Articles & Studies
Acknowledging Vaccination Concerns
I feel like such a rebel. The British Medical Journal recently featured an editorial, Improving uptake of MMR vaccine. As the title suggests, this article tries to isolate the reasons why some parents choose not to vaccinate and how to change this disturbing (in the authors’ opinions) trend.
Part of me really emphasizes with the pediatricians and other health officials who urge vaccination compliance. Until I had children I didn’t realize how imposing the word is… v-a-c-c-i-n-a-t-i-o-n-s. In fact I clearly remember my best friend, lying on her hospital bed, a few hours after giving birth, asking me whether her newborn son should get one vaccination or another.
I don’t remember the exact words I uttered 6 years ago but I’m sure they were along the lines of,
Well of course. If they say he should get it there has to be a reason.
But now, well, I’m just not so ready to jump the gun.
In fact, when I recently took my son in for a well-child visit I felt intense pressure to give the go-ahead on his vaccinations. Since he was sick at his prior “well-check” visit and unable to receive vaccinations, he was a few months behind schedule and it was time to get him back on track.
But I said no. Well, no to most of the vaccinations.
No vaccinations? I felt as though I were wearing a scarlet A on my chest representing anything from Anti-vaccination movement to A clearly misinformed individual to A bad mother.
And then, I read this. The article points out that researches have loosely identified two groups of people who choose not to have their children vaccinated with the MMR. One group of parents, one that refuses all vaccinations, are considered radical. This group is basically beyond hope; regardless of any information they receive they will most likely say no to the MMR. The other group of parents are those that opt out of particular vaccinations or choose to have their children vaccinated with “single antigen vaccines” (one vaccine for measles, one for mumps, one for rubella instead of the combined shot, etc.). These parents fit in the reformist category and may be able to be persuaded to vaccinate according to the government’s schedule.
Now, if you haven’t guessed, the authors of this article are pro-vaccination. And you may think that I’m anti-vaccination but I won’t claim that title. I think that certain vaccinations have their time and their place; I don’t inherently think they are wrong. In fact, my child is about 85% vaccinated already. I’m open to looking at any and all research on the subject and my mind is not inflexible on the matter. But I definitely fit in the reformist group… although I think that title is a little, um, shall I say condescending. I’m not quite sure I need to be reformed.
When I visited my doctor and asked her a basic question about the amount of thimerosal in the shot my child was going to receive she laughed it away. Thimerosal in shots today, no way. All that mumbo jumbo about thimerosal in shots — propaganda. The funny thing about her response was that if she had only sat down and talked to me about realistic concerns I had, she would have done more good than trying to blow off the “alternative health propaganda” out there. Does she think that government sponsored vaccination information is void of propaganda?
It’s easy to take information from supposedly wiser sources than ourselves and run with it, so to speak. And there are times when that’s the only thing we can do. But when it comes to injecting our children with a HUGE number of vaccines, I don’t think that sitting silently on the sidelines is the best route to take. I’m not saying that vaccinations are wrong, I’m just asking questions:
Why is this the right way to proceed?
What long term studies have been done regarding the long-term effects of these vaccinations? (And don’t just talk about a reduction in polio or mumps… what about other problematic childhood epidemics we’ve seen crop up?)
Why does the government recommend this particular schedule? How do they know that this is safe considering the brain developments during this time?
And possibly most importantly,
Can you discuss anti-vaccination issues with me without acting like I’m dumb, naive, or insane?
I actually find it ironic that asking questions about vaccinations seems to be shunned. Since when did it become wrong to ask, to discuss, to question your paediatrician about the well-being of your child? Especially in this day and age when there are many hidden “factors” that influence various entities, including our government. We don’t simply shrug off rising gas costs and politely say,
Well, if they say it’s so high, there has to be a *legitimate* reason.
In an article titled, MMR controversy has left parents emotionally scarred, study finds, the author discusses the impact that research — which showed a connection between the MMR and complications — has had on parents of autistic children. (Note: since being published many of these findings have been unsubstantiated.) The article points out that many parents:
… felt anger towards health visitors and GPs, who they felt did not appreciate their anxiety when making the decision on whether to allow subsequent children to be given the MMR vaccine… (Kmietowicz, 2007, p. 715)
The article goes on to say that some of the parents felt as though their doctors were being “inflexible” and “dismissive” regarding their concerns regarding the vaccination.
Come on people. The days of patients blindly following doctor’s directions are over. After all, how many times do we hear that we are ultimately in charge of our own health?
If someone wants to convert me from my “reformist” viewpoints, acknowledging my questions and concerns as valid is the first step. After all, I do realize that propaganda does exist… but at least I acknowledge that it’s present on both sides of the debate.
References
McIntyre, P., Leask, J. (2008). Improving uptake of MMR vaccine. BMJ, 336(7647), 729-730. DOI: 10.1136/bmj.39503.508484.80
Kmietowicz, Z. (2007). MMR controversy has left parents emotionally scarred, study finds. BMJ, 334(7596), 715-715. DOI: 10.1136/bmj.39174.371493.DB
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11 Comments
Respect is a two-way street, and doctors are only human themselves.
As a physician, I see myself in the role of a consultant, not the paternalistic figure of yore. Luckily for me, I don’t get this conversation a whole lot as I’m not directly involved in giving most childhood vaccines (in Israel, they’re given at gov’t-run well-baby clinics attended by nurses), though I deal with similar issues.
However, if a parent were to approach a doctor in a not-so-veiled hostile manner (and I am definitely reading hostility between the lines of your article) and ask questions with the assumption that the answers given are those of a paid government/pharma shill, can you understand why they might be terse and impatient? I’m not saying it’s right to do this, but it’s a fairly natural human reaction on the part of the doctor, especially if s/he’s heard the same spiel 20 times before, has 10 minutes per patient and several others in the waiting room. The irritation is not necessarily aimed at you, mind; it could also be at the people who instilled these doubts and fears into parents’ minds.
If I were having this conversation with a patient, I would be very interested to know the sources of information that made them doubt the government’s schedule and the underlying assumptions the parents are working from (in your case, the fear the HUGE number of vaccines is something children’s immune systems can’t handle, and that vaccination is somehow responsible for “other problematic childhood epidemics”). It’s much easier to counteract misinformation when you know who’s providing it and what, exactly, it is.
I know it’s fashionable to ‘question authority’ and all that, but it might be prudent to consider that whose who provide alternative information might have even greater ulterior motives than the government to peddle untruths. Andrew Wakefield certainly did!
I wonder if it has something to do about UNhealthy children encountering problems with vaccinations - whereas healthy children usually have no problem.
Well, now that is just ridiculous!
Individual people have individual bodies - and sometimes those bodies react differently. Kids who are sensitive to immunological overload or to foreign chemicals aren’t necessarily “unhealthy.” (Those same kids may be sensitive to other stimuli in ways that can be quite beneficial - the great chefs, the master musicians, etc.)
As for Estherar’s comments: I’ll tell you, it is really tough for me to trust medical professionals when they are disrespectful. And so, I agree with JR White’s thoughts on mutual respect. Fortunately, my son’s current pediatrician is pretty good about acknowledging concerns, but I still have fear.
For my son’s first pediatrician, I asked my questions from a scared place, not a hostile one. I understand how the questions can become tiresome from the doctor’s pov, but assuming that it is all “misinformation” is dangerous. We are human - we are not perfect - and the information that we have is always evolving and changing. Assuming that a child’s body today is the same as it was a decade ago is risky: we *do* have more chemicals around, there *are* kids who have had some unfortunate reactions to vaccines.
It would be great to find an objective answer to everything, but we know that each individual is truly an individual! And so, if I already know that my child will regress for a week or so after a vaccine, I think it is natural for me to worry about it. No, my son hasn’t skipped any vaccines, but each time I worry that he won’t “come back.”
Fear is not stupidity. And yes — fear can create unsafe situations, but it also can create innovative ones.
After all, I do realize that propaganda does exist… but at least I acknowledge that it’s present on both sides of the debate.
YES, exactly! Like any “debate” there are radical viewpoints on both sides, and that is why it makes it so hard
keith
Thanks for putting your foot in your mouth. Let me give you some advice. Before you start attacking people - read their comments and take a minute to understand.
You showed a complete misunderstanding of my comments. But yet you attack me.
Thank you for participating in the Mommy Blog Carnival. Your post will be included in the June 15th edition hosted at The So Called Me. Please visit then to see the other participants posts. Thanks again!
Thanks for participating in this week’s Carnival of Family Life by contributing this post! The Carnival is at ice cream is not for breakfast this week and will be live on Monday, May 19, 2008, so drop by and check out some of the other excellent articles included in this edition!
I think that parents absolutely have the right to all the available information on any treatment being given to their children. The problem comes with the sources of that information. The media really ran with the MMR/Autism story even though it was really a non-story, and this has had significant effects on uptake of vaccinations.
When I visited my doctor and asked her a basic question about the amount of thimerosal in the shot my child was going to receive she laughed it away. Thimerosal in shots today, no way. All that mumbo jumbo about thimerosal in shots — propaganda.
Your doctor is right. Although, by the sound of it, her tone made you skeptical. There is *no* convincing evidence for a link between thimerosol and autism or any other serious complaint. In fact, there is a growing body of evidence against such claims. As far as I’m aware, thimerosol has been removed from the vast majority of vaccines anyway. Also, in countries where this was done years ago, autism rates have not started to fall. The statistics used by the anti-vaccination people do not suggest the link they are claiming.
Of course, a small minority of children will have some adverse reaction to any vaccination. All treatments have side-effects. Those that are prescribed are deemed to have advantages that far out-weigh the potential side-effects.
You have a very valid point here. While there are some good doctors out there, there are also a number who feel that their degree makes them better than the lowly parents who soil their presence. Disrespectful attitudes, talking down, and at times flat out lying to parents is far too common. If a doctor were willing to actually have a discussion that would be one thing, but too many feel their you have no place to question their authority at all.
This article has been included in the current edition of Mom’s Blogging Carnival.
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You are correct. People need to question their “health experts” and get their questions answered.
There are a lot of reasons that doctors and health experts are giving bad advice. Sometimes they are forced by insurance, by their licensing boards, sometimes ignorance, sometimes by drug companies, sometimes by political agenda.
Although I have not followed the vaccination arguement - I wonder if it has something to do about UNhealthy children encountering problems with vaccinations - whereas healthy children usually have no problem.
Kids can have reactions to most anything. Perhaps vaccinations are just one more thing to add to the list.
Keep fighting the good fight!
Keith