Narcissus, so goes Greek legend, was an incredibly handsome son or a river god and a nymph. He was so beautiful that when he caught sight of himself in the river one day, he fell in love. And basically, there he sat, enamored of his own reflection, until he died. Now, that’s self-love. We all know the girl in high school who could not stop checking herself out in every mirror, and window, and mirror again. Going a step further, there is a psychiatric diagnosis called “narcissistic personality disorder.” Individuals with NPD go beyond fancying their image in a mirror, and possess traits such as exaggerated sense of self-importance, expectations of being recognized as superior (but with no achievements to warrant this), having a sense of entitlement and superiority, and lacking an ability to empathize with others.
Recently, this article equated anti-
But, do I really think the anti-vaccine movement is just a club of narcissistic people? No, I don’t. This is not about a lack of empathy or self-importance for the absolute majority of parents. So what is it? There is something useful in engaging in an exploration of the “why” behind the decision not to vaccinate. From a public health standpoint, we need to know the “why” if we plan on improving our vaccination rates. Simply saying anti-vaccine types are uneducated or narcissistic is not only generally untrue, it’s also totally unhelpful.
So let’s start with reason number 1: Fear. Fear. Fear.
Imagine your kid wants to ride a bike. You give him a bike and off he goes, flipping over the handle bars and breaking a wrist. Lousy day, right? Now, imagine you were so afraid of this scenario that you refused to buy the bike in the first place. He borrows the neighbor’s bike, doesn’t own a helmet and winds up with a head injury. In the first case, your action is directly linked to your child’s injury. Your inaction is the cause in the second. But for many parents who refuse to vaccinate, the fear of possibly causing injury is much greater than the fear of the alternative. Psychologists call this fear an “omission bias.” Essentially, it is the idea that doing something (acting) is much worse than failing to act (omission). Parents who chose not to vaccinate may be more likely to exhibit omission bias — thus, they are much more afraid of the decision to vaccinate and possibly cause a vaccine-injury, then they are to fail to act and have their child fall ill from a perceived outside threat of disease.
Other parents have misplaced fear. That is, they have been led to believe that the vaccine is much scarier than the illness. People who minimize conditions such as measles can be blamed for this. Yet vaccines save an estimated 3 million lives every year. The risk of vaccine injury is incredibly remote. But here again, we see how fear can get into someone’s head and make them behave irrationally. They are fearing the wrong thing.
2. Mistrust/Anger at the Medical Profession. When the Toyota seller tells me that Toyota’s are the best car on the road, I take it with a grain of salt. I mean, there’s a bit of self-dealing going on here, right? I’m going to do my own research and I’ll get back to Mr. Toyota when I am good and ready to buy. This is exactly what some vaccine hesitant or refusing parents think about healthcare providers and vaccines. They see the doctor and the larger mainstream American medical system as part of a giant corporation, full of self dealing and profit-mongers. Many of these people also generally distrust the government and assume that there is some hidden agenda lurking beneath the vaccine recommendations of the CDC (and anyone else).
This is a tough one for me because I cannot wrap my head around it. The only agenda I see behind promoting vaccines is the desire to stop the spread of vaccine-preventable diseases. The government does not want to deal with epidemics of deadly diseases that can be prevented with a simple vaccine (look, they have diseases like Ebola and HIV to deal with that are not vaccine-preventable and are terrifying). Your average doctor is not secretly trying to poison your child. And, contrary to popular belief, vaccines are not a money-making drug. Look, there is a lot more profit in hospitalizing a child with meningitis than there is in vaccinating that kiddo against it. It is estimated that the current immunization schedule saves $14 billion in direct healthcare costs per birth cohort. One Czech study showed that the cost of vaccinating against pneumococcal disease was 556 times lower than the cost of a hospital stay for pneumococcal meningitis. So, I’d be much more suspicious of the doctor who says vaccines are not necessary. . . which leads to #3.
3. Misplaced Trust in Less than Trustworthy People. Charlatans. Snake-oil salesmen. Whatever you want to call them. There are a lot of people out there making a healthy living selling parents on the idea that vaccines are bad and “natural” remedies are better. Anyone who tells you not to vaccinate your child against pertussis and then offers to sell you a natural remedy for the disease may not be the most trustworthy guy around. But these people are convincing and they rely on parental fear and distrust of medicine to sell a host of expensive products that don’t have very much scientific backing. That’s why the FDA is reevaluating its approach to homeopathic treatments.
Another example of this is celebrity intoxication, as I like to call it. This actor is so compelling, so convincing, without any apparent agenda, and she says vaccines are dangerous.
Fear. Mistrust. Snake-oil. Certainly these don’t explain all of the anti-vaccine choices, but it is a start.