Persuade, don’t malign anti-vaxxers

 

If we really want to convince parents to vaccinate their children, name-calling and vilification is not the way to go.

image: Wired

Yet, that seems to be a common tactic. You don’t have to go far on social media to find out. Here’s an example from Twitter:

Craig Levine @AstronomerXI “Let’s call #antivaxxers what they are: pro-disease, pro-death, pro child-suffering, ignorant, arrogant, stupid, fanatical, brain-washed, pathetic, selfish.”

Having lived through polio epidemics as kid, I don’t have to be convinced of the benefits of vaccination. Polio vaccines not only saved lives, it removed my fear of going to movies and school, and of going out to play.

The danger is real. A measles outbreak in the U.S. is at a 25-yar high. Three-quarters of those who caught the extremely contagious disease are children or teenagers.

Canada has large pockets of unvaccinated children. In Ontario, they have things in common:

“Those students tended to have things in common. For instance, unvaccinated children with non-medical exemptions were more likely to go to private or religious school, or be home-schooled, live in a rural area or a community with a small- to medium-sized population and be located in the southwest and central west regions (Globe and Mail, April 30, 2019).”

The Vancouver area is also experiencing a measles outbreak this year. And in neighbouring Washington a state of emergency was declared due to a measles outbreak -although no cases have been linked to B.C.

As is typical of character assignation, reluctant parents have been unfairly grouped together. But they are not monolithic say professors Julie Bettinger and Devon Greyson of UBC and the University of Massachusetts, respectively:

“While dismissing non-vaccinating parents as anti-science, uneducated, conspiracy theorists might be tempting, we find these stereotypes represent only a small minority of this population (Globe and Mail, April 22, 2019).”

Professors Bettinger and Greyson found that these stereotypes represented a minority of non-vaccinating parents. They surveyed, interviewed, and observed more than 2,000 parents to understand what causes vaccine hesitancy and how to address it.

First, despite the characterization of non-vaccinating parents as “pro-death” and “pro child-suffering,” they have the best interests of their children at heart. Additionally, they care about other children who can’t be vaccinated and who are at risk.

Yes, they may fear the safety of vaccines as a result of what they have heard from people they trust. Some lack of knowledge of the extensive testing and safety monitoring that ensures our safe vaccine supply. Sometimes their reluctance is born from a lack of trust and a perceived betrayal by the health care system -they don’t believe anything medical researchers tell them.

Some indigenous people don’t trust the colonial system that decimated their communities by purposely introducing disease.

They may live in remote areas and face barriers of getting to clinics. Access can be a problem for urban dwellers, too, for those who can’t get time off work to take in their children.

Some fear talking to health-care providers about their concerns because they’ll be labelled as “one of those parents.”

The remedy to vaccination-resistance is not easy. Trustworthy relationships must be developed. Mobile clinics with extended hours will help. Name-calling and the failure to address the genuine concerns of parents will only deepen the divide.

 

 

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‘No Jab, No Pay,’ not here

Australia has a blunt way of getting parents to vaccinate their children called ““No Jab, No Pay.”

image: Forbes Phoenix

As the name suggests, parents don’t receive welfare payments, tax benefits, and child-care rebates if they don’t vaccinate their children. It can amount to $15,000 annually.

Not only do parents lose payments but unvaccinated children can be barred from daycare and schools during disease outbreaks. Daycares that allow unvaccinated children can be fined up to $30,000.

The exceptions to vaccinations are those children who have some medical condition such compromised immune systems or cancer. These children have a genuine reason not to be vaccinated; and these are the children who can benefit most from everyone else being vaccinated.

Australia has one of the highest vaccination rates in the world. But rates only improved slightly since the ‘No Jab, No Pay’ policy was implemented, from 90 per cent to 93 per cent. The improvement was not entirely because of the threat. A key to their success is a national registry. Health reporter Andre Picard says:

“We should not forget either that, in addition to financial penalties, Australia greatly improved its monitoring of vaccination. Having a register that shows what vaccinations children have – or haven’t – received has contributed greatly to bolstering rates (Globe and Mail, July 9, 2018).”

While it seems effective, it’s not appropriate for Canada. We are similar to Australia in that we are both former British colonies but Australia’s culture is different than Canada’s. Perhaps it’s because they were a former penal colony that the big stick approach is more accepted.

Canada has a hodgepodge of provincial systems with no consistent registry. We need to do better. We now have an immunization rate estimated (because we don’t know) to be 85 per cent. Herd immunity requires rates of 90 to 95 per cent.

There are many excuses for not vaccinating children. One is selfishness. If sufficient numbers of other children are vaccinated, herd immunity protects my child.

These parents don’t remember, or never knew, what it was like when vaccinations didn’t protect against diseases like polio. I do. I remember growing up in Edmonton during the “polio season” when epidemics of the crippling disease raged in the summer and fall. Provincial public health departments tried to quarantine the sick, closed schools, and restricted children from travelling or going to movie theatres. My uncle survived polio but walked with difficulty with the use of a cane and died prematurely because of polio complications.

Another reason is the irrational fear that vaccinations cause disease. While these hard-core anti-vaccination parents receive a lot of press, they only number about two per cent. The other 13 per cent fall into the categories of complacency, those who doubt the necessity of vaccinations, and those who just don’t’ find it convenient to get the vaccinations done.

Convenience is a big factor. Parents don’t get around to vaccinating because it takes time and effort. One-on-one attention is sometimes all it takes, such as an email or phone call reminder.

Canadians need to be encouraged, not bullied into improving or vaccination rate. We need a national registry. Improved rates will provide immunity, not only for their own children but for those vulnerable children who are unable to receive them.