Vaccine advocacy 101

People with PhDs in science fell for the MMR scare.

If people choose to embrace FUD - as is the current fashion - you will never change their minds about those topics.

What you need to do is go deeper. You need help from psychology - how do you make it uncool to fall for silly scare stories? How do you make it fashionable to openly rise up above tabloid conspiracy theories?

Frankly, my observation so far is that the world is full of people who have no sense of perspective and hence have no ability to make accurate intuitive risk assessments.

Thanks. Very nice. You really polished the sentences too.

Finally, while there may be no single leader of an anti-vaccine “movement,” many of those listed in Table 2 are highly media-savvy and unafraid to push their opinions that vaccines
are dangerous, full stop.

Some of those listed in Table 2 hold medical licenses that ought to be yanked by their state medical boards and some of them belong to the American Academy of Pediatrics which ought to show some spine and expel anti-vaccine pediatricians. Such strong actions would send a clear message to the public that quacks like Sears, Mercola, Tenpenny, etc are so far off course that they are not competent to practice medicine.

Thanks! You don't have a link to the full paper do you?

Vaccine advocacy is fine and good, and it is essential for free exchange of information. However, everything has a compromise, and as a scientist, I know that it is too easy to turn science into a conviction. The problem I see from both sides of the vaccine argument is the lack of understanding of the compromises. Pro-vaciine folks insist there is absolutely no harm in vaccines, and anti-vaccine folks insist every vaccine is pure poison. The truth is somewhere in the middle.

Apologies for the delay--the system thought I was a spammer and wouldn't let me log in.

Craig, absolutely--did you read the paper? It gives an introduction to some of those issues and describes a few of the research papers in that area. Unfortunately there's no good answer on how exactly to do that, and likely no universal approach that will work for everyone.

Chris, agree. Sears at one time was under investigation, but I don't know of the outcome to that.

dingo, it's at the link in the reference--go to "pdf" and the accepted proof of the paper is fully available. (Unfortunately the fancy edited version isn't ready yet).

Andrew, I agree, but in all the time I've done this I've very rarely seen anyone say "there is absolutely no harm in vaccines," though I see this frequently as an anti-vaccine talking point. I speak frequently about the risks versus benefits, and note that many "vaccine injury" stories are completely unproven. That doesn't mean that vaccines never can or do harm, but that many of the various conditions that some attribute to vaccines (SIDS, autism, and more) are just not causally related. Even seizure disorders that used to be linked to the prior DTP vaccine have been shown to be instead due to genetic issues such as Dravet syndrome. I think we need to be honest, but part of that honesty is noting that any serious poor outcome from vaccination is truly exceedingly rare.

I have a vaccine injury story that I like to use, to open the discussion.

Once upon a time, I got my flu shot and the next day I was sick as a dog. It was horrible, and my whole body was shrieking "don't ever get that nasty shot again!!!"

Fortunately I know enough about vaccines and possible reactions and food poisoning and a similar illness going around friends and family on that day to recognize that it was all a big silly coincidence.

And yet my body kept yelling about that shot.

So there are many directions a group can go from here: trust and lack of trust in the medical system, personal history including failures and disappointments, and the whole subject of risk analysis - which is often counter-intuitive, and often neglected or poorly taught, but overall is a powerful tool for quantifying dangers and promoting wise decisions.

One thing that wasn't mentioned in your post that I think is highly relevant, is the fear that people have based on the fact that the mandatory vaccine manufacturers are exempt from liability. Would you buy a Ford automobile if Ford was exempt from any liability? I certainly wouldn't.

If that wasn't the case then people wouldn't feel like there was no recourse should something go wrong. Since vaccines are so safe and effective, this liability policy does more harm than good at this point. There's no need to shield vaccine manufacturers from liability, and it just serves to call vaccine safety into question, so why not just get rid of it?

Completely disagree that we can remove the liability part. Vaccine manufacturers don't make much money off of vaccines relative to other products, and one scare is enough to tank them. Liability is difficult to prove and can be falsely attributed to vaccines (look at GBS and swine flu, or seizures and DPT, both initially attributed to vaccines and only later shown to be falsely associated after much time had passed and many studies conducted).

I don't know, seems like a no-brainer to me. Lack of liability is used as a canard to fuel conspiracy theories, and not surprisingly, it tends to work in a "follow the money" kind of way. Parents are told that not only are manufacturers not liable for the rare vaccine injury, they aren't liable even for outright negligence. This provides easy fodder for conspiracy theorists. There's no other product that has a similar exemption so it can arouse suspicion in even the most trusting parent.

Given that vaccines nowadays are so safe and effective, manufacturers no longer need exemptions since vaccine injury is so vanishingly rare. No sane personal injury attorney is going to take a vaccine injury case, so manufacturers have little to fear legally, and thus don't need the exemption. Indeed, its doing more harm than good as far as vaccine hysteria is concerned.

Not only would doing that ease fears and derail the conspiracy theorists, it would lower the cost of vaccines since there'd be no need for a separate vaccine injury court. Seems like a win-win to me if reducing anti-vaccine hysteria is the goal.

Again, disagree. The cost would increase dramatically. Right now it's just a few cents per vaccine to fund the "vaccine court" and its payments, but if you put that back on the vaccine companies (and eliminate the rules & protections of the court) that means potential settlements of millions right from the companies. Again, making it likely they may stop manufacture altogether. Perhaps instead remind skeptical individuals that it was one of their own, Barbara Loe Fisher of the NVIC, who led the charge for the court's creation.

"This provides easy fodder for conspiracy theorists. "

Conspiracy theorists can twist anything and use it as fodder for their misinformation. Eliminating the court would do nothing to make it harder for them but would, as Tara points out, up the risk for manufacturers by a great amount. It's a complete lose-lose.

" up the risk for manufacturers by a great amount. It’s a complete lose-lose."

What risk? Vaccines do no harm and save lives, its been proven over and over and over again. Are you claiming that manufacturers need protection from lawsuits due to vaccine adverse reactions? That's insane.

No lawyer would ever waste their time/money to try and sue a vaccine manufacturer. In fact, even if one tried it would be thrown out by summary judgement. So I'm really not sure what risk you are referring to.

Conspiracy theory gets traction when there are concrete examples to point to, and the vaccine court is one that is always pointed at to show how vaccines cause damage, requiring a special court. Since vaccines are the one and only product with a special court, it just screams "conspiracy" to the weak-minded.

Since manufacturers don't need protection from liability these days since vaccines are so safe, it seems they are only shooting themselves in the foot by keeping it.

Its like trying to make the claim your house is fireproof, yet you have fire extinguishers placed in every room. It doesn't instill confidence in your claim, and any conspiracy theorist is going to make hay out of that. Get rid of the vaccine court and conspiracy theorists wouldn't have a leg to stand on, and parents would feel less hesitancy about getting their kids vaccinated knowing that if something happened they have recourse. Of course, nothing will happen, but its the reassurance parents need to keep getting their kids vaccinated.

I think it would go a long way in reducing hesitancy. I'm far more concerned about that than manufacturers profits, lawsuits or anything else. Manufacturers can take care of themselves there. What we need help with is with parents hesitancy, and having special courts isn't helping in that regard. When I talk to parents its often something that is brought up, and it makes even the average parent very suspicious. I am sick of trying to answer the question "Why are manufacturers exempt from all liability for their products if they are so safe?"

I've already explained how, even though vaccines are quite safe, it can be very difficult to prove a negative (that a vaccine *didn't* cause an injury), and how we've seen false-positives proven wrong but only years or decades later. Not sure why this is so difficult to grasp. And yes, lawyers absolutely would sue. That was the whole issue that jump-started Wakefield's MMR work.

"Are you claiming that manufacturers need protection from lawsuits due to vaccine adverse reactions?"

No, I am not.

"No lawyer would ever waste their time/money to try and sue a vaccine manufacturer."

Well yes, they most certainly would. Despite what your comment implies, not every lawsuit filed now is based on reasonable things.

"Get rid of the vaccine court and conspiracy theorists wouldn’t have a leg to stand on"

There is not a hint of fact to support that assertion. Look at how long conspiracies about JFK's assassination or September 11 have gone on, and the numbers grown, in spite of the fact that in neither of those cases is there any reason to support them.