Vaccination: the dangers of a single story
‘The dangers of a single story.’ This title comes from an inspiring TED talk given by the novelist Chimamanda Ngozi Adichie. She warns that if we hear only a single story about another person or country, we risk a critical misunderstanding and a narrowing of our critical minds. Although she refers to cultural narratives, it can be applied to the anti-vaccine propaganda.
Take an anecdote (a sad one): the story of a child that gets vaccinated and few days later develops a life-threatening disease. Blend it with a touch of pseudo-science (the more complicated the words the better), a handful of emotions (save our kids), a spice of paranoia (doctors/governments are lying to us) and a big chunk of social media… Et voila!
Don’t get me wrong. I am not saying that we live in a perfect world where vaccines do not have side effects. They do and they are generally mild and extremely rare. Some parents have reported sad stories about their kids getting sick after being vaccinated. Is it due to the vaccines, an ongoing condition or a sudden unrelated infection? It needs to be formally assessed. Reporting suspected adverse reactions to pharmaceutical drugs or vaccines is essential; but it is the combination of all the reported effects, including patient history and susceptibility to diseases that is going to tell you if the benefit/risk balance of the vaccine is leaning more towards the risks than the benefits1. This process is called pharmacovigilance2.
Be careful about the general conclusions from a single story.
For years, anti-vaccination activists have powerfully used single stories to discredit vaccination3. It worked to some extend. Hundreds of years of efforts to eradicate life-threatening diseases are put in danger. It is good to remember that millions of lives were saved due to vaccination, including yours, and the one of many more4.
Why do we have doubts about vaccination now?
Do we trust doctors? Do we trust scientists? We do. But we are also humans. And tragic stories make us sad and outraged. Why is the single story strategy not used to communicate the positive effect of vaccination to the public? Why not fighting the battle with the same weapons, the emotional single story telling. It is hard when nothing happens, when all that happens is great health. ‘My kid got vaccinated, and nothing happened. He is healthy. Nothing happened.’ Who wants to hear about that?
So what about a fictional single story in favour of vaccination?
OK, let’s try one. The fictional story of someone that lives in a world where anti-vaccines activists made it happen. Imagine. Imagine a world without vaccines…
Imagine you are in your 30s/40s, you are living a fulfilling life with a good job, amazing friends and family, and a lovely cat (or dog …). Back home tired, after a stressful day at work, you switch on the TV. There has been the same news over and over for the past six months. It has conquered all the newspapers, social media, books, radio and TV programmes on the planet. ‘We should STOP killing our people.We should STOP vaccinating our children.’Anti-vaccination activists that are being massively heard for the first time and suddenly gaining credibility, have successfully managed to trigger the debate amongst political leaders. Due to the uncontrollable and mislead public shaming on vaccination, politicians have decided to start the first worldwide real-life trial ever done: stopping vaccination for the next 5 years, collecting a vast array of data and finally determine if it’s beneficial or not.
Interested in science, you checked the original paper. It is totally flawed. Patient selection is not representative from the general population, the trial procedure is dubious and results are barely significant. It is not the first time that social media have brought random statements to be massively accepted without real proof. Exhausted and harassed by so much nonsense, you decide to go to bed. Tomorrow is going to be great, you are finally on your holidays.
The next day, you take the first flight to Buenos Aires with your friends and start the best trip of your life in South America.
You have so much fun enjoying life far away from all fuss. Everything was good until you start feeling nausea, headache, fever and abdominal pain… You pay a little visit to the local hospital, where they then send you home with a few anti-inflammatory and nausea pills. But quickly, the fever is coming back and you weirdly turn yellow, it’s like a jaundice. Your friends are worried and force you back into the hospital when you realise you are bleeding in the mouth and eyes. The diagnostic comes quickly: Yellow Fever6. 50% risk of dying. You are in shock; tired, sick and mentally exhausted. You just can’t believe it, you were just having a great holiday with your friends…The doctor looks at you and tells you that they have seen a recrudescence of cases of yellow fever. Since the US, Canada and Europe have decided to stop vaccination, they have never been so busy. Their hospitals are full of tourists, young incredulous travellers that do not understand what is happening.
Calling your family back home to tell them the news, you learn that someone else is sick in the family. Your 4-year old nephew has got diphtheria and is between life and death. After stopping vaccination, schools have seen a massive recrudescence of diphtheria. Diphtheria is a bacteria that lives in the mouth and throat and causes sore throat, fever and chill7. Young children are particularly at risk. As a result, they are less able to fight against it, and the bacteria can produce a toxin that can cause serious complications such as heart failure and paralysis7. And that is at this stage that you nephew is. ‘The doctors said he has 20 % chance of surviving.’
That’s when you think, why the f* have we stopped vaccinating people? After all, vaccines are just attenuated forms of a pathogen to stimulate our own immune system in case of real encounter with the fully virulent bacteria/virus…
Then, suddenly it hits you. It happened before. After the break down of the Soviet Union in the 1990s, vaccination rates dropped down and there was an explosion of diphtheria cases. In 1991, there were 2000 cases, which rapidly increased to 200,000 cases by 19988. So we knew already! We knew the dramatic effects of lack of vaccination. Have we forgotten? Or have we just refused to remember the past? Or maybe we are simply influenced by story tellers…
Luckily for you, you did not die this time. Neither did your nephew. But you will keep scars for life. At least you know now that you have a voice, and that you will say something. Because remaining silent is supporting stupidly dangerous behaviours.
End of the story.
So now, guess what would happen if we stop vaccination?
We could find ourselves battling against epidemics of diseases we once thought to be under control. Previously, we have already observed the relapse of diseases following decrease in immunization in countries like Russia, Japan, Australia and Sweden8,9. Immunization stops, diseases come back; vaccination resumes and the incidence drops again! Vaccination is not only about protecting yourself but also the people around you, especially those that are unable to get vaccinated, failed to respond to vaccination or are susceptible for any reason.
Well you have got the point now. Next time you hear anti-vaccines speeches, try to see past the single story; understand the concerns and challenge the arguments. Being critical could save your life, and the life of others.