Monday, June 02, 2014


I have long suspected that much of the objection to vaccinations stems from a dislike of needles (and "chemicals," see below).  I am not trying to say that people who object to vaccinations are merely afraid of shots because they hated getting them as kids.

But it's moderately close to that.  About halfway there. As that is a bit insulting, I should provide more evidence than mere impression.

I have two other streams of data that are not available to most people.  I have not been methodical about gathering it, but they're there and you should know about them.

First, many psychiatric medications come in long-acting injectable forms. It is very hard to talk people into taking those.  It is not the case that there are more side effects when delivered in this form.  In fact for most of them, smaller doses can be prescribed, reducing the side-effects.  There is a confounding factor with the mentally ill that they often don't want to take these medicines at all, and hope to cheek them or otherwise avoid them.  Many don't believe they need them, so why lock oneself in to a medicine coursing through the blood that cannot be removed?  Yet even subtracting those out, and including the pressure that providers and families put on people to accept the biweekly or monthly shot, there is simply a lot of refusal to switch from oral to injectable medication.  I have heard from nurses that the same applies for Depo Provera, but I don't have any numbers on that.  The impressions of nurses are not infallible, but neither are they chopped liver.  Weigh that as you will.

Second, because of the questions at the Red Cross blood center about recent vaccines, I am always reminded to ask that day's nurse about my pet theory: Do people who refuse vaccines give blood?  No one has any numbers, but the question always intrigues them.  They note that none of the refusers they know are also blood donors.  That may seem a small sample size, but people who don't like vaccines seem to be eager to tell nurses about this a lot. Nor, when discussing the question about recent vaccines, do they ever encounter people who say "Oh I never get vaccines." This data source has pretty much dried up now, as the questions are answered privately on computer.

I'm betting that people who don't vaccinate their kids don't give blood, either.  It's unnatural.

People sometimes don't get the flu shot because they forget, or are too busy, or otherwise miss it for reasons of "soft avoidance." As they seldom get influenza, they are generally rewarded in this. Less bother, no change in health outcome.  We also all encounter people who announce every year "I never get the flu shot, and I never get the flu.  The only time I got sick was the year I got the shot." Which is crap, but how can you prove their evidence wrong?  But these folks likely have some effect on the soft avoiders. The best one can do is to point out that you don't get into an accident every time you don't wear your seat belt either.  In fact, some people go their whole lives unbuckled and uninjured.  But that doesn't mean that fastening your seatbelt is a bad idea.  Because when you need it, you really need it.

I note that people who do not get their children vaccinated are invariably people who prefer what they call "natural" treatments and medicines. That is only partly so for those who don't get flu shots.  Those certainly tend that way, but I have encountered some who are not especial granolas who nonetheless have talked themselves into not getting flu shots. I will spare you the lengthy scientific discourse about the history of medicine except to note that 99% of the plants and animals around you are inedible, and often poisonous. People who live in safe areas that have not had epidemics tend to believe that it's all largely controllable if we just take care of ourselves.  They read only selected history and science.

"Natural solutions are always better," read one of the facebook comments in my feed.  Such comments are delivered with the authority of philosophical, even religious advice.  Christians who say such things include a belief in naturalness in their theology, in fact.  They prefer to believe that God has provided everything naturally, if we would just cleverly use it and trust in Him and not vainly pursue solutions of man's devising. There is nothing in scripture to even remotely suggest this, they just like that sort of god better.  That's the way the world should be, therefore it is that way. It's a variation on some German heresies of the 18th & 19th C's. People combine it with any religion now, or have it as a religion to itself.

It would be a charming eccentricity - and in fact the individuals are often charming eccentrics - if it weren't for the dead children.

Putting a needle under your skin is unnatural.  I get it.  It's not in the Bible, it's not in Gram's list of home remedies (and she lived to be 99, so those millions of folks who died of the Spanish Flu must have...oh, forget it; they've never really thought about epidemics), it's got chemicals in it that you can't find in Nature (that is, God's World), or those much wiser Native or Eastern folks. Not to mention those corporations that are getting rich lying to you, so stay away from that. And it hurts, and kids cry, which parents of young children spend a lot of energy avoiding, and they don't like the feeling that I let them hurt my child, who will be traumatised and hate me at some level.  I want her to think mommy's presence is a safe, gentle place.

Even the idea of spacing the vaccinations out derives from this idea that if it's a shot, then it must be very risky, and hard on your child's tiny body, which must be given some sort of rest before it can be put through the ordeal or another shot.

Here's my contention: Vaccination avoidance stems from needles and chemicals, and the associations we have of such things as unnatural, painful, and unholy.  All the other arguments are post hoc.


Texan99 said...

I have some crazy attitudes about vaccinations, not all of which I act on, and most of which I can't explain at all, so here they are, for purposes of your research.

I don't believe for an instant that anyone should forgo vaccinations for dangerous diseases like polio. Well, maybe polio's a bad example; isn't that vaccine oral? Anyway, I don't avoid all vaccines for fear of autism or any of that kind of thing. I keep my vaccinations for tetanus and whooping cough current. If I were traveling to Africa or the like, I'd certainly get vaccinated for yellow fever or whatever is being recommended these days. When I was a kid, everyone just assumed they'd get measles and chicken pox and get over them, but if I had kids now, I might well opt for those vaccines. I came down with shingles earlier this year, and probably will get the shingles vaccine as soon as the doctor says it's OK. I believe in herd immunity and the responsibility to do one's part in fostering it.

At the same time, for reasons I cannot explain, I never have gotten a flu vaccine. It's true that, from what I read, the flu vaccines are notoriously unreliable, because the virus changes so often and manufacturers have to make a wild guess what it will look like in six months or so. It's also true that coming down with the flu is not the unthinkable risk that, say, smallpox is. But I'm not sure that I reject flu vaccines for rational cost-benefit reasons.

It's partly a conservative attitude toward medicine that leads me to minimize the care I accept, whether it's pills or shots or diagnostic procedures or elective surgery. It may be an aversion to injections, but then I opt for antibiotic injections without qualms if I think they'll cure an infection faster than pills. Yeah, it hurts a bit, and yeah, I truly hated needles as a kid, but it's not a big deal--consciously. I give blood without the slightest hesitation; the minor pain is about the same, and utterly inconsequential. It can't be only about the needle. (A difference between injecting and withdrawing?)

So why don't I get a flu shot? I honestly don't know. There's some atavistic reluctance I can't explain. Could it be an irrational reaction to a friend's Guillain-Barre syndrome some years ago after a flu shot? Maybe. Something else buried in my psyche I can't quite get to? Maybe. It's a mild phobia that I'm not very motivated to overcome. I think I've had the flu once or twice, but never the true I-wish-I-were-dead variety.

Donna B. said...

I think the chemical fear you speak of is the major factor. Or the fear of needles is due to something other than pain.

While I know very few women who have opted for drug-free childbirth, every single one I do know is also against some aspect of vaccination. They are into all things "natural". Fear of pain is not their problem. I would bet they'd submit to some of those "unnatural" substances being injected into their bodies if they had appendicitis or kidney stones. It's much harder to rationalize that kind of pain when you don't get a cute baby after it's all over.

I think there's another fear unrelated to needles or chemicals that comes into play with Depo Provera: losing control. That's because that would be my objection.

Now, if I knew that it was physically unhealthy for me to ever become pregnant, I'd consider the shot, but it's still a matter of control. I'd want to make darn sure it didn't happen. But if I thought I might want to become pregnant in the next year or so, I'd avoid the shot.

If you subtract out the psychiatric patients who don't want the medications at all and those who don't think they need them, then aren't you left with those who are at least somewhat compliant about taking their pills? Perhaps for at least some of those, it's symbolic of having or gaining some control over themselves.

Assistant Village Idiot said...

Fair points, both.

Laura said...

A little late on this but... what about the nasal spray version of the flu vaccine? Do you know of anyone who won't take the shot, but who will take the nasal spray? I personally don't know of any, which makes me think the driving factor is chemicals, not needles.

In interest of full disclosure: I can't take the nasal spray, due to asthma. I do get the flu shot religiously every year, as soon as physically possible. But that's because I did get the "true" flu (positive snot test) when I was pregnant with my first daughter-- got a fever of 104, heart palpitations, and then had the baby prematurely. We both were OK in the end, but it could easily have been really, really bad.

I got it from a guy at work. He was back from a trip and was behind on his project. He said he'd just push through being sick. Jerk. He got four of the seven of us sick, one other person sick enough to end up at the ER. (Wouldn't have mattered if he had got the shot-- that year an unexpected strain caused about 30% of the disease, and since I was tested we know it was that one. But no, he "hadn't gotten around to it.")


(It's all natural!)

Leonardo said...

What an in-depth piece of research you did there. I commend you for it. I personally am very scared of needles, yet I am even more scared about having to miss out on work and potentially lose my job. For that very reason, both me and my son to get the flu shot every year. Thanks for sharing this!

Leonardo @ U.S. Healthworks Medical Group