Letter to an Anti-Vaxxer from a Pro-Vax Mom

By Amanda Z Naprawa

I am pro-vaccine.

Vaccines are one of the greatest medical breakthroughs of the twentieth-century.  I believe vaccines  should be mandatory, except for a few very limited exemptions.  That because vaccines save lives. They prevent complications from disease by preventing the disease itself -- complications like blindness, deafness, infertility, paralysis. I am fully vaccinated. My children are vaccinated according to the recommended schedule. We all get flu shots every year.    

I'll say it again and without hesitation: I am pro-vaccine. 

You, on the other hand, are anti-vaccine. You may also be a beautiful celebrity or a best-selling author of childcare books. You may be the president of a "vaccine information group" or the leader of your local "clean living" club. But you are also anti-vaccine.  Please stop referring to yourself as "pro-informed consent" or "pro-safe vaccine" or any other name that tries to hide the truth of your position.

Individuals who urge parents to avoid vaccinating their children based on a slew of myths are anti-vaccine.  If, in the face of dozens of peer-reviewed, scientifically sound studies, you continue to scare parents into believing that vaccines cause autism, you are anti-vaccine.  If you use your good looks and flashy smile to convince parents that vaccines are more harmful than the diseases they aim to prevent, you are anti-vaccine. If you smile benevolently upon chickenpox parties, and mock concerns over the spread of measles, you are anti-vaccine.  If you threaten the scientists and doctors who have worked to create vaccines with bodily harm and death, you are anti-vaccine. If you bully high school students for making a documentary exploring the anti-vaccine movement, then, yes, you're anti-vaccine.

You are anti-vaccine, not "pro-informed consent."  If you were really for "informed consent," then you would push accurate information. True informed consent  requires that the relative risks, benefits and  uncertainties for each alternative treatment option be given to the patient.  When my child gets a vaccine,  my physician gives me an information sheet filled with all the benefits and potential risks of each vaccine.  I vaccinate my child knowing that the vaccine will offer significant protection against serious illness, and that my decision to vaccinate comes with a very, very small risk of some side effects.  I am fully informed.

If you were really pro-informed consent, then you would be giving the true risks of vaccines and the true benefits of vaccines.   You would tell parents --honestly -- that some vaccines carry an extremely small risk of seizure. You would also tell parents -- honestly -- that there is simply no evidence (aside from anecdotal, post-hoc stories) that vaccines carry a risk of autism.  You might tell parents, that you really really hoped that autism could be explained by vaccination (we would all like a simple explanation for autism)  but its not.

You claim to be pro-informed consent.  Informed consent requires that you give accurate, unbiased information necessary to make an informed medical decision.  If you were really  pro-informed consent, you would tell parents that the diseases that vaccines prevent are real. They are scary. They are dangerous.  Yes, many people have had diseases like measles and survived without lasting harm.  But why take the risk? Why let your child suffer an illness that is preventable? In the pre-vaccine era, 400-500 children died a year from measles. Per year. In contrast, 142 people have been compensated for measles vaccine-related injuries over the last eight years.  That's information that a parent can use to make an informed decision about vaccination. That's pro-informed consent.  But that is not what you are about. You minimize the death of children from vaccine-preventable disease by "putting them into perspective."

You are so proud of your accomplishments in increasing awareness of the alleged dangers of vaccination. You have worked so hard to increase the number of states with exemptions to mandatory vaccination. You have tirelessly spread the news that the government cannot be trusted, that vaccine manufacturers cannot be trusted, and that the average vaccine-friendly pediatrician cannot be trusted either.  You have made money, sometimes lots of it, selling the idea that vaccines are dangerous and should be avoided.

There's a name for that. And its got nothing to do with informed consent.

Amanda Z Naprawa is an attorney and graduate student in the Masters of Public Health program at University of California, Berkeley. She believe in promoting immunization through the dissemination of accurate information about vaccine safety. She is the author of various articles, including "Don't Give Your Kid That Shot: The Public Health Threat Posed by Anti-Vaccine Speech and Why Such Speech is Not Guaranteed Full Protection Under the First Amendment." 11 Cardozo Pub. L. Pol'y & Ethics J. 473 (Summer 2013)

Invisible Threat: Speaking Up

In recognition of the national launch of the Invisible Threat movement on May 1st, 2014 the Moms Who Vax blog is participating in a blog relay to raise awareness of the threat the film explores—the anti-vaccine movement. Each day, a different blogger discusses his or her personal perspective of the film as part of an exciting ten-day countdown to a kick-off event for the film, which will be attended by national legislators at the Capitol Visitors’ Center in Washington, D.C.  You can follow along to find out how you can join us in this movement, arrange for a local screening of Invisible Threat, and continue our fight against infectious diseases.

Karen Ernst

Teenagers are amazing people. If you want to view the world through a lens of optimism and idealism, ask for a teenager’s perspective. My other career--the one I began long before I had children or embarked on my mission to get parents to pitch in and help prevent disease outbreaks--is teaching. I began my adult life as an English teacher and became who I am today because I spent my hours learning along with the teenagers who populated my classroom and my life.

So I am difficult to surprise with news about how incredible teens can be. Stories in the media detailing how these young people are transforming our world through their activism and creativity often feel like merely revealing the spirit of what it means to be on the cusp of adulthood.

But a group of student-film-makers has surprised me. By delving into the world of vaccine-preventable disease and rationally examining the claims of the anti-vaccine movement, the student-creators of Invisible Threat have done what many adults fail to do: discover the objective facts about vaccines. Before all of us pro-vaccine parents go patting ourselves on the back for arriving at the truth about immunization, we need to recognize that these teens have also gone above and beyond what most of us do. They’ve chosen to speak publicly about the importance of vaccination.

Most vaccinating parents are not telling their stories. Some of us are afraid to cause discord in our families and so we don’t speak up. We have looked at the science, but don’t want to start debate because it’s just not our area of expertise. So we remain silent, and by our silence we allow the anti-vaccine voice to be the default voice of parents.

The Invisible Threat filmmakers faced steep challenges when creating their documentary. They came to the topic green: with no experience with any vaccine-preventable disease, and largely unaware of the anti-vaccine movement, they read materials both for and against vaccines. They sought out experts and got their opinions. The interviewed anti-vaccine parents. They discussed among themselves what all the information meant and came to a conclusion that was both reasonable and in line with the scientific consensus: vaccines are safe and save lives.

Invisible Threat follows the evolution of their thoughts on vaccines, but behind the scenes, these students faced the same obstacles that we vaccine advocates face. Lisa Posard, parent volunteer and executive producer, explained that when news about the topic of this documentary first came out, anti-vaccine bloggers wrote about the teenagers. Anti-vaccine activists even called their school to try to convince them not to do the film.

Despite this harassment, the students were adamant that they would not be bullied out of tackling vaccines. These young people have done the hard part, and we can do something easy right now. We can invite our senators and representatives to an event on May 1st at 10am in Washington D.C. to discuss the issues behind the documentary.

Invisible Threat is a fantastic documentary, and we are fortunate the filmmakers had the moral fortitude to stand up to those who were trying to shout them down. Next time we are tempted to be quiet about vaccines because we don’t want to make enemies or because we aren’t up-to-date on all the latest science or because it takes effort and we are busy, we need to remember that making a difference means taking a risk. It might mean we have to hearken back to our youth and our days of idealism, when standing up for something was critically important. And what could be more critically important than the health of our children and our communities?

You have the ability to make a difference in our fight against infectious diseases. Follow the Invisible Threat Blog Relay and find out how you can be a part of the movement. Tomorrow's post will be hosted by MOMentumNation.  And be sure to like the Invisible Threat Facebook  and follow the filmmakers on Twitter @InvisThreat.

Telling Anti-Vax Parents They're Wrong Only Makes Them More Anti-Vax

By Karen Ernst

Today, a study in the Journal of Pediatrics seemed to point out that what pro-vaxxers are trying to do is all wrong.  It might seem to suggest that debunking vaccine-autism myths, explaining relative risks of disease, and demonstrating the effects of vaccine-preventable disease is ineffective.  

The study tried to influence parents’ decisions about vaccines using four strategies, all utilizing online resources: correcting misinformation about the MMR-autism myth, giving information about the risks from vaccine-preventable diseases, presenting first-person narratives about children who had contracted VPDs, giving visuals of those risks. After being presented with one of these four strategies, parents were surveyed about how much more likely they were to choose an MMR for their children.  The information used came from the CDC, although the source of the information was not given to the parents surveyed.  The parents participating in this study came to the study with a wide variety of beliefs about vaccines, and almost none of them left with their beliefs being changed.

In short, the Pediatrics study found, in summary, that:

1. Showing ardently anti-vaccine parents proof that vaccines don’t cause autism only made them less likely to vaccinate.

2. Explaining the risks of vaccine-preventable diseases does not increase the chances that parents would agree to the MMR in the future.

3. Showing parents visuals about disease risk or giving them stories about children suffering from vaccine-preventable diseases did not make them more likely to vaccinate their children.

Those findings seem pretty damning for the pro-vaccine message, but I think we should take heart.  There is so much this study didn’t cover, and so much we can do that would work. Here are my thoughts on the findings:

1. Anti-vaccine parents have a broad range of concerns about vaccines beyond the vaccine-autism myth. Hitting one discussion point only irritates their sense of “they don’t get us.” The study might also fail to nudge ardently anti-vaccine parents because there is no human component, and the targeted parents have no opportunity to feel that someone took the time to genuinely hear out their concerns and address them in a personalized way.

2. Emphasizing risks often feels to parents like “fear-mongering,” and parents who refuse vaccines might feel that they are able to continue refusing vaccines since they live in communities with high vaccination rates where the risk of their child actually contracting a vaccine-preventable disease is low.  Just the other day on our Voices for Vaccines Facebook page, one mother commented, “I do not vaccinate, but would definitely consider it if traveling overseas.”  Anti-vaccine parents believe that their risk for contracting diseases is greater where those diseases are endemic, and trying to convince them that their children are at risk for complications from diseases they are unlikely to catch at home is problematic.

Conversely, anti-vaccine parents are likely to disbelieve in herd immunity. As Amy Parker’s mother once did, anti-vaccine parents often rely on organic foods and healthy living to protect their children from diseases that are often airborne and highly contagious. Those of us providing the cover of herd immunity to their children only make it easier for them to continue to delude themselves into believing that their lifestyle is the deciding factor. And because allowing children to become ill to prove our point is wrong in every sense of the word, it’s simply unlikely that anti-vaccine parents will change their minds due to fear of risk from disease.

In reality, what these anti-vaccine parents are doing is increasing the risk that these diseases will come back and that someone will suffer from a serious complication.  The parent who already vaccinates does so not only out of concern about serious complications, but also because they want to prevent illness in their children. But only ardent pro-vaccine parents are typically also passionate about the power of protecting her whole community.  However, maybe we can use pride in protecting the community not as a way to motivate parents to vaccinate but to motivate vaccinating parents to take pride in their actions and speak up about them.

3. Images and stories about children in peril because of disease only makes parents look for other dangers.  I call this the “Law and Order: SVU” effect, named so because after I have watched episodes of this show where children were in peril, I tend to see dangers for my children everywhere--beyond the scope of the subject of the episode.  

The researchers call this the “danger-priming effect.”  Priming parents for danger doesn’t make them more likely to take the solution you are offering, according to this theory.  It makes them more likely to look for dangers everywhere, including in that syringe you are holding out to them.

4. This study was limited in what it could reasonably do to ease fears about immunization because it was online and impersonal. There’s simply no way to quantify all of those conversations that occur on the playground among parents or around the Thanksgiving table or even between friends on Facebook.  

Parent-to-parent communication is entirely different than the communication in this study.  Think about what we know about ardently anti-vaccine parents:  They are more likely to believe conspiracy theories and thus less likely to believe officially sanctioned scientific evidence.  They are more likely to have a social network guiding them toward vaccine refusal, and providing them positive social reinforcement for their decisions.  The cold, impersonal online survey has no chance for success in the mind of a parent whose decisions are socially reinforced and are based on a distrust of official stances.

So what can we, as pro-vaccine lay-advocates, do? Are we likely to make parents less likely to vaccinate through our advocacy?  

I do not believe so.  In fact, I think lay-advocates--everyday parents and citizens--are key. Recent research shows that normalizing immunization works.  So let’s do that. Let’s let people know that we happily vaccinate our children because we understand the science behind it is clear and because we value our children’s health.

And vaccinating is normal.  Well over 90% of parents vaccinate on-time. If anti-vaccine parents feel that their position is being reinforced by their social network, then we as parents are not doing our job to protect our children and their friends. If every parent with fully vaccinated children simply stated that their children were vaccinated on-time, there would be a groundswell. The voices of these parents would drown out the fear-mongering and lies of the anti-vaccine movement, and concerned parents would feel more confident to join our ranks.

In other words--speak up. It just might work.

They Don't Speak for Me: Why We Must Act Now

As a parent who vaccinates your child, you probably don't know that as you are going about your daily life, parenting, working, doing volunteer work, writing the Great American Novel in your spare time (what spare time?), a very small but vocal army is pounding the pavement in your name.

It may surprise you to know that the anti-vaccine movement has long claimed to speak for parents in this country when it comes to vaccines. And it is because they are so vocal and we are so, well, busy living our lives, that legislators, government officials, and even some public health organizations think that anti-vaccine activists who believe the MMR causes autism and that the decline of vaccine-preventable disease is due to "better hygiene" represent parents as a whole, when it comes to immunization in this country.

The vast--vast--majority of us choose to vaccinate our children for two reasons: one, we don't want our children to suffer from a preventable disease, possibly become seriously ill, or even die; and two, we don't want any of those things to happen to our neighbors either. Here's the problem: we don't talk about it. I suspect this is because we consider it commonsense. One mother on this blog wrote a post titled: "There's an Anti-Vaccine Movement?" because it had never occurred to her before she had children that people would willingly forgo something that has nearly eliminated one of the most dreaded diseases in human history (polio) and saved the lives of countless children and adults from other diseases that, if not kept in check by widespread immunization, cause unimaginable amounts of suffering.

We never thought we'd have to advocate for something that saves lives, especially the lives of children.

But here we are, and our complacency and our silence has allowed a fringe minority to sit at the table of public health in our place. And there are now consequences for our silence. In Vermont, a common sense bill that would make it more difficult for parents to "conscientiously object" to vaccines and still be allowed to benefit from the public school system has been derailed and defanged because of a highly organized counterattack from anti-vaccine forces, led notably by Barbara Loe Fisher's National Vaccine Information Center (a cleverly named anti-vaccine activist organization). In Oregon at this moment, legislators are considering a simple addition to immunization law that would require parents who opt-out of vaccines to receive educational materials about the risks of vaccine-preventable diseases. The fact that anti-vaccine activists objects even to this speaks for itself. These are the fears of anti-vaccine parents who do not want any obstacle in their quest to get their kids in school with the general population while not having to get those kids immunized.

Who have these legislators heard from? You guessed it: anti-vaccine parents and activists. And not just those living in Oregon. They are getting e-mails and letters from all over the country from people who will fight tooth and nail to preserve their ability to opt-out of immunization and keep their kids in school.

Who haven't they heard from? Us. The parents who vaccinate. The overwhelming majority of us who vaccinate our children because it's the right thing to do for us personally (our kids are protected) and because it's the right thing to do as human beings who live in a community (we protect others). We are the parents who likely would not dream of sending our sick kid to school and infecting his entire class. We are the ones who used common sense. And we're sitting back letting people who have chosen fear and lies over evidence and science speak in our names.

If I sound a little more passionate than usual, it's because I'm angry. We must rise up as a group and take back the conversation. We must let lawmakers know where we stand. I think back to my high school civics class, where we were taught that lawmakers take each letter they receive and apply that strange political calculus to it that, in the end, makes that single letter speak for 10,000 people. Right now, there are legislators in Oregon who believe that millions of parents do not believe in vaccination and do not want the law changed to better protect the community. Let's prove them wrong. You can write and voice your opinion on SB 132, the Oregon bill currently in committee by visiting this site from the Oregon Pediatric Society. It will take you directly to a form where you can write your note. It needn't be long--although mine was about four paragraphs--and you don't have to be a citizen of the state of Oregon (although if you are, we really need you). Let's do this--let's go letter for letter, and beyond. Let's make sure the people who make our immunization law know that we are here, that we care, that we are the 95%.

It's About Time: Voices for Vaccines

The reason this blog exists—why it continued beyond our initial efforts—is because of fellow parents. Since starting Moms Who Vax, Karen and I have met many remarkable moms and dads who choose to vaccinate their children and are, frankly, fed up with the lack of push-back against the loud and rancorous voices of parents who intentionally leave their children unvaccinated. By sharing their stories, we know many of these parents have changed minds, provided reassurance, perspective, and sanity.

But it’s not enough. It’s one thing to blog. It’s quite another to join forces in an official way, under the auspices of an organization. Organizations get invited to conferences. They get a seat at the table. They can streamline advocacy efforts, print flyers, provide educational materials, reach out to media, provide members to testify at legislative hearings. Time and time again, Karen and I heard parents asking: what else can we do?

Now we have an answer: join Voices for Vaccines.

Over the past eight months, Karen and I have been working with vaccine legends Dr. Deborah Wexler, Dr. Paul Offit, Dr. Alan Hinman, and Dr. Stanley Plotkin to re-launch—and perhaps more important, to re-imagine—their pro-vaccine advocacy organization, Voices for Vaccines. Initially designed to be the “go-to source for vaccine information,” the project stalled, despite great interest. When Karen and I came to the project, we both felt very strongly that a parent-driven, parent-focused organization was the missing link in this vaccine conversation. More than ninety percent of parents overall vaccinate their children. If this is the case, why are the anti-vaccine parents the ones we see in the media, on blogs, in the comment sections, and at legislative hearings? Why is the anti-vax National Vaccine Information Center the dominant parent organization in the vaccine world? It was this conundrum that we wanted to address, and the founders of Voices for Vaccines were in complete agreement.

Karen and I held a few conference calls with some of our past contributors and trusted partners to share the initial idea, and when we gave them a description of this new direction, the excitement was palpable. One of our “Moms Who Vax” said she’d been dreaming about such an organization for years. The enthusiasm was infectious (no pun intended--okay, pun absolutely intended), and it has kept us going over these last six months. Between preschool, soccer games, dance lessons, our day jobs, and our other vaccine-related efforts, this thing slowly came together, along with the help of some amazing individuals, including Immunization Action Coalition's Julie Murphy and Mike Franey.

Now we are ready to open the workshop doors, and even though we still have work to do, particularly on the website, we didn't want to delay bringing pro-vax parents into the fold any longer.  At Voices for Vaccines, you will find a home for the ninety percent of us who vaccinate our children on time. You will find vaccine information vetted by the best minds in vaccinology, but you will also find opportunities to make your voice heard—in your local community as well as nationally. You can share your story in the VFV blog Parents Who Vax (still a work in progress). You will be able to download toolkits on topics from “How to Write an Op-Ed” and “Keeping the Media Honest” to “How to Talk to a Vaccine-Hesitant Parent” and beyond. You can sign up for the VFV newsletter to stay on top of the latest vaccine news and to receive action alerts, including calls for comments on articles about vaccine topics (typically dominated by anti-vax voices) and invitations to conference calls with heavy-hitters in the medical and scientific communities, and beyond. Learn about opportunities to join forces with other pro-vax parents! We need you--your creativity, your ideas, and your passion. 

We have a new website, although it is far from complete and still in need of fixes and design tweaks. But this is just the beginning. Even more changes are in store, and we want you with us. Please join VFV and join forces with other pro-vax parents to take over the world—or at least protect children and vulnerable members in our community from vaccine-preventable disease and bad science!

For us, and for the founders of VFV, this relaunch is the stuff of dreams. A national organization uniting parents who vaccinate and are passionate about it?

It’s about time.

Editor's Note: If you're in Minnesota this weekend, please come to the Voices for Vaccines' launch party, "Our Voices Rockin' at downtown Minneapolis' PourHouse. Hosted by Don Shelby and featuring the music of rock band Verge, there will also be a silent auction. Saturday, January 19th, 7pm-10pm. Suggested donation of $10 and 21 and up. Hope to see you there! 

Letters to the Editors: Jenny McCarthy Edition

Over at Vaccinate Your Baby/Every Child by Two, the fine folks who run that page are encouraging parents to speak up against the Chicago Sun-Times decision to hire Jenny McCarthy as a columnist offering up parenting and family advice. Let's leave alone the comment such a hire makes on the state of journalism in this country and focus on the fact that McCarthy's anti-vaccine nonsense has been profoundly destructive in this country.

Amy Pisani over at Every Child By Two is asking parents who care about protecting children and vulnerable adults from infectious disease to write to Jim Kirk, the Editor-in-Chief of the Chicago Sun-Times to explain why McCarthy's history as an anti-vaccine activist and her new soapbox at the paper puts all of our children at risk. Below is my contribution, which I just sent. If you're interested in speaking up, email Jim Kirk at the Sun-Times. You can even crib from my letter if it reflects your feeling. Every Child by Two also has sample language on its site.

Dear Mr. Kirk,

It was with great dismay that I learned you hired actress and model Jenny McCarthy to write a daily blog on parenting and family advice. The rise of vaccine-preventable disease in this country can be laid squarely at her feet because of her vociferous and completely erroneous claims about the dangers of vaccines. Having received her degree from the "University of Google," she capitalized on her fame to spread anti-science nonsense and to scare the bejesus out of new and expecting parents.  

In an ideal world, you'd reconsider the decision to hire McCarthy for a column aimed at parents. But I'd also be very happy if she would write a column exonerating vaccines from having any connection with her son's autism diagnosis (which apparently has magically disappeared). I expect better from a paper as long-lived and well-respected at yours. Hire a celebrity model to dole out advice to parents if you wish, but at least choose one who has a basic grasp of science and a willingness to say she was wrong.

Ashley Shelby

Know a Fabulous Pro-Vax Parent or Provider?

We're putting the call out. The CDC wants to recognize the efforts of parents, health care professionals (Nurses, pediatricians, other physicians, medical assistants, etc), immunization advocates, and other fearless pro-vax champions, with their CDC Childhood Immunization Champion Award.

This is a new annual award that recognizes individuals doing exceptional work in the area of childhood immunization. This is not easy work, especially on the front lines. To get into this line of work is to invite heaps of abuse from anti-vaxxers, but the rewards are so great: healthy kids, happy parents, and safe and healthy communities.

Do you know anyone who helped reassure you about the safety of vaccines? A pediatrician who took the time to listen to your concerns and then gently but firmly tell you vaccines are safe for your child--and why? What about another parent who does work in the community? 

Here's the cool part--each of the fifty states, and the District of Columbia, get to select a CDC Immunization Champion. Awardees are recognized at both the local and the national level during National Infant Immunization Week, April 21-28th, 2012. So no matter where you're reading this, you can submit someone for nomination.

You can find the nomination forms and more information about the award at www.cdc.gov/vaccines/events/niiw/champions/childhood.html.

Nominations are due February 10th, 2012. If you live in Minnesota, you can send completed nominations to:

Andrea Ahneman

Immunization, TB & International Health
Minnesota Department of Health

P.O. Box 64975

St. Paul, MN 55164

Email: andrea.ahneman@state.mn.us