Pushing back smartly against vaccine antiscience

Vaccine antiscience doesn’t directly confront physicists, but does challenge science generally. Based on empirical findings, and with public health at stake, pediatricians and others are becoming—or anyway, hoping to become—more effective in addressing it. Journalists are enthusiastically endorsing the effort.

A February 2014 study in the journal Pediatrics called to mind, whether or not inadvertently, a frequent finding about climate-science communication. It observed, “Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive.” The paper concluded, “More study of pro-vaccine messaging is needed.”

More study has taken place. That same journal’s September 2016 issue includes what the publisher, the American Academy of Pediatrics, calls a clinical report , “Countering vaccine hesitancy.” The paper appeared online on 29 August. It prescribes thoughtful, in some ways gentle, but at the same time firm measures for constructive science-grounded pushback against vaccine antiscience.

Coauthors Kathryn M. Edwards and Jesse M. Hackell, representing the pediatrics academy, adduce statistical data to show that although “the majority of parents accept vaccines, the increasing frequency of refusal and the requests for alternative vaccine schedules indicate that there are still significant barriers to overcome.” They emphasize that the “term vaccine hesitancy has emerged to depolarize the ‘pro’ versus ‘anti’ vaccination alignment and to express the spectrum of parental attitudes toward vaccines.”

They review the history of vaccine development and the history of vaccine opposition, starting with opposition to smallpox vaccination after Edward Jenner pioneered it more than two centuries ago. They lament that “recent years have seen a marked increase in the availability and use of ‘philosophical’ or ‘personal belief’ exemptions from vaccination.”

They cite four sources for their statement that studies “have demonstrated that parents who refuse vaccines are more likely to be white and more highly educated than those who do not.” Media reports about vaccine antiscience have often made this same point.

The two pediatricians’ new clinical report advocates working “to eliminate all nonmedical exemptions for childhood vaccines” and points to agreement from the American Medical Association and the Infectious Diseases Society of America. It also reports “recognition among pediatricians that delayed or incomplete vaccination schedules are probably responsible, at least in part, for the spread of measles” in the 2015 outbreak in California. (Some readers might more easily recall that outbreak if reminded that media reports linked it to Disneyland.)

One passage in the paper addresses the variety in vaccine antiscience. Some 44% of parents in one study, it says, “reported concern over pain associated with receiving multiple injections during a single visit, 34% expressed unease about receiving too many vaccines at a single visit, 26% worried about the development of autism or other potential learning difficulties after receiving vaccines, 13.5% expressed concern that vaccines could lead to chronic illnesses, and 13.2% stated that vaccines were not tested enough for safety before their use.”

Autism? Learning difficulties? Illnesses? Safety? At the US Centers for Disease Control and Prevention website, and elsewhere, it’s easy to find objections to vaccines authoritatively debunked .

Another survey, the paper reports, “found that parents who decide to not vaccinate their children have a greater distrust of health care professionals and the government and are more likely to use complementary and alternative medicine, compared with parents who vaccinate their children.”

The paper offers pediatricians and other medical professionals extensive discussion of what it calls “targeted discussion strategies” for countering vaccine hesitancy and refusal. Echoing that 2014 conclusion, it also addresses the possibility that “current public health communications ... may actually increase misperceptions and reduce vaccination intention.” Still, it declares, a “well-informed pediatrician who effectively addresses parental concerns and strongly supports the benefits of vaccination has enormous influence on parental vaccine acceptance.”

After carefully outlining the practical complexities, legalities, and ethical dimensions of dismissal of persistently vaccine-rejecting families, the paper announces that “the individual pediatrician may consider dismissal of families who refuse vaccination as an acceptable option.” This statement has received considerable attention in media reports.

In the media, it’s hard to find anyone who countenances vaccine antiscience. It’s even hard merely to find the false-balance phenomenon—the misguided journalistic practice of presuming that because opposition to facts exists, it should get equal coverage.

A January 2015 media report in this venue carried the headline “Journalists debunk vaccine science denial: Both before and after the Disneyland measles outbreak, most reporters have forthrightly exposed ‘anti-vaxxers.’” It was plain at the time that unremitting condemnation of vaccine ignorance and irresponsibility pervaded the media coverage.

That approach also dominates reporting about the pediatrics academy’s latest analysis. Sympathetic, supportive pieces have appeared at CBS , ABC , the Huffington Post , the New York Daily News , Forbes.com , and elsewhere. The Washington Post published such a piece on 29 August, then later in the day re-reported the news, this time framing it in terms of an illustrative outbreak of mumps on Long Island. In California, the scene of notable past vaccine-antiscience struggles, newspapers have echoed the Los Angeles Times article “Pediatricians urge states to get tough on parents who don’t want to vaccinate their kids.”

A pediatrics academy press release about the new paper asserted bluntly that “non-medical exemption laws have failed.” It quoted clinical report coauthor Edwards: “People today may not remember that before vaccines, diseases like whooping cough, measles, polio, meningitis, and diphtheria sickened and claimed the lives of thousands of children and adults each year.” It also highlighted data from the paper: “In the United States 2009 birth cohort, routine childhood immunization will prevent about 42,000 early deaths and 20 million cases of disease, according to the report, saving $13.5 billion in direct costs and $68.8 billion in societal costs.”

Do the US presidential candidates’ views say anything about how well society at large understands vaccine science and efficacy?

On 1 August, the Atlantic summed up candidate Hillary Clinton’s unambiguous view by quoting her: “The science is clear: The earth is round, the sky is blue, and vaccines work. Let’s protect all our kids.”

On 24 August, Vermont Public Radio reported that former New Mexico governor Gary Johnson, the Libertarian candidate, “is newly in favor of mandatory vaccination, he says, after learning more about the science of immunization.”

A July Washington Post article reported hedging and uncertainty in the vaccine views of Dr. Jill Stein of the Green Party, but in mid-August the Guardian quoted her exclamation that “the idea that I oppose vaccines is completely ridiculous.”

And then there’s candidate Donald Trump, of whom the physicist and science popularizer Lawrence Krauss recently wrote in the New Yorker, “Just as he was a persistent ‘birther’ even after the evidence convincingly showed that President Obama was born in the United States, Trump now continues to propagate the notion that vaccines cause autism in spite of convincing and widely cited evidence to the contrary.”