I try to listen to my patients, to be sensitive to their feelings and concerns. I try but, when it comes to parents who don’t want to vaccinate their children, I don’t succeed. There is an attitude in the anti-vaxx movement, an anti-medicine, anti-science, anti-doctor conspiratorial mistrust, that stretches my patience.
I have tried to see things from the anti-vaxx perspective. I have researched the claims of anti-vaccine activists, visited their websites and read their “evidence”. It is hard to wade through their passionate arguments without getting angry. Facts are twisted, science is ignored and evidence is discarded. Even the purportedly “scientific” papers cited in support of their positions are misrepresented, overstated and biased. Not one of the articles I have read would survive critical peer review. They were universally poorly written and scientifically absurd. In spite of the seemingly obvious flaws in these articles, thousands (if not millions) of parents believe these arguments and choose to not immunize their children.
Because I care about the health of children I have debated and argued with dozens of anti-vaccine parents over the years. Each encounter has left me amazed at the willful ignorance displayed. I say willful, because in order to believe vaccines are harmful one must choose to ignore mountains of evidence about vaccine benefits and to instead believe that we live in an evil society filled with deceived and sinister people who are willing to harm children for the sake of profit.
If vaccines are harmful, the cover up is massive. The CDC has 14,000 employees, 68,000 people work for the pharmaceutical giant Merck, there are over 30,000 pediatricians in the United States, and over 130,000 Family Physicians. If vaccines are truly harmful then there are over 200,000 people in America who are part of a system that is willfully harming children. What an evil world that would be!
If vaccines are as dangerous as the anti-vaccine crowd declares then evidence of this harm must exist and should be easy to discover or reveal. Surely there would be at least one well placed whistle blower who could reveal such a conspiracy. Riches and fame would surely await the man or woman brave enough to reveal such an important truth. The fact that no one has come forward with such evidence has only one explanation. The evidence does not exist.
Anti-vaxxers often say that “Big Pharma” is behind the push for vaccines, that vaccine makers are endangering children for the sake of profit. Those who make this argument fail to apply this reasoning to the entities that actually pay for vaccines, the insurance companies. Insurance company vaccine costs are over $2000 per child. There is no profit in paying for useless treatments. In addition, if a child is harmed by a vaccine, insurance companies are on the hook for the cost of treatment. If vaccines are dangerous, then insurance companies are run by very stupid people.
While many of us will chuckle at these facts and dismiss the absurd arguments of anti-vaccine parents the fact remains that millions of children being placed at risk due to the willful ignorance of their parents. One has to ask, “How is it that so many parents are willing to believe such lies and expose their children to preventable illnesses?”
In speaking with anti-vaccine parents one explanation is readily apparent. There is immense psychological reward found in feeling superior to others. Anti-vaxx parents believe that they are smarter than others, more concerned for their children than other parents, more knowledgeable about immunology and vaccines than their doctors. Not only do they refuse to vaccinate their children they look down on those who do. They are crusaders, special and noble warriors in the fight against a greedy and evil society.
It is this attitude that makes dialogue with anti-vaxx parents so frustrating. Since all who disagree with them are either ignorant, misinformed or evil there is no reason for them to listen. My training is irrelevant because the AMA is in the pocket of Big Pharma. My knowledge is insufficient because I have not read the things that they have read. (The fact that they have read none of the reputable scientific research and know nothing about physiology and immunology is dismissed.) I have learned that there is nothing I can say to change their minds.
In spite of their proclaimed commitment to "researching" treatments I have found this commitment selectively applied. Many of these proudly skeptical parents readily embrace unproven and non-scientific therapies. They have no problem with homeopathy, naturopathy, body cleanses, or essential oils, in spite of the lack of studies demonstrating their effectiveness. In the case of some treatments, such as body cleanses, in spite of overwhelming evidence against effectiveness. It sometimes seems that there only two criteria that need be met for them to endorse a therapy. First, some stranger on the internet must say it worked for them. Second, traditional medicine must reject or question it.
It is extremely frustrating to dialogue with those who claim science in one circumstance and then ignore it in another. I can't help but believe that if people applied the same level of doubt and skepticism to alternative medicine as they did to vaccines, alternative medical practitioners would be out of business in a week!
The question of what to do with the anti-vaccine movement is frequently debated in the healthcare community. There have been many studies conducted and many articles written on how physicians can best respond to anti-vaccine parents. I have read many of them and after significant reflection have decided to give up. I don’t argue anymore. If parents want to learn about the overwhelming evidence in support of vaccines it is just a few mouse clicks away. If they choose to believe the anti-vaccine lies and place their child at risk then I tell them to seek care elsewhere. I am not the doctor for them.
This position is often heart-breaking for me. I have lost many patients over the years as a result of this stance. Just this month I found myself saying goodbye to a family with whom I had shared a long and seemingly close relationship. I have no doubt that similar partings will happen in the future. As painful as the loss of relationships can be, with each farewell I take comfort in the knowledge that the choice to leave was ultimately made by not by me but by the parents of the child. Parents who did not trust my training, experience and judgment, parents who wanted someone to submit to their faulty conclusions without questioning. Parents who didn’t want me.
- Bart