To the Parents of My Unvaccinated Patients:

Let’s get a few things out of the way before we begin, so we have a better chance of understanding one another: I’m a pediatrician who works in a hospital. It’s true that sick kids pay my bills, but I would much rather that kids never got sick, even if it meant losing my job. (I’m adaptable. I’m sure I’d be OK.)

I’m also a person who thinks that when young people become seriously ill from diseases that might have otherwise been prevented, it’s a tragedy. Pertussis outbreaks in this country are on the rise; paralytic polio quickly returned to Syria after immunization rates dropped due to the war; the measles outbreak currently taking young lives in Europe may now do the same in Texas. When children die of these diseases, it’s unconscionable.

I am, as you might have guessed, pro-vaccine. I am amazingly grateful that my own children are growing up in an era in which it is highly unlikely that I will have to watch them die. One hundred years ago, it was ordinary to lose a child before they reached the age of five. Can you imagine? I don’t even want to.

That’s me, in a nutshell. What about you?

Statistically speaking, I know that you are smart and educated people. You love your children as much as I love mine. You want what’s best for them. You are not and do not want to be confused with the unhinged anti-vax bloggers who believe vaccines are part of a government conspiracy to intentionally injure children. You probably aren’t personally responsible for the sharp uptick of online anti-vaccine posts on Twitter, statements that are as far removed from reality as their wealthy authors are from the median income. A new study even suggests that these posts are coming from only very localized areas in California, Massachusetts, New York, Connecticut, and Pennsylvania. You’re normal and rational enough to know that while there is formaldehyde in some vaccines, it’s also present in pears, which your children have probably enjoyed in both puréed and solid forms. And you are not, no matter what I say, going to vaccinate your son or daughter just because I think you should.

Communicating effectively is something doctors are meant to do well, so it’s tempting for me to just try harder to convince you that vaccinations are not harmful. After all, the diseases that standard childhood immunizations protect against — pertussis, pneumococcus, meningococcus, etc. — aren’t in the same league as, say, the common cold. These are the sorts of bugs that kill. Paradoxically, though, it may be better if I don’t say anything at all. Research suggests that if you express concern about the measles, mumps, and rubella vaccine and I respond by teaching you about measles infections and their dangerous complications (pneumonia, encephalitis, death), you walk out of that room more convinced that MMR causes autism (it doesn’t) than you were when you went in. I never said the word autism. Neither did you. But I pushed back against your hesitation to vaccinate with information that sounded scary, and so you doubled down.

I understand. In the face of uncertainty, doing something can often feel more frightening than doing nothing. Saying yes to a vaccine may feel weightier than saying no.

Considering all this, one might conclude that we have no common ground at all, but there is one very important thing that we do agree on: we both want your children to be healthy. If you choose not to immunize your family, I can’t force you to. But that means to minimize your child’s risk of exposure to a potentially life-threatening infection, it is absolutely necessary that the children your own kids come into contact with (at school, on the playground, in the grocery store) be vaccinated themselves. The antibodies in those vaccinated children’s immune systems are what’s keeping your own family safe.