On 22 September 2016 at 13:21, Ben Johnson <[log in to unmask]> wrote:

Sorry to be repeating, but...

Pam's response was long enough to put off a busy reader, and if that includes you please take a minute to read it through (below). Preferably to the sound of a nail being struck squarely on the head.

Ben Johnson
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Disclaimer: The author of this email never meant a word of it.
do you really need to print this email?

From: psci-com: on public engagement with science [mailto:[log in to unmask]UK] On Behalf Of Pamela Buchan
Sent: 22 September 2016 12:35
To: [log in to unmask]
Subject: Re: [PSCI-COM] Vaccines

Hi Sara,
I have come across this many times as a parent and had deep discussions with anti-vaxxers. It is an interesting subject indeed. Coming from my more inter-disciplinary perspective (science-society) than the research behind vaccines I am personally somewhat more open about the debate than I find most scientists to be, though I do have my red lines (e.g. MMR does not cause autism, Wakefield was a deceitful man out for personal gain, not a martyr).
From a medical perspective every vaccine carries a risk of encephalitis, allergic reaction and suchlike which will be greater or lesser for individuals and an unknown in most cases. The risk is of course both quantified and low but not absent. How that data is interpreted by decision-making parents is going to depend on their own individual perceptions of risk informed by data sheets, probably whale.to or natural news (ugh), conversations with others, and their 'instincts'. The majority of anti-vaxxers in my experience are mothers informed primarily by a lack of trust in medical practice in general (often warranted given most women's birth experiences) and by peer conversation. Their references don't extend beyond readily available online propaganda or texts. I have known a couple who have taken up my scientific challenge and provided research papers. These have been interesting too. In the large part they have been open access, written in some obscure journal, and authored by either people who have not got as far as a doctorate or if they have it is usually in an unrelated field (IT in one case). There have been one or two studies that seemed more legit, I'll return to that in a mo. These people STILL seem to believe Wakefield has been scapegoated - the cognitive dissonance runs high. There is such a lack of trust that I struggle to believe any amount of quality scientific evidence would reach them, but of course poor quality and pseudo-science reinforces their beliefs. (Parallels with most of our current political issues.)
So, of the papers that seemed reputable (sorry, no refs as it was an age ago) I recall one from a large study in Europe that seemed to indicate that metabolic conditions likely to occur did seem to show earlier onset in those vaccinated with (I think) DTaP. It was a large sample. The problem I found was the interpretation of the research. Vaccinations may trigger earlier onset of autoimmune diseases was interpretated as vaccines cause autoimmune diseases. I have not looked further into this since it was a couple of years ago but could be worth looking up to see if it has been replicated/rejected.
A second, arguably legitimate concern, is of differing effectiveness of each vaccination and the lumping of vaccines as either good or bad. For example, whooping cough seems to be a not very good vaccine (I think this was a second reasonable looking paper) whereas MMR seems to be very effective, flu of course can be hit or miss and people don't tend to understand the epidemiology that goes into choosing the strains each year. Taking stock positions on either side without considering vaccinations individually is I think both scientifically coarse and problematic when seeking trust from parents.
I also think there is a lack of nuance about individual factors in relation to vaccines. Personal e.g. When my son was three and vomiting daily from phlegm and asthma was being talked about, I got him the H1N1 flu shot that year. He is now seven and grown out of all that and never ill so I won't be getting him the flu shot this year.
A final thought on the conversations had around this. I think there is a tendancy in science to be yay vaccines, why aren't you getting them all for your children you science deniers?! Which I find very unhelpful. Lots of concerns I think could be ironed out with a more tender approach and open discussion between professionals and parents about individual circumstances and respect for choice should parents not want to have certain vaccines. I know quite a few vaccine sceptical parents who have in the end gone for it on a delayed programme in their babies. I am also not in favour of enforced medication of anyone so the model of banning children from public education if they aren't fully vaccinated, found in some states, is not a good thing in my opinion.
I suppose a summary of my thoughts is that I'm in favour of a more nuanced and individualised approach to vaccination. But obviously time and money is required for staff to do that...
I like your proposition below, that sounds like a very sensible way forward.
Pam

On 22/09/2016 11:44, Sara Santos wrote:
I'm grateful for your replies. I am also receiving private messages.
So far I pushed a few people to give me references. I divide the group into three so far: those that distrust official bodies and figures; those that have direct experience of side effects; those that are unsettled by vaccine compensation schemes in the US. It is the last two that I feel have been failed by public understanding of science and perhaps by lack of testing against individual intolerance.
Ultimately I would like to be able to get people to stop campaigning against vaccines and instead feel they can fight for solutions for the groups of people that may be at risk through vaccination.
Keep your messages coming.
I'll respond to the last three emails later when I'm not pushing the pram :)
Cheers
Sara
Dr Sara Santos, Director and Owner
www.mathsbusking.com
@MathsBusking
Mathematics as Street Performance, since 2010
tel: 078 430 21 209
'Maths Busking' is a trading name for 'Sara Santos Productions Limited', registered company 9378618

On 22 Sep 2016 09:55, "Lizzie Ellis" <[log in to unmask]> wrote:
Hi Sara,

If you're also looking for any statistics then our team at NHS Digital have just published the latest annual figures on uptake of childhood immunisations within England for 2015-16:
http://www.digital.nhs.uk/catalogue/PUB21651

We receive the data from Public Health England. And there is more general information about the immunisations process in England here:
https://www.gov.uk/government/collections/immunisation

Hope that helps!

Thanks,
Lizzie

Lizzie Ellis
Information Analyst
Screening and Immunisations
NHS Digital
www.digital.nhs.uk
@NHSDigital

NHS Digital is the new trading name for the Health and Social Care Information Centre (HSCIC).
We provide ‘Information and Technology for better health and care’.
Find out more about our role and remit at www.digital.nhs.uk

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