What We Need To Understand About Anti-Vaxxers

When it comes to dealing with anti-vaxxers and community-wide fears about vaccination, it’s time to show a little compassion. Obviously, the current response isn’t working.

We do a pretty good job at showing compassion when working with people who have mental health disorders. We’re compassionate when we talk about post-partum depression and the effects it can have on women and their families. We’re compassionate when we talk about obsessive compulsive disorder and the irrational fears that accompany it. We’re compassionate when we talk about anxiety and panic attacks.

But we are not compassionate when we talk about people who are afraid of vaccines.

This does not mean that people who are hesitant to administer vaccines have mental health issues — but fear and unanswered questions are often major contributing factors in the refusal to vaccinate.

You might be tempted to argue that people who spread misinformation don’t deserve compassion, but challenge yourself to think of this from a different perspective: these people are so absolutely terrified of vaccines that they are going to extreme lengths to protect their children from something that they believe is a legitimate fear.

“I just can’t do it,” your friend explains. “Studies have shown that bridges can collapse. Here are some pictures of bridges collapsing. I can’t even get in my car. I won’t let my kids go anywhere near bridges, either.”

You respond with, “Don’t be ridiculous. Bridges are safe.”

Your friend answers, “You don’t understand. Nobody understands.”

Your friend finds a community of likeminded people who are also terrified of driving over bridges. They read study after study. They analyze photos and videos of bridges collapsing. They read articles written by architects who criticize the design of certain bridges.

You won’t have any luck getting this friend to drive over a bridge by telling them that your evidence shows that bridges are safe. They’ve already made up their mind, and this fear is real to them.

The fear of vaccination is just like any other phobia, only it can and will become a major public health issue if we don’t tackle it compassionately.

People who want to hurt their children don’t spend their time Googling how to keep them safe, lobbying for vaccine safety, or panicking about autism. I hate to throw this term around, but one look at the Google results for vaccines + SIDS is enough to make any new parent sick to their stomach with worry. Will my child wake up? they wonder. I’m not going to risk it.

It might sound like propaganda to you, but when sudden infant death occurs, it often occurs right around the time that the first round of vaccines are administered. Something like this vaccine pamphlet — which states that SIDS has occurred post-vaccination and that some cases of SIDS can “be expected” just by chance — could terrify a parent to the point that no pro-vaccine website could change their mind.

Anti-vaxxers might be putting their children (and others) at risk unintentionally, but it’s naive to suggest that they opt out of vaccines because they want their children to get sick.

You can’t turn an anti-vaxxer into a former anti-vaxxer by responding with hostility. Unfortunately, someone who has already developed such a severe phobia will not just stop being afraid when they see an article about how vaccines are safe.

Put yourself in the shoes of someone who is holding a fragile, newborn baby in their arms. Their instinct is to protect this child. They take this 9-pound bundle, wrapped in a blanket, to the pediatrician for the standard 2-month well visit.

“Your child is 2 months old today. We’ll be administering 8 vaccines,” the doctor says. “DTaP, Pneumonia, Hib, Rotovirus, Polio, and Hep B. You’ll need to hold your child down. Hold his legs tightly so he doesn’t kick.”

The parent hesitates and says the word “SIDS”.

Stop right there.

You are looking in the eyes of someone who believes their child could die after receiving these vaccines.

They aren’t worried about pertussis or tetanus — they’re worried about something else.

Listen. Vaccines are basically a preventative medication. Like all medications, a particular vaccine will never be right for each and every patient. There are contraindications to certain vaccines. If your child has an allergy, or if your child has a high fever, for example, certain vaccines shouldn’t be administered.

But other vaccines can usually be administered safely.

This parent probably has their heart in the right place, but fear is powerful. So why not respond with compassion?

Take the extra 10 minutes to print out the vaccine pamphlets in advance, review the contraindications, review the risks and benefits, and let the parent voice their concerns.

“But reading those pamphlets will make them even more afraid,” you might argue.

No — they’re ALREADY as afraid as they can possibly be. Do you really think they haven’t imagined much worse than the potential side effects the pamphlets might list?

This is a great time to assuage those fears about autism, too, because MMR, the vaccine that people most commonly believe causes autism, is not administered at that first vaccine appointment.

Read that again. This is the first vaccine appointment. Most anti-vaxxers decide how they feel about vaccines right about… now. Not after their child has suffered a debilitating vaccine injury. Before the first vaccines are even administered.

Instead of, “We don’t see unvaccinated patients in our practice!”, why not try:

Or:

That’s it. It’s called compassion, and a lot of times, it helps people overcome irrational fears.

Would you rather have this child get vaccinated at 3 months instead of 2 months, or not at all?

When it’s time for MMR and you have a stubborn patient who claims that the vaccine is most safely delivered in 3 separate doses (M, M, and R, not MMR), why not just do what they ask? Fine, it’s irrational. But it won’t kill your bottom line to administer the 3 vaccines separately, and you just might show a terrified parent that their child can receive the vaccines and not suffer any severe adverse effects.

What parent would want their child to be given 3 injections instead of 1? A parent who gets a kick out of watching their baby cry with each additional injection? Or a parent who has developed a serious fear?

Your compassion could be more contagious than a vaccine-preventable illness. That parent might stop spreading misinformation. That parent might let their friends know that their child received the vaccines from a doctor who listened to their fears, and that everything turned out just fine.

That parent might become a former anti-vaxxer.

When it comes to vaccine safety, true contraindications are nothing to laugh about. Yet, we don’t address them. This just worsens the fear and decreases the level of trust that parents have in their child’s doctor.

While there are some people who are staunchly anti-vaccine, there are also some parents who believed in vaccines until their child had an adverse reaction.

We need to tread carefully here.

Let’s look at DTaP. The “pertussis vaccine” — although it actually includes diphtheria and tetanus vaccines as well. This is an important one.

DTaP has caused encephalitic reactions before. Encephalopathy was much more common when the vaccine was made with a whole-cell version of pertussis, but even the newer acellular version can cause this severe reaction.

If your child receives DTaP and falls into a deep sleep from which they can’t be easily roused, and then has a high-pitched scream unlike anything you’ve ever heard before, future doses of the vaccine might be contraindicated.

If a parent approaches a doctor with a concern about a reaction of this nature and the doctor brushes it off, saying that it wasn’t a big deal, they might have just created an anti-vaxxer.

This parent, whose child could have received diphtheria and tetanus vaccines separately, and whose child could have had other vaccines, might opt out altogether as their fears were not taken seriously.

If we want to keep doing the same things that don’t work over and over again, we’ll never get to the root of the problem. The real issue is not just the spread of misinformation, it’s what happens before misinformation is spread. Fear. Another issue is the spread of information that is medically accurate, but misinterpreted or unaddressed by physicians. The medical community’s reluctance to approach these fears with compassion has done nothing to improve vaccination rates.

Neither have the pro-vaccination articles that are preaching to the choir instead of speaking directly to those who are afraid.

Measles is spreading like wildfire because we can’t seem to address these fears in the same way that we address other phobias.

It’s easier to put our feet down and to say, “Get over it — vaccinations are safe!” than to lend an ear and help parents rationalize these fears.

It might take a little TLC, but we can break down the barriers between the anti-vax community and the medical community if we try.

What We Need To Understand About Anti-Vaxxers

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