Paranoia kills. And the internet, which allows anyone to post any conspiracy theory without having to include minor things like facts, is a growing problem for doctors, because our patients who google sometimes end up at conspiracy theory sites for their medical information.

And this ignorance is one reason why Bachman is now no longer considered seriously as a presidential contender.

No, I didn’t see the debate where Bachman gave a crazy answer about HPV vaccine. I live in the Philippines, and am a Democrat.

I’m aware of the paranoia among the extreme Christian right about the vaccine: it was so bad that even Focus on the Family tried to counter the hysteria by pointing out that the shot is not a “say yes to sex” shot, and that even Christian girls who promise virginity might have sex, and even the strictest Christian girl could catch it if she married someone who might not have been pure and had been exposed to the virus, and reminded the parents that date rape does occur a lot more than people realize.

(There is some confusion about their stand and they’ve been misquoted by their enemies, but the fact is they support giving the vaccine to girls, even though they also support the parents’ right to make the decision on their minor children’s health care, including refusing the vaccine, which is another issue).

But the dirty little secret is that the real problem is not fundamentalist Republicans, but that new group: Green Parents who believe everything they read on the internet.

From NPR:

Doctors Counter Vaccine Fears In Pacific Northwest

a recent U.S. Centers for Disease Control and Prevention report flagged the poorest rates of kindergarten vaccination in relatively prosperous states, like Washington and Oregon.

Public health officials say they see this trend, which they call “vaccine hesitancy,” often among well-to-do, educated parents. Private Waldorf schools, for instance, often have unusually high percentages of families who get exemptions from state vaccination requirements. In Seattle, exemptions are also high at some public schools, especially those with an alternative bent.

Jorge Gutman sends his child to Seattle’s Thornton Creek Elementary, which last year reported a vaccine exemption rate of 18 percent. He says he’s done a lot of reading about vaccines, and he doesn’t like what he’s learned.

“We have this medical-industrial complex that is pushing vaccination,” Gutman says. “It’s an enormous amount of vaccines. And I don’t think it’s justified.”

Yes. It’s the “back to nature” types who hate big business.

But the dirty little secret on why capitalism does work is because, if it doesn’t work, they won’t make a profit, they don’t get paid. So they have a vested interest in making the best medicine money can buy. If they overdo it, well, that’s a different problem altogether.  (I do think the government is better making orphan drugs for rare diseases where the profit margin is low).

Sigh.

The good news is that those who try to live a green lifestyle are usually healthy: they eat locally, and eat organic food, not a lot of high fat high sugar junk foods. I am not actually against green living. It’s just that like every lifestyle, there is a paranoid fringe that exaggerates and influences the mainstream parents.

Is it the internet?

When I started blogging, I read how to get folks to your site. One way was to keep to one subject. A third way was to introduce controversy.

It’s easy to do a “ain’t it awful” story on anything to get readers. You simply have to cherry pick your facts, find the worst interpretation of them, and voila, instant controversy.

Never mind the truth. Never mind nuances. And when it comes to medicine, never mind the “cost benefit” ratio of medicines, where a small amount of side effects can scare people from using something that would save thousands of lives.

So the internet is full of conspiracy things that are backed by “experts” who aren’t really experts, and the real stories, such as fewer women dying of cervical cancer, or fewer kids with brain damage from Measles encephalitis, are alas often overlooked by the press.

So X medicine for arthritis causes heart attacks gets the headlines. (But the alternative does too, by counteracting that aspirin folks take). And what is the risk of heart attacks or kidney failure from the older arthritis medicine, or problems such as having a bleeding ulcer or liver damage? Is this risk of any medicine worth the the advantage of not hurting, and being able to live a normal life? What is the  risk of taking no medicine? Chronic pain not only can lead to a lot of people suffering but hurting results in no exercize, obesity and depression…Or should we just let them take narcotics instead (leading to the oxycontin overdose problem, when medicines are stolen or diverted for “recreational use”).

Yet just because drug companies make a profits doesn’t make them evil. They use their profits to investigate new medicines to cure more folks.And how many are making money from the hysteria?

Some probably profit, but most just get involved to save the world.

The feeling you are right and on a crusade is a wonderful feeling, be it a jihadi or being born again or crusading against GM food, so we don’t need money to explain the motivation, even if there was money behind the notorious MMR study that helped start the paranoid craze. (Some vaccine hesitancy is blamed on the 1998 British study that famously — and fraudulently — linked vaccines to autism.)

So how to counter the problem? Train docs working with these patients in “cross cultural” medicine, similar to how I was trained before working with Native Americans or as a missionary in Africa.

Train the docs on the culture, and train them to understand the questions and problems, and give them the facts to answer the parents clearly and calmly.

The states can help by making parents get an exemption from their doctors:

Washington state has changed its law; this school year, parents requesting exemptions have to get a note from a medical professional….

“I think the trick is really to listen,” he says. Even if parents come in with debunked information that the doctor’s heard before, he says, it’s important to hear them out. “I think one of the most important reasons to listen is for parents to have felt like they’ve been heard,” he says.

This is better than ignoring the problem.

Back in the 1970’s there was a lot of hysteria over the old pertussis vaccine (that actually caused a small number of children to become retarded). When this erupted in the UK, a lot of parents refused to get their children immunized: as a result, there was a huge epidemic of pertussis (whooping cough) and some deaths.

In the third world, it is worse. Every once in awhile you read of an iman who reads these rumors started on the internet, and forbids the local children from getting immunized. Voila, some end up dead, or in the case of polio, paralyzed.

In polio it is worse, since stopping the vaccine led to an “iatrogenic” outbreak of polio.

The oral vaccine can change back to the full blown virus in the child’s intestines. The child is rarely affected, but it can spread (via the fecal/finger/feces route, in places where water is not clean) to other kids who weren’t vaccinated during the time the iman was stopping the vaccine. Instant epidemic, probably not as many as would have caught the normal vaccine, but a real problem for the doctors trying to save lives.

And that is why your kids now get the shot for polio instead of the oral vaccine.

But in third world countries, the cost of clean syringes and trained people to give shots is a problem: it costs money that many poor countries don’t have to buy syringes and pay the salaries of trained medical folks to give the shots.

Sigh.

But the real problem behind the vaccine paranoia is cultural, not medical.

The real problem is that people in the US feel they are in complete charge of their own lives. And the problem is that they are not. Despite being the rich and educated and eating correctly and exercizing, people do get sick, and die, and sometimes this happens even to children. That is why there is so much anger and anxiety over the stories of kids harmed or killed by such vaccines: Because such things are not supposed to happen.

Never mind that without all the shots, such things would happen a lot more often. They don’t remember polio outbreaks, or measles encephalitis, or when we docs did a lot of spinal taps on kids with high fevers to check for pneumococcal or H.Influenza or meningococcal meningitis. And they probably don’t know about cervical cancer that killed their neighbor or relative either (few people talk about such things).

And few of them have worked in a third world hospital where kids do die of hepatitis, measles, typhoid, dengue fever,and tetanus, or simple diarrhea. That is why I  thank the Lord every for all those agnostic scientists and greedy drug companies whose medicines save thousands of lives every day.

————————————–

Nancy Reyes is a retired physician living in the rural Philippines. She cross posted an earlier version of this on her HeydocXangablog.

Be Sociable, Share!