Imagine a world where one out of three people who get struck by a disease will die from it and a good number of people who do manage to survive will end up with debilities caused by that disease. Does it sound like something right out of a disaster movie? Before vaccines were invented, smallpox killed nearly 300 million people worldwide in the 20th century. Diseases like measles, diphtheria, rubella and polio killed thousands of people each year. Infants and children died from diseases that are now easily preventable because we have vaccines.
Why are there anti-vaxxers?
The invention of vaccines is considered to be one of the greatest achievements in medical history, and we are fortunate to live in an age where diseases that once spelled a death sentence could be avoided. However, ever since its discovery by Edward Jenner, there have been people who are against it. Some of the reasons given include culture, religion, politics or distrust toward the medical field. For example, some people from the well-educated and upper social classes may choose not to vaccinate their children because they trust the advice from their social networks more than the medical community in general. They may have also been given reading materials that are used in disseminating misinformation about vaccines.
Some people may also cite religion as their reason for not wanting to vaccinate. However, most of the major religions do not explicitly prohibit vaccinations and most of them now recognize its importance. For the majority of those who cite religion as their reason not to vaccinate, it has been found that most of them are simply concerned about the safety of vaccines. Most of the opposition to vaccination that are really attributed to religious beliefs only involve small groups within a community.
Some assertions against mandatory vaccinations in the United States relates to the issue of individual liberty versus public health needs. An example of this is the case of Henning Jacobson, who refused to take the smallpox vaccine as mandated, saying that it violates his right to personal liberty (Fourth Amendment). However, the Supreme Court ruled against him, reasoning that the state had the right to impose the mandatory vaccinations because the health and safety of the citizenry must be protected by the state, especially in cases of a communicable disease.
It is important to remember that vaccines are not just for individual protection. Smallpox was eradicated though mass vaccinations. This prevents the transmission of disease from one person to another, and thus from one community to another. Through herd immunity, people who cannot be vaccinated because of certain conditions can be protected by those who are vaccinated, acting as barriers for disease transmission. These people are ones who are usually the most vulnerable, like those who have compromised immune systems. These include patients who are under immunosuppressive therapy, or those who have cancer and are undergoing chemotherapy. They don’t have the option of being vaccinated, so they have to rely on people who can. In this case, vaccination now becomes a matter of social responsibility for each person so as not to transmit a preventable disease to others by being in contact with them.
The refusal of parents to vaccinate their children puts not only their children at risk, but also other people around them. Most of the time, the reasons why people are skeptical of the safety and efficacy of vaccines is due to fear, lack of correct information and misinformation. One such example of misinformation in the public was caused by a published journal article by a doctor named Andrew Wakefield which contained falsified data that the MMR vaccine caused autism. Despite the retraction of the paper by the journal, public fear lingered and some people might still think that vaccines are harmful.
How to professionally deal with Anti-Vaxxers?
When a physician encounters a situation wherein a patient is hesitant to be vaccinated or a parent is afraid of vaccinating his or her child, it can be a difficult and frustrating situation. However, a physician can influence the decision of a patient to get vaccinated or a parent to vaccinate his or her child. The American Academy of Pediatrics has made a guideline on how to communicate with patients and parents regarding the real benefits and risks of vaccines.
The first step to dealing with the situation is to know why the patient or parent is against vaccinations. Is it because of safety concerns? Or is it mostly a due to certain beliefs? It is important to be able to listen and to acknowledge their concerns without judgement so that we can address them properly. This also makes the patient or parent more receptive to the views and advice of the physician.
- EDUCATE WITH EMPATHY
The next step is to create a decision-making partnership with the parent or patient and provide him or her with relevant and correct information regarding vaccinations. Many of them are likely to have misconceptions that need to be eliminated through clarifications. We need to make sure that they understand the information that we provide them by personalizing it based on the type of concern, cultural beliefs and level of literacy. We also need to be honest in discussions regarding the real benefits and risks of vaccination and to openly discuss information regarding what is currently known or unknown. We can provide reliable sources of information regarding vaccines such as Vaccine Information Statements, reliable online resources and other educational resources.
Lastly, we can enlighten the parent or patient regarding the number of lives saved and the benefits of vaccination on individuals and communities through herd immunity, and explain why some institutions require vaccinations prior to admission. It is, however, important to maintain a positive approach instead of simply statin g the deaths that occurred as a result of not vaccinating.
Because doctors are the face of the medical profession, the faith that people have in this profession depends on the actions on each physician. Since fear and misinformation are at the root of the anti-vaccination movement, the way a physician handles a situation can have a big impact on the decision of the patient or parent to vaccinate. Physicians have the ability to change people’s perspectives on vaccines by making sure the right information regarding vaccinations is disseminated and that misconceptions are eliminated through open and respectful dialogue.