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Finding Compassion for ‘Vaccine-Hesitant’ Parents

They’re infuriating and dangerous. I try to remember they’re also the terrified victims of misinformation.

Credit...Joe Raedle/Getty Images

Contributing Opinion Writer

“Why are parents not vaccinating their kids? What the hell is wrong with people?”

As a father of two young children, I’ve had outbursts like this on more than one occasion as I sit in my Play-Doh- and Lego-littered family room, reading the latest news about measles and other preventable viruses making a global comeback.

This week, Senator Rand Paul, who has previously fueled the dangerous myth that vaccines cause harm by saying in 2016 that it’s “wrong to say there are no risks to vaccines,” spoke out against government-mandated vaccines at a Senate Health Committee hearing, saying, “I believe that the benefits of vaccines greatly outweigh the risks, but I still do not favor giving up on liberty for a false sense of security.” This was just days after the news that passengers might have been exposed to measles at Chicago’s Midway Airport, even though the virus has been considered eradicated in the United States since 2000.

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With a measles outbreak affecting over 200 people this year and a recent study proving yet again that there is no reason to believe that the measles, mumps and rubella vaccine, known as M.M.R., causes autism, it’s infuriating to know that parents still resist vaccinating their children. But I know people whom I think of as otherwise intelligent and well intentioned who aren’t convinced that vaccines are safe. In the face of their dangerous choices, I’ve been thinking seriously about what I can do to get through to them.

Medical professionals refer to these parents as “vaccine-hesitant.” As much satisfaction as it might offer to bring my family-room rants — What is wrong with you? — to my conversations with them, I’m starting to believe I can’t simply write them off as idiots. Even presenting facts might not be enough. Those of us who understand how important and safe vaccines are might need to meet them where they are, trying to express empathy for the misguided fear they’re obviously experiencing, if we’re to break through to them and encourage them to make choices that can save lives.

This outlook is inspired by conversations I’ve had at home. My wife, Sarah, is a family medicine physician with a public health degree. She has told me that most of the skeptical parents she sees each week aren’t raving conspiracy theorists — bug-eyed stereotypes who write manifestoes in crayon, listen to Alex Jones and live off the grid. They’re people who seem to make rational choices in most other areas of their lives. “Parents are worried about the vaccine side effects,” she said. “They believe they might cause autism in their children or some debilitating illness.”

“Vaccine-hesitant” parents are often influenced by a thoroughly debunked, nearly two-decade-old study that erroneously concluded that the M.M.R. vaccine is linked to autism in children. Since then, a small but highly organized and zealous group referred to as the “anti-vaxx” movement has promoted this misguided propaganda and also intimidated and harassed pro-vaccine doctors. Russia has strategically weaponized this doubt, unleashing bots on social media to spread disinformation and promote discord, creating a false equivalency between “both sides” of the debate and “eroding public consensus on vaccination.

All of this has influenced friends of mine from the Bay Area and Virginia, otherwise highly informed individuals who pride themselves on sniffing out fake news, to remain skeptical about vaccines. Sarah described their mind-set and those of the patients she sees: “The parents don’t trust big pharma. They don’t trust scientific studies, and they think evidence is always changing. They don’t understand how vaccines work. Some will be like ‘I don’t want to overload my kid’s immune system with too many shots at once.’”

This global “doubt” explains why measles reached a 20-year high in Europe in the first six months of 2018. The House Committee on Energy and Commerce held a hearing last week to discuss response efforts to this “growing public health threat” that can easily be prevented. A top Washington State official just declared that the United States needs a national campaign to combat the anti-vaccination movement. Washington has recently been hit with a measles outbreak costing the state over $1 million.

Part of the solution is legislation. California, for example, has a law requiring all public and private school students to be vaccinated. That being said, we’re still seeing measles cases pop up in the state. Parents in 17 states can still opt out of vaccines because of philosophical and personal exemptions. And an Arizona House committee has approved three bills to expand vaccine exemptions. It’s clear that we can’t depend on laws alone to solve this problem.

I’ve begun to agree with Sarah, who believes education, personal relationships and counter-narratives are the long-term keys to success and rebuilding trust in health professionals and experts. Her mantra: “Don’t vilify, bully or mock the parents, but try to empathize and teach, and then empower them.” She encourages doctors to actually listen to their patients’ unfounded fears before jumping in with the kind of harsh critiques or judgment that can backfire and solidify their false beliefs. Instead, she suggests doctors acknowledge their concerns and build trust over time, while also providing correct information, facts and relatable personal stories.

It’s obviously difficult to empathize with parents who are “vaccine-hesitant,” as they engage in reckless behavior that is far too dangerous to be left unchecked. The World Health Organization listed vaccine hesitancy as one of the top 10 global threats of 2019. And it’s important to remember that these parents are not making choices that endanger just themselves or even just their children — they’re putting vulnerable groups at risk. People who can’t receive vaccines depend on herd immunity to protect them from diseases.

Still, I try to remember that some vaccine-hesitant parents are victims themselves — of misinformation spread through social media. When I meet parents who don’t believe vaccines are safe, it reminds me of my experiences talking to people who believed conspiracy theories about President Barack Obama being a Muslim born in Kenya. I’m not naïve enough to think I can change the minds of all, but I hold on to the hope that by establishing a relationship and offering facts, we can get many of them to come around. (For those who don’t, I hope they enjoyed having a Muslim president.)

My wife recently persuaded a vaccine-hesitant parent to give her baby some of the four-month vaccines — but not all of them. The mom said she’ll strongly consider it next time, and there’s an appointment on the calendar. When that day comes, Sarah will try again — in a visit that starts with listening.

Wajahat Ali is a playwright, lawyer and contributing opinion writer.

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A version of this article appears in print on  , Section A, Page 21 of the New York edition with the headline: Swaying ‘Vaccine-Hesitant’ Parents. Order Reprints | Today’s Paper | Subscribe

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