Vaccine discussions may be most useful early in pregnancy: shots

In 2017, Kim Nelson had just relocated her family to her hometown of South Carolina. Boxes were still scattered around the apartment and, while his two girls were playing, Nelson was running a newspaper article on his phone. Religious exemptions for vaccines have climbed nearly 70% in recent years in the Greenville area – the part of the state in which she had just moved.

She remembers shouting to her husband in the next room: "David, you have to come in here! I can not believe it."

Until then, Nelson had not met a friend's mother who had not vaccinated.

"It really opened the eyes that it was a big problem," she says.

Nelson's father is a doctor. she had her vaccinations and her children too. But this news scared him. She knew that infants were vulnerable – they could not get most vaccines before the age of 2 months. And some children and adults have diseases that prevent them from being vaccinated and therefore depend on the immunity of the herd.

At the time, Nelson thought a lot about public health and was even considering a career change from the banking sector to public health. She decided that she had to do something.

"I really believe that if you have the ability to plead, then you have to do it," she says. "The burden is on us if we want a change."

Like many mothers, Nelson had spent hours online. She knew how easy it was to fall into rabbit holes on the Internet, in a world of fake studies and scary stories.

"As a person who just can not stand the bad things on the Internet," says Nelson, "If I saw something with vaccines, I was not hesitant to add" This is not true "or" No, that's not how it works "… I'm usually banned."

Nelson has created his own group, South Carolina Parents for Vaccines. She started posting scientific articles online. She started responding to private messages from concerned parents with specific questions. She also found that positive reinforcement was important and that she would move around mother groups, spreading assertions.

"If someone publishes" My child has received his two-month vaccines today, "Nelson says she would quickly post a complementary comment:" Great job, Mom! " "

Nelson was inspired by peer groups in the country doing similar work. Groups with national reach, such as Voices for Vaccines, and regional groups, such as Vax Northwest in Washington, are taking a similar approach, encouraging parents to educate and share information about vaccines with children. other parents.

At the national level, 91% of children under 3 are vaccinated against measles and rates for other vaccines range from 82 to 92%. But in some communities, the rate is much lower. In Clark County, Washington, where the measles epidemic has made up to 62 cases, about 76% of kindergarten children attend school without all their vaccines.

Public health experts are concerned about the need to improve immunization rates. But efforts to reach reluctant parents in the face of immunization often fail. When presented with facts about vaccine safety, parents often remain rooted in the decision not to vaccinate.

Pediatricians can play a role – and many do – but they are not paid to have long discussions with their parents and some of them find it frustrating. This leaves an opening for alternative approaches, such as Nelson's.

Nelson thought that it was better to focus on the mothers who were still on the vaccine barrier.

"It's easier to separate a hesitant parent than someone who is firmly anti-vax," says Nelson. She explains that parents who oppose vaccination often have such a belief that they do not engage in a discussion. "They feel validated by this choice – it's part of the community, it's part of their identity."

The most important thing is timing: people may need information about vaccines before they become parents. A first pregnancy – when men and women begin to assume their parenting roles – is often the time when the problem first arises. Nelson refers to a study by the Centers for Disease Control that shows that 90% of pregnant women made their decision about vaccines at the time of their six-month pregnancy.

"They are not (yet) going to a pediatrician," says Nelson. "Their OB-GYN probably does not talk about the pediatric vaccination schedule … so where are they going?" They go online.

Nelson tries to counter the wrong information online with facts. But she also understands the value of the dialogue in person. She organized a course in a public library and announced the event on the mothers' forums. Nelson was worried that opponents of vaccines, which she calls "anti-vaxxers", might appear and provoke a scene. She had already been banned from some online forums by opponents of the vaccine.

"Are they here to get me a new one? Or are they here to learn more about vaccines?" Wondered Nelson. "I just decided, if they are there I will give them good information."

Amy Morris was pregnant, but she drove an hour and a half to attend the class. Morris was not the typical mother of the first time Nelson was trying to reach. She has already had three children. But during this pregnancy, she was more and more worried about vaccines. She had just had a miscarriage and it was about the time she was vaccinated against the flu. Morris was reading articles about and against the vaccine in the mothers' forums and was beginning to have doubts. In Nelson's class, she learned the risks of do not vaccinated.

"It's been talking to me more than anything," Morris said.

Now, holding her son in good health, Thorin, 8 months old, on her lap, she says she is happy about her departure because she felt vulnerable.

"I've always known that it was the right thing to do," Morris said. "I was listening to that scary monster in the back of my head."

Nelson says the anti-vaccine community feeds on fear. She learned to ask questions to help parents understand the source of their anxiety.

"I think they appreciate that you meet them with sympathy and that you're not just trying to tell them facts in their throats," Nelson said.

Nelson is now trying to get local hospitals to incorporate this vaccine talk into their delivery classes. She is studying at the MSc in Public Health at the University of South Carolina and also collaborates with the Bradshaw Institute for Promoting Child Health in the community. She even plans a race for the public service.

This story is part of the relationship partnership between NPR and WFAE and Kaiser Health News.