Distrust of the System

The fear of vaccinations for children has been with the U.S. health care system for many years. Indeed, Michael C. Dorf reminds us: “Skepticism of orthodox medicine has deep roots in American constitutional culture.”

We all know anyone can read all manner of misinformation on the Internet. Medea personalities support all manner of causes, including refraining from vaccinating children.  Suddenly, now that measles has shown up in various places in the United States, a shouting match has erupted between the general public which feels it deserves to be free of the threat of measles, joined by the medical establishment and all those who feel research has shown the shots to be safe. With the new push for “evidence-based” medicine, the implication is that whatever is “evidence-based” is 100 percent correct. I’ve posted here before on the flaws in “evidence-based” medicine.

Yet the fundamental underlying problem between the two perspectives, the vaxxers and the anti-vaxxers, as they have become dubbed, has never been addressed. The anit-vaxxers don’t trust the reports of vaccine safety, and the vaxxers do, or are willing to sacrifice everything for “herd immunity,” a term I personally find abhorrent. The underlying issue, then, isn’t really whether to vaccinate or not, but distrust of the system, whether it’s the government, public health, or the medical establishment.

Better to look for the cause of the distrust rather than simply denigrate those who don’t trust. Persons who perhaps distrust the system with good reason. It may be an anecdotal reason, but a reason nonetheless, and no less worthy of being taking seriously.

Anecdotal Evidence

Most parents know of anecdotal cases in which a measles shot or some other vaccination was followed by an illness or any number of of significant problems, even autism.  However, researchers thumb their nose at anecdotal examples. Researchers and those companies paying for it watch to see trends in large numbers. Indeed, the “outliers” as they are sometimes called, are often excluded from the “evidence.” A uniform sample of like persons is the goal in research sampling. There’s nothing wrong with this as far as gathering information about a trend. As a result, however, the results simply doesn’t include the outliers, the exceptions.

The anecdotal evidence, then, is generally removed from research studies.

Let me provide a very simple, really trivial example of “anecdotal” evidence. Compared to the problems with vaccinations, my son’s problem with food colorings that often coat the childhood pills he was given is really trivial. But I remember the arguments I had with his pediatrician to try to get the pediatrician to prescribe medications for my son which had no coatings, or at the very least, without red food coloring. As my son got older, he became able to verbally describe his frustrations with his reaction to medications. Even after all these years, I vividly remember the day he was sitting on the kitchen stool and said “I don’t know why my legs are jumping but I just can’t stop them.” This is one of numerous anecdotes, if you will, of my son’s poor reactions to “evidence-based” medicine. And I was castigated for pestering the pediatrician with this concern.

A problem I had to live with and the pediatrician did not.

Exceptions Exist

Exceptions to the norm do not exist. And exceptions are often not included in research studies.

The medical establishment, the government, and research groups often announce great discoveries (coffee is bad for you, fat is bad for you, milk is bad for you, eggs are bad for you) with later announcements to the contrary, often years later. Charles Lane takes up the issue of ever-changing health care recommendations in “Science, with a Side Order of Humility.”

So instead of angrily demanding everyone be vaccinated against measles, why not admit there are sometimes poor outcomes, study those outcomes, and address how the poor outcomes might be avoided. But that takes money, and no pharmaceutical company is going to invest money in solving the mysteries of anecdotal evidence. Instead, those shouting most loudly for vaccination prefer to believe the procedure is absolutely 100 percent safe, and pretend there are no exceptions.

The current public, medical establishment, government, and media mania over vaccinations is just the tip of a much greater iceberg. The problem is not the reactions to the bad outcomes, but that the medical establishment, government, and big pharma refuse to accommodate the notion that one size does NOT fit all. Most everyone has had experience with a generic drug that does not provide the same relief as a brand name. People react differently to all kinds of things, including vaccines. Let’s stop pretending otherwise.

If the defenders of vaccination would admit the underlying problems with research studies, they could then turn a compassionate, concerned eye to the outliers, the patients who do not react to a procedure, a food, or a medicine in exactly the same way as the research subjects. The reasons for the problematical reactions with vaccinations might then be discovered so they could be addressed.

Sacrificing those who do not fit the “evidence-based” outcomes is no different than throwing the outliers to the lions. Whether it’s vaccinations or any other medical procedure or situation, those who have symptoms which do not fit the expected pattern will often receive no care at all, and have to put up with denigration by the medical community as well. Examples are everywhere.

It comes down to distrust of the underlying system.

Remedy parental distrust of vaccinations with responsible action. Address and remedy the individual risks of vaccination to those children who may not fit the pattern.

Address the cause of distrust rather than rant about the distrust.

 

 

 

dhaugen

Some young HR person once looked at my CV and asked me, quite seriously, if I had really done everything I had listed there. Well, yes. Because I am someone who can’t sit in a Morris Miller cubicle every day, much less for any great stretch of time. Once the problem is solved, I get bored and I’m ready to move on to the next challenge. This hasn’t afforded me any great stability in my work life. I simply arrive in places about ten years ahead of time. So far, at least, that penchant for early arrival hasn’t been accompanied with a pocketbook full of door knobs.

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