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Source:  http://www.forbes.com/sites/tarahaelle/2015/02/17/15-myths-about-anti-vaxxers-debunked-part-1/
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Tara Haelle Contributor

I offer straight talk on science, medicine, health and vaccines. full bio →

Opinions expressed by Forbes Contributors are their own.

I am a freelance science journalist and photojournalist who specializes in reporting on vaccines, pediatric and maternal health, parenting, nutrition, obesity, mental health, medical research, environmental health and the social sciences. My work has appeared in Scientific American, the Washington Post, Politico, Slate, NOVA, Wired, Science and Pacific Standard, and I write regularly for HealthDay, Frontline Medical Communications and my science and health mom blog Red Wine & Apple Sauce. I was the health editor at Double X Science and am currently co-authoring an evidence-based parenting book due in late 2015. I received my master's in journalism at the University of Texas at Austin (also my undergrad alma mater), and I teach journalism at Bradley University in Peoria, Ill. I previously taught high school and often think of my journalism as a form of teaching, by helping others understand science and medical research and by debunking misinformation about vaccines, chemicals and other misunderstood topics.

The author is a Forbes contributor. The opinions expressed are those of the writer.

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Pharma & Healthcare 9,779 views

15 Myths About Anti-Vaxxers, Debunked - Part 1

This is part one of a three-part series. Here are parts two and three.

Alongside the measles cases that have spread across the country since late December has been a rising awareness among parents and the media of a problem that medical professionals and public health officials have been battling for years: parents who opt out of vaccinating their children, thereby weakening herd immunity and increasing the likelihood of large disease outbreaks. Judging by the headlines of the past several weeks, folks couldn’t stop talking about “those anti-vaxxers” who refuse to vaccinate their children and ruin that whole disease-elimination thing for the rest of us.

It was reminiscent of last fall’s Ebolamania except, unlike Ebola, neither measles nor non-vaccinating parents are new to the U.S. This issue has flared up in the media previously now and then, usually name-dropping Jenny McCarthy as a scapegoat and providing the obligatory “vaccines aren’t related to autism” line. Those past blips on the radar screen were nothing, however, compared to the past month and a half. But to public health advocates and science journalists, the only thing surprising about the past several weeks is that this issue finally struck a nerve, unearthing a wellspring of anger about “those anti-vaxxers,” apparently undoing all our progress in banishing so many life-threatening childhood diseases to history books.

But in all that anger, one misperception after another about “those anti-vaxxers” has also repeatedly sprung up. Because vaccines have been my beat for a number of years, I’ve partly built my reputation on debunking myths about those life-saving interventions. But now I see a different task before me: It’s time to set the record straight when it comes to parents who don’t vaccinate their children. The myths are numerous – and can be almost as damaging as the myths I so often see about vaccines – so I won’t be doing this in one fell swoop. We’ll start with the top five.

Myth #1: “Any parent who doesn’t fully vaccinate their child is an anti-vaxxer.” Nope.

Fact: There is a continuum of hesitancy and confidence about vaccines – and total outright rejection of all vaccines is just one extreme end of that continuum, composed of a tiny minority of hard-core, true-believin’ anti-vaccine parents and advocates. Most parents who don’t fully vaccinate their children aren’t “anti-vaxxers” at all. They’re just parents, trying to make the best decision for their children that they can. “There are people who are so far to the anti-vaccine side that no amount of data, no amount of talking, no amount of anything is going to convince them to vaccinate their child, and then there are lots of people on the other side of the spectrum vaccinating their children according to the CDC schedule,” said Jessica Atwell, a PhD candidate in Global Disease Epidemiology and Control at the Johns Hopkins Bloomberg Bloomberg School of Public Health. “Then there are all the people along the continuum in the middle who are hesitant or have concerns.” Some parents pick and choose this or that vaccine. Some delay vaccines. And some opt for no vaccines at all because they have concerns about vaccines, many of which might not be unreasonable if they’re based on misinformation instead of accurate, current information. These parents are more accurately called “non-vaccinating” as long as they’re not out there campaigning for everyone else to skip the shots too. Yes, there are anti-vaxxers out there, but they’re a tiny yet extremely loud few, spreading the misinformation that’s freaking out parents. But lumping together every non-vaccinating parent or guardian into the blanket label of “anti-vaxxer” is inaccurate and, worse, counter-productive. If you think anti-vaxxers’ minds can never be changed, and you think of every non-vaccinating parent as an anti-vaxxer, you’re setting yourself up for a depressing and fatalistic conclusion indeed.

Myth #2: “The anti-vaccine movement started with Wakefield’s fraudulent 1998 paper attempting to link the MMR with autism.” Far from it.

Fact: Anti-vaxxers have been with us a long time. It’s incredibly easy to pinpoint precisely when anti-vaccine propaganda started: in 1796, when Edward Jenner first inoculated 9-year-old James Phipps against smallpox by injecting him with cowpox. The first day we had a vaccine, we had folks opposing that vaccine, and that sentiment has continued through the ages. Remarkably, many of those concerns by anti-vaccine advocates several centuries ago are little different than many concerns today, such the fear that vaccination will kill babies. In fact, in the U.S., concerns about the MMR are dwarfed by the fears of the DPT vaccine in the 1980s, the same fears that eventually led anti-vaccination advocate Barbara Loe Fisher to found the most influential anti-vaccination organization in the country, the Orwellian-sounding National Vaccine Information Center, in 1982. Wakefield is just one of the latest in a long line of fearmongerers.

An early political cartoon portray's Jenner's smallpox vaccine as having some unfortunate side effects – turning people into cows. Clearly, fears about vaccine side effects are nothing new. Photo from Wikimedia.

An early political cartoon portray’s Jenner’s smallpox vaccine as having some unfortunate side effects – turning people into cows. Clearly, fears about vaccine side effects are nothing new. Photo from Wikimedia.

Myth #3: “The anti-vaccine movement is rapidly growing.” No evidence for that.

Fact: There’s no good evidence that the anti-vaccine movement – even insomuch as you can call it that – is growing. First, the only part of anti-vaccination sentiment that can be called a “movement” is the tiny handful of organized folks like Fisher and the NVIC, Sherri Tenpenny, Joseph Mercola, Mike Adams of Natural News, and so forth, who peddle outright false information and stir up fears. Then there are the middle managers, mostly parents who have taken up arms with their own little groups, like Sane Vax or the odd Facebook page. But the vast majority of parents who aren’t vaccinating their children are “just minding their own business and trying to decide what’s good for their kids,” according to Yale researcher Dan Kahan, who has studied vaccination attitudes. And what about their numbers? The most efficient way to track vaccine refusals is to look at non-medical exemptions that allow parents to send their children to school without all the required immunizations, and there was evidence that these refusals were increasing at least in some areas up through 2011. But we don’t know if they’re still going up, especially since the new laws in California and Washington appear to have stopped the climb in those states.

But even these rates doesn’t tell us the full story about vaccine refusers. A child might have an exemption because his mom wanted to skip the chickenpox vaccine but he got jabbed with every other shot. Or in states where exemptions are easy to get, the parent may have simply not gotten their child up to date yet. Or, parents might be delaying certain vaccines, which requires an exemption until the child gets the vaccine that dad was planning to get him all along. But looking at the whole U.S., children’s vaccination rates are uniformly high, and the proportion who receive no vaccines at all hovers just over a half percent. “There are so few true hard-core anti-vaccine people that studying them quantitatively is almost impossible,” said Brendan Nyhan, a Dartmouth political scientist who has studied vaccine hesitancy. “The hard-core folks – they might as well be unicorns.”

Myth #4: “Parents who don’t vaccinate are all either rich, dirty hippies or Tea Partyers or Big Pharma conspiracy theorists.” Nope.

Fact: Those who don’t vaccinate are a hugely diverse group, and they don’t fall along any political divide – and in fact, it’s dangerous to suggest otherwise. As Kahan has shown in his research, Americans of all political stripes overwhelmingly support vaccination. And while some certainly do believe in a Big Pharma or government conspiracy, they’re a tiny minority among all the non-vaccinating parents. What about those stereotypes of GMO-avoiding, 7-year-old breastfeeding, essential oils-using, Whole Foods-shopping natural freaks? Well, they’re stereotypes, and they reflect reality about as much as any stereotype does, which is to say, not at all. “When you collect data, and you have a nationally representative population, there’s very close to zero correlation with any group’s identity or cultural style. You just can’t find it,” Kahan said. “My guess is that if you go to any particular place where you can find people who are anti-vaccine, they’re going to have integrated with their style, but they’re only a small percentage of the people who have those views – they’re outliers. You’re not counting the people who shop at Whole Foods who don’t have anti-vaccine views like theirs.”

Don’t believe it? Well, look at the evidence. One of last year’s outbreaks was tied to the Amish, and another past one was tied to an orthodox Jewish community. Studies have found vaccination refusal linked to higher and lower incomes, and a systematic review of more than 70 studies concluded, “Determinants of vaccine hesitancy are complex and context-specific – varying across time, place and vaccines.” The factors that unite vaccine-hesitant parents are not ones easily categorized. They are less likely to think their children will catch a vaccine-preventable disease and more likely to know a child supposedly hurt by a vaccine. One of the strongest factors is a mother’s age. Younger moms are more likely to have vaccine concerns – and they’re also the least likely to have first-hand experience with the disease. As a group, non-vaccinating parents have only one characteristic in common: They don’t vaccinate. That’s it.

Myth #5: “Parents who don’t vaccinate are all ‘pro-disease,’ on the lookout for a measles or chickenpox party.” Are you kidding?

Fact: Non-vaccinating parents fear disease too – they just fear the vaccines more. Yes, there is a very tiny (and yes, truly crazy) minority looking to infect their kids with diseases, and if you hear of or see one, please call child protective services. But the measles party craze is way overblown. Consider Tara Norman, of Montgomery County, Maryland, a mother of two who started, then stopped, vaccinating her children because of concerns about her family’s health. She had a relative who died of tetanus (and her children are up to date on tetanus) and a friend who died of meningitis in college. “I’m terrified of meningitis,” she told me, “but I wouldn’t give [my son] the meningitis shot because it doesn’t protect against all of the strains. Am I a little worried when they’re in college? I really am worried, but I’m more worried about giving them the shot.” And from a risk perception point of view – based on what we perceive, regardless of whether it’s reflects actuality or not – this rationale isn’t far-fetched, according to David Ropeik, a former director of risk communication at the Harvard Center for Risk Analysis. He points out that fearing vaccines more than diseases is rooted in psychological phenomena. “The diseases seem to be gone,” he told me. “Why take even a small risk with vaccines to protect a child against a disease that doesn’t appear to be a threat at all?” Of course, “appear” is the key word there – the diseases aren’t gone (if they were, we’d stop using the vaccine, as we did with smallpox), and the risk of disease is greater than the risk of its corresponding vaccine, but Ropeik points out that “the public health folks did a poor job of keeping awareness of the disease high.” And so, when risks of vaccines appear greater than risks of a disease, parents like Norman are making a rational decision based on the information and perceptions they have. So no, non-vaccinating parents are not opening their doors and welcoming disease into their midst.

 

I’m just getting started, folks, because there is a lot of misinformation out there about parents who may not vaccinate, but are doing the best they can to take care of their children based on the information they have. Here are more misconceptions about non-vaccinating parents in part two and part three.

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  • Carey Head Carey Head 6 days ago

    Thank you for this article. Like so many scares, this one has tiny roots in truth which were then blown to hyperbolic proportions by media and social media. It is also true that there are many who are not “anti-vaccine” and still support parents’ right to choose for themselves. Pro-choice on the vaccine issue.

  • kausikdatta kausikdatta 4 days ago

    It is also true that there are many who are not “anti-vaccine” and still support parents’ right to choose for themselves. Pro-choice on the vaccine issue.

    This is a common trope that many dedicated anti-vaxxers are deliberately injecting into the discussion. “Right to choose for themselves”, eh? They are choosing what, exactly? When they choose not to vaccinate their children, they are putting – whether deliberately or through ignorance – at serous risk their children AND countless other children, including those who cannot be immunized due to age, or genuine health issues.

  • Tara Haelle Tara Haelle, Contributor 4 days ago

    To be fair, there are a lot of “pro-vaccine” people who also believe in the right of parents to choose. We are talking about a medical intervention that does carry risk — just an unbelievably tiny amount of risk — on a healthy child. It is reasonable for parents to have a choice there, and many vaccine researchers and advocates agree with that. However, the balance of convenience in exercising that choice should be far more difficult than it currently is.

  • Kathi Mattea Kathi Mattea 3 days ago

    Why? Why should exercising the choice to vaccinate or not be more difficult than it currently is. In California you have to have a note signed by your doctor that you discussed the issue with him and have been warned/explained the risks/benefits. Why does it have to be more difficult than that?

  • First Last First Last 6 days ago

    Great article Tara! I’ve been trying to debunk a lot of these myths in comments on various vaccine articles for years but some people seem to be resistant to a lot of these facts. You’ve done a great job presenting these ideas and I hope they catch on but I’m kind of pessimistic about that happening.

    I think myth #1 is the one that bothers me the most because it does have the potential to be so counter-productive. The problem is there seem to be a number of bloggers and commenters who insist that any parent who does not adhere precisely to the recommended schedule is an “anti-vaxxer”, even if, for instance, their child is sick on the day of their scheduled vaccines. These vaccine advocates’ position seems to be that it is just very black and white and that it is always unacceptable for parents to question the authority of those who created the vaccine schedule and even a parent who delays only one vaccine should be labeled an “anti-vaxxer”. I just think the really rigid, arrogant and demeaning “you’re either with us or against us” approach used by some self-appointed vaccine advocates has the potential to turn many vaccine-hesitant parents further away from vaccinating.

    I’m looking forward to your next article.

  • Tara Haelle Tara Haelle, Contributor 5 days ago

    You said, “I just think the really rigid, arrogant and demeaning “you’re either with us or against us” approach used by some self-appointed vaccine advocates has the potential to turn many vaccine-hesitant parents further away from vaccinating.” That is *precisely* what worries me as well and one of the biggest motivators behind my doing this piece. On the one hand, I was glad to see all the coverage about the measles outbreak, the issue of immunization, the concerns some parents have about vaccines, etc. However, that gratitude was quickly overcome by the sheer hysteria and vitriol that came with the wave of reporting. I know that’s the way the media cycle works, but when it has the potential to do such harm, I worry.

  • Michael Lynch Michael Lynch, Contributor 6 days ago

    Very nicely done. Looking forward to parts 2 and 3.

  • Kathi Mattea Kathi Mattea 6 days ago

    OK Forbes, Lets take a look at what you say “Judging by the headlines folks couldn’t stop talking about (double x for effect) “those anti vaxxers”? No, it’s the MEDIA who can’t stop fanning the flames with inflamitory headlines. It has not been REPORTING, but propaganda, ie: “Ruin that whole disease-elimination thing for the rest of us” You then go on to correct many of the myths about who is questioning vaccine safety, but only after a few jabs right.

    It’s interesting to me that less than a month ago you ran an article titled “Measles Can Kill, and it’s Spreading. Sue Parents Who Don’t Vaccinate? Absolutely” Yeah, there was nothing inflamitory about that article, nothing to make people “hate those anti-vaxxers ruining things for the rest of us right?” http://www.forbes.com/sites/dandiamond/2015/01/28/measles-is-spreading-and-kids-might-die-sue-parents-who-didnt-vaccinate-absolutely/2/

    Then on Jan 28 you ran an article “Ebola only a warm up, the measles outbreak is for real” http://www.forbes.com/sites/dandiamond/2015/01/23/ebola-was-a-warm-up-the-measles-outbreak-is-for-real/ which went on about how this measles outbreak was just going to continue to get worse. It contained the strange claim that “And anecdotally, some people that clamored for a non-existent Ebola vaccine last year also admitted to not-vaccinating their kids for measles, mumps, and the flu.” in an attempt to make those “anti vaxxers” seem even more absurd, as it trumped up the dangers of measles with the final exclamation “But near zero isn’t zero (discussing death rates for measles) and we should all be terrified by willful ignorance” Meanwhile vaccines are reported as completely safe, or just a tiny risk. Using that logic, “Tiny risk” isn’t no risk. One in a million? OK, so if 9 million children get MMR shots, and only 9 die, that’s an acceptable risk? To you maybe, as long as your precious bundle is protected from measles, but not to the family who lost a child.

    The article you ran on Feb 1 was even worse, AND inaccurate http://www.forbes.com/sites/stevensalzberg/2015/02/01/anti-vaccine-movement-causes-worst-measles-epidemic-in-20-years/1/ Not even going to bother quoting that absurd article.

    I appreciate the effort to set the record straight regarding people who question vaccine safety. Too bad your website already did the damage regarding vilifying those parents.

    And for the record, many parents are working hard to ensure the CDC Whistleblower, Dr. William Thompson is called to testify before congress. Please read tinyurl.com/kennedycdclies to see just what he’s going to testify about.

  • Tara Haelle Tara Haelle, Contributor 5 days ago

    I think part of the confusion here is that you’re unclear on how Forbes blogs work. Each blogger has our own blog where we report on whatever we choose based on our own perspective. My reporting and perspectives are here on my blog. Dan Diamond’s are his, and they do not represent anyone’s perspective or opinions except his own. Steven Salzberg’s are his, and they do not represent anyone else’s. I do not necessarily share Mr. Diamond’s or Mr. Salzberg’s opinions, and they do not necessarily share mine. None of these articles represent “Forbes” so much as the words of each individual author because they’re blogs.

  • Kathi Mattea Kathi Mattea 5 days ago

    Thank you for the clarification.

  • Robert J. Szczerba Robert J. Szczerba, Contributor 6 days ago

    Tara – I enjoyed reading the article. Very well done. I look forward to the next installments.

  • Tara Haelle Tara Haelle, Contributor 5 days ago

    Thanks! Working on them!

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