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Anti-Vaxxers, Like Drunk Drivers, Are a Danger to Us All

These infants were counting on us, their herd, to provide them with community immunity until they were old enough to get vaccinated. It is not science's fault that these children, our fellow Americans, caught the measles. It is not their parents' fault. It is the fault of the anti-vaxxers.
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It angers me when people make bad decisions that threaten the health and safety of other people. Whether you're driving drunk, parading loaded firearms in public, or choosing to not vaccinate your child (exceptions for children with health conditions that contraindicate vaccinations), you are a danger to your own health and to the health of others -- and I am fed up with the ignorance and arrogance behind these decisions.

To be fair, I have to briefly clarify my frustration with drunk driving. Knowing what we now know about the interactions between genetics, neurobiology and the social variables of alcoholism and substance abuse, I can wrap a little compassion around those drunk drivers who are struggling with addiction. By no means will I condone or pardon drunk driving, but there is some tiny fragment of that phenomenon that eventually warrants patience and understanding.

Anti-vaxxers, on the other hand, are no longer deserving of my patience and compassion. People who purposely choose not to vaccinate themselves or their children against diseases like measles, whooping cough, rubella, and so on are endangering the lives of others. In the current measles outbreak that started in Disneyland, six babies have contracted measles. All of these babies are younger than 1 year old, which is the age at which the first MMR (measles-mumps-rubella) vaccine is done. These infants were counting on us, their herd, to provide them with community immunity until they were old enough to get vaccinated. It is not science's fault that these children, our fellow Americans, caught the measles. It is not their parents' fault. It is the fault of the anti-vaxxers, the vaccine cynics.

Let's all stop calling anti-vaxxers "vaccine skeptics" because it is unfair to genuine skepticism. As a pediatrician, I have seen the difference between skeptical parents and cynical parents. Skeptics are driven by curiosity, and they make it clear that health care providers have to earn their trust -- but it can be earned. As a health care provider, I do not assume anyone's trust and appreciate the opportunity to earn and maintain the trust of my patients and their families. Whether we are talking about vaccinations, medications, imaging studies, or surgical procedures, the skeptical parents of my patients want to have their concerns acknowledged and their questions answered. I am happy to oblige. My conversations with them are informative and even enjoyable because these are transparent exchanges about what priorities shape our perspectives, where we get our information, and how to contend with risk. Genuine skepticism can transform the doctor-patient relationship from patriarchy to partnership, and we need this now more than ever in modern medicine.

Anti-vaxxers are mostly cynics, and they are a whole other phenomenon. I am fortunate to have only experienced cynical parents outside of my direct clinical work. Cynics are not driven by curiosity but by an ugly mix of ignorance and arrogance. After dumpster diving on the Internet for pseudo-science, anti-vaxxers have decided that their contempt for public health guidelines and their distrust of modern medicine somehow makes them more "informed."

As a pediatrician and public health policy wonk, the cynical anti-vaxxers frustrate me on several levels. First, there is no amount of expensive scientific research that will assure anti-vaxxers about the safety, efficacy and necessity of vaccines. Where genuine skeptics ask questions in order to learn, cynics ask questions in order to scorn. Presenting legitimate peer-reviewed scientific data to anti-vaxxers does not persuade them because they already reached a verdict based on their fears and contempt. The scientific community has diverted so much funding and resources towards disproving any causal relationship between vaccines and autism, but to what end? Those who get vaccinated don't really need the additional proof, and anti-vaxxers don't really care about the real work of the scientific method. As a result, millions of dollars that could have been used to research the real causes of autism or to study the real toxins in our environment are wasted proving what has already been proven repeatedly: Vaccines are safe, effective, and necessary for public health.

It frustrates me that anti-vaxxers benefit from herd immunity but refuse to contribute to it. Those of us who get vaccines are improving our own individual lives as well as those around us because vaccinated bodies do not give dangerous viruses and bacteria opportunities to start an infection, reproduce, and pass on to others. This is exactly how the United States declared itself free of measles 15 years ago. Regardless of whether the anti-vaxxers admit it or not, they benefit from herd immunity. But anti-vaxxers are not the ones for whom herd immunity is intended. As a pediatrician, I see infants who are too young to receive certain vaccines. I see patients whose immune systems are impaired because they have organ transplants or they are undergoing treatments for cancer. All of these children are part of our herd, our community, and they are depending on the rest of us who are healthy enough to get vaccines to do our part in maintaining our collective immunity.

Getting vaccinated involves an element of social responsibility. The strength of our public health is reliant on a web of mutuality. When we drive sober and at the speed limit, or when we ban smoking in public places, we are doing the basic but important work of keeping each other safe and healthy. Vaccinations are an integral part of that process, and no one should have to suffer from preventable diseases. As much as anti-vaxxers may think they are exercising their right to choose, they do not have the right to put others at risk. It took tough laws against drunk driving to keep people safe, and there has been a slow but welcome cultural shift against driving under the influence. Similarly, we must urge anti-vaxxers to look beyond their egos and show some responsibility toward public health.