QMC 10 – Vaccination or no Vaccination

Dr RD wants me to make a case for vaccination.

“I’m a pediatrician. I have a couple of parents who want to delay polio vaccination indefinitely. It’s freaking me out, because there’s no reasoning with them. I’ve explained to them that they’re putting thousands of children at risk. But they refuse to budge. I mean come on, we just eliminated polio last year. It took us over 60 years. I don’t want to be the doctor whose negligent care brings polio back to this country. Please help me!”

I have to admit I had a good chuckle at this doctor’s expense. It almost sounds like he wants to pull his hair out, if he hasn’t gone bald already. ūüėÄ

So Vaccination. Let’s be very clear, the majority is convinced about vaccinations. There are a handful of people sowing doubt and with journalists giving them adequate and unnecessary press, it seems to have bloated into something it isn’t.

Since Dr. RD is from India, let me say this is actually a first world problem. Most Indian parents have been educated ad nauseum about the benefits of vaccinations. I mean come on, Aamir Khan and the Bachhan’s have asked people to immunize their children and if not for the love of their kids then for the love of their Bollywood heroes they’ve gone out and done it. Parents who have these doubts are highly educated, poorly informed, impulsive, (I hate to say this- millennials) and most likely to have returned from abroad.

vaccination

Vaccination in children

How do you deal with these people?

1.Reschedule the appointment

The first thing you do is reschedule the appointment with these anti-vaccinators, (let’s call “anti’s” for short). You can’t have a logical discussion without proof and evidence and if you have to refute their flawed science you need to read up. Also ask them to print and bring all their documentation and evidence that supports their super idea.

2. Go home and Read

Read everything on the subject. Read the statistics, the pros, cons, the accidents, the side effects, the package insert (a lot of them will use this as ammunition), the cold chain process, any deaths or patient horror stories. Devour it, understand it, memorize it and carry it along with you to the appointment

3. Don’t be confrontational

There’s no need to ask, “Do you love your child?” Sometimes these decisions are plain ignorance or little knowledge or some social media post that has got them carried away. Often it’s just going against the crowd, or a brush with other illnesses blamed on vaccination. ¬†Stick to logic and reason. ¬†Keep your cool.

4. Show the numbers

I don’t know why, but people respond to numbers. Tell them that 99% of the time the medicine works. It achieves immunity. Even when I tell adults to get vaccinated they respond to stats far more than research or reasoning. ¬†Graphs and charts do wonders. Use them

5. Remind them it’s a medicine

Tell them it’s a medicine and no medicine is perfect. The side effects on the package insert cover the entire spectrum of problems humans can face. Because it’s our job to inform them. But tell them that the vast majority you have vaccinated, and tell them how many if you can, have never faced a problem

6. Show them the alternative

If you can print pictures of non-copyrighted images of polio and other diseases from the web then please do. Show them your research papers and the “real science” supporting vaccination. The results are overwhelming. I don’t mean you should blackmail them but polio is not a five letter word, it’s a crippling disease.

7. Admit there have been mistakes

When children who were vaccinated with OPV in India developed VaPP(Vaccine-Associated Paralytic Poliomyelitis) there was immediate furor. They found out that OPV was responsible but since the immunization program is 90% funded by the government the more expensive IPV hasn’t been implemented. So admit yes, there are side effects, especially when the cold chain hasn’t been maintained or when the village health worker make mistakes. ¬†Don’t brush these aside.

8. Explain the pathogenicity if explaining consequences to other children

Most parents don’t care about other people’s children. Just go to a playground and you’ll see it. They’re only concerned about their own. When explaining the far reaching consequences of non-immunization, always explain how the pathogen and the vaccine works. Then explain what happens if another child doesn’t get vaccinated how it puts their child at risk. Reverse psychology works.

9. Tell them about costs

Remind them about the cost to the government and to them if privately vaccinating. If cost is their reason then tell them about the government program where free vaccinations are provided. Also tell them that ¬†you get nothing financially out of vaccinating their child. I’ve never heard a med rep tout vaccines. There’s been some marketing for the HPV vaccine but otherwise no.

10. Refer them to another doctor

If all fails then refer them to another doctor. No, not a psychiatrist. Another pediatrician. Who knows they may say it better. Either way, ¬†don’t let them out of your sight. Every opportunity you get bring up the issue. Your persistence may be rewarded. Besides if something does happen to the child, you’ll be the first to know what’s wrong and take care of the issue before it progresses.

Every time ¬†we doctors hang out, vaccination comes up. Adults don’t want to be vaccinated. Parents are fussy, but the vast majority read the research and say yes. Always use this widely published research to make you case for vaccines. The science the anti’s are using is flawed, incomplete and dangerous.

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