The words we choose

Vaccines have a serious PR problem. No, they weren’t photographed canoodling with the anti-virals. Neither were they replaced by a younger, sleeker version with more bells and whistles. After 100+ dependable years on the job (different vaccines have been made available at different times),  there are many Canadian parents who would gladly give vaccines their walking papers, with no severance pay, and are basically doing just that by refusing vaccinations for their kids.

It’s like when Gotham suddenly decides Batman is a bad guy. If Batman was vaccines, he’d be full of all kinds of gravelly-voiced protests, such as, “I was trying to help you, you idiots. I can’t work like this. I’ll be in my bat cave.”

So many parents have fired vaccines, in fact, that we’ve seen quite a few measles outbreaks in Canada in 2014/2015.

I’ve included a few links in case you want to read about it yourself, but you probably won’t. The subject is all over the news and impossible to avoid. Here’s the argument in a nutshell: those who are pro-vaccine worry that herd immunity is getting dangerously low. We are worried that these kinds of outbreaks will get more common, and that we’ll see a resurgence of illnesses joyfully declared eradicated by the World Health Organization in the seventies. Those who are against vaccinations, who worry that vaccines cause autism and other problems (even though this has been unequivocally disproven) argue that measles are no big deal and they’re not going to throw their child under the bus for some dubious greater good. Some have even suggested that children and society would be much healthier without vaccines, blaming the vaccines for illness.

http://globalnews.ca/news/1806757/toronto-public-health-investigating-measles-outbreak/

http://www.cbc.ca/news/canada/ottawa/measles-case-in-ottawa-prompts-public-health-warning-1.1356643

http://www.cbc.ca/news/health/b-c-measles-outbreak-reveals-vulnerability-of-unvaccinated-children-1.2585457

http://www.cbc.ca/news/canada/montreal/quebec-measles-cases-linked-to-disneyland-outbreak-1.2953336

Like I said, a huge PR problem.

Many years ago, when I was in university, people used to bust on us English students all the time. Hell, even my own Dad wondered more than once how I could possibly need one degree, let alone two, studying a language I’d mastered by the age of three. Despite any misgivings he might have had, he still graciously packed up all my stuff into his truck and moved me into the graduate student’s residence at the University of Waterloo, muttering to himself about how I was never going to cram all those clothes into such a tiny room. A feather boa was spilling out as we dragged everything down the hall past the room of my soon-to-be bestie. She told me that’s when she knew we were going to be friends forever. My mom knew it too, and made sure she’d secured our acquaintance before she left me on my own for the first time in my life.

But I digress.

Obviously I wasn’t learning how to speak English during those years. I was learning how to use language, how it works, is stretched, pulled, and allowed to rest quietly. How a single, simple slogan can inspire a country to gird its loins and tough it out a bit longer. How assigning certain other words to a group of people can empower others to exclude and abuse them in terrible ways.

Words are powerful. Words matter.

CBC Radio had a great discussion the other day with journalists from around the world about using the word terrorist (as opposed to militant or another less-loaded choice). The panelists were in agreement that journalists should label violent acts aimed at civilians as terrorism, and the perpetrators of such crimes as terrorists. The only point on which they differed was on when it was appropriate to do so. One panelist felt neutral language was key until the facts were properly sorted, but they all felt there was no value in downplaying the act itself with neutral language.

The words around the vaccine debate have really heated up this week. There was a heartbreaking post on social media from mother Jennifer Hibbens-White, who received a note saying her infant son may have been exposed to measles at his doctor’s office near Toronto. If you haven’t heard of this family, they suddenly lost a five year old daughter a few years ago to a rare blood infection. I think both sides could probably agree that they have suffered enough.

Just so we’re fully clear, my kids (and us) are fully up-to-date on our vaccines. I have an autoimmune disorder and can’t afford pointless assaults to my immune system, and I love my kids and don’t want them to die or suffer from completely avoidable icky diseases. Life’s just better when you’re not sick. Maybe I’m biased because I married a really smart one, but scientists have consistently made our lives better. Wear glasses? Got yourself a nice, shiny filling instead of a shot of rye and a hammer? Not planning to have one baby a year for each of your 30 fertile years? What’s that? Had your appendix out? The antibiotics cleared that little indiscretion right up, did they? Pretty much anybody from any other time in history, and plenty of developing nations today, would trade places with Canada in a heartbeat.

Up until recently, I no sooner would have felt compelled to establish my belief in vaccines any more than I would my belief in gravity. It just seemed so obvious, what was there to discuss? There certainly wasn’t any wiggle room with either my mom or the family doctor when I was a kid. As kids, we used to compare our small, shiny, matching arm scars. The pro-vaccine side has started to take notice and speak up now, but for many years vaccinating was such a default position no one bothered to defend it.

Neither was there any debate from the grandparents. Ask anybody who has lived long enough to experience disease outbreaks first-hand and they’ll tell you, baffled, that vaccines are obviously fantastic. I heard one older lady ask, “Hasn’t this generation ever walked through an old graveyard? There are entire sections of children who all died of outbreaks the same year.” We visited an old cemetery in Tadoussac, Quebec years ago. There was a section for young kids who had all died in what can only be assumed to have a terrible winter for the town. Some families lost more than one child.

I listened to an older lady talking about life as a student nurse before vaccines. An outbreak of polio took away her friend’s mobility and robbed her of an upcoming marriage. She spoke of the children in her care dropping away each nightfall. Her anguish at being unable to save them was still there, sixty years later. She said when her mom heard a vaccine had been found, she wept with relief. Modern science to the rescue! We’re all saved.

That’s a far cry from where we are today. It’s become quite fashionable to dismiss anything the older generation has to say about parenting. Maybe it’s because the pace of change has been so dizzying we can barely keep up ourselves, and assume that they can’t either, but I can tell you it is very instructive to speak with someone who has first-hand knowledge of life before vaccines.

Unbelievably, the Higgens-White article attracted its share of haters from both sides. Keywords from the pro-side: science, evidence, greater good. Keywords from the anti-side: my choice, my child, my right.

Here’s a sample:

“No one should be bullied into vaccinations by a doc or ped., it’s a very personal and individual choice.”

“I think people are immunizing their children out of fear! Pushed on us by the media. Have you not read any of the ingredients in these vaccines? Vaccines suppress our immune system! Immunize your baby and they will never have a strong immune system.”

“This whole ‘anti-vaxxer’ problem is not that every idiot assumes that their ‘opinion’ is as important as anyone else’s opinion. It is. The problems is that no one’s OPINION is as valid as a someone else’s FACT…the anti-vaxxer’s (and almost all Fox New/Sun New Network) viewers…don’t understand the science, but instead of doing a little research, they fall back on the failed belief that they are entitled to an opinion on the matter which in the absence of knowledge on the subject is simply foolish.”

My goal here isn’t to convince any anti-vaxxers to vaccinate their kids. Let’s face it, anyone inclined that way would have stopped reading at the point where I announced that we’re all vaccinated.

As a language person, I’m curious about the argument, and what it might take to persuade people to vaccinate.

So far, the science side has been completely unsuccessful in convincing the anti-vax side. No amount of proof, evidence, or studies has swayed them one bit, and actually some surveys have suggested that trucking out the evidence has the opposite effect, causing the anti-vax side to become even more entrenched. I think it’s fair to say there are some serious trust issues. All it takes is for one personal anecdote to circulate online about someone’s cousin’s kid’s somebody-or-other having an adverse reaction to a vaccine and we’re back to square one.

Let’s say for the sake of argument we take disease prevention as a common goal both sides can agree upon. Let’s prevent infectious disease. Seems simple, right?

Could we even establish that common goal? Anti-vaxxers don’t believe that outbreaks are serious; that side-effects and even death can occur as a result of these diseases; or that vaccines don’t cause other problems. Increasing numbers are convinced that not vaccinating is the only path to wellness. They think they are doing the best job possible protecting their kids, so arguing that they should vaccinate to protect their kids isn’t working.

A couple who have opened a daycare (in my town) exclusively for non-vaccinated kids, say that allowing vaccinated children into their care could pass viruses on to the other children, something they’re protecting against by only admitting unvaccinated kids. Ottawa Public Health was quick to point out that vaccinated kids don’t pass infectious diseases to non-vaccinated kids, and that more importantly, if one child in their care contracts measles, they could take out the whole group. The couple indicated that they don’t trust the ingredients in vaccines. They also provide organic food.

http://news.nationalpost.com/2015/02/09/ottawa-daycare-promises-vaccine-free-environment-for-kids-public-health-is-not-happy-about-it/

The pro-vax side thinks there is only one way to prevent infectious disease, and it’s not with more organic kale.

If we forget about establishing common ground, we can set a reasonable goal to convince as many on-the-fencers as possible to vaccinate to increase herd immunity to non-outbreak levels (which is what many doctor’s offices are currently doing) and put some small fences around those who refuse. In persuasion, there are carrots and there are sticks.

Carrots in this context would include everything that’s already happening; reputable information sources (all major Canadian newspapers and governments) are urging parents to vaccinate. Doctors are addressing concerns with patients. Supporters are getting more vocal on social media, I suspect along with a corresponding rise in unfriendings. While a few pediatricians in the US have refused to treat unvaccinated patients, the more common approach seems to be to maintain access to these parents by using gentle tactics. Probably a smart approach, but one that will take awhile to show results.

Sticks would include measures that pinch in some way. I had heard that a ski resort in the US has refused to admit anyone who does not provide proof that they are vaccinated. I wasn’t able to find any supporting articles so I don’t know whether it’s true. It seems like a crazy idea until you consider that kennels have been doing this for years to prevent outbreaks. How can we have a higher standard of disease prevention for our companion animals than for our children?

The pro-vax side could try to discredit Jenny McCarthy, but I doubt that would have any impact. They know she lacks credibility and I suspect the anti-vaxxers would welcome an opportunity to distance themselves from her.

A few months ago, I read “I Am Malala.” One aspect of the book that really struck me was the lack of centralized leadership and organization in the Taliban. They as described as a bunch of poor young men very loosely arranged around a few points of shared ideology, each of them expressing that ideology in whatever way they see fit.

Similarly, the anti-vax movement neither has nor requires central leadership or a spokesperson to be effective. Social media has made it very possible to fuel movements through sharing of personal information that then morphs into facts and science on the sole basis that it exists online. It’s like that old shampoo commercial, “I’ll tell two friends, and you’ll tell two friends, and so on.”

The other connection between the Taliban and vaccines is that the group is credited with derailing the eradication of polio, which was well underway until Taliban soldiers started shooting doctors and nurses delivering vaccines. Vaccines got on their radar when the CIA used an undercover agent posing as a doctor delivering polio vaccines to try to figure out where they’d stashed Bin Laden. Many Pakistani children have paid the price for that decision. Of 128 polio cases worldwide last year, 99 were in Pakistan.

http://www.npr.org/blogs/goatsandsoda/2014/07/28/330767266/taliban-in-pakistan-derails-world-polio-eradication

The anti-vax movement doesn’t need Jenny McCarthy. The shadow side of social media is its ability to keep rumours alive that would have died long ago. Years ago I wrote a paper on how the internet fans paranoia by giving those who would otherwise be the lone voice in their town the ability to form communities with all the other lone voices. Many voices equals more legitimacy. My paper was about alien abduction, but it’s possible to wade deeply into any number of conspiracy theories online. By the end of my research, I was even starting to feel a little paranoid. We have not yet figured out how to address on a policy level the infectious nature of this kind of information.

So what other sticks do we have? Some have suggested we don’t allow unvaccinated kids into school, which we can’t do because parents are required by law to send their kids to school after age six or provide proof of home-schooling, and because I think it’s better to avoid pushing these families away from general society.

I was remembering when the boys were little how stressful and difficult it was to find quality childcare, and thought, what if all the daycares refused to admit unvaccinated kids? Then I saw this article about the daycare mentioned above. So much for that approach.

http://news.nationalpost.com/2015/02/09/ottawa-daycare-promises-vaccine-free-environment-for-kids-public-health-is-not-happy-about-it/

Sadly, I think what will have to happen for the tide to turn back towards some good solid herd immunity is for some kids to get sick and suffer and for people to remember that these are terrible diseases. A combination of social media, stories like that of Hibbens-White, and some gentle pressure from educators and doctors will hopefully help convince a few, and every little bit counts. What does everyone else think? Is there another solution here? Will social media be effective in turning this problem around?

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6 thoughts on “The words we choose

  1. Great read! Great point about boarding kennels!
    Unfortunately, I think we (collectively) are headed for a major epidemic, and it’s not going to be pretty. History will repeat itself unless we sit up, pay attention, and learn from the past.
    I wonder if I should be asking about a small pox vaccine, since I was never done as a kid?

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  2. This is a great analysis of this problem Kari. Very interesting how the anti-vaccine movement is able to exist and – persist with only Jenny McCarthy (as far as I’ve read) heading it up. The main problem is that you can win an argument when one side is using rational arguments and the other side is using ideology – like trying to win an argument with a 3 year old – It’s impossible. My favorite solution is requiring vaccination for entrance into school and children sports/arts organizations. I don’t think there is enough money is the anti-vaccine “movement” to open alternative schools, but I could be wrong. Anyway – this was a very informative read about the current state of this problem. I’d like to see it published elsewhere too.

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    1. Thanks Bec. I had originally planned to suggest requiring vaccination for sports and programs as well and forgot. Good point. Jenny McCarthy has some explaining to do, if you ask me, but even if she came out and publically admitted she was wrong, I don’t think it would have any impact.

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  3. Very interesting! You bring up so many great points. I had the two older boys at their yearly check-up two weeks ago and thinking they were shot free the Dr. Whipped out two needles and surprised them with the new second dose of chicken pox vaccine. We had just heard about all the measles outbreaks. I felt good about giving them a second dose. I said bring it on. Let’s erradicate those nasty chicken pox like we thought we had measles. I had the chicken pox at 16. Chicken pox becomes worse on the body the older you are. I was in agony for many weeks. I would never wish that on my kids. generations before us, that would have lived through these horrible disease much worse than chicken pox , should be heard. Hindsight is 20/20 and why would anyone wish suffering on their loved ones.

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    1. Hi Tanya, thanks for the comment. I had a friend who got chicken pox in high school and she really suffered. Also linked to shingles later in life, and that’s no picnic either.

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