Saturday, March 28, 2015

Talking About Vaccines: Maybe We've Been Doing it Wrong

(Image: Coursera, "Epidemics- the Dynamics of Infectious Disease")
Recently I have been working on a piece for the Bangor Daily News about pending legislation in Maine that would make vaccine opt-outs and exemptions more difficult to acquire.  This is an important topic up here, since our immunization rates fall below herd immunity threshold.  Translation: unvaccinated persons are officially at elevated risk for contracting vaccine-preventable diseases.  This not only means the medically exempt; it means kids who had been exempted voluntarily, and most tragically of all, all infants up to one year of age.  As such, members of the state legislature have introduced a bill to address this problem and restore the state of Maine to herd immunity levels in defense of all infants and the medically fragile.  Makes sense to me.



I have been having trouble writing this piece, because every time I finish it, I hate it.  It sounds like every clinical or scientific defense of vaccinations I've ever read (those snarky ones on BuzzFeed and HuffPo, or this wonderful piece in Grounded Parents notwithstanding).  Why should this piece be any different from the others, where we try and repeatedly fail to sway hearts and minds into protecting children?  How the heck do we lose this argument so frequently?  It's baffling!  This seemed well outside my expertise, so I started talking to some colleagues who are experts in neurosciences.  Paydirt.

Of the phenomena discussed, one has given me something reasonable to try with this article.  Apparently somewhere deep in the limbic system, our brains are conditioned to believe things as true based not on how much sense it makes, but on how many times we've heard it.  Reading up on this a bit more, I found a paper that discussed this idea with regard to vaccine policy.  The upshot of my exercise is this: by systematically debunking vaccine myths, we keep repeating them.  The context is irrelevant to that very primal part of our brains.  We keep repeating them.  A great example I can think of here would be the "birther" nonsense about Barack Obama.  No matter how many ways his birth in the state of Hawaii has been documented, verified, and everything else, a disturbingly high number of people still believe he was born outside the United States.  Instead of saying "in response to suspicions he was born in Kenya, blah blah blah", a more effective presentation would have been "President Obama was born in Honolulu, as documented here."  The second statement does not repeat the myth, and the first does.


I am going to start my BDN piece from scratch.  I am further going to reconstruct my course materials for the med students on how to talk with patients about vaccines.  "In the state of Maine, a 6-week-old infant is at risk for contracting whooping cough due to low immunizations rates.  This has a high rate of death, and an almost universal chance of leaving surviving infants with permanent damage to their respiratory tract.  A critical way to address this is to ensure that everyone in the household has received a safe and effective TDaP vaccine" would hopefully be a good place to start!


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