We started a war in the 15th century that we are still fighting today. It began as a war on devastating diseases such as smallpox and has morphed into a war between people: people and institutions, people and society, one profession and another, parents and schools.
Vaccinations are a very polarizing topic. I feel like the debate on this topic is akin to fighting with your best friend where you both state strongly worded views that are only partially correct because you are trying to make them pay attention. You know what they are saying also has some truth to it, but you can’t bear to let them have the satisfaction of knowing that until they stop saying things that are hurting you and consider your point of view as well.
The goal is to create the healthiest society we can. Some people believe this involves vaccines, some do not. This isn’t about whether or not you believe vaccinations are good or bad. This is about whether vaccinations are safe and effective based on the accumulation of evidence we have.
When a Harvard trained immunologist makes a statement about vaccines it gets a lot of attention . Even if we disagree with her position we are more likely to read and react to what she has to say because we place on her the responsibility of doing decent fact checking. Indeed, Obukhanych’s stance on vaccines has drawn a lot of criticism . I won’t regurgitate all these points in this post; I encourage you to read her letter and a rebuttal to her opinions here and then form your own opinions.
The naturopathic profession takes a lot of heat for being “against” vaccinations. The funny thing is that you could argue, as one of my mentors does, that vaccines are actually naturopathic if you consider their history. And there are naturopaths who are open to the appropriate use of vaccinations [See 3 for an example, or read the Pediatric ANP's position paper on vaccines here]. Regardless, the topic was a point of contention at the AANP Annual Conference last year.
It can be difficult to distance yourself from a long-held belief and to look at research with your head instead of just your heart. Especially if you have had the misfortune to know someone affected by an adverse vaccination reaction. And yet if we are to move forward and help the greatest number of people, we need to set aside our biases as best we can and give the research a chance. We must be very careful what we are willing to believe.
Consider the methods of studies rather than the abstract and conclusion. How are the authors defining their variables? For example say you’re looking at a long-term study on diet and cardiovascular disease. The authors group healthy foods as fruits and vegetables and unhealthy foods as refined sugar and red meat. Are these good ways to categorize healthy vs unhealthy foods? Fruit consumption (especially in excess) could be argued to be detrimental to health and red meat could be argued not to be harmful. So what happens when the results are based on categorizations of healthy and unhealthy that you or other research don’t necessarily agree with?
Now what about the variables that aren’t controlled for? In studies that compare vaccinated and unvaccinated children one must be aware of the potential confounds of socioeconomic status and healthy user (or in this case, non-user) bias.
Also, it’s not just about interpreting studies correctly, but also about how those interpretations are applied to real life. It is possible to construct a surface-smooth argument on a landmine of misplaced logic.
Keep questioning even if you read something that agrees with what you “believe”. If you only ever read what confirms your current views, you will never change. Your views will become stagnant and obsolete. For those of us who intend to become doctors or already are, this is not in the best interest of patients.
A friend of mine loves to make bold statements. He says that if you don’t take a stand then nobody will listen to you. Splashy news articles want readers. Be cautious because once you get into the realm of generalizations you’ll start tripping over bad science.
There is much we still do not know. Rather than arguing about the extremes of each position let’s identify what research we need to further our understanding. Brogan makes some interesting points on how different individuals react to vaccinations in her paper on the psychobiology of vaccination effects and proposes a more individualized approach to the topic .
For the people that are against vaccinations – maybe we could put our efforts into making vaccinations safer rather than doing away with them altogether. An example of this would be looking at the potential for botanicals as adjuvants . Or maybe we can work at creating healthier populations to improve their responses to vaccinations. For the people that are for vaccinations – maybe we could keep an open mind to areas that need improvement. Or maybe we need to focus on fostering a stronger understanding of how the immune system works. Productive discussion will accomplish more than endless arguing.
Let’s consider both sides of the coin in this debate, but also in all other aspects of our respective fields of medicine. Doctors cannot afford to be complacent when there are people who will trust them to make their lives better. Electricity, sewage systems, and the internet are not “natural” and yet they have helped improve our lives. There are also plants that are “natural” but deadly. Don’t let yourself be blinded by sentiment.
Addendum: After reading this friends and family are asking which side of the fence I'm on. My reply is that I cannot afford to shy away from the science supporting the use of certain vaccines for certain populations when there will be people trusting me to accurately represent the evidence. When the science changes, I will change too. We're constantly in the quest for black and white answers but vaccines simply aren't that simple.
Available at: http://circleofdocs.com/harvard-trained-immunologist-demolishes-california-legislation-that-terminates-vaccine-exemptions/
Hall, H. “Why does this immunologist reject vaccinations?” Science-Based Medicine. Available at: https://www.sciencebasedmedicine.org/why-does-this-immunologist-reject-vaccinations/
Barral, M. (2015). Measles: A different perspective from another Phoenix physician. Available at: http://drmatthewbaral.com/archives/1699
Brogan, K. Psychobiology of vaccination effects: Bidirectional relevance of depression. Alternative Therapies 21(3). Available at: http://kellybroganmd.com/wp-content/uploads/2015/09/Psychobiology