Listening vs Coercion on ‘Vaccine Hesitancy’ by Kate Raines

Listening vs Coercion on ‘Vaccine Hesitancy’

by Kate Raines

Published February 20, 2019 | Vaccination, Vaccines

Story Highlights

• Public shaming of vaccine-hesitant parents has reached new heights.
• Those who question mainstream vaccine policy tend to be among the most educated, well-informed parents.
  
• Respectful conversations about vaccination between health care professionals and their patients is more effective than coercive tactics.

The rhetoric surrounding vaccination has long been dismissive of anyone who questions the safety or effectiveness of vaccines or refuses to follow vaccine use recommendations by public health officials and physicians, but the vitriol has reached new heights of late. On one end of the spectrum is the relentless bashing of a young mother who had the audacity to ask on social media what she might do to protect her unvaccinated three-year-old from outbreaks of measles.¹
On the other end of the spectrum is the World Health Organization’s (WHO’s) declaration of vaccine hesitancy as “one of the top ‘Ten Threats to Global Health in 2019’, alongside air pollution and climate change; noncommunicable diseases; global influenza pandemic; antimicrobial resistance and infectious diseases such as Ebola, dengue fever and HIV.”²
However, one thing many studies have found is that people who favor exercising their informed consent rights with regard to vaccination tend to be among the most educated and conscientious of parents. Several of those studies are summarized and referenced by pediatrician Paul Thomas, MD.³ Commonalities that arose from those studies indicated that while the parents of incompletely vaccinated children trended toward being single, young, poor and less well educated, those of deliberately unvaccinated children were more likely to be college educated and married, with a higher income and had spent time rigorously researching vaccine information.³  
Other researchers have shown that a prevalence among vaccine-hesitant parents “salutogenic parenting,” defined as those who “practised health promoting activities which they saw as boosting the natural immunity of their children and protecting them from illness (reducing or negating the perceived need for vaccinations). Salutogenic parenting practices included breastfeeding, eating organic and/or home-grown food, cooking from scratch to reduce preservative consumption and reducing exposure to toxins.”⁴
Another quality identified as common among those who question the recommended schedule of childhood vaccinations or forced vaccination policies is distrust of conventional Western medicine.⁵
Some mainstream doctors, who restrict health care to use of pharmaceutical products and interventions that conform to the medical model, may attempt to shame caring, educated parents into giving their children every single vaccination recommended by government health officials and medical trade associations. However, this tactic has often met with mixed results. Some parents choose to acquiesce, while other parents dig in their heels and opt to delay recommended vaccinations or stop vaccinating altogether. For the more reluctant or “vaccine hesitant” parents, the preferred methods of persuasion today are to educate them about the dangers of not vaccinating, or to incentivize them by citing insurance premium penalties for not vaccinating, or threatening to exclude them from a medical practice for being “non-compliant.”⁶
The one thing that hasn’t been widely tried by mainstream medical professionals is listening with an open mind to parents who are hesitant about vaccination and working as partners with them rather than taking an authoritarian adversarial approach. This may be changing. On its list of six recommendations for responding to “vaccine hesitant parents,” the American Academy of Pediatrics (AAP) first lists listening to “parents’ concerns” and acknowledging them in a “non-confrontational manner.”⁷

It is unclear whether this recommendation is a serious attempt to be open to parental concerns about vaccination and respectful of the informed consent ethic or merely another tactic to coerce parents,⁸ but the idea of vaccine providers at least being willing to listen to their patients is a good start toward developing a mutually civil and respectful conversation about vaccination.

---

References: