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I have a story about the doctor's office.
Three months ago, while our toddler was only two weeks old, my wife and I were looking for a dentist who could review her serious links with the lip and tongue, a Congenital tissue accumulation between the lip or tongue, respectively, and the mouth. who had prevented him from breastfeeding and would have affected his speech if he had not been corrected. We found one that had received complimentary recommendations from other vendors and who had graduated from a famous dental school. His desk had the same gloss lacquered and the same staff that you would expect from any other high-end medical office.
The procedure went well. The CO2 laser she used to free my son's lip and tongue seemed to have been teleported from the future. The procedure took a minute and then our baby was brought back into my wife's arms.
Everything seemed to be fine.
In the recovery room, while my wife was soothing and feeding our child, I saw a set of pamphlets. They did not come from companies offering supplements or provided by medical providers announcing additional procedures.
They came from Texans for Vaccine Choice, the main anti-vaccine organization in our state.
I was shaking with fear, then with rage. My wife has gathered our son. I have collected our belongings. While they were looking from the pavement outside, I went back into the office and picked up the brochure. I asked the employee at the front desk if the practice supported the group and asked if they were asking the parents for the vaccine records. They told me a monologue about the fact that vaccines were a matter of "parental choice" and that no "dentist" asked for a vaccination card. The office, she said, was "neutral" about the idea of vaccines.
I demanded to know why a practice that will eagerly carry out medical procedures on children too young to get vaccinated has allowed an anti-vaccine organization to do propaganda in its office. I asked them if they understood the immunity of the flock and it was just a wheezing delusional libertarian. I asked them if they had feverish patients that day. A week later, after contacting the office and asking to speak to the doctor herself, a staff member called me, a hygienist we met on our first visit. The conversation was also filled with half answers, although I was told that anti-vaccine pamphlets "were not political". Of course, the "neutral" position of the office meant that the presumed security of a medical office was up for grabs. In our experiments, unless you ask them directly to speak, it is rarely possible to know the position of a health professional on vaccines, even those who work with young children.
The science around vaccines is settled. They work. They are remarkably safe. The fact that they have been standardized and scaled for global use is a miracle of modernity. But the rise of the anti-vaccination movement has become a prism through which every type of American fear is refracted into madness. Anxious parents who really love essential oils and delay the purchase of "non-essential" vaccines for paranoid anti-elitists who believe in the New World Order and who know full well that the eradication of measles is an integral part of the great takeover Swiss pharmaceutical companies. it's a cause that attracts parents from all political and ideological perspectives.
Actress Jenny McCarthy, an anti-vaxxer of OL who believes there is a correlation between vaccinations and autism, now has a "charity" for autism called Generation Rescue, whose board members are getting richer spreading anti-vaccine paranoia and hawking snakes. substitutes for immunization against oil. Twitter's CEO, Jack Dorsey, has recently appeared on a podcast with Ben Greenfield, author, triathlete and self-proclaimed health expert, who repeats the refuted claim that vaccines are at risk. 39, origin of autism. A Texas state representative, Jonathan Strickland, has doubled his denial of anti-elite science and recently went on Twitter to call "witchcraft" vaccines.
The Dallas-Ft. The Worth area, where my wife and I live, has joined a very scary map of measles-affected areas across the country. I look at this card regularly. A cruise ship filled with Scientologists, including at least one measles survivor, was quarantined near St. Lucia. New York City and all of Germany will now sentence parents who allow unvaccinated children to go in public. While the national measles epidemic has reached a generational peak, vaccine deniers have marshaled an old episode of Brady's group evidence of the ineffectiveness of the measles vaccine. Another common thread emerged: thinking of vaccines that I once thought to be nuanced and reasonable now seems insufficient or even inextricable. I do not have any more names for this madness.
In 2015, the Vaccine Trust Working Group, a collection of physicians and public health professionals from the National Vaccine Advisory Committee of HHS, released a report titled "Vaccine Confidence Assessment". in the United States: recommendations of the National Advisory Committee on Vaccines. "While the VCWC reassures readers about the generally high rates of complete and timely vaccines for children, it reminds us that" national estimates can also mask geographic variations in coverage rates. "The report provides an alarming example:" in the state of Washington, the overall exemption rate in 2006 was 6.0%, but county-level exemption rates ranged from 1 , 2% to 26.9%. "
Literally, your friends and neighbors have the power to transform the health environment around the children in your community. Most childhood diseases require extremely high vaccination rates – north of 90% – which means that only a few families who delay or refuse to vaccinate their children can open their community's doors to life-threatening diseases. These clusters of hesitant parents to vaccines and deniers – "negations" and "negation" being words that often come up in the vaccine literature – may remain invisible. Even families living in communities with high vaccination rates may unintentionally experience these pockets of parental neglect if, for example, they attend a basketball game where a person infected with measles can infect approximately 20,000 people. .
When I asked Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, how to properly approach the subject of vaccination with parents hesitant about vaccination, he said that "the main obstacle is anti-vaccine content on the Internet "He described well-organized vaccine denial groups having" armed Amazon "with anti-vaccine books.
Medical experts like Hotez, who publicly call anti-vaccine groups and share information on the success of vaccines, are attacked and threatened online. Jonathan Strickland, the representative of the state of Texas who called the vaccines "witchcraft" claims on Twitter that Hotez had been "bought and paid by the greatest special interest for politics".
It's terrifying to think of the number of parents who hang out in the deranged Facebook group of publications and to embrace insidious anti-vaccine organizations or skeptics about the vaccine who dress up in benign language, like the Children's Health. Defense of Robert F Kennedy Jr. Texans for the choice of vaccine. Unscrupulous doctors, desperate to ask their patients to advise on medically delayed drugs, delay "alternative calendars" – calendars that break with time windows of maximum effectiveness and minimal risk for some vaccines sought and reaffirmed by l & # 39; WHO. The rich Californians of the South rely on the "purity" of their children and on the ubiquitous shadows of "toxins" not to vaccinate. Conservative Texans view "big government" vaccine requirements for public schools. If language creates worlds, then perhaps language failures are at the root of the anti-vaccine movement.
At the same time, parents who do not want to read a few paragraphs from a reputable source still rely on a single, belittling, 1998 study by a shameful former physician, Andrew Wakefield, claiming a link between measles, mumps and mumps vaccine. antirubeol and spectrum disorders. The lancet, the number one medical journal in which the study was published, finally retracted the play, the first and only time the journal published such a retraction. Wakefield lost his medical license and was seen traveling across America persuading vulnerable immigrant populations not to vaccinate. Coincidentally, he is now living in Texas.
I was thinking of Eula Biss's 2014 book On immunity, a non-fiction mix of dissertations and research alternating chapters on the history and contemporary status of vaccines, the story of his son's birth and the medical events of his early years. As soon as it was published, it seemed like a call to understand the power of vaccines. First collection of essays by Biss, Notes of no man's land, offered some of the most in-depth and thoughtful articles on race and American history that a white American could write. j & # 39; hoping On immunity could do something similar for public health and parenthood, and I was not alone. Written with the scrupulous eye of an archivist and the visceral fears of a new parent, the book received extremely positive reviews and won the National Book Critics Circle Award.
But, reading again recently, I was struck by the way he discreetly embodies part of the problem of vaccine rhetoric.
Biss works best in the rhythms of history. She discusses the racial realities of the contemporary (white, rich and educated) anti-vaccine movement and how fundamentally flawed political ideas about US freedom and independence have plunged into the history of vaccines and came out. In addition, she notes the history of women who have lied, been dismissed or subjugated by the medical community, providing a context that helps put into perspective women's mistrust of the medical establishment.
I sympathize with the memory elements of the book. Like Biss's son, my eldest son had scary breathing problems during his infancy. Biss's discussions with her husband about the safety of certain products and the widespread anxiety associated with early parenthood could easily become my wife and me. His landing, on which we should focus on community-centered health models, is hot.
But in 2019, in the midst of a new wave of preventable childhood diseases, the book dangerously confuses the reasonable fears that accompany parenting with unnecessary, even dangerous fears. A Greek choir of anonymous peers – "another mother" and "a mother I knew" – reappears to allay Biss's worries about vaccines. "For some mothers I know, the refusal to vaccinate is a broader resistance to capitalism," she writes, and "the proliferation of childhood vaccines has become, for some of us, a a kind of metaphor for American excesses. lines combine reasonable anxieties with those that should be discarded. Worry about chemicals in infant formula, of course. Delaying a single vaccine, in the interest of God, no. More than a few times in On immunityI would have liked Biss to be able to give up his words and move on to straightforward, ungodly facts.
I asked Dr. Scott Frank, Director of Public Health Initiatives in the Department of Population Health Sciences and Quantitative Health Sciences at the College of Medicine's Case Western Reserve University, to On immunity and contemporary conversations about vaccines. He also worried about how On immunity has aged, claiming that "Biss's attitude in the book has become a standard bearer for feelings that have grown bigger" since its publication. He described the rhetoric of Biss that belongs to the younger generation and has not "lived [doctors] treated with patients with measles and meningitis, diseases that deprive children of their lives and brains. He emphasized that vaccinations, like all medical decisions, do not offer a "guarantee" and that parents, like any other patient, "for a higher level of certainty than they have. "
In a recent interview with New York Magazine, Biss took up the main ideas of his book: the effectiveness of the vaccine depends on whole communities, individuals who are reluctant to get vaccinated can be convinced that they must at least vaccinate their child to protect children who for legitimate medical reasons, can not receive vaccines.
"People who have an anti-vaccine position and those who have a pro-vaccine position often work with at least some of the same information," she said. "I do not think it's a disinformation problem, it's a problem of analysis."
I do not agree. It's a problem of false information and optics. Early parenthood drowns parents in a bath of sensory experiences. Your child is coughing. Your child cries endlessly, you offer him food, you position him in different ways for optimal roasting and baleing. They are vivid sensory details. They will keep you at night. Vaccines work in an invisible way. You do not see your child's immune system training and fortifying against mumps or polio.
Biss said New York These fear-based calls "do not have a huge effect" on her. Well. But could they on others? Frank is skeptical. "Taking anti-smoking campaigns as a model, anti-fear campaigns have not proven effective," he said. "The most effective counter-arguments for tobacco did not talk about impacts on the body, but rather aimed at manipulating the tobacco companies." Parents could recall that billionaires and monolithic technology companies like Amazon often fund, directly and indirectly, anti-smoking actions. groups of vaccines. Amazon in particular has been a key territory for anti-vaccine groups. As part of the Amazon Smile program, Amazon's purchase products could be donated to charities of choice, including anti-vaccine organizations. Until March, Amazon had no problem storing manifestos and anti-vaccine books on the site.
At the end of our conversation, Frank offered me a quote: "The world belongs to those who present themselves". That's a saying used by Hells Angels, who has successfully lobbied against the laws on wearing motorcycle helmets; they triumphed by organizing, soliciting and calling their representatives. "The anti-vaccine movement is more passionate," said Frank. "They present themselves. They cause anxiety among parents who may have never thought of fearing them before. "
Nobody talks to you about the loneliness of a young child's parenting. Even talking with your partner in the mist of his childhood, you will have the impression that two people mumble in exploded walkie-talkies. The relief of meeting new parents and finding playmates for your children is based on a safety valve forged by social contract: none of our children will transmit to the other a disease that could kill them. But now, before socializing with other young families for the first time, my wife and I are creating e-mails and texts – not opaque but not too brutal, hopefully – to test things out. "Are your children caught off guard?", Reads better than "Have you vaccinated your children?". I never know how other parents we would like to know will receive these missives.
It's hard to deal with my own scandal and fear lately, my own desire to push hesitant parents and shame organizations that deny the effectiveness of vaccines. One may feel that puddles of dangerous and unscientific Facebook pages have spread out of the Internet and into the real spaces where children live. I wish that my peers, the health professionals and the thinkers that I admire around me can lift the ambiguity of a little more action, a passion a little more justified.
But that may be my own problem. Perhaps the ideas of the community that interest Biss, Frank and Hotez can become a lucid community of people who can appeal to the institutionalized anti-vaccine sophistication and advise the young parents we know to do the right thing – the only thing we can do. goal, good, ethical, sure thing. Among their many gifts, vaccines help us to not be alone.
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