In 1998, British former gastroenterologist and researcher Andrew Wakefield published a paper that linked the measles, mumps and rubella (MMR) vaccine to autism. It was completely false. The Lancet journal retracted it, The British Medical Journal declared the study an “elaborate fraud,” and investigative journalist Brian Deer uncovered the fact that Wakefield was not only wrong, but was paid by a lawyer. But the seed of doubt had been planted.
Nearly 20 years later, we’re still battling this myth. The anti-vaccine movement is still going strong, energized by vaccine skeptics such as the President of the United States and celebrities such as Jenny McCarthy and Robert De Niro. Timothy Caulfield, an Edmonton-based professor and Canada Research Chair in health law and policy, is determined to challenge it. In his 2015 book, Is Gwyneth Paltrow Wrong About Everything?, Caulfield separates celebrity endorsements from evidence-informed advice. In his new book, The Vaccination Picture, which combines art and essay, Caulfield continues his campaign to debunk common vaccine myths and pseudoscience. He spoke with us recently about the challenge of overcoming a powerful, anxiety-inducing narrative.
It seems like the anti-vaccination movement is getting louder and more vocal. Is this true?
I think they’re louder than they have ever have been. The true hardcore anti-vaxxers aren’t a large percentage, though. There really aren’t that many people. But there is an increasing number of people who are vaccine-hesitant. They want the best for their kids, they’re looking for answers, and there’s evidence that the anti-vax voice is having an influence on that community. In one example, Josh Greenberg from Carleton found that more than a quarter — 28 percent — of Canadian parents had some concern that vaccinations are tied to the autism. That’s more than a quarter of Canadian parents who have a concern about vaccinations that is really founded on a lie.
Who is most vulnerable to these myths?
There seems to be a portrait of people who are vaccination-hesitant. They’re more likely to use complementary and alternative medicine, follow their intuition, and be suspicious of government. Then there are all these studies that show your classic conspiracy-theory believers. The unfortunate thing is that once a conspiracy theory is out there, whether it’s about vaccination or John F. Kennedy, it’s very hard to get rid of it.
Then there are individuals who are very vocal against vaccinations, Jenny McCarthy being one of them, where that causal illusion is part of the reason they have such a strong view. Their child gets a vaccination and then starts to show some characteristics of autism, and the parents see a causal connection — which is really an illusion. It’s a very powerful force; human beings are hard-wired to see connections that are not necessarily there.
How can people be persuaded that the link between vaccinations and autism is false?
It’s important to listen to people — why are they vaccination-hesitant? Not everyone is worried about autism; some are worried about vaccination overload, or perhaps they’ve had a bad experience, or they may have suspicions about Big Pharma. We have to listen to their concerns. There’s interesting research around narrative – the personal experiences that people have. There’s a lot of research that suggests “story” is very powerful, that it can overwhelm all the data in the world. [In his new book, Caulfield writes that one powerful anecdote can sway public perception of vaccines, even if there is an abundance of science demonstrating its safety.] I think we need to leverage that fact. Use engaging communications strategies to get science across. We shouldn’t fight fire with fire; we should fight fire with science-informed fire. Studies show that throwing facts at people doesn’t change their minds; you need to also provide the story about why [the science] is important. We have to continuously set the record straight.
So what exactly should I say to a friend who is considering not vaccinating their child?
While it is very difficult to change people’s minds — and facts alone are rarely enough — there are some strategies that might help. Most important, listen. People have different concerns and beliefs. Use information that is relevant to the particular person. And use a variety of approaches. It can help if you present the evidence in a respectful manner, explain the consequences of not vaccinating, relate stories from other parents and even show pictures of the consequences of the disease.
In your new book, you write about the fact that France has the worst vaccination rates. How does Canada compare?
Canada is pretty good, but we have pockets where the vaccination rate is unacceptably low. We had the potential for a measles outbreak this year [a disease that was eliminated in Canada in 1998]. We can’t be complacent. The good news is that most Canadians support vaccination. But you still see really low uptake of the flu vaccine and people are suspicious of the HPV vaccine. We still have a lot of work to do. People should remember that getting vaccines is an altruistic act. It’s not just for you, it’s for your community. It’s especially true for the flu vaccine.
Should we be enforcing vaccinations then?
That’s complex. In some cases, mandatory vaccination might be logical, like if you’re talking about kids going to school. I lean toward that myself, but it’s complicated — you don’t want to create animosity and tension. You have to look at both the benefit and risk of every single policy tool and make that science-informed decision for that jurisdiction.