Anti-Vaxxers: Why Medical Students Aren’t Being Trained to Weigh-in

With increasing frequency I have been asked by friends and well-wishers about how “anti-vaxxers” are being broached by my medical school professors. Simply put, we aren’t being taught anything on the matter. This is insight on how future physicians are being groomed to handle public misinformation and media outcry. Obviously we are given the molecular biology and public health angles as to how vaccinations work from the micro to macro scale, but we aren’t supplied with the tools on how to discuss these seemingly controversial topics with our patients. This could be for a few reasons.

First, the rising trend in vaccination refusals and recent measles outbreak, coupled with subsequent media hysteria, will raise awareness of the harm of not vaccinating children—and this trend will correct itself. After all, it seems affluent Millennials are seeing the greatest raise in foregoing vaccinations. They understand that chemicals are pervasive in today’s world, and while they might not buy that vaccines cause autism, they certainly don’t believe that injecting children with man-made concoctions at an early age increases their biological fitness. Therefore, when the educated anti-vaxxers see the harm they may be causing society as a whole, let alone their own kids, the trend will inevitably correct itself. One would hope.

It isn’t only the Millennials; some of the unvaccinated come from isolated religious communities, and the poorer counties within a state tend to have lower levels of vaccination rates. Each patient is unique and asks questions regarding vaccinations with different levels of background knowledge. Therefore different ways to convey the same message about the effectiveness of vaccines would need to be employed by the physician. This is a technique developed more during third and fourth year of med school (I’m still in my second year which is primarily classroom-based) so maybe it is more appropriate to have these discussions later in schooling. Sometimes a patient’s anecdotal evidence (e.g. “My friend’s sister had a normal child until they got vaccinated and then the child became autistic”) is too ingrained and no amount of sound evidence can dissuade them from their preset justification. My school might just be trying to allow its students to form their own ways of picking and choosing their battles when it comes to handling these issues with the patients.

Lastly, perhaps doctors feel that by and large they are above the entire “debate” about whether vaccinations are good or bad. Let the 24-hour news cycle run its course. Football just ended, it’s too early for 2016 elections, Russia and Ukraine’s ceasefire is mildly interesting, and by national news standards there’s not really much going on besides the latest ISIS comings and goings. By physicians engaging in a discussion about the merits of vaccinating your kids, it may lend credence to the extreme minority’s position as a legitimate conversation starter. Last year, noted scientist Bill Nye entered a debate with noted Amish-look-alike Young Earth Creationist (YEC) Ken Ham on whether creationism and a 6,000-year-old Earth is a viable model for our origin. Many people felt that Nye showing up to the debate was essentially giving YECs publicity and a form of legitimization, even though they are an extremely small and vocal minority without the backing of any evidence or scientific merit—much like the anti-vaxxers. The biggest difference being that someone believing Earth is 6,000 years old won’t necessarily raise the chance that my child gets a debilitating illness.

As far as med school teaching is concerned, we are urged to strongly recommend for vaccinations for inquiring patients, but maybe we should also be discussing issues on a larger scale and how it relates to public health. Although we have a bioethics course, which excels at giving students the facts regarding the law and why and how the law was passed, we are never given the tools for how to make more permanent change in the community. We are not instructed on how to engage in ethical discussions about whether or not something like vaccinations should be mandated by the government. In the last decade there have been failed or short-lived attempts at making HPV vaccinations mandatory throughout the U.S. The issue has been up for legislation in nearly half of the states and has failed in all but Virginia and D.C. (it was passed and later repealed in Texas). Perhaps not surprisingly, people would prefer to have the opportunity to make the wrong decision rather than having the right decision forced upon them.

I believe that people are very much products of their environment and will naturally gravitate towards the path of least resistance. Change on a macroscopic scale, like how society views public health mandates, can be unnecessarily slow to develop, except in rare cases like the polio vaccine—which was almost literally an overnight sensation. If many of the medical aspects of how we treat our bodies are dealt with in an “opt out” fashion I believe that we may see a significant increase in the quality of life across all strata of society. A great example of this is Spain’s organ donation rates. They have the highest rates of organ donation on the planet primarily due the country’s policy that each individual is automatically enrolled as an organ donor. If you want your organs to stay in your body to take them with you to heaven (or hell) after you die, you would have to fill out some paperwork. Well guess what? People generally find paperwork to be a nuisance and a tedious endeavor. You want me to fill out these forms just to be able to fill out more forms like we’re in some bureaucratic Soviet state? I’d rather just let you have my organs.

And that is the idea: create a society in which it is commonplace for people to generously donate their unneeded organs and they will eventually do so, not because it is the path of least resistance because it is the right thing to do to save other people’s lives. I envision after years or perhaps generations with a certain policy in place (like having to opt out of donating blood) that when the opt out policy is removed people still donate at the same rate because donating blood is something that people should feel compelled to do to help their fellow man. In the meantime, don’t incentivize performing a positive action, simply tack on some form of negative reinforcement to make a negative action (such as not donating blood or organs) more difficult. This way only those who have a true objection to the task will take these necessary steps.

In all likelihood there is no formal teaching for medical students on how to deal with anti-vaxxers in our pre-clinical years because it may not come up in doctors offices as much as the cable news-watching public may think. According to the CDC, vaccination rates have only had a very modest dip over the past decade and it should be far down the list of concerns doctors have for their patients. Some combination of it being a trendy topic, each patient’s situation being unique, and that it’s just beneath us as physicians to discuss, is what’s most likely being employed by our professors. There is already so much packed in our ever-expanding curriculum that we simply might not have time to really delve into the issues surrounding medical trends. Plus, by the time I actually become a doctor seeing my own patients, the medical landscape could be so vastly different that people questioning vaccinations would be a relic of a bygone era.

13 Comments

Filed under Education, Medicine

13 responses to “Anti-Vaxxers: Why Medical Students Aren’t Being Trained to Weigh-in

  1. Jon, with all respect, when you fail to present the strongest arguments available against the nearly 70 vaccines “recommended” given to American children (http://www.nvic.org/CMSTemplates/NVIC/pdf/49-Doses-PosterB.pdf), then you fail to make a compelling argument beyond, “Trust us.”

    Any friend of Ben Spielberg is a friend of mine, so let’s look at some data points that absolutely refute trust in this area:

    1. Source (with documentation for below claims): http://www.naturalnews.com/048665_vaccine_propaganda_public_suspicion_medical_profession.html :
    “Flu shots still contain mercury, a neurotoxic heavy metal. Some vaccine inserts still admit they are backed by no clinical trials. The U.S. government really has quietly paid out nearly $3 billion in compensation awards to families of children who were irrefutably damaged by vaccines. A top CDC scientist really did confess to taking part in scientific fraud at the CDC, covering up data linking vaccines to autism.”

    2. Source (with documentation): http://www.washingtonsblog.com/2014/12/vaccine-vortex-devouring-innocent-children-naive-parents-gullible-physicians.html
    “As many in alternative media document, so-called “health” oligarchs act against public interest in obvious ways when the facts are examined. For example, every economic cost-benefit analysis concludes Americans would save from $100 billion to $300 billion annually if we had universal single-payer health care for all rather than “health” “care” oligarchs consuming ~one-third of all payments.”

    3. same source as #2:
    “A related problem is the cartel of pharmaceutical companies colluding with our government “leaders” for padded industry profits. Dr. Marcia Angell, former Editor in Chief of the New England Journal of Medicine and currently a Senior Lecturer at Harvard Medical School documents:

    The combined profits for the ten drug companies in the Fortune 500 ($35.9 billion) were more than the profits for all the other 490 businesses put together ($33.7 billion).

    Dr. Angell concludes that US government will never provide universal health care because both political parties’ “leadership” obeys health insurance companies’ lobbyists rather than legislate for the public good.”

    Jon: have you really looked at the arguments for legitimate concern from vaccines?

  2. Mother of a Vaccine Injured Child

    Ben, the vaccine/autism link does exist. It’s been covered up. There is much information out there but the most telling is the CDC whistleblower, Dr. Thompson, who admitted that he and his colleagues at the CDC were instructed by the Big Pharma/revolving door heads of the CDC to destroy evidence that there was a strong correlation between the MMR given to African-American males and autism. That coverup should alert everyone, but pro-vaccine people are just looking the other way. https://healthimpactnews.com/2015/will-cdc-whistleblower-on-vaccines-testify-before-congress/

    Given that and the fact that the there has been over 3 billion dollars given out to vaccine-injured children by the vaccine court (oh yeah, there’s a special vaccine court because we’re not allowed by law to sue the vaccine makers), I think the red flags need to be addressed and not derided.

    • Again, I appreciate the skepticism of Big Pharma and government agencies, but my mother-in-law is a pediatrician and my wife is in medical school and they’ve looked at the research in great depth. The potential downsides of getting vaccines are minimal, while the potential downsides of not getting vaccines are enormous. I’m all for more research and I have looking into the Thompson story on my to-do list, but to give you a sense of why I’m skeptical, references to him are often paired with references to Andrew Wakefield, whose “research” was fraudulent and has helped lead to lots of preventable deaths.

  3. No Dr. Wakefield’s research was NOT fraudulent. Dr. Thompson’s confession is huge. Please, you and your wife, take the time to see the truth. Watch VAXXED!!!!! If you dare. Your wife won’t be able to state what you have studied is accurate.You will start to see a pattern. Remember the days when we were told that smoking tobacco was healthy, DDT was safe, soldiers were not sick from Agent Orange??????The list goes on and on. If your wife got into medicine to heal people she MUST open her eyes and ears and investigate all that is available for the sake of her patients to be. Med schools are run by Big Pharma. They write the curriculum.
    The research you have seen is a lie. This has now been PROVEN!!!!!
    They have NEVER researched vaccines in tandem or research non vaxed against vaxed.You will see the hearing where that is undeniable in VAXXED. The truth is non vaxed kids are MUCH healthier. I am a holistic healer and I have seen the truth. I also have 4 vax injured in my family. Please do your own research. Start with going to the CDC’s own website. It states that vaccines contain unavoidable risks. Google the inserts for these vaccines. They state many life threatening diseases including death, right on the inserts. This is why Doctors get angry if you ask for them . They will usually hand you a single page from the manufacture( akin to a flier).
    FACTS: Number of vaccines given to children to age 18……
    1962 5
    1983 24
    2016 72
    Huge law suites coming to the doctors who push this stuff …why ?
    Because in1986 in Our government gave the Pharma industry a release of all liability resulting from vaccine injury or death with the , ” Childhood Vaccine Injury Act”
    We the tax payer has however paid out over 3 BILLION dollars through VARS for vaccine injure and death for proven connections.
    So if doctors keep pushing this, parents WILL now be holding the doctors who told them they were safe accountable since the evidence is now available for all to see..

    • I’m sorry, but your statements about what has been proven and about medical schools and doctors are simply incorrect. There are many real problems with medical schools, Big Pharma, and even the way we approach wellness and medicine in the United States, but a vast conspiracy about vaccines isn’t one of them. There is tons of legitimate research that vaccines save lives and many doctors’ frustration with arguments such as yours is based both in the lack of evidence in support of those arguments and their concern for the lives of people who fail to take important vaccines as a result.

  4. Elizabeth Buiocchi

    There’s a significant difference between proving that two things are not correlated, and failing to prove that they are. Most people don’t understand this, even those who have taken advanced statistics classes. For decades, parents were told that studies repeatedly proved that there was no link between food additives and hyperactivity. But it turns out that, in a subset of kids, there is. In the 1990’s, the CDC convened an off-the-record meeting with parents who believed that their kids were neurologically damaged by vaccines. Parents who were there have stated that the CDC admitted that there is a disturbing link in African-American boys. I hadn’t heard anything about it being isolated to MMR vaccinations. Not all of the parents who believe vaccines caused their children harm are kooks. Some can describe, in detail, neurological regression which occurred shortly after vaccinations. Some even describe partial or full recovery of symptoms, only to experience similar or worse regression after subsequent vaccinations. There’s something real going on. I don’t think it’s sufficient reason to avoid vaccinations, but there should definitely be an effort made to avoid the suspected preservatives and/or alter vaccination schedules.

    • Thanks, Elizabeth, for the thoughts. The standard you’re proposing, however, is a pretty absurd one. One can’t generally prove the absence of something; I can’t prove that dragons won’t come and light your house on fire tomorrow, for example. But we can be pretty confident they won’t, and you probably shouldn’t make decisions based on the idea that that might happen :).

      I don’t know about the off-the-record meeting you mention, but I do know that there is a huge amount of evidence contradicting the idea that there is a link between vaccines and autism, and that vaccines have saved millions of lives. I don’t think parents who believe there is a link are “kooks,” but they are wrong, and it is important for public health that they look more rationally at this issue.

  5. Re: The CDC. If you don’t trust what they have to say, there are these things called *other countries* – go look at what they have to say.

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