Anti-Vaxxer Sympathy

[Aractus]

Actually, I know a lot of people who refuse to immunize.  I live in Oregon.  A lot of people here think it is "unnatural" and prefer homoeopathy or naturopathy. I suppose that is distrust for organized medicine, but Oregon has very good public health care for the poor (I know, I've been homeless here and I was still able to get basic healthcare).

What you define as being "basic healthcare" might be enough to satisfy your health needs. However other people might have a different point of view when it comes to whether their health needs are met or not.

All throughout history people have been putting their trust and care into the local 'wizard' and his alternative health services. There are plenty of examples in history where poor people in the middle ages, or earlier, refused the care a physician even when a physician would offer their services below the cost of the local wizard. We now know that this is primarily due to inequitable access to health services: that is the wizard and his alternative practise accepts anyone, but the physician cares for the middle and upper class people in the main.

Education is one barrier, but it's not the only one. I've mentioned three just in this one post: education, equitable access, and addressing patient needs. In previous posts I've repeatedly mentioned fear and mistrust as well as another prominent well-recognised barrier.

[Aroura]

Actually, I know a lot of people who refuse to immunize.  I live in Oregon.  A lot of people here think it is "unnatural" and prefer homoeopathy or naturopathy. I suppose that is distrust for organized medicine, but Oregon has very good public health care for the poor (I know, I've been homeless here and I was still able to get basic healthcare).

What you define as being "basic healthcare" might be enough to satisfy your health needs. However other people might have a different point of view when it comes to whether their health needs are met or not.

All throughout history people have been putting their trust and care into the local 'wizard' and his alternative health services. There are plenty of examples in history where poor people in the middle ages, or earlier, refused the care a physician even when a physician would offer their services below the cost of the local wizard. We now know that this is primarily due to inequitable access to health services: that is the wizard and his alternative practise accepts anyone, but the physician cares for the middle and upper class people in the main.

Education is one barrier, but it's not the only one. I've mentioned three just in this one post: education, equitable access, and addressing patient needs. In previous posts I've repeatedly mentioned fear and mistrust as well as another prominent well-recognised barrier.

Haha, no.  I'm disabled.  I need quite a lot of healthcare.

Anyway, what exactly is your point?  It sounds like you are defending anti-vaxxers by listing these barriers, but not giving us any ideas of how to address those issues (and also, no, not everyone has those issues.  Actually, statistically speaking, here in Oregon at least, many of those who opt out for non-medical reason are middle class and up, not poor, have plenty of education AND access to whatever health care they would like). So the whole local wizard thing isn't it.  

I swear to you, some people do it because it's the cool fad.  I can share some FB posts with you from some of my "friends", who are clearly not vaccinating, because it's cool to be all anti-establishment.  

The only serious anti-vaxxers I know have good educations and good jobs (excluding one native American couple I know), and just love to talk and talk about how awsome their alternative medicine is.  And they pay a BUTTLOAD for that alternative medicine.  Certainly more than the FREE clinic would cost for the poor ones.

I guess this annoys me especiialy because I know soooo many people who are anti-vaxxers.  My dad rents a room from a lady who MAKES homeopathic "medicine" and will lecture everyone on the evils of modern medicine.  Even things like Tylonol!  She said to my dad after his hip surgery that he wasn't in pain for lack of codien (Well freaking duh), and talked him out of taking it, until he called me in tears. 
And she's far from poor.  I just feel surrounded, I guess.  Sorry, I get defensive over it.

It appears that the new law here to FORCE education on people is working, as are laws elsewhere that prevent your child from going to school unless you get them vaccinated. So as much as I hate it, seems like government forced education and vaccinations are the most effective thing for the subset of people who refuse to listen to reason.

[Ravenshire]

Gist of the article:
Sometimes even smart people get taken in by junk science but a loving empathetic approach can bring them around.

Yes, even smart people can be duped by junk science, especially when it's coupled with fear.

Love and empathy bringing them around. Usually bullshit.

Maybe it's bullshit. What works better than love an empathy?

Education.

[Aractus]

Anyway, what exactly is your point?  It sounds like you are defending anti-vaxxers by listing these barriers, but not giving us any ideas of how to address those issues (and also, no, not everyone has those issues.  Actually, statistically speaking, here in Oregon at least, many of those who opt out for non-medical reason are middle class and up, not poor, have plenty of education AND access to whatever health care they would like). So the whole local wizard thing isn't it.  

I swear to you, some people do it because it's the cool fad.  I can share some FB posts with you from some of my "friends", who are clearly not vaccinating, because it's cool to be all anti-establishment.

I'm not "defending" anyone. I'm simply explaining to you that failure to deliver health service outcomes is never the fault of the patients. That point of view is not tolerated in healthcare today - it's akin to assimilation and all it does is drive people who already have a reason not to seek out health services further away from accessing the services they need.

Let me put this in perspective for you - just because someone fails to respond to one health service does not mean you want to alienate them from other necessary health services. I could list a whole bunch of services that people routinely fail to accept that are all equally as important as childhood immunisation (in fact probably more important because the services I'm thinking of have a direct link to early mortality and life expectancy whereas individual immunisation does not).

Aroura - it doesn't matter what their reason is. If their reason is that it's "a cool fad" and that is the genuine reason, then health services should be looking to ways to engage with those people in order to deliver the health services and health outcomes that are desired. You can't just ignore them, call them dumb, and expect them to convert to a different way of thinking.

Forcing health services on people is never the right thing. Yes forcing education is one important tool (e.g. parents can only access government payments if they take a parenting course); but as soon as you start forcing health services you will drive people away from receiving needed health services in the future. Yes they will get the service that you've forced on them (in this case childhood immunisation), but they will not go back to the healthcare system when their child has another medical need since their experience with the health system is they are forced to do things against their will.

[Thumpalumpacus]

You have once again lost all credibility with me by suggesting people either do or should make healthcare decisions based on "rationality".

lol, what criteria do you suggest, if not rationality?

I rest my case.

I notice that you still haven't answered my point about that 5% uninoculated providing a substantial reservoir to allow for microbial evolution. At this point, I don't honestly expect an answer from you on it, so I'm going to leave this conversation, with this being my last post. You have a nice day, now.

[emphasis added, prediction confirmed]

[Lemonvariable72]

Ask stated before, why not include that in prenatal classes?

Yes that's one valid idea - but remember that unless a health practitioner is the one delivering the class that people will be rightly sceptical of any health advice given from some random instructor. You need to ensure that the message is communicated in an effective way to the target clients - not just ensure that it's delivered "somehow" and assume everything will be OK. Additionally you would need to ensure people can raise their concerns and have those discussed privately with a practitioner. Even someone having an unanswered question is a barrier to the effective delivery of health services.

In Australia you would not be able to have an Anglo-Saxon instructor give the message to Ingenious parents full stop. It doesn't matter if they're the best doctor in Australia we know that Aboriginal and Torres Strait Islander people have a justified and well-established fear of "White Medicine". You would need to get an Indigenous health practitioner to deliver the message.

Normally I would say what your saying is balantly racist. In fact even though it is, you are right. However in the US we aren't talking about natives, but white, Christian, Middle class people. Aka members of the majority.

[brewer]

mh.brewer

Look this is my field of study,

Credentials please. Articles, books, papers, any supporting evidence.

Aractus:

Noticed you chose not to respond. I will. Graduate University of Nebraska Medical Center, 1983. Dr. of Clinical Pharmacy, speciality in psych and geriatrics.

I don't like (or even really know how to use) the quote function. I've copied and pasted parts of some of your posts (in black type). If you feel they are in error I am  willing to correct them if they need correction. My response in blue.

Referencing the OP link: “Did she have a good reason? Yes in my opinion she did [edit] she had a negative experience which is an indication that the healthcare service is inadequate." Opinion based on hearsay and very limited facts. I doubt that the MD only offered her pills. I don't believe there are not enough facts for either of us to come to an objective opinion. I will concede that she had fear/mistrust (justified or unjustified).


“But wait a second. We have (Australia) maybe 93-94% rate of childhood immunisation. Now compare that to say the fact that 20% of women in Australia report that they have experienced childhood sex abuse.” Off topic. Adds no value to the vaccination discussion.

"And I take issue with the statement that "children who don't get vaccinated put other children at risk". [edit]  2. No they don't, they just don't participate in herd protection." Actually yes they do. Children, vaccinated or not, are part of the herd. The non-vaccinated by choice would be considered an anti-participant/anti-portection/free rider. They have the potential to spread disease to other parts of the non-vaccinated herd (members of the herd/community without choice, children under 15 months, persons without immunity due to genetics, disease, disease treatment or old age. Again, please notice that these individuals have no choice). If infected and released into the herd they have the ability to transmit the disease directly or indirectly (produce a subclinical infection in the vaccinated who then have the ability to infect the members of the herd/community without choice).

"4. The so-called harm that people don't vaccinate their children is only a "potential" I agree. However it is a potential that society has deemed an unacceptable risk. That’s why there are vaccination schedules in both our countries.
 
"Immunisation is about preventing outbreaks, not individual cases. So this whole argument that parents are putting their own children at greater risk is not correct - they are putting the community at greater risk." This is incorrect, it is about both. Don’t think it’s about individuals? Have the child/parent/you take a trip to an endemic area with measles, cholera or yellow fever without being vaccinated and come into direct contact with the infected, taking no extra precautions. Look at the US and Aus requirements for individual vaccination when coming from another country with no proof of vaccination. Those individuals are given a choice, get the required vaccinations or don’t become part of this herd/society.
 
"Particularly that you shouldn't victim-blame people who have distrust in health services." I won’t blame them. However, they do have a choice, unlike other members of the herd/community. I will state that there should be societal consequences for their actions. The primary one (as stated in an earlier post) isolation. If the isolation is not complied with then other consequences should be enforced.

"Once you get to 95% it doesn't matter about the other 5%. [edit] There's no need to call it selfish, as long as 95% are immunised it doesn't matter whether the last 5% are or aren't. Individual cases do not matter. [edit] Vaccinating 95% or more of the total population provides the maximum possible protection." Herd protection position. Herd protection only applies when the herd remains static, relatively non-changing. In modern society with ability to travel outside the herd, the herd protection logic fails. The non-vaccinated that travel outside the herd (into areas where they become susceptible to infection) if infected then have the ability to bring the infection back to the members of the herd/community that are without choice. Again, this is why the US and Aus have vaccination protocols for individuals that travel to endemic areas. First to protect the individual while there, second to protect the disease from returning to the herd.

"If you want to blame anyone blame doctors, nurses, and pharmacists for not communicating the need to their patients effectively. [edit] They slip through the net often because they don't follow it up by getting advice from their GPs, and their GPs don't bother to actively engage their clients to get their children immunised. [edit] Is an indication that there's something wrong with healthcare delivery." Sounds like everyone is blaming. I agree that both sides have responsibilities. For vaccination, which is regulated by society, the parents/patients have the majority of responsibility. It is not feasible (physically/economically) for healthcare to contact every individual. If the parents/patients want to be a part of the herd/society (without limitations), it is their ultimate responsibility.

"Again this isn't "my view". I'm stating the conventional wisdom of the healthcare professionals." I read the two articles that were online. They are directed at healthcare in general, not vaccination specific. Healthcare in “general” is not a societal requirement, vaccination is (at least in US and Aus). If you can provide an article specific to vaccination I’ll be happy to read it. In fact I’ll provide one myself: http://www.who.int/mediacentre/news/rele...itancy/en/

My only point is that if an individual (or their children), for what ever reason (fear,ignorance,mistrust), knowingly elects to not get vaccinated then they need to be aware that they may not have all of the rights and privileges of those who do vaccinate. That there may/should be consequences. The first is voluntary isolation, restricted movement/contact, i.e. day care, public/private school participation, public transportation, public gathering places, public events (Disneyland comes to mind)....... If the individuals choose not to abide by the imposed isolation/restrictions, then the society needs a vehicle to have them enforced. The second, responsibility for damages caused by infecting others in society who don't have the ability to choose (legal-criminal or civil).

[Redbeard The Pink]

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mh.brewer

Look this is my field of study,

Credentials please. Articles, books, papers, any supporting evidence.

Aractus:

Noticed you chose not to respond. I will. Graduate University of Nebraska Medical Center, 1983. Dr. of Clinical Pharmacy, speciality in psych and geriatrics.

I don't like (or even really know how to use) the quote function. I've copied and pasted parts of some of your posts (in black type). If you feel they are in error I am  willing to correct them if they need correction. My response in blue.  

Referencing the OP link: “Did she have a good reason? Yes in my opinion she did [edit] she had a negative experience which is an indication that the healthcare service is inadequate." Opinion based on hearsay and very limited facts. I doubt that the MD only offered her pills. I don't believe there are not enough facts for either of us to come to an objective opinion. I will concede that she had fear/mistrust (justified or unjustified).


“But wait a second. We have (Australia) maybe 93-94% rate of childhood immunisation. Now compare that to say the fact that 20% of women in Australia report that they have experienced childhood sex abuse.” Off topic. Adds no value to the vaccination discussion.

"And I take issue with the statement that "children who don't get vaccinated put other children at risk". [edit]  2. No they don't, they just don't participate in herd protection." Actually yes they do. Children, vaccinated or not, are part of the herd. The non-vaccinated by choice would be considered an anti-participant/anti-portection/free rider. They have the potential to spread disease to other parts of the non-vaccinated herd (members of the herd/community without choice, children under 15 months, persons without immunity due to genetics, disease, disease treatment or old age. Again, please notice that these individuals have no choice). If infected and released into the herd they have the ability to transmit the disease directly or indirectly (produce a subclinical infection in the vaccinated who then have the ability to infect the members of the herd/community without choice).

"4. The so-called harm that people don't vaccinate their children is only a "potential" I agree. However it is a potential that society has deemed an unacceptable risk. That’s why there are vaccination schedules in both our countries.
 
"Immunisation is about preventing outbreaks, not individual cases. So this whole argument that parents are putting their own children at greater risk is not correct - they are putting the community at greater risk." This is incorrect, it is about both. Don’t think it’s about individuals? Have the child/parent/you take a trip to an endemic area with measles, cholera or yellow fever without being vaccinated and come into direct contact with the infected, taking no extra precautions. Look at the US and Aus requirements for individual vaccination when coming from another country with no proof of vaccination. Those individuals are given a choice, get the required vaccinations or don’t become part of this herd/society.
 
"Particularly that you shouldn't victim-blame people who have distrust in health services." I won’t blame them. However, they do have a choice, unlike other members of the herd/community. I will state that there should be societal consequences for their actions. The primary one (as stated in an earlier post) isolation. If the isolation is not complied with then other consequences should be enforced.

"Once you get to 95% it doesn't matter about the other 5%. [edit] There's no need to call it selfish, as long as 95% are immunised it doesn't matter whether the last 5% are or aren't. Individual cases do not matter. [edit] Vaccinating 95% or more of the total population provides the maximum possible protection." Herd protection position. Herd protection only applies when the herd remains static, relatively non-changing. In modern society with ability to travel outside the herd, the herd protection logic fails. The non-vaccinated that travel outside the herd (into areas where they become susceptible to infection) if infected then have the ability to bring the infection back to the members of the herd/community that are without choice. Again, this is why the US and Aus have vaccination protocols for individuals that travel to endemic areas. First to protect the individual while there, second to protect the disease from returning to the herd.

"If you want to blame anyone blame doctors, nurses, and pharmacists for not communicating the need to their patients effectively. [edit] They slip through the net often because they don't follow it up by getting advice from their GPs, and their GPs don't bother to actively engage their clients to get their children immunised. [edit] Is an indication that there's something wrong with healthcare delivery." Sounds like everyone is blaming. I agree that both sides have responsibilities. For vaccination, which is regulated by society, the parents/patients have the majority of responsibility. It is not feasible (physically/economically) for healthcare to contact every individual. If the parents/patients want to be a part of the herd/society (without limitations), it is their ultimate responsibility.

"Again this isn't "my view". I'm stating the conventional wisdom of the healthcare professionals." I read the two articles that were online. They are directed at healthcare in general, not vaccination specific. Healthcare in “general” is not a societal requirement, vaccination is (at least in US and Aus). If you can provide an article specific to vaccination I’ll be happy to read it. In fact I’ll provide one myself: http://www.who.int/mediacentre/news/rele...itancy/en/

My only point is that if an individual (or their children), for what ever reason (fear,ignorance,mistrust), knowingly elects to not get vaccinated then they need to be aware that they may not have all of the rights and privileges of those who do vaccinate. That there may/should be consequences. The first is voluntary isolation, restricted movement/contact, i.e. day care, public/private school participation, public transportation, public gathering places, public events (Disneyland comes to mind)....... If the individuals choose not to abide by the imposed isolation/restrictions, then the society needs a vehicle to have them enforced. The second, responsibility for damages caused by infecting others in society who don't have the ability to choose (legal-criminal or civil).

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Dude, be careful with that shit. You're going to break our microphones if you keep dropping them that hard.

[CapnAwesome]

Summarizing the article, his wife is an anti-vaxxer nut and also a nice person. Big deal. I've met hardcore racists who seemed like pretty nice people. Not vaccinating your children is dangerous for society and for your children.

[Aractus]

lol, what criteria do you suggest, if not rationality?

It's one valid option but it's not the only one. You can't just go around labelling people who have a different view of what healthcare means to them as wrong. Some people view health as an individualistic thing, others view it as a community centric concept. What seems rational in one view would not seem rational in the other.

I've already repeatedly stated what some of the other criteria that is meaningful to people is. Feeling their concerns are being listened to. Whether it addresses something that is important to that person for their health. It depends a lot on where a person's values lie.

There is a huge difference between curative and preventative health measures as well. Some people view curative measures as being more important - others see the value of preventative medical services as being more important.

It's very difficult to get action on any preventative measures when compared with curative ones. What you're discussing in this thread of course is a preventative health service - and you are acting as if people view that preventative measures as being as important as curative ones - which is absolute rubbish. Take breast cancer screening for example.

In Australia in 2010-2011 the participation rate of at-risk women in breast cancer screening was 55%. Yet the rate of immunisation is over 93% (and we know that a portion of the final 7% is because children were unable to be immunised as well as patients slipping through the net, inadequate access to the service, and parents who don't understand the need). Yet 45% of women don't participate in breast cancer screening ... so as I was saying you should be very happy with the rate of participation in childhood vaccination when you compare it to other preventative health health measures that are nowhere near the participation rate that it has achieved.