Collateral Damage

A recent Instagram post by a pediatrician showed that the damage caused by the anti-vaccine movement isn’t limited to outbreaks of preventable infections.

Recently, a pediatrician named Megan Prior posted a three-minute video on Instagram expressing her frustration:

“I just got out of clinic and I’m tired. I need to vent. I don’t want to come across like I am whining because I realize that I am lucky to be a pediatrician. But being a pediatrician has changed. My job feels different.”

Dr. Prior recalled a time when it wasn’t so hard to explain the value of vaccines.

“I spend so much more time counseling people on vaccines than I have done in the past. Ten years ago, I would tell people you’re getting standard vaccines today. Then I would give them handouts with the names of the vaccines, what diseases they cover, and side effects. Parents would review the handouts and that was that. Occasionally people would ask me an extra question or two or they’d google something, but it went well. It was easy.”

Now, with the onslaught of confusing, misleading, and often frightening information about vaccines on social media, appointments have gotten longer and harder. The handouts she had given in the past are no longer adequate.

“Now it feels like I must go into this long-winded discussion almost every visit. Parents want to know what exactly they are getting vaccinated for, what do those diseases do, what are the side effects of each vaccine, what types of vaccines are being given, and what are the additives. I can answer those questions, [but it takes much longer].”

She offers a specific example.

“There’s a vaccine we give at 2, 4, and 6 months called Vaxelis. When a parent asks me what is contained within Vaxelis, I say it vaccinates against the Haemophilus influenzae bacteria; it also vaccinates against hepatitis B, also DTaP which is diphtheria, tetanus and pertussis, and against polio. That sentence alone, and explaining what all those different diseases do, takes me a really long time. I explain that the pneumonia vaccine is made from a piece of sugar coating of the bacteria that gets hooked onto a protein that stimulates your immune system. I don’t even know if parents get what I’m talking about. It is so incredibly challenging to condense this really complicated topic into short visits.”

Dr. Prior wonders whether her explanations about vaccines make a difference.

“I’m not mad at these families for asking questions. I’m mad at the people whispering in their ears, ‘Don’t trust vaccines,’ ‘Ask about the ingredients,’ ‘Do your own research.’ Imagine if you were boarding a plane and some passenger went into the cockpit and said ‘Hey, before we take off, I’m going to need you to explain to me what every single button on this plane does.’ And the pilot could do that, but it will make everybody else late to takeoff. And I’m not really sure that it changes what’s going to happen.”

In the end, Dr. Prior worries that she is not serving her patients or families as well as she did in the past.

“The visits take longer. Then I’m running late and the families are mad that I’m late. I get out of clinic late and I spend less time with my family.”

Because much of the routine visit is now devoted to talking about vaccines, the pediatrician doesn’t have as much time to offer the anticipatory guidance that, depending on the age of the child, includes advice on feeding, development, mental health, exercise, oral health, gun safety, and injury prevention, among others. All in the name of trying to quell fears raised by vaccine misinformation that has made parents more fearful and, given the increase in vaccine refusals, children less healthy.