Yes, I just don’t get how people cannot see how vaccines are actually proven to be some of the safest medical treatments in existence. Billions of people at this stage have been vaccinated against the likes of polio etc. That’s some clinical ‘trial’! If they don’t rate that evidence then they must surely refuse all other pharmaceutical products or medical treatments that have not been used to quite the same massive and global extent.
(Idiots! :mad:)
I think you are misremembering. I have had no such intention to follow such a lead. Concern that we could not become the only ones still trying and worry about what the consequence of that might be.
Yes, I have had and continue to have concern that those who dismiss vaccine-refusers rather than work on developing the relationship of trust and confidence that often results in flipping many of them over, are shirking their responsibility to society, and are dumping that responsibility onto the rest of us. Less so now as the numbers of outright refusers has dropped in recent years* (and more wanting “alternative schedules”). It is frustrating and time consuming to deal with these families. No question that I hate it.
The risk others of my practice is greater in the grocery stores and playgrounds than the five minutes or so they are in my waiting room (we run pretty much on time almost all the time thank you very much) and I am doing them much more good by working to keep the total numbers of those vaccinated in our community adequately above the levels needed for herd immunity than I would be by contributing to having those (for now) refuser and hesitant families clustered together mutually reinforcing each other in “alternative” provider’s office, with the consequence of an outbreak that causes harm even to those vaccinated. You do appreciate, I am sure, that in outbreaks a majority of those infected are those who have been vaccinated? They are much less susceptible for a given exposure but there are just many many more of them. Keeping the overall community numbers over that herd immunity threshold is what protects the others of my practice.
Those who abdicate their ethical obligation to work at flipping these families over time are in fact contributing to the risk of the community dropping below that herd immunity threshold and increasing the risk to both their patients and to mine.
*Not just my perception - This Medscape survey documents that in 2016 46% of children’s doctors believe that vaccine acceptance has increased compared to only 12% who believe it has decreased, a bit better than the previous year. “Although the findings of these surveys are not directly comparable, this degree of vaccine acceptance is encouraging, because it suggests that increasing acceptance is not merely a temporary boost prompted by a major outbreak of vaccine-preventable disease. Overall, vaccine acceptance appears at least to be steady, and trending in the right direction.”
On the contrary - surveys by the American Academy of Pediatrics show more pediatricians reporting outright vaccine refusal by parents in recent years, while the percentage of pediatricians routinely dismissing such parents from their practices has nearly doubled (to almost 12%).
No doubt the overall risk is spread among different environments (along with your waiting room, examining rooms etc.). Should however pediatricians be adding to that risk, especially when we consider that sick and vulnerable children are concentrated in the pediatrician’s office compared to the playground? I referred to children too young to be vaccinated and those who are immunosuppressed; are none of the patients in your practice at risk for or suffering from a primary immunodeficiency disorder, on chemotherapy for cancer or taking steroids or other immunosuppressive drugs? It must be a difficult position for you, making the decision to jolly along parents who want to delay or refuse vaccination for their children, knowing that other kids in your practice may be at heightened risk.
I hope you are aware not only that outbreaks of vaccine-preventable diseases commonly get their start in unvaccinated children, but that in many outbreaks, most of those affected have been unvaccinated. To look further at measles: a 2008 outbreak apparently got its start in the office of pediatrician Bob Sears (who is big on promoting “alternative”/delayed vaccine schedules). Measles, remember, is a very highly contagious disease.
Other pediatricians have a different view of their ethical obligations.
“…when families won’t budge, doctors have to weigh the unvaccinated child’s need for care against the risk he or she may pose to other patients—particularly vulnerable children too young, or perhaps too ill, to have received certain shots. In the (Wall St. Journal) story, for example, Dr. Allan LaReau described barring anti-vaxxers from his Michigan practice after an unvaccinated child came in with what he feared might be meningitis—a contagious, potentially deadly infection, for which inoculation usually begins at age 11 or 12. “I lost a lot more sleep than I usually do,” LaReau said at the time—but he ultimately told the vaccine-resistant parents, “This is going to be a difficult relationship without this core part of pediatrics.” “Some families chose to go elsewhere while others agreed to have their kids inoculated,” the WSJ reported.”
That last part is interesting: once parents realize their children will lose out on care from a respected pediatrician, that can be just the push they need to reevaluate their position on immunization.
Sorry but I have to on the contrary your on the contrary.
I am specifically discussing the trend in the last few years not the comparison of 2006 to 2013 that the Pediatrics article you cited refers to. No debate that 2006 to 2013 had seen an increase in the refusers. The tide shifted in 2014 after eighteen measles outbreaks across the country that year strongly associated with vaccine refusal, after measles had been considered a virtual non-entity. The cite I provided documents that shift. Another Pediatrics article also documents that in 2015 more children’s doctors were seeing fewer refusers than previously.
Indeed concentrating vaccine refusers and delayers in the offices of quacks like Sears is an almost sure way to facilitate the start of an outbreak. And that would be the unavoidable consequence if all reputable children’s doctors refused to care families who initially said no. (In practice it usually does not happen only because a majority of pediatricians do not dismiss so some get away not doing their fair share of the work of gaining compliance … sort like vaccine refusers benefiting form the others who vaccinate.)
I’m not sure what point you think you are trying to make with that Forbes article but what the numbers they cite document is that the majority of people who got measles as the result of an outbreak that began in deliberate refusers and that was only possible because of a critical mass of them were in people who either could not be vaccinated or who were. Again, the harm is created when we do not achieve a threshold needed to achieve herd immunity, and the harm is not contained to the refusers.
Let us be very clear: I do not know of a single case of measles or pertussis reported that was caught from a vaccine refuser to someone who was not a refuser in a general pediatrician’s office. Do you? Even one? Oh we’ve had pertussis outbreaks locally. The spread is in schools not offices. The risk to the not yet vaccinated babies? Adults who have not kept up with their vaccines and who have not had an adult Tdap. And adult docs are frankly often horrible at even bothering to advise it. The OBGs are better at immunizing the moms and we push on the dads and the grandparents, offer to give it to them in our offices, but most adults out there are not even aware that they need to get an adult Tdap booster and that without it they are posing a risk to any babies that they see. I highly doubt that even most posting here have had an adult Tdap unless they had a child in the last ten years or recently became a grandparent and even then. Have you had one Jackmanni? If yes color me impressed.
Kicking out patients who refuse (instead of engaging and over half the time convincing them) in the name of other patients’ perceived safety is the pediatric equivalent of Trump’s claim that we need “extreme vetting” … oh some believe that there is current real risk that such would reduce, but in reality it would do more harm than good.
That WSJ quoted pediatrician was not doing something out of any perceived ethical obligation to his patients and did not pretend to be. His issue was not wanting to have to worry his pretty little head when a refuser got sick was all. “Some” complied and some left to become concentrated in a Sears-like office? How many was that first some? Tell me when you have data.
What actual data do we have? At least a third of those refusing vaccines come around as the trusting relationship with the child’s doctor is established. I personally run more like half. No question that means that we waste our breath and lots of time a lot of the time but until someone documents that one third of those who are threatened with dismissal flip it is more than otherwise would. And anecdotally in the practices around me that do dismiss I have heard of zero flipping. Maybe a handful have in people I have not talked to but overall it does not appear to me to be an effective tool.
Anti vaxxers are hated for the exact same, very sound reason, Typhoid Mary was tracked down and put into jail!
I’m not Jackmanni, but I had my tdap booster in 2008 and I’ve never had children nor, obviously, grandchildren nor do I work in a profession involving a lot of contact with kids. I just don’t want to get pertussis, even if it’s usually not that serious in adults, just really annoying. Or tetanus. Or diphtheria.
I get all the vaccines and boosters I’m supposed to get, I make a point of it, but I can’t get the flu vaccine due to a prior bad reaction and inability to find a safe(r) alternative for me to the traditional jab (they won’t let me use the nasal spray variety due to my asthma).
Yep, pro-vaccine here.
In that case, you shouldn’t be supplying a quote that relates to a survey conducted during 2012, implying that it supersedes the more comprehensive surveys I alluded to and then (farcically) concluding that the tide has turned, vaccine refusal is on the wane, no problemo. :dubious:
Bad as these people are, they represent a small minority of pediatricians. But when there are many more peds who accomodate vaccine refusers and “alternative schedules” that delay protection, the risk is spread over a much wider area.
You’re still unsure? It specifically refutes your statement that “in outbreaks a majority of those infected are those who have been vaccinated” (which, incidentally, is a claim straight out of the antivaxer playbook that you would do well to avoid).
I just cited you the case of Bob Sears’ office - in which one of the infected children was a child too young to be vaccinated. Does your practice see any infants and children too young to be vaccinated, who are potentially at risk from your cadre of refusers and delayers?
That’s another dogmatic statement that does not square with reality. Unvaccinated children have been shown to help fuel pertussis outbreaks:
So to recap: in a previous thread you gave credence to the highly dubious proposition that increasing incidence of shingles can be blamed on introduction of the chickenpox vaccine. In this thread you’ve made the sweeping (and false) claim that “in outbreaks a majority of those infected are those who have been vaccinated” and blamed infant pertussis risk entirely on unvaccinated adults.
I would have expected more informed commentary from you.
*Note: it’s true that in some outbreaks of vaccine-preventable disease, a majority of victims have been partially or completely vaccinated (for instance, in a number of pertussis outbreaks and a current mumps outbreak out West). This reflects the vastly higher number of vaccinated compared to unvaccinated children and imperfect protection offered by vaccines. The risk of contracting vaccine-preventable disease remains much higher in the unvaccinated population.
I’m sure they’d say that we’ll never learn…
And indeed well done. Fact remains though that you are the minority. The recommendation came out over a decade ago and the rate adults (counting former adolescents who have aged into being classified as adults over that time) with up to date coverage for Tdap was only 20.1% in 2014 (most recent data) and even among those with children under 1 year old in the household it was only 32%. Hell even among health care providers a majority were not up to date (only 43% appropriately immunized).
**Jackmanni **(who may be in that 43%, I don’t know, he has ignored the question, interpret how you will) is being a bit obtuse here.
His ignoring the cited 2015 study? Meh, I don’t expect more from him, honestly. The problem of outright refusers is less than it was, but is still a risk. The elevation of anti-science in the current administration may cause it to flip back too. The battle goes on. As one actually in the trenches and not hiding from the fight I am quite aware.
YES the point of not concentrating the fairly small number of refusers is that it dilutes the risk … so that it stays above that herd immunity threshold.
Uh yeah those quacks are a very small number of pediatricians but there is no shortage of others who offer “care” to children whose offices these families end up congregating in. Who then also put kids on megadose of vitamins and all sorts of other potentially harmful crap.
The majority of those infected, even in the measles outbreaks, were not vaccine refusers. The point of course being that the harm having more of them out there is not restricted to them alone, not even close, even though each of them is at many-fold high risk than the vaccinated on an individual basis. Yes it is a function of the size of the n. Keeping the rate up across our communities and reducing the risk of having the refusers congregate into clusters (which increases the risk of a community-wide outbreak) is required to protect all of us. Those who dismiss may believe that their problem is solved because out of sight out of mind. Maybe they also think homelessness does not exist if the police clear them out of where they have to see them too?
A child in Sears office is a case of a family of non-compliers. That is why they are there.
Do you bother reading your cites? No the NPR link does not in any way show that infants who get pertussis were most often exposed directly from the non-vaccinated. The source of infant pertussis infection is overwhelmingly immediate family members (2/3s of the time). Actually siblings number one, then mothers and then fathers. Before 2008 it was mothers but giving the Tdap with every pregnancy has succeeded in reducing that risk.
Again, my goal of protecting the infants in my practice not yet directly protected themselves is best served by doing my best to ensure that the community schools do not have outbreaks which infect the older siblings. The risk to these infants in a standard pediatrician’s office is essentially zero.
I’m not “ignoring” it. Unlike you, I paid enough attention to note when the survey was taken (during a portion of 2012). The idea that a 2012 survey shows that a 2015 measles outbreak caused fewer adults to refuse vaccination for their children is, frankly, daft.
The more comprehensive (and recent) survey evidence I cited demonstrates that the problem of vaccine-refusing parents is (according to the perception of pediatricians) increasing, not lessening.
You’ve been shown that’s untrue. The facts may be difficult for you to accept, but they cannot be airily dismissed.
It directly refutes your claim that pertussis risk to unvaccinated infants consists of “Adults who have not kept up with their vaccines and who have not had an adult Tdap.”. Speaking of which, you’re really flailing if you feel the need to attack me personally on this score (my immunizations are up to date; I do not feel the need to interrogate you about what shots you may or may not have had).
At this point, I don’t expect you to concede that your hanging on to children of vaccine-refusing/delaying parents in your practice is placing your other patients at risk. The least you can do, however, is to learn from your errors and stop recycling memes popular among antivaxers.*
*Speaking of which, this site nicely refutes the vaccinated-kids-are-more-at-risk-of-disease-than-unvaccinated-children myth, in easy to understand language.
You are being very dense and it is tiresome.
57% of those in the measles outbreaks were not vaccinated, of whom 29% had not been vaccinated for medical reasons, and 71% for “religious or philosophical reasons” … i.e. were vaccine refusers.
You are apparently claiming that 71% of 57% is greater than 50% … it isn’t. No, a majority of a majority is not necessarily a majority. Sorry that such is so confusing to you. Vaccine refusers drove those outbreaks, no question, and 60% of those who caught measles as a result were not vaccine refusers. Refusers clustered and refusers of sufficient numbers to get a community below levels sufficient for herd immunity put those who are not refusers at risk and most who suffer as a result of outbreaks are not refusers.
Again, the risk to my patients (all of them) from vaccine preventable diseases is that the community level of protection drops below herd immunity levels and/or that those at risk cluster enough to get an outbreak going. My job, my role in the trenches, includes preventing that from occurring. I sell healthy decision making. And I have no false modesty: I am pretty good at it. I readily admit it can get tiring and I get frustrated often.
Let’s return to something you said earlier
You are right there and it should be taken further because there are different levels of hesitancy and refusal and “antivaxxer”. The most effective action varies accordingly some. If you are going to sell know your customer and understand their POVs.
Start off with the complete refusers. That’s about 0.8% of the population overall. A small number. They are the most likely to have anti-science beliefs and express strong distrust of organized medicine, governmental organizations, and business. And some of them can be sold to at least vaccinate for the ones I personally identify as most important for their children and for the community as a whole. Selling requires them first feeling that their concerns have been heard and is ill-served by treating them disrespectfully or dismissively. It requires establishing a personal connection. Most facts and the science are going to be fairly immaterial to them. For them you validate the concern about greed and conspiracy and *direct it *at the proper target: Wakefield faked his data in return for £400,000 from lawyers planning on suing vaccine manufacturers; Mercola lives in a $2,000,000 mansion paid for by those who sells his quackery too; Bob Sears also has made millions selling unfounded fear. There is greed and conspiracies afoot and these are those who have blood on their hands in pursuit of green in their pockets. If I succeed in getting even a third of these people to go wth at least the Pentacel series and the MMR I’ll have done all of my patients, and the community a major service. And I think I do better than that.
Some of the same principles of listening, treating with respect, and developing the relationship of trust, apply to the larger numbers who have various degrees of hesitancy. Note that this group is broad. Delayers and refusers include those who don’t want to do the HPV at 11 but are willing to do it at 15, those who comply with all except influenza vaccine, or don’t want to do the HepA or want to delay the HepB a few months, to those who refuse the ones that matter the most. Different concerns though require different responses. Still an effective intervention is less about the science than it is replacing their narratives. Painting the HPV or HepA delayer or even refuser the same as the MMR refuser would be foolish.
Here’s what DSeid said earlier in this thread, and is still trying to obfuscate:
That makes no distinction between “vaccine refusal” and other reasons for non-vaccinated status. It’s stimply a false and deceptive generalization, which commonly is used by antivaxers to justify their claim that vaccines are ineffective. Simply put, you should not be employing such a malignant argument.
Nor should you falsely be blaming pertussis spread entirely on unvaccinated adults, or arguing that a measles outbreak in 2015 has led to lower incidence of vaccine refusal, based on a 2012 opinion survey. But I don’t see you acknowledging any of these glaring errors.
For a viewpoint from a pediatrician who does grasp the seriousness of the issue, I recommend https://www.nytimes.com/2017/02/08/opinion/how-the-anti-vaxxers-are-winning.html?_r=0
"]this op-ed by Peter Hotez.
*"A single person infected with the (measles) virus can infect more than a dozen unvaccinated people, typically infants too young to have received their first measles shot. Such high levels of transmissibility mean that when the percentage of children in a community who have received the measles vaccine falls below 90 percent to 95 percent, we can start to see major outbreaks, as in the 1950s when four million Americans a year were infected and 450 died. Worldwide, measles still kills around 100,000 children each year…
As a scientist leading global efforts to develop vaccines for neglected poverty-related diseases like schistosomiasis and Chagas’ disease, and as the dad of an adult daughter with autism and other disabilities, I’m worried that our nation’s health will soon be threatened because we have not stood up to the pseudoscience and fake conspiracy claims of this movement…
Texas, where I live and work, may be the first state to once again experience serious measles outbreaks. As of last fall, more than 45,000 children here had received nonmedical exemptions for their school vaccinations. A political action committee is raising money to protect this “conscientious exemption” loophole and to instruct parents on how to file for it. As a result, some public school systems in the state are coming dangerously close to the threshold when measles outbreaks can be expected, and a third of students at some private schools are unvaccinated."*
Personally, I’d hope that the pediatrician my grand-niece and nephew go to does not cater to vaccine-refusing parents, and it appears that increasing numbers of parents feel the same way about protecting their children.
You have claimed the statement “The majority of those infected, even in the measles outbreaks, were not vaccine refusers.” is “untrue.”
It is not untrue. It is completely accurate.
In the measles outbreaks the majority of those impacted were not vaccine refusers.
Yes in the measles outbreaks a slight majority of those impacted were the vaccine refusers plus those who were not vaccinated for medical reasons. And in pertussis outbreaks, much larger numbers, the vast majority of those who end up catching the disease are the vaccinated, such as in the one in WA in 2012
We have had 495 cases of mumps this year in the United States in January alone. Typical for mumps are the numbers seen in this CDC recap of an outbreak at a university in 2015 to 2016:
The statement “in outbreaks a majority of those infected are those who have been vaccinated” is true. Even in the exceptional case, measles, only a minority of those infected are the intentional refuser/delayers. And their numbers are still often the major cause of the outbreak occurring.
Your linkee no workee but I had read Hotez’s NYT op-ed and concur both with his concern that Trump’s anti-science positions raises the risk of “reversal of several decades in steady public health gains” and that what is critical to prevent outbreaks is “the percentage of children in a community” that are at un- or under-vaccinated.
I 100% agree both with Dr. Hotez’s concern that the Trump administration may cause harm by perpetuating the autism myth and that achieving high community-wide immunization rates is critically important to protect us all. I hope you agree as well.
Let me emphasize Dr. Hotez’s point: we need to prevent the community level of protection from dropping below the level sufficient for herd immunity. If we fail to do that then not only are the unvaccinated at risk but so are those who both are vaccinated and those who cannot be (either yet or because of medical reasons).
The issue is how to achieve that goal.
I have my ideas.
Public policy. States that have a “personal” or “philosophic” objection clause to immunization compliance need to eliminate it. Elevating anti-science in the political sphere needs to stop.
Effective broad pubic communication campaigns. In general in we of the medical and scientific communities have failed at being effective communicators. We argue but we fail to understand how to convince. As a group we suck at sales. This bit articulates the point:
More recently the same writer said this
And using those same communication techniques at the one-on-one doctor to patient family level.
You disagree. I know.
It would be wonderful if “communication techniques” that metaphorically pat “vaccine refusers” on the back and tell them we understand their concerns worked.
Trouble is, there’s no real evidence that hardcore antivaxers are convinced by “sensitivity”, any more than calmly refuting their venomous memes with sound science or (the latest recommendation) focusing on harms from not vaccinating do. And while antivaxers claim we are being mean to them, the reality is that nastiness much more commonly is directed at pro-vaccine advocates.
The risks posed by antivaxers (and their accomodationists) have gotten to the point where the most effective tools are likely to be legislative action (like the California law eliminating “philosophical” exemptions to vaccination, and the Australian regulation denying monetary benefits to parents who don’t get their kids immunized).
I’m reminded of those who say we must be nice to raging bigots, that if they perceive they are social outcasts they’ll just cling together in small groups and pose a greater danger. I call bullshit on the racist accomodationists as well.
What we certainly do not need in regards to supporting vaccination, is supposedly responsible public health figures and physicians propagating antivax memes, like your continued false and grossly deceptive generalization that “in outbreaks a majority of those infected are those who have been vaccinated”, or implying that vaccinated kids drive infectious disease outbreaks, when you’ve been repeatedly shown that’s untrue.
Perhaps that’s one additional danger of pediatricians harboring overtly antivax parents in their practices, under the delusion that they’ll eventually win them over. Quite possibly the reverse happens with some pediatricians, and they come to believe some of the same nonsense those parents are spouting.
I hope you don’t wind up like (for example) Paul Thomas*, the “vaccine-friendly” pediatrician, who presents himself as pro-vaccination while ultimately calling for delaying or avoiding most immunizations, and building a sizable practice of worshipful parents. Great for his practice’s bottom line, not so terrific for protecting the community.
*Interestingly, even Thomas doesn’t go so far as to charge that pediatricians who discharge antivax parents from their practices are “unethical”. He insteads suggests they are ignorant and misinformed, a statement that has blown up many irony meters.
I gather from a very recent court case in France that no separate vaccine is produced anymore anywhere (not just in France) since the early 2000s, and that it would take up to 10 years to start again such a production. Hence that there’s no way vaccinations could be done separately. It’s either a 6-vaccines or a 10 vaccines injection (or nothing at all).
I’m not sure why that’s interesting. Neither side of the political spectrum holds a monopoly on stupid ideas.
The reason a lot of people have such strong feelings against “anti-vaxers” is because it is yet another example of ill-informed people deciding they know better than the experts. Trump is another example. There are people who spend their entire careers studying these things. So for someone with know experience or knowledge on a particular subject to declare “I know better than the experts”, that, to me, is the height of arrogance. For people who decide that they believe the non-expert in spite of overwhelming evidence to the contrary is the height of stupidity.
Every fringe contrarian “expert” isn’t Copernicus.
Since the anti vaxxers are killing other people kids, I think it is perfectly appropriate for them to be “harassed”. They are murderers, so they deserve it.
Here’s an example of what can happen when pediatricians try to cater to antivax parents.
Despite arguably going the extra mile in this case, the peds’ reward was being harassed by a medical board complaint.
It’s not surprising that more and more pediatricians are opting out of dealing with such parents.
In other news fresh off the antivax crazy train, RFK Jr. and Robert DeNiro are holding a press conference this morning under the auspices of something called the “World Mercury Project”. We already know RFK Jr. has a bug up his posterior (actually, an entire ant farm) about mercury despite its virtual nonexistence in vaccines and lack of any evidence of harm, while DeNiro is apparently still sulking about having to pull the propaganda film “Vaxxed” from his film festival.
Should be lots of juicy bits forthcoming.
Indeed a physician can be reported and/or sued when they have made good medical decisions and been excellent doctors just as easily as when they have done things wrong. Doing the right thing however more often than not prevents you from losing.
No there is no actual reason to believe that the vaccine hesitant or even resistant are more litigious than the rest of the population. No question though that are often “difficult” ones. Sure one can avoid a certain amount of hassle and aggravation if one just decides that dealing with them is not part of your job. They are few in number true, but each one takes more than average time and effort. And they hurt your quality metrics too! (Many plans have incentives based on a variety of metrics and percent of completion of certain combos of immunizations by 2 years old is one of them … don’t worry about me, we far exceed the targets :))
True anti-vaxxers use certain techniques and make certain sorts of arguments; interestingly the same sort of techniques and arguments Jackmanni uses in this thread. (Such as fearmongering over risks that are virtually or possibly even actually zero, be they rare adverse reactions to vaccines or imagined risks in general pediatrician offices.)
Meanwhile today I coincidentally had a patient family in who had come to me initially as full out vaccine refusers. They aren’t now. Oldest was a bit delayed before we started catching him up by still had MMR and pertussis up to date before 2. The younger two were on time with just delaying the newborn HepB to 2 months. Okay, they still decline flu and are not yet of age for the HPV but that might be a stretch when the time comes. And yes mom still leans to some woo ideas, and knows my opinion of them. I have not changed her worldview. OTOH the ones she leans to are mostly harmless and are not being used in lieu of established effective care that is clearly indicated.
Lecturing that family on the facts, filling them up with the sound science and expert panel conclusions that you know they must just not have heard, would not have achieved that. It doesn’t help because they don’t trust the facts as reliable. Dismissing them? Uh no. By engaging, by becoming a person they trust (and not just assuming I am owed it because I have my M.D.) that family is one less group of kids contributing to significant risk across the community, in addition to themselves.
No I have not succeeded with every family. And some successes have been more partial than others. I understand why other docs who have the same success rate I do can see the same circumstance as a glass half empty and despair. But the is no question that the glass is more full than it would have been without the continued effort.
The “hate” that some feel to the vaccine resistant is understandable. Again, despite Jackmanni’s repeated false claim that he has shown otherwise, most of those harmed in outbreaks of vaccine preventable diseases, outbreaks most often sparked by and driven by the minority that are intentionally un- and under-immunized, are the rest of us (and our children) who are complying with the vaccine schedule as best we can. Hell, even if there is no outbreak, they are at best freeloading, 'cause there are actual (small but non-zero) risks and costs to getting immunized. Risks of allergic reactions, seizure, low platelet reaction, (all rare but non-zero) down to mere fever and muscle soreness. Most often enough of the rest of us share in those tiny risks that we all, inclusive of the freeloaders, benefit by way of herd immunity. Of course the rest of us resent that, understandably. It is not fair.
But the goal that matters remains to keep that community herd immunity threshold exceeded and then some. Let me know when telling someone that they are or treating them as if they are evil or idiotic convinces them to change their behavior. Let me know when not engaging with them works to change their minds and behaviors either.
This is rich.
I am not the poster in this (and an earlier antivax-related thread) who has repeatedly regurgitated antivax talking points, such as vaccinated-children-outnumber-unvaccinated-kids-in-disease-outbreaks, chickenpox-vaccine-is-responsible-for-rising-shingles-cases, pro-vaccine-advocates-are-mean-and-hateful, and the latest one, fearmongering-over-risks-that-are-virtually-or-possibly-even-actually-zero (antivaxers love to pretend that preventable infectious disease risks are exaggerated by “fearmongering” physicians and public health experts).
All of these memes are highly deceptive, exaggerated or overtly false. which is why I warned DSeid in an earlier thread that he should be very careful employing any arguments beloved of antivaxers. Sadly, the message obviously hasn’t gotten through.
Oh, and there’s the rancid antivax tactic of shifting the goalposts. First DSeid said “You do appreciate, I am sure, that in outbreaks a majority of those infected are those who have been vaccinated?” When that was shown to be a false generalization (in many measles outbreaks alone, the unvaccinated were in the majority), the goalposts got shifted from the unvaccinated to “vaccine refusers”. And even now he’s doubling down on his nonfactual claims.
And discharging parents of unvaccinated kids from their practices hurts pediatricians’ bottom line too. Let’s not forget that.
Sacrificing income for the sake of protecting their other patients is largely what motivates an increasing number of pediatricians in discharging antivax parents and their unvaccinated kids. They deserve more than sneers about an alleged lack of ethics.
That “bombshell” press conference by RFK Jr. yesterday yielded a bogus $100,000 Challenge to pro-immunization advocates who can show that thimerosal in “vaccines” is safe (RFK Jr. is still doggedly promoting the idea that the vaccine schedule is riddled with thimerosal, when the preservative is only found in multidose formulations of flu vaccine, which are not the common form used in the U.S. and for which thimerosal-free alternatives are readily available). Like similar antivax “challenges” of the past, this one is just a publicity stunt and rigged to defeat anyone who tries to meet it.