I wept at the end of the movie I watched last night, The Imitation Game. The reason really was this: it reminded me how we’re just so terrible to each other at times. How much suffering occurs when we don’t think things through. The movie wasn’t about measles or vaccination, but injustices in it pushed me to leave my Sunday morning with my children to share this:
My patience with vaccine hesitancy has pivoted. I’m embarrassed to say it took an outbreak of measles stemming at Disney to move me from impatient and passionate to hands-on-my-hips fired-up and disappointed. Today I feel a bit of outrage that unvaccinated families are not pounding on the door to get their MMR vaccine, even on Superbowl Sunday. In my mind they should be doing so selfishly (for personal protection) and they should be doing so altruistically (for others who really count on them). I expect both from the public.
Read Charlie and the Chocolate Factory author Roald Dahl’s 1988 message about his daughter’s death from measles — insane that it rings true today.
I feel somewhat enraged that many parents with babies in the United States are nervous right now about their infants getting measles. The chance is small but it shouldn’t even be a chance when there is a vaccine that is nearly 100% protective for those milling around these delicious babies. I’m angry because a friend of mine has a child who got measles when she was too young to be immunized. I’m enraged that children who fulfill their “Make A Wish” trip to Disneyland — after a liver transplant or after chemotherapy or after a tumor is cut out of their bone — must feel a little shaky making the choice to go there now. Can you imagine getting a short straw like a liver that didn’t work like it should or a childhood cancer diagnosis and then getting another one (increased measles risk) just when you’re elevated to celebrate your life?
I’m angry at myself for not being a good enough communicator to sometimes sway a nervous or distrusting parent into believing in the promise of the MMR shot. I’m angry because I’ve remained calm at moments when I maybe shouldn’t have. Right now I’m recalling a mother who laughed at me, at my intensity for wanting to protect her child with the MMR vaccine, in a visit a couple years ago. I should be better than this as a pediatrician, mother, advocate, writer, and spokesperson. All this reach and potentially no good?
I’ve been here (right here) for over five years writing about the opportunity of vaccines, the science that is on their side, and the rich potential of prevention. I’ve discussed the rare side effects to the remarkable MMR vaccine. I’ve detailed different small outbreaks and the confidence those of us who are immunized can feel traveling and going to school and having playdates even when outbreaks pop-up. I even entitled a chapter in my book, “Measles In America.”
There’s simply no reason for measles outbreaks in 2015. The hysterics around misinformation and “liberty” and righteousness about expertise misplaced have no place right now. The science and morality is clear here: measles was once declared done in the United States (year 2000) and now because people went against scientific and medical advice, it’s returning. Unvaccinated pockets have grown. Consequently babies, unvaccinated or vulnerable children, teens and adults are getting an infection they never needed to have. Rarely, vaccinated individuals who didn’t respond to their shot are getting measles, too.
I’m so pleased with the density of press entrenched in the measles issue this week. I’ve done numerous interviews about measles where I detailed the numbers, the risk, the MMR shot’s profound success. I see a new measles article every few hours in my social channels. I’m not including the data about the outbreak here because I think most of you know it (please ask for info, I’ll happily respond in comments with data & links). My email inbox is full of content on the outbreak, physician list-serves are jam packed with pediatrician dialogue about how to avoid missing a measles diagnoses in the office, how not to confuse it for adenovirus, and opinions/questions regarding the challenges and fears we have for our patients that may not be protected.
Thank goodness I can report I have still never seen measles in practice. I will be so overwhelmingly sad if I do. In fact I’ll tell you now that if I ever do see measles I’ll weep at the bedside or in the exam room after I care for that child or family.
Unvaccinated pockets of well people are just another example that as a culture we’re just not good to each other. We’re just not as good as we can be.
In the past year we have seen countless examples of thoughtless mistreatment of our fellow humans, both in the U.S. and abroad. Vaccines represent a chance to do the right thing, to protect ourselves, our children, and our at times vulnerable communities
A major U.S. newspaper (I refuse to link to it) published a piece earlier this week highlighting the attention a vaccine-antagoinst-pseudoscience-doctor was getting for his counter-current ideas about shots amid the outbreak. The minute they hit publish, his attention skyrocketed. We live in this world where I wrote about the Injustice of Immunization Interviews by the news media way back in 2011; little has changed.
After I sent a tweet yesterday that I was thinking of writing a post on measles a physician colleague replied, “Stand up.” It was retweeted numerous times. This is my attempt to stand unlike before and let you know I’m still in it for passion and clarity, compassion for those who distrust, but there’s new fuel to my intensity.
Chad Hayes says
Great post–anti-vaccine advocates are vocal and extremely active, while pediatricians have, for the most part, tried to avoid the fray. The recent media attention is a great opportunity to “stand up” and help keep our kids healthier!
Bobbie Fager says
As a nurse who works with neurologically damaged children, I beg to differ with your opinion. I have personally heard from over 20 parents that their children were developing normally until they received multiple vaccines (as many as 5 or 6 vaccines given simultaneously). Their child developed a high fever within hours, convulsed and then began the descent into the damaged child I was seeing. This identical story is repeated countless times all over this country – forget what the experts for and against vaccines say, these parents know what they lived and they are not going to be silenced. I received 17 childhood immunizations. The current recommendations are for in excess of 40 injections before the age of six with another 15 before the age of 18. It is no coincidence that this number has almost doubled since vaccine manufacturer were given legal immunity from law suits (and accountability) in the late eighties. Blaming the modest number of recent measles cases on the unvaccinated makes no sense…look into the issue more in depth and you will see that previously vaccinated adults with waning or no immunity or the more likely culprits. Is the solution to require more and more boosters of a vaccine whose immunity pales in comparison to immunity that is acquired naturally? Many more cases of measles now occur in adults (as much as 25%) than in the past….a time when the disease can cause many more problems than if acquired in childhood. It is believed that mothers who are vaccinated pass a much shorter acting immunity to their babies than those mothers who developed natural immunity from having the measles. We seem to be creating a population whose immunity depends on vaccination as opposed to a strong immune system.
Identical autism stories aside, consider the massive increase in other chronic childhood ailments over the last 20 years…allergies, ear infections, JRA and asthma have all seen dramatic increases over the same last 20 years that the immunization schedule has doubled…can we please have some research UNCONNECTED to the drug companies who profit from the products being researched? We are raising the most damaged and chronically unhealthy generation in American history…and a few hundred cases of the measles are the least of our problems.
I just lost my job for declining a flu vaccine – I have never had one and last had a case of the flu in 1982. This year’s flu vaccine was estimated by the CDC to be about 25% effective in preventing the flu…and are you aware of the studies showing that flu deaths among the elderly have INCREASED as the number of vaccines in that population has increased?
Place your trust in vaccines if you want…I prefer to keep my immune system healthy and ready to fight true illness instead of using its reserves to combat artificially injected illness. My unvaccinated child is not a risk to society but those who unquestioningly accept the current religion of vaccines are.
Vincent Iannelli, MD says
“I’m angry at myself for not being a good enough communicator to sometimes sway a nervous or distrusting parent into believing in the promise of the MMR shot.”
When I have thought of the measles outbreaks over the years and the problems getting some vaccine-hesitant parents to overcome their fear of anti-vaccine misinformation they read in books and on the Internet, I sometimes think of a quote from the movie Gladiator:
“Your faults as a son is my failure as a father.”
But who can really be called at fault in all of this?
Those who started the modern anti-vaccine movement back in 1982?
Andrew Wakefield or the media for publicizing his study?
Oprah and Larry King and others in the media for giving Jenny McCarthy and other anti-vax celebrities a voice?
The politicians who wrote the laws to allow all of the personal belief vaccine exemptions we now have?
Those who look to natural or alternative treatments and turn away from evidence based medicine, buying amber necklaces, essential oils, anything natural they can get their hands on, and visiting homeopaths, naturopaths, holistics doctors, and chiropractors, most who are anti-vaccine?
The media who was on the wrong side of the vaccine safety issue for years, providing false balance, and is only now writing about vaccines and measles that it has begun to trend?
Or is it the vaccine-friendly pediatricians who pander to parents fears, providing made up immunization schedules, and reinforcing the idea that it is okay to skip some or all vaccines?
You have a lot of people to be angry at if you want to. I think it is safe to say that you can take yourself off the list though.
Chad Hayes, MD says
Another thought: perhaps the term “vaccine-friendly pediatrician” should be changed to “vaccine-preventable-disease-friendly pediatrician.”
Wendy Sue Swanson, MD, MBE says
Thanks, Dr Iannelli. I always appreciate all your writing and speaking out about realities and trends in vaccine science (and hesitancy) and really do appreciate your thoughts here.
Chad Hayes, M.D., said: “Another thought: perhaps the term ‘vaccine-friendly pediatrician’ should be changed to ‘vaccine-preventable-disease-friendly pediatrician.'”
“Vaccines are My Superpower.”
Dr. Swanson, you have been a champion of immunization for so long, and you have been clear and unwavering on the importance of vaccines. In addition, you have been handling the vaccine conversation with your parents and with the general public in exactly the way doctors and the AAP have advised the medical community to handle it. People like me–parents who are passionate about vaccinations–are lucky in that we can get super passionate and angry without alienating patients. I’ve long felt that both as a vaccine activist and as a parent, that I would’ve vastly preferred straight talk, such as the kind you hear from folks like Dr. Offit and Dr. Robert Jacobson of Mayo, than the gentle “talking-around” approach that most physicians use. But I have found that among vaccine-hesitant parents, I was the exception. I’m so glad you’ve written this post but I don’t think you should beat yourself up about your approach up to this point. Anti-vaccine activists advise new parents that when they go to their well-child checkups that doctors will “bully” them into vaccinating. And by “bullying” they mean telling parents the risks of leaving a child unvaccinated (i.e. illness or death).
One idea might be to utilize that passion you’re feeling about the failure of the social contract among those parents who don’t vaccinate. For example, what if the conversation about vaccines brought in not just the health and well-being of their own child, but also of the other young children in that parent’s life. Nephews and nieces too young to be vaccinated? The infants in the waiting room? Perhaps any infant sibling who might be born into that family at a later date. I don’t know. More and more I feel that practices that do not seeing intentionally unvaccinated families are a good idea. I know the AAP thinks that will only drive families to naturopaths and other quacks, but it will also protect the vulnerable in the herd. The chances that a family with a child battling leukemia would go to a school where vax-exemption rates are high isn’t great, nor would they patronize a naturopath. Who knows. I ran out of patience a long time ago. I think we’re lucky that pediatricians have more patience than me. I’m sure there are parents whose minds you’ve changed, and that is so valuable.
Wendy Sue Swanson, MD, MBE says
Thanks, Ashley. I do think it’s the herd that will help build trust. And I’ll keep chipping away at sharing what I know (and how I feel).
Mary Murphy says
Parents who’ve decided not to vaccinate their children are not listening to the medical/scientific community, and they will persist in not listening. They have achieved mental immunity to the preponderance of scientific evidence supporting childhood vaccination. They are deeply convinced of and committed to their own “purity” and “specialness.” It’s nothing short of a religious mindset, intrinsically tied to self-image, and they will not turn their back on it, not without de-programming. As a parent who did vaccinate her children I am also feeling enraged at the “anti-vaxxers.” It’s not easy to agree to those shots. I had fears about possible side effects, fears about toxicity and even neural damage. I was scared to death of hurting my children. But I went ahead with the prescribed course of vaccines, because that’s what responsible, informed & loving parents are supposed to do. It was awful to witness. The 4 ear old appointment was beyond horrible. I still experience flashback moments of mental anguish about those multiple injections, especially when I see how frantic & terrified my six year old is about shots now as result to the trauma of that awful Doctor’s office visit when he was just four. So when I hear about a measles outbreak due to parents who’ve opted not to vaccinate, putting their own children at risk, as well as the children of their friends and neighbors, not to mention the risk to vulnerable immune deficient people in the world, I get mad as hell. Vaccinating your child is the right thing to do, and it’s incredibly hard to do, and it’s viscerally scary, but most of all it’s damned unforgivably irresponsible of you to chicken out on this life and death action. Because that’s precisely what it is when you refuse those shots, it’s cowardice, and only that. You owe it to all of us who share this earth to go through with the ordeal of watching as those needles are jabbed in your beautiful, wonderful child’s body. So many of us fearful, conflicted and uncertain parents did it. We love our children just as wholly, completely and utterly as you do. And you vaccine refusers have benefitted from our difficult decision to vaccinate. The self-serving, bloated, ego-extended behavior has got to stop.
Rob Cordes, DO, FAAP says
well said Dr Iannelli.
Thank you for this. I hate questioning whether or not I should be bringing my 7-month old to Target because of the selfishness of others that could put him in danger. What do you think? Would you be avoiding public places if you had an infant under 1?
Wendy Sue Swanson, MD, MBE says
I think risks are very low for infants unless you’re in a county with active cases. I’m sorry the question even enters your mind. More on the blog tomorrow abt specifics, including a Q&A with vaccine expert re: infants, domestic travel and doses of MMR before age 1.
Also, I entirely agree with Dr. Iannelli.
Emily Gibson, M.D. says
keep saying the message, louder and louder, with as much angry emphasis as possible.
However, as a doctor who has seen cases of rubeola measles in my clinical practice, I’m not enraged at Measles 2015 as the virus is simply doing what viruses do best — spreading from vulnerable to vulnerable host, efficiently and effectively and will continue to do so until those hosts are either immune, immunized or dead.
No, I’m enraged at parents who have been seduced by misguided “authorities” who teach them to distrust doctors and good science. I’m enraged at our own legislators who adopted state laws that allow “personal” exemptions from the vaccine requirement. And I’m enraged at myself because every time I’ve blogged, spoken or written about this issue, I’ve allowed the slings and arrows that come my way to hurt me and make me question my sanity for putting myself in the middle of a war zone.
Stand firm and stand strong on this issue, no matter what comes your way. There are plenty of us ready to take the heat with you as you are in a powerful position to get the message out.
Ellen Mary says
I’ve been trying for the better part of a week to get the MMR for my 1 year old. Truth be told I’ve been trying for the better part of a month, but there was a detour, when a doctor rescheduled on me & then ultimately was unhelpful. Everyone I deal with wants me to transfer the records, establish all my kids, wait for a well child visit, etc . . . Parents have a role to play but so do doctors. If a parent calls you asking for the MMR, in an *outbreak*, get them in with minimal ‘I’m going to make you my forever patient’ shenanigans. And YES, I have called the Health Department, they won’t help me because I am insured even though they we have a high deductible plan and I am also willing to just pay cash. We just moved, this is why I am not yet ‘established’ but there should be some way for me to get this shot without pledging my first born. We need easy access clinics in every county and we need them STAT.
Wendy Sue Swanson, MD, MBE says
Good grief, yes. I’m so sorry for the frustrations. Can you call the clinic you’re scheduled to establish and get a “shot visit?” It may not be possible as many clinics want to see a patient first to ensure allergies, past medical history, etc are all reviewed. The other thing I’d recommend is calling your previous pediatrician in your previous location/state. My hunch is tomorrow they could advocate for you to get the shot!
Sarah Day says
You can also get the MMR at many of the larger chain pharmacies such as Rite Aid and Walgreens.
What I and, I think, many other Seattle parents would like is the option of going to a pediatrician who refuses to accommodate parents who won’t vaccinate. We have looked and have never been able to find a practice that excludes them. We are expecting our second child in March. I don’t relish the prospect of sitting in a waiting room with a newborn worrying about what vaccine-preventable diseases she might contract there.
You make a very compelling point, Jennifer.
Kelly Bray says
As a parent and a layman I would like to see the medical profession police it’s own. In the midst of this outbreak I would like the AAP take a strong stance. Publish a strong PSA statement unequivocally supporting vaccines. Take Sears and Gordon specifically to task. Name names. Toss them out.
As a parent of an infant, I understand your anger. I have feel it, too. But being angry or providing facts isn’t working. Unfortunately, it appears that for many of the parents, trying to reason with them only serves to make them more entrenched. The growth of the unvaccinated population over the last decade suggests that at best this approach isn’t working.
So, I’m proposing a different positive strategy focused on people on the fence. We give so much energy on the people who aren’t vaccinated, but luckily except in very highly defined communities they remain a minority.
I’ve made signs using Google docs (the best I could do with a new crawler) saying “my kid is vaccinated”. I also made signs saying “I’m vaccinated” “my grandkids is vaccinated” and “I vaccinate”. I taped mine to my car window. My hope is that if an expecting parent saw my sign and my charming little guy, the might think that the vaccine didn’t harm him. I hope that they might think, here’s someone who thought about the decision and chose vaccinations. I hope someone asks me about my sign and we can have a little conversation. And my biggest hope of all is that vaccinations can become more fashionable. This is a small step anyone who is concerned can make.
I post the link to the Google doc as the website. To anyone reading these comments, please steal my idea. Hang your own sign. Make extras for others. Get out the positive word of vaccinations!
Beth Crispin says
I love your positive idea and actions with the signs! I would wear a button that says “I vaccinated my kids!”. Great idea!
Chris Hickie says
Be angry at those who would ban vaccines if they could: the NVIC, Andew Wakefield, Roberts Sears, MD, FAAP, Jay Gordon, MD, FAAP and others (including this vile “holistic cardiologist” Jack Wolfson who is mentally unfit to practice medicine ( https://scienceblogs.com/insolence/2015/02/02/antivaccine-cardiologist-jack-wolfson-and-the-resurrection-of-false-balance-about-vaccines-again/)
Stand up against the anti-vaccinators. Please lobby your AAP chapter to push AAP national to expel Sears and Gordon. If they won’t stand up, the QUIT the AAP. There is NO excuse for Sears and Gordon to remain FAAPs. NONE.
Please lobby the United Way to not fund the NVIC
And please take on any local anti-vaccine lunacy in your backyard–head on and without remorse. My patients in Tucson, AZ are deeply appreciative that I expelled all non-vaccinating families in 2013.
This is a war of sorts. The time for niceness to our opposition is past.
Chris Hickie, MD,PhD
I applaud this article. Our son was born with hypotonia, struggled with plagiocephaly, chronic ear infections, severe constipation, FTT, GDD and later diagnosed with ADHD. He has been going to Seattle Children’s most of his life and goes several times a year for follow ups. So many times I have people insinuate that he has these medical issues because we vaccinated him, and it angers me. I know having a child that has medical problems with no official cause is frustrating as a parent we want a reason, someone or something to blame. It takes a lot to come to terms with the possibility of never knowing who or what did this to your kid. He was just born this way. He had these things wrong the moment (or before) he entered the world, long before he had any shots. I think parents that have kids diagnosed with something should receive counseling. There is so much guilt that you carry and trying to find the reason can drive you mad. I can suspect many things may have caused this but you know what, it won’t take it back. It won’t change it. And as we bring our mostly healthy child to his visits at SCH we see kids with severe problems and illnesses that break my heart. My child is vaccinated for not only his safety but the safety of all the kids we come in contact with, especially at SCH. Along this 7 year medical journey we have run into medical providers that I would hope to never see again. The majority, especially those at SCH, have been amazing and I trust them because they are the ones with many years of experience and training. I haven’t gone to medical school, and neither has Jenny McCarthy. Thank you Wendy and the Neurodevelopmental team that has made my son’s life much better than it could have been.
Chris Clark says
I have a 26 year old son with spina bifida. I have heard every blame-related comment in the universe (I think!) about what I did to cause this to happen to my child. People want to believe you did something (or a vaccine did something) so they can be sure it will not happen to their child. Its a cruel and mostly unthinking form of self-protection. You didn’t do anything and neither did the vaccine (and neither did I). Things happen, bad things, and fairly often. Having a healthy, unvaccinated child is no guarantee that they won’t be in a car accident, for example, and need full time nursing care their whole lives. Kids don’t come with guarantees unfortunately. All we can do is minimise the risks we know about. Put a seat belt on them and vaccinate. Best wishes to you and your son.
First, thank you for writing this. I hope more and more doctors express their feelings on this matter.
Second, I believe that all doctors have a special power to help make vaccines more accepted nationwide: simply refuse to treat patients who are not vaccinated. If enough anti-vax parents cannot get a doctor’s care for their children, they might start to see the light.
While it is certainly helpful to have doctors speak out, we (the vaccinating people of the world) are up against so much garbage on the Internet it’s a difficult battle to wage. I’m amazed at how seemingly educated people can cite articles and studies that look pretty and scientific without investigating who wrote the articles or how the “studies” were done. The general public doesn’t seem to have either the ability or the desire to dissect the information out there, and the result is a plethora of dangerous, bogus information on fancy letter head from important sounding websites.
I recently had someone try to argue the danger of vaccines based on 5,000 deaths over the course of 20+ years. She paid no mind to the nearly 150,000 that died in one year from the measles. It’s things like this, half stories, that perpetuate fear and cause irrational decision making.
I have three kids. I will never say it’s not scary to vaccinate. You never know if your kid will be the one allergic or that has an adverse reaction. But dying from the measles is a hell of a lot scarier and I have so much rage toward everyone that makes me worry about the health of my 5 month old because he’s too young to be protected.
I want the anti-vaxxers out of my herd.
Elizabeth Ramstad says
I agree with every word of your article and plan to share on my Facebook page, but I fear blanket statements such as all naturopaths are quacks-sweeping statements are just as polarizing and unnecessary.
I think part of the problem with how new or expecting moms get started down a path of non-vaccinating is the availability (or lack thereof) of online support forums. Maybe it’s changed in the last couple years, but when I was expecting my first in 2007 and my second in 2010 the available options for online mama group forums were very polarized:
Baby Center was in the What to Expect When You’re Expecting camp, containing many moms who wanted to schedule c-sections out of convenience and who were not at all sympathetic to or interested in doula support or midwifery.
For those of us looking for a more natural birth plan, the only other site out there was Mothering.com, which unfortunately skews to the opposite end of extreme. I have a friend who stalks the expecting forums because she wants to be there to counter the voices advocating for unassisted home births or telling moms with concerning symptoms not to go in to the hospital. One can find support for Bradley method birthing, doula care, etc, there, but the site is also dominated by anti vaxers, which results in many moms following that path.
I think a pregnancy/motherhood community dedicated to treading the middle ground between those extreme positions would be a very important addition to the online resources and community surrounding this issue. I ended up being invited to a private board of 20 which broke off from mothering after a moderator disciplined our thread for agreeing that tylenol is a good idea when baby has a fever. My private group of middle of the road moms has been an invaluable resource to me in the years since, as we have the basis to discuss and work through complicated issues like this one.
I started out having read Sears and committed to fully vaccinating on a delayed schedule. My pediatrician was skeptical, but gave me the benefit of the doubt and I earned her respect by taking advantage of the walk-in shot clinic and dutifully getting each shot one month apart for the first couple years. In the meantime, an old friend began posting thoughtful counterpoint articles on Facebook and I began reading them. By the time my daughter was born in 2010 I had gone back to using the AAP schedule for my son, and actually had to ask for the DTaP early for my daughter because there was a pertussis outbreak in CA, and she’s been on the AAP schedule since birth. I just went and obtained for her her second MMR a year earlier than her pediatrician had it scheduled for because of the measles outbreak that’s getting closer to my my county every day.
When he was five, my son was diagnosed with autism. I continue to read the medical literature and agree that there is no connection between vaccines and autism. I am hurt by the arguments of the misinformed ableists whose arguments put death by preventable illness as preferable to autism.
All this is a long winded way of saying I believe that what you can say or do in the context of your appointments with your patients that will potentially sway those patients to rethink their position is different for each patient. I wish every health plan had a walk-in shot clinic that pediatricians could offer up as a middle ground for those who are concerned but would be willing to get all the shots if they could do them slowly – I know most patients are not going to come into the office except for scheduled well baby visits, so if the shots aren’t given then, the likelihood that they will be drops drastically.
But I think the one most important thing that could have headed off my initial trip down that wrong path was a pregnancy forum that sees the benefits of both natural birth and vaccinations, one that takes more of a middle path, since I think most people out there aren’t naturally inclined to extremes, but are vulnerable to heading toward there when surrounded by those who hold those views.
Thank you so much for sharing your experiences. The friends I have who are anti-vaccination are so deeply entrenched in their viewpoint that I despair of them ever changing their minds. I love to hear this story of someone who thoughtfully investigated both sides of the argument and came done on the pro-vaccine side.
Kim G says
Thank you so much for posting this reply. I feel like I could have written this article because I share some of the same thoughts you’ve expressed. I too have a son with autism and have felt the hurt you mentioned. I was on the fence about some vaccines for a while (and used the one or two vaccines a month schedule at first), but have since come across enough evidence for vaccines’ safety and necessity that I am staunchly pro-vaccine.
I am forever finding myself as an in-betweener and sometimes feel excluded. I homeschool, but not for religious reasons. I had homebirths, but found a well-trained non-homeopathic CNM and was glad to get my shots and tests during pregnancy. I engage in a form of attachment parenting (and still feel the child-rearing books by the elder Dr. Sears have good recommendations), but am not into essential oils or reiki or most of the other “crunchy” things many attachment parenting folks are into. It is so hard to find other parents who embrace the same parenting/birthing methods I do, but don’t hold to pseudo-scientific beliefs like being anti-vax. I would love to find a forum for in-betweeners.
Wendy Sue Swanson, MD, MBE says
Thanks for your comment. I think if you strip away the labels, what you’re asking for is a group of people to communicate, learn from, and find fellowship in various choices while raising children without judgment and with science in arm’s reach. Hope you find it in real life and online! tell us if/when you do and what strategies you use.
I love some of the Dr Sears attachment advice too. I believe in vaccines. I want the care I get to be expert but personal. We’re all likely more alike than we give ourselves credit for!
Carolyn Kramer says
I am a public health trained professional with 2 small children and am surrounded by a range of family and friends with differing opinions about vaccination.
I have read and listened to the vaccination debate for the past 10 years. A great one was from This American Life- an episode that interviewed a family whose child got measles and the mom said that even she, having lived through it, was unable to convince anti-vaccination friends to change their minds (https://www.thisamericanlife.org/radio-archives/episode/370/ruining-it-for-the-rest-of-us).
What I have decided is that our best chance to turn this tide is through regulation. It is time for Public Health to enact regulations during outbreaks that limit unimmunized children’s access to public places “to limit the spread of measles and protect the health of vulnerable children” – like the schools in Orange County who are not letting unimmunized children in school until the outbreak is past. This is something that would apply to schools, public pools, libraries, government buildings, etc. I would be great if the private sector did the same (Disneyland). I wish that daycares would do this as well.
Being nice is just not working. Education is not working. Jenny McCarthy is more persuasive than our own doctors (sadly). Too many people will believe anything they read on the internet, no matter how false it is. It is time for Public Health to do what they are supposed to be doing- protect the health of the public.
I agree with you, Carolyn. I know people scream about their rights and their choices when things like this suggestion come up, but the fact is that their choices also impact others. As the saying goes, you can choose your actions (in this case, the choice to not vaccinate) but you cannot choose the consequences of your actions (losing your access to some spaces).
If you have vaccinated your own children and hence they are protected, why should you worry about other people’s unvaccinated children?
Wendy Sue Swanson, MD, MBE says
Mary, You’ve got to be kidding me, asking a pediatrician and child advocate this.
The reason for me is clear: I adore and cherish my own children but also work desperately hard to care for other children, as well. Suffering anywhere is suffering. Further, those unvaccinated children could spread infection to unprotected and/or vulnerable people. I care about reducing the likelihood.
Fact: some people cannot develop an immunity even with the vaccine.
Fact: it is dangerous to those who don’t have an immunity (and worse with other factors taken in to consideration).
Point: If the above two are true (and they are), then those with incredibly irresponsible, ignorant and frankly arrogant (enough to risk others!) parents (and that is about as nice as I can muster …) should be sterilised. Yes, really. If they’re so selfish to risk their own kids they don’t deserve to be allowed parenthood. It is worse with others at risk. You know, sort of like drunk driving, it hurts others and often kills others; others that were simply in the wrong place at the wrong time. Call it cruel, outrageous or whatever you wish. Doesn’t make it any less valid.
Fact: the Internet does not equate to research. Neither does “googling” (as some call it).
Fact: Those that think the Internet equates to research are incredibly ignorant (including indeed to the Internet itself and more correctly what some think the Internet is but it is only a component of the Internet – the web. Just as an aside). Ironically they’re just like people who think they know best about vaccinations but yet refuse to believe they’re not infallible.
Hans Flaatrud says
Vaccines work by way of herd immunization. Even if you are sufficiently blithe about the danger that those parents are posing to their children – and I certainly understand that it’s not your responsibility – the fact is, the word ‘immunization’ is misleading. The outbreaks that are happening around the country due to anti-vax malarky aren’t just striking droves of unvaccinated people; those people are more susceptible, but vaccinated people are able to get infected by way of contact with people who are carrying the disease.
When everyone in a group is immunized, the diseases don’t have an initial point of contact to make easy landing on; but once the disease is inside the herd, humans’ own gregarious nature make infection of others more probable.
What if one of your children is too young to receive the vaccine? What if a child has a cancer diagnosis and is immunosuppressed due to anti-cancer medications? Fortunately there are lots of infants and unfortunately there are lots of pediatric cancer diagnoses. These are the children who need the herd to protect them. These are the children I worry about.
Thank you for speaking out! I recently got revaccinated after a titer revealed no immunity to the measles — I’m not sure if the vaccine I received in the 60s was ineffective or if immunity decreases with the passage of time. i wonder how many baby boomers might think they are immune but are not?
Wendy Sue Swanson, MD, MBE says
I can’t say enough that it makes sense for adults who wonder to go in and discuss with their doctor!
I’ll tell you who has failed us–businesses. I do vaccinate my children, but having witnessed the insane amount of money being made in pharmaceuticals, I question their desire to create the safest vaccine possible. If there’s a healthier way to vaccinate, but it lowers their profit margin, will they choose it? No. My son died from brain cancer. Am I saying vaccines did it? No, I hope not. But, I certainly question everything being put into my children’s bodies now because the truth is we DON’T know long term side effects for many of these vaccines. Having spent years with doctors, the “God aura” has evaporated and now I see they are people just like me, but have read a few more articles (maybe). I respect both sides opinions, but am sick of the either/or argument.
Wendy Sue Swanson, MD, MBE says
Hi Amy, I’m so sorry to hear about your loss and am thankful you took the time to comment here.
Kim Lee says
Amy, do you really believe pharmaceutical companies make profit from vaccines – and do so at the expense of making a less profitable, better working vaccine? They spend billions of dollars to create vaccines and other meds – they are only allowed to hold the patent for a few years, and while it is true that they make profit on a lot of their drugs, the profit margin for vaccines is tiny. People love to hate pharmaceutical companies, but w/o them we’d have no insulin for diabetics, no Tylenol for headaches, no antibiotics for infections.
Ann Fowler says
What really bothered me was when a doctor, in a national TV network interview, said that we do not need to be concerned at all with the outbreak, since measles is such a benign illness that will not result in any health concern. I don’t know how anyone can say something so ridiculous when facts have shown otherwise. What’s even more frustrating is when the network did not present any opposing view. The everyday person watching this would be so misinformed.
During their childhood my parents’ generation all knew families that lost babies and children to various diseases. Having experienced that, they didn’t hesitate to have their own children immunized when vaccines became available.
The biggest deal I remember was whether or not you got the “shot” in your arm or leg to prevent the scar from showing when you were grown and wearing a sleeveless dress.
I suspect when enough of today’s parents start seeing babies die from preventable illness, they will embrace vaccinations. Heaven forbid we need to re-open the sanitariums for long term care of polio patients in iron lungs.
Brittney Mills says
Hi Dr. Swanson, You were our beloved pediatrician for about four years, for our first son and a short period for our second, and I just want to tell you that it was at your very helpful, informed advice that I elected to vaccinate my children. I am so glad I did – I was initially on the fence a bit about them. I did feel you were passionate about the cause for vaccination. So thank you, for caring. I too feel this is a very important issue.
Sathya Rau says
With the measles epidemic there is a lot of derision poured on vaccine hesitant parents and even on pediatricians who accept parents who do not immunize. I am a pediatrician with a flexible open-minded vaccine policy. I accept the patients who don’t immunize and have, in fact began to attract them from a considerable distance. I have been under considerable pressure to turn away those patients who don’t adhere to the AAP-ACIP-CDC guidelines. I understand the risks and hence the urge to deny care to vaccine non- compliant patients, from the practical business point of view, the medico-legal consideration and epidemiological concerns.
Isn’t that not the surest way to make the problem worse?
Closing the door on the un-immunized and the under immunized to me feels a lot like giving up, quitting when the going gets tough. In my practice I don’t take the no on face value, I keep a constant pressure on them to vaccinate. On every visit I offer them the vaccine, they politely refuse, and I launch into a whole set of ‘rants’ I on the ready, to counter their arguments and ally their fears. Some of them leave, most of them eventually will accept vaccines, perhaps with some caveat– Only two shots per visit or, no live virus vaccines or, no mercury/aluminum containing vaccines. I graciously accept and shower them with praise like you would a toddler in toilet training. Until the next visit and the nagging/negotiations begin again.
We try to win parents over by giving them scientific facts, which is never going to work. It is a very basic protective instinct that parents have where they feel they are protecting their child from harm and pain. We are up against maternal protective instincts and overcoming that. Their fears however unfounded they seem to us, are very real to them and we have to acknowledge it. I pick the ‘rant’ most likely to work in the circumstance. here is a small sample of my rants:
“This very germ in his ear, can cause meningitis if it went half an inch farther.”“The miracle of immunization is not the vaccine, it is you baby’s amazing immune system”. “The vaccines are merely mug shots we are showing the immune system so that it can recognize the bad guys” “We can wait till he learns to talk and you are convinced he is not autistic, then give we him the MMR.” ‘If you use a car seat, a football helmet, training wheels why not vaccines’
One of the greater didactic pleasures I have enjoyed the most over the years has been convincing anti-vaccinator parents, surrender to reason, and actually sign the consent form and have their child immunized. It is a lot like winning an argument with your wife, just the quiet inner triumph.
That’s a very hard line to draw. As a parent who is very concerned about vaccination status, I really like the idea of going to a doctor’s office where I can feel sure everyone is vaccinated. And at the same time, I know that the parents who aren’t vaccinating aren’t doing it maliciously. Even more, I know that the children aren’t at all responsible and they can’t be denied medical care. I don’t know what the “right” solution might be for this situation, but I am glad to hear that you have a great technique and have been able to have some success in persuading parents to vaccinate!
rachel hall says
“mug shot”? Live virus is not a “mug shot” its the real deal. Yes my kid is vaccinated. She ran 103 fever for more than a day every time. More education on care of a child and what to expect after each vaccination would go a long way for making this easier for everyone. Acknowledging that even if a reaction is within “normal” range it can still be scary or damaging if not handled properly would also be nice. The “you’re hurting your kid by not doing this” rant. Infantalizing your patients is abusive and ultimately does no one any good.It makes me want to curse. Doctors and scientists are not gods. The also are not demons. Acknowledge the risks AND benefits and PLEASE – come up with a way to find out if someone is sensitive to a vaccine before you pump a full dose in their body.
Ben Anderson says
I have questions about vaccinating at say cvs or walgreens and the break down the door to get a shot mentality. I have been instructed that introducing new things to an infant/ Ped is not good if the child has had a cold recently. Do you share this concept? Second question is at what point do we stop vaccinating? I have seen ads for several different vaccines from pneumonia to chicken pox. I am a simple man that thinks in simple terms and it just seems that we are messing with a grand design. The human body is the best science on the earth and we are doing things to handicap it. Why don’t you give just a measles vaccine? I don’t have a fear of government or or support the Jenny McCarthy project. I do have a respect for the human body and it’s ability develop a stronger immune system then we could ever build in a lab. In turn, it is necessary to support it with a healthy diet, proper sleep patterns and good hygiene. I am intrigued by this and need to investigate your side more to come to a fully informed disision. Thank you for your time.
Beta Lisa says
I’ve been waiting for the doctor’s response, but in the meantime, having “respect for the human body and it’s ability develop a stronger immune system” is what vaccinations are all about. The shot is not a lab-created immune system, it’s a non-active “sample” of the disease virus. It sparks your immune system to say “hey, an invader!” and create specialized T-cells to mount a defense. That defense is “remembered” by T-cells that remain. If you are exposed to the actual measles, say, those special T-cells will recognize the virus, multiply, and immediately fight it. If you haven’t had the vaccine and encounter the actual virus, your body will likely succumb to the disease before your immune system is able to mount the full attack. For some people, particularly children and the elderly, the immune system will not be strong enough, quickly enough, to prevent serious complications or death.
alexia roney says
Thank you Doctor.
concerned citizen says
Just from my own personal experience, it seems to me that people who are against vaccination, far to often, take the work of those in the various medias we consume as sacrosanct. They don’t realize that these people are only trying to (in no particular order):
a) increase internet page views and clicks. If they lie or sensationalize certain facts is of no consequence. If they get enough of views and clicks, the page becomes a revenue stream.
b) trying to increase ratings. they will say anything for a ratings jump. This includes lying and making mountains out of molehills
c) increase circulation. Anything to get you to buy that rag at the supermarket.
The other thing, it seems to me, is that anything a media personality says is taken as the ultimate authority. Most of these people have not even finished highschool, and yet they are taken as some sort of professor on the topic of vaccinations. I’ve also heard “why would they lie?” repeated and no amount of simple minded explanations would move them to believe they were taken in by the modern day equivalent of a snake oil salesman.
My father, until he retired from pediatric practice several years ago, refused to treat patients whose parents refused vaccines. Those families were simply not welcome in his practice. He considered the success of the anti-vaccine movement the great failure of public health advocacy in the 2000’s.
He pointed out to me recently that when people of inadequate (specific) education presume to know more about the science, medicine, and downstream effects of vaccination than people to whom they otherwise wish to entrust the care of their children, the relationship will never be fruitful. He believed (and I agree) that there’s a significant difference between dialogue and dismissal; anyone so corrupted by conspiracy theory that they simply discard 100’s of years of empirical evidence in favor of assumptions that 1) the diseases that vaccines prevent aren’t dangerous and 2) that vaccines exist not to preserve public health but to preserve pharma profits and some esoteric symbiotic relationship between government and the pharma industry at the expense of public welfare, simply can’t be relied upon as a partner in their children’s health.
Importantly, he drew a distinction between benign therapies (some holistic medicine) that were considered in tandem with treatment of chronically ill patients he understood the placebo effect for the parents and the child. Those who were willing to subject their children to unnecessary suffering and masked that willingness as concern though, they were worthy of DHS intervention.
Keith D, MD says
Very nice article (and kudos for being mentioned in a Slate.com article). I got curious and pulled up the form that parents have to sign in order to get a non-medical vaccine exemption in the state of Washington. (https://www.doh.wa.gov/Portals/1/Documents/Pubs/348-106_CertificateofExemption.pdf)
I think the wording doesn’t adequately convey the tradeoff the parent is making. How about this?
I acknowledge that by forgoing vaccinations advised by my child’s doctor I am:
[_] intentionally placing my child and members of my child’s family at an increased risk of serious, but preventable illness, injury and death.
[_] intentionally placing other children and adults at risk of preventable illness, injury and death
[_] that I may be personally responsible for an epidemic of disease that leads to the suffering, injury or death of many children and adults
[_] that, if my child decides to decline vaccination in the future, her or his children will be at significantly higher risk of birth defects, and of serious illness, permanent injury and death.
If the government is going to support this as an issue of freedom and liberty, then at least we should ask for an acknowledgement of responsibility in return.
Prior to this measles outbreak, I was under the impression that the anti-vaccination movement was relatively small. It is sad that in 2015 there are so many parents who think it’s a bad idea to vaccinate their kids.
celeste bianco says
I grew up before MMR or chickenpox vaccines were available. I had chickenpox, 3-day measles, and German measles. They were miserable experiences. I still remember staying in a dark room for days to protect my eyes and wearing a blindfold to get to the bathroom. I hurt. I itched. I remember how worried my folks were. I remember house calls because I was too sick to go to the doctor’s office and the doctor not being able to help me with anything other than calamine for the itch (which didn’t help at all) and tincture of time.
I didn’t have any complications – no meningitis or severe scarring, and they didn’t kill me or put me in the hospital. But even so, who in the world would wish that on their kid? Especially when the risks of complications from the disease are so much greater than those of the vaccines?
No thanks. If the vaccines had been available, I would hope that my folks would have given me that protection.
Before we had our first, we met with our future pediatrician and I asked him about the concerns surrounding vaccinations. He told me that if I didnt trust him with his knowledge on vaccinations, He couldn’t trust that I’d be able to trust him in any future diagnosis and corse of treatment and because of that I should go with a different pediatrician. I stayed with him.
Wendy Sue Swanson, MD, MBE says
Hi SM, thanks for sharing your story. This is certainly a strategy that many pediatricians (and potentially more now than ever) have employed to feel they are doing their best work to protect children and support families.
Jennifer Shay says
I understand your perspective and certainly agree about the importance of vaccines. However, it is important to see this from a parent’s perspective. Although the doctor who published an article about autism and vaccines lost his medical license and has his work retracted, it is now a fear that has been planted. Most medical professionals fail to recognize, address, and show compassion for this. If a child is harmed by a vaccine (which does happen as medicine is not completely without side effects,) the doctor will not have to live every day with the aftermath. It is impossible to have an open, reasonable discussion with a health professional to discuss these concerns because parents are often treated as idiots for daring to question the system. It happened to me because I dared to question why the amount of vaccines have increased exponentially since the 70’s when I was vaccinated and why there is such a prevalence of food allergies, autism (because you can’t deny that the number of austic children have increased,) and other health issues. While these may or may not be tied to vaccines, doctors are doing a great disservice to parents when they belittle these concerns. My concerns about the necessity of hep b vaccinations for infants and the necessity for the chicken pox vaccine for anyone has never been adequately addressed. I know the anti vaccination camp well, and they are disillusioned with the medical profession because much of the other advice received by doctors in the child care realm are merely throwbacks horrible advice from the 1950’s. Most doctors give terrible advice from lack of knowledge about breastfeeding, most are woefully uninformed about infant sleep, most take the abstinence-only stance on co-sleeping (because it obviously works so well with sex,) and most still recommend rice cereal, which is basically void of all nutrition with the exception of iron which has to be added. The anti vaccination demographic leans towards breastfeeding, cosleeping, holding off on solids, etc., and are often treated like bad parents for questioning rather questionable advice. If medical professionals wonder why these parents have a hard time trusting the party line on vaccines, they need to have a good, hard look at their bedside manner and the advice they eagerly dole out. Medical professionals need to stop acting like they have ALL the right answers when it comes to child care and be willing to engage in an open, non-judgementsl dialogue about a parents fears and hopes for the ongoing health of their children. Anti vaccinators often have legitimate reasons for the choices they make, and treating them like idiots or acting holier than thou isn’t going to change their position. It will only strengthen it.