Anti-anti-vax: Getting to the gist

I’m currently putting the finishing touches on a presentation for the The Ontario Public Health Convention next week, where I’ll be speaking, with occupational therapist Kim Hébert, about the anti-vaccine movement and social media (SM): how antivaccine advocates use it, and the challenges and opportunities for public health advocates. I’m pleased to see Seth Mnookin, author of The Panic Virus and someone whose work is likely known to many SBM readers, is one of the keynote speakers – his perspective will be valuable for the public health crowd which has traditionally relied on fairly static “key messages” for disseminating information on vaccine safety and effectiveness. The panel discussion of which I am a part will be an examination of challenges and opportunities presented to public health advocacy, and particularly vaccine advocacy, in a Web 2.o environment. What seems clear is that the old public health channels don’t cut it anymore: these methods are distant and insufficient to address the wide and rapid spread of misinformation in an era of social media. We all remember the anxiety over H1N1 just a few years ago – and judging by the poor uptake of the vaccine, it seemed the anti-vaccine movement had some success in propagating fear, uncertainty, and doubt. I’d almost forgotten about this chestnut from the Health Ranger himself:

In about two minutes, Mike neatly compiles most of the still-common anti-vaccine gambits in use. It’s not keyboard cat popular, but almost 200,000 views is likely greater than any pro-vaccine video produced. But is it effective? I looked to the medical literature for any current articles on the tactics of the antivaccine movement. In contrast to the wealth of information online, particularly here at SBM, there is a much smaller set of papers in print.  A friend of the blog covered one recent paper back in January, Anna Kata’s Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement. Kata neatly categorizes the disingenuous tactics and messaging used by the antivaccine movement. Tactics include:

  • Skewering the science of vaccine safety and efficacy, while trying to create legitimacy for unfounded or discredited theories of harm.
  • Shifting the hypotheses and the villain, from MMR, to thimerosal, to other “toxins”, and more recently, “too many, too soon”.
  • Censoring criticism, whether it’s at Age of Autism,, or other antivaccine sites that delete comments or restrict access to their events.
  • Attacking the opposition, whether it’s our own David Gorski or lawsuits against Paul Offit or Amy Wallace.

And then there are the tropes, known to SBM readers as they’ve all been covered in some form before:

  • “I’m not anti-vaccine, I’m pro-safe vaccine”
  • “Vaccines are toxic!”
  • “Vaccines should be 100% safe”
  • “You can’t prove vaccines are safe”
  • “Vaccines didn’t save us”
  • “Vaccines are unnatural”
  • “Choosing between diseases and vaccine injuries”
  • “Galileo was persecuted too”
  • “Science was wrong before”
  • “So many people can’t all be wrong”
  • “Skeptics believe…”
  • “You’re in the pocket of Big Pharma”
  • “I don’t believe in coincidences”
  • “I’m an expert on my own child”

I’m sure there are more than a few missing, as the spin continues despite the overwhelming evidence that vaccines, on balance, are safe and highly effective. Kata points out that the anti-vaccine movement has been around as long as there are vaccines: It exists despite the evidence, so no amount of evidence will ever cause it to disappear. She summarizes with a list of some potential solutions to arresting the propagation of this misinformation, noting the potential opportunities for social media campaigns to “immunize” against misinformation.

And that’s where a second article picks up, a  more detailed examination of “Web 2.0″ as the newest battlefield for both the antivaccine movement and for public health advocates. From Betsch et al, it’s entitled Opportunities and challenges of Web 2.0 for vaccination decisions and was published earlier this year in the journal Vaccine. The paper is a summary of a conference on vaccination decisions held in 2011. As someone who discusses vaccines directly with patients, but also via the interwebs, I found the paper discussed some of my personal questions about vaccine advocacy:

  • What is the most effective way for me, as a health professional, to identify and address antivaccine sentiment among my patients?
  • What is the most effective way I can use social media to present science-based information in a way that maximizes its usefulness to the largest audience?

The paper focuses on the impact of impact of Web 2.0, a term which may sound trivial to those who already contribute on a blog, as you’re already in a 2.0 environment. Briefly, any technology that facilitates user-to-user interaction can be thought of as Web 2.0. Social media (e.g., Facebook, Twitter, etc.) is any 2.0 technology that facilitates sharing, adapting, and crowd-sourcing material. Compared to the static websites of several years ago, most of the internet is now squarely 2.0. The key feature relevant to vaccines and web 2.0 is the ability to add a personal narrative to data. That is, users can adapt, promote, support and personally contextualize internet content easily now – sharing this article to your own Facebook feed, perhaps prefaced with your own comment on its merits, is one click away.

The emerging consequence of social media as it relates to vaccination decisions is the ability to attach a personal narrative to vaccine information.

Vaccination decisions

Betsch summarizes the considerations that go into vaccination decisions, which include recommendations from health professionals, social norms, previous experiences with, and beliefs about, vaccines, trusted individual and organizations, and related background knowledge. The key drivers of the decision are believed to be those that have an effect on risk perception – that is, the perceived risks and benefits of vaccinating, and also of not vaccinating. Both the frequency or likelihood of an event, and the severity of that event, may be considered.

And here’s where it gets interesting with Web 2.0.  As I’ve noted before, it takes only a few minutes of reading anti-vaccine information to shift perceptions of relative risk and benefit, and to lower vaccination intentions. And social media makes it that much easier – by effectively using the power of a simple narrative. And narrative is among the most potent tactics of the antivaccinationist.

The narrative

I take great pains as a health professional to give the proper context for my recommendations. If questioned about MMR vaccines and autism, I might provide a response like, “Numerous studies have demonstrated that there’s no relationship between the MMR vaccine and neurodevelopmental disorders”. While that may be accurate, it may not be most effective way to address the underlying uncertainty. The individual benefit of vaccination may be hard to see (though it’s easier when there are outbreaks to point to.) The harms, whether real (injection pain) or just attributed to vaccines, may be more tangible. The antivaccine response, while wrong, is far simpler: “MMR has been linked to autism. The vaccine is dangerous.” The ability to link a personal, emotional narrative to an antivaccine trope is facilitated by Web 2.0 technologies – it can personalize impersonal information. Emotional appeals can push the actual evidence into the background. The producers of the Greater Good movie used this approach to deliver their antivaccine message: Three narratives of harm attributed to vaccines, around which all of the antivaccine tropes described above were packaged and delivered.

Betsch points out how the narrative, or anecdote, is a powerful communication device. It’s easily understood, concrete, seemingly credible, and emotional. Whether or not they’re causally linked to the vaccine isn’t relevant – narratives increase the perception of harm and of the resultant risk of vaccination. While there have been some attempts to compile narratives of consequences of vaccine avoidance (What’s the Harm? comes to mind), on balance, negative personal narratives on vaccines seem far more prevalent.

The gist

So the challenge for public health advocates in a Web 2.0 environment is twofold: We must be accurate and effective. Accuracy may mean more complexity and nuance to our messaging. Plus we need to be able to rapidly respond to emerging concerns, ideally in a way that facilitates dissemination and sharing via social media to the same recipients of antivaccine messages.  And here’s where we come to the third paper, one which explores theories of risk perception and decision-making: fuzzy-trace theory. It’s examined in detail in a 2011 publication by Valerie Reyna, Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach. According to this theory, we integrate information in two distinct ways:

  1. Verbatim memories: the precise details of the facts
  2. Gist memories: the essential meaning of the facts

Based on this theory, gist memories are derived not from verbatim facts, but are developed in parallel with verbatim memories. Because they’re subjective, they incorporate existing biases and understandings.  Reyna argues that gist memories are relevant to reasoning and decision-making – and that gist is in fact preferred when exact answers are not required. Importantly, meaning is at the core of gist memories. She argues that traditional public health messaging, designed to warn and persuade, doesn’t provide the necessary meaning to support the development of a pro-vaccine gist. From this perspective, anti-vaccine messages can create strong gist memories: they provide meaning to adverse events related to vaccinations – even where no true relationship exists. The narrative is coherent, even if it’s not rational. Positive vaccine communication needs to do the same, appealing to values, such as how vaccinating protects those that cannot be vaccinated. Emotional resonance counts, too – messages can be resonant while remaining accurate and distilling risk perceptions in ways that support positive gist interpretations.


Social media has changed the way we share information on the internet, presenting challenges and opportunities to public health advocates. The ability to attach a personal narrative to vaccine communication has the potential to shift risk perception about vaccines. While research on best practices continues to evolve, it seems safe to conclude the following: Make the gist of your pro-vaccine message easy to extract, and make it memorable.


Betsch, C., Brewer, N., Brocard, P., Davies, P., Gaissmaier, W., Haase, N., Leask, J., Renkewitz, F., Renner, B., Reyna, V., Rossmann, C., Sachse, K., Schachinger, A., Siegrist, M., & Stryk, M. (2012). Opportunities and challenges of Web 2.0 for vaccination decisions Vaccine DOI: 10.1016/j.vaccine.2012.02.025

Kata, A. (2011). Anti-vaccine activists, Web 2.0, and the postmodern paradigm – An overview of tactics and tropes used online by the anti-vaccination movement Vaccine DOI: 10.1016/j.vaccine.2011.11.112

Reyna, V. (2011). Risk perception and communication in vaccination decisions: A fuzzy-trace theory approach Vaccine DOI: 10.1016/j.vaccine.2011.11.070

Posted in: Vaccines

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40 thoughts on “Anti-anti-vax: Getting to the gist

  1. wjhopper says:

    I spend a lot of time on Youtube having these discussions. Why? I don’t know. A few comments I’ve received in my latest exchange:

    “You actually want everybody to blindly believe that the CDC, FDA, WHO, etc., are there for the benefit of mankind?”
    “The reason vaxers always revert to statistics as a fallback, is because their junk science fails.”
    “The CDC simply cannot be trusted for reliable, unbiased, & truthful information”
    and my favourite, “You can get an infectious illnesses from anyone who has been recently vaccinated……deadly vaccinations kept the diseases going. The UNVACCINATED people catch the disease from the VACCINATED!!”

    I’m still awaiting a source for that last claim. I wont hold my breath. It honestly feels like banging your head against a brick wall.

  2. cervantes says:

    Alas, wjhopper, the last claim is in fact true in the case of the live virus polio vaccine. This is a big problem which has stymied efforts to eradicate polio. Unfortunately, the Salk virus, which does not have this disadvantage, is so far too expensive and difficult to administer in the remote areas where polio persists. Yet escaped virus from the Sabin vaccine is responsible for most of the polio outbreaks which occur today. It’s a perplexing paradox.

    However, you can tell people that this does not apply to any other vaccines, and that the Sabin vaccine is not currently used in the U.S. The bad news is that when the story is a little bit complicated, as in this case, it’s much harder to straighten out the thinking of the terminally confused.

  3. Lancelot Gobbo says:

    I sidestep much of the useless debate with anti-vaxers by reducing the decision to its simplest form – is it safer to have the vaccine, or to not have it? eg 1 in 10,000 get encephalitis? More than that will die from the disease it prevents. Safest course is to get it. Works nicely, and avoids rankling arguments with people I have to live with and treat for years to come.

  4. BKsea says:

    Great article. The key information in my mind that fails to be adequately communicated is the “social contract” aspect of vaccination. Most people think of vaccination only in terms of personal benefit. I think people would have fewer reservations if they understood that 1) choosing not to vaccinate is choosing to put other people at risk of death; 2) aggressive vaccination can eliminate a disease altogether (e.g. smallpox and almost polio); however, every individual who is not vaccinated puts future generations at risk by keeping the disease alive.

    I realize this argument is made often in places such as SBM, but I don’t think it is heard among most parents. I can envision being a parent on the fence about vaccination. If I took these social benefits into account, it would easily move me in the right direction.

  5. WilliamLawrenceUtridge says:

    I have to reference Mistakes were made (But not by me) as incredibly relevant to the discussion. Once you put a foot into the rabbit hole, once you dip a toe in, you very quickly fall all the way fall down to the bottom. Memory, as Tavris and Aronson say, is a self-justifying historian that makes it very easy to ignore contradictory information and events.

  6. Zetetic says:


    The “social contract” doesn’t play too well with a certain sector of the anti-vax group – Libertarians!

  7. DavidRLogan says:

    Compelling and interesting post! But why did you back away (or did you?) from negative narratives against anti-vaccine? You mentioned negative narratives FROM anti-vaccine are more prevalent. But even so…those narratives are (at present) more prevalent than what you suggest, also.


    Here’s why I think negative narratives work best in these cases. I take Reyna to mean the following. There’re framing effects in vaccine decisions. So, X weighs two considerations when contemplating vaccine:

    1) X is (at present) healthy without vaccine.

    2) If X gets vaccine, X will be healthy (like present) OR suffer vague circumstance Q.

    Framing considered, Reyna thinks, X will not take vaccine: option (2) appears to provide nothing over (1) except the possibility for Q, which-being connected to a “gist memory”-provides an irrational bias against vaccines (I take it this falls from the meaning of ‘gist memory’)

    That sounds OK. So you’re/Reyna’s saying a positive narrative will give X a third option (say, vaccine will confer benefits on others?) Call it (3). [also…there’s your own recommendation regarding the evidence…essentially denying the possibility for Q]

    But won’t X STILL prefer (1) to (2) or (3)? I don’t find the empirical claim presented for why X prefers (1) very plausible. I tend to think we’re hardwired to avoid worst case scenarios regardless of how irrational or what positives we lose (I thinking of eg the work of Kahneman and Tversky).


    So I think maybe a better strategy is to make (1) seem as bad as possible (you suggested this, I thought, but then backed off). This might work better than a positive narrative…assuming I’ve understood the relevant arguments. (or at least mudslinging the anti-vaccine crowd prominently should be an ADJUNCT to the positive narrative).

    Of course, this is only a minor point (and I don’t think you were saying focus entirely on positive narratives anyway). But I think it’s at the heart of the issue. Almost all the negative narratives are on the other side. We’ve been denying the credibility of those narratives vs. creating a negative of our own. What do yall think?

    Thanks again for the thoughtful post.

  8. Linda Rosa says:

    Those working to counter the propaganda of the anti-fluoridationists would like to put together a group of “first responders” (recruited from skeptics groups?) who will take a bit of time everyday, over their morning coffee, to look for online stories about fluoridation and interject a positive message about the value of community water fluoridation amongst the antis’ messages. Perhaps forming a similar team of volunteers would good idea to help counter anti-vaxer messages.

  9. Earthman says:

    What an awful ‘song’ from the Health ranger. I managed to get 29 seconds into it before hitting the stop button. But then I find all rap to be torture to the ears, and the entire genre should be thrown into Room 101.

  10. lizditz says:

    Linda, you probably won’t be surprised to hear that there’s a loosely knit group of pro-science, pro-vaccine commenters who do what you propose, including calling each other in for reinforcement.

  11. David Gorski says:

    I’d almost forgotten about this chestnut from the Health Ranger himself:

    You forgot an even bigger “chestnut” from the Health Ranger himself. :-) It’s an animated video called Vaccine Zombie:

    Sample lyrics:

    When I took the shot then my face turned blue
    I started feelin’ hot inside but I didn’t have a clue what to do
    My temperature was hundred and two
    Then my nut sack shriveled up and fell off too

    The nurse screamed and said something was missin’
    she called the physician who said he had a suspicion
    that the vaccine caused a neurological condition
    and soon I would see the mortician

    They started cuttin’ out my brain happy as can be
    Bunch of undead doctors from the CDC
    I finally figured out what happened to me
    When they said we got another vaccine zombie!

    Step one: Remove your brain
    Step two: Replace with zombie vaccines
    Step three: Watch television for further instructions from the Centers for Zombie Control

    Truly, the loony is strong in this one.

  12. David Gorski says:

    For those not aware, Liz Ditz and her posse perform a valuable service, scouring stories on (mostly) vaccines and countering the horde of antivaccine trolls that inevitably descend. It’s a hard, thankless task that takes a lot of time. I used to try to do that, but I can’t maintain my blogging output and do that at the same time. Countering the antivaccine hordes in comments just takes up too much time. I can do one or the other but not both, and I think my “talents” (such as they are) are better used blogging.

  13. lizditz says:

    It was fearless commenter Chris who got me started on the commenting gig, to the detriment of my own blogging. Lilady, frequent commenter at RI, is indefatigable at HuffPo (a cesspit I often avoid). There are others.

  14. Linda Rosa says:

    Liz – Wonderful! Glad to hear it.

  15. papertrail says:

    I do the same thing (post replies to anti-vax arguments) on comment threads and forums, usually anonymously. It is very time-consuming but I like to believe I’m doing some good. At least it forces me to look deeply at the issues, if nothing else. I don’t have too many delusions of changing the mind of the antivaxers who continue to post the same arguments over and over no matter how rational the replies, but for readers/parents who might be on the fence.

    I have friends who don’t vaccinate, or do it selectively (thanks for nothing, Dr. Sears, and authority figures who parrot his misinformation), and find it much harder to confront them directly, but I have done it. Doesn’t seem to do a bit of good.

    Oh wait, now I remember a mom revealing to me that I helped her make the decision to vaccinate her new baby; she was on the fence. Cool. I forgot about that. Hmm, we might be having more of positive influence than we realize. That mom was in a position to bring vaccination facts to the public eye, which she then did.

    Still, too many communities are vulnerable and it seems to be getting worse.

    Keep up the good work, SBM and the like-minded posters here who speak out against anti-vax propaganda in their own way – including myself ;-)

    Good article, Scott!

  16. EricG says:

    anyone ever watched the youtube channels “theramin trees” or “qualia soup?”

    should contract one of those guys to do a vaccine video. they each have a tremendous ability to mix flash animation, narration and information into compelling arguments.

  17. MerColOzcopy says:

    I wasn’t anxious over H1N1, nor do I remember anyone who was. You guys worry way too much whether or not people get vaccinated. People have the right to choose.

    What is the position here, SBM advocates the population get any and all vaccines available?

  18. Harriet Hall says:

    I advocate that people get full, accurate information about vaccines showing that the risks of not vaccinating greatly outweigh the risks of vaccinating. I hope that once they understand the facts, they will choose to vaccinate. If they unwisely choose not to, I wouldn’t support forcible vaccination, but I would support consequences (for example, like paying more for insurance). People have the right to choose, but they don’t have the right to endanger others with their choices or to burden others with avoidable costs arising from their poor decisions.

  19. Chris says:


    People have the right to choose.

    Even children? Do children get to choose whether or not to spend two weeks with itchy open wounds with chicken pox, or mostly avoid it with to simple shots?

  20. MerColOzcopy says:

    I guess I don’t fully understand how vaccines work. Perhaps simplistically, you get the shot you live…I don’t, I die. How does that endanger you? How about the actions of those that necessitate the need for a vaccine, what do you suggest there?

  21. Harriet Hall says:


    “How does that endanger you?” By reducing herd immunity and allowing the disease to spread through the community, thereby putting at risk (1) some of those who have been vaccinated (since vaccines are not 100% effective), (2) those who are too young to have received the vaccine, and (3) those who can’t be vaccinated because of medical issues, and (4) those who are immunocompromised.

    “How about the actions of those that necessitate the need for a vaccine, what do you suggest there?”
    I don’t understand. What do you mean by actions that would “necessitate the need for a vaccine”?

  22. Th1Th2 says:


    It’s a perplexing paradox.

    It’s not a perplexing paradox, infection promoter.

  23. pmoran says:

    I wasn’t anxious over H1N1, nor do I remember anyone who was. You guys worry way too much whether or not people get vaccinated. People have the right to choose.

    Before that we have the right to full and accurate information, and it seems that something is going wrong in that regard.

    I wonder if we vaccine proponents are so distracted by the extremist, ridiculous notions concerning vaccinations that we may fail to adequately deal with less unreasonable concerns. People are known to be very risk averse when it comes to actively exposing themselves to immediate risk, especially where there is no clear or certain personal gain to be had later (more so with a precious child).

    It is also not a stretch for them to suspect that the medical profession is prepared to accept significant risks to some individuals in pursuit of valid public health objectives.

    So it is all about trust (again). We need to be honest about the tiny risks that do exist. We need to allow where there is uncertainty. We should not be overly dismissive of public concerns. Find out precisely what they are and deal with them honelty and directly.

    One aspect that perhaps gets overlooked is the serious lifetime risk to anyone who grows up without immunity to common childhood epidemic illnesses. While those illnesses can be serious for some children, they are many times worse in adults, with a much higher risk of death, and of complications ranging from infertility to cerebral damage. So while those illnesses continue to exist anywhere in the world, such a person is a mere plane flight away from serious threat for the rest of their lives.

  24. MerColOzcopy says:

    Thank you for the informative respectful reply. To me anyway, one of the most disheartening aspects of this issue is that extremists on either ends are often medical professionals. How is it that the same science based education in the medical profession can lead to this dissension?

    On the news tonight 1 in 88 are now being diagnosed with Autism. Relax!!!!!! How ironic would it be that cure for Autism is a vaccine. Thus, hypothetically the cause of some actions resulting in the need for a vaccine.

  25. Scott says:

    Medical professionals OVERWHELMINGLY support vaccination. (I am aware of no pro-vaccination “extremists” – the use of that term seems to be a counterfactual attempt to imply that both positions are equally reasonable.) There are a few fools who apparently didn’t learn much in medical school. There will always be such fools.

  26. therling says:

    What I find interesting is the overlap of the anti-vaccination crowd and the HIV denialist group; they seem to share the same paranoid conspiracy tropes. Note the commentators for this posting:

    Kudos to liditz for wading into that mess.

  27. DW says:

    “such a person is a mere plane flight away from serious threat for the rest of their lives.”

    And then, on debarking from the return flight, passing that threat along to susceptible people back home.

  28. DW says:

    “It is also not a stretch for them to suspect that the medical profession is prepared to accept significant risks to some individuals in pursuit of valid public health objectives.”

    Why would this be something to hide or apologize for? These goofy people have to have it explained to them that we’re all going to die, we’re all susceptible to disease, that treatment has “significant risks” sometimes – after all, we’re talking about treating DISEASE – and that public health is always about managing risks, balancing risks to individuals with the good of greater numbers etc. ? It’s like these people haven’t outgrown childhood. They want medicine to be magic. Make it all better. When they’re told it’s not magic, and that some people are going to die anyway, they’re mad and decide that actually doctors are out to get them.

  29. windriven says:


    “The “social contract” doesn’t play too well with a certain sector of the anti-vax group – Libertarians!”

    Hmmm, why do you believe that? I’m quite sure that one can find libertarians who are anti-vax but those of my acquaintance take their social responsibilities quite seriously. Libertarians such as Charles Murray would argue, I think, that liberties can only exist where the concomitant responsibilities are scrupulously followed. That is IMO what renders libertarianism an interesting political theory and an impractical political reality.

  30. MerColOzcopy says:

    Does the SBM community advocate getting all vaccinations that are available today?

  31. Scott says:

    No. Nobody does.

  32. Chris says:

    I have had vaccines for typhus, typhoid and smallpox (lived a good chunk of my youth in the tropics). Even though those vaccines are still available none my children have had them.

  33. Chris says:

    Oh, and I have also been vaccinated for yellow fever. I forgot to put that in the list.

  34. David Gorski says:

    In case anyone’s aware, Dean Esmay is an HIV/AIDS denialist and quite sympathetic to the woo:

    This explains why Celia Farber is a regular (indeed, frequent) commenter on his blog.

    Dean’s also not very fond of peer review, either:

    So it’s not too surprising that he’s “confused” by the exoneration of Walker-Smith.

    Since Dean really, really hates Orac, maybe someone could post my little explanation of the situation that I wrote a couple of weeks ago:


  35. Zetetic says:


    Re: Libertarians

    I guess I’ve mostly encountered a different group of perhaps self styled “Libertarians” with the sliding scale of liberties versus responsibilities considerably skewed to the liberty side. They aren’t about to let any authority or ideation of a social contract dictate to them what they should do – like get their children vaccinated.

  36. windriven says:


    “They aren’t about to let any authority or ideation of a social contract dictate to them what they should do – like get their children vaccinated”

    Yow. I thought it was only the mother earth types not wanting to pollute the precious bodily fluids of their ill-mannered spawn. But it doesn’t surprise me that those who confuse liberty with license would style themselves libertarians.

  37. aeauooo says:


    “Does the SBM community advocate getting all vaccinations that are available today?”

    I won’t presume to speak for the entire SBM community, but as a public health professional, I advocate the receipt of vaccines that are indicated for the individual.

    Chris mentioned yellow fever (YF) vaccine. YF is no longer endemic in the U.S., so most people who never leave this country shouldn’t need a YF vaccine (let’s hope). BCG is generally not recommended for U.S. residents either.

    Before my trips to Africa, I have received YF, typhoid, meningococcal, cholera (no longer available in the U.S. and no longer required for travel), and rabies vaccines. I was even offered a plague vaccine 25 years ago (no longer available in the U.S.).

    Having never travelled to Asia, I have not received the Japanese encephalitis (JE) vaccine. I’m not old enough to receive the shingles vaccine and I’m too old to received either rotavirus or HPV vaccines.

    I have a smallpox vaccine scar. My wife, who is 14 years younger than me, does not. She was born when receipt of smallpox vaccine was no longer indicated for most U.S. residents.

    So no, I doubt that the SBM community at large recommends getting all of the available vaccines.

  38. Alia says:

    I’m also trying to do some good job in my home country – fortunately, anti-vax movement is not so strong here and the main problem is that not all vaccines are covered by insurance – so for example I have to pay quite a lot for my HBV booster shots. But I managed to convince a friend of mine who was a bit afraid to vaccinate his baby daughter.

    My mother lost her two small sisters because of one the childhood diseases that are now almost extinct due to vaccination. She became a nurse, vaccinated me and my sister with every recommended vaccine and is really appaled by the anti-vax movement.

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