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Diving In, Part Two (Or, Why the Vaccine Debate Isn’t Cut and Dried)

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In case you missed, it, Part 1 of my writing on vaccines in the US can be found here.



I suppose that, like most other very controversial subjects, it shouldn’t surprise me that the vaccine debate tends to get framed as an all or nothing, black and white, choosing sides issue. Whenever we are driven by fear, human beings tend to lose the ability to think rationally and begin to believe that there is a Right and a Wrong answer, and the question of whether or not to vaccinate can certainly be a fearful one.
I do continue to be mystified, however, by people who should know better – public health officials and medical practitioners, for starters – that position vaccines as an all-or-nothing proposition, and here is why:
Vaccines are not all created equal. Accusing me of being “anti-vaccine” because I am concerned about the safety and/or efficacy of some vaccines or the current US vaccination schedule is akin to saying I am “anti-car” because I wouldn’t consider driving a Volkswagen but I might choose a Toyota.

  • There are a vast array of vaccines available, some of which were created decades ago and some that are fairly recent. 
  • Some vaccines on the market are multivalent (that is, they are designed to inoculate against more than one disease-causing organism) and others are monovalent (for one organism only).
  • Some vaccines were created to work against bacterial disease and others were designed for viruses.
  • Some vaccines contain adjuvants (chemicals that are supposed to increase the body’s immune response to create stronger immunity) such as aluminum and others do not.
  • Some vaccines are designed to be injected once in a person’s lifetime and others require multiple boosters in order to maintain a high level of immunity.
  • Some vaccines contain inert ingredients derived from animal parts, others from human fetal tissue, and things like MSG (monosodium glutamate).
  • Some vaccines have been tested many times over a long period of years on individuals of all ages, genders and races, and others have been “fast-tracked” which means that there was a determination that there was some public health risk that necessitated them getting to market faster, so there hasn’t been the same rigorous level of testing. 
I could go on, but hopefully it is imminently clear that the vaccines Americans are encouraged to give their children (and have themselves) are very different from one another. Much like buying a car, it is important to do research on each individual vaccine in order to determine a risk/benefit ratio and decide what is comfortable for you. For example, when my daughters’ doctor recommended the chickenpox vaccine for them, I researched it as thoroughly as I could and ultimately chose not to have them get those shots because I felt as though the risks outweighed the benefits. Similarly, they have not had the HPV vaccine and I don’t foresee either of them getting it anytime soon. (If you’re curious about why, you can read this post particular to the Gardasil vaccine. Since I wrote it, there has been a great deal more information published by other people who are critical of both Gardasil and Cervarix that shouldn’t be difficult to locate online.)

Please don’t think that I am under the impression that doing research on the safety  and efficacy of individual vaccines is a simple endeavor. I am fully aware that it is not, and I know how lucky I am to have both the time and the educational background to locate, digest, and mostly understand the data. Many, many people are unable to do what I have done, and the system is unfortunately not set up to support any kind of patient education regarding vaccines or any other pharmaceutical, for that matter. Many vaccines are available through drugstores and grocery stores in America, which makes it a challenge to have an in-depth conversation with the provider regarding risks and possible complications. Even if you go to a physician for vaccines, many of them aren’t as well-informed about the individual attributes of each vaccine as they could be, and a great deal of them are unwilling to have a candid conversation about the ingredients of individual vaccines. In a perfect world, the person who is recommending that you inject your child with something would have looked at the studies done on that drug to determine whether or not it is a good idea, but the amount of information is incredibly huge. The doctors I’ve met are content relying on the word of the CDC that vaccines are safe, but because these drugs are created and sold by massive
corporations who may or may not be interested in the greater good of public
health, but who are nevertheless incentivized to create a product that they can
bring to market quickly that will produce enormous profits for their
shareholders. In turn, these corporations use that money to lobby lawmakers who
wield a great deal of power over government agencies responsible for
determining whether these vaccines are safe and effective and when they get to
go to market, as well as recommending where in the vaccine schedule they ought
to be placed. There is a very clear conflict of interest for many physicians
and scientists working on vaccines who are being paid by large pharmaceutical
companies to create new vaccines. And, in many states, regular family physicians are paid by the state to give patients vaccines, so the more children they inoculate, the more they are rewarded. 

Ultimately, this issue is much more nuanced than many of us would like to believe, and because it is so complicated, we often fail to have productive conversations about it. In my heart of hearts, I believe that we are all striving for a country with healthy children, but if we are going to get there, it will, at some point, mean that we sit down together without fear or anger or labels and get everything out on the table with that singular goal in mind. 











 

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When That Publication Wasn’t What You Thought it Was

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I just had to go and check whether my essay had been published yet.
I couldn’t email the editor or wait for her to email me. I had to visit the site and see it.

I submitted a piece to an online parenting magazine after multiple rejections from other places at the urging of a Facebook writers group. I didn’t know much about the ezine and I did a cursory check of it before submitting to make sure it wasn’t populated with articles about the Kardashians and “mom-jeans.” I figured since other writers I know from the group had published their work there that it was probably fine, and so I didn’t dig too deeply.

Last week when the editor emailed me with a few suggested changes, I was pleased. Her ideas were great and, in one case, she said she thought I should cut something because she thought it was victim-blaming. When I pushed back a little, she explained further and I saw that she was right. After I thanked her for her perspective, she said she was just looking out for me – that their commenters are pretty smart and can be murder on a writer.  I was tremendously grateful.

Today when I went to the site to see whether the piece was up or not, something caught my eye; namely, an essay with the word “Anti-Vaxxers” in the title. My heart sank. I read the article to the end, the bile rising in my throat with every word. As if that weren’t enough, I chose to read the comments. I’m not sure what I was hoping for – perhaps one or two voices that took the author to task for being nasty, for reducing the issue to black-and-white, some sort of intelligent conversation? I wanted to see that this was a community of parents who were thoughtful and compassionate, educated and nonjudgmental. Unfortunately, that isn’t what I saw. I saw eighty-plus comments from women cheering each other on for their choice to vaccinate their children for everything under the sun, egging each other on as they characterized anyone who wouldn’t do the same as “stupid” or “pro-death.” I saw not one comment defending a decision not to vaccinate (even against the flu). I saw not one compassionate response that called for an understanding of the difficulty of the issue.  In fact, at one point, the comment thread devolved into vilifying families for choosing organic food or avoiding GMOs.

Sigh.

One woman commented multiple times and seemed particularly gleeful when she was hating on “those people.” She wrote that she loved this particular site because “this place is so pro-vaccine/pro-common sense/pro-community…[it is] my vaccine safe space.” Oh. Well, then.

The last thing I want is to be part of a community that is one-sided. I don’t want to write for a group of readers who are so convinced that they already know everything there is to know about Subject X that they refuse to think about grey areas or nuances or what someone else’s life might be like. And so now that my essay hasn’t yet shown up, I have the dilemma of whether or not to ask them to pull it. It isn’t a subject that’s terribly controversial for this particular ezine and I’m not worried that I’ll get trashed in the comments (in fact, I may not even read them, after this), but I hate the idea that this particular site is known for polarization or nastiness. I don’t want my writing associated with that, especially if I’m being paid for it.

When I looked at previous articles by the author of this one, I was surprised at what I found. Honestly, many of her posts were funny and/or interesting. One or two were even helpful. I guess I was struck by the passion that this particular issue can incite in what I would consider to be an otherwise reasonable person. But if there is something that I can’t stand, it’s reducing a complicated issue to black-and-white and then using that as an excuse to call names and make fun of other people who disagree.  And so, here I find myself, in the crux of a dilemma. I think I’ll go sleep on it.

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Of Oil and Water and the Deep Unknowing

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As I walked the dog yesterday following a particularly ill-advised exchange on Facebook regarding a vitriolic “anti-vaxxers” blog post, I struggled to tease out the strings of what bothers me so much about these kinds of interactions.  The same gut-burning, chest-tightening, jaw-clenching feelings came over me yesterday that I get when I encounter anti-choice protestors or read stories about the Westboro Baptist Church and their hateful acts against homosexuals. It seemed to me that there was some wisdom in my body that wasn’t making it through to my brain.

I am certainly bothered by the Us vs. Them mentality – the assumption that there are only two sides to these issues and the disregard that there might be a shared goal.  No, neither pro-life nor pro-choice activists think killing babies is okay. Yes, both think that it would be a good thing to reduce the number of abortions. Neither folks who vaccinate their children nor those who choose not to (or slow down the regimen or ask question after question before deciding) want horrible diseases to take over mankind. Yes, we all want healthy, thriving children.  And regardless of your sexual preference, each of us wants to live a meaningful, happy life shared with people we love.

But beyond that, I honestly think that there is a bigger issue. At least in these three instances, one group recognizes the need for individual allowances within the whole and supports a diverse population of choices and the other believes they are Right and everyone should just do what they say.  It is truly pro-choice versus anti-choice and the pro-choice contingent has a much more accepting, understanding, dare I say compassionate view of humanity. It is inclusive.

Being pro-choice (whether in relation to vaccinations, reproductive rights, homosexuality, etc.) means that I am floating in a vast sea of unknowing. It is scary sometimes and floating does not equal passivity. I must still often tread water to keep from drowning and often things come up from the deep to bite me in the ass.  It is difficult to find information and validate it and from time to time I have to seek out other people who are floating for support.  Residing in the vast sea of unknowing means that I have given up absolutes, I forego imposing my will on others, I admit that I don’t know what it’s like to be you.

The folks who have already decided – those who are certain they are Right – stand on the beach, firm in their own footsteps and throw rocks at those of us floating in the sea. Some of them might dip a toe in the water from time to time (“I get how you might think it’s okay to ____________, but if you listen to me you’ll see why I’m Right”) but without fully giving over to the idea that maybe there is more they can’t comprehend, their feet stay firmly on the ground. Others never even venture close to the water’s edge, sunk deep into the sand and their convictions that Homosexuality is Wrong or People Who Don’t Vaccinate are All Idiots or Being Pro-Choice Means You’re a Baby Killer and just keep throwing shit and yelling.

But compassion means that my views have to include these folks, too.  As I walked, I puzzled on the idea of some sort of Venn diagram that might illustrate it, but there isn’t one, because that would imply mutual acceptance or overlap of some kind.  In my ocean of “I don’t know all that I can and I accept that others know differently than me and that’s okay,” I am okay with someone who chooses not to abort an unintended pregnancy or vaccinates their kids on the doctor’s schedule or exhibits their heterosexual tendencies, because I accept the notion of choice and I know that what is right (without a capital R) for me is not necessarily right for another. So instead of a Venn diagram, my vast sea of unknowing encompasses everyone’s choice including those folks on the beach. The beach-dwellers’ circle is a little like a puddle of oil sitting atop my circle without accepting it or incorporating it.

In the sea of unknowing there are people who slowly stepped in foot by foot, cautiously examining what it might be like to float out there and truly not know; folks who were willing to entertain the idea that there are circumstances about which they know nothing that are part of the lives of other human beings every day. There are also those who were thrust into the water by a traumatic event – instantly faced with a horrible choice or a life event so jarring that it made them examine everything they thought they knew before. Others may have been born into it.  Don’t be fooled, we are all afraid. There is something about not knowing that runs counter to the way we think and many of us continue to search for knowledge and investigate so that we are not consumed. The thing about lying back in the water and relaxing into the idea that there are things I cannot know is that I have no need to prove anything to anyone else. There are some questions for which there isn’t a Universal Answer that applies to everyone and if we can’t all share in the Right Answer, then at least we can share in the pursuit of a common goal, a shared humanity.

The beautiful thing about seeing these issues as diverse and complex is that it means we can progress. If there were only pro- and anti- camps (pro-vax/anti-vax, pro-abortion/anti-abortion, pro-homosexuality/anti-homosexuality), it would be like flipping a coin over and over again. There is no forward movement, no growth, only switching back and forth between views. If the definition of one group requires the certain annihilation of the other, there is no ground from which to work. The recognition that there are really not two distinct “sides” to any of these arguments gives us the opportunity to define a shared goal and work toward it.  Not that I think that will happen anytime soon, because it is far too tempting to stand on the beach with the sand beneath your feet and believe that you Know. When you can define the threat as something “out there,” all you have to do to eliminate it is walk away and ignore it or stand on the shore and throw rocks at it. When you don’t have to take the uncomfortable step forward and question your own knowing, why would you? I understand. But standing in the water doesn’t mean you’ve given up what you believe, it just means you’re willing to accept that not everyone sees the same horizon you do.

But here’s the thing. Our knowledge of anything is never complete. If it were, Pluto would still be considered a planet and doctors would still be writing prescriptions for Thalidomide for pregnant women with morning sickness.  But we learned. We evolved. We questioned.

Once I fully succumbed to the pull of the deep unknowing, I couldn’t imagine going back to shore. The richness and diversity of this place is amazing and I learn something new every moment. Being willing to suspend Knowing has allowed me to forge connections with brilliant, passionate, articulate people who agree that there is more to our lives than Black and White, Right and Wrong. And floating in this sea surrounded by others who will not judge my ideas and experiences because they, too, have accepted the unknowing feels safer than standing on that slowly shifting sand throwing rocks out at the sea.

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