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Uniqueness – Yes influence



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Uniqueness – Yes influence

Changing the minds of anti-vaccination parents is possible – now is key.


Palmer 15 – Katie Palmer, senior associate editor at Wired covering science and health, member of the Science, Health and Environmental Reporting Program (SHERP) at NYU's Arthur L. Carter Journalism Institute, recipient of the Jeffrey Owen Jones Fellowship in Journalism, 2015 (“How to Get Silicon Valley’s Anti-Vaxxers to Change Their Minds”, Wired, February 12, Available Online at http://www.wired.com/2015/02/get-silicon-valleys-unvaccinated-change-minds/, accessed 7/22/15, KM)
THERE’S BEEN A lot of shaming and blaming of the anti-vaccination crowd in response to the Disneyland measles outbreak ( even we did it). And when we released our investigation of vaccination rates at Silicon Valley preschools, people were justifiably angry: Every unvaccinated kid at those schools threatens the greater community’s protection against disease. But yelling at anti-vaxxers won’t change their minds—which is what we need most to prevent more outbreaks. That begs the question: What can turn them around? After writing about how vaccinated people got measles in California, I read the comments posted about it on Facebook. Among the anti-vax commenters, there were a few science-hating, vitriol-slinging, homeopathy-hawking kooks. But the vast majority werereasonable. Take this person, for example: Someone strong enough to get the vaccine (and thus be conferred limited immunity for 2-10 years) is likely strong enough to handle the disease and consequently have real life-long immunity, which is what is really needed for “herd immunity” to actually work. This person is wrong, of course, but there’s some science—or at least some attempts at using science—in there. It’s worth repeating, clearly: Refusing vaccines is a bad choice, but anti-vaxxers aren’t evil for making that choice. Every parent who turns down a vaccine is simply trying to make the right decision for their kid. As long as that motivation exists, there’s a chance that a parent can be convinced that vaccination is the safest choice—for their child, and those around them. To figure out how to turn that “no” into a “yes,” it’s important to know how that decision occurred in the first place. As Amy Wallace explained in a WIRED cover story, vaccine refusal comes down to one emotion: fear. Or, in the current environment, the lack of it. Thanks to the success of vaccination programs, many Americans have never seen a single case of measles—they didn’t get it themselves, and probably don’t know anyone who’s had it. That interferes with how they process fear in two ways. Number one, we get responses like this one (from that same story, on Facebook): Measles is not a dangerous disease, it is just a normal childhood disease, it’s safer to get antibodies from the actual virus than from vaccines. Unvaccinated children have higher and stronger immune systems, so they fight it fast… Measles has, for many, become a hypothetical disease. And a hypothetical disease isn’t scary. “People become desensitized to the seriousness of the disease when they’re not exposed,” says Kristin Hendrix, a pediatric researcher at Indiana University School of Medicine. Measles was eradicated in the US in 2000, so even if you’ve seen a case, you probably haven’t met someone who pulled the short straw: The one person in 10 who gets an ear infection, potentially resulting in deafness, or the one in 20 who gets pneumonia, or the one in 1,000 who develops encephalitis—or dies. Which leads us to number two. The risk of vaccines—the one in 3,000 chance of seizure for the MMR, or the one in more than a million chance of a serious allergic reaction—starts to seem much bigger in comparison to those fading memories of measles past. “Parents can be scared very easily by hearing about potentially negative consequences,” says Gary Freed, a pediatric researcher at the University of Michigan. And the act of stabbing your kid in the arm with a needle is far more immediately threatening than the potential exposure to measles, especially if you’re counting on her not being exposed to the disease in the first place. My husband nearly died from the tetanus vaccine when he was a kid. Fear is a powerful, often irrational emotion. No matter how many times you drive home the statistical near-impossibility of a negative vaccine reaction, it’s often overlooked in the face of a personal anecdote. If someone has a relative who had a bad reaction to a vaccine—or even a great-aunt on Facebook whose friend’s daughter became withdrawn after one—the immediacy of that story will carry more cognitive weight than numbers. Humans are big on narrative. Science (usually) is not. So now, medical professionals and researchers must figure out how to use information—cold, impersonal facts—in a way that can counteract the power of that primal (and inaccurate) risk calculation. That job is far harder than it used to be. Doctors once were the primary source of medical information, but now it’s everywhere online—some of it true, some of it not, and the vast majority somewhere in between. That’s a problem, because humans suffer from a major case of confirmation bias. “We seek out and gravitate toward information that confirms what we know to be true,” says Hendrix. Sometimes confirmation bias is so extreme that it even turns positive messages into negative ones: One paper last year found that while pro-vaccine information corrected some misperceptions about vaccines—like the fallacy that it causes autism—reading it actually made some resolutely anti-vax parents even less likely to vaccinate. Unfortunately, recent research has shown that presenting provaccine messages and evidence to anti-vaxers only makes them become more ingrained in their misguided beliefs. Researchers don’t have any great ideas about how to change the “stickiness” of bad information once it gets that distorted. But there’s hope. There always have been a certain number of staunchly anti-vaccine parents—researchers estimate about 2 percent of parents fall into that camp, and that number isn’t changing much. It’s a second group of parents and patients—the so-called vaccine-hesitant—that are the ones fueling the fire of vaccine refusal. But they’re also the ones that still may be open to change. Doug Opel is a pediatrician at Seattle Children’s Hospital working to target those fence-sitters with individually tailored information. “Parents themselves can have a hard time knowing where they are, or they don’t fully disclose what they think about vaccines in an appointment,” says Opel. “That turns a pediatric appointment into a chess match.” Opel’s shot at a solution is a 15-question survey that gives parents a score on a scale of 0 to 100—over 50, and you’re much less likely to vaccinate. He’s most interested in targeting parents in that 50-to-80 range, by addressing their specific concerns in one-on-one conversations instead of relying solely on an impersonal Vaccine Information Statement from the CDC. It’s not an easy job: Any conversation he has with a parent is going head-to-head with personal horror stories from Facebook friends and anti-vaccine celebrities. “We know that personal narratives and anecdotes that are emotionally laden are very persuasive,” says Hendrix, “and that people play into fear-based information more than positive information.” Anti-vaccine stories are so powerful because they capitalize on both of those persuasive techniques. But two can play at that game. With this major outbreak—which has racked up 103 cases at last count—to play into the fear of parents, and a potent narrative to boot (Wow, we’re not even safe in the Happiest Place on Earth), this might just be a pro-vaccine story that can change some minds. Normally, pro-vaccine messages don’t have the splash and the buzz of a crisis,” says Freed. “Now we do.” It may just be that the anti-vaccine movement has created the outbreak that could kill it.

Pro-vaccination is changing minds – recent California measles outbreak is persuading “vaccine-hesitant” parents to get vaccinated.


Frankel 15 – Todd Frankel, reporter for the Washington Post, teaches journalism at University of Washington-St. Louis, won several journalism awards, including a National Headliners Award, Livingston Award finalist, and a member of the 2009 Pulitzer Prize finalist team for breaking new, 2015 (“Forget ‘anti-vaxxers.’ The Disney measles outbreak could change the minds of an even more crucial group.”, The Washington Post, January 26, Available Online at http://www.washingtonpost.com/news/storyline/wp/2015/01/26/forget-anti-vaxxers-the-disney-measles-outbreak-could-change-the-minds-of-an-even-more-crucial-group/, accessed 7/22/15, KM)
The child was behind on her vaccinations. Wendy Sue Swanson took note of this as she talked with the girl’s parents last week at a medical clinic in Mill Creek, Wash., outside Seattle. Swanson, like many pediatricians, sometimes needed to coax parents to get the shots for their children. A few might be unmovable in their objections. But most were like this couple: A mom and dad who might harbor doubts or were just behind schedule. They were at least willing to listen. Now, Swanson had a new way to prod parents like them: Discussing the Disney measles outbreak in California, which has spread to at least 68 people in 11 states since Jan. 1 and raised alarms about the reemergence of a disease once considered all but vanquished. There was something powerful about the disease hitting a popular, recognizable vacation spot. The girl got her vaccination. Her parents were on board. “Their eagerness was different,” Swanson said later. “I think it is changing people.” Much of the scrutiny in the Disney measles outbreak has fallen on an entrenched anti-vaccination movement in places such as Orange County, Calif., home to the two Disney theme parks where the outbreak gained its foothold. These “anti-vaxxers” are viewed as dead-set against vaccinations. But doctors believe the current outbreak could change the minds of a less-known but even larger group: parents who remain on the fence about the shots. These “vaccine-hesitant” parents have some doubt about vaccinations, leading them to question or skip some shots, stagger their delivery or delay them beyond the recommended schedule. An estimated 5 to 11 percent of U.S. parents have skipped at least one vaccination or delayed a shot, according to studies. That compares to only 1 to 3 percent of parents who object to all vaccinations. Boosting compliance among the “vaccine hesitant” population could have major public health implications, doctors say, especially because last year the United States had its highest number of measles cases since 1977. The topic of “vaccine hesitant” patients has become the focus of a growing body of medical research in recent years. Doctors are trying to understand what triggers vaccine worries and which strategies work best for overcoming those fears. Doctors spend many office hours trying to convince these parents that the scientific evidence proves the shots are, in fact, safe and effective. But these hesitant parents have been bombarded by conflicting information. And they don’t view all of the shots the same way. The vaccine to protect against measles, mumps and rubella faces particularly strong resistance as a result of thoroughly discredited studies linking the vaccine to autism. So some parents, even those generally open to other vaccines, push to delay or skip this one. The shot is supposed to be given at 12 months and again at age 4. “One of the problems that vaccines face now is they work too well,” said Michael Smith, a pediatric infectious disease specialist at the University of Louisville School of Medicine in Kentucky, who has studied vaccine-hesitant parents. Parents don’t have experience with measles, how children can become very ill and in rare cases suffer brain swelling or even die, Smith said. At the same time, these parents are confronted with stories about the unexplained rise in the U.S. autism rate. “I can understand as a parent why you’d skip the vaccine if you’d been convinced that it’s a choice between giving my kids a shot or giving my kid autism,” Smith said. But the Disney outbreak changes the discussion. Now, doctors have an event to point to. The threat is no longer abstract or distant. “This is definitely going to be a talking point that pediatricians should keep in their back pockets,” Smith said. Studies have shown that “anti-vaxxer” parents are likely to remain steadfast in their opposition. Barbara Loe Fisher, president of the National Vaccine Information Center, a group that raises doubts about the shots, said she was not convinced that the Disney outbreak was even a story about the dangers of being unvaccinated. “I don’t think we know completely what’s going on,” Fisher said. But physicians such as Kathryn Edwards of the Vanderbilt Vaccine Research Program said the measles vaccine is at least 99 percent effective after the second dose. And measles is one of the most communicable diseases, much more so than the flu. The dangers posed by the disease have been forgotten. Many U.S. doctors have never even seen it. Edwards still recalls the only patient she ever saw with measles, years ago when she was a medical resident. He died. “So I have a lot of respect for measles,” Edwards said. At Boston Children’s Hospital, pediatrician Claire McCarthy said she is always happy when parents decide to vaccinate their children against measles in particular. She worries about the current situation in California. And she plans to use the Disney outbreak to try to convince hesitant parents that vaccinations are the right choice. “I am planning on talking this one up a lot with families,” McCarthy said. “I think this probably will make a difference.”



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