Dr. T. has been a pediatrician in Tennessee for 28 years. In the last decade, he says, he’s seen an increasing number of anti-vaxxers come into his hospital. He blames the amount of misinformation online.
“It has been an emerging and growing trend over my practice’s lifetime,” he says, “concurrent with the more general anti-science, anti-intellectual swing of the pendulum.”
Using a pseudonym for fear of online harassment, Dr. T. explains, “Anti-vaxxers aren’t monolithic. They range from the folks who hadn’t considered it much and easily retreat with reassurance and explanations, to the hard-core deniers.”
In his experience, he’s found most anti-vaccine people are “entrenched in the upper-middle class, eloquent and educated. Perhaps it’s a sort of entitlement: ‘I’m educated, so my opinion is of greater value than the average.’”
Having dealt with a number of anti-vaxxer parents, Dr. T. tries to understand where they’re coming from. “My experience and reason don’t matter for many [of them], and regurgitating the plethora of studies in favor of vaccines only solidifies their stance.”
What’s the root of the issue? “At the core, I believe there is fear,” he says. “Fear that by somehow allowing the pediatrician to inject fewer antigens into their child than one is likely to get from a knee-in-the-gravel abrasion, they have abdicated their duty to protect and defend. That somehow they will have failed their child.”
After hearing similar stories from doctors in my Central Illinois hometown, I realized the anti-vaccination movement is much more prevalent than I had imagined. So I reached out to a few doctors to hear what happens when anti-vaxxers spill out of fringe Facebook groups and into real life.
“I watched a teenager come in to our ER with chicken pox and die days later.”
Dr. T. (a pseudonym), pediatrician, Tennessee: My 28 years of being a pediatrician have been spent in one place, a town just outside of Chattanooga. I had one family years ago who all got pertussis, which is the whooping cough. They were miserable, but still had no regrets, believing that their choice was the best one for their family at the time. I don’t argue with beliefs, and they remained my patients until they aged out.
In my experience, the true conspiracy theorists are super-rare. I’m seeing them a lot less frequently anyway, but that’s most likely because the word is out that our practice no longer agrees to “altered schedule” folks.
The stories of changed minds do exist, but in my experience, they are few and far between. We decided that if we’re going to protect our patients, then we’re sticking to the science, and we have to stick to the schedule. So our practice currently asks families who choose not to vaccinate to please find a pediatrician who they can trust completely. If they choose not to vaccinate, that’s not on us.
The most sobering case was a neonate, too young to be vaccinated, who was exposed to a community of non-vaccinated children. He was diagnosed here, east of the Mississippi, and spent three weeks in three different pediatric ICUs in the area before he was stable enough to go home.
[As for] the conventional wisdom that says “chicken pox is no big deal”: In residency I watched a teenager come in to our ER with chicken pox and die days later with overwhelming sepsis.
I even had a nurse at the hospital where we work who went so far as to create a close facsimile of our refusal/consent form. It looked very much like ours, and she signed it and turned it into us, but we caught it.
All refusers bring personal experience and knowledge, and expect me to be moved by their anecdotes. I in turn share with them my personal experience and knowledge, recalling having to pull pus from spinal taps done on extremely irritable babies with super-high fevers — a normal spinal fluid should instead flow clear. The culture would usually grow Haemophilus type B.
Over time, I’ve distilled my response to those who wish to argue [down to this]: “In the end, your position holds that the experts at the ACIP, the AAP all willingly place children in harm’s way. I’m sorry you feel that way.”
We currently have a vaccine that prevents a form of cancer. Years from now, I fear that there will be regret for having denied the protection provided by HPV. That their worst fears at failing will be realized.
I won’t really know, because they won’t be my patients any more.
“Whatever I say ‘is funded by pharmaceutical companies,’ so therefore the information I have can’t be ‘honest.’”
Dr. Lift, Family Practitioner, the Southeast: I work in an outpatient setting in the Southeast. It isn’t a rural area, it’s more of a small city/suburban area. The population around me is mostly older white folks, and I definitely see the anti-vaxx movement more prevalent in caucasian households, but it doesn’t seem to be prevalent in a certain economic status, as most people may think. I see it in the poorer population as well as in the more affluent population. Believe it or not, I am starting to see it more in the educated and well-to-do population who come in quoting things that they read “online.” Since they have a college education or higher, they think that they’re right.
Still, I would say it’s a very small percent of the population of patients that I see. I have noticed it slowly increasing as of late, but that’s just because of the misinformation that’s available online now, and also how accessible information is on the internet for everyone to access. More commonly, I have parents who come in and ask me questions about vaccinations for their child, and what I think they should do.
When I discuss the pros and cons of vaccinations and answer their questions, 98 percent of them are … all for it. The other 2 percent are those who come in spewing out misinformation and not even wanting to discuss facts. They have this theory that whatever I say “is funded by pharmaceutical companies” so therefore the information I have can’t be “honest” and “truthful.”
Unfortunately, a lot of these people are the same ones that treat cancer with essential oils and the like. Not all, but there is a strong overlap. They take natural remedies as substitutes for medicine instead of things that can complement modern medicine. But that’s a whole different topic and conversation to be had.
I had a mother bring her child to see me as a new patient. When I saw that he wasn’t vaccinated, I asked my nurse why not, and she told me that the mother had a “religious exemption.” When I entered the room, I asked the mom what the religious exemption was. She said, “Well, when he was a baby, he had a rash from the hepatitis B vaccine.”
To clarify, she wasn’t bringing her child in for any emergent or even sick issue. She needed a school physical/sports physical done. … I tried to have a conversation with her to dispel her misconceptions of vaccines, but she was not even open about talking about since she was a self-appointed “expert.” I think that’s my biggest gripe with most anti-vaxxers.
So I kindly told her that I couldn’t care for her child because he was not only a risk to my staff, myself but also to other patients in my office. She went off on me and ranted about “how she can not believe that every doctor’s office that she calls refuses to treat her son because he isn’t vaccinated.” And that “the only doctor in the county that will see him can’t see him for almost two months.”
I stopped her and said, “If I was one of a few that refused to treat your child, I would understand your frustration. But don’t you think there’s a message that not a single doctor in the entire county — save for one doctor who did some really questionable practices — will treat your kid, that maybe there’s a valid reason behind it?”
Yeah, she definitely wasn’t happy, and left.
Everyone is entitled to their own opinion, but it really saddens me when they won’t even have an open dialogue. I take the time to listen to them and all of the “evidence” that they present, I just wish that they would give me the same courtesy, which the majority of them don’t.
And the ones that do generally don’t do so with an open mind, because “I read on this person’s blog that X, Y and Z.” This particular incident was so weird because the kid actually got an immunization shot at birth. He had a “fever” which is NOT an allergic reaction to the shot. It’s a very common effect and is reassuring because the body is posing an immunologic response to make antibodies against the disease, which is how you build up an immunity.
But this mother was using a basic side effect or reaction to the shot as grounds for “my son will never get another immunization again,” and therefore filed for “religious exemption.”
It’s a shame because these people are causing a much greater risk than reward in this situation, which can be highlighted by the outbreak of diseases such as measles and mumps — things that had essentially been eradicated since vaccinations were commonplace.
“The mom clutched her son to her, saying, ‘He’s my only son.’”
Dr. Erin, Family Practitioner: My worst experience with vaccinations was a woman who brought two of her children into clinic to get her daughter vaccinated. She was anxious because none of her children had ever gotten vaccines, as she didn’t believe vaccines were safe.
We asked what had changed her mind. Apparently her other child was in the ICU with fulminant meningitis from a vaccine-preventable illness, hanging on for dear life. The nurse in the ICU sat her down and told her point-blank that we rarely see this disease because most people are vaccinated for it. The mom couldn’t understand how her child had contracted it. We asked if she knew anyone who wasn’t vaccinated. Apparently none of her close friends or contacts vaccinated, and several had been sick recently; despite this fact, she couldn’t believe the source could be them. But that’s not what made it a difficult visit.
The difficulty was that she also brought her son to our clinic. We offered to vaccinate him as well while he was there, but she panicked and refused to vaccinate him, literally clutching him to her and saying, “He’s my only son.”
Apparently someone had shown her a video claiming that the measles mumps and rubella vaccine causes autism, but just in African-American boys. This video was based on a journal article in a small medical journal that has since been retracted. The way the data was analyzed in the article was not consistent with the kind of data used for the study. As an analogy, this paper took a square peg and jammed it into a round hole until the corners wore off, then proudly presented the newly worn-down round peg as though it were the original square one.
The woman did not believe that the article had been retracted or that the data didn’t pertain to her son. She also didn’t care that the video she had seen was made by Andrew Wakefield, the man who is infamous for faking a link between autism and vaccinations to try and sell a different brand of vaccines that he had developed. It became very clear that no amount of reasoning would change her mind when we pointed out that even in the flawed and retracted study, only African-American boys had higher levels of autism, and her son was white.
“He’s a grown-ass adult who thinks he’ll suddenly be autistic!”
Dr. Rick, ER Doctor: I’ve worked at multiple sites in Virginia for five years, two of which are rural, and one is midsize city. I actually find more anti-vaxxers in urban areas. Country people don’t think that hard about it and tend to go along with what doctors say… although they don’t go to doctors much.
As an ER doc, anti-vaxx conversations do not come up much. I give out one vaccine regularly, and that is tetanus, and never had one be refused. Every now and then we get kids whose family are anti-vaxxers, and when that happens it’s the hardliners, the conspiracy theorists. That being said I did have one guy come into the ER with a fever, and tested positive for having the flu. I told him as much, and that I’d write him a prescription for Tamiflu — an antiviral medication that fights the flu virus. But when I told him that, he goes, “Doesn’t that cause autism?”
Like, he couldn’t even remember that it was vaccines that reportedly cause autism, and he couldn’t remember that Tamiflu isn’t the flu vaccine, and of course he is wrong about vaccines causing autism… yet he is a grown-ass adult who thinks he will suddenly be autistic!
Beyond that guy, a much more depressing story was a child with persistent seizures and fever, and from a wealthy anti-vaxxer family. I don’t know what the end result was, but basically she went to a pediatric ICU for treatment of meningitis from N. Meningococcal, which is a very severe infection with high mortality. I remember thinking how wild it was that this well-off, upper-middle-class girl is dealing with an avoidable life-threatening infection that isn’t a risk to most first-world kids.