By Karli Carston
As a kid, I took vaccines for granted. Shots were something that was mildly unpleasant but necessary.
Then I grew up and became a mom.
I followed the car seat recommendations. I followed recommendations for breastfeeding and starting solid foods. I understood the relative risks and benefits of vaccines and followed the Centers for Disease Control and Prevention (CDC) schedule for both my kids. I assumed pretty much everyone else did the same.
It wasn’t until a couple of years ago when I moved to Boulder, Colo. to start a new job when my bubble burst. A local education news outlet, Chalkbeat Colorado, had calculated the proportion of students in each public school who were fully vaccinated and published the rates for parents like myself to see, and the information was both surprising and disheartening. A well-regarded charter school recommended to us by friends and neighbors had a 50 percent vaccination rate. Our local elementary school was much better at 85 percent but still fell far short of what is necessary for herd immunity. Not everyone accepts that the health benefits of vaccines outweigh the minuscule risks?!, I thought. How could this be? But the data were there in black and white.
Because I am a scientist, I had access to the academic literature and I began digging into the reading on vaccine hesitancy. There’s a surprisingly large amount of research on the topic, spanning many disparate fields: anthropology, medicine, public health, sociology, psychology, and economics.
Three main themes emerged from the literature: First, contrary to the image painted by the dogmatic fighting on the Internet, the population as a whole is not divided into strict pro-vaccine and anti-vaccine camps. Instead, there is a spectrum of vaccine hesitancy. Many parents who fully vaccinate their children still express doubt about the safety of vaccines, and tend to agree with the statement, “Too many vaccines will overwhelm my child’s immune system.” Other parents want to follow their pediatrician’s recommendations on vaccination but have lingering concerns about the now-debunked link between autism and vaccines and choose to delay some vaccines. These individuals in the middle of the spectrum can be considered “on the fence.” Unlike ardent anti-vaccine activists, they are probably receptive to evidence about vaccine efficacy and safety — if the delivered information is in the right context.
A second theme from the literature is that vaccine hesitancy often results from the lack of trust in medical and governmental institutions. In particular, people are concerned that profit motives, rather than health, are the driving force behind vaccine recommendations. This lack of trust is troubling for many reasons, not least because it is difficult to address. No amount of education can correct misconceptions about vaccines if the perception is that the information is coming from an untrustworthy source.
Third, the scientific literature identifies social networks as highly influential in vaccine-related decisions. People do not necessarily use evidence to make their vaccine-related decisions. In fact, evidence that runs counter to the anti-vaccination stance can have the effect of heightening vaccine hesitancy. However, people do seem to follow the lead of friends and family, which is promising considering that the large majority of the population chooses to immunize.
The importance of social networks turned out to be particularly true for me when I met Lindsay Diamond through a mutual friend on Facebook. Lindsay, a Boulder County resident, had been thinking about vaccine hesitancy for a long time and had been mulling over starting a non-profit devoted to vaccine education. We met early in 2016 at an empanada shop in Boulder and began getting organized. A couple of weeks ago our non-profit, Support Your Herd, was federally approved for official non-profit status.
Support Your Herd has two primary goals. First, we aim to provide vaccine education, particularly for expectant parents who are wondering whether to vaccinate their newborn. Allowing parents to ask questions in a non-threatening and unpressured atmosphere BEFORE the baby is born would give them access to the information and the time to consider and process it. Complex decisions are difficult to make on the spot, especially when it’s a counter-intuitive one like vaccination (What? You want me to stick needles in my baby? Why on earth would I do that?). Pre-natal classes would give parents time to digest the information and commit to the idea before they are in the overwhelmed and sleep deprived state of mind that characterizes the first few days after birth. Moreover, because Lindsay and I are both moms and have extensive scientific training, we hope that we will provide the right mix of trustworthiness, empathy, and credibility that will persuade “fence sitters” to be receptive to the evidence.
Support Your Herd has a second goal, which is to mobilize vaccine advocates in the Boulder community and its surroundings. Currently, individuals who are pro-vaccine are the “silent majority.” In contrast, anti-vaccine campaigners, despite being a small minority, are organized and highly vocal when it comes to vaccine-related policy. The promotion of the anti-vaccine cause to local and state representatives goes virtually uncontested, making it difficult for our politicians to justify the legislation of vaccine-friendly policies. We need this level of organization and activity among pro-vaccine Colorado citizens. If Support Your Herd can mobilize the silent majority and motivate individuals to communicate their stance to their representatives, then we stand a better chance of implementing statewide policies that favor better public health.
Support Your Herd is still gaining momentum. Our website is under construction and we are trying to find a home for our prenatal workshops, but we are hopeful that we can bring our community together in a way that protects us all from infectious disease.
To become involved with Support Your Herd:
- Follow us on Facebook
- Sign up to receive email alerts
- Contact us: Lindsay@supportyourherd.org
- Tell your friends!
Karli Carston is a Boulder transplant and the mom of two boys, ages 3 and 8. She is currently research faculty at the Institute for Cognitive Sciences at the University of Colorado, Boulder. After receiving her Ph.D in Neuroscience from the California Institute of Technology and completing a postdoctoral fellowship at Duke University, she moved to Boulder in 2014. Here she was surprised by low rates of vaccination in the schools, which prompted her to become an outspoken vaccine advocate.