14 Dec 2017

Advice on how to talk to anti-vaxxers from a former anti-vaxxer

11:29 am on 14 December 2017

Calling them stupid and selfish won’t change their minds.



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Photo: Illustration: Rachel Neser

Anti-vaxxers have been around for a long time. The movement can be traced right back to the invention of the first vaccine more than a century ago when Edward Jenner figured out a way to protect people from the deadly smallpox disease.

In 1796 Jenner discovered that by injecting people with the cowpox virus, their bodies could build immunity to smallpox. The technique was highly effective and the government decided it should be compulsory for all children. But this led to strong opposition from some with religious, political, and safety fears.

In 1855, about 100,000 anti-vaccinators marched in the town of Leicester and subsequently, a law was passed allowing parents to object to vaccination without penalty.

The Cow Pock — or — the Wonderful Effects of the New Inoculation. J. Gillray, 1802.

The Cow Pock — or — the Wonderful Effects of the New Inoculation. J. Gillray, 1802. Photo: National Library of Medicine

The disease – which is estimated to have killed at least 300 million people during the 20th century – was eventually eradicated thanks to the smallpox vaccine but the anti-vax movement arguably slowed down the process.

Vaccines are counted as one of the greatest public health achievements in human history, yet unsubstantiated claims about the danger of vaccines still circulate. The groups who oppose vaccinations are the minority, yet some say their decisions help vaccine-preventable diseases to spread - and this affects everyone.

Parents who receive warnings about vaccinations are twice as likely to delay having a child immunised, New Zealand research has found, and vaccine refusal has been shown to have an association with the spread of vaccine-preventable diseases in the United States.

In New Zealand, the immunisation rate for measles still hovers below the 95 percent mark needed for herd immunity and parents choosing not to vaccinate is one of the reasons for measles outbreaks in the country.

But not everyone who doesn’t vaccinate is a staunch anti-vaxxer; there is a continuum of hesitancy about vaccines and nearly all parents are just trying to do what’s best for their children.

Michelle Nicholls is a district nurse who used to oppose vaccinations. She says the first step to talking to anti-vaxxers is trying to understand where they’re coming from, and approaching the topic with love and empathy.

Nicholls grew up in small-town New Zealand where her mum worked as a midwife. She received all of her childhood vaccinations but recalls that when her younger siblings were born, her mum had begun to question whether vaccines were actually safe.

“She’d come across some articles that suggested that vaccinations were politically-motivated and heard through friends that she respected that there were some risks,” says Nicholls.

Thinking she was doing the right thing, her mum would give anti-vaccination pamphlets to parents she was looking after.

As Nicholls grew up, she took on her mum’s immunisation skepticism and developed some of her own. She was left-leaning, environmentally conscious and passionate about sustainability and being anti-vax just felt part and parcel.

“It was partly an image thing. I figured it just fit into the package of beliefs. To be honest, I feel a little bit embarrassed about having been anti-vax,” she says,

Before Nicholls’ son was born, she started a degree in nursing at Massey University and started to learn more about how research works.

“When you do anything medical, you do the basics of learning how to interpret research papers, learning what a qualitative versus quantitative study is, learning what makes something statistically significant, learning to look at the sample size - all of that kind of stuff,” she says.  

“I feel so passionately about it now because there is, literally, zero science to the anti-vaccination movement.”

“It’s really easy to get sucked into emotive YouTube talks by someone whose daughter has been disabled but look at the science because if you want to find the truth, you need to find it through a valid course.”

There's a misconception that anti-vaxxers just haven’t done any research. Health journalist Tara Haelle points out that they’re actually well-educated and informed – it’s just that it’s with the wrong information.

After finishing her nursing degree, Nicholls trained to become a flu vaccine administor and learned even more about the efficacy and safety of vaccines. But she still understands some of the anxiety some parents feel.

“I remember taking my son in for his first vaccinations and even though I knew all of the science, I was still so nervous because it’s your precious little baby.”

As with all medicine, there is the risk of anaphylaxis for anyone who gets a vaccine. But it’s well-managed and extremely rare.

“Severe allergic reactions are scary. It happens to about 1 in every million people who get a vaccine but vaccine administration is so tightly controlled now that whenever we give a one, we have the adrenaline right there.”

Nicholls is still good friends with people who oppose vaccination. She tries not to bring up the topic since she knows it can get heated, but after her best friend posted a link to an anti-vax article, she had to speak up.

“I got into one Facebook argument about it, just because this article was suggesting that a doctor was forcing vaccines on people. No. We can’t force vaccines on anyone. We have something called informed consent so that insulted me as health professional for one and everything in the article was so inflammatory. I just kinda got stuck in and nothing, nothing good came of it,” she said.

“After that, me and my friend decided not to talk about it. That is a shame but I get really worked up. It’s just one of those things that seem to escalate so quickly.”

“You’d think having been anti-vax would help my case seeing as I used to agree with everything they’re saying, but it doesn’t help that much.”

Simply giving parents facts about vaccines doesn’t necessarily work. Research has found that for different people, different morals resonate more effectively and parents who are concerned about vaccines highly value liberty and purity.

Conversations with anti-vaxxers could be more effective by taking a page from their book and focusing on points that better align with their morals, like reminding parents that vaccines work with a natural system in our bodies.

“The spread of misinformation is going to be a danger long term”, Nicholls’ says. We are at risk of the herd immunity dropping if more people choose not to immunise their children. We’re going to see a resurgence of a lot of these diseases,” says Nicholls.

She wants to be able to talk to her friend again about vaccinations but knows she’ll have to tackle it differently. For one, she says she won't be having the discussion online.

“I learned don’t have this conversation on Facebook; have it face-to-face when you can see the person you love and respect.”

She notes that shaming anti-vaxxers, calling them stupid and selfish, won’t change their minds and is almost always untrue.

“I think coming from a place of love is important and understanding that we all want what is best for our kids,” she says.