Category Archives: Childrens health

What’s not to Like? Less beige, Zuckerberg

Like Reply

Last week I eavesdropped on two 30-somethings talking about their favourite skiing destinations. When they finally agreed on a snow field in Japan, the guy said, “Oh yes! Big Like! ”

Thank you Facebook, for doing away with hyperbole around the things we love, for flat-lining our great passions and worst fears into one beige syllable.

We need this conflation, don’t we, Mr Z?  The sort of pale pleasantness that Zuckers has decided will arbitrarily help us scale down nasty aggression and unbridled positivity.

Well, in line with a current FB meme currently, I am thinking of ‘doing something different’, of laying down ‘new neuronal pathways’, by going to live in Spain or Holland. I’ve dreamed of hanging out in both places while finishing my novel, and now there’s an even stronger incentive to do it: these are the two countries where FB is trialing alternatives to ‘Like’.

I forget the more nuanced expressions that FB mavens are considering, and I don’t know exactly what they’re testing for.

Perhaps they want to know how alternatives to Like are understood in other languages?  Will shades of emotion cause confusion? Yes.  But confusion of this sort helps make life experience so piercing, so puzzling, so enticing – and so unique to the individual.

I am afraid of hearing more and more people say “Oh, big LIKE!”
I want to hurry to places where you can pick through a cornucopia of synonyms for warm feeling … weakness for example, or soft spot, partiality, bent, leaning, proclivity, inclination, disposition; enjoy, appreciation of, taste for, delight in, relish, passion, zeal, appetite, zest for, enthusiasm for, keenness around, predilection toward, penchant, and in the most beige moments, perhaps simple fondness?

What is wrong with ‘fond’? Such a lovely last-century word? So Scott-Fitzgerald, or even earlier, so Austen, so Elliot. Think Zuckers ever read Austen or Elliot? Possibly. But they clearly didn’t work for him. Because we have ended up at this anodine ‘LIke’.

I can see this young woman and man, clearly attracted, heading off for the incredible, six-meter powders on the Japanese slopes, pumping their funny skiing things and flexing their fine, powerful young bodies along the pistes and chutes and so on (I don’t ski).
They feel the blood powering through their cells, wind chewing their earlobes, the one-off sensations of being young, strong and happy … and, through the fizz of adrenaline and roaring pheromones, they’re yelling to each other:  “Oh, like, like, like, like.”

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The red man: a mother’s tale

Red-manLate afternoon last Sunday I went to fetch a woman from the emergency entrance at the new children’s hospital in town.   You take the sickle-shaped drive up to glass doors and behind them you see a spacious cave, pale green and grey, more like a hotel lobby than a landing stage for frantic families.

She was waiting beneath the portico outside, craning anxiously  forward; before I’d even set the brake she raced across and leaped in.  Only when she was beside me did she ask was I “for Georgia”.  I was.

“Let’s just run to the supermarket in West End,” she said, “I need ice-cream and that, stuff for my daughter.”  Not much of a ride for me, ten minutes in traffic, but a ride is a ride.

She was white in the face but sweating, brown hair unraveling from a ponytail, the neckline of her tunic dragged down to the side.  As we moved off she began a high-speed chatter and it occurred to me anyone might shelter in front of the hospital, with it’s busy street-frontage.  The area is dotted with hostels, and residents commonly wander around in search of remedies.

She had to get ice cream she said, because it was one thing her daughter would eat more than two spoonfuls of.  She needed shampoo, and maybe she would get some crackers, though they could be hard to swallow.

“How old is she?” seemed like a safe enough question.

“She’s four, but she was three when she came in.  It’s a year on Friday.”  What could you do with that?  You are honour bound to ask what’s going on, aren’t you?

The woman said her daughter had a crushed diaphragm and upper spine.

“Her brain can send messages to her body,” she said, “But her body doesn’t know what to do with them.  They get to the middle of her chest and then they sit there; like a traffic jam that never moves forward.  So I do everything from there onwards.  I’m the green man.”

I noticed the Southern Cross needled into her left forearm.  The blue stars were a little coarse and rough-edged now; she’d probably worn that hopeful constellation for decades.  She had a tiny gold stud in her nostril, and a red stone in her ear.

There was little traffic to slow us and we were only seven or eight minutes getting to the shops, but in that hiatus Georgia told me how twelve months previously, she drove herself and all three of her children into a catastrophic accident.

She wasted no time on details about causes, state of mind, none of that, she talked about consequences.

“My second daughter, well she was really, really badly injured but she pulled through.  She’ll be injured all her life, but she’s okay, she can get about.  My son, he climbed out with hardly a scratch – unbelievable, isn’t it?”

“What about you?”

“I had it really bad,” she said, “Lost a few toes, almost lost me foot, but they sewed it all back on, a miracle. I had quite a few broken bits, ribs, calf-bone and that, but they fixed those.  Punctured lungs, both sides.  For about a month I couldn’t remember much, but it was shock not brain damage. I’m lucky.”

“Are you in pain?”

“More inside than out,” she said. “Tara was the one who really caught it.  She was in the back, strapped in her capsule.  She was  three, like I said.  Smashed up. It was an accident.”

“I’m so sorry.”  The protocols of empathy.  Vacant words that could leave you quite alone with your anguish, but Georgia was used to them.

“Oh that’s all right,” she said, “Don’t be sorry. It was an accident. My best friend was in the car behind.  She saw it all happen.  She saw it all, she knows it was an accident.”

This then was the mantra, a cloak and a cover: “It was an accident”.

They lived up north, in Mackay I think. That’s over a thousand kilometers from where we were, but her crash had been just a few hundred meters from their home.  The whole family was flown down by air ambulance.  For the last eleven months she’d been beside the smallest girl; for months she slept on a gurney right next to the child’s bed, but now insurance put her up in a small apartment nearby.  Until three weeks ago she came each morning at seven, and stayed until seven at night.

“And now everything’s changed again.  Three weeks ago my best friend got flown down as well, from an accident.”

When disaster blows out to this degree of magnitude, your ability to believe can be momentarily suspended; it can turn you suddenly agnostic, even downright atheistic on a cynical day.

“What?  The same friend who saw your accident?  Your best friend?”

“Yes.  A week shy of a year from our crash, she’s had one herself. They flew her down too and now she’s over the road, at the Mater.  She’s that far from nearly written herself of, but they’ve saved her,” Georgia said, “So now I’ve got the two of them and I go back and for across the road all day.  She’s divorced, see.  No kids.”

“You’re married.  That’s something, isn’t it?” Here was something, a gleam of light at last.

“Yes, it is,” she said, “But he can’t be here.  He has to be there.”

“But at least you’ve got his support,” I said hopefully.

“Not really.  He’s up there working and looking on to the other two full time.  I can’t expect much can I?  Who has time?”

Irredeemably stupid, I asked: “So have you got a good marriage?”

“Honestly?  I don’t think there’d be a marriage without this.  We were on our last legs.  Sounds weird.  This saved us.  We’re better now than we were for years.”   This is why I like people: there may only be yea number of pieces in the puzzle, but the ways we in which can arrange them is infinite.

As we rounded the corner into the supermarket precinct, with all its adjacent shops and little public square, she said, “Listen, I’ll only be a few minutes, can you wait for me?  Keep the meter running, I won’t be more than five, ten?”

“Okay,” I said.  I was parking, not focused, and she leaped out, dashed up the stairs and disappeared between glass doors.

So I waited, illegally parked in a disabled zone.  It was a warm and golden sundown hour and the area’s drunks and addicts were out lazing in the public forecourt.  A thin woman and her companion lounged on the concrete edging and shared a two-liter bottle of soft drink.  From time to time the woman glared at me and mouthed obscenities, her expression a mixture of fear and rage.  The man, thin and shaved bald, leaned over and clasped her in his arms, stroked her hair; he seemed to be reassuring her that I wasn’t the anti-Christ, a cop or Shrek.

After five minutes I decided to put the meter on hold.  I was worried about this woman.

Almost ten  minutes passed before it occurred to me anyone could shelter in front of the children’s hospital; you needn’t be associated with any of the goings on inside, nobody would move you on from there.  I started to review Georgia’s anxious body movements, and couple them to her story, which now seemed remarkably decorative considering we had only spent seven minutes together.

I thought about the secret police I’d encountered way back, living in Apartheid South Africa.  Since I left I’ve read a fair bit about the lives these people are made to concoct for themselves before they go undercover.  The ones I met had chosen utterly incredible stories, stories that should have made anyone think, “This can’t be right!” But for some reason, you most often just accepted their bullshit, even as you shook your head.  I’ll tell you about them another time.

By then I was berating myself about why I hadn’t asked her to settle the first part of her bill before the shops.  But I second-guessed that immediately: perhaps she didn’t offer to pay because she didn’t want to risk waiting for another cab; because she was in hurry to get back to her child.  Then I began to get angry with myself about when or if I would ever grow up.

The woman with the soft-drink bottle had decided to lie down on the ledge.  She was so thin her body-line looked no more than six inches deep, except for her hip-bones draped in yellow cheesecloth which stuck up like hillocks in a Fred Williams landscape.  She had her head on the man’s lap and he stroked her hair carefully. She had the back of her hand over her eyes, like a Victorian hysteric.  Then another bloke stumbled over to them, and the sitting man mouthed the words, “Fuck off.”

Fifteen minutes into waiting, I surrendered to goodwill. I decided it was better for your health to believe, and allow disappointment arrive when it really had to, not before.  Just then Georgia ran out with three white bags dragging her down: I knew it wasn’t just ice cream and crackers she was needing.

On the backward leg to the hospital she told me that nowadays they could take skin from inside the nose and use those stem-cells to repair ‘diagramatic’ injuries like her daughter’s … but only if ‘the red man’ started blinking first.  I preferred the red man; he was easier for both of us to understand than the other word, with its dangerous silent consonants that could change the meaning of everything.

As an example, she cited a famous 20 year-old rugby player who just last year had suffered a catastrophic injury during a game: “Broke his neck. Snapped it.”  Even so, after a couple of months his red man began blinking, there was feedback, and they had something to work with. A couple of months ago he ran a half-marathon.

But in Tara’s case they’d waited for that bloody red man for months and months, and now they were pretty certain he was permanently switched off.

Buff-rumped_ThornbillThe child is four.  Georgia was going to be Tara’s green man for as long as her body wouldn’t say yes to her brain, or until Tara was big enough to manage other options.

“So like, when she needs to toilet, the brain gives her a ‘feeling’ of pressure, and even if her organs don’t know what to do, her little mind understands and she warns me,” the mother said, sounding rather proud.

“Who looks after you?”  I asked.

“I look after myself,” she said, “I have to.  Next weekend will be a year here exactly, and the three of them are all coming down here.  We can celebrate. They’re flying down.”

“It worries me that nobody looks after you,” I said.

“I’m fine, I have to be,” she said, but I saw water glittering along her eyelid.  I wanted to tidy the wisps of brown hair from her forehead, and say something appropriate, but I’m just useless at that stuff.

This time she directed me to the back of the hospital, the regular entrance where visitors go in, more homely, less intimidating than the great glass doors beneath the concrete awning on the other side.

As we pulled up she whipped out her phone, “Here, have a look at them,” she said, and thrust the image in front of my eyes.

I can tell you now, those children were beautiful. All three had large, dark eyes and strong brows, and wonderful glowing complexions.  Tara, lying down across the front of the group, was propped on one elbow with her hand cupping a round pink cheek.

The husband was a handsome, black-haired man with shining blue eyes. He looked buff and healthy, his tanned skin shone, and he had the same ruddy cheeks as his kids. Worry attacked me.

“Listen,” I said, “Why not go and have a bit of a makeover day before they get here?  A bit of a hairdo and a face do?  Just for you?”

I was lying: I didn’t mean just for her.  I was fearful for her, the lank hair untidily pulled back and shabby clothes, unpainted toes, and the dark skin beneath her eyes.  She didn’t look older than her husband, but she had none of his volume, his shining wellness.

She reminded me of a little bird I had recently written about for another project: the buff-rumped thornbill, acanthiza reguloides.  It is a round, busy little creature that hops about the undergrowth wherever there are no houses.  Its feathers are beige and brown, with just a tiny flare of yellow below the tail, to flag at males.  You can spot buff-rumps across ten million hectares of eastern Australia, but most of us will never see them, let alone know what to call them, even less discern them from the other eleven thornbills in their family.

“I know,” she said, looking away from me, “I’ve thought about it.”

“You should. He’s coming down to see you.  You should, for yourself.”

“I’m thinking about it,” she said again, and looked away. In her tone I heard, “It was an accident.  I don’t deserve it.  He might leave me.  I don’t deserve it.  I’ll never deserve it. It was an accident.”

She said, “You know, if you drive straight ahead and round the corner, there’s a rank there.  You could pick up someone else.  You could get a ride back.”

“You’re the end of my shift,” I said, “You’re my last.”  I swiped her card, we said goodbye, good luck.

There were five cars lined up round the corner.  It seemed momentarily odd that my brown bird had called for a pickup when these guys were already there.  Then it seemed not odd but ‘beshert’, destined.

Brown bird said the others were coming down, and now I remembered it was the Easter weekend.

Maybe on Thursday I’ll bake some chocolate caramels and drop them in.  I won’t interfere.  I’ll tell the nurses at the desk about the brown bird hopping between the two hospitals, and the little girl with a red man in her chest; they’ll work it out.  They might be a bit wary.  I’ll leave them my card.  I’ll show them my license.  You don’t want anyone to doubt your cookies, even if you’re worried about your motives yourself.

Reasoning with fear: the rise and rise of the anti-vaccination movement

Child with meales

Ten years ago in Northern New South Wales I finally found a community of people who felt like my true cultural kin. If you are the creative sort, or yearn for space to think about anything you like, the prevailing attitudes in that little enclave toward personal freedom can be very liberating. For around half a century the regional tribe has built a reputation for liebensraum – living ‘space’. Followers of the meditative religious traditions have settled there, along with a significant group of writers, artists and creative industries professionals, well-heeled lefties and of course, alternative health aficionados.

Almost by definition, living in those parts means you seek a more balanced, less processed-and-packaged lifestyle, and newcomers quickly adopt as much as they need of the local alternative health and natural medicine opportunities.

It is magnificent country for bringing up young children: a plethora of independent schools, a strong tradition of parenting groups and ‘natural parenting’ styles. Also among these fathers and mothers is a staunch tribe of anti-vaccinators. Almost half the children in the area have never been immunised against measles, mumps and rubella (MMR), or the more ‘old fashioned’ infections like diphtheria and polio.

The pitch and heat of these parents’ opposition to inoculation took me by surprise.

I grew up in central Africa and my generation received jabs and drops against everything – measles, mumps, rubella, polio, cholera, yellow fever, you name it – vaccination was just a fact of life. The rural areas were different; vaccination roll-out by-passed many villages in places without adequate clean water: in those places epidemics continued and people of all ages died, especially children.

As the country transitioned from British rule to independence, people migrated from rural areas to settle and find work. Some of my new classmates wore the scars of polio and smallpox.

Half a lifetime later, and here I was blissfully happy … among people who held this strong oppositional belief and resisted vaccinating their kids.  I was at first shocked and then negatively self-righteous.

I heard their claims and declarations, but I had no strong scientific rebuttal other than the obvious: people in developed countries no longer died in epidemics and pandemics were a thing of the past. My anti-vaxx friends seemed unphased by any of that. Any suggestion that their position might be selfish led to a shut-down of further discussion.

I soon realised that if I wanted to be comfortable in my new community and build relationships, it was going to be more productive to exchange outrage for curiosity. And so I began thinking about how our socio-cultural paths had diverged and look for the storylines that influenced the beliefs of my anti-vaccinating friends.

As this inquiry went along it ran far beyond notions of right and wrong, moral and immoral, or selfishness and the common good, leading instead to the origins of our fears and beliefs, and how we interpret these in a world full of conflicting information streams and interest groups.

. . . . .

Frontline anti-vaccination troops are always parent activists. This the story of how these parents, their influential media spokespeople and their children, are now perceived as a significant threat both to civic order and to the health status of some communities.

Their position obtains extra muscle from groups like the Australian Vaccination Network, and outspoken medical practitioners who’ve chosen to work against their original training.

The Australian Vaccination Network was founded as an online resource years ahead of the social media onslaught by a canny, naturally resistant American named Meryl Dorey. Ordinary parents in search of information about vaccinating their babies were driven to the website by its deliberate misnaming and there found a substantial archive of material urging against vaccination.

In 2010 the NSW Health Ministry compelled the AVN to change its name to the more accurate ‘Australian Vaccination Skeptics Network’, but it still runs under the original name on Facebook, and has several thousand friends.

Among the medical doctors who have transitioned out of the mainstream, Motherly Sherri J Tenpenny is a vociferous and unequivocal defender of anti-vaxx: It is always amazing to me how strongly a parent will defend the rights to inject their children with viruses, bacteria and chemicals.’

Tenpenny was right about that:  In January 2015, parent-led pro-vaccine groups went to Immigration Minister Peter Dutton insisting he cancel her visa for a planned lecture tour. He did not, but the media went on poking at her until venues cancelled, and Tenpenny withdrew.

Another spear thrower, American surgeon Joseph Mercola, is as much media salesman for himself as he is anti-vaxx rep. Though authorities cautioned Mercola against making spurious claims, Oprah gave him an entire segment to spruik the dangers of vaccination. He’s been interviewed on CNN, NBC, US ABC and in Time Magazine.  That is significant reach and influence by any standard.

On his website Mercola writes: The existing medical establishment is responsible for killing and permanently injuring millions of Americans … the surging numbers of visitors to Mercola.com since I began the site in 1997 … convinces me that you, too, are fed up with their deception.” His website is reputed to attract more traffic than almost any other alternative medicine site in the world.

Mercola’s statement goes to the core of parents’ fears, helping to sustain notions that we’ve been duped by science, that modern medicine and government are united against us for expediency’s sake, or perhaps just to make money.

. . . . .

One of the anti-vaxx movement’s strongest beliefs is that infant inoculation can cause autism and other abnormalities in children who were born perfectly healthy.

For nearly six decades two supporting narratives have swirled around this notion, and as with most important myths, its power comes from elements of fact.

First is the story of a corrupt doctor, medical malfeasance and public mistrust of the official version of events.

The second is a complex, real-world morality tale about medical proofs and practices, money and the greater good, socio-politics, and certain compromises that are sad, yet realistic.

In 1998, an English surgeon named Andrew Wakefield submitted a paper to the revered medical journal The Lancet. Wakefield claimed that in a study of eight autistic children he found a correlation between the onset of their autism and their MMR inoculations.

The Lancet had this study reviewed by six medical peers, four of whom rejected it outright. The editor decided to publish regardless – he thought the story would stir some interesting discussion.  He was correct: all hell broke loose in the medical world, and pretty soon every aspect of the study had been disputed and junked.

Soon after, a British investigative journalist discovered that a lawyer paid Wakefield a substantial sum of money to produce the study. He planned to use the published work as part of his defense in a class-action to be brought by the children’s parents. The Lancet issued a complete retraction. Vilified, Wakefield was charged with fraud and barred from practice.

Newspapers picked up the story and gave it front-page notoriety. In response, a significant group of punters decided Wakefield was not a villain; they said he had been framed by medicine and the scientific media because he had identified an inconvenient truth. Wakefield became and remains a counter-culture hero, and his specific claims ­– about how vaccines cause autism – still fuel anxiety.

Ironically, Wakefield in his work did intuitively flag a connection between vaccines and neurological problems in children – but it was the wrong flag. The right flag was flying over an ethylmercury-based vaccine preservative called Thimerosal, which was to become the focus of a far bigger and more complex drama.

. . . . .

For seventy years, Thimerosal has been in continuous use stabilising the world’s most common childhood vaccines. For half that time, its efficiencies have conflicted with suspicions about its toxicity.

People’s concerns about Thimerosal/ethylmercury come out of its perceived association with another mercury-based compound, methylmercury. There really need not be any confusion because while both compounds contain mercury – and mercury in certain concentrations is poisonous to mammals – methylmercury has no commercial applications.

Methylmercury is a by-product of petrochemical processing and a known neurotoxin. In the 1950s and ’60s, a processing plant on the edge of Minamata Bay in Japan, discharged methylmercury waste straight into sea. The Bay also provided the local community with their staple protein, fish and seafood ­– which animals naturally ingested the mercury-poisoned water.

For over a decade Minamata experienced the onset of a range of neurological diseases that eventually affected an estimated two million people. Unborn babies were affected by their mothers’ diet, and scores were born with symptoms similar to cerebral palsy – a condition now called congenital Minamata disease.

To this day Minamata stands as one of the worst industrial accidents on record. The event alerted researchers worldwide and they began identifying similar neurodevelopmental problems wherever mercury-contaminated effluent flowed into waterways.

The scope of research enquiry expanded to other mercury-based compounds, eventually focusing on the ethylmercury-based vaccine preservative, Thimerosal.

Originally tested on monkeys, ethylmercury was found to be an efficient, non-toxic substance which when ingested at approved levels passed rapidly through the system, and was safely eliminated. Once approved, the same result was found when ethylmercury was administered to human infants; it appears to pass quickly and harmlessly through the body.

Thimerosal became manufacturers’ preservative of choice in a range of vaccines, including the most common of all infant jabs, the measles-mumps-rubella vaccine, or MMR.

Medical historians believe that confusion around methyl- and ethylmercury has sustained a line of suspicion from Minamata Bay to the edges of parents’ consciousness in the West. That said, there is no confusion around the intrinsically poisonous character of mercury.

. . . . .

Although researchers’ real concerns about mercury had been ongoing, Andrew Wakefield’s deception in 1998 undoubtedly brought public anxiety about vaccination to a head.

In 1999 the US government determined to settle the question of Thimerosal’s safety by funding a scientific review involving eight separate studies.

Epidemiologists found ethylmercury safe in the quantities approved for use in vaccines, but now they had other concerns. For example, since infants at that time received up to nine vaccinations before six months of age, what might be the cumulative effects of ethylmercury contained in all those needles? So the substance is of itself safe, but the application could cause problems.

The US Public Health Service includes the five peak US medical bodies, including the American Academy of Pediatrics. In 1999 and again in 2000, the USPHS, ‘issued two Joint Statements, urging vaccine manufacturers to reduce or eliminate Thimerosal in vaccines as soon as possible.’

In 2001, the US Academy of Pediatrics added a rider to the earlier statements: ‘Mercury in all of its forms is toxic to the fetus and children, and efforts should be made to reduce exposure to the extent possible to pregnant women and children as well as the general population.’

Since then, Thimerosal has been phased out of almost all children’s vaccines manufactured in the US – but not the MMR shot. A recent US Food and Drug Administration summary says that since 1999 some of the major pharmaceutical manufacturers have developed alternatives to Thimerosal for some vaccines, while others have reduced the amount of ethylmercury in vaccines to trace levels – but it is still there.

You might think the anti-vaccination lobby could now claim vindication, but they do not. Because regardless of negative findings and shifts in the politics of drug manufacture in the West, on the global market Thimerosal persists as medicine’s preservative of choice.

. . . . .

In December 2014 an international working group of health professionals met at the World Health Centre in Geneva to look for workable vaccination solutions in the developing world. At that point measles and whooping cough epidemics had been raging through sub-Saharan Africa for more than five years.

An original agreement reached in 2002 had aimed to eradicate measles by 2020. Despite that, in 2010/11 more than 27,000 people across the Horn of Africa were infected, almost two-thirds of them children under five. Far away to the west and south, Nigeria and Zaire have suffered outbreaks in similar numbers. Things are not under control.

For the WHO’s plans to work, every unvaccinated person needs two doses of measles-containing vaccine. Here we are talking giant quantities of serum with delivery and logistical issues special to emerging countries.

The Horn nations, Ethiopia, Kenya and Somalia, are famously war-torn with patchy infrastructure, electricity and clean water supplies. Massive refugee camps perched on regional borders shelter nearly one million people in conditions even more rudimentary than elsewhere, and the incidence of measles is even higher among children who live there.

Delegates at the Geneva conference voiced their concerns about mercury in vaccines, but they still need vaccines that will work for their region. That means cheap to manufacture and produce in multi-dose vials with a rubber stopper that lets you reintroduce a syringe without contaminating the balance, keeping serum viable for at least a week. The vaccine must also be less costly to deliver, store and refrigerate than single-vial vaccines. There is still only one solution that fits all those parameters: Thimerosal.

To First World anti-vaxxers this is a pyrrhic outcome.

. . . . .

People are not necessarily convinced by ‘the facts’ – sometimes they arrive at a position based on the intuitive knitting together of feelings, values and their lived experience. This could be why anti-vaxx parents are not more likely to vaccinate when presented with proofs, no matter how strongly founded.

In a recent research project, two scientists set out to test this hypothesis. Doctors Brendan Nyhan and Jason Reifler used three different approaches to see if they could affect the mindset of nearly two thousand anti-vaxx parents.

Whether they presented respondents with a scientific report issued by the US Centres for Disease Control, or emotive anecdotal material supported by disturbing pictures of infected children, the parents dug their heels in: None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism … but nonetheless decreased intent to vaccinate …’

The same researchers had already authored a now famous inquiry into the contrarian power of personal values – and fears – over changes in available information.  The study looked for shifts in position by self-professed conservative voters who believed George W Bush’s declarations about weapons of mass destruction in Iraq. When the WMD narrative was universally discredited as misinformation – and Bush himself issued a retraction – the study respondents continued to insist Bush’s initial statements were the truth.

. . . . .

As fascinating as those findings are, I wonder if the Nyhan/Reifler studies bypass one or two other aspects of being human, such as a sense of personal agency, and of prerogative over our own and our children’s bodies.

In the reading I found analysts and the media consistently blame the Internet and social media for fanning the anti-vaxx fires. That may be a fair assessment, but it is not a wrong thing. The debate both on- and off-line comes from such a broad and well educated demographic, the people just cannot be dismissed as bumbling Arcadians, or ignorant monkey-do’s.

Nevertheless it is true that without arbitration, the on-line discourse usually disintegrates. As Sydney psychologist Robin Grille says: ‘It is a viciously unmanaged debate, invariably personal and insulting, as is so often the case when the underlying motivation is fear and the overlay is the absence of scientific methodology.’

I decided to open a vaccination thread for discussion on Facebook.  I worded my query as carefully as a politician testing the waters on potentially unpopular policy.  Then I posted it to Friends generally, and added tags for a trans-global selection that might take a special interest.

I lined up private conversations with professionals in a variety of fields, who preferred to comment outside the public domain: a Melbourne GP; consultant paediatrician; Sydney family therapist and writer on child abuse; family educator in the Tiwi Islands, and someone in the non-profit community with special insight on how NGO funding can support and influence global health programs.

When I tried to engage an established West Australian naturopath – a rabid Anti-Vaxxer and trained Registered Nurse – she unfriended me at once. In her farewell note she forbade me ever refer to her by name.

Every one of my anti-vaxx friends insisted on anonymity – later the penny dropped that these people feared discrimination against their kids.

The online thread evolved quickly. For the first time I was in a vaccination debate that did not descend into vituperation. For or against, people said their piece – and although a few men chipped in, mostly it was women who responded, all of them mothers.

. . . . .

It was becoming more and more apparent that anti-vaxxine resistance runs far, far deeper than wonky belief systems, Big Pharma conspiracy theories, and Nyhan and Reifler’s exciting experiments in moral cognition.

For many anti-vaxxers the real argument is about human rights: the sanctity of my body, my body as the final frontier against external interference – and a parent’s right to make decisions about their children’s well-being.

Sydney psychologist, Robin Grille thinks there is something in that. Author of a history of child abuse, Robin suggests anti-vaxx parents ‘might be exhibiting a visceral rejection of the legitimacy of authority.’ 

He reminded me that the perception of child ownership is still very much alive in the Western zeitgeist: it is less than fifty years since American law changed a child’s status from that of parents’ ‘chattel’, to that of ‘person’.

Robin suggests parents might also have a ‘sense of violation’ around exposing their innocent babies to jabbing needles, similar to the feelings of some contemporary parents around circumcision.

Things have moved on from where it was inconceivable to resist or reject the proposed benefits of contemporary medical science. Perhaps anti-vaxxers are a bellwether for growing public suspicions about the objectives and intentions of science generally and medical science particularly, and about financial opportunism and widespread manipulation of people’s fears.

‘What makes matters harder for all sides of this debate is that unless you study and apply scientific methodology, anecdotal evidence remains the profoundly emotive driver for this argument,’ says Robin.

. . . . .

As the online chat went along, more and more people seemed to conclude that a parent should retain the right to choose or refuse vaccination.

Even though Ebola was breaking out on the other side of the world, nobody in my Facebook thread started baying for compulsory vaccination, but within two months of those conversations, Australian media began feeling around for a public response to that very idea.

Within three months, government and the judiciary were announcing plans to enforce vaccination, including severe penalties for those resisting. As enforcement arrives, the anti-vaxxers have been remarkably quiet – these are good, middle-class activists after all, and the threat of punitive action and of family support benefits may have caused serious shock-waves through the movement.

A Brisbane primary-school teacher told me she’s ‘sick and tired of these parents who think it’s trendy not to give kids their needles.’ She said avoidance was ‘rife’ at her school and she found it hard to accept the risks people were taking. At 23 years of age she had never seen an epidemic of any kind – but she fully understood the risk implications for public institutions.

Anna, an adult educator, therapist and mother from Tasmania has three children born in the ’80s and chose not vaccinate them. ‘I was lucky,’ she told me, ‘I could stay home with my babies. They were all healthy and strong and I felt perfectly able to nurse them through any ordinary childhood disease.” Then she added a rider: ­­­ ‘That said, if I were a young mother today, I would vaccinate. There is no way I could stay at home and raise kids now, it’s just too costly – I would have to work, I would have to put them into care.  They would be far more vulnerable and exposed.’

Over a glass of wine on a warm afternoon, Anna’s story had pointed up the real cost of childhood disease in another, critical way. In the social structures we have worked so hard to create there is little space for old-fashioned illnesses; a sick kid can severely impact the household economy, and an epidemic of sick kids could disrupt the economy of an entire community.

. . . . .

Such complications – emotional, economic, legal and expedient – weave through so many arguments where moral and human rights rub up against state and legislative control over a person’s body and their possessions.

Euthanasia, suicide, corporal punishment, all create the same level of contentious social concern where debates rage over time, and change comes through at glacial speed – but comes through nevertheless.  Compared to such dilemmas, it could seem comparatively easy to legislate and force parents into vaccinating, and design repercussions for those who refuse or avoid.

But even if vaccination enforcement were in place, the borders would forever be porous. How will laws account for children of a religious denomination or culture that opposes vaccination – will they be denied school entry?  Will people have to carry proof of vaccination ­– perhaps recorded on chips in Medicare cards? Will gay people be forced to have an AIDS inoculation? And how will the state police gaps created by legal and illegal migration from places with threadbare human services?

Any of those possibilities include inherent threats to individual rights, and infractions of civil liberty. That is why successful mass vaccination in developed countries has rested not only on individual choice, but on our human predisposition to work as a group.

Those values, together with our cultural tendency to utilitarianism (belief that the best behaviours serve the largest number of people), also underpin Thimerosal’s continued use across the planet.

From that perspective, the anti-vaxxers might be called society’s critical dissenters – even if you are tempted to brand them as selfish rebels.

At the very least, the strength of their resistance asks us to question the notion of Western medicine and science ruling by their obvious virtues.

The anti-vaxxers remind us that moralistic tut-tutting by citizens who vaccinate is not the only driver: research and vaccination programs go-ahead at the behest of business and government, and in that order.

If there is insufficient financial return, medicine and pharmaceuticals will unceremoniously drop development or delivery of a vaccine, and shift resources to somewhere with safer returns on investment.  That is what happened with the Ebola vaccine, and with tragic consequences.

A decade ago, Australia’s Nobel-winning Professor Peter Doherty, was working with an international team to develop a vaccine. They were on the verge of success when funding was withdrawn and the research shelved.

Speaking about the seemingly unstoppable progress of the disease in August last year, Professor Doherty said: ‘This is a big issue really because unless there’s profit in a product, there’s a real issue on how you take forward, say new antibiotics and new therapeutics for minority diseases.’ The expression ‘minority diseases’ of itself puts grunt into an argument about practical economics and medical discovery.

On this topic Robin Grille and my Melbourne GP both suggest that in this instance the profits to be made from standard vaccines are so negligible as to hardly count in the argument about the greedy pharmaceutical industry. “They’re bread and butter, like most old, off-patent drugs’, wrote the Melbourne doctor.

But in this I suspect they are wrong. Where demand is high and a vaccine is cheap to manufacture, the quantities involved and the business around packaging, distribution and administration will be massive – and safely funded by governments, or by substantial NGOs like Rotary.

This returns us to the group of health workers gathered in Geneva in 2014, searching for ways to stem disease breakouts in Africa. Irrespective of their anxieties about drug safety, the cost effectiveness of serum preserved by Thimerosal won the day.

Also present at the Geneva conference were representatives of the international anti-mercury lobby, the Zero Mercury Working Group. They did not interfere with the discussion about Thimerosal. A co-ordinator of the ZMWG said: ‘As far as we’re concerned all mercury uses are a problem and they all should stop. But on a pragmatic level, we try to fight battles that we think we have a chance of winning.’

. . . . .

Anti-vaxx parents remind us that an infant is a person who cannot yet make complex choices for themselves, and a parent has the duty and the risk ­of doing it for them. Access to more information does not necessarily make the duty or the risk less confronting.

After all, some babies do suddenly show serious developmental and neurobiological disabilities following vaccination.  And while medicine can explain some of these, they cannot explain them all.

. . . . .

As the online investigation began winding up, someone called me on my own view, ‘You can’t be sitting on the fence,’ they said, ‘Not after all this sturm und drang‘. I replied that I would vaccinate my children without hesitation.  I said if even the most articulate and well informed of my anti-vaxx mates tried dissuading me, I lacked the nerve to let a child go without needles.

To that one of my closest friends came straight back: ‘Isn’t that interesting. I felt exactly as clear and adamant as you … except I simply could not justify the risk of sticking needles into my perfect, healthy, beautiful child. So far she has never had anything but chicken pox, and nobody vaccinates against that anyhow.’

Postscript
March 12, 2015. Child immunisation: Queensland Government moves to allow childcare centres to reject unvaccinated kids.  http://www.abc.net.au/news/2015-03-12/child-immunisation-qld-government-moves-on-childcare-vaccination/6308706

March 2, 2015.  Pakistan arrests parents for refusing polio vaccine. BBC News Asia.  The story notes that In November 2014, “… four polio vaccination workers were shot dead in the south-west city of Quetta.”
http://www.bbc.com/news/world-asia-31703835

.  .  .  .  .

Image credit:  Julien Harnells.  His photo journal is accompanied by an incredible short essay on the measles epidemic in Guinea, West Africa.  I strongly recommend that anyone interested in this topic read the essay and look at his images.
https://www.flickr.com/photos/julien_harneis/sets/72157622891864502/

Information resources

Goodson, James L., Kebede, Assegid A., Ahmed, Hinda, et al. Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control, USA. August 31, 2012 / 61(34); 678-684

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm

Gastañaduy, Paul A., Redd, Susan B., et al. Measles — United States, January 1–May 23, 2014. Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control, USA. June 6, 2014 / 63(22); 496-499 http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm

Controversial anti-vaccination campaigner to visit Australia. January 6, 2015.
http://www.abc.net.au/pm/content/2014/s4158300.htm  Anti-vaccination campaigner Dr Sherri Tenpenny cancels Australia tour amid security concerns. January 29, 2015. http://www.abc.net.au/news/2015-01-29/american-anti-vaccination-campaigner-cancels-speaking-tour/6053852

Doctors Against Vaccines: The Other Side of the Story is Not Being Told http://healthimpactnews.com/2014/doctors-against-vaccines-the-other-side-of-the-story-is-not-being-told/#sthash.Be5gpsup.dpuf , built around the multiple-award winning documentary, The Greater Good, released 2014 – http://www.greatergoodmovie.org/#!wp-video-lightbox/0/

Vaccine Hub. Admin: Sanofi Pasteur. http://www.vaccinehub.com.au/content/whooping-cough

Minamata Convention on Mercury. United Nations Environmental Programme. http://www.mercuryconvention.org/Negotiations/History/tabid/3798/Default.aspx

Fitzpatrick, M. The Cutter Incident: How America’s First Polio Vaccine Led to a Growing Vaccine Crisis. Journal of the Royal Society of Medicine, March 2006, 99(3): 156. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1383764/

Griesbauer, L. Methylmercury Contamination in Fish and Shellfish. Proquest. February 2007.

Thimerosal in Vaccines, US Federal Drug Administration Phttp://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm096228#thi

Bernard, S., Enayati, A., et al.  Autism: a novel form of mercury poisoning. Medical Hypotheses, (2001) 56 (4) 462–471. Harcourt Publishers Ltd, 2001. http://www.idealibrary.com on

Baker, Jeffrey P. Mercury, Vaccines and Autism: One Controversy, Three Histories. American Journal of Public Health, 2008 February; 98(2): 244–253.

Hollywood’s Vaccine Wars: L.A.’s ‘entitled’ Westsiders behind city’s epidemic.   Baum, G. The Hollywood Reporter, Sept 2014.

Tavernise, S. Vaccine Rule Is Said to Hurt Health Efforts, , New York Times, Dec 17, 2012

Mid-Year 2013: Measles and Rubella So Far. American Red Cross, US CDC, WHO, et alhttp://www.measlesrubellainitiative.org/measles-outbreaks-mid-year-2013-update/

Effective Messages in a Vaccine Promotion: A Randomized Trial. Nyhan, B and Reifler, J et al, in Pediatrics, 2014. http://pediatrics.aappublications.org/content/early/2014/02/25/peds.2013-2365

Will mercury be removed from vaccines? Rebecca Kessler, FairWarning. Salon.com. Jul 1, 2013

When Corrections Fail: The persistence of political misperceptions of conservative voters.2 Nyhan, B and Reifler, J. Dartmouth College, New Hampshire. http://www.dartmouth.edu/~nyhan/nyhan-reifler.pdf

  1. McCalman, J Science and Fear: a review of vaccination documentary Jabbed. The Conversation, 2013.
    http://theconversation.com/science-and-fear-a-review-of-vaccination-documentary-jabbed-14291

140 000 people to get cholera vaccine in South Sudan. WHO Media Centre news release, Feb 22, 2014. http://www.who.int/mediacentre/news/releases/2014/cholera-vaccine-20140221/en/

Jacob, T. J. and Samuel, R. Herd immunity and herd effect: new insights and definitions. European Journal of Epidemiology, pp 601-606, Vol. 16, Issue 7, 2000.

The Greater Good Movie. www.greatergoodmovie.org/

Pemberton, S. Jabbed: Love, Fear and Vaccines. 2013.
For a fascinating, easily digested – and subtly biased – review of the history of vaccination and immunization, watch Sonia Pemberton’s award-winning documentary, ‘Jabbed’, 2013. Funded by SBS and available on SBS On Demand.

http://www.sbs.com.au/ondemand/program/690/Jabbed-Love-Fear-And-Vaccines-Series-1

The promos for this documentary are also useful:
http://www.sbs.com.au/ondemand/video/28843587685/Jabbed-History
http://www.sbs.com.au/ondemand/video/28845635660/Jabbed-Immunity
http://www.sbs.com.au/ondemand/video/28836419886/Jabbed-Herd-Immunity

Grille, R. Parenting for a Peaceful World. Longueville, Sydney. 2nd edition, 2013.
Essential reading for anyone interested in the Western history of child-rearing over the last 3000 years: origins of childhood, genesis of child-abuse, and the begetting of violent societies. http://hearttoheartparenting.org/great-news-2nd-edition-of-parenting-for-a-peaceful-world-is-out/

Nobel Prize laureate says Ebola outbreak shows need to rethink vaccine research funding.  Sarah Dingle reports on P.M., ABC Radio, Sept 17, 2014. 9

Copyright: Naomi Radunski, February 2015