Across the country, worries about children’s vaccination rates have accelerated in light of outbreaks of measles and pertussis and the growing number of children whose parents have withheld one or more vaccines because of personal beliefs. In news reports on these trends, parents who forgo vaccines for children have been called selfish, ignorant, bizarrely uninformed, and even stupid.
But these aren’t parents of both genders. In our national conversation about children’s vaccination, it is mothers who overwhelmingly represent the face of “misguided” worries about recommended vaccines.
History sheds some light on this, for we’ve long held mothers uniquely responsible for nearly everything involving childrearing, including their children’s vaccination status. And women had special reason to be critical of vaccines at the precise moment that the vaccine schedule for children began to expand several decades ago.
Back in the 1960s and 1970s, public health efforts to promote the use of new vaccines—against polio, measles, rubella, and mumps—typically focused on mothers. Doctors and health officials appealed to mothers’ special love for their children, their responsibility for their family’s health care, and even, as time progressed, their career-mindedness. The mumps vaccine, for instance, was pitched to mothers as a convenience that would prevent them from having to miss work to care for a sick child.
Not surprisingly, when vaccination rates fell short of health officials’ expectations, the blame was often fixed squarely on mothers: “poor” mothers, “busy” mothers, “lazy” mothers, and mothers “too young” to know how important it was to prevent diseases like polio and measles.
This new push for children’s vaccination (and this focus on mothers’ responsibility) happened to coincide with the women’s rights movement of the 1960s and the women’s health movement that followed on its heels. In other words, it came at a time when women’s health activists, less willing to passively listen, were questioning their doctors’ advice, requesting full disclosure about the risks and benefits of medical treatments, and arguing that they had the right to make their own health care choices.
They were encouraged, in part, by the number of drugs heavily promoted to women that later turned out to have serious side effects, such as the first birth control pill (strokes), DES (cancer), thalidomide (birth defects), and valium (addiction). Not surprisingly, some women soon began questioning the advice doctors gave to their children, too – specifically advice about vaccines.
So it was no accident that by the early 1980s, an organized movement of self-described vaccine safety advocates emerged, led largely by women. The movement made demands that likely sounded familiar to members of the women’s health movement. They wanted more information on vaccine risks and benefits and a greater role in vaccine decision-making for their children.
These vaccine safety advocates pressed for a new pertussis vaccine with fewer dangerous side effects, which was eventually introduced, in the 1990s. They also asked the federal government to keep track of vaccine side effects, give parents complete information on vaccine risks and benefits, and compensate the families of vaccine-injured children.
These demands weren’t outrageous. Scientists had long debated the side effects of the old pertussis vaccine. And CDC scientists themselves had been discussing the need to disclose risks and compensate Americans harmed by required vaccines. But it was consumer activists, led largely by mothers, who brought these issues to public attention and pressed for change—which they got when Congress passed the National Childhood Vaccine Injury Act in 1986.
Today, however, the medical community has stopped listening to parents’, particularly mothers’, vaccine worries. Mothers who express any reservations about the growing number of vaccines and vaccine doses required for children are dismissed out of hand as ignorant or worse. They’re labeled “anti-vaxxers” whether they refuse all vaccines or just one. And their concerns are grossly mischaracterized. Mothers are all too often blamed for listening to Jenny McCarthy and trusting a long-discredited study linking vaccines to autism. Listen a little more closely, however: they're concerned, not unjustifiably, about conflicts of interest on the part of vaccine policy makers, what they feel are inadequate safeguards against vaccine risks, and a system that seems likely to require more doses of more vaccines.
We have a long history of holding mothers uniquely responsible for children’s health. We have an equally long history of dismissing women as ignorant because they’re women. We’ve left most of that history behind, but it’s time to admit that the trend is still alive in our national conversation about childhood vaccines. And that’s too bad, because public health is best served when the public is respectfully included in discussions of best practices.
Elena Conis is author of Vaccine Nation: America’s Changing Relationship with Immunization (University of Chicago Press).
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