Front Burner - Kids at the centre of anti-vaxx movements

Episode Date: October 22, 2021

The anti-vaccine movement has long revolved around children. As the pediatric COVID-19 vaccine rollout approaches, what can we learn from this phenomenon to improve uptake in kids? Sociologist Jennifer Reich shares her insights.

In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. This is a CBC Podcast. Hi, I'm Elamin Abdelmahahmoud, sitting in for Jamie Poisson. So yesterday, Canada announced that we are getting 2.9 million doses of Pfizer's pediatric COVID-19 vaccine as soon as Health Canada gives its approval. Which means kids aged 5 to 11 will likely soon be able to get the shot that is if their parents consent. I feel that's great. So we get back to normal.

And I think I would do so much more research on basically what's in the vaccine for the child vaccine. I don't know how safe it is. If I see other children, they take it and all of them, they are safe and have nothing or other issues like health issues or like this, I'm going to send my kids to take it. Why not? Today, how the anti-vaccine movement since the 1980s has revolved around children and what that means for the next stage of the fight against COVID-19. that means for the next stage of the fight against COVID-19. To break that down, I'm joined by sociologist Jennifer Reich. Hi, Jennifer. Thanks for being here.

Hello. Thanks for having me. Listen, I'd like to start by maybe getting to the roots of some of these fears that lead to anti-vaccine beliefs around children. Because I think a lot of us know this Lancet study, but you believe the modern anti-vaccine movement started a little bit before even that. Yeah. I mean, it's worth noting, we've had small numbers of people who have always been opposed to vaccines since the earliest vaccine against smallpox. But really, the modern version of parent objections to vaccines started really in the 1980s. And at that time, the vaccine against whooping cough was a wholesale virus vaccine.

And there was a group of parents who observed their children suffered after that vaccine. And while there's still pretty passionate debates about causality versus correlation in medical literatures, estimates are about one in a million kids who got that vaccine were harmed by them. And that vaccine has since been reconfigured into an attenuated virus vaccine that's much safer, but also less effective. The groups of parents that we're meeting were actually a fairly diverse group. And what was really interesting is that there was a documentary on a US newsS. news station, and parents began calling the network, and the network began putting parents in touch with each other. And they were politically diverse.

They were from a range of perspectives, but they all shared concerns about their own children's experience. It's a fact of life. All children must get four DPT shots to go to school. Shots, we are told, will keep our children healthy. Shots, we are told, will protect every child healthy. Shots, we are told, will protect every child from a dread disease, pertussis. It's whooping cough. But the DPT shot can also damage to a devastating degree. What spun out of that was an evolution into a group that is one of the

largest organizations in the U.S. that opposes vaccines and vaccine mandates. And that group tends to define itself not as an anti-vaccine organization, but rather as a parents' rights organization and one committed to informed choice. Since then, we've seen that kind of rhetoric spread throughout the U.S. and Canada. And we see this insistence on individual personal choice and what's newly in the COVID era called health liberty, really driving claims that you are the only one who can decide about your children's health. You are the only one qualified to make a decision for your family. And drawing on information, some of which is well-intentioned, but perhaps scientifically not accurate, but some information that is intentionally deceptive, and that's really driving a kind

of criticism of vaccines with only partial information about them. So let's talk about that Lancet study, because I think a lot of people are familiar maybe with that being an origin point or one of the origin points. Can you explain what that was about and how this kind of blew the movement up? So in 1998, a gastroenterologist published a study with a very small number of participants who had autism and said that he had identified a pathway by which vaccines against measles, mumps, rubella could cause autism in children. And that announcement was powerful and it created a kind of chill effect, but it never happened. No one study is going to change the world instantaneously. So it's worth noting

that at that same historic moment, the U.S. was having hearings about what was the safe level of mercury in environmental and occupational exposures, what was happening to seafood and recommendations for pregnancy, for example, for seafood intake, that all of these conversations about mercury were happening simultaneous. And at the time, the vaccine was using thimerosal, which is chemically a different kind of mercury than we see in the environment and in seafood and in occupational exposure. But it started raising new questions about vaccine safety. And that study really was amplified then by these multiple conversations that were really asking questions about vaccines, vaccines, ingredients, and safety.

And it's worth noting that this was also a window where measles really wasn't seen commonly in North America. It was considered eradicated in 2000 from the U.S. and most of North America. And so there was really a sense that maybe the vaccine wasn't perfectly safe, stacked against a perception that maybe the vaccine wasn't entirely necessary anymore because the virus had become so uncommon in circulation. I guess we should talk a little bit about the context of that original article and the way they get picked up because the person who issued that study, Dr. Wakefield, that study has been retracted, of course. Disgraced and discredited, the doctor who convinced thousands of parents to skip vital vaccinations for their children.

Andrew Wakefield's already been stripped of his medical license. Now he's been called a fraud. Thirteen years ago, he published research in The Lancet magazine, which claimed the three in one measles, mumps and rubella vaccine, MMR, was linked to autism. Now, after a long investigation, the influential British medical journal says the report has been discredited. He'd done all these public appearances that said, you know, he recommended single vaccines rather than the combined MMR vaccine. And some parents who were seeking some kind of reason, I guess, some kind of reason for the children's illness, picked up on saying, I guess this must be the reason. This is what a lot of, you know, this is what some Canadian researchers have found in terms of the ways that we've talked about

that retraction and that story. What's interesting now is that in my research, when I talk to parents about their decisions around vaccines, most parents don't necessarily say they're afraid of autism, but what they describe is something much more general, which is to say that they're afraid of unknowns. And they'll say things like, what if this vaccine can cause a problem in 10 or 20 years? Or how do we know for sure that these childhood vaccines are not one of the causes for an increase in autoimmune diseases in middle age? How do we know for certain that acting on a young child's immune system doesn't change their bodies in ways

that we can't fully account for? And when you get to something that can happen 10, 20, 30, 40 years apart, it's really hard to talk about causality because there's so many other things that come into play in a person's lifetime, so many environmental exposures, so many other kinds of things that can happen. But that sense of uncertainty is really powerful for parents. And so parents are often trying to figure out what's the safest path for their families and their children. And often doing nothing feels much safer than doing something, particularly if you're not afraid of infectious disease. If you don't think that measles is a particularly scary disease. You know, I'm a parent myself.

My daughter's four, and I have to say that I don't have that instinct. I don't have that muscle that says that only I know what is best for her in terms of her medical future. And I say this because I don't have the expertise, right? I don't have any of the expertise. I outsource that to the judgment of scientists, to the judgment of doctors. That is the place where I am most comfortable. I say, I don't know much about that, but I'm glad that you do. And I trust your judgment. And when I think about some of the real consequences that have come up in terms of this movement taking hold. I'm thinking here of the measles outbreak in Disneyland in California. Health officials fear thousands may have been exposed to the measles

at Disneyland and Disney California Adventure last month. Most of those who got the disease were not vaccinated against it. Which ended up resulting in laws changing in the state of California. Or as recently as 2019, when health officials here in Canada were warning that measles cases were actually on the rise. Did the spread of these diseases change the beliefs of parents, or did anti-vaccine beliefs kind of continue to spread even in the face of that? So one of the things that's just worth highlighting is that I appreciate your deference to people

with expertise, but it's worth noting that vaccine decision-making is almost entirely maternal territory, that mothers are the ones who make most of the decisions for their families, and that mothers are blamed when things go wrong for their children. What I found in my work is that this is highly fraught territory for mothers who really agonize about their children's health in ways that fathers are often not held to quite the same social standard. And I guess I wonder how much of it has to do with the expansive notion of parenting in public. We once had to sort of parent around our specific community of people, maybe our extended family, our neighbors. Now we kind of parent in front of the whole world, in a sense.

And I can see how that kind of takes the stakes a little bit higher up so that if you're a parent these days, it can be kind of an anxiety-inducing environment. And there's constant pressure to compete for your kids and get them some kind of leg up on other kids. How does that play a role in all of this? I think that's such an important question. You know, one of the ways we see this playing out

is what I term in my research individualist parenting. In the last couple of decades, we've culturally defined good parenting as making informed consumer decisions. Find the right tutors or choose the right traveling sports team or somehow maximize opportunity for your children, even if it's at the exclusion of equity for other people's children. And the way good parenting gets

recognized then is in these ways of defining individual decision-making as the way you can demonstrate that your commitment to your own children. And simultaneous to that, I think what's also worth recognizing is that the way we talk about what it means to be healthy matches this kind of individualized behavior. So we can see the way that public health agencies, for the most part over the last couple of decades, have prioritized personal behavior as the way to avoid disease. So stop smoking, count your calories, watch your diet, count your steps, you know, think of download apps, monitor your personal risk factors, send your testing off to genetic monitoring services, right? Like this idea that you can somehow personally manage and control disease is a misunderstanding. You can, you know, it turns out most of disease is some combination of genetics,

environment, and bad luck. And you can do everything, quote unquote, right, and still get sick. And that's so clear when it comes to infectious disease. Yet that vocabulary of personal responsibility and personal accountability is so powerful, and it maps so perfectly onto the way we think about good parenting, that vaccines have really become a kind of consumer choice for your personal benefit or your children's individual benefit. And we don't really talk about them as part of community strategies anymore in the same way. And so the result is that if it's a consumer choice, then you get to decide if you want it or not. And you're not really encouraged to think about this as having a larger outcome

beyond your individual child. In the Dragon's Den, a simple pitch can lead to a life-changing connection. Watch new episodes of Dragon's Den free on CBC Gem. Brought to you in part by National Angel Capital Organization, empowering Canada's entrepreneurs through angel investment and industry connections. Hi, it's Ramit Sethi here. You may have seen my money show on Netflix. I've been talking about money for 20 years. I've talked to millions of people, and I have some startling numbers to share with you. Did you know that of the people I speak to,

50% of them do not know their own household income? That's not a typo, 50%. That's because money is confusing. In my new book and podcast, Money for Couples, I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. I help you and your partner create a financial vision together. To listen to this podcast, just search for Money for Couples. Let's zoom in a little bit more because you talked a bit about how parents navigate these choices, but what about the root causes? And I'm thinking here about this anti-vaccine movement. It is growing. There's a kind of

language or a message that parents are responding to. a kind of language or message that parents are responding to. What kind of language, message, or theme is used to persuade parents to question vaccines, would you say? So when information gets produced that's outside of government agencies or outside of data provided by pharmaceutical companies that have funding to conduct large clinical trials, often that's perceived as more reliable because it comes from outside existing systems and is therefore seen as independent. And what's challenging is often those studies don't hold up to scientific scrutiny. They don't hold up to peer review. They might be retracted from a journal in the way that Wakefield's Lancet article was when it actually came to be evaluated and nobody could

replicate the findings. And yet that retraction is frequently perceived as a kind of punishment for speaking truth to power, for standing up against overwhelmingly, by the sense of like an overwhelming institution. Even though Wakefield's study was retracted, he lost his medical license for ethical violations. The fact that he had tried to profiteer on some of his suggestions around MMR distribution are all factually based and documented. But I nonetheless have heard organizations offer him a humanitarian award for standing up to the forces, right? For valorizing that kind of discredited science. And it is not a lack of information. I mean, I talked to parents who they try to read medical journals. They try to gather information from as many sources as they can and to feel like

they're making an informed choice. So it's not just information, it's information and something else. I'm trying to maybe understand like the specific words that would end up persuading a parent to go down the road of questioning vaccine. What's a specific kind of language? What's a specific kind of message that ends up opening that door for those parents? There's been a couple of really interesting examples, and so we could think about the COVID vaccine as one. One of the most persistent forms of misinformation has been that it will cause long-term effects on fertility. So the fertility claims that there's no scientific basis for it, and yet they've been really persistent as an unknown. And that question with children about what are the unknowns long-term, it casts a really long reach because

parents are nervous about their children's futures all the time. Let's actually talk a little bit more about that because a lot has hinged over the past year, I would say, on the idea of protecting kids. We've seen that during the big movement against the COVID-19 health measures, whether it's masking or distancing or the closure of lots of public institutions, a lot of those arguments have been hinging around protecting kids. And we'd say, we've seen here, for example, in British Columbia, anti-vaccine activists entering schools. There was an entire school district that went into lockdown after protesters entered three schools. Just two weeks after disrupting health care services at hospitals across BC, opponents of vaccines and vaccine mandates are now targeting

schools. Staff at schools in the Salmon Arms School District today were forced to initiate hold and secure protocols, meaning students had to remain in their classes and all entrances other than the main entrance were locked. We've seen parents who get shouted at for having their kids wearing masks by anti-vax protesters. There's been these terrifying-looking posters, these posters of masked children with their eyes wide open on street poles. And the suggestion is saying that actually this actually, this is like abusing your children. And again, like I have a kid who goes to school and she has to wear a mask all day at

school. And her teachers tell me when I go pick her up, that from time to time, she will say, hey, can I have a five minute mask break outside and she will have one. But for the most part, she's not showing signs of deep damage because she has to wear a mask the whole day. But there's a way that this message kind of gets seized upon by anti-vax folks who say, like, actually, we're trying to protect your children. And, like, all these health measures are not good for them. I will say, as someone who's been thinking about this for a long time, I'm shocked at the way masks have become politicized. Because, you know, we can have an argument about minute risk of injury from a vaccine. But the idea that masks are harmful has been so surprising. And I will, I'm like the first to say that I think children's schools should have been open and bars should have been closed. You know, I am not ambivalent about what we owe children that we did not give

them. And we can also have conversations about children are part of communities and children have roles to play in communities also. And understanding that mask wearing, which I think, you know, I teach my undergraduate courses with a mask on. My children go to school with masks on and they understand that they are part of protecting the people around them, particularly those children in their schools or my students who are vulnerable to a bad outcome of infection. And that they have a part to play in protecting them in the same way that my children have grown up not always getting peanut butter at school or having a classmate who had a significant metabolic disorder and they stopped doing cupcakes for birthdays and instead became really creative about non-food ways of celebrating to make sure that the kid in their community was safe. And I think talking to our children about their role to play just makes our communities stronger in the long run. I don't think that's a cost to them. I think you expressing that surprise about the politicization of mask wearing to me is kind of in line maybe with some of the epidemiologists that I've heard speak,

who've said things like, you know, when we've spent the decade planning for the next pandemic whenever it comes, we never anticipated this kind of response, never anticipated this kind of politicization to the things that we'd ask people to do in response to that pandemic. And I'm assuming that they will incorporate this into all future models of pandemic planning. But in the meantime, how do you think a narrative like that is going to impact the pediatric rollout of the COVID-19 vaccine, this idea of this really torqued speech? You know, I tend to believe that parents are doing the best they can with the information they have and trying to make the best decisions and that everyone wants their children to be successful and healthy. And if we start with that premise, I think there's a lot of

a space to grow. You know, no one has ever changed their mind about vaccines by being called ignorant, selfish or stupid. So it's just not a helpful place to start the discussion. So we have to really assume people are well-intentioned in doing the best they can as a starting place. I think that we have a lot of examples and masks are probably one of them where things are announced with a level of certainty that is not entirely clear or true. So, you know, with mask wearing early on, people were told not to wear masks and they were told they should wear masks. Then they were told that any fabric mask would do. Then they were told it has to have ear loops and be double or triple fabric. And there was always a level of uncertainty with a new virus. And I think

that people can handle living with that uncertainty by having interesting and clear conversations. Here's what we know. Here's what we don't know. And I think with the COVID vaccine rollout, we ran into the same problem. There was such enthusiasm for a vaccine that was 90 some percent effective in preventing hospitalization and death, that the fact that there was no evidence of how good it was going to be at preventing transmission was overlooked. So I think the first place to start is with transparency. Here's what we know, here's what we don't know, and here's how we can do this work together. We heard from Dr. Sam Wong. He's a past president of the Canadian Pediatric Society, and he has pediatric practices in Alberta and the North.

And he's been trying to deal with vaccine hesitancy for years with some of his patients. Sometimes you have to persevere. Building trust is really important, I think. And we've, I think, unfortunately lost some of that trust in the last few years, and we need to rebuild it. And the best way to do it is spending the time and having that one-to-one conversation. And it may be more than one conversation with that particular parent or person. It may take several conversations. What do you make of his approach, this one-to-one

approach? I think Dr. Wong sounds like an amazing doctor to really prioritize that kind of time because increasingly people are saying they don't experience that kind of time with their doctors when they have questions. You know, commission is always harder emotionally than omission. You know, what does it mean to make a decision that carries some risk? And vaccines are not 100% safe or 100% effective, but they're very, very good and very well monitored by safety systems that we never talk about. But one of the things we know is that the source of the information is as important as the information itself. So we also know that outside of medical settings, other community leaders have a role to play. Schools, it turns out, when they provide

information about vaccines, increase their vaccine rates. We know that religious leaders have a role to play in thinking about their congregations. We've had examples for other diseases where hair salons have become places where there's been efforts to really empower barbers and hairstylists with accurate information so they can answer questions when it comes up in their community. So having this ability to really provide people with information so they can be empowered and they can share with others is really helpful. And in part, we see that because people share misinformation, often well-intentioned, because they think it's helpful to share information. And when we don't have official information, those gaps are almost always filled

by informal information, which is often not true. Parents want to feel that the information is relevant to them and whether that information comes from their pediatrician or their physicians, or whether it comes from other people they trust, who they believe share their values is equally important. Well, thank you so much for your time, Jennifer. I really, really appreciate that. Thank you. My pleasure. I look forward to hearing how this all turns out. That's all for today. Front Burner is brought to you by CBC News and CBC Podcasts. The show was produced this week by Simi Bassey, Imogen Burchard, Allie Janes, Katie Toff, and Derek Vanderwyk. Our intern is Akanksha Dhingra. Our sound design was Thank you. and Angela Starrett will be joining you in the host chair next week.