Wednesday, January 14, 2009

Vaccine thoughts

Vaccines are an interesting issue, and I think I bring a different perspective than many of my classmates. Being a doula - spending time with natural childbirth promoters, being on doula listservs, working with families who are interested in non-interventive birth - exposes me to many people who question the safety of vaccines. I think most of the people in my department come from a mostly public health perspective - and often an international one - where vaccines are a no-brainer, and the only problem with them is how to make sure everyone gets them on the proper schedule.

This article in the New York Times got me thinking about the pro- and anti-vaccine camps. As I move back and forth between them, I see a lot of difficulties they have communicating around the individual benefits and risks of vaccines, and the population benefits and risks. I believe that public health practitioners tend not to understand why anti-vaccine families are doubtful about vaccine safety. But I think I've learned something about where families are coming from: the likelihood that their individual child will become suffer seriously from these diseases is very small, and they see autism (the main concern) all around. There's been enough statistical dust kicked up around the issue that even recent studies, which public health authorities consider definitive, are not enough to counteract people's fears. Families have been compensated by the U.S. government for adverse vaccine reactions that led to autism-like conditions, and stories abound of children withdrawing or "losing words" after their vaccines.

There is a tendency to cast parents who refuse vaccines as irresponsible, ignorant, or "parasitic" (because they depend on herd immunity - the large percentage of the population who does get vaccinated - to protect their children from these diseases). I think it would be a fairy accurate statement to say I don't think these characterizations are helpful. They're not helpful for public health professionals who are interested in convincing more people to vaccinate both because they demonize non-vaccinaters (who then just ignore whatever else is said) and because I don't think they accurately represent the targeted population. I would venture to say that most people who choose not to vaccinate are educated, highly caring parents who want the best for their children and are fighting hard to get what they believe is the best. They don't trust studies funded by, or done by people with connections to, the vaccine industry, and with some good reasons (the pharmaceutical industry does not have a stellar record of financing neutral research for the public good). And I don't believe they consider themselves parasites. One of my classmates who worked on vaccine issues in Oregon said that one of the most effective ways to get reluctant parents to vaccinate was to appeal to their sense of civic duty - that by vaccinating their children they were protecting babies who were too young to be vaccinated and would be much more severely affected by vaccine-preventable diseases.

I try to stay agnostic on my vaccine views; I haven't done enough research on it to know what I personally think - just what other people think. Although I do feel there's such an intense concentration on the vaccines and autism link that it's obscuring other possible environmental contributors. A study came out recently linking Pitocin use in childbirth to later behavioral problems - so many environmental factors have changed in the past 50 years that vaccines are a very tiny puzzle piece to be focusing all this energy on.

3 comments:

Sally said...

There was a good story about this on This American Life a little while ago. Worth listening to...

publichealthdoula said...

I missed that one! I'll have to go back and look for it...

Sally said...

http://thisamericanlife.org/Radio_Episode.aspx?episode=370