I found out about this special through Tangled Bank, the awesome production house that worked on Neil Shubin’s Your Inner Fish, also on PBS. You can watch the program here. As skeptics, we know the importance of continuing to beat this dead horse of a subject. It’s one of the most important from a public health standpoint, and one of the most frustrating and infuriating on a personal level. We understand the facts about vaccination, what’s more important is how messaging should reach vulnerable populations.
As we in WTF learned with our survey paper, the vast majority of parents do vaccinate, but a lot of them are still dangerously on the fence as to how much they trust institutions and how dangerous they perceive vaccines to be. This show didn’t shy away from statistics by any means, but it also made heavy use of emotional appeals and personal accounts of children and adults who were harmed by vaccine-preventable diseases. As much as we skeptics like to harp on anecdotes not being data, I think we can agree that this is still the best way to sway public sentiment.
The show opens with some basic stats about vaccination rates in the US (90% overall, USA! USA!) but also some vignettes of (clueless, Californian) mothers expressing doubt: “We give so many shots now, I think I’ll space them out,” (false, all that does is make children vulnerable to disease, the schedule’s timing is safe and science-based); and “There’s no such thing as an unbiased source.” Well alright, while that is technically true, but let’s not equate the CDC with Dr. Mercola. Then we see a tiny baby, Osmond Chandev, suffering from whooping cough. He was a week away from getting his first vaccination for it, but some jerk (I feel safe assuming) out in the herd got to him before that could happen (we are currently experiencing an epidemic). It is pretty hard to watch, and reminds me of the PSA Jenny from the Block did for the same subject. His repeated (tiny) coughs make him turn red while his anxious mother looks on. If this doesn’t spur you to have your Tdap up to date, then I have no words for you. Luckily, the little guy pulled through and we see him again later, but the odds are not worth playing. 1 in 100 babies infected with pertussis will die.
Then, there is a recounting of the recent outbreaks of measles, including the one in 2013 in Brooklyn. I appreciated how the transmission was demonstrated with actual surveillance footage of patient 0 leaving respiratory droplets in an elevator (with an appropriately gross animation overlay of floating particles), which were then inhaled by the next elevator occupant 2 hours later, infecting him. It’s like all the gross fomite scenes in Contagion all over again, and the point is that the measles virus is highly infective and easy to catch without vaccination. There is also a great graphic overlayed video explaining herd immunity as concentric circles of people.
Brian Zikmund-Fischer, a decision scientist, explains the concept of vaccination rates falling because of their own success. He also later touches on the fact that emotional stories are the most likely to “go viral.” Even our buddy, Paul Offitt offers up an emotional story about having to watch 7 children die at his hospital during a 1991 measles outbreak.
We are shown a history of inoculation and Jenner’s cowpox vaccination with cool, painterly motion graphics. This includes the first Wakefields/McCarthys/shrill antivaxxers of their day who thought people would become cows if they received cowpox. At least people back then had the excuse of not knowing much of anything about microbiology!
The explanations of the immune system and the mechanism of vaccines are portrayed with more cool motion graphics and Transformer-like white blood cell 3D characters. It reminded me of a similar project I’d worked on in Flash since I also used a “Wanted” poster as a metaphor for the end result of immunity. Antibodies are missiles. Macrophages are cell characters with brooms.
There are three testimonies of people who you might expect to be anti-vaccine: a family with a son who had recurrent seizures after a childhood vaccination, a woman with an autistic daughter, whose symptoms appeared after vaccination, and an adult who had caught polio from the oral version of that vaccine as a child. The little boy in the first case, Luke Philbin, ended up having a denovo genetic disorder, Dravet syndrome. It turns out that any fever, including the one induced from vaccination, would trigger this. The family understood this and say that they now rely on herd immunity, since they can’t give him any more shots. The Alison Singer, mother of the autistic daughter, suspected vaccines as a cause, but then was convinced otherwise by the evidence. And she became an autism advocate and was involved in raising funding to find the real causes. Whew, that was not where I thought she was going with it for a moment there. There is also a great explanation of the suspected causes of autism later in the special (spoiler alert, a combination of genes and prenatal development events).
David Salamone, who caught polio from the oral vaccine as a child (the attenuated virus mutated over time to cause disease, a 1 in 2.4 million chances event), wasn’t at all bitter about his fate, he even says “I am pro-vaccinations.” His parents had the same attitude, though they lobbied to have the oral version of the polio vaccine taken off the market in lieu of a safer injectable one. You do see him limping, but also helming a boat. The sledgehammer message here seems to be “if these people who have been through difficult situations can see the nuances of the science of vaccination and still think it’s worth doing, why can’t you?”
The segment on the HPV vaccine seemed the most timely and had an especially emotional testimonial. A barrage of talking heads and pundits make aggressive proclamations for both sides (Bachman included, naturally). A pediatrician explains to a faceless mother that this shot prevents cancer. The mother expresses her icky feelings about giving her daughter something that acknowledges future sexual activity since she “tries to teach abstinence and chastity” (PLEEEASE lemme know how that works out for you lady). This is contrasted with a tearful mother of a daughter who’d died from cervical cancer. She emphasizes how much of a gift it would have been to be able to prevent her daughter’s slow, painful death, that she would have done anything. It is painfully raw and emotional. The pediatrician emphasizes that “it is irrelevant how the disease is contracted.” No one questions how you contracted diphtheria, and victim blaming and having a sex-negative attitude is not going to prevent cancer when 80% of people contract HPV at some point in their lives.
A striking concept that I’d never considered was reiterated several times during the show: the fact that today, parents expect their children to survive childhood. It seems like a weird or obvious thing to point out, until you remember that 1/3 of children under 5 used to die of early childhood diseases.
Overall, this program seems to have the right mix of information and heartstring tugging to reach the vast majority of people who are “vaccine suspicious.” Of course, the Merrill Doreys and Jenny McCarthys of the world will not be swayed, but they are a vocal 1%. There is an emphasis on the idea that “it’s OK to question vaccine safety,” but also that here are the facts and here are the relative risks, so how’s about we play the smarter odds?
Images courtesy of NOVA.