Well, I have to say that it's a lovely pleasure to be invited to guest-blog over here at Isis's place. It's pretty amazing back here in her blogging quarters: it smells fabulous, like a combination of honeysuckle and roses. My sensitive side is very tempted to use some of these outrageously colored lipsticks, too. But damn! The stacks of shoes! I fear that I am about to be smothered by an avalanche of leather and heels.
Be that as it may, I shall soldier on.
Those of you who know me from over at Terra Sigillata will recognize that I am usually very well-measured and peaceable with most posts. For those of you who don't read my blog, I am a natural products pharmacologist who professionally straddles the line between science-based medicine and dubious promotion of dietary supplements. So, my nature is generally to walk the middle ground.
But when Isis offered me the chance to guest-post, it came with the condition that I do some shit-stirring, maybe even call someone a "fucker" or "douchenozzle" - for my personal benefit and to free myself from the moderate behavior with which I constrain myself.
Well, I'll go one better, and in my own way.
People who do not have their children vaccinated should be prosecuted for domestic terrorism and child abuse.
As with science bloggers elsewhere, I am been writing about my concerns that public figures who are not scientists or physicians are gaining high-profile forums to foster fear among parents that childhood vaccines cause autistic spectrum disorders. (see this subtly titled post, "Oprah Teaming With Jenny McCarthy Will Kill Children"). Despite the fact that this association between vaccine components has been repeatedly disproven, people such as Jenny McCarthy are granted access to shows like Oprah! to spread misinformation.
Last Friday night, one of my New York City homeboys read that post and hooked me up with a Los Angeles-based children's book author, mother of an autistic son, and former advertising executive. She is angry about the needless fear being spread by the former Penthouse centerfold Playboy playmate (apologies for the misapprop - I don't read either) and has an interesting idea: she is engaging an extremely attractive, scantily-clad female colleague to record a series of YouTube public service clips to support childhood vaccination, followed by an online awareness campaign.
Because I thought this might be an effective counter to Jenny McCarthy's messages (and because my new friend made some very complimentary statements about my blog - I'm here at Isis's so I'm allowed to be vain, right?), I offered my endorsement and support when the videos came out and said that I would disseminate this information to the larger sci/med blogging community.
Having indirectly volunteered my colleagues, I decided after several glasses of wine Friday night that it might be best to query some colleagues, primarily women whose opinions and counsel I respect deeply and who might have strong feelings about this approach, including my incredibly hot blog host. As one might suspect in retrospect, I received quickly a number of responses questioning the YouTube near-soft-porn public service videos. A number of these responses contained language that would make PhysioProf blush. I hope that my colleagues will feel free to share these missives in the comments below.
I also ran this approach by my wife, a physician who is returning to training in a dual preventive medicine residency/ master's in public health program. Of all people, I guessed that she would support any approach that might raise awareness that vaccines save lives and stresses that no association exists between vaccination and neurological conditions.
I guessed wrong.
Beyond the obvious displeasure with yet another case of objectifying women, my wife and other counselors questioned the effectiveness of the "sex sells" approach. Specifically, who is it that makes the primary decisions about vaccinating their children and would they be influenced by a breathy, beautiful woman sharing a scientifically-valid message about one of the most effective modalities in preventing debilitating and potentially fatal childhood illnesses?
The argument made to me is that vaccination decisions are largely be made by mothers and mothers will not be swayed by a sexy video in the way that salivating, farting, beer-swilling Neanderthals might. I don't have data to argue one way or another but observations of the apparent gender of anti-vaccination commenters at my blog are split roughly between men and women as far as I can discern.
But what if the controversy over these pending videos reaches both mothers and fathers and leads to an increased public dialogue about the safety of vaccines?
I was trained originally as a toxicologist and making risk-benefit decisions is something that has permeated my education. As a father, husband, brother, son, and colleague of some remarkable women, I still submit that the education approach of my advertising colleague will be successful, with the benefit of public awareness of vaccine safety outweighing the offensive exploitation of a sexy model. By the way, the sexy model in question has unequivocally offered her support to this project.
I haven't touched on such a hot topic since I posted a couple years ago on whether the San Antonio Riverwalk Hooters restaurant could ethically run a breast cancer promotion during the week that the internationally-recognized San Antonio Breast Cancer Symposium was being held (I pondered this question while at the meeting as the spouse of an attendee while strolling our daughter along the Riverwalk). In turn, could breast cancer research funding entities ethically accept monetary donations that would result from a promotion?
This created a shitstorm.
So, the current vaccination video query is the best I could do to similarly agitate the crowd here.
Once this initiative goes public, I'll be sure to come back and discuss this in greater detail with more specifics.
Unless Isis bans me.
Brain & Behavior
Comments
This is a gambit that PETA uses all the time. For dang sure they increase the breadth of their message's reach. Does that mean it is more effective? Do they convert or attract supporters that would otherwise have remained ignorant of their message? Do they turn off those concerned with exploitation of the female form?
(and yes, that language from a usually even tempered individual made me blush too)
Posted by: DrugMonkey | May 11, 2009 1:53 PM
I think it's poorly targeted. If you're trying to reach parents who are vacillating about vaccinating then from what I've seen both online and in person you primarily want to be reaching women, not men. Even in dual income households women are disproportionately the final arbiters of medical decisions for the children (exception being extreme conservative religious households, who are immune to reason anyway).
I'm pretty sure McCarthy isn't using sexuality to reach her intended audience, she dresses fairly modestly these days and her hook is entirely about her devotion to her son. To counter it you don't need someone who is a counter to what McCarthy was doing 15 years ago, you need someone who is a counter to what she's doing now and *someone who can get the attention of Oprah*. McCarthy's success is based entirely on media access. She is dating one of the biggest male stars in Hollywood, that gets a LOT of access. As wonderful as Amanda Peet is, she doesn't have the connections that McCarthy or Carrey have.
And perhaps I'm just too rational, but seeing a video of a scantily clad woman promoting vaccination would actually make me question the validity of the data in light of the completely inappropriate way they were choosing to deliver the message.
Posted by: Rev Matt | May 11, 2009 2:07 PM
As a pediatric subspecialist I am all for anything that gets people to vaccinate. If a sexy video will get one more kid done - post it! Perhaps what we really need are videos of kids emergently trach'd for diptheria or coughing their brains out (literally) with pertussis. I mean, if the public will watch "2 girls - 1 cup" surely they will watch something involuntarily gross and maybe figure out why vaccines have been considered a blessing by previous generations.
Most recently I was asked if I was going to vaccinate my then 19 year old daughter for HPV. The mom asking thought it would be giving her daughter permission to have sex. Now, I had already had my daughter vaccinated. It's a CANCER VACCINE, the holy grail, what we have all been waiting for. We can't get kids to think about pregnancy before having sex - and you think they might consider the chances of cancer 15 years down the line?????? And you think she won't have sex anyway? [Given some of this mom's behavior, well, I suspect the apple won't fall far from the tree.]
Perhaps what we really need to know is if the Pitt-Jolie clan has been vaccinated. I mean, if anyone can trump McCarthy-Carrey (whose last few movies were, well, crap), that would be the duo. Could probably even get them on Oprah. Maybe Angelina could sport a pro-vaccination tat. Now THAT would be hot!
Posted by: Pascale | May 11, 2009 2:22 PM
umm... in my opinion, that's really not the way to go about it. i would think that context should be considered here. when thinking about one's child, does one want to think of sex?
i dunno. that whole connection feels very wrong to me. and i don't even have kids.
i don't know if i'd go so far as child abuse, but i would agree 100% to gross negligence. (but i've got a very different perspective on child abuse than most, i suspect.)
Posted by: leigh | May 11, 2009 2:23 PM
"People who do not have their children vaccinated should be prosecuted for domestic terrorism and child abuse."
This is a slippery slope, Abel. It is not a far cry from this to the cases where mothers have been legally forced to undergo a c-section they have not consented to, or the cases where mothers who have been found to have drugs in their system while pregnant are prosecuted for child abuse. I am not fond of the idea of infringing upon people's rights and privacy.
That said, I think people like Jenny should be prosecuted for domestic terrorism and child endangerment for running their mouths off about shit that just isn't founded in science. The parents themselves are naive and desperate to do what's best for their children - people like Jenny are feeding off of that and encouraging bad choices. THEY are the ones responsible for the misinformation and for blocking the real scientific information from being heard and understood.
Posted by: JLK | May 11, 2009 2:37 PM
Well, my first reaction was "sex is used to sell every other goddamn thing so why not accurate scientific information about vaccination?"
My second thought is....who is this aimed at? That is, who is the sexy woman in the video being sexy for? Are mothers who are not wanting to vaccinate their child because they fear autism going to be influenced by a sexy young something talking about science? If so, is this a little like the Cosmo soft porn covers that are actually aimed at women? Or is it the fathers? So, you know, like a Maxim cover? Or what? How, exactly, is sex being used to sell, to what audience?
I am having a difficult time imagining who the sexxy chick in the video will be whoring things up for. Or, how exactly the "sex sells" works in this situation.
"Vaccinate your child, and YOU'LL be fuckable, too!" ???
"Vaccinate your child and you can get hot fuckable women like this one!" ????
"All the hot wimminz iz vaccinatin' the kidz these days, you don't wanna be left out!" ???
"I'm more fuckable than you could ever hope to be, therefore you should listen to what I tell you to do, because clearly someone as unfuckable as you are is not the type of person to be setting agendas of any sort!" ???
Mm. That last one has the sting of the underlying truth of most "sex sells" advertising.
Posted by: Zuska | May 11, 2009 2:48 PM
Not to nitpick, but I believe Jenny McCarthy appeared multiple times in Playboy and has never appeared in Penthouse. Since your target audiance is women who listen to Opra, why not use a sexy male model to deliver your message?
Posted by: Danimal | May 11, 2009 2:50 PM
I think the questions raised above about whether this kind of marketing strategy would reach and/or persuade the target audience are good ones.
Even if there was good reason to believe that the sexy sell would reach the target audience, however, there are other effective marketing techniques that don't rely on reinforcing the idea that women's value is primarily a matter of fuckability.
Given the availability of other effective means to a worthy end (cf. Amanda Peet), why use the shitty means?
Posted by: Dr. Free-Ride | May 11, 2009 2:56 PM
"People who do not have their children vaccinated should be prosecuted for domestic terrorism and child abuse." OMFG I laughed - mainly because I too am tempted to think that non vaccination of children does border on child abuse - essentially because it is the infliction of unnecessary harm and suffering to a child who had no choice in the matter. I mean herd immunity will only take you so far - even if the majority of parents who decide not to vaccinate knew what herd immunity is. While sexy vids may not do the trick - at least its spoken about - the whole vacination = autism argument just makes me cringe. Being a microbiologist I understand bugs and vaccinations, and I like my children medium rare and vaccinated thank you very much.
Posted by: Eppendork | May 11, 2009 3:02 PM
For the record, below is my exact response to Abel Pharmboy's query:
I don't understand the point of using sex. I know Jenny McCarthy was once a centerfold. But I have not seen her posing naked in anti-vaccine ads. Has she?
As a mother who recently vaccinated her child who is friends with women in the position of having to vaccinate now, I don't think women are listening to people because they are "sexy." I think they are listening to them because they are the loudest, most vocal voice. What this cause needs is not a woman in her bra and panties, but someone as loud and known as the celebrities that are anti-vaccine. Women need a source of counter-information information that is equally visible.
I'll keep an open mind for your friend Abel, but I fear she may be on the receiving end of an open letter rom yours truly. Then again, if she finds that half-naked women makes parents vaccinate their children, I'll start regularly showing my tits around the clinic for the cause because seeing babies with preventable diseases breaks my heart.
Posted by: Isis the Scientist | May 11, 2009 3:21 PM
I think we're back into the "torture" debate: given that something is neither effective nor moral, which argument gets priority?
Posted by: D. C. Sessions | May 11, 2009 3:30 PM
Ack -- this is specifically why I hate PETA. Remember their 'fuzz-down-there' ad? Disgusting. http://feministing.com/archives/008699.html
Don't go there.
Posted by: gnuma | May 11, 2009 3:30 PM
PS: Keep your big man feet out of my shoes. I don't want them all stretched out, d00d.
Posted by: Isis the Scientist | May 11, 2009 3:30 PM
Given that most of the Jolie-Pitt family is (unless there have been some developments *like triplets* that I haven't heard/seen plastered all over the place) from foreign adoptions, I think we can be relatively certain that yes, all of those children have been vaccinated.
Posted by: Kate | May 11, 2009 5:11 PM
Maybe instead of a half-naked model, she could do something along the lines of the Christian Children's Fund. With the bearded respectable-looking guy showing us children suffering (ala Pascale's suggestion) and you could prevent it if only you. . . vaccinate your child. And donate to get children without medical coverage vaccinated too.
Posted by: Robin | May 11, 2009 5:13 PM
I can only offer this -- should someone think this is actually a good idea, it would be a wise idea to find someone whose intelligence actually matches her looks. Victoria Zdrok comes to mind, though I'm sure they could come up with much better.
But overall, I'm not real crazy about the idea.
Posted by: Brian X | May 11, 2009 5:30 PM
"(exception being extreme conservative religious households, who are immune to reason anyway). "
*giggle*
But wait... who said anything about reason... what we need to know is, are they immune to sex?
"19 year old daughter for HPV. The mom asking thought it would be giving her daughter permission to have sex. Now, I had already had my daughter vaccinated. It's a CANCER VACCINE, the holy grail, what we have all been waiting for. We can't get kids to think about pregnancy before having sex - and you think they might consider the chances of cancer 15 years down the line??????"
Or three years down the line. Cervical cancer can hit remarkably young if you get the short end of the stick with genetics and HPV viral strain.
Anyway, I'm not a fan of this plan- I doubt it'd be the most effective option, and I think there are other effective options to tap first. That said, I found Obama Girl hilarious (not that I'm proud of it). Her approach wasn't exactly commendable, it was certainly not convincing, but I was definitely amused.
Posted by: becca | May 11, 2009 6:09 PM
Rev. Matt said, "you need someone who is a counter to what she's doing now and *someone who can get the attention of Oprah*."
I think this is a very good analysis, and I'd humbly suggest that the very best person to get both Oprah's and most other American women's *and* men's attention is Michelle Obama. Now, how do we recruit her?
Posted by: chezjake | May 11, 2009 6:10 PM
"Don't worry; this won't hurt a bit. One little prick and it'll all be over!" hasn't worked for me even once.
Oh, we're talking about vaccinations?
Posted by: Brownian | May 11, 2009 6:40 PM
Historically, men have dominated public vaccination debates, and women (specifically mothers) have been the ones making the actual decisions regarding their children. So while the sexy ads *might* influence public discourse on the topic, its potential effect on vaccination rates seems dubious.
Ever since the introduction of compulsory smallpox vaccination in the nineteenth century, medical and scientific commentators have been describing parents who chose not to vaccinate their children as 'ignorant' or 'apathetic' (and more recently 'child abusers' and 'terrorists'). This is unhelpful, because it fails to recognise that most parents are making the best decisions they can with the information that they have. They are, often, making these decisions on the basis of assumptions and values that are different to those of medical orthodoxy. Calling them names will not make them change their mind, when they think they are making decisions in the best interests of their children. Perhaps a more useful (and less patronising/insulting) approach would be to study how people make decisions about vaccinations and use this information to better target pro-vaccination campaigns.
The sexy ad approach seems to me to say 'wow, people who don't do what I do are dumb. Better try to change their attitude with a dumb campaign then!'
Plus, we don't actually want to stifle discussion of the safety of medical interventions. That would be unscientific and immoral.
Posted by: ratty | May 11, 2009 7:02 PM
Do-da, Do-da, Doh - I should just wander by to see if anyone saw my post at Isis's today.
Whoa! I don't even know where to start! Don't you people have day jobs? Or are you all in Europe and wrote all this during Monday evening?
Very, very interesting to see the comments split but still running again this being a good idea.
Let Papa grab a glass of wine and I'll be right back, my little chickens.
Posted by: Abel Pharmboy | May 11, 2009 7:22 PM
Whoa, LOVE the Michelle Obama idea! How could we make that happen?
Posted by: Asphericity | May 11, 2009 7:41 PM
I haven't seen the YouTube video(s) so I can't comment on them directly but I'm not convinced that using sex to sell parents on the idea of vaccinations will work. Why not just tell it like it is and show examples of what happens with preventable diseases like measles, mumps, rubella, diphtheria, whooping cough, tetanus, hepatitis and polio? Why not show pictures of kids in wheelchairs, on life support, in the morgue, etc to demonstrate what really happens with these diseases? McCarthy and her followers are trying to scare the easily-influenced population based on heartbraking stories and anecdotal evidence so why not counter it with cold hard facts and the truth? It might make some a little uncomfortable but if it saves the lives of some innocent kids it's totally worth it.
Posted by: Professor in Training | May 11, 2009 7:53 PM
I think it's a bad idea. Would I send my granddaughters the link, now that they're on the way to motherhood? No way! One would be offended, the other would critique the "sexiness" of the model.
Would my grandson or g-sons-in-law be influenced positively? Maybe, but imagine them trying to get their wives to watch the video: instant massacre!
Better a mother, with her child at the school playground, explaining herd immunity. Better a couple with a toddler, a father at his daughter's wedding, a pre-school teacher ... anything but a sexy model.
Posted by: Susannah | May 11, 2009 7:56 PM
@DrugMonkey - I really wish there were some data on the effectiveness of the PETA campaign. Unfortunately, we're pushing the limits of my expertise. After writing this post, I realized I should probably hit up my colleagues in marketing and social behavior - I just participated in a great wine marketing experiment with Dan Ariely, Duke/MIT prof and author of "Predictably Irrational" - that team would be great to tap for this particular experiment.
@Rev Matt - You've definitely articulated the stance of those who feel that women would be expected to be the primary target audience and that this approach might not be effective.
@Pascale - What an honor to field your comment! Your contribution to the Letters to Our Daughters project was simply superb and inspiring to this father of a mini-woman. wrt to the current topic, I find your response to be consistent with the majority of clinicians: saving one life is worth any approach. And let me also echo your endorsement of the two HPV vaccines - now-preventable cervical cancer kills more women in the US each year than died in the combined 11 September terrorist attacks.
@leigh - I hear you; the approach, in my understanding, is less about sex as it is to capture attention. But your concerns are very valid. and with @JLK Yes, my "child abuse" comment is over the top and dramatic - perhaps "negligence" is better. But I hope you both can see that I hold paramount a parent's responsibility to have their child vaccinated. And JLK, I couldn't agree more that McCarthy's use of her bully pulpit is evil.
Posted by: Abel Pharmboy | May 11, 2009 8:14 PM
@Zuska - I cannot argue with a single one of your points when one considers the assumed target. I love how you just go for the jugular. I cannot refute a single one of those contentions. This is why you rock so tremendously. Ever point valid, well-articulated, and eye-opening to this guy who still has a lot more to learn from you.
@Danimal - I fixed the mistake - fyi, I don't read either mag. I have a personal rule that if a woman will not be naked with me in person, I have no business looking at photos of those who won't.
@Dr. Free-Ride - Again, I cannot argue. Part of my point for bringing this discussion online is to gather the wisdom of the hivemind as to the most effective strategies if this is not one.
@Eppendork - as with Pascal, I think those who also work in medical microbiology view this slightly differently since you are used to thinking in public health terms. Although that doesn't explain why my wife kicked my ass.
@gnuma - Ack. I hadn't seen this before. The whole campaign. Sorry. Now I see why DM brought it up.
@Isis - Okay, I'll stay away from your shoes. Then how 'bout this: you pick out some heels in my size for next year's Fantasy Fest.
Posted by: Abel Pharmboy | May 11, 2009 8:29 PM
@Robin and @PiT - You both raise exceedingly good points. In fact, I'm just reading a book about my hometown that describes what life was like there for kids in the 1940s before vaccines were available. My concern with the impact of such an approach is that footage would largely be old and make people think we still didn't need to worry about these childhood diseases. But this deserves much more thought.
@ratty - I'm torn. I agree that men have largely defined worldwide public health agendas. What other commenters are raising is that mothers may be the ones to influence local and personal agendas.
Posted by: Abel Pharmboy | May 11, 2009 8:52 PM
I think you'd get farther using one of the hunky guys who play doctors on TV. Like House or McDreamy.
Posted by: Female Engineering Professor | May 11, 2009 9:31 PM
Perhaps the best long-term solution would be for doctors to quit shoving unnecessary treatment and medication down our throats, so that when a doctor did recommend something, I would take it seriously. One might especially start with obstetricians, since they're high on the offenders list, and they treat women who are about to be parents of small children. (Yes, I'm a cranky pregnant lady who just heard yet another friend's story about an unnecessary induction leading to a terrible labor. Yes, I file this under "Reasons not to listen to the doctor.")
Another good long-term solution would be to find the cause of the apparent rise of diseases that are clearly immune-related, e.g. asthma, lupus, etc. My impression is that this is only in part due to increased diagnosis. Once you can explain how the increase in immune disorders occurs, I'll feel a bit more comfortable that it doesn't have anything to do with vaccines for diseases that are not particularly lethal (e.g. chicken pox).
And yes, I plan on vaccinating.
Short-term, though, yeah Michelle O. Or since she might be busy, has the now-not-Surgeon-General Sanjay Gupta gotten into this at all?
Posted by: Dr. Jekyll & Mrs. Hyde | May 12, 2009 12:24 AM
DJ&MH- simple prevention for asthma and other autoimmune diseases- give your kid tapeworms. Mmmmmm IgE.
Also, I almost hate to point it out, but they haven't been giving the chicken pox vaccine as long as the asthma rate has been rising. If any vaccine causes it, it's more likely to be one of the ones for MMR or something equally frequently lethal. Better asthma than dead.
Incidently, if you think chicken pox is not particularly lethal, you haven't seen a nasty bought of shingles acommpanied by a secondary infection (also, although the etiology isn't a simple one-to-one-function relationship, shingles is an autoimmune-associated disease that's prevented by vaccination). Nevermind what catching chickenpox when you're pregnant can do to an embryo.
That said, as one cranky pregnant woman to another, I'm begining to take doctors less and less seriously.
Abel Pharmboy- Well, at least for polio, you don't have to go back to the 40s for pictures... just try Afganistan. Of course, if we want to be cynical, we could question how compelling images of poor brown children dying are to Americans (sorry; I work on malaria).
Posted by: becca | May 12, 2009 1:56 AM
As someone who coordinates an immunization program for uninsured, low-income children, I have given this issue a lot of thought, but since my experience is mostly with the underserved my perspective may be a little skewed. Most of the parents who bring their kids to my clinic do so because they are required to have some vaccines for school. Parents who refuse certain vaccines are usually just trying to protect their kids against an ethereal threat they've heard about and latched onto as one danger, in a very dangerous world, they can protect their children from. They identify with "little people" like Jenny McCarthy who fight "the system." A lot of health care professionals make the mistake of treating these parents like they are dumb/incompetent/ "abusive". This just erodes whatever small trust still existed. Having tried several different approaches, what I've had the most success with is asking them about their concerns, listening, and addressing them, respectfully and earnestly, in lay terms, and then leaving the decision up to them rather than pushing pushing pushing. You have to build trust again before they will take your advice.
A sexy commercial will not influence these parents. PSAs featuring attractive (because we do admire attractive people), pulled-together supermoms (such as Michelle O or Jolie) talking about the incredible protection offered by vaccines and their comparably mild risks would be much more effective.
Posted by: Jean | May 12, 2009 3:25 AM
It would be better if the author and the commentators read a little more and did a little more research than reading a post about the FDA and the greatness of vaccinations. Don't mistake me, I think that the eradication of smallpox is one of the greatest achievements in history. But, I am loathe to adopt the vaccinate or die! motherfucker! attitude of most people represented here.
That you cannot apply the skepticism you claim to support is obvious. Take for example, the latest advertisements on vaccinations against cervical cancer - bogus advertisement, pharmaceutical corporate crap and politics. All in the name of health and science. Gardasil is just an example of how the worth of the vaccination, the target of the vaccination, the recipients of the vaccination, the need for booster vaccinations at closer intervals than reported, etc are all somehow GREAT SCIENCE that you marginally science literate people swallow. Please learn to sharpen your critical thinking skills before trying to coerce people into following your (idiotically flawed) lead.
And, for the record, try washing you fucking hands instead of relying on vaccinations to save your ass from the flu. OR measles. OR pertussis.
how lame.
Posted by: heather | May 12, 2009 4:29 AM
oh, and the "i was trained as a toxicologist and my wife is a doctor" line is too funny...your appeal to authority cracks me up...
can't say nothing about the autism ordeal (though I think Mccarthy is a bit of a schlep), but I can say that not all vaccinations are created equal.
Posted by: heather | May 12, 2009 4:34 AM
I like Female Engineering Professors suggestion, and vote for Mc Dreamy.
Posted by: angela | May 12, 2009 6:22 AM
And might I suggest a trip to the pharmacy for some Tylenol when your child gets the measles or pertussis (or whooping cough), instead of a trip to my hospital for treatment.
How lame, indeed!
Posted by: Isis the Scientist | May 12, 2009 7:26 AM
@angela and Female Eng Prof - I'll pass that along to my new L.A. advertising colleague; a perfectly valid point to appeal to different audiences.
@DJ&MH - Hey, I haven't been in touch - I hope your pregnancy is going well. I'm really excited for you. I share your concern that medicine sometimes cries wolf; the latest pharma embarrassments with Elsevier, for example, do absolutely nothing to encourage trust. As for the increase in asthma, etc., I'm not an expert there but what I've read seems to suggest that we don't allow *more* exposure to allergens early on - be sure to let Little DJ&MH play in the dirt as well as get vaccinated.
@becca - I'm out of the loop - congratulations on your own pregnancy! Agreed with all of your points and sorry to overlook the impact of poor vaccine access in other countries. Your point is, sadly, well-taken.
@Jean - Your comment is absolutely fantastic. My wife gave me this CDC-authored Pediatrics paper while I considered this post ("Children Who Have Received No Vaccines: Who Are They and Where Do They Live?") that addresses the two major populations of undervaccinated children: the uninsured, low-income group you work with who generally get only the required vaccines and the second, more affluent (>$75,000USD/yr), geographically-clustered, vaccine prohibitionists. I believe that my colleague is trying to hit the latter group. But your suggested communication strategies with your group are excellent; you're there on the front line and it is invaluable to have your input here.
@heather - I can't help you here because it appears that your own mind is made up. Washing your hands will not prevent HPV-mediated cervical cancer, for one.
oh, and the "i was trained as a toxicologist and my wife is a doctor" line is too funny...your appeal to authority cracks me up...
But I was. And she is. We can't help it. And since I write under a pseudonym, there is no way the reader will know that. In fact, I note that to point out that my experience influences my perspective. That's not an appeal to authority in logic because I provide far more information that just my expertise; nevertheless, these are facts that readers can take into consideration if they care to or not.
Posted by: Abel Pharmboy | May 12, 2009 7:42 AM
Would it be effective? I can't imagine any way in which such a campaign could be directly effective. Having attractive people talking about autism would likely be very effective (go Amanda Peet!), but having that talk dripping with sexual innuendo seems, well, unlikely to provide any direct benefit to the target audience (women).
However, there may well be a secondary benefit: this would obviously be a rather unusual move, and as a result may well allow the pro-vaccine camp wider circulation in popular news and whatnot. Just by stoking the flames of controversy, we may help to get the facts about autism out to a wider audience.
Posted by: Jason Dick | May 12, 2009 8:33 AM
I had the vague impression that one of the potential reasons for the rise in immune system disorders WAS vaccination - in that an awful lot of children who would otherwise have died young due to childhood diseases, who perhaps would be more likely to have less strong immune systems, now survive to adulthood due to vaccination. The price for a low infant mortality rate now being a higher level of some disorders later on. But then I do read an awful lot more history than science.
Posted by: artsgraduate | May 12, 2009 9:49 AM
@FEP & Angela:
OK, OK, I can see where all of this is going. Toaster will oblige and be the hunky scientist in the lab coat explaining vaccines, just so long as he isn't required to tan.
@Heather:
And, for the record, try washing you fucking hands instead of relying on vaccinations to save your ass from the flu. OR measles. OR pertussis.
Yes, of course. Toddlers can be taught to wash their hands very well and reliably, of course. It's not like they pick up or touch anything that catches their fancy and put half of that into their mouths.
@everyone:
I think that this underlines a broader need for scientists to actively engage with the public instead of relying on the media to do it for us. The anti-vaccination movement is driven largely by a deep ignorance of biological principles in the general population. I mean, think about it, the average American has had, maybe, high school biology and they probably don't remember it very well. Their knowledge of DNA and genes comes from Jurassic Park, X-Men, and Gattaca; and of medicine from House, Grey's Anatomy, and Scrubs. We scientists live and breath by these biological principles, to us they are dogma, second nature and influence our very patterns of thought. Most people aren't like this, and most people are fundamentally scared by biology because it exposes their own frailty. Look into the eyes of a child with a broken bone waiting on the X-ray table--they have a huge, scary-looking machine hanging over them, surrounded by strangers and in pain--all they want is to stop hurting and go home. Most people retain this fear of health care because it is weird and magical and gross and exposes us for the tottering squishy bags of chemicals and tissues that we really are.
As scientists, we're not doing a good enough job of trying to empathize and educate. By trying to speak to the public from our jargon and our terms we come across as elite and haughty and cold, making it easy to be dismissed as pharma shills or untrustworthy. We need to meet them on their terms, in their language. Anti-vaccination logic is appealing to many because it is a simple answer to a deep fear and it makes sense because there's the appearance of supportive correlation. Because of this it is easy for McCarthy et al to twist facts and manipulate people.
A sexy video for vaccines is on par with Bud Light commercials. Do we want the science to be lowered to the same level as crappy beer? What's needed, IMO, is a campaign with high profile, well-polished videos explaining the science behind medicine in layman's terms. Start with vaccines. Get the scientists in the videos on news channel debates, work up the media ladder, and finish off with an unscripted sword fight with Jenny McCarthy on Oprah.
A final point: demonization of autism, and by proxy, autistic people pisses me right the fuck off. Of all the things that can go wrong with a child, autism isn't that bad and is generally quite manageable. Maybe the "heartbroken" parents of autistic children should let go of their perfect idealized child and accept the reality that the children they do have are wonderful people just the way they are.
Posted by: Toaster | May 12, 2009 10:07 AM
artsgraduate,
I don't think you could honestly say that vaccines "caused" this, though. Rather, if your information is accurate, saving children's lives caused higher incidences of certain disorders. Vaccines were merely the vehicle for saving those kids' lives, and are unlikely to have had much of any direct impact on the incidences of immune system disorders.
That said, the link between immune system disorders and saving kids' lives through vaccines seems to me to be tenuous at best. Vaccines, after all, work by priming the immune system for future infections. They rely upon a healthy and effective immune system to work. So I'm not so sure that vaccines actually help all that much for people with immune system disorders (though not being an expert in medicine or even biology, obviously I lack the information to say anything remotely definitive here).
With antibiotics, you might have a point. I'm not so sure about vaccines.
Posted by: Jason Dick | May 12, 2009 10:19 AM
@heather
Washing hands is insufficient protection for many of these diseases. It helps prevent the spread, but many of these disorders are so infectious that they spread anyway, especially among close contacts, with disastrous consequences. Having seen measles, mumps, and pertussis go through unvaccinated communities during my training (Hmong in Minneapolis, Christian Scientists in St. Louis) I can personally attest to the death and destruction these infections cause. OK, so mumps is unlikely to kill you, but male sterility is a serious outcome as well.
I have never personally seen diptheria or tetanus, but the historical descriptions are scary enough to make me give thanks that this is the case. I probably had pertussis during one outbreak in Chicago. While I was large enough not to have my brain compromised, I did cough up blood and cough until I vomited. Not a pleasant disorder, I assure you. I acquired my infection with exposure to hospitalized patients with handwashing, mask, glove, and disposable gown.
I have seen bad vaccination reactions, and they are scary - but not as tragic as the number of children who would be left brain damaged by pertussis if we quit vaccinating.
I just got my diptheria and tetanus vaccine early since we can now get an "adult" pertussis vaccine in the mixture. These preventive measures are the most amazing medical advance of the 20th century.
Posted by: Pascale | May 12, 2009 10:24 AM
Becca--I didn't realize you were preggo also! Smug much? ;) [from Dr I's earlier post]
Abel, you can see that science-friendly people like us end up being less and less impressed with the medical establishment during pregnancy. And gee, what's one of the first things they do to the baby after birth? A Hep B vaccine (at least at my hospital). I think pregnancy is a key time that doctors often end up eroding trust with women, and that has repercussions.
Several of my scientist friends with kids have chosen to space the vaccines out rather than doing the one-bolus doctor's trip(s). Anti-vaxers? No, not at all. But focusing on the "McCarthy is killing our children!" approach, especially with equally unsexy ladies, is going to alienate intelligent, high-income, skeptical people who understand that science and medicine do not progress forward in a linear fashion.
I don't think the chicken pox vaccine causes asthma etc per se, just that it's a great example of a vaccine for a disease that most of us have never seen cause anything but itching. Everyone I know had it as a kid, missed a few days of school, end of story. I'm aware there are other outcomes. But for the average well-educated parent, I think they hear "chicken pox vaccine" and think, "Is that really so important?" And I don't blame them. If you want an ad campaign to reach these people, I think you should use an equally well-educated, equally intelligent celebrity* as your spokesperson, not a scantily-clad model.
* such a person might not exist.
Posted by: Dr. Jekyll & Mrs. Hyde | May 12, 2009 10:39 AM
If doctors can't handwash regularly (see Atul Gawande's(sic) Better for an example), then I don't really see how normal people (let along children) are going to wash their hands often enough to prevent the need for vaccines. The time requirements for doctors and nurses, who see a lot of sick people and thus probably need to wash their hands more often than other people, add up to about a third of their useful time. I can't see how that's going to fly much.
You don't fight stupid with stupid, you fight stupid with smart. There are lots of smart people who want their children to be safe and happy and aren't willing to compromise the lives of their children and those of others to do it - one of those would be a far more effective carrier for the provaccination message than a half/three-quarters-naked woman. I think the framing that works for the McCarthy/Carrey iron bar of stupid is the "uncaring doctor/scientist versus caring parents" - disrupting that (by showing lots of smart people who care for their children aren't buying what McCarthy and others are selling) would seem to be a better idea than throwing around attractive chaff (which might make people think that the provaccination people have something to distract people from, a bonus negative).
Posted by: Hap | May 12, 2009 11:27 AM
All the good points have been made well by others. I am not in favor of sexy pro-vaccine videos, and Abel, if you're not ok with seeing women naked who would not normally be naked with you, why would you be ok with viewing nearly-soft-porn images of women you would not spend bedroom time with?
I just want to second the ideas of Michelle Obama, Jolie-Pitt, House and McDreamy as good spokespeople in the pro-vaccine camp. Someone call their publicists!
Posted by: Kate | May 12, 2009 11:30 AM
J-Lo, it seems, has recorded a PSA urging parents to vaccinate against pertussis:
http://www.looktothestars.org/news/2431-jennifer-lopez-records-whooping-cough-psa
Posted by: Dr. Free-Ride | May 12, 2009 11:33 AM
anyone who argues the chicken pox vaccine is trivial apparently got the chicken pox when they were younger. i never got the chicken pox despite playing in the neighborhood chicken-pox-playhouse, so if i weren't vaccinated now, at my age that virus could do some serious damage. i'm quite thankful for the varicella vaccine, thank you.
Posted by: leigh | May 12, 2009 11:41 AM
Furthermore:
PING!!!
Posted by: Toaster | May 12, 2009 12:35 PM
This is another example of why we scientists have a PR problem.
Judge for yourselves whether this is a fair synopsis of the discussion so far:
Men are a bunch of brain-dead, testosterone-driven neanderthals who will salivate uncontrollably and do anything a half-naked attractive woman tells them to. Maybe we can use this to get them to to vaccinate their children. I mean, Jenny McCarthy was a former Playboy playmate. That could be why men are listening to her.
But wait a second. Being neanderthals and all, they aren't making the decisions about vaccinations anyway - it's the mothers we need to reach. Except of course for those stone-age conservative households that believe in the man being the head of the household, but those men are too stupid to understand stuff like epidemiology, immunology, and viruses anyway.
And the mothers won't respond to the video in a positive way since it objectifies women. Maybe we should, oh yeah that's it, put a hunky, attractive man (objectification, anyone?) up there to convince them to vaccinate.
Come on, everyone. You can do better than this. A little respect for your target audience might go a long way.
Posted by: BrainGuy | May 12, 2009 1:32 PM
"But for the average well-educated parent, I think they hear "chicken pox vaccine" and think, "Is that really so important?""
I think there is a lot of that, but it's partially because it's a newer vaccine (I think rubella and even mumps were viewed as minimal inconveniences by the majority of people that got them). Personally, I do think of it as a shingles vaccine more than a chickenpox vaccine.
"I think pregnancy is a key time that doctors often end up eroding trust with women, and that has repercussions." Well, I know I've become less impressed with "expert advice" generally due to things like dietary restrictions for pregnant women.
I'm not sure the doctors I have are eroding my trust. Oh wait, that's right, I'm not seeing any doctors (just a nurse-midwife*).
*This is no accident. My attitude toward doctors and nurses is strongly influenced by having nurses and midwives back in the family for a very long time. Family members still tell the story of Ignaz Semmelweis and how medical students had three times the birth complications as midwives (due to lack of handwashing on the part of those dirty med students). And, if Hap/Gawande are right, this may be an example of 'the more things change the more they stay the same'.
"If you want an ad campaign to reach these people, I think you should use an equally well-educated, equally intelligent celebrity* as your spokesperson, not a scantily-clad model.
* such a person might not exist."
Yes, I think that is the problem, such a person does not exist. Clearly, Abel will just have to get us to do it. Call it the CrankyPregnantWomenForVaccines campaign! Also, we should totally get House and Michelle Obama in on it to, cause I really want to meet them.
"Becca--I didn't realize you were preggo also! Smug much? ;)"
No more than usual. ;)
Posted by: becca | May 12, 2009 1:43 PM
WTF is that about, Toaster? I mean, yeah, it's Isis in the form of Hathor nursing Horus, but what's the ping?
Posted by: Isis the Scientist | May 12, 2009 1:44 PM
"place" contains a proper link. But I wrote that because I was inspired by all y'all and stuff, that we need to do a better job communicating the Science clearly to the public. If that was an improper pinging, please notify me and I'll do better.
Posted by: Toaster | May 12, 2009 2:31 PM
Here's the thing - you dont create a vaccine for a simple rhino virus it isnt necessary - you create a vaccine for a bacteria or a virus that causes terrible disease and potentially death. These people who refuse to vaccinate their children should be shown exactly the sorts of outcomes their child may end up with if they dont. And do it graphically - take N. meningitidis or measles or pertussis - if you would willingly subject your child to these 'harmless' childhood diseases then i do think it borders on child abuse.
Like these ones (dont click on them if you are squeamish) - this is what happens if you get infected with N. meningitidis:
http://srs.dl.ac.uk/Annual_Reports/AnRep99_00/Meningitis_Figure_1.jpg
http://www.rch.org.au/clinicalguide/cpg.cfm?doc_id=5227#pic1
and this is a good article:
http://en.wikipedia.org/wiki/Charlotte_Cleverley-Bisman (this why you need to vaccinate)
Damn - and I rant because I care - there is no proven link between autism and vaccination - there is a granite solid link between highly pathogenic bacteria and devastating disease and death. My child is vaccinated - all of them.
Posted by: Eppendork | May 12, 2009 3:11 PM
Hi DJ&MH -
Your curiousity concerning the rise of other autoimmune diseases is a refreshing dose of intellectual honesty. You could also easily add type 1 diabetes, multiple sclerosis, and food allergies to your list. These types of conditions, however, do not have the fuzzy behavioral diagnostics of autism that allow for lots of fidgeting as towards if we are actually experiencing an increase or not.
You might be interested in knowing that since the varicella vaccine has been introduced, some studies have shown an increase in shingles admissions. It is postulated this is the result of decreased latent exposure to wild varicella.
http://www.ncbi.nlm.nih.gov/pubmed/18999945
In an ironic twist, those people most likely to get shingles, the immunosuppressed, are those who cannot get the current shingles vaccines.
Also, did you know that delaying DTP by two months is associated with a full halving of the risk of getting asthma? And another two month delay reduces the risk even further.
http://www.ncbi.nlm.nih.gov/pubmed/18207561
My biggest relief is that I'm sure these are the only unintended consequences of an increasingly aggressive vaccination schedule. After all, we have a perfect understanding of how adjuvants actually work to initiate an immune response, the different genetic risk factors for adverse reactions, and the effects of the timing of an immune challenge in the developing immune system on consequent behavioral and physiological changes into adulthood.
Whew!
- pD
Posted by: passionlessDrone | May 12, 2009 3:45 PM
#48: see #31 and #36. I think they already addressed the target issue. Sex is good at selling things that don't have much substance on their own (or much to differentiate them from others of the same type - beer, for example) - it is relying on visceral and irrational reasoning to get people to pick one thing over another (roughly comparable) thing. The actual data and the qualities of the things are irrelevant. In this case, that is precisely what you don't want - the evidence for vaccinating over not vaccinating is what you want people to think about, because the substance should cinch your argument, and methodology that renders it unimportant or irrelevant is self-destructive.
Competing at stupidity with the masters of the field will get you nowhere. You want a sales pitch that relies on the concerns of people in your target audience and addresses them. Selling vaccines on sex bypasses those concerns and makes them appear irrelevant, which is how (the feeling of irrelevance, not the sex) McCarthy has an audience in the first place. It doesn't require any assumptions on the mental capacities of your audience to presume that sex won't work at selling vaccines, but an awareness of what you want from them and how you want to use their mental capacities.
Posted by: Hap | May 12, 2009 3:52 PM
Ignoring in(s)ane antivax Krappe, I think it's really two simple issues:
1) Would it work?--marketing and ad folks are really good at knowing these kinds of things.
2) If it would work, would it be a good tool to use or would it help perpetuate a second harm and therefore be a Bad Thing despite its single good outcome?
Posted by: PalMD | May 12, 2009 4:20 PM
I think becca might be onto something here: "Call it the CrankyPregnantWomenForVaccines campaign!" The basic idea being using a pregnant woman in a science or sciencey field (real, not an actress) with something like the following.
Camera shows pregnant woman (can be astronomer, nurse, MD, physiologist, chemist, physicist, etc). For our purpose we will call her Female Woman Scientist (FWS).
FWS: Hi my name is {hotfemalesciencename} and I am a {insertsciencefieldhere} who studies {insertfield}
We see FWS looking at her obviously pregnant belly and/or perhaps rubbing it.
FWS: I am concerned about the future of my child as well as others, because some parents are failing to vaccinate based on misinformation about the safety of our current childhood vaccines.
Some facts are now displayed on screen about children diseases and deaths in the past and how they helped eradicate certain diseases and perhaps the diseases return do to failure to vaccinate.
FWS: You see herd immunity is needed even if I vaccinate my child.
More messages explaining herd immunity and why it is important.
Hopefully you all get the thrift. And hey, sex is involved, it was needed for the pregnancy! This would hopefully have two effects. Making mothers aware of the reasons why not vaccinating is not a good idea and putting real woman scientists who are also mothers (or mothers-to-be) forward for all to see. Good idea becca. I just filled in how it might work. Orac and PalMD can hopefully be consulted as to what the factual text screens actually say.
Of coarse the campaign cannot in anyway be associated with BigPharma and must appear to be coming from concerned female scientists, so some name has to be invented, like Female Scientists Saving Our Children From Disease, but something way cooler than that.
Posted by: Danimal | May 12, 2009 5:52 PM
I have a psychiatric practice in a rural community in which many, many people do not vaccinate their children, ostensibly due to religious beliefs or "because The Gummint can't tell me what to do."
I share office space with an internist and a physiatrist.
Because of our subspecialties, we see a lot of immunocompromised folks.
Two years ago, the internist put up a sign in the waiting room after a pertussis outbreak.
"Please do not bring your child into our office if you have chosen to not vaccinate your child for [list of diseases.] We understand this will be inconvenient for you, but the risk is unacceptable for our patients.
If you do not understand the reason for the policy, please ask [office manager] to make a no-charge appointment with any of us, and we will explain how vaccination does and does not work to you."
I read it on my way in the door (this was a unilateral snit on my officemate's part), went "huh, bad night?", and had no problem with it.
I think we had maybe 20 people who wanted to talk to us about it, and 15 of them ended up vaccinating. 2 left the practice. 3 found sitters.
Parents just brought or faxed in shot cards without being asked, if they were the parents who brought their kids along to their appointments.
Whether it was our amazing powers of persuasion - I doubt we said anything their peds hadn't said better - or the inconvenience of having to arrange babysitting, or the reality that "your unvaccinated kid potentially puts this actual person over here at risk," or just that there are not a lot of specialists around here who do what we do, I have no idea.
All three of us are female and concerned, but none of us were pregnant.
Still, I've wondered what would happen if other offices here started to do this and explained the rationale. We *weren't* terminating patients for lack of vaccination - we were asking our patients not to bring ancillary children to the parents' appointments if the kiddos weren't vaccinated.
Posted by: Silver | May 12, 2009 9:12 PM
Let me just say for the record what a terrific experience this has been for me to come over and guest post. I've commented here for some time but have never been as intimately involved in a discussion as I have been now.
I'm so struck by how you have collectively created such a great community here at Isis's blog. With the exception of a couple of name-calling loons, I admire how so many of you have come here and expressed very divergent feelings but in a manner that is respectful and even humorous. When I think about why I went into science, I am reminded that these kind of robust discussions are what got me fired up in the first place.
Abel, if you're not ok with seeing women naked who would not normally be naked with you, why would you be ok with viewing nearly-soft-porn images of women you would not spend bedroom time with?
This note from Kate is a particularly good example of where the author has been challenged for an assertion he had not previously associated with his stance on the topic at hand. Kate didn't ream me or call me a two-faced typical male douchemonkey (though she may have wanted to); she asked me a perfectly valid question for which I do not yet have an acceptable answer and, as I don't, she leaves me to ponder why I am okay with these discordant thoughts. If I come away thinking more about my values and more cognizant my privilege in a way that makes me grow and be a better mentor, friend, partner, father - whatever - then this blog and your community does what I rarely encounter in my daily academic life.
What I am saying is that you all have created a fabulous community here of which I am grateful to be a part. I wish to thank our host, Isis, for sharing with me her platform, but also to each of you for being both honest and respectful with one another.
Posted by: Abel Pharmboy | May 12, 2009 9:25 PM
Oh goodness people! The point of this blog post on sex and drugs is to ramp up vaccination hoorahs with no view on vaccinations other the panacea version OR with a great intention but pretty poor follow through. And, blogwrite, no apologies about the appeal to authority thing that I find too funny. You could be the doctor for all it matters...it has no relevance on this issue as there are good doctors, poor doctors, doctors of medicine, naturopathy, and history..blah blah!
I never stated that washing hands would stop HPV,that was a brief but appropriate poke about the broadness of the treatment of vaccinations in this and many articles on the subject.
VACCINATIONS for what? is the POINT. So, some may want to try to be cute and snarky about tylenol and hospitals but the fact remains that proper sanitation is the first barrier to and point made to bring down disease transmission. I am not an idiot and well aware that washing your hands wont' stop HPV transmission, but you are not too bright for not figuring out that the vaccination against it won't do much for most recipients either! The missing the humor was something else entirely...
I am a vaccination supporter, but not in the way that is advertised poorly here. Some are great, some are deadly, and the combo packs of 26 variants on 3 disease causing pathogens are fucking stupid (IMO and others too). Most vaccinations are cash cows, and like the pertussis issue ongoing across the globe the FACT that the vaccination has a failure rate of approx 60% is usually not advertised too much. And, pertussis aint AIDS, smallpox etc.
So, while the author may glibly say "your mind is made up" I still ask "what are you trying to convert me to?" HAHAHAHA. I don't need my mind made up, I just wish that polarizing a subject that has far reaching impact on health and immunity were less glibly addressed or treated with blanket statements/endorsements
My mind is occupied with being literate and numerate and not succumbing to bad press, info overload, and medical people who think because they wipe asses and have looked through a microscope that the rest of us who also wipe asses and have looked through microscopes are somehow "whacky anti science types who are endangering everyone's children." Both lame and crap.
How many of you have read the drug trial and reporting on gardasil?
And the idea that it is child abuse to not vaccinate! Please, up until 1972 the surgeon general said cocaine was not addictive, so if you are going to start condemning people because of your thoughts on holy science, please DO more science to become a better science writer instead of thinking you are cool by liking science and writing non-scientific ad-copy for the pharmaceutical establishment.
Look at the stats on the rise and fall of infectious illnesses again, and folks no need to try to "outdoctor" or explain, my background is medical too and I can read and do stats enough to get myself in and out of hot water. The idea that if one vaccination is good does not necessitate that ten thousand are better.
Again, get mad all you want, but this article was lame not because I am some "anti-vaccination wingut" but because the appeal to science in this context was offensive to someone who is a scientist and skeptic in the traditional sense.
Posted by: heather | May 17, 2009 12:08 AM
Posted by: Danimal | May 17, 2009 7:31 AM
Dear Dr. Isis,
I have am comment for heather that needs you approval. Thanks.
Posted by: Danimal | May 17, 2009 9:26 AM