Treating Others

by Lee Boot

Who in 1965 would have imagined that if an effective vaccine existed to inoculate against a horrible disease, people would choose not to use it? Just imagine telling all the intrepid researchers, bent over their microscopes for months and years, that the biggest barriers to delivering their vaccines could be people’s shifting beliefs and attitudes battered about by the currents of culture. But this is the reality we face today—not among a sequestered Amazonian tribe whose people have never seen a Western doctor, but here in the present-day US. Vaccines have become the focus of a culture war that cuts across political boundaries. It expresses a mistrust of science and government so one would think: Tea Party. Not so. Ask Arianna Huffington. Despite that the data on the cost-benefit ratio for using vaccines to stall pandemics is overwhelmingly in favor of vaccines—those data aren’t driving Ms. Huffington’s thinking. What does? Hard to say, but mistrust is rampant. I googled the word “vaccines” and 4 of the first 5 listings were anti-vaccine sites. One was a rock band—great name: Vaccine.

So, you can beat the virus and not end the disease. At the root is a factor even the military now deal with nearly everywhere they go. It’s those pesky hearts and minds. Populations of humans, as it turns out, will not simply roll over for what others have decided will help them, even when it will. In trying to promote the notion that we should begin to look at our world through the lenses of culture and human nature, I’ve learned that even the best educated people often have no framework with which to see and appreciate this alternative point of view. It’s just not how we think.

Nonetheless, I keep trying. Now I’m working with the Institute of Medicine on a video installation for their annual conference. They’d like to help researchers, public health organizations and clinicians look beyond the end of their syringes to better perceive those whom they are puncturing. It’s become obvious that “target populations” will have to agree on the benefits of a vaccine for its delivery to work. Still, most of these scientists and practitioners were brought up at time when the science of medicine and nearly everything it produced was perceived as the shining knight on horseback come to rid the world of disease. I know how creating this shift in their perception will be. It is ironic these modern medical professionals have their own cultural dynamic, and it too can reject otherwise informed thinking. How can I spread the virus of the idea that cultural dynamics matter a lot more than people think?

I’ll end with a question: Would you give your child a vaccine? If not an exhaustive review of the literature and the advice of the most knowledgeable medical scientists, what guides your thinking?

Words and Images by Lee Boot

2 Comments

  • Lee August 1, 2011 at 11:45 pm

    Emily makes a great point about the challenges individuals have in deciding whether or not to become vaccinated, or to have your children vaccinated. And we know, for example, that a percentage of people will likely have horrid side effects from some vaccines. To me, even in those cases, it’s a question of the greater good. Alternatives are indeed needed—ones that can keep an unvaccinated child from being a danger to the whole population. It’s hard to expect someone to take a high personal risk in order that others, whom they don’t know, can live. Thanks for your thoughtful comment, Emily.

  • Emily July 25, 2011 at 1:55 pm

    Until more pediatricians are willing to carry on thoughtful conversations with the families of their patients about vaccine decisions in light of personal circumstances such as personal and family medical histories, there will continue to be mistrust. While broad vaccination may be good public health policy, when it comes to personal decision-making, there are plenty of reasons to evaluate its efficacy on an individual level.

    Research is moving increasingly towards the idea that our health is guided by genetics triggered by environmental factors, such as vaccinations. So while something may be safe for one child, it may not be safe for another. We can not know the precise risk involved for a given child with a specific family history when it comes to being injected with, say, aluminum, a known neurotoxin which is unstudied as a vaccine ingredient. So it’s reasonable for families to be skeptical and weigh the risks of extremely rare disease against genetic illness possibly triggered by environmental factors.

    While there may be those who are simply paranoid without cause, many families who choose to not to vaccinate or vaccinate selectively have good reason to do so. The medical community may have more success in reaching some of those families if they were willing to discuss options and work with parents to tailor individualized vaccine schedules, offering delayed or selective vaccinations, and acknowledge the unknowns and risks as well as the benefits.

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