A recent episode of the PBS program Frontline was called "The War on Vaccines." The title alone should have been the tip off that the producers' goal was to inflame and incite – to assume this was an entirely adversarial discussion between diametrically opposed viewpoints. But I knew that my colleague Jennifer Margulis, Contributing Editor at Mothering where I am Politics Editor, was interviewed on the program so I felt obligated to watch. I knew also the show would feature pro-vaccine zealot Paul Offit – as famous for his vehement opposition to all questioning of vaccines as he is for the money he takes from vaccine manufacturers.
Imagine I insert an ominous voiceover here. In case you don't have time to watch the entire Frontline report, I can give you a feel for the experience. For all fifty minutes, you are constantly reminded the discussion – oh, just suspend your disbelief and accept there is a discussion – is life or death for every child. Make sure you are really worked up about dying toddlers because the Frontline producers want to make sure you have an opinion about vaccines at the end of the show that is linked to the images you see on the screen and hear in the voiceover. We are moved and motivated by the sights and sounds in film. Having worked in television production I know how this works but I think any discerning viewer can figure that out. If this were not so, we would all just read the paper.
One of the opening scenes in Frontline's "The War on Vaccines" is about a helpless innocent baby coming into the world waiting for mommy to do all she can to keep her safe and healthy. You see through a car windshield the sign for Doylestown Hospital but, if you watch this online, the section is called "A Visit to Ashland, Oregon."
"A new life begins," says the ominous voiceover. Little Rachel Murphy is coming into the world. But wait. Mommy is on her back in an operating room at Doylestown Hospital with a curtain between her and the birth. Yup, she is having a cesarean section. "It's a girl!" says a member of the team pulling Rachel out of her mother's uterus which has been surgically lifted from her body. "AW!" says Rachel's mother who can not see her own child. The very serious narrator comes back and explains that little Rachel had been born into "a world filled with countless germs." Then we have a series of camera shots of Rachel being handled by medical staff, in a cart being wheeled down the hall, getting her first vaccine at an hour old (according to the ominous voiceover) for Hepatitis B (a form of Hepatitis contracted primarily through sexual intercourse or I.V. drug use, so use of this vaccine assumes either Rachel's mother is infected or Rachel has been pretty busy in her first hour outside the womb). Some time more than an hour after all of this has taken place away from Rachel's mother, we finally see a camera view of Rachel and her mother together – her mother still flat on her back post-surgery.
Wow. The joy of birth in America. Strangers will handle you, wheel you around, and pump you full of chemicals – some of which are toxic – before you even get a chance to meet your mother. That world full of countless germs? Well, that would be the hospital. Some of Rachel's protection against these germs have been washed off of her before she can get a whiff of her mother's breast where the colostrum is waiting for her. A hat has been put on her head which she does not need because her mother's body could provide warmth and the exchange of scent between Rachel and her mother could help an already challenged breastfeeding relationship.
Next we have some Centers for Disease Control party line on the benefits of vaccination followed promptly by, with a dark lowering of the voiceover's tone, the announcement that some communities in America are resisting the CDC advice and have much lower rates of vaccination. I could be wrong about what appears to me to be a misleading connection between little Rachel Murphy's birth and Ashland. If you didn't see the hospital sign, you don't know where Rachel was born. I think one could easily think, hearing Ashland, Oregon named as a pocket of vaccine renegades, that Rachel was born in that community. So in case you were confused, here is a little geography lesson Mr. Ominous Voiceover omits.
Doylestown Hospital is in Doylestown, Pennsylvania. Doylestown is about an hour north of Philadelphia. Now I don't necessarily have a preconceived notion about any particular hospital's c-section rate. And I will look carefully if a hospital offers a birthing center. Birthing centers often (though with decreasing frequence nationally) have midwives and lower rates of c-section. However, if you hit the home page link on the Doylestown Hospital website for what purports to be that hospital's "birthing center," you come to a page with a huge graphic of people in white coats and surgical scrubs under the headline "Maternity Care Reinvented." Below the cluster of white coats and surgical scrubs is the tag line, "Doylestown Hospital Welcomes CHOP Newborn Care at Doylestown Hospital." CHOP, for those of you closer to Ashland, Oregon – that renegade town that is 3000 miles away from Doylestown – is Childrens Hospital of Philadelphia, the professional home of … you guessed it, Paul Offit.
As a not so amusing side note, I glanced over at the "birthing center" physicians to see the name of the surgeon who cut my third son out of me at a different hospital. I have two profound memories of that man. One was the frightening tower of formula cases behind him in his office. He was such an unpleasant man I tried to mentally will the boxes to fall and crush him. I asked him about all that formula and whether it wouldn't be better to encourage women to breastfeed their babies rather than assume they will formula feed. He snarled his response: "Would YOU want to nurse quadruplets?" He was a specialist in multiple births (the reason I had been coerced into being seen by him). I replied, "I certainly would want to try." He made a disgusted sound and refused to discuss it with me anymore. The other memory I have of that doctor is what he shouted to me as he was scrubbing in for that dreaded third c-section. "This is a tubal as well, right?" He and I had never had any discussion of his performing a tubal ligation and I had hoped to have more children. "NO!" I shouted back, more than a little frightened that he might have asked this question after I was unable to respond. His response was his usual sneer. "You would do this again?" I think I will remember forever glancing over at the array of scalpels a nurse was counting while I was being prepped, thinking violent thoughts along with "what an asshole."
Back to Frontline.
Jennifer Margulis has written a blog post I highly recommend about what she sees as the failings of "The War on Vaccines" and I highly recommend you read it. At least two of her complaints are mine as well. All of the doctors and government officials shown in the final cut of this Frontline are opposed to any variation from the CDC recommended vaccine schedule. The conclusion one is forced to draw is that there are no physicians – particularly no respected physicians – who challenge the statements made by Offit. Not only is that untrue but if you read Dr. Jay Gordon's blog post concerning this Frontline piece, you find out that he was interviewed for hours as was Dr. Robert Sears. As Gordon describes in great detail, the producers made a deliberate choice to exclude these respected doctors who offer a different viewpoint from either extreme presented by Frontline.
Another dangerous and professionally irresponsible choice made by the Frontline producers was to entirely exclude discussion of the ideological space in between Offit's "all vaccines on the CDC schedule no matter what" position and the "no vaccines ever under any circumstances" position erroneously attributed to Margulis. There are many parents and professionals, like me, who believe that every parent must examine each vaccine and each child and decide whether the benefits of a particular vaccine outweigh the risks. This is called "selective vaccination" and I have been practicing it with my children since my eldest son was a year old.
I allowed doctors to vaccinate my now nearly sixteen year old son on the CDC schedule when he was born. There were many fewer vaccines on the schedule back then, I trusted my carefully chosen pediatrician and did as I was told. But, as is my nature, I did my research and as I read more studies I began to question whether he needed all of the shots and whether he needed them at the times they were being given. Tetanus may have been the first one I questioned. I have a particularly violent physical reaction to the tetanus vaccine so I was worried that he might as well. I researched how one gets tetanus and wondered whether my child, with his access to clean water, disinfectant and a tetanus shot if he has an injury so deep one can't be sure washing alone will protect him – well, why did my son need to risk the reaction I get to the vaccine? Then I read a study about the MMR vaccine. I don't even remember what it was about but I remember it was in Lancet, a journal one's pediatrician should be expected to read. I asked my pediatrician a question about the study and he said he knew nothing about it. I wanted to discuss my concerns with him before making the decision to give the vaccine to my son. The pediatrician was surprised I thought the decision was mine to make. And then he said it. With a patronizing laugh he said, "Your Medline privileges should be revoked." I was not amused. That was the day I decided my children would be selectively vaccinated. I would be the one who decided whether my children needed a particular vaccine at a particular time. I would do something public health officials can't do. I would look at just one child in his own unique environment with his own unique biology and family history. I would assess the risks and benefits of each vaccine for each child.
If you let the imagery and ominous tone of Frontline's "The War on Vaccines" wash over you, you would never know that parents could make intelligent and safe decisions for their own children. You would never know there are doctors who support parents' ability to do this. You would think that I make my parenting decisions based on what I see on YouTube. In fact, I chose selective vaccinating before I had even heard of YouTube. I read peer reviewed medical journal articles and consider the advice of a wide range of medical specialists including Dr. Jay Gordon and Dr. Robert Sears. The Frontline producers would have you believe that parents taking control of the medical care their children receive is a bad thing.
In between the interviews portraying extreme and irreconcilable views, along with the frightening images of sick children, there is interspersed B roll of children in a gymnastics class. Hmm. Is gymnastics there to lighten the mood by showing happy children at play? Or is it there to suggest the metaphor of risky behaviors parents encourage their children to engage in? After all, the chances of my child dying of chicken pox is far lower than the chance of my child being seriously injured as a gymnast. Or are the producers trying to leave us with that uncertainty – is that child flying through the air going to land safely or break her neck? Regardless, it is just manipulative.
So what do you think? I am not going to give you a poll and don't encourage you to participate in Frontline's two choice poll. On my blog as in life, you have more than two choices. I'd like to hear how you make your decisions about vaccination. If you saw the Frontline episode, I'd like to hear how balanced you think it was. And if you just want to to write about vaccine decision making and/or how media portrays it, let's hear it.