HealthScience

Vaccination is a Choice: There’s One Right Choice, and One Wrong One

One of the biggest issues of the pro-vaccination movement is that we are struggling to know how to get through to the other side. Not just the anti-vaxxers, but also the people on the fence, the people who delay vaccines, and the people who don’t understand what’s at stake. It’s easy enough to just call the anti-vaxxers names. Believe me, I’ve been there. It’s frustrating to talk to people who won’t listen or who think their Google Research actually counts as research. Sometimes it just feels like yelling into the wind.

But if we want to reach people, we need to try to understand the other side.

I was listening to the radio the other day, and the hosts were talking about the recent events involving pro/anti-vaxxers. One woman called up and said something like, “my husband is a biologist and we decided to delay-vaccinate our child and I had to push and push to get the vaccine with fewer toxins.”

After I finished rolling my eyes and dismissing this caller (I’m only human, give me a break), it occurred to me that parents who choose to delay or forgo vaccines only really want one thing: control.

If you have ever parented a toddler, you know that giving little kids choices helps them to feel more in control of their lives. So instead of saying, “it’s time to go to bed,” you would ask, “would you like to brush your teeth first or put on your jammies?” And the same is true of adults. By being given choices, we feel more in control of our lives.

Alternative medicine is great at providing choices. And most of the time, choosing a non-evidence-based approach to healthcare will not affect you that much. Do people who take supplements to “boost their immune system” understand that a boosted immune system is actually a bad thing and that the supplements they’re taking do nothing? Do people who take juice cleanses understand how the colon actually works? Do most people who use the word “toxins” really understand chemistry or toxicology? Likely, the answer is no.

The physical manifestation of Toxins, shown at 1000x magnification (source)

The physical manifestation of Toxins, shown at 1000x magnification (source)

Unfortunately, with regards to vaccines, there are really only two choices: get vaccinated on the doctor-recommended schedule or don’t. And not having another choice can make people feel powerless, which is why they seek out alternatives.

Another thing I’ve heard people say is, “I’m not anti-vax, but I did choose to delay-vaccinate my child.” If you choose to vaccinate your child on a delayed schedule for no legitimate doctor-recommended medical reason, you are in fact anti-vax. You are saying that you don’t understand how the immune system/vaccines work or what “toxins” are. You are buying into anti-vax rhetoric as if it’s based on actual science. You are saying that your own research, based on confirmation bias and cherry-picked information from self-proclaimed experts, is more correct than the majority of scientists who research and develop vaccines for a living. (And a lot of pediatricians put up with the delay-vaccine parents because at least the child is getting a vaccine eventually.)

The only thing that delaying vaccines does is give people the illusion of control. And by being in control, you feel better about your choices and you feel like you are helping your child. But you aren’t—you are only putting your child and others unnecessarily at risk.

Here’s where the cognitive dissonance and confirmation bias come into play. First, if you haven’t read Mistakes Were Made (But Not By Me): Why We Justify Foolish Beliefs, Bad Decisions, and Hurtful Acts by Carol Tavris and Elliot Aronson, you should pick up a copy. In the mean time, take a minute to read about cognitive dissonance on Wikipedia.

Basically, cognitive dissonance partly involves how your brain resolves conflicting ideas and deals with information that goes against how you see yourself as a person. It creates a weird self-rationalization loop that can go against your best interests. For example, if you are a parent and you love your child, then every decision that you make for your child will be what you consider the “best” decision. Why? Because you made it, and you love your child. If someone intervenes and says, “Even though you love your child, this isn’t the best decision,” your natural urge is to say that they’re wrong, because you know that you would never give your child anything less than the best. You would never put your child’s life at risk. This is the kind of rationalization that can lead to child abuse—for example, the case where Adrian Peterson beat his son with a switch, hard enough to cause bleeding. When Peterson was confronted with the indisputable fact that he had abused his son, he said he was “not a perfect parent, but I am, without a doubt, not a child abuser.”

He also said:

“But deep in my heart I have always believed I could have been one of those kids that was lost in the streets without the discipline instilled in me by my parents and other relatives,” he wrote. “I have always believed that the way my parents disciplined me has a great deal to do with the success I have enjoyed as a man. I love my son and I will continue to become a better parent and learn from any mistakes I ever make.”

 

“My goal is always to teach my son right from wrong and that’s what I tried to do that day,” he wrote. “I accept the fact that people feel very strongly about this issue and what they think about my conduct. Regardless of what others think, however, I love my son very much and I will continue to try to become a better father and person.”

That is cognitive dissonance. His parents  likely “disciplined” him in a way that others might view as child abuse. But to him, because his parents loved him, what they did was necessary. So when he beat his own son, that wasn’t child abuse, because he loves his son. Do you see how cognitive dissonance is a vicious cycle, like that picture of a snake eating its own tail?

Ouroboros_1

This probably won’t end well. Plus, this tail isn’t even that tasty! (source)

 

In the same way, when people choose anything other than “vaccinating my child on a doctor-recommended schedule,” they think they are making the best decision because they only make the best decisions when it comes to their child.

Sometimes, in our efforts to rationalize our decisions, we will seek out research and other people in our situations. There is a thriving anti-vax community online, full of people who have “done their own research” and have determined, for whatever reason, that either delayed scheduling (against the recommendation of their doctor) or not getting vaccinated is the best choice for their child. And it’s a vicious cycle again. If a source agrees with you, it must be a good source. If you are presented with evidence to the contrary, then the evidence is likely bad.

You could say that cognitive dissonance and self-rationalization apply to scientists too. And it definitely does, individually! But true scientific evidence is based on multiple, independent research studies, and the overall culture encourages other scientists to speak up with dissenting information. In academic settings, a group of scientists will get together and read a research paper, and then they will verbally shred it. This doesn’t mean it was a bad paper, it just means that the other scientists are trying to figure out if the research is as robust as it seems.

The fact is, there is a lot of actual scientific research about vaccines and autism. Unfortunately, even if you are well-versed enough to do a PubMed search for research papers, you need the expertise to know the good research from the bad. In addition, most journals are behind a paywall, so even if you wanted to look at the latest research, you are prevented by not having access. When you look at the abstract of a research paper, you’re putting a lot of trust in the authors, not only that they made scientifically-accurage conclusions but also that their methods are robust and their results are repeatable. And it’s extremely hard to prove a negative. There can be 99 research papers stating no link between vaccines and autism, and then 1 that does, and forever there will be doubt, despite the scientific consensus.

As parents, we all try to do the best for our children. Sometimes, that doesn’t always happen, but we need to be aware of cognitive dissonance and have the ability to critically analyze our choices and not just find people who agree with us. We need to ask ourselves more often, are we making our decisions to feed our desire for control? Am I self-rationalizing instead of looking critically at the evidence?

It’s hard to realize that you haven’t made the best choice for your child, and there is a lot of guilt associated with that, but you need to be an example and own up to your mistakes and focus on the solution, not the blame.

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Mary

Mary

Mary Brock is a scientist who works on drugs you've hopefully never heard of. She enjoys cooking to Blue Grass music, messing with her cats, and hosting the Boston Skeptics' Book Club. She was born in the South but loves living in New England (despite the lack of chocolate chip pizza). Mary does not use Twitter and don't even try to follow her, because she is always looking over her shoulder.

3 Comments

  1. February 8, 2015 at 3:26 am —

    Cheers. And thanks for the bonus link to why even if Emergen-C worked, it wouldn’t be good.

  2. February 8, 2015 at 2:18 pm —

    I’d like to add that 99.9% of people who happily vaccinate their kids on schedule don’t really understand how this works, the author of the comment included (like, yeah, I have a basic idea. I also have a basic idea how nuclear reactors work…)

    • February 8, 2015 at 2:21 pm —

      That’s true, but you know enough to trust your doctor. I don’t know how a car works either and I can still drive in to work. There is a certain amount of trust that I have to place in experts and I’m OK with that.

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