Shared from the 4/10/2019 Philadelphia Inquirer - Philly Edition eEdition

VACCINATION OPPOSITION

Smart people making poor health decisions

Children at risk from spread of misinformation.

If you’re against vaccinating your child, there’s agood chance you’re a college-educated white woman making decent money.

The rebel forces in America’s latest culture war — the so-called anti-vaxxers — are often described as middle-and upper-class women who breast-feed their children, shop at Whole Foods, endlessly scour the web for vaccine-related conversation, and believe that their thinking supersedes that of doctors. Typically their families earn more than $75,000 a year.

That’s based on findings from various studies, including the National Immunization Surveys conducted by the federal Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases. It’s also echoed by doctors, sociologists, and anthropologists who follow the vaccination debate raging around the country at a time when measles outbreaks have hit several states, including New Jersey, New York, California, and Michigan.

“ Frankly, these Caucasian, suburban, educated parents believe they can Google the word ‘vaccine’ and get as much information as anybody.
Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia

As of last week, 465 measles cases had been reported this year, the most since 667 cases in 2014, according to the Associated Press. And 140 cases of mumps have been recorded at Temple University this year as well.

Reports indicate many of the infected weren’t vaccinated. The CDC says that the percentage of children who are unvaccinated has quadrupled since 2001. About 25 percent of parents are delaying vaccinations or allowing only certain vaccines to be used “cafeteria style,” said Jennifer Reich, sociologist at the University of Colorado and author of the book Calling the Shots: Why Parents Reject Vaccines.

The World Health Organization calls reluctance or refusal to have children vaccinated one of the top 10 global health threats of 2019.

Medical experts insist there’s no scientific debate on the efficacy of vaccines: The CDC and the National Institutes of Health stipulate that childhood vaccinations save lives.

Doctors don’t mince words about anti-vaxxers.

“Frankly, these Caucasian, suburban, educated parents believe they can Google the word vaccine and get as much information as anybody,” said Paul Offit, a professor of pediatrics and director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“These people are educated just well enough to make terrible decisions for their children.”

Epidemiologist Neal Goldstein at Drexel University’s Dornsife School of Public Health agreed.

“The affluent classes tend to be more hesitant about vaccinating,” he said. But that’s based “on wrong information that leads them down a rabbit hole of falsehoods. I can spot credible data online, but the general public doesn’t have my training.”

Vaccine resistance has become a “form of privilege,” Reich said. Educated mothers develop a sense of entitlement that helps them decide which vaccines are unnecessary, Reich said, adding, “They focus on organic foods, health-promoting practices at home — ways they see of mitigating disease risk.”

Moms see their efforts as superior to those of doctors who don’t know their children. But, Reich said, maternal vigilance “cannot control infectious disease.”

Working-class and low-income parents view vaccines differently.

Many of them are minority mothers who “never hesitate” to get shots for their kids, said Alison Buttenheim, a nursing professor at the University of Pennsylvania. “They say, ‘A good mom does what the doctor tells me to do.’ ”

Working-class people are less entitled than those who are educated, said Temple University sociologist Judith Levine. “They don’t feel they have the power to demand not to have their children vaccinated.”

Many working-class minority mothers in fact fear the government might take their kids by judging them as bad parents for refusing to vaccinate, said Lindsay Glassman, a Penn doctoral candidate in sociology whose dissertation includes discussions of vaccination and class.

Most parents aren’t necessarily reading medical journals online to formulate their ideas, said Glassman, who surveyed and interviewed mothers who won’t vaccinate. What they think is what they see posted by like-minded people on their social networks, she said, adding, “It’s like politics that way. You join Facebook groups about this, and it becomes an echo chamber.”

Such people begin to believe they possess inside information that even doctors lack, said Janet Chrzan, a nutritional anthropologist at Penn. “They validate each other, and make their belief systems seem rational.”

Offit, of CHOP, said current preoccupation with not vaccinating may have begun in 1998, when a British medical paper linked vaccines with autism. But 18 subsequent studies debunked the paper’s findings, Offit said.

Then people began complaining about chemicals in vaccines, or the notion that too many vaccinations hurt a child’s immune system, or that the government and pharmaceutical companies are conspiring to sell medicine without caring for patients. Many cite religious reasons for not vaccinating, like Illinois’ “All Natural Mom” blogger Sheri Davis, who writes, “Our family’s religious beliefs prohibit the injection of foreign substances into our bodies.”

On Tuesday, New York City declared a measles public health emergency in different sections of Brooklyn to contain the spread in ultra-Orthodox Jewish neighborhoods, where many people object to vaccination on religious grounds, the New York Times reported.

Also, vaccines work so well, doctors say, many people have never seen the diseases they control, making inoculation seem unnecessary.

To counter some of this, the CDC stresses the importance of vaccines and reports there is “not a plausible biologic reason to believe vaccines would cause any serious longterm effects.”

Anti-vaccination parents acknowledge “it’s not politically correct in a world of vaccine zealots to mention that anything else but vaccines could have contributed to saving lives from ‘preventable diseases,’ ” writes a woman who describes herself as a college-educated toxicologist in her Think-LoveHealthy blog. It’s “historically inaccurate” to say vaccines save lives, the anonymous blogger says. It’s better to concentrate on “better nutrition ..., hand-washing, food safety prep ....”

It’s “too easy” to call such anti-vaxxers selfish or ignorant, Reich said. “I’m not unsympathetic for how hard making decisions for children is.”

And attacking the mothers is fruitless, she added, explaining, “I don’t know of anyone changing their mind when they’re called stupid.” alubrano@phillynews.com

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AlfredLubrano

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