Friday October 27, 2017

Just five minutes on the Internet can sow seeds of doubt about vaccines

Dr. Noni MacDonald

Dr. Noni MacDonald

Listen 9:00

It can take as little as five minutes on an anti-vaccination website to make a parent decide against vaccinating their child. 

Dr. Noni MacDonald , an infectious disease specialist at Dalhousie University says a study by German researchers  found that the Internet has proven to be an effective tool for sowing seeds of doubt about vaccines. 

"Five to ten minutes on an anti-vaccine website changed people's intention to immunize,' she told Dr. Brian Goldman, host of White Coat, Black Art.

"Before the Internet and social media, you could have people who didn't believe in vaccines but they didn't have the same kind of reach as they do now."  

According to MacDonald, anti-vaxxers often succeed by employing five main strategies:

  • Spreading conspiracy theories about 'big pharma"
  • Being selective in using studies that support their point of view over the multitude of other research that shows vaccines are effective.
  • Playing up the minor risks that are associated with administering vaccines.
  • Using false logic to make their case.
  • Using fake experts.

"They'll say somebody is an expert and he's giving this advice and he doesn't even have a nursing or medical degree  and...he's a botanist.," MacDonald explains. 

Preventable outbreaks

The result is the numbers of those who are vaccine-hesitant is slowly creeping up. That's alarming for public health watchers like MacDonald.  She worries that unless the vaccination rate increases across Canada we will see more outbreaks of preventable infectious diseases, such as the measles outbreak in Laundiere, QC., which affected 119 people in 2015.

It was entirely preventable, MacDonald says.

The infection originated at Disneyland and was spread when the travellers returned home.to a community with lower than optimal rates of vaccination. For the measles vaccine to be effective, over 90 percent of the population needs to get inoculated.

MacDonald has made it her life's mission to turn this barrage of anti-vaxx messaging around.  As a consultant for the World Health Organisation (WHO), she studies ways to convince vaccine-hesitant people to change their minds.

She says the key is in how you frame your interaction with patients. It's been shown that when doctors presume that patients are there to get their shots, even doubters often follow through. 

"If you come in with a presumptive presentation...'Today it's time for Timmy to get his immunization'...of the people who were hesitant, 80 percent chose to get immunized,' she says. 

Having the facts at hand is crucial, because the public doesn't understand how many lives vaccines have saved. 

And that means they don't understand what it might mean if diseases that are vaccine preventable make a comeback.

"If you get measles encephalytis, we can't fix that brain damage. It's done and we can't prevent the deaths." 

The irony is that many vaccine hesitant people are well-educated.

"They are often very well-educated, have good jobs, (are) affluent. They may be 'everything has to be natural and I like organic'." she explains. 

She says in Australia, public health officials created a campaign to target a group that fit that profile that convinced 79 percent to get vaccinated. 

Vaccines saving money

One way to reach doubters is to explain the actual cost of refusing vaccines. 

According to the Public Health Agency of Canada, every dollar spent on the children's measles, mumps and rubella immunization program saves $16. Each dollar invested in the diphtheria, pertussis and tetanus immunization program saves $6.

On the flip side, failure to convince people to get up to date vaccination has a huge cost.

 "If you undo immunization we go way backwards because most of the diseases for which we use vaccines, we can't treat the complications you get once you;ve  got it....You just don't want to have this happen again. It's not where we should be." 

UPDATE: The original audio of this item contained incorrect information. It has been edited to remove  a statement made by Dr. Noni MacDonald. She misstated the infection and fatality figures related to the 2011 measles outbreak in France. The correct figures are as follows: There were 22,178 cases of infection which resulted in 10 deaths. You can read more about it the outbreak here