"Let's shame them!": part and parcel of the dangerous seat-of-the-pants, evidence-free style of risk communication we are using to protect universal vaccination in US
A thoughtful correspondent asked me what I thought of proposals to "shame" parents who don't vaccinate their children. I'm against doing that. Actually, I'm not opposed to "shaming" when it makes sense; but I am opposed to doing anything in public policy that disregards the best evidence we have on the challenges we face and the best strategies for combatting them. Here is what I had to say about why shaming parents who don't vaccinate should be viewed as falling into that category:
I myself don't see any value in shaming here.
The conflict-entrepreneur, anti-vax organizers deserve ridicule and are awful people etc. But denouncing or shaming them actually only gives them exactly what they want -- more attention, which in turn does make more members of the public agitated and confused.
This is known as the “rope-a-dope” strategy. Many vaccine advocates are falling for it big time and are doing more harm than good by falsely overstating the impact of the small fringe of society that is anti-vaccine.
In addition, shaming individual parents risks chilling anxious individuals who aren't militant or political but just confused from trying to get answers to their questions from their drs or neighbors etc.
No one could think that’s good for public health. Thoughtful and reflective people can actually help those parents see that vaccination makes sense for their kids and for society as a whole--but only if those parents seek out their counsel.
Finally, shaming risks undermining the social norms most worthy of protection here.
One is the general confidence that parents indisputably have (as manifested in maintenance of the public-health goal of 90%+ vaccination rates for over a decade) in vaccine safety. The main source of information that people use to assess risk is the attitude of other ordinary people as evinced by their behavior.
What we definitely don't want, then, is to give people a false impression that fear of and resistance to vaccines are widespread or growing. The incessantly repeated, demonstrably false assertion that vaccination rates are falling & exemptions rising in the US does exactly that: it causes people to misperceive how much confidence US parents have in vaccination -- to misperceive how high our vaccination rates are & have been for well over a decade.
The other is reciprocal cooperation. People contribute to public goods when they perceive others are -- but don't when they perceive others aren't, in which case contributing makes one feel like a sucker. Herd immunity is a public good. In fact, studies show that giving people the impression that others are refusing to vaccinate diminishes their own intention to vaccinate.
I'd worry that the spectacle of orchestrated shaming -- b/c the premise for it is falling vaccine rates, etc. -- could reinforce these norm-eroding effects.
Instead, we should want parents and the public generally to know, as Moms Who Vax wisely emphasize, that “the vast, vast majority of” parents do recognize that vaccines are critical for their kids welfare.
Those parents have better things to do than march around asserting the obvious, so it is easy to lose the benefit that their behavior and confidence can contribute to the norms that promote universal vaccination.
Let's follow the lead of MWX and and raise the profile of the behavior and attitude of those ordinary parents.
We should also take the money and attention that would otherwise be devoted to pointless and likely self-defeating shaming campaigns (ones coordinated by commercial marketing firms poised to carry out this questionable strategy) and direct it to research into developing screening instruments that can help identify vaccine-hesitant parents and targeted risk counseling for them.
The scientists doing this research aren't nearly as loud, nearly as self-promoting, as the advocates who are overstating anxiety about vaccines and the need for unresponsive policies like "shaming campaigns."
So like MWV, we should be trying to remedy this inattention by hearalding what these researchers are up to, and helping those dedicated to perfecting our universal vaccination regime to make sure that these researchers are adequately supported in their efforts.