The art of vaccination persuasion

Many anti-vaxxers are not set in their beliefs and are open to having their minds changed

“Iam the second to last of 13 siblings, five of whom died of vaccine-preventable diseases in infancy. Born to poor immigrant parents, I remember well my mother’s account of the causes of their deaths. Three from pertussis and two from measles. Even after many years had passed, she spoke of the death of her angels with a great deal of emotion. Imagine losing not one, two, three or four, but five babies. It was common in the pre-vaccine era. Like our family, many families lost several children to these diseases. We forget. Time blurs our memory of these common tragedies of yesteryear.”

Excerpt from a letter to the Immunisation Action Coalition from Prof E J (Gene) Grangarosa, Emeritus Professor, Emory University, Atalanta, Georgia 2000.

We sat, muffled in jackets under the large canopy and ordered coffee from the waitress with the black mask. Six women, we occupied two and a half tables, following the social distancing guidelines, our meeting time arranged to beat the mid-morning coffee crowd. We had come together for the first face-to-face meeting of the Killenaule Book Club (KBC) since March and the early morning September sun shone favourably through the gaps in the overhead covering as if delighted to see such a gathering.

Unsurprisingly, the conversation turned to Covid-19, how it had impacted us and the likelihood of a vaccine coming soon. “What do you think about the flu vaccine?,” one friend asked. “Do you think I should get it this year?” I answered that I got the flu vaccine every year, even before Covid and that I thought everyone should get it.

A tap on my shoulder caused me to turn abruptly, to see a man I did not recognise standing over me, holding his phone out as if he wanted me to look at something. Surprised by his proximity, I automatically pushed my chair away from him. “I heard you say that everyone should get the flu vaccine,” he said. “You shouldn’t say that. I wouldn’t touch it. Did you know that it has mercury in it?” I noticed that other customers had arrived on the plaza and most of them were looking in our direction.

“I’m sorry,” I said, “I am a doctor and I know the constituents of the flu vaccine. I get it every year and have never had any side effects.” (As it happened, I didn’t know all of the constituents of the vaccine, but that was beside the point. I knew that the benefits outweighed the risks, and that was good enough for me.) I turned my back on the man and resumed my conversation, feeling as if I had just swatted away a fly.

Later, I couldn’t help thinking about the incident and how I might have handled it better. Anti-vaxxers have been around for as long as the vaccines themselves. Despite the overwhelming evidence that vaccination is safe and effective, these people continue to spread misinformation. As a GP, I consider vaccination to be one of the most essential tasks that I perform. I take every opportunity to encourage appropriate antenatal, childhood, adult, and travel vaccination. The relationship of trust that GPs have with their patients means that most GP practices have a very high uptake of vaccinations. And so, immunisation has become the victim of its success. Most people nowadays do not know anyone who has died from influenza, pertussis, or measles. As the diseases disappear, so too does our memory of them.

The absence of these diseases creates fertile soil for anti-vaxxers and the unsuspecting public can fall victim to misinformation. Research has shown that approximately 15 per cent of those who are opposed to vaccination are committed anti-vaxxers. The other 85 per cent are open to persuasion.

In my defensive state, I had decided that the man who approached me was an entrenched anti-vaxxer who was not worth challenging. But I may have been wrong. This man may have believed that he was doing good. He may have accidentally landed in an anti-vaccination bubble while researching vaccines and not been able to get out of it. In retrospect, because immunisation is such a significant health issue, I could have given this man a little of my time. I could have replied that influenza is still a severe disease that causes hundreds of thousands of people to become ill and die every year. There may have been no need to say any more than that to make him reconsider his beliefs.

With knowledge comes responsibility. Doctors are responsible for promoting good health both inside and outside the surgery. No one wants to be bothered with medical issues when meeting friends for coffee, but neither do we want to miss an opportunity to change someone’s mind for the better.

It may save a life.