This is an open letter to all physicians and researchers who work to inform the population on the importance of vaccinations as well as to pro-vaccine advocates who engage in conversation with parents who have not or plan not to vaccinate their kids:



Hi. You don't know me so before I dive in I want to make one thing abundantly clear. I am extremely pro-vaccine. I myself received the DTaP and flu shots while pregnant with my children and have kept them both on the recommended schedule for immunizations. I always encourage people to make sure their children are vaccinated as well. As a mother, a social worker, and a concerned member of the community I am very concerned about the epidemic(s) that await us if people keep choosing to opt out of this necessary preventative measure.



It is precisely because of this concern and my desire to see as many children immunized as possible that I believe we need to work together to change the conversation. As a therapist, when a client tells me that she has tried the same approach over and over again and isn't getting her desired results, my response is simple: it's time to change your approach.



There has been very little real dialogue on this topic. Those in the pro-vaccine camp see the issue as black-and-white. It is a necessity to vaccinate children; anyone who does not is a fool. The assumption is that this choice is based on bad science ("vaccines cause autism") or sheer ignorance ("they're toxic") and that these assertions are best met with no response for fear of validating the entire anti-vaccination movement.



The truth is, though, that the majority of people choosing not to vaccinate their children are genuinely afraid. They are afraid not just of autism, but of real side effects that do sometimes occur. And ignoring people's fear or suggesting that they are stupid, or crazy, or just plain wrong, is not going to make them any more inclined to do as we say.





When I was a camper at overnight camp we used to go swimming in a lake. There were little fish that lived in the lake that were, for the most part, harmless. Every once in a while, however, a fish would bite someone. It was fairly uncommon and not really a reason for avoiding the lake, but it was a legitimate concern for some, particularly those with a pre-existing fear of such things. In order to combat the epidemic of kids refusing to swim, the lifeguards and counselors used to tell us there were no fish in the lake. It was a lie. We knew it was a lie. We could see them! But somehow, they assumed, likely because we were children, that if they told us there were no fish we'd be reassured and would jump right back in the lake. The lie had the opposite effect, though. We knew there were fish and by failing to address that reality, those campers who were afraid felt neglected and ridiculed. They could no longer trust the very people who were supposed to be taking care of them. It would have been much more helpful to acknowledge the risk, have a discussion about what - if anything - was being done to minimize it, and promise to continue working on making the lake a safe place to swim.

You see when you acknowledge a person's reason for being afraid, and you work with them to find a solution, you do much more for the cause than if you attempt to pretend there is no threat. Vaccines are, by and large, extremely safe. The good they do far outweighs the bad. But adverse reactions do exist. The CDC website acknowledges this explicitly. For a large number of anti-vaxxers these potential reactions are a real fear. Putting a hand up in their faces and saying there's nothing to fear is like saying there are no fish in the lake. The refusal to meet them where they are and to address their fears makes them feel abandoned by the medical community and reinforces the notion that doctors can't be trusted. They have spoken directly to parents whose children have suffered after receiving a vaccine. Any suggestion that it can't happen to their children is seen as a lie.

Make no mistake. People who are choosing not to vaccinate their children are making a grave error. I know it seems counter-intuitive to give credence to people who are making reckless and medically unwise decisions when it comes to the health of their children and the entire population at large. I have been scoffing rather loudly myself since the practice not to vaccinate became so widespread. But the fact remains that our collective goal is to help people see the importance, the necessity, of vaccination. Our current methods are not cutting it. The longer we make anti-vaxxers feel that their concerns are absurd and unwarranted the more they are going to be suspicious of our good intentions and feel that pro-vaxxers can't be trusted. There is no question that there is a major health crisis waiting for us if the vaccination rates continue to drop. But by not engaging in the right conversation we are doing nothing to fix the problem.

We've tried one approach. It's not working. It's time to try something new.

People want answers. Or, at the very least, they want to feel like doctors care and are searching for the answers. What makes certain children more susceptible to some of these extremely rare complications? Are cases of adverse reactions to vaccines carefully reported? Are we being honest about what the numbers are? I am fully confident that the statistics would show that vaccines are incredibly safe, but these concerns need to be taken more seriously by everyone on the pro-vaccine side of the equation. If people feel like they aren't being told the whole truth, they will conclude they aren't being told any truth.