Vaccines - How to change minds and change the world!

Hi Steemit,

This post was made as a throwback to @kryzsec and their series on vaccines. We had a good discussion on attitudes towards vaccines, and I wanted to write my own thoughts on the subject.

Source

Introduction

For those of us in healthcare, the phenomenon of parents being unwilling to vaccinate their kids is an ever present danger. I work in immunology, specifically pediatric infectious diseases, specifically pneumococcal disease, so I have the opportunity to see the havoc these diseases wreak firsthand. I see kids presenting with sepsis, pneumonia and meningitis. Frequently, these children are either unvaccinated or undervaccinated. It’s painful to witness the suffering these kids endure; it’s also painful to see the emotional pain their parents go through. Even though I stand by the viewpoint that not vaccinating eligible kids is child abuse, every anti-vaccine parent I have ever met only had their kids’ best interest in mind. This post is geared towards them.

The Anti-Vaxx Hivemind

If we are to attempt to get people to reevaluate their stance on vaccination, first we need to understand the environment these sentiments fester in. One such environment exists entirely online, in the form of social media.

Negative vaccine sentiment seems to exist on social media networks in clusters. One study by E.K. Brunson showed that people who did not conform to the vaccine schedule typically had people networks where 75% of the members also had nonconformist and vaccine negative views (Brunson, 2013). Compared this to vaccine compliant parents whose social networks were comprised of only 13% nonconformists (Brunson, 2013).

Parents who have negative attitudes towards vaccines are also more likely to hold anti-government, anti-establishment and conspiratorial thinking (Mitra, Counts, and Pennebaker, 2016).

Conspiratorial thinking, general distrust towards the medical establishment, and unprecedented ability to talk to people all over the world creates a perfect environment to foster anti-vaccine sentiment. Social media creates a perfect sounding chamber where you can have your viewpoints repeated and validated, even if they fly in the face of accepted science.

What we face now is a philosophical dilemma: if people who have negative vaccine sentiment are able to cloister themselves away amongst their similarly-minded peers, how can we change their minds?

The New Anti-Vaxx Agenda

When confronting an anti-vaxxer on their viewpoints, the first thing most of us attempt is an appeal to reason. Surely scientific facts can sway their opinions; after all, we KNOW that vaccines work! There’s a hundred years of science behind the concept of vaccines.Maybe if we just told them about herd immunity, they would vaccinate their kids! When that doesn’t work, we then move on to debunking the idea that vaccines have dangerous chemicals in them. After all, there’s less formaldehyde in a pear than in a vaccine! Surely that will make them reconsider. If you really think about it, everything is a chemical. And finally, we retort with the fact that Wakefield had a huge conflict of interest and had his license revoked after being accused of research misconduct.

These are all great arguments. They are factual and rely on reason rather than emotion. Therefore, no one can accuse us of trying to control them or tell them how to run their lives. We are just presenting them with the truth.

This is all noble, but does it really work? Current research actually points to no.

Wait, really?

Yes! It seems counter intuitive but the most effective way to change someone’s mind about vaccination is making an emotional appeal. An article by Horne et al (2015) looked at parents’ and non-parents’ attitudes towards vaccination after three different interventions. One intervention was an informative article debunking the “vaccines cause autism” myth. The next intervention was a story from a mother whose child had contracted measles, three pictures of children who had contracted vaccine-preventable illnesses, and warnings on the dangers of not vaccinating. The control intervention was a scientific article with no mention of vaccination (Horne et al, 2015).

Their research showed that people exposed to the autism myth debunking literature had no significant change in their vaccine attitudes compared to the control (P=0.721). However, the participants exposed to the disease risk literature experienced a significant positive shift in vaccine attitudes compared to the control (P=0.006).

Disclaimer: I am aware of the folly in relying on P values entirely for significance. However, for a brief review, I feel like P values and linked sources are appropriate.

From my experiences working with parents in both healthcare and science education, these results reflect my anecdotal evidence. If we consider that these attitudes propagate via social networks and confirmation bias (thinking back on stories about someone’s cousin‘s best friend’s baby getting a wheat allergy after getting the DTAP), it stands to reason that the most effective counter is appeals to emotion. Actually seeing a child’s suffering and reading about the very real symptoms of these diseases feels much more real than being lectured on innate and adaptive immunity.

Going Forward

Now that we know that anti-vaccine sentiment can be challenged by emotional appeals, we need to consider the ethics and implications behind this methodology. Is it exploitative to distribute uncensored images of a child suffering from a life-threatening disease? What if the parents consent to their child’s image being used in educational materials? What if the child has reached the age of consent and no longer wishes to be used as a bargaining chip?

Furthermore, is it ethical to falsely appeal to our human instincts to protect children in order to get someone to believe the same thing we do? What if the study isn’t reproducible? What if our attempts to convert vaccine non-compliant parents backfires?

I don’t have the answer to any of these questions. I think it’s worth exploring in another post, however.

I welcome others’ thoughts on how to approach this topic going forward. Let’s all do our part to eradicate vaccine preventable disease!

Love always,
T

References:

Brunson, E. (2013). The Impact of Social Networks on Parents' Vaccination Decisions. PEDIATRICS, [online] 131(5), pp.X16-X16. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23589813.

Horne, Z., Powell, D., Hummel, J. and Holyoak, K. (2015). Countering antivaccination attitudes. Proceedings of the National Academy of Sciences, [online] 112(33), pp.10321-10324. Available at: http://www.pnas.org/content/112/33/10321.

Mitra, T., Counts, S. and Pennebaker, J. (2016). Understanding anti-vaccination attitudes in social media. Proceedings of the Tenth International AAAI Conference on Web and Social Media. [online] Available at: https://www.aaai.org/ocs/index.php/ICWSM/ICWSM16/paper/download/13073/12747.