at 8:33 AM on February 22 [13 favorites]


I was a sick baby and am a sick adult. I need tons of medications. I use diet and environmental controls to help as much as possible. My mother decided to go militant anti-vax on her grandchildren. It's a nightmare to think that if she had exercised that option in my childhood I wouldn't even be here. It tears me to shreds thinking of how lucky I am to have modern medicine and how my immune system might have transferred in some way to those precious children in my family who won't stand a chance. We already have evidence of issues with them. It's scary.
posted by lextex at 8:35 AM on February 22 [8 favorites]


Adding to my point, I listened to an episode of Hidden Brain last night on Eugenics and Forced Sterilizations of women, never having realized the tie in here of eugenics being more “control the bodies of women”. Here, science was used to justify some truly awful behavior. And yes, it was the 1920s

Nonconsensual sterilization of poor, immigrant, and ESL women were not uncommon in the US into the 1970's.
posted by The Underpants Monster at 9:03 AM on February 22 [11 favorites]


I would think you could still know that vitamins cannot harm a baby...especially when they are recommended by the same doctor you trusted you and your baby's care to in the first place.
So, the midwife, who was the person she actually trusted to care for her and her baby, told her it would be a massive overdose of vitamin K. Reading b/w the lines, it looks like she didn't trust this doctor or the hospital. She wouldn't have been there had she not had to have a hysterectomy. She had no relationship with the doctor before the vitamin K balking issue, and in fact they had never met before: "We introduce ourselves as the paediatricians who will be there when her baby is born."

The decision to try to avoid a hospital birth is not necessarily based in crazy superstition. Hospitals have a bad track record with childbirth. Unnecessary episiotomy, unnecessary hysterectomy, twilight sleep, separating babies from mothers, advocating formula feeding for decades, hell, thalidomide. And it's not just historic bad-old-days horror stories, either. I mean, Serena Williams just nearly died. The US doesn't exactly have a fantastic reputation for high standards of care for mothers and babies. Wanting to avoid the hospital isn't crazy. And being confused about what is actual danger and what is fictional danger is completely understandable. Tennessee needs to take a serious look at its midwife licensing and ensure that homebirths aren't consigning children to a lower standard of care. They at least must weed out rumormongoring monsters like this midwife so that people don't get wrong information that endangers their children.
posted by Don Pepino at 9:18 AM on February 22 [14 favorites]


I think the approach should be to allow parents to choose freely, but they have to face consequences for that choice.
Refuse them enrollment in public schools. Refuse them daycare spaces. Make it as difficult as possible for their voluntarily unvaccinated children to be in a situation where they are likely to share germs with large groups of other humans. Not as retribution, but to protect the rest of us.
Market forces predict that specialized private schools, daycares, and summer camps will spring up that cater exclusively to the unvaccinated children who aren't welcome anywhere else...likely at added cost to the parents. Over time, the non-vaccination phenomenon will fade away.
posted by rocket88 at 9:22 AM on February 22 [7 favorites]


Wanting to avoid vitamins? Is crazy, in my book. I already know all the horror hospital stories about birth. Never heard a horror story about vitamins.
posted by agregoli at 9:26 AM on February 22


I would think you could still know that vitamins cannot harm a baby

well, except that if she’s just given birth, she’ll have been advised for the previous 9 months to avoid foods and vitamin supplements containing high vitamin A because it can harm the unborn baby. This is not woo hippy advice, this is standard medical guidance.

Vitamin A is not vitamin K, and the newborn vit K injection is not a liver pate sandwich - it’s still a safe thing to get for the baby and a hell of a lot better than the worst-case consequence of avoiding it. But it’s not quite as simple as “why don’t these idiots trust vitamins, they’re harmless!”
posted by Catseye at 9:32 AM on February 22 [22 favorites]


This woman just had a surgical procedure! An advanced technology deal. But vitamins are a problem. The problem is clearly trusting some science and not other parts, which is not understandable at all to me. I don't know how to combat selective choosing of what facts are. It's disturbing in all areas of life (ahem, Trump-y people) but we are facing it more and more and it makes me want to scream.
posted by agregoli at 9:35 AM on February 22 [4 favorites]


And I think it IS simple. It is SO simple. A person who is not a doctor thinking meh, naw vitamins, risk is overinflated, is fucking thinking INSANE things! I feel like there could be a great short film about this, like when the next airborne virus hits, there will be millions going like, ah that shit's overblown, I'm not going to take those government CDC precautions! All hogwash. Just eat healthy! You'll be fine!
posted by agregoli at 9:38 AM on February 22


Maybe some respond to mockery and derision, others don't. Perhaps we should be scientific about this to obtain our results, even if it means not Talking Science and Statistics always

i wasn't aware that calling a spade a spade was "mockery and derision". being a "vaccine skeptic", or "vaccine hesitant" or however they want to phrase it is still using anti-vaccine rhetoric. it's no different than allowing people to call themselves "pro-life" when they're, well, not really.

i'm sorry you view it as mockery and derision when all i was saying, without mockery, without derision, that that's the exact sort of rebranding that allows toxic views to spread, because they seem "reasonable" all of a sudden.

---

Do you want to be right or do you want to be effective?

i don't know, honestly, with this sort of thing, because i think you can be right and effective, and i think there's definitely a place for calmly, and not dismissively, pointing out that there are bad actors out there who utilize language to try and dupe people. there are entire industries for this.

the way to be right and effective, i think, is definitely not to cast those two as two things that cannot coexist, and it's definitely not to be dismissive of someone's point in the fashion you did.
posted by anem0ne at 9:48 AM on February 22 [6 favorites]


This is a very interesting research article (AAP) about addressing vaccine hesistancy as a pediatrician http://pediatrics.aappublications.org/content/138/3/e20162146
posted by typecloud at 10:35 AM on February 22


I had a horrible allergic reaction to a totally routine vaccine when I was a kid. I survived, and I got the rest of my shots, thank you, but this "these people are IDIOTS this is SCIENCE, DUH" attitude is cold vaporizing a whole lot of Actual Lived Experiences, which is a thing that occasionally has currency here. No public health crisis was ever solved by this two minutes' hate shit.
posted by prize bull octorok at 10:36 AM on February 22 [15 favorites]


"Refusing vaccinations is a fairly new concept." Movements to refuse vaccination are as old as vaccination itself. People get seduced by the effectiveness of herd immunity into rejecting vaccination based on individual consequences, and unfortunately it often takes a resurgence of contagious disease to get people back to it.
posted by Selena777 at 10:40 AM on February 22 [9 favorites]


I noticed that there's an AMA coming up later today (4:30 EST) on r/askscience from a vaccine expert, Dr. Saad B. Omer. Many of the questions posted so far are very relevant to this thread, so I suspect that some here will find his responses interesting.
posted by randomnity at 10:44 AM on February 22 [1 favorite]


mostcommenters agree vaccines are good, avoiding them equals harming your children and other people.

we disagree about methods of persuasion and the desireability of coercion.

im ok making vaccines manditory, im also ok with calling them magic-Baby-bliss-juice if that will help medical-independents get with the program.

its easy to create us-them divisions
repairing them much tougher
posted by Anchorite_of_Palgrave at 10:45 AM on February 22 [5 favorites]


No public health crisis was ever solved by this two minutes' hate shit.

Even when advocating a gentler, more understanding method of winning hearts and minds, the first tool reached for is a denigrating and expletive-laden insult designed to shut down and drive off opposition.

I'm reminded of a very intelligent comment I'm sure we all agree with:
Do you want to be right or do you want to be effective?
posted by the man of twists and turns at 10:49 AM on February 22 [3 favorites]


The problem with the "it's not surprising that women distrust the medical community" argument is that this "distrust" seems to be very specific to vaccines. Do these people also refuse antibiotics? Painkillers? Asthma medication? Insulin? When their kid is sick where do they take them? To the same pediatricians who recommend vaccines? Why would you trust doctors with other aspects of your child's health if they're all in cahoots to give your child autism?

It's perfectly reasonable for women to distrust the medical establishment. I just think it's a weak argument when applied to vaccine refusal.
posted by sarahw at 10:50 AM on February 22 [13 favorites]


I too can envision the war being won in part by insurance companies which won't insure vaccine-preventable illnesses in unvaccinated people who are old enough and have no medical exemptions for them. I don't think that financially it makes sense for them to do this quite yet.
posted by jeather at 10:50 AM on February 22


Movements to refuse vaccination are as old as vaccination itself.

Yes! You could even argue older, as 'vaccination' goes back to Edward Jenner but there was significant resistance to the earlier form of inoculation for smallpox that arrived in the West in the 18th century. General distrust in medicine was a bit more well-founded then of course, and it's ironic compared to some of the 'Western medicine is bad' rhetoric that some of that earlier resistance took a 'this is a weird primitive custom from Africa/China that we can't trust' line, but yes, resistance is definitely not at all new.
posted by Catseye at 10:51 AM on February 22 [2 favorites]


Do these people also refuse antibiotics?
Yep! They'll kill you. You just need to drink kombucha to rebalance your microbiome.

Painkillers?
Chiropractic; acupuncture/pressure; yoga; reiki; cupping; colonic irrigation.

Asthma medication?
Asthma comes from chemical sensitivities. If they can get rid of everything in the house that's made of a nonnatural fabric and work from home to avoid sick building syndrome, it will resolve.

Insulin?
Sigh. This one I have personal experience with. Friend's mom. She installed a salt-water pool with healing properties and wore magnet jewelry and ate the Pritikin diet. I'm not in close touch with them but would be informed if she died, so I guess she's probably back on insulin. But she was off of it for a terrifyingly long time.

When their kid is sick where do they take them?
To a practitioner of holistic medicine.

To the same pediatricians who recommend vaccines?

No. See above.

Why would you trust doctors with other aspects of your child's health if they're all in cahoots to give your child autism?
They wouldn't and they don't.
posted by Don Pepino at 11:10 AM on February 22 [7 favorites]


Interesting how many people interpreted the adoption of vaccine hesitancy as some sort of softball coddling of virulent anti vaxxers. I meant to address this more upthread but my kitchen caught on fire and I've just got back to the thread.

The uptake of the term vaccine hesitancy isn't necessarily to placate active deniers, its meant to recognize that these opinions work on a spectrum, or more accurately across several points that can be graphed out. People at the forefront of public health have adopted the term because it's a more accurate framing of the problem. As mentioned above, organizations like the WHO use the term while actively trying to reduce the spread of these beliefs.

The people whose job it is to combat the anti vaccine movement use the term, so don't freak out. We're doing it because it's more effective than just calling people idiots and smugly laughing at their perceived stupidity. By recognizing that there are different reasons for alternative vaccination schedules and delayed vaccinations, we can better address the causes of these hesitations.

There are a lot of incorrect assertions in this thread. I think we all agree that vaccines are one of the cornerstones of modern medicine and have saved hundreds of millions of lives. That being acknowledged, let's try to clear up a few issues. I've dumped citations below because I didn't have time to embed them to each point.

• The modern vaccine hesitancy movement in high income countries is positively correlated with both education and income. (This probably just means rich people have more time to worry about these things and care about the ingroup signalling of things like eating organic, doing yoga and not getting their kids vaccinated.)
The poorer, less educated people you do get vaccinated are largely categorized as passive acceptors. Meaning they don't believe more strongly in vaccines, they merely get them because that's what's expected and that's what the norm is. (Overall, great.)

• Antivaxxers have existed for as long as there have been vaccines. Often the debate is framed of self sovereignty or freedom. This is not new.

• There was an antivax movement before Andrew Wakefield, antivax movements in other countries or other cultures cluster around entirely different fears and vaccines. (IE The Japanese and the French are worried about different, probably equally untrue issues.)

• The vaccine hesitancy movement is more about mistrust of authority and group identity than it is about just vaccines. This is true of many conspiracy theories and political movements as well.

• Sometimes people do have adverse reactions to vaccines. Yes, statistically, you're better off getting vaccines than dying of measles etc, but children and adults can and do die from vaccines. Unfortunately narratives of bad effects are more powerful than the best statistics.

• To a large extent this is a free rider problem. Many people have cited herd immunity, which is true. Keep in mind that the risk of getting vaccinated is not 0. That's inconvenient but true. Some people bank on this when they decide not to vaccinate.

• Ostracizing vaccine hesitant parents will often just push them further into their corners. One on one conversations with empathetic health care professionals can be a very effective intervention.

• Most people just want to be reassured.

• General distrust of institutions is on the rise and is correlated with all sorts of things like the 2007 financial crash, social media, the US reaction to September 11, the constant hoopla over swine flu. Pretty much anytime an expert fucks up, people add it to their box of reasons to distrust authority figures. Also some people just have a higher distrust personality trait. (These people are often conspiracy theorists.)

I was going to embed references into the above statements, but if you're really interested in this sort of things, there is a whole body of excellent research that will help next time vaccine hesitancy comes up.

Most of these papers should have free access. See also anything from the Sage Working Group on Vaccine hesitancy. I'm accessing from a university so I'm not sure what's paywalled.

"Nature Does Things Well, Why Should We Interfere?": Vaccine Hesitancy Among Mothers.
Addressing issues of vaccination literacy and psychological empowerment in the measles-mumps-rubella (MMR) vaccination decision-making: a qualitative study
“We are fierce, independent thinkers and intelligent”: Social capital and stigma management among mothers who refuse vaccines
Sources and Perceived Credibility of Vaccine-Safety Information for Parents Attitudes to vaccination: A critical review
The Influence of Narrative v. Statistical Information on Perceiving Vaccination Risks
How to deal with vaccine hesitancy?
Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement
Vaccine hesitancy, vaccine refusal and the anti-vaccine movement: influence, impact
and implications

Vaccine Hesitancy: Clarifying a Theoretical Framework for an Ambiguous Notion
Vaccine hesitancy: Definition, scope and determinants
'Leaps of Faith' and MMR: An Empirical Study of Trust
posted by Telf at 11:24 AM on February 22 [49 favorites]


some of that earlier resistance took a 'this is a weird primitive custom from Africa/China that we can't trust' line

Turkey, actually! It was Lady Mary Wortley Montagu who, in the early eighteenth century, brought the custom of anti-smallpox vaccination back from her stay in Constantinopole with her husband who was ambassador to Turkey. Her letters are very interesting, and she also had the good sense to reject a suitor named Clotworthy.
posted by praemunire at 11:35 AM on February 22 [11 favorites]


There is a book about the history of variolation called the Speckled Monster Jessamyn recommended it in a thread and it's a good book on the subject.
posted by Homo neanderthalensis at 11:39 AM on February 22 [1 favorite]


I had a horrible allergic reaction to a totally routine vaccine when I was a kid. I survived, and I got the rest of my shots, thank you, but this "these people are IDIOTS this is SCIENCE, DUH" attitude is cold vaporizing a whole lot of Actual Lived Experiences

It is of course well-known that there are potential side effects to vaccines, as with virtually any medical treatment. There is a special federal no-fault system for compensations for vaccine-related injuries. To the extent it injures innocent third parties, at least, I feel pretty comfortable cold vaporizing a profound inability to judge relative risk. There are people who are deathly allergic to penicillin, too.
posted by praemunire at 11:44 AM on February 22 [3 favorites]


...which is not to say that I'm opposed to the "vaccine-hesitant" label. People are resistant for different reasons and throwing them all into the GOOP-radical-moron box probably isn't helpful. There are some people who won't change their minds even after they end up being responsible for their own kid's severe injury or death. There are probably a lot more who are reachable. No doubt it would help if all parents had a positive history of being treated with respect and care by the medical establishment, which is obviously not the case today.
posted by praemunire at 11:48 AM on February 22 [3 favorites]


Turkey, actually!

Yep, Turkey and all around the then-Ottoman Empire area as well. It seems to have been discovered independently in several places; China eg used a different method. It also probably was around in the West before the 18th century, maybe brought by trade/sailors/slaves?, although in isolated areas and with moderate success.

I’ve read some accounts from parents deciding whether or not to inoculate their children back when inoculation meant ‘give them a milder form of smallpox’, and it was a horrible decision to have to make. Inoculation is safer than catching it naturally, but it still had a chance of killing the child and even best-case scenario is you watch your child go through smallpox and know you caused it. I found it upsetting enough that my child had blood drawn for jaundice checks, I’d have been a pathetic sobbing mess having to make that kind of call.
posted by Catseye at 11:50 AM on February 22 [2 favorites]


praemunire,

You're exactly correct, the issue is that with the internet and social media, negative narratives spread very quickly and are more effective at changing opinions than are statistics. People think in stories, not numbers.

More more accurately, multiple negative narrative have a multiplicative effect in changing decisions whereas a well designed study only counts once. Therefore 3 bad stories on the internet more than negate a meta-analysis in most people's' minds.
posted by Telf at 11:50 AM on February 22 [3 favorites]


if you go in for a flu vaccine they tell you straight up it's got mercury as adjuvent. a small dose surely but do i really need to take a small dose of mercury?? how would i know?

Did you know you can go to your local Walgreens or CVS or physician and get a flu shot without Timerosal? You just have to ask. It will cost you a little bit more because it uses a single dose pre-loaded syringe instead of a cheaper multi-dose bottle. Thimerosal is only used to prevent contamination when using multiple dose bottles. Mercury fears are no excuse.
posted by JackFlash at 11:55 AM on February 22 [9 favorites]


I've often thought they should tie the child tax credit to vaccination. You want to claim the credit? Great, here's where you show either proof of vaccination or letter showing a legitimate medical exemption (religious reasons not included).
posted by bowmaniac at 11:56 AM on February 22 [7 favorites]


“I just don’t think she needs all those medicines right away,” she says. “My midwife told me to say no.”

Seems like this is a problem.
posted by JackFlash at 12:14 PM on February 22 [2 favorites]


It's interesting that midwife is one of those words that means something subtly different in the US and the UK.

In the UK, midwives are traditional medical practitioners. They're part of the medical establishment and are sort of the equivalent of nurses. Every hospital has midwives; it's how it's done. My wife and I had our first child at a midwife led unit in Scotland.

In the US it's a bit different. Midwives can run the spectrum from medical professionals to self taught quacks. There are a host of competing credentials of varying degrees of scientific rigour.

So keep that in mind when reading articles from across the pond. It messed me up when I first moved to the UK. I just assumed everyone was a hippie with all this talk of midwifery. (The brits pronounce it mid-whiffery which also messed me up.)

In the article, it's presumably a US midwife, which holds as much consistency as getting dietary advice from a random magazine found in a waiting room.
posted by Telf at 12:26 PM on February 22 [17 favorites]


We don't need to "accept" these people, or convince them, or be nice to them. We could quarantine them, though, just like society used to do for people who were disease vectors. They can have a vaccine and their freedom, or their beliefs and walls, pick one.

Humanity has a pretty awful track record with quarantining large groups of people based on beliefs.

If it were up to me, we'd load MMR vaccines into dart guns and shoot them at anti-vaxxers headed into the NICU.

Great googly moogly, this thread! Anti-vax people are doing a stupid and dangerous thing for stupid and frustrating reasons. No argument there. But we can deal with this issue without the violent fantasies. One hopes.
posted by We put our faith in Blast Hardcheese at 12:40 PM on February 22 [8 favorites]


> Maybe they should just play out entire fake emergencies or “good-cop/bad-cop” routines with idiot patients to make them make the right choice instead.

> If you want to win people over and help your cause - I'm not talking about the peddlers of this filth, but the well-meaning who have been influenced by this rot..... maybe a different approach is required.

> It would be nice if we could have conversations about new parents and medical choices and misinformation without so angrily adding our voices to the deafening roar of personal criticism already directed at them from all sides, for all kinds of reasons, specifically at mothers.

> But we would never, for instance, say that if a diabetic person was eating too much sugar, their doctor should berate them and call them an idiot. We recognize that a good doctor comes from a place of compassion, even if they keep educating the patient, even if they are blunt about consequences.

> If I thought for a red hot minute that more people would go for vaccines if they were rebranded as BabyMagic LifeSyrum and colored purple, I would suggest that we do that...the US, as a nation, is not willing to FORCE people to vaccinate their children. The world as a whole benefits from herd immunity, but we as a nation value personal autonomy and belief systems more than herd immunity. Since we're not willing to do it by force, then we need to do it by persuasion.

> ...this is where the public health community need to talk to psychologists, communication and marketing experts. I don't know that they've solved the problem, but they may have a lot to contribute.

> By recognizing that there are different reasons for alternative vaccination schedules and delayed vaccinations, we can better address the causes of these hesitations.

> People are resistant for different reasons and throwing them all into the GOOP-radical-moron box probably isn't helpful.


Motivational Interviewing
posted by CheapB at 12:46 PM on February 22 [2 favorites]


Most likely I will die of (respiratory complications from) the flu. I have a mostly invisible disability: serious, chronic asthma. I do all I can to stay fit, healthy, medicated, but as I get older, chances are more and more likely that someone will transmit a flu to me that I will catch and the respiratory and congestion related symptoms will suffocate me.

So basically my mortality/survival will hinge upon enough folks getting the flu vaccine that the collective health protects me.

I'm writing this so it's a less abstract equation. Not getting vaccinated means I'm more likely to die sooner.

Maybe that risk is one you're willing to risk. It's not one I will risk for others, so I keep up with my vaccines.
posted by kalessin at 12:48 PM on February 22 [21 favorites]


I'm terrified that the woman in this article was resisting a VITAMIN K SHOT, simple vitamins that greatly reduce her baby's risk of hemmorage, and she still refused. Vitamins. That's truly insane.

For some reason our doula was all "yeah that Vitamin K shot isn't really necesasry unless *reason I don't remember*" and I really got the vibe that she thought we should just skip it unless the reason manifested. But we still gave the shot to the baby.

Things are so bad, we actually had somebody come in while we were trying to rest post delivery (its hard without people coming into the room all the time) to advocate about vaccines, and it took a lot of "Yes we know, trust us we'll make sure she won't miss shot" before that person would leave and let us rest. I'm glad they're doing this, I'm scared that they have too.
posted by WaterAndPixels at 1:11 PM on February 22 [5 favorites]


This mother’s child is holy, and his body is perfect and we ought to leave it be.

No, fuck her, vaccinate your fucking kids. There is LITERALLY nothing else to say. Feel all the feels you want for that woman, but no, fuck her, vaccinate her kid.

(Yes I read TFA. No, fuck her, vaccinate your kids.)
posted by tzikeh at 1:20 PM on February 22 [12 favorites]


What is clear from reading this thread is that people can simultaneously understand the value of vaccines and the risk posed by unvaccinated populations and also be just really, really awful.
posted by grumpybear69 at 1:24 PM on February 22 [16 favorites]


My eyes damn near rolled out of my head when I read the above-the-fold part of this FPP and saw the "holy child" stuff, but what does "fuck her, vaccinate her kid" mean?

Like, are we talking Vaccine Enforcers in riot gear, or nurses sneaking in and vaccinating on the sly when the mother is asleep?

If people start avoiding hospitals due to mandatory vaccination laws and infant/maternal mortality rates start going up, is that just an acceptable loss of stupid people who don't understand science and risk assessment, so who cares?

I say this as somebody who argued with my kid's mother to not space out her vaccinations. I 100% want the same ultimate outcomes as alla y'all, but I cannot imagine anything more counterproductive than the contempt and posturing filling up this thread.
posted by prize bull octorok at 1:42 PM on February 22 [17 favorites]


What is clear from reading this thread is that a whole lot of people who have never had to deal with individuals who don't want to do a very obviously correct medical thing are really sure they know better than people who do that every day for their job, who have training and study this exact, specific problem. So far they are pretty universally on the side of 'being mean makes it worse'. Exactly no one here is advocating that vaccinations are a bad thing, so it's weird that there can be an argument on that subject. Some of us would like to talk about how to change their minds. They were not born that way.

Like, are we talking Vaccine Enforcers in riot gear, or nurses sneaking in and vaccinating on the sly when the mother is asleep?

For real some people are and it's insane.
We could quarantine them, though, just like society used to do for people who were disease vectors. They can have a vaccine and their freedom, or their beliefs and walls, pick one.
I'm like, deeply unsettled by the tone of a lot of people in the recent vaccines threads. It's like we're reflecting alt-right rhetoric for rational, good causes, and that scares me. Calling for violence and rounding people up to put them in camps is not our style, or at least I didn't think it was.
posted by neonrev at 1:50 PM on February 22 [23 favorites]


Exactly no one here is advocating that vaccinations are a bad thing, so it's weird that there can be an argument on that subject. Some of us would like to talk about how to change their minds. They were not born that way.

Yeah to be clear, because apparently I have to be? Not wanting people rounded up into quarantine huts or SHOT WITH DARTS doesn't mean I want mefi posters to die early of flu. Holy cats.

I don't know. Everyone's angry. Everyone's angry about everything, every day, all day, forever, and it is deeply enraging to be told, mid-forever-anger, to be NICE to someone when that someone is being so STUPID and how DARE THEY. I fully share this emotional state.

But folks, we really do have to try. Or not, I guess. What do I know, I only have a "basic college degree." /snark

The people spreading the misinformation, making money off of frightened parents (however misguided and foolish those parents might be, to be frightened) -- no quarter for them. But TFA is talking about, in part, people whose bodies and minds and hearts have just, literally just, moments ago, gone through childbirth and we need to have some motherfucking compassion or what are we even?
posted by We put our faith in Blast Hardcheese at 2:11 PM on February 22 [18 favorites]


Here's a birth center in Vancouver that's being reasonable about vitamin K:
http://www.pomegranate-midwives.com/resources/birth/newborn-vitamin-k/

So midwives can be a great force for good. I'm not up to date with Call the Midwife; have they shown any vitamin K injections?

we're reflecting alt-right rhetoric for rational, good causes
Yes, all the "use of force" stuff is creepy no matter who's spouting it. It feels really good to get really mad about something you're comfortably sure an outgroup is doing wrong, and it's fun to imagine them being made to do what's right. So the right-to-lifers get a big rush of joy when they succeed in closing down another clinic and taking away women's access to something they don't believe women should be able to access. It feels fantastic to MAKE them do it RIGHT.

Perhaps I should have desisted and come back in an hour or more. No doubt it would have been better. But I have seen at least two children lying dead in bed of neglect in such cases, and feeling that I must get a diagnosis now or never I went at it again. But the worst of it was that I too had got beyond reason. I could have torn the child apart in my own fury and enjoyed it. It was a pleasure to attack her. My face was burning with it.

The damned little brat must be protected against her own idiocy, one says to one's self at such times. Others must be protected against her. It is a social necessity. And all these things are true. But a blind fury, a feeling of adult shame, bred of a longing for muscular release are the operatives. One goes on to the end.

posted by Don Pepino at 2:21 PM on February 22 [7 favorites]


I don’t like the idea of vaccination or vit k injection becoming legally mandatory because historically this hasn’t worked and has led to bad consequences. (“But at least that way all the children get vaccinated!” No they don’t, though, that’s the thing.)

Probably there’s no way to convince 100% of the eligible population to vaccinate, and well just have to do the best we can through herd immunity. Great things can be achieved this way, though. Smallpox is gone; polio is nearly gone; here in the U.K. the NHS no longer needs to routinely vaccinate against TB, and no longer does rubella screening in pregnancy because rubella is now defined as eliminated here.

None of this will help with vitamin K injections (it’s not a vaccine, it’s not protecting against a pathogen). Still, it’s progress.
posted by Catseye at 2:37 PM on February 22 [3 favorites]


grumpybear69: What is clear from reading this thread is that people can simultaneously understand the value of vaccines and the risk posed by unvaccinated populations and also be just really, really awful.

prize bull octorok: what does "fuck her, vaccinate her kid" mean? Like, are we talking Vaccine Enforcers in riot gear, or nurses sneaking in and vaccinating on the sly when the mother is asleep?

Yes, you guessed it: I'm a really, really awful person who advocates enforced vaccinations, and neither of you have ever used outsized language to vent your frustration about ignorant people being ignorant in a comment on MetaFilter in your lives.
posted by tzikeh at 2:38 PM on February 22 [8 favorites]


For real some people are and it's insane.


When you frame mandatory or coerced vaccination this way, what I hear is "individuals' right to bodily autonomy extends to the right to endanger disabled people, and to prefer burying children to the specter of having children with developmental disorders. If you disagree, I'm gonna use ableist language to describe the badness of your ideas."

that sure is a loud dog-whistle!
posted by bagel at 3:06 PM on February 22 [2 favorites]


Ableist language is totally avoidable. But you have to be paying attention and you have to care about people's feelings and preferences. That respect is rarely won by internet strangers it seems.

I wrote above about my dependence on others to vaccinate to help ensure my own long term survival. It doesn't mean I'd force vaccinations on anyone. I'm very pro-choice. I would just prefer it if more folks would vaccinate. For my sake and others'.
posted by kalessin at 3:18 PM on February 22 [4 favorites]


So... everybody knows that when you give cpr, you do chest compressions to the beat of Staying Alive, right? Everybody knows that you should wash your hands for two recitations of the abcs song. Everybody knows that you're not supposed to put butter on a burn or try to "suck out the poison" if somebody's snakebit, just keep the victim as calm as possible and get them to the hospital. But I never heard this thing about vitamin K injections for newborns in my life before today, when they've been standard apparently since the 50s. What if we just teach this stuff the way we do first aid and hygiene? In PSAs, in schools, and in birth centers?

Why couldn't ob-gyns spend a little time and team up to do inservices at birth centers and just say, "hey, we respect what you do and we want to help you and we think you can help us; let's work together on this stuff and make sure we're not giving people contradictory messages so that we can make sure we have happy births and healthy mothers and babies. We've heard from patients that they're being told that vaccines have toxins in them or that our vitamin K injections are poisonous and they should just administer oral vaccines like the Dutch; well, the problem with that is that no oral vitamin K has been approved for babies in the US and nobody knows what's in those supplements that parents are trying to use to DIY the vitamin K dose. Meanwhile the injections are regulated and FDA approved. So you can see how patients are being told exactly wrong, about vaccines and about vitamin K. And the result is that some babies aren't getting what they need and are getting hurt. Can we help you set up a protocol for offering these services yourselves so that birth center mothers and babies will have all the available options and potential clients won't decide that they have to go to the hospital to get the care they need? Here's how to get the supplies, here's how to explain it to patients, here's why it's necessary, here's how it will help your practice, here's the flaws in all the stories, here's all the great things that can happen if we start to combine forces and get this right."
posted by Don Pepino at 3:35 PM on February 22 [8 favorites]


If it turns out that the only way to prevent anti-vax sentiment from destroying herd immunity and causing the widespread, utterly preventable deaths of millions of vulnerable people is to in fact:
- vaccinate individuals without their consent
- vaccinate children without their parents' consent
- impose mass quarantine zones for unvaccinated persons

then we as a society will have very hard and distasteful choices to make, and ultimately bodily autonomy and parental prerogative will, you know, probably lose. And then we'll have to reckon with what that means for all of the other ways in which bodily autonomy might be less than absolute, and I think a lot of us here on this site today will definitely not love where that goes. But if it comes to that, we will go forth and reckon.

But for now, at least, this is a false choice. There is no indication yet that the only way forward is coercion and imprisonment. It was not necessary for vaccination programs to be successful the first time around, after all. Our systems and institutions as a whole are not coping well with the disinformation and misinformation capabilities of the internet age.

But we still are in a position where this is the goal:

I would just prefer it if more folks would vaccinate. For my sake and others'.
posted by We put our faith in Blast Hardcheese at 3:43 PM on February 22 [6 favorites]


"It was not necessary for vaccination programs to be successful the first time around, after all."

We used to do these things to people - it was ugly, sometimes effective and subsequently used as precedent for involuntary sterilization.
posted by Selena777 at 3:53 PM on February 22 [1 favorite]


I mean, we used to, as a species, do every monstrous thing imaginable to each other. (we mostly still do.) But there is a precedent of voluntary vaccination programs succeeding on a wide scale, and no reason (at the moment) to abandon all hope of that.

I dunno! Maybe I'm wrong! Maybe we have to become the stormtroopers before the bad guys do and that's all there is to it. Maybe we could at least aim to be really kind stormtroopers who don't call new mothers fucking assholes while we forcibly vaccinate their newborns?
posted by We put our faith in Blast Hardcheese at 4:08 PM on February 22 [2 favorites]


Maybe it's the rampant socialization that Being A Mom makes you an expert on everything.

Wait, where do I sign up for this version? I don’t even have kids yet, and all I’ve ever gotten is the version that says there’s no right way to Be A Mother — not as in “there are many okay ways,” but as in “all of the ways are Wrong And You Should Be Ashamed.”
posted by haltingproblemsolved at 6:46 PM on February 22 [3 favorites]


We are emphatically pro-vax -- I have an immunocompromised family member and also I understand science -- and we quizzed our pede before we chose her about how she handled vaccine-refusers, but I do remember, with my first baby, when they wanted to immediately give him the Hep B shot and the Vitamin K shot, my brain stuttered a bit with hesitation. I knew they'd put the stuff in his eyes to prevent infection, but I don't know if just nobody told me there'd be first-day shots or if I heard it but didn't register it or what. (And some of the problem is that you're getting your prenatal care from an ob/gyn or a midwife, but the infant care comes from a pediatrician, and we were lucky enough to have a sit-down with our pede before the baby came which most Americans don't, but you're still getting pitched in the deep end there.)

But here we are with an incredibly tiny new baby, after a difficult C-section, I'm hopped up on painkillers, and suddenly this decision presents itself, do you want us to stick two needles into your baby or nah? And for a second every fiber in my body was like "NO WHAT IS WRONG WITH YOU HE WAS JUST BORN AND HE IS FRAGILE AND TINY AND FRAGILE AND JESUS CHRIST" and I asked the pediatrician some inane question about what they were for (which, I knew what they were for, but my mouth was trying to figure out what polite noises to make while my brain having a complete meltdown) and my pediatrician kindly and gently explained their benefits and that gave me enough time to get my brain back into gear and shake myself out of it and we said, "Yes, of course, yes," but the truth is that even then I still felt super uneasy about it because he was my first baby and he was BRAND NEW and everything is terrifying at that point. (By the next day so many further terrifying new baby things had happened that I'd completely forgotten about the shots.)

With number 2 and number 3 I was like, "WOOOOO SHOTS! I LOVE SHOTS! GIVE ME MODERN MEDICINE MIRACLES!" But with number 1, just everything was so new and different and frightening and all at once, and if my pediatrician had gotten stern with me I probably would have balked. I mean I probably would have gotten the shots anyway, but it would have started us off on a footing of distrust, and my "hesitancy" wasn't about being anti-vax or even vaccine-hesitant; it was about being overwhelmed with being responsible for a person who was two hours old and having to make five billion decisions about brand new things while trying to figure out how to get this tiny stupid primate to suck on a boob properly WHAT IS HARD OH MY GOD YOU HAVE ONE JOB, BABY, ONE JOB. Ten seconds of calm explanation and reassurance was much better than a scolding!

And I remember a woman on the local news talking about not vaccinating her children (I think they had caught whooping cough) and her rationale was, "As a parent, if you can protect your children from even a tiny bit of pain, you want to do that. I couldn't voluntarily hurt them by having needles jabbed into them!" And at the time I screamed at my television, "THAT'S WHAT THE VACCINE IS FOR YOU MORON, IT PROTECTS THEM FROM THE PAIN OF WHOOPING COUGH." But that's exactly the same lizard-brain reaction that I had when my baby was brand new and they wanted to give him shots, and it was hard to overcome! And I think, in a way, she hit on bad parenting in a nutshell -- of course you WANT to protect your child from every tiny bit of pain that you can, but you have to recognize that sometimes pain is necessary (like the needle stick of a vaccine) or unavoidable or even educational (if your kids never face the consequences of their actions, they will grow up to be nightmares). And the world right now is terrifying and hard and full of pain and full of things I want to protect my children from -- and all children from -- and I think that's part of what drives people into very orthorexic styles of parenting with the panic about toxins and vaccines and gluten and offgassing mattresses and screen time and all these things that you can control that aren't actually what's hurting your child, but you can't really control school shootings or immigrant family separation or air pollution or environmental lead or the Pacific Garbage Patch or global warming, so people who are frightened and want to protect their kids from the legitimate horrors of the world and are unable to do so cope with that by becoming very controlling about what they CAN control, and that's self-reinforcing because feeling in control makes you feel better, feel calmer, and it makes it easier to not think about all the things you can't control, and the more control you take over what you can control, the less you have to think about the actual problems.

And, I don't know, I feel like in a lot of ways we don't really have a cultural narrative anymore for talking about the dangers and fears of the everyday world -- there's conspiracy theories on the right, there's "wellness" on the left, but there's not really a narrative that helps us cope emotionally and spiritually with the fact that the world is kind-of in deep shit. Those narratives used to be religious, but those have lost their cultural power and/or relevance for most people (and in the US been further subverted by the highly individualistic culture that manages to turn, for example, socialist Jesus into a personal-responsibility capitalist) and in the US, the way you cope with problems is do fix them yourself. I mean we can barely talk about low-level social cooperation issues like taxes and roads; coming up with a way to think about and talk about the big scary things is really hard! So people do what they've always been taught to do, which is come up with an individual solution to a major social problem, by pretending there isn't a social problem to see and solving an unrelated individual one instead, and refusing vaccines or whatever other ill-advised parenting decisions they use to feel some control in a frightening world.

(Sorry I got a bit carried away there, I didn't mean to go on so long.)
posted by Eyebrows McGee at 8:37 PM on February 22 [44 favorites]


I don’t even have kids yet, and all I’ve ever gotten is the version that says there’s no right way to Be A Mother — not as in “there are many okay ways,” but as in “all of the ways are Wrong And You Should Be Ashamed.”

This is 100% true and yet there is also the moronic counternarrative of "As a mom, I...."
posted by praemunire at 9:26 PM on February 22 [5 favorites]


(To avoid unnecessary dispute, let me be clear, I do not mean "As Rob's mom, I know that he concentrates better on his work when the lights in the room are turned down," I mean, "as a mom, I totally know better than Science!")
posted by praemunire at 9:28 PM on February 22 [4 favorites]


This is interesting- YouTube is demonetizing anti-vax videos, apparently some of the advertisers were notified their ads were placed on these videos and they got mad. I think we have many many steps to go before forced vaccinations are necessary, de-platforming the kooks and taking away their reach to the vulnerable should come first. Imagine if mid-wives in this country were licensed and trained better like they are in the UK? Then the woman in the article would never have been given the mis-information in the first place.
posted by Homo neanderthalensis at 10:17 PM on February 22 [12 favorites]


I think that was brilliant Eyebrows McGee, and I think hearing from more parents about the time right before and after birth would be useful. I've heard from doctors, who know all the baby medical stuff to the core, say similar things about their own experiences. I think it would be most productive if more parents shared how they felt in those times, but it's also very obvious why one might now want to share having ever had a moment of doubt or hesitation on this subject in this thread, so I appreciate your doing so.
posted by neonrev at 10:19 PM on February 22 [4 favorites]


For various reasons my immune system is less able to fend off shit than most AND I live in a part of the West Coast where entitled people feel super-entitled SO when I see toddlers I run for my life.

Your kids are lovely, you high-end mofos. Keep them the fuck away from me.
posted by goofyfoot at 11:03 PM on February 22 [4 favorites]


I don't know if just nobody told me there'd be first-day shots or if I heard it but didn't register it or what. (And some of the problem is that you're getting your prenatal care from an ob/gyn or a midwife, but the infant care comes from a pediatrician, and we were lucky enough to have a sit-down with our pede before the baby came which most Americans don't, but you're still getting pitched in the deep end there.)
See? SEE? I rest my case. The people administering the injections aren't telling parents about the injections until three seconds before they administer the injections. And all the various roles are idiotically adversarial and siloed and parents are getting contradictory information sometimes and they don't know which of the two? [midwife and pediatrician] three? [midwife, ob-gyn, and pediatrician] FOUR? [midwife, doula, ob-gyn, and pediatrician] types of birth professionals and medicos they're consulting about their incipient bairns is trustworthy. As usual, the US system proves to be tore up from the floor up and completely moronic.
posted by Don Pepino at 3:33 AM on February 23 [5 favorites]


here's a person in science (who i have actually had lunch with) who believes simply that vaccine benefit is overrated and vaccine dangers are underrated. (but i do know people in the past have lambasted this woman on mefi)

The bit of science she's 'in' is ' human-computer interaction, and algorithms for language understanding and speech recognition'. Her being 'in science' is no more relevant to her views on vaccination than someone who's 'in plumbing'. I hate this 'oh, they're a scientist' line when it's used with respect to climate change deniers who have no academic expertise or research in the area, and this applies equally here. It's a false claim to authority.
posted by reynir at 4:03 AM on February 23 [9 favorites]


Women, who seem to be the primary on the ground proponents of anti-vax, are behaving entirely rationally when they don’t trust a medical system that rountinely abuses them and has for centuries. Is their any wonder that some of them refuse to believe the authority figures that tell them to “trust us, this vaccine is safe.”?

“I just don’t think she needs all those medicines right away,” she says. “My midwife told me to say no.”

I'm pro-vaccination to the point that it seems silly to say "pro-vaccination" because vaccination is so obviously a good thing. But in my opinion, there has been far too little soul-searching on the part of both the medical and regulatory establishment about how this movement sprung up. An entire community of midwives and doulas exists to help women navigate the western medicine birth experience for a reason. The US regulatory agencies don't have a perfect track record of protecting children from dangers (e.g., chlorpyrifos), so networks have sprung up to spread this information to parents. I don't blame women for not having perfect and complete trust in establishment advice and reassurances, and instead seeking independent sources of information.

Even in this story, they acknowledge that she probably didn't need two of the three interventions because she had good prenatal testing -- which is what the doulas teaching our birth class took the time to explain to us. (They said Vit K was useful and important. And for the record, I went ahead with all three.) People pay a thousand dollars to doulas who make sure that people have the facts, including the risks and benefits, presented to them because too often the medical establishment is happy to just not bother. Our doula advised me to change hospitals for delivery because one followed more current evidence-based advice (such as actually letting women eat and drink freely during labor) while one did not. The one that did follow that advice, the one I switched to, has a far lower rate of C-sections, a major surgery that carries risks. At what point do I stop finding out this information and switch into "just trust us we know best" mode? The anti-vac movement draws the lines and makes decisons differently enough from me that I come to a very different conclusion, but i don't think the efforts to understand it have engaged enough with the sociological processes of the movement and ultimately, some of the not-completely-unfounded roots.
posted by slidell at 9:15 AM on February 23 [19 favorites]


Even in this story, they acknowledge that she probably didn't need two of the three interventions because she had good prenatal testing -- which is what the doulas teaching our birth class took the time to explain to us.

Yeah, when I was reading TFA I did a double-take at the fact that they were just automatically medicating babies for infections passed on from the mother - without so much as questioning if there was any reason to believe the mother might or might not even have those infections? It reminds me of all the pregnancy tests I've been given in the emergency room, some of them after my hysterectomy.
posted by The Underpants Monster at 9:35 AM on February 23 [5 favorites]


Like, are we talking Vaccine Enforcers in riot gear, or nurses sneaking in and vaccinating on the sly when the mother is asleep?

I read this as a moral objection rather than a practical one and I really don't get that.

All infant vaccinations we do are without patient consent because infants aren't capable of consent. It's just that in many places we leave that decision with the parents rather than doctors. But that's not law handed down by God, it's simply where society has mostly decided the decision should rest.

Many of the same people who would object to mandatory vaccinations of infants would be on the other side of the issue if it came to, say, Christian Scientists refusing to have their infant treated for diabetes or cancer. We intervene in those cases because the parents are making bad decisions which affect their child negatively. Parents refusing vaccines in the absence of legitimate medical reasons like an allergy are likewise making bad decisions. And those bad decisions can affect not only their own child but other people's children negatively. And yet somehow intervening in the case of Christian Scientists (or cases of neglect) is the obviously correct decision while intervening in the case of antivaxxers is the path to jackbooted Vaccine Enforcer tyranny? It doesn't make sense.

There haven't yet been enough antivaxxers to make shifting the line of intervention seem necessary. But that could easily change; there's already been movement to get rid of personal vaccine exemptions in places hit by the recent measles outbreaks caused by anti-vaxxer parents.

Would some people still refuse vaccinations? Sure. And the Enforcer Squads don't pursue them relentlessly. Because the idea is to get the compliance rate high enough to ensure herd immunity, not necessarily to make sure that absolutely 100% bar none of parents get away with shirking their parental duty.
posted by Justinian at 10:11 PM on February 23 [4 favorites]


Many of the same people who would object to mandatory vaccinations of infants would be on the other side of the issue if it came to, say, Christian Scientists refusing to have their infant treated for diabetes or cancer. We intervene in those cases because the parents are making bad decisions which affect their child negatively. Parents refusing vaccines in the absence of legitimate medical reasons like an allergy are likewise making bad decisions.

I get your point, but I think there's also one difference to consider: Leaving a child's cancer or type 1 diabetes untreated is a guarantee of slow, painful death. (I've had diabetic ketoacidosis, and I seriously don't have the vocabulary to describe how bad it is.) Leaving a child unvaccinated for no good reason is a roll of the dice. Granted, the stakes are extremely high, but the odds of the kid surviving until they're old enough to get their own shots are greater than zero.

NB Please do not misunderstand me; I am not saying that the mathematical probability of avoiding certain death without vaccines not being zero makes it a good decision not to vaccinate.
posted by The Underpants Monster at 11:13 PM on February 23 [4 favorites]


Yeah I acknowledge they're not exactly analogous. But it is an example where we already support intervention in a medical setting; intervention with regards to vaccination would be an expansion of that principle and not a completely new area of governmental overreach.
posted by Justinian at 12:19 AM on February 24 [3 favorites]


Perhaps visa restrictions might be useful, to keep entitled-first-world idiocy contained:

The reintroduction of measles to Costa Rica comes a month after the World Health Organisation warned that “vaccine hesitancy” is in the top ten of the worst health threats facing humanity in 2019.

...though as the Brexit fiasco has shown, borders are basically just for poor people.
posted by pompomtom at 5:44 AM on February 24 [3 favorites]


Vaccine hesitancy is a problem in low and middle income countries too. It's a people thing.

*Edit: What I meant is that it's not uniquely a privilege thing.
posted by Telf at 7:47 AM on February 24 [2 favorites]


This sort of story is why we must insist on vaccination without exception (save medical): Measles returned to Costa Rica after five years by French family who had not had vaccinations.

They eradicated measles in Costa Rica and some idiots who knew their kid had been exposed to measles and hadn't been vaccinated decided it was a good time to take a long flight to a foreign country.
posted by Justinian at 11:55 PM on February 24 [2 favorites]


There's an intermediate way: not forcing vaccination, but allowing other individuals, countries, etc. to sue folks like that family that brought measles back to Costa Rica - basically, if you know you or your kids haven't been vaccinated and thus could be carriers, that could bring with it an enhanced duty to be aware of potential exposure to diseases like measles and avoid getting into situations where you could pass it along to others. Such a policy would have to be incredibly carefully worded if adopted, though, to avoid bigoted applications like panic over HIV-positive people trying to lead normal lives. So probably also a bad idea. It's almost as if public health is a complicated topic that people get entire PhDs in, and maybe we should listen at least somewhat to what experts in the field tell us about the actually effective ways to maximize vaccination rates.
posted by eviemath at 6:23 AM on February 25 [2 favorites]


...avoid getting into situations where you could pass it along to others.
Situations like airplanes. Do not get your kid into the situation called: airplane if your kid has not been vaccinated. Because what about the other people on the plane? What about the other people in the airport jammed up next to your kid in a million lines waiting to get ON the plane? What about the other people in the connecting airports?

Could proof of vaccination be part of preflight screening, or better yet buying a ticket in the first place? they could ask you how many bags you planned to check, whether you wanted a window seat or what, and whether you're potentially going to spread a deadly disease to vulnerable people in the airport/on the plane/at your destination.

No guns, no sharps, no explosives, no liquids or gels over two ounces or whatever it is, take off your shoes, throw your keys and change in a salver, and hey, while you're at it, if your kids have been exposed to measles, then whatsay you and your kids stay away from the crowdedass airport 'til you're sure you're not all about to die and kill other people, do you not understand AnYtHiNg?
posted by Don Pepino at 8:46 AM on February 25 [2 favorites]


diseases like measles and avoid getting into situations where you could pass it along to others.

For anyone not familiar with the details of measles (since we had made so much progress towards eradication) "situations where you could pass it along" include literally any time you are near another person.

Measles is one of the most contagious diseases known. The number of others a person with measles infests (R0) is around 18. That means that every kid with measles infects around 18 other kids. For comparison, the Spanish Flu pandemic which killed up to 100million people because nobody had any immunity had an R0 between 2 and 3. Smallpox, one of the scourges of humanity, had an R0 around 6. So measles is up to 6x as contagious as a Flu pandemic and 3x as contagious as smallpox.

The only way to avoid being in a situation where you could pass measles along is literally to be quarantined.
posted by Justinian at 10:56 PM on February 25 [11 favorites]


If you are wondering how it can be so contagious it's because measles is transmissible through the air. Not like a cold or the flu which the public commonly says are airborne but actually aren't (they require droplet transmission) but actually airborne. The measles germs hang out in the air for several hours. Anyone who passes through the air can catch it. You don't have to touch the infected person. You don't have to touch your eyes or your mouth or your nose, you simply have to be in the same airspace as the person with measles, or in the place the measles carrier had been a couple hours ago.

What this means for an airplane with an enclosed space you sit in for many hours and uses recycled air throughout the cabin is left as an exercise for the reader.
posted by Justinian at 10:59 PM on February 25 [9 favorites]


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