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Why Does Opposition To Vaccines Persist?

March 11, 2019 1:42 p.m.

GUEST: Mark Sawyer, M.D., infectious disease specialist, Rady Children’s Hospital San Diego

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A recent effort in Sacramento to make sure there's no repeat of San Diego's hepatitis A outbreak has come up against some unexpected controversy. Language in the bill HB 262 would allow public health officers to order actions necessary to control the spread of communicable disease anti vaccination forces are rallying against the language saying it could allow the government to mandate vaccinations during outbreaks. This is only one instance of a seeming resurgence of the anti vaccination movement. Joining me by Skype is Dr. Mark Sawyer professor of clinical pediatrics at UCSD school of medicine and infectious disease specialist at Rady Children's Hospital.

Dr. Sawyer welcome to the program. It's a pleasure to be here. Now it seemed that after the link between autism and vaccinations was disproven that the anti vax movement would subside and there was just another huge study from Denmark finding no link between autism and vaccinations. Why do you think this concern continues to persist.

It's a bit of a mystery when you look at the question scientifically that is certainly as you mentioned the link between vaccines and autism is just been been disproven. And the other things that are brought up by anti vaccine folks such as the vaccines overwhelming the immune system there's really no evidence for that. So my opinion is that people get inaccurate information which is easily spread these days on the Internet and they're making decisions based on that. And for some reason that information continues to circulate despite the scientific proof to the contrary.

As you mentioned the vaccine opponents often are promoting their message on social media sites like YouTube or Facebook. Do you think the anti vax movement is primarily a conspiracy theory. In other words why do you why do they believe in an overwhelming majority of medical professionals would support vaccinations.

Well I think there's a subset of people who are opposed to vaccines who feel that you know they're exerting their personal right and don't want the government telling them what to do. But I think the majority actually are legitimately concerned parents who are looking out for the welfare of their children but they're taking information that's inaccurate in making a decision that I don't think they would make if they got accurate information.

Are you in support of platforms like Facebook taking down anti vax content.

Well you know I certainly would like them to have some sort of filter so that at least credible information with you know good resources and references and science behind it can be distinguished from somebody whose personal opinion which can circulate just as easily on Facebook and other platforms. So you know I'm a proponent of free speech just as much as anyone else. But I do think there needs to be some way for the information to be identified in the sources from from which it's coming easily identified so that people hopefully will will turn to the sources that are going to give them good information.

There is a measles outbreak currently underway in the Pacific Northwest. It's being seen primarily in a cluster of unvaccinated children do outbreaks like that pose risks to the larger community.

They do and they number of those outbreaks seems to be increasing over the last couple of years. None of them have been really big but the number of mere middle sized outbreaks continues to go up and I think that is a clear reflection of a subset of the population that is not getting immunized and the reason they pose a risk to the general public is that measles for example is very very contagious. We learned that in the Disneyland outbreak where a single person managed to infect over 100 people. And there are people in our community who can't themselves be protected through vaccination because of their underlying medical conditions.

And those people are going to get measles when an outbreak gets going in a community.

Are there risks involved though in having the government step in and mandate vaccinations.

Well I think the government has lots of broad powers in outbreak situations including quarantine telling you you have to stay in your house so you know personally I don't see this as a is a significant risk that the government is suddenly going to mandate vaccines where it wouldn't be appropriate. And I'm not terribly familiar with the details of the proposed legislation and whether it would even do that. But I do think vaccinations are important to control outbreaks of disease.

California has a law that bans personal and religious exemptions to vaccinations that requirement went into effect in 2016. Has that law led to a decrease in outbreaks of infectious diseases in California.

I think it has so far. California has escaped the cases that are started in Washington state that you already referred to even though people from that community have traveled to California. We certainly know that the rates of immunization in schools have gone way up because of that legislation up to the level where we would predict that we would no longer see outbreaks of disease. So I think the law is doing what it was intended to do.

There was a very disturbing story out of Oregon where an unvaccinated child really suffered terribly from tetanus. He was given the vaccine as doctors tried to save his life but his parents refused to allow him a second dose after he recovered. So this is a very strongly held belief among some people. How did doctors like you try to counter it.

Yeah that is frustrating for us. And I don't think we have a clear way to sort of commend people with those strongly held beliefs that they're making a decision that's putting their children at risk. I don't know what else would do it more than a disease like tetanus which is extremely dramatic when you see it. So the best we can do is give accurate information and try to provide risks and benefits both from the vaccines but also for the diseases that they prevent and hopefully most parents are going to decide in favor of the vaccines.

Finally a Senate committee recently heard from 18 year old Ethan Linden Berger who went against his parents wishes and got himself vaccinated. He called his parents anti vax beliefs kind of quote stupid. Do you think the anti vaccination movement might possibly be a generational thing.

I'm not sure if it's generational but I think the solution to it ultimately is to improve the scientific literacy across our community and maybe education in more recent years has done a better job of that so that this particular student learn things that his parents didn't about science and immunology and infections and led him to choose a different outcome. So I think we just need to candy continue to make sure people understand the importance of the data behind the recommendations and how it should put them at ease to recognize that the risk from the vaccine is always less than the risk from the disease.

I've been speaking with Dr. Mark Sawyer professor of clinical pediatrics at UCSD school of medicine and infectious disease specialist at Rady Children's Hospital. Dr. sorry. Thank you so much. Thank you Maureen.

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