Cites please!

October 28, 2009 8:08 AM

What do I say to well-meaning people trying to dissuade me from the flu shot?

As an immuno-compromised individual, and a mother of a young child, I'm pretty keen on the whole flu shot thing. Problem is I've got loads of people sending me stuff like this trying to persuade me not to do it. This ties into a larger (and disturbing) trend among mommies today that if you really love your children, you won't subject them to the evils of vaccination. (The chemicals! The horror!) So....what do I say to such folk? More importantly, what helpful links can I send them in return? My policy so far has been to smile and nod, and when pressed lightly explain that I love needles and chemicals, the more the merrier. I'm looking for something that more actively contradicts my well-meaning friends, and perhaps changes their minds.

posted by Go Banana to Health & Fitness (55 answers total)

"I don't want my child to die from the flu."
posted by aabbbiee at 8:10 AM on October 28, 2009 [16 favorites]

Arguing with people who have formed a strong opinion on something based on FUD spread from the internet is a waste of your time and energy. You're not going to change their minds. You've done your own research, are comfortable with your decisions and are doing what you think is right for your family. I don't think you're going to change their minds though.
posted by IanMorr at 8:15 AM on October 28, 2009 [2 favorites]

Best answer: My policy so far has been to smile and nod

This is best.

If pressed, you could always say what a good friend of mine says under such conditions: "I'll take it under advisement."

It's just dismissive enough that the other person may feel vaguely like they've been blown off, but won't be able to put their fingers on how to respond. Or, if they're kind of clueless, they can convince themselves that "ah-ha, I convinced her!" and they'll leave you alone.
posted by EmpressCallipygos at 8:15 AM on October 28, 2009 [2 favorites]

"Well before they even knew about vaccines 50 million people died from the flu in just 18 months. The odds are way better now."
posted by Gungho at 8:15 AM on October 28, 2009 [2 favorites]

When people talk about the risks of immunization they invariably ignore the risks of the disease, which are much greater. It's virtually impossible to logically argue with people who don't wear seat belts because they fear being trapped in an accident.
posted by weapons-grade pandemonium at 8:16 AM on October 28, 2009 [5 favorites]

There's an organization called Every Child By Two which advocates for baby vaccination. Maybe ask them where Polio went?
posted by tmcw at 8:17 AM on October 28, 2009 [1 favorite]

"I prefer to listen to the advice of the scientists and doctors, rather than some cackling nincompoop on The View."

The walk away.
posted by bondcliff at 8:20 AM on October 28, 2009 [7 favorites]

There is a great blog called "Respectful Insolence" (link) that often analyzes (and mocks) anti-vaccinationists. I wouldn't suggest forwarding the link straight on to your friends, but would instead recommend using many of the studies and reports he links to.
posted by gagoumot at 8:21 AM on October 28, 2009 [5 favorites]

Megan McArdle had a pretty good blog post about the erroneous conclusion that vaccines cause autism.
posted by dfriedman at 8:29 AM on October 28, 2009

You don't have to justify yourself at all - say nothing!
posted by devnull at 8:35 AM on October 28, 2009

"That's ridiculous." Also, what Bondcliff said.
posted by The Michael The at 8:38 AM on October 28, 2009

"Your input is noted."
posted by jgirl at 8:40 AM on October 28, 2009

Normally I'd advise against arguing with ignorant people like this, but in this case their decisions actually endanger the rest of society. Read through the featured article in Wired for advice:
http://www.wired.com/magazine/2009/10/ff_waronscience/all/1

If you can explain herd immunity, the trade-off between disease risk and vaccine risk, and the other factors involved, then you at least have some hope of convincing 1 in a million of these jerks.
posted by RobotNinja at 8:42 AM on October 28, 2009 [1 favorite]

Ben Goldacre's Bad Science website is a good place to start (he mostly talks about the MMR controversy though rather than jabs in general) and has many links to similar websites which between them should be able to effectively arm you against ridiculous views.

As per tmcw above, asking where polio went is a good tactic, as is asking why smallpox disappeared soon after immunisation started and reappeared after immunisation stopped.

However, IanMorr is also correct - you are highly unlikely to change anyone's mind. At least if they know you have done your research and are firm in your views they might leave you alone.
posted by jonnyploy at 8:44 AM on October 28, 2009

I think, in many ways, arguing with people that have been brain washed into thinking that vaccinations are evil things is like arguing with someone who drives like a jerk. They may listen to you (or appear to) and then they are going to go right back to doing what they were doing.

Don't waste your time on them. Do what is right for your family and let them worry about their family.

The way I look at it, if they don't get vaccinated and then they die, you'll get the last laugh (yes, I'm kidding).
posted by fenriq at 8:48 AM on October 28, 2009

I don't know what catch phrase you could say, but I will recount the agony of a co-worker, a mother who watched her child struggle through a fever disease that she could have prevented with a vaccine. The child had vision and perhaps some brain damage from the illness. She lived with her guilt every day.
posted by effluvia at 8:50 AM on October 28, 2009 [1 favorite]

"Shut your germ-ridden virus-harboring face" would be a start.

Unfortunately, I don't think anything you are going to say is going to change their minds or sway their opinions. And I say this as someone who has endured a rogue relative posting youtube videos on Facebook nearly every day about how the H1N1 vaccine causes everything under the sun and we'll all be safe if we just take more vitamins!

Say nothing about it. If pressed, maybe say "due to our medical issues, we were strongly advised to take part in the vaccination."
posted by jerseygirl at 8:51 AM on October 28, 2009 [1 favorite]

"If your kid dies of the flu, do I have permission to come to the funeral with a wry chuckle?
posted by notsnot at 8:51 AM on October 28, 2009

Best answer: So....what do I say to such folk? More importantly, what helpful links can I send them in return?

I have observed that arguments between anti-vaccinators (and more generally anti-Western medicine folks) and people in favor of vaccination tend to go very poorly, often because the arguments are advancing along two totally different planes with the two sides talking completely past each other. If you really want to change your friends' minds, there's two things you're going to need to do: (1) assume good faith on their part [that is, be willing to believe they're trying to be helpful and acting out of concern for you, not just because they're stupid idjits worthy of ridicule]; and (2) understand what underlying fears they have that are making the anti-vaccine argument resonate with them.

It can be kinda frustrating to do #1 and #2 and continue to engage respectfully with people, even in a situation where you really love the person in question [hi mom!], so I really encourage you to consider just continuing your policy of smiling, nodding, and saying "uh huh, thanks for the info, I'll take it under advisement." That said, if you feel it's really important to try to change your friend's minds, in my experience sending links or duelling studies is not likely to be an effective method. If your friends were the type of people who had high scientific literacy and generally a lot of faith in the scientific and/or medical community, they probably wouldn't be against vaccinations in the first place.

The best technique I've found is as follows.

First, acknowledge any points in their argument that you can agree with [e.g., "I think it's incredibly important to be aware of all the chemicals in our environment, there are so many chemicals that have been banned in Europe but are still used here, it's hard to know what's safe when it seems like the FDA is so toothless these days"]

Second, suggest that those valid fears are mis-directed at vaccines ["I'm actually much more concerned with chemicals in the food supply chain, particularly ones that have been linked to cancer. Are you aware of the fight right now to ban atrazine from farming? I can't believe it's taken this long to do."]

Third, acknowledge their underlying fear as valid but nicely say that you've come to a different conclusion after reviewing all the evidence ["I try to do as much research as possible into possibly harmful chemicals, especially now that young Child is on the scene, and after looking into all the studies about vaccines I think on balance I feel more comfortable with the small level of chemicals than with the risk of the disease. I think it ultimately makes more of a difference for me to make sure the food Child eats is safe in terms of avoiding chemicals."]

Fourth, drop it. If you acknowlege their concerns as legitimate, say you've done research and your informed opinion is that it's worth it, then drop it without trying to push them, it's not unlikely that those who would be open to being swayed are going to start asking YOU about the research you did. At that point, you have a lot of credibility since you seem to share their concerns but maybe have seen some research that they haven't, and you're not obviously pushing an agenda.

Like I said above, this conversation is incredibly difficult to have without losing your shit and alienating the people you're talking to unless you absolutely positively force yourself to believe that you are talking to someone that is a good person at heart that is doing the best they can with the information they have. (It's kind of like talking about religion that way.) It's okay to take a pass on frustrating conversations where you think there's no chance you'll change any minds.
posted by iminurmefi at 8:55 AM on October 28, 2009 [33 favorites]

I'm looking for something that more actively contradicts my well-meaning friends, and perhaps changes their minds.

You can only mother so many children.
posted by Blazecock Pileon at 8:55 AM on October 28, 2009 [9 favorites]

Without making any value judgements (and I'm on the fence myself as there's enough pseudoscience and conflict of interest to go around) the underlying issue I'm seeing is that what goes on in your doctor's office is not really anyone's business and this kind of gets into matters of personal privacy. Health choices are not battles you can win and you don't owe anyone explanations, unless the concerned people are grandparents, daycare owners, etc.

I'm siding with smiling and nodding, hearing them out, maybe a nod of faux approval, then using things that they say as hooks for changing the subject... e.g. "your kids? you have a daughter, does she go to XYZ school?", etc. If you're talking to the sorts of people where you might be held morally accountable for your decision later on, then next time you go to the doctor have a discussion about the pros and cons. Then when this comes up just selectively relay his concerns and that will put a stamp of authority on the whole thing.
posted by crapmatic at 8:55 AM on October 28, 2009

I like guilt. "Are you saying that autistic children are less of people than regular children? Do autistic parents love their children any less? My, I never knew! How tragic?" I have a friend with an autistic child who hates these people.

If you are non-confrontational, I would just say, "Thank you for the information." That doesn't mean you have to take it.
posted by itsonreserve at 8:58 AM on October 28, 2009

I don't think you're any more likely to persuade the anti-vaccine crowd than the anti-vaccine crowd would be able to persuade you. It's an argument that happens because both sides firmly believe in their rightness.

I really think epidemiologists should speak more about vaccines --- the trends associated with each disease after the vaccine came out as well as what other factors contributed to that disease's decline or rise. One argument many people against vaccines put forth is that sanitation can be just as responsible for disease prevention as vaccines have been said to be. There's some truth to this, but taking polio for example, as sanitation improved, there were a few pockets of increased cases.

"As a society improves its sanitation (a transition which helps eliminate a number of other diseases), individuals are likely to be exposed to polio later in life, if at all, so the paralytic disease starts to occur in sporadic epidemics. Because the wealthy are the first to benefit from improved sanitation, they are often the first to experience these epidemics. Franklin Roosevelt, perhaps the most famous polio survivor, was a victim of this phenomenon. "

So arguably, yes, sanitation certainly helps overall and most likely longterm, but sanitation alone can't be fully credited with either a decline or increase. And neither can a vaccine for the same reason, though vaccines can help immensely.

So, maybe, on the off chance that you have someone you can persuade to your side, taking the approach from an epidemological angle may be better than a, "This study said," or "my doctor said" angle. An overall picture of the disease's course may do better at helping someone understand your reasoning. If you're not basing your answers on, "This study said," or "my doctor feels" (many anti-vax people make use of alternative medical practitioners and distrust medical professionals) and are instead basing your answers on well-done personal research, you may at least find that these people respect your decision for yourself and your child a little more.
Personally, I don't think you'll have much luck taking it further than that and convincing someone who doesn't vaccinate to vaccinate.
posted by zizzle at 8:59 AM on October 28, 2009

I already favorited aabbbiee's response of "I don't want my child to die from the flu", but I felt it might be helpful to explain why I think that response might be appropriate.
The people advocating not getting vaccinated are doing it based on emotion. After all if it was rational, then they would be swayed by all the rational arguments out there for getting a child vaccinated. Their emotional response is fear of doing harm to their child through an active choice, however they are completely neglecting the very real aspect of doing harm to their child by being passive. The statement that indicates you fear the threat of the passive approach much more than any issue from vaccination puts the issue squarely in the appropriate emotional context. It dismisses their fears as minor compared to what they should be afraid of, and it has a better chance of changing their opinion (though it probably won't).
posted by forforf at 9:01 AM on October 28, 2009 [1 favorite]

You cannot reason people out of a position they did not reason their way into.
posted by ricochet biscuit at 9:01 AM on October 28, 2009 [11 favorites]

I've got 3, and we haven't run into this yet, really.

If we did, I suppose I'd ask them how often they see diseases like measles, mumps, rubella, diptheria, polio, tetanus, smallpox, pertussis, etc. among children they know

When they answered, "Very Rarely", I'd ask them how that could be, when these diseases afflicted and even killed children pretty regularly as recently as the last century.

Then I'd say, 'Thank You For Your Concern".
posted by spirit72 at 9:13 AM on October 28, 2009 [1 favorite]

Smile and nod.

Let them figure it out when their child is diagnosed with autism and the flu at the same time.
posted by WeekendJen at 9:21 AM on October 28, 2009

Response by poster: Thanks, all. Some good stuff. And in the meantime I've got an excellent comeback (sadly). Just found out my 5 year old nephew is in the hospital with swine flu. Thinking good thoughts.
posted by Go Banana at 9:31 AM on October 28, 2009

I don't have an answer to your question, but I am flabbergasted by someone's lame attempt to edit the word "shouldn't" to "should" at min 2:02 in the linked video clip!
posted by TurkishGolds at 9:33 AM on October 28, 2009

iminurmefi's approach seems the most likely to make an impression and maintain mutual respect.

i've found that most anti-vaccinionists are either ill informed, or simply invested in doubt, or both. If someone's position is based in doubt, you can't get anywhere. There's no way to prove conclusively that a link between vaccines and autism doesn't exist; all you can prove is that no reliable evidence has ever been found, but people who take as their founding belief that there is a link just argue that we haven't looked hard enough for the evidence, or are ignoring the evidence. That's a dead-end conversation, so once you've pointed out that there is no finding that would satisfy them, they're left with that to think about.

But if they're ill informed, and think that you are ill informed because you don't share their fear, then pointing out the enormous amount of actually harmful environmental toxins that we continue to tolerate (personally I'm getting freaked out about pthalates), or the risks we take every day by doing things like, oh, driving in cars, might just return this concern to proper perspective. It demonstrates that you have exhaustively considered the topic, probably more than they have, and have based your decision on better information than they can muster. All politely.

That's a great script, iminurmefi.
posted by Miko at 9:33 AM on October 28, 2009

I'm sorry to hear that, Go Banana. Hope he recovers quickly.

And, if anyone is so uncouth as to suggest that "well, on the bright side, he'll have natural immunity now without being vaccinated", I say the proper respone in that situation is to beat them about the head and shoulders with a large blunt object.
posted by EmpressCallipygos at 9:35 AM on October 28, 2009

jonnyploy writes "As per tmcw above, asking where polio went is a good tactic, as is asking why smallpox disappeared soon after immunisation started and reappeared after immunisation stopped."

Not sure if you were referring to pre eradication however smallpox was finally eradicated in the 70s with the last natural cases contracted in 1978. It was officially certified as eradicated on December 9th, 1979 and no cases have been reported since.
posted by Mitheral at 9:41 AM on October 28, 2009 [1 favorite]

If you legitimately want to change someone's mind, iminurmefi's strategy is the way to go. Above all, assume good faith. And keep in mind that patience is required. People very rarely change deeply held beliefs overnight. You're not going to get an anti-vaccinationist to say, "OMG, I realize now how wrong I've been! I will have my children immunized immediately!" in the space of a single conversation. But your conversation, if done respectfully, might be the spark that starts them investating further and eventually—possibly not for months or years—changes their minds. I'll agree with anyone who says it's rare for an anti-vaccinationist to change his mind, but disagree with those who say it's impossible.

At the same time, you might want to consider whether it's worth your time and effort to engage in a debate that may or may not bring the result you want. If you decide it's not, the responses in this thread may be useful.
posted by DevilsAdvocate at 9:46 AM on October 28, 2009

Orac over at Respectful Insolence is a blogger (and surgeon and cancer researcher) who has been dutifully and prodigiously toiling away for years to completely annihilate the moronic claims that flow from the anti-vax crowd. He has covered every gambit they use, so if you want the scientific basis to refute their stupidity then just search his archives. It's all there.
posted by Rhomboid at 9:47 AM on October 28, 2009

I find that people who are anti-vaccination often credit anecdotal evidence. So I might try mentioning anecdotal evidence about the harm from not vaccinating. Such as in Minnesota, where at least one child died from meningitis because they were not vaccinated against the disease. Or San Diego, where an unvaccinated boy was the source for a measles outbreak.
posted by EatenByAGrue at 9:49 AM on October 28, 2009

On a somewhat related note, The Final Inch is a wonderful short documentary I saw a few weeks ago, about the ongoing attempt to eradicate polio. Most of the film is set in the densely populated Uttar Pradesh state of India. The volunteers there have their own set of anti-vaccinationist beliefs they have to confront; some Muslims there fear the polio vaccine is an American plot to sterilize the Muslim population. (I don't mean to suggest that view is widespread among Muslims there; in fact, the documentary includes footage of an imam preaching vigorously on the duty of all Muslims to have their children immunized.)
posted by DevilsAdvocate at 10:00 AM on October 28, 2009

Back in my day, we went to the doctor periodically and got our shots, and that was pretty much that. No real need to discuss it with anybody.
posted by spilon at 10:09 AM on October 28, 2009 [1 favorite]

I'm really disappointed when I hear of people not getting vaccinated for H1N1 because too often they treat it as an individual thing. It's not. I didn't get vaccinated for myself, but I did it so I don't shed the virus on my pregnant co-worker, or on my friend's mother, who is immuno-suppressed. The point of a vaccine is public health, not "I personally didn't get the flu". (grrr)

Anyway, since you're looking for citations, I found this link to be helpful in terms of explaining the science behind immunization in fairly plain language while still referencing all the studies you could want.
posted by Kurichina at 10:21 AM on October 28, 2009 [1 favorite]

I'll agree with anyone who says it's rare for an anti-vaccinationist to change his mind, but disagree with those who say it's impossible.

Just as a data point: it has not been my experience that it is particularly difficult to change someone's mind about getting a specific vaccination. In the past few months, I've had 100% success in changing the minds of the N=2 people I've talked to who expressed reluctance to get vaccines (Gardasil and H1N1). I'm know the dynamics are different when we're talking about parents who are hesitant about vaccinating their kids, but in my experience the majority of people who fall in the anti-vaccination camp aren't Jenny McCarthy-level set in their beliefs, not by a long shot. They're generally reasonable people with understandable reservations--usually, they think that there are plausible claims on both sides and feel like they don't have the necessary skills to decide which side's evidence is correct--and since the anti-vaccination crowd tends to come across as a lot less unhinged and nasty than the pro-vaccination side when talking about this stuff (seriously, there are people in this thread who are talking about laughing at kid's funerals), they end up thinking the anti-vaxxers are more credible. That's an incredible shame and a loss for everybody.

If some of the responses in this thread are representative of how people are approaching their friends and acquaintences who are against vaccination ("Shut your germ-ridden virus-harboring face", is that really something you'd say to a friend?), then yeah, I'm not terribly shocked that they'd think it's impossible to get people to change their minds.
posted by iminurmefi at 10:23 AM on October 28, 2009 [1 favorite]

"Do you have polio?"

"Do you know anyone who has ever had polio?"

"Do you know why no-one has polio anymore"?

etc
posted by modernnomad at 10:26 AM on October 28, 2009 [2 favorites]

Cough and sneeze on them, and then moan about how you think you have a fever and body aches.
posted by elder18 at 10:43 AM on October 28, 2009

1) There are no adjuvants in the flu shot (as rumored); adjuvants are illegal in the US.

2) There is more mercury in a serving of canned tuna than in a thimerosol-containing vaccine. (And only multi-use vials of flu vaccine have thimerosol, single-use ones don't.)

3) People who don't get flu shots usually tell me, "Well, I've never had the flu, so I don't need it." Well, I have had the flu and it is miserable. Even if I don't actually die from it, I don't want to be miserable for 2 weeks.

In your case, though, you are immuno-compromised, so you can just repeat that your doctors recommend it because getting the flu would be far more serious for you than for most folks. You could end up in the hospital with pneumonia, and worse. Lay on a little self-righteousness, that's what I would do. Fight fire with fire. : )
posted by Knowyournuts at 10:43 AM on October 28, 2009

Why are you even discussing your personal medical choices with anyone in the first place? Just... don't tell anyone. Is there any reason anyone other than you and your healthcare provider needs to be in on this decision?
posted by DarlingBri at 10:53 AM on October 28, 2009

I've never had the flu, so I don't need it.

Someone who says this probably doesn't realize that different strains of the flu are prevalent every year, and each year's flu vaccine is formulated to prevent the varities of flu most expected to be problematic and communicable. Not having had the flu (we should really say "a flu") in the past means nothing about whether you're going to get it in the future. It's not a one-type, one-time illness like chicken pox.
posted by Miko at 11:03 AM on October 28, 2009

Why are you even discussing your personal medical choices with anyone in the first place? Just... don't tell anyone.

I think that's precisely the problem: Go Banana would rather NOT be discussing these things, but other people are trying to goad her TO discuss them, and are discussing their OWN views with her. And polite refusals thus far are being met with more nagging.
posted by EmpressCallipygos at 11:15 AM on October 28, 2009

1) There are no adjuvants in the flu shot (as rumored); adjuvants are illegal in the US.

Go Banana is in Toronto. The first batches of vaccine available here in Canada do have adjuvant, but there will be another batch coming out after that without adjuvant.

I think you have a lot of good responses already, but another blog with useful information about the flu and vaccines is Effect Measure. Of special interest: analysis of The Atlantic article on flu vaccines here and here.

I hope your nephew recovers soon, Go Banana. This is a scary time for parents.
posted by maudlin at 11:41 AM on October 28, 2009

"I'm immunizing my child to keep him from catching the flu and passing it on to your child. You're welcome."
posted by kindall at 11:56 AM on October 28, 2009 [1 favorite]

Slate ran an article last week about immunizing your children for the sake of others. If you're looking for a short article to forward to your friends I'd suggest this one.
posted by lilac girl at 12:14 PM on October 28, 2009

Oh, Maudlin, you are right! How US-centric of me! I had assumed that the anti-vaccine movement was a crazy US thing.
posted by Knowyournuts at 12:36 PM on October 28, 2009

I had assumed that the anti-vaccine movement was a crazy US thing.
FWIW: here in the Netherlands it seems to be even more crazy than in the US. There are actually booklets in my fairly mainstream health food store that argue that vaccins could contain a sort of tracking device so that the government can control us all. Or something. It is really weird.

I do wonder if there is no vaccine shortage in the US? Because in this thread and the other vaccin thread a few days ago (about mercury) people argued that if you don't do it for yourself, you do it to protect others. Here in the Netherlands it isn't even possible to get a H1N1 vaccin if you do not belong to a risk group, because there is a shortage, so it makes much more sense to vaccinate the people who are most at risk.
posted by davar at 1:40 PM on October 28, 2009

Best wishes for your nephew's recovery.

The VAERS data is a really wonderful resource for reported information on adverse effects of vaccination. Though it has all the statistical limitations of a passive-reporting system, it has a great deal of data available (esp for current issues, following the National Childhood Vaccine Injury Act (NCVIA) of 1986).

I have found this more helpful than journalistic reporting or opinion pieces in talking to friends about vaccine concerns.
posted by judith at 3:00 PM on October 28, 2009

Thanks for vaccinating your child.

How much do you want to discuss it? If not much, then say "I appreciate your concern, and I hope you'll respect my decision." If they say "But..." respond with "I don't want to discuss it."

If you want to discuss it: "Every vaccine carries a tiny risk. Each child takes a tiny risk, so that everybody can avoid a larger risk, the risk of measles, polio, flu, etc. There are some children who can't be vaccinated because they have significant health problems. It's okay with me if those kids get protected without taking a small part of the risk. It's not okay with me if other children don't get vaccinated. It's a community responsibility, and, honestly, it's a moral issue."
posted by theora55 at 3:35 PM on October 28, 2009

jonnyploy writes "As per tmcw above, asking where polio went is a good tactic, as is asking why smallpox disappeared soon after immunisation started and reappeared after immunisation stopped."

Not sure if you were referring to pre eradication however smallpox was finally eradicated in the 70s with the last natural cases contracted in 1978. It was officially certified as eradicated on December 9th, 1979 and no cases have been reported since

You're absolutely right of course. Apologies, not sure how that piece of anti-knowledge got into my head; thanks for pointing out the error. In future I will check before unloading my brain onto the page.
posted by jonnyploy at 4:08 PM on October 28, 2009

"Duly noted."
posted by astrochimp at 10:01 PM on October 28, 2009 [1 favorite]

"If you insist on living in the dark ages I'm afraid you'll have to stop watching television and driving cars."
posted by mmoncur at 2:27 AM on October 29, 2009