My mother is not an anti-vaxxer. I received all my childhood immunizations that were available at the time I was still of age to go to a pediatrician's office. Some took, some didn't - I've had the titer tests done to test my immunity and determine what shots I need boosters for as an adult. But let me tell you a story very quickly here.
As I said, I received my childhood vaccinations on schedule. However, when I was about four years old, I had a bad reaction to my DTP shot, which protects against diphtheria, tetanus, and pertussis (today's DTaP and TDaP shots have different formulations). My arm swelled up the day I received the vaccine and I developed a fever, which frightened my mother at the time. I recovered, and seemed to have no lasting side-effects, but my mother was wary of the DTP vaccine for me afterwards.
Flash forward five years, and at nine years old I broke my finger by slamming it in our family car door. Sitting in the emergency room that night after X-Rays, I listened to the doctor tell my mother that he recommended a tetanus booster shot for me, since I had a few small puncture wounds along with my fractured finger. My mother was wary, explaining the reaction I had several years prior to the tetanus shot.
Here are the things the ER doctor did not do to my mother:
- Laugh at her.
- Call her ignorant or stupid.
- Blow off her concerns.
The emergency room doctor patiently listened to my mother's story, and acknowledged her concerns as real. Then he proposed the following:
- I could receive the Td shot, which only had tetanus and diphtheria in it, and the lesser amount of virus exposure would probably lessen my response, if there was any at all. He explained that sometimes younger children could have vaccine reactions while older children would have lesser ones, if any at all.
- I could stay and be monitored in the emergency room for a few hours to make sure that I had no immediate reactions, and if I did I would then be located in the hospital for quick evaluation and response.
- He explained what the consequences of developing tetanus would be, if I did contract the disease from the accident.
- He explained the choice was ultimately up to my mother, but he highly recommended the above course of action based on his personal experience of how deadly and serious tetanus could be.
My mother chose to give me the vaccine. I did not develop tetanus.
It's very easy to mock anti-vaxxers. Countless studies have debunked the theory that vaccines cause autism. Unvaccinated populations are contributing the the comeback of measles and whooping cough outbreaks. These diseases, and others are incredibly serious, with much higher mortality rates than the rate of serious vaccine reactions. The problem is that all this mocking does not make anti-vaxxers any more likely to vaccinate their children.
There have been several studies in recent years indicating that mockery and government-sponsored public education pushes have not been effective in getting more people to vaccinate. In response, it's become common among people in my social circle to respond with demands for vaccinations to become mandatory. This is a terrible, terrible idea.
Do a thought experiment with me for a moment. Lets go back to the 1990's emergency room where my mother was nervous about me receiving a tetanus booster after I broke my finger. Do you think it would really have helped the situation for my mother to face prison time for possibly refusing? Should the doctors have threatened to call CPS and have me taken away? Should they have forcibly removed a child from her mother, strapped her down, and given her an injection? For me, I have to believe that none of those choices would have been beneficial in the long run, and all of them would have left my mother ultimately more frightened of the medical establishment, and less likely to seek care for me or her other children in the future. As it was, she left comforted and more trusting in both vaccines and taking me to see doctors.
What does persuade people? One theory, put forth by Robert Cialdini in the 1980's, is that there are six principles of influence: reciprocity, commitment and consistency, social proof, liking, authority, and scarcity. When we look at what public pro-vaccination and anti-vaccination campaigns actually work, we can see these principles being effective. Anti-vaxxers succeed primarily because of the social proof, liking, and authority phenomenons. A medical doctor writes about the dangers of vaccinations, and authority is granted to the anti-vaccination movement. Joining Facebook groups allows for social proof to have an effect - anti vaxxers see that others believe the same as they do. Celebrity endorsement, whether by Jenny McCarthy or Alicia Silverstone appeal to the liking effect. We are more likely to do something if people we like do it. To effectively combat this phenomenon, we need to interrupt these strategies.
Let us look at what pro-vaccination campaigns actually work. Mississippi and West Virginia are currently the only two states in the U.S. that do not allow for religious exemptions from vaccines. All public school children in these two states are required to be vaccinated barring a medical condition. Both states have higher vaccination rates than the national average, with Mississippi's being one of the highest in the country due to a combination with an aggressive vaccine outreach program run by the state's health department. This helps combat the phenomenon where parents often miss vaccinations due to the difficulty in taking time off work to get to doctor's offices, rather than any particular anti-vaccination belief. This is reciprocity at work - get your kids vaccinated, and they gain access to the public school system, something very important to most parents in the U.S.
Another persuasive way to get people on board with vaccinations is to appeal to liking and social proof - two of the methods that make the anti-vaccination crowd so wide-spread in the first place. This is where Rand Paul, of all people, is actually on the right track.
Rand Paul earns his anti-vaccination credentials (and widespread public mockery) by saying it should be a parent's choice, not the government's. This reassures nervous mothers that their precious snowflakes aren't about to be ripped from their arms and forcibly injected with chemicals. But Paul immediately follows this up by publicly getting vaccinated - demonstrating that he expressly believes in the safety and effectiveness of immunizations. Thus, someone the anti-vaccination crowd likes demonstrates his pro-vaccine position - a far more effective act in the long run than endlessly mocking or demeaning the anti-vaccination crowd. Paul deserves praise for this act, not disdain.
Personal testimony is another powerful tool when it comes to persuasion. It's one the anti-vaccination crowd has used to great effect, especially when parents tell personal stories about their children's real or imagined suffering, believed to be at the hands of vaccination. To counter this, we should be searching out more personal testimony like that of Roald Dahl's 1980's letter, where he told the heart-breaking story of losing his daughter to complications from measles. Stories are easier for most people to understand than data, and are thus more effective. We are still of a generation where we have many people who can tell their personal stories of losing family members or suffering from life-long disabilities due to polio, measles, rubella, and others. All of these diseases are now preventable. But we need to change our persuasion methods if we want to keep up the vital herd immunity and protect our most vulnerable populations.
Don't mock, disdain, or ignore the concerns of anti-vaxxers. Listen to them, acknowledge them, and let medical professionals educate them, but also allow them the freedom to walk away. Don't pretend that bad vaccine reactions don't ever happen, but don't let parents fool themselves about the dangers of the diseases themselves. Don't make vaccination mandatory by law for all, but do make it mandatory for entering public schools. Combine that with an outreach program, like in Mississippi, to ensure you are reaching vulnerable populations. Find authority figures and celebrities to do pro-vaccination endorsements. Publicize famous figures getting their vaccinations. Find emotionally convincing personal testimony about the dangers of these illnesses and make it wide spread.
Finally, spread your own stories in a positive way. If a friend asks you about vaccination concerns, there is no need to be mean or demeaning. Simply say that you have received all of your vaccinations, your children have received theirs, and you have seen no side-effects. Say that you're comforted to know that your children are protected - but leave it at that. You and your children being healthy and happy will be social proof to your friend on your own. While you may be tempted to argue and bring up facts, that will be counter-productive, due to the backfire effect, where people are more likely to double down on mistaken beliefs when presented with contradictory evidence. So here's a thought - stay positive, keep your friend, and promote vaccinations all at once.