Mary Poppins said it best — sometimes “a spoonful of sugar helps the medicine go down.” The saying refers to the general idea that accomplishing something unpleasant is more doable by manufacturing a bit of fun, but it can be seen quite literally in the world of medicine. We inject all sorts of sweetness into unpleasant tasks, especially those for children, such as adding fruity flavoring to cough syrups, shaping vitamins like cartoon characters and rewarding them with a piece of candy for good behavior at a doctor’s appointment. Administering shots is much more difficult to sweeten; not much can be done about the fact that the needle is going to pinch.
Still, many doctors and nurses try their best, by making shots into a fun game or by promising a special bandage after. Ensuring proper medical care is necessary to support individuals in leading their best lives and to produce a healthier population, but sometimes this care can be uncomfortable, frightening and downright painful. Many medical practitioners and institutions emphasize compassion, understanding and a little bit of sweetness to support their patients through difficult procedures. Unfortunately, this principle does seem to have its limits, especially when a medical issue becomes highly publicized. At present, the societal response to the hot button issue of the anti-vaccine movement has been overwhelmingly bitter.
It’s understandable why it’s difficult to take a saccharine approach to such a scary issue. Many believe the anti-vaccine movement will leave a large population vulnerable to illnesses with horrifying side effects which ravaged entire societies just decades ago. As such, the fear and rhetoric surrounding anti-vaccination are somewhat out of proportion to the actual scale of decreasing vaccinations. According to a 2017 report from the Centers for Disease Control and Prevention (CDC), vaccination rates remain relatively stable and high. Still, the same report does note that the proportion of children receiving no vaccines by 24 months of age has increased, albeit slightly and gradually. This small increase matters, however; the decline in vaccinations is often credited as causing a “global resurgence” of preventable diseases, inhibiting the goal of eradication.
Measles is an especially notable example — although it was declared eliminated from the United States in 2000, it has recently made an infamous comeback. The year 2019 saw the highest number of reported cases since 1992, totaling 1,241 as of September 5. The prospect of measles and other debilitating and deadly diseases returning to the U.S. is certainly terrifying, so the vitriolic reaction to the anti-vaccine movement seems only natural. The term “anti-vaxxer” has become pejorative, often grouped with the same type of “stupid” as flat-earthers and climate change deniers. Unfortunately, this vilification is unlikely to sway those hesitant about vaccination to the positive side.
In fact, a hateful response only serves to deepen divides, allowing the anti-vaccine movement to create a narrative of persecution. With the anti-vaccine sentiment taking a continually deeper hold in the U.S., it is imperative to reassess how we are approaching this movement, and shifting the basis of our policies and discussions to understanding and compassion.
For one, skepticism of vaccination is often treated as ignorance and stupidity. But many people have personal and cultural histories with the institution of medicine that lead to understandable hesitation and mistrust, which may include the prospect of vaccination. Furthermore, the concept of vaccination is certainly not intuitive. The narrative of illness prevention is largely based on avoiding germs, so the idea of having germs inserted into one’s body seems directly in opposition. Beyond active or inactive viral cultures, many other ingredients that compose vaccines do not merely seem scary — we have been warned to avoid them, notably formaldehyde and mercury-containing thimerosal. Of course, vaccines have been well established as scientifically and medically safe. But a mere statement of safety accompanied by absolute authority instead of understandable evidence can be intimidating and isolating rather than convincing.
Skepticism is largely treated as irrational and unreasonable, but this black-and-white response is incredibly invalidating and frustrating. Instead, patients should be treated as rational, capable of having reasonable concerns and discussions about the evidence behind vaccine safety. Reason is a far more effective response than resentment.
It is also important to acknowledge the emotions which accompany vaccination. These emotions may contribute to irrational thinking, but mitigating irrational responses are not always accomplished by outright ignoring such feelings.
Often, the decision against vaccination is made by parents on behalf of their children, and many vaccines are scheduled for the first couple of months of life. Parents are tasked with the heavy responsibility of caring for this delicate, fragile new person, so it’s understandable that protective instincts may kick in at the thought of several massive needles containing viral cultures being injected into them.
YouTuber Unnatural Vegan summarizes this well, noting her own emotional response to her child’s vaccination — while her “rational” side knows vaccines are safe and necessary, her emotions did cause a moment of hesitation. For a new parent who doesn’t understand vaccination and has never seen the diseases they prevent, such emotions may cause an even more influential response. Instead of invalidating this emotional response, the focus should instead be on increasing understanding of the technology and the importance of vaccination.
Validate protective parental instincts, and channel them into protecting children from preventable and potentially deadly diseases. Instead of operating with absolute authority, treat parents as autonomous decision-makers in their children’s health, supported by medicine rather than ruled by it.
Clearly, the bitter approach to the anti-vaccine is not the most effective one. Maybe it’s time to try employing a bit of sweetness instead. Maybe it’s a spoonful of compassion — rather than hatred — that we should utilize in the effort to quell the influence of the anti-vaccine movement. Vaccines absolutely are a revolutionary, priceless public health technology that should be embraced and utilized by as many people as possible.
Creating a more positive attitude toward vaccination will not be accomplished by fighting fire with fire — or by reacting to ambivalence with bitterness. Finding a smarter approach to this prickly subject is not just crucial for the health outcomes of individuals — it is a public health imperative.
Mary Rolfes can be reached at morolfes@umich.edu.