Anti-vaxers, RFK, etc

[DrMetal]

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I'm very pro-vaccine. My kids have had the full schedule, I'm first in line for the flu shot every year.

I'm disheartened by patients who refuse vaccines. But I'm not surprised. Many of these patients also refuse BP meds, insulin, bronchodilators, etc . . . and end up in the hospital.

So in fact, vaccine refusal makes perfect sense to me, it perfectly aligns with the ongoing theme of human stupidity.

But where was this (media-lead) vitriol against anti-vaxers, when we needed it, 20 years ago? Back then (circa 2005), RFK Jr was a democrat. He and and a clothed Jenni McCarthy were running around spewing all sorts of nonsense, with the support of the far left. That liberal movement (and all of those now teenage young adult, un-vaccinated kids running around) is why measles and polio made a comeback.

Sad that vaccines have now taken it from both sides of the political spectrum (again, credit goes to human stupidity), but is it not true this was first a liberal far-left doctrine?

 

[VA Hopeful Dr]

I'm very pro-vaccine. My kids have had the full schedule, I'm first in line for the flu shot every year.

I'm disheartened by patients who refuse vaccines. But I'm not surprised. Many of these patients also refuse BP meds, insulin, bronchodilators, etc . . . and end up in the hospital.

So in fact, vaccine refusal makes perfect sense to me, it perfectly aligns with the ongoing theme of human stupidity.

But where was this (media-lead) vitriol against anti-vaxers, when we needed it, 20 years ago? Back then (circa 2005), RFK Jr was a democrat. He and and a clothed Jenni McCarthy were running around spewing all sorts of nonsense, with the support of the far left. That liberal movement (and all of those now teenage young adult, un-vaccinated kids running around) is why measles and polio made a comeback.

Sad that vaccines have now taken it from both sides of the political spectrum (again, credit goes to human stupidity), but is it not true this was first a liberal far-left doctrine?

Sorta. It was originally a far-left and certain really intense branches of Christianity thing.

And the left has been against anti-vaccine people for years. John Oliver did a thing on vaccine safety in 2017 which was way before the right started to become anti-vaccine.

Our pediatrician (a field that is notoriously left-leaning) when my kids were born required all patients at their 6 offices to follow the standard vaccine schedule. This was 10 years ago.

 

[glorifiedresident]

While some people might view vaccine refusal as stupidity, this is counterproductive. When people feel attacked or called stupid, they often become more defensive and entrenched in their beliefs. This can create a self-fulfilling prophecy, making them less likely to listen to evidence-based arguments and more likely to reject advice from medical professionals.

 

[DrMetal]

While some people might view vaccine refusal as stupidity, this is counterproductive. When people feel attacked or called stupid, they often become more defensive and entrenched in their beliefs. This can create a self-fulfilling prophecy, making them less likely to listen to evidence-based arguments and more likely to reject advice from medical professionals.

I suppose you always have autonomy. Back in the day when drunk driving was legal, you had the autonomy to decide how many beers to pound down before driving. Long road trips were measure by the quantity of 6-packs.

Your point is well taken though, I guess I shouldn't call my patients stupid.

 

[chessknt]

While some people might view vaccine refusal as stupidity, this is counterproductive. When people feel attacked or called stupid, they often become more defensive and entrenched in their beliefs. This can create a self-fulfilling prophecy, making them less likely to listen to evidence-based arguments and more likely to reject advice from medical professionals.

We are long past that point. These people are in charge now and need to be held accountable (eventually) for what they are doing. I don't care if people do stupid **** that impacts themselves but when they make it impossible for me and other people to actually get vaccines and force me to have awkward conversations daily in clinic about divergent vaccine recommendations that is unacceptable.

 

[anonperson]

I'm very pro-vaccine. My kids have had the full schedule, I'm first in line for the flu shot every year.

I'm disheartened by patients who refuse vaccines. But I'm not surprised. Many of these patients also refuse BP meds, insulin, bronchodilators, etc . . . and end up in the hospital.

So in fact, vaccine refusal makes perfect sense to me, it perfectly aligns with the ongoing theme of human stupidity.

But where was this (media-lead) vitriol against anti-vaxers, when we needed it, 20 years ago? Back then (circa 2005), RFK Jr was a democrat. He and and a clothed Jenni McCarthy were running around spewing all sorts of nonsense, with the support of the far left. That liberal movement (and all of those now teenage young adult, un-vaccinated kids running around) is why measles and polio made a comeback.

Sad that vaccines have now taken it from both sides of the political spectrum (again, credit goes to human stupidity), but is it not true this was first a liberal far-left doctrine?

Anti vax is an interesting issue that crosses party lines.

I practice in Southern California which is majority liberal. Our vaccination rate for flu, RSV, COVID and Tdap is low. These are not right wingers/MAGA that I am seeing.

There are a few problems.

People are stupid. The concept of a vaccine conferring immunity/protection goes over their head and when they get a sore arm or a mild bout of fatigue/body aches after a vaccine, they automatically have a negative feeling with vaccines. It's hard to fight this type of stupidity because as a society in 2025, people wear their ignorance as a badge.

Add in social media and now people with crazy ideas can commiserate with other crazy people.

The other issue is public health/vaccines are a victim of it's own success. We are so far removed from polio, measles etc that for the majority of the population, these are abstract concepts. When that happens, you get crazy ideas.

I see it in obstetrics commonly. Deliveries in general in the United States are safe for what used to be a very risky condition. Now you have patients wanting to dictate their care to an unsafe manner based on their feelings. We could drop them off in sub Saharan Africa or Bangladesh so they could see what truly happens without medical intervention ( death, fistula, disfigurement etc).

 

[glorifiedresident]

I love vaccines, and think the more the better. However put yourself in the shoes of someone who was reluctant or refused the Covid vaccine. Let's say the person was fired for refusing the vaccine because they were told that being unvaccinated posed a threat to other people, then as time passes it becomes readily apparent that breakthrough infections were the norm rather than the exception. Do you think they were given an apology (or their job back). Then they are labeled as anti-science and stupid? No I don't think that's the right approach. Am I supporter of what RFK Jr. is doing, definitely not.. he should be summarily dismissed, however I think approaching people who have discordant views requires you to understand them rather than belittling them.

 

[dozitgetchahi]

I'm very pro-vaccine. My kids have had the full schedule, I'm first in line for the flu shot every year.

I'm disheartened by patients who refuse vaccines. But I'm not surprised. Many of these patients also refuse BP meds, insulin, bronchodilators, etc . . . and end up in the hospital.

So in fact, vaccine refusal makes perfect sense to me, it perfectly aligns with the ongoing theme of human stupidity.

But where was this (media-lead) vitriol against anti-vaxers, when we needed it, 20 years ago? Back then (circa 2005), RFK Jr was a democrat. He and and a clothed Jenni McCarthy were running around spewing all sorts of nonsense, with the support of the far left. That liberal movement (and all of those now teenage young adult, un-vaccinated kids running around) is why measles and polio made a comeback.

Sad that vaccines have now taken it from both sides of the political spectrum (again, credit goes to human stupidity), but is it not true this was first a liberal far-left doctrine?

To an extent, yes. But it was more of a fringe thing on both sides of the aisle. Historically I think it was more associated with crunchy ultra liberal types, but there was also a deep conservative side that didn’t favor vaccines either. Now, this far right perspective has become much more visible and widespread.

 

[gutonc]

To an extent, yes. But it was more of a fringe thing on both sides of the aisle. Historically I think it was more associated with crunchy ultra liberal types, but there was also a deep conservative side that didn’t favor vaccines either. Now, this far right perspective has become much more visible and widespread.

I like to say that these people were so far to the left that they came all the way around to the far right.

Interestingly, I've seen some people come around the bend the other way as well lately. Especially the aging libertarians.

 

[VA Hopeful Dr]

I love vaccines, and think the more the better. However put yourself in the shoes of someone who was reluctant or refused the Covid vaccine. Let's say the person was fired for refusing the vaccine because they were told that being unvaccinated posed a threat to other people, then as time passes it becomes readily apparent that breakthrough infections were the norm rather than the exception. Do you think they were given an apology (or their job back). Then they are labeled as anti-science and stupid? No I don't think that's the right approach. Am I supporter of what RFK Jr. is doing, definitely not.. he should be summarily dismissed, however I think approaching people who have discordant views requires you to understand them rather than belittling them.

I mean, I guess?

Here's the thing, understanding them doesn't change the end result nor does it make them more likely to change their views and quite frankly I'm sick and tired of trying.

 

[DrMetal]

I mean, I guess?

Here's the thing, understanding them doesn't change the end result nor does it make them more likely to change their views and quite frankly I'm sick and tired of trying.

Indeed. Everyone can ultimately do WTF they want. Our recommendations need to be firm and solid.

If our sternness is labeled as "belittling", then so be it. Belittle away. You're welcome to seek your healthcare from someone else.

 

[dgdg]

In my primary care practice I try to meet people where they are and provide as much cogent information as I perceive they'll accept, to help them make the most informed decision based on their personal beliefs. Hopefully the choice that they make (to the best we currently and imperfectly understand it) is the most scientifically correct.

I don't own responsibility for what we here may perceive as a patient's poor decision, but I do document their informed refusal accurately and carefully. I look for future opportunities to revisit the question without my patient feeling admonished - like a parable of the Prodigal Patient. I always welcome them home.

I learned this documentation lesson clearly during my intern year indigent clinic. Every visit with one particular patient with afib, I documented informed refusal to take warfarin - every visit. One day, probably a year later, the neuro fellow called me about him. My patient was in the ED with a stroke. The fellow commented that he looked through his chart and at every visit I documented my education efforts and his informed refusal. It was a tragedy, but it was his right to make a bad choice.

People with power and influence that worsen the health outcomes of vulnerable persons is a large never ending thread in itself, so I won't go there.

I have learned so much over years in college, grad school, premed, med school, 90 hour weeks in residency, and continued education. How can a person, even an intelligent person, without a high school diploma take in everything that has taken me decades of skill investment? The entirety of the relevant fact based understanding is impossible to fully convey to patients during visits even when informed consent/refusal is legally satisfied. Even I need to practice evidence based guideline medicine as I don't have the time resources to review all the journal articles and make completely independent determinations for every question at hand. For my patients, an executive summary with added clarifications should hopefully be sufficient in a good professional relationship.

Some element of trust must occur to bridge this knowledge gap. That is the art of medicine.
I hope that my patients sense the fact based advice that I give is entirely directed in their best health interests which engenders trust and better health outcomes.

It's a low pressure sale. Sometimes when I am very concerned, I'll end with that - "I care about you, and I'm concerned".

In the end, as physicians, we help treat the human condition without judgment even while witnessing innumerable avoidable tragedies at all levels.

 

[DrMetal]

That is the art of medicine.

I wish we'd stop using this phrase. Medicine is not an 'art', not in the 21st Century (our lawyers and hospital administrators would kindly remind us of that).

We do or don't do things based off of scientific and objective evidence (presence of, or lack thereof). That's not 'art'.

The problem with calling medicine an 'art', is that then everyone (including the patient) thinks they're an artist! And then they think they can do WTF they want! Until they end up in our hospitals, at which point then we practice the 'science' of medicine.

 

[dgdg]

It's simply a phrase that conveys a widely understood metaphor about how we might apply our science based objective reasoning more effectively to another human being which is a highly emotional creature.
I'll stop! Won't say again.... 🙂

How about,
The humanistic side of medicine, or
The relational dimension of medicine, or
The human touch of medicine, or
The soft skills of medicine, or
The how you get what needs doin' done when they are afraid to trust your facts over the 'facts' of their neighbor, blogger, podcaster, social media group, or news commentary show who is peddling false information that seems credible to them on the surface, etc.
Not sure yet.

Of course, I could care less what lawyers and hospital administrators might think of my developing and nurturing soft skills to achieve good, science based, objective outcomes.

This, formerly called Art, concept is common in all objective tasks that involve the human element - politics, marketing a business plan, trial litigation, etc. You can have all the factual know-how, but if they don't like or trust you, it's all worthless and goes the wrong way. We can't even get to the science.

Anyway, I grow verbose. I think we both have the same heart. It's challenging, and we can agree on that!

 

[anonperson]

In my primary care practice I try to meet people where they are and provide as much cogent information as I perceive they'll accept, to help them make the most informed decision based on their personal beliefs. Hopefully the choice that they make (to the best we currently and imperfectly understand it) is the most scientifically correct.

I don't own responsibility for what we here may perceive as a patient's poor decision, but I do document their informed refusal accurately and carefully. I look for future opportunities to revisit the question without my patient feeling admonished - like a parable of the Prodigal Patient. I always welcome them home.

I learned this documentation lesson clearly during my intern year indigent clinic. Every visit with one particular patient with afib, I documented informed refusal to take warfarin - every visit. One day, probably a year later, the neuro fellow called me about him. My patient was in the ED with a stroke. The fellow commented that he looked through his chart and at every visit I documented my education efforts and his informed refusal. It was a tragedy, but it was his right to make a bad choice.

People with power and influence that worsen the health outcomes of vulnerable persons is a large never ending thread in itself, so I won't go there.

I have learned so much over years in college, grad school, premed, med school, 90 hour weeks in residency, and continued education. How can a person, even an intelligent person, without a high school diploma take in everything that has taken me decades of skill investment? The entirety of the relevant fact based understanding is impossible to fully convey to patients during visits even when informed consent/refusal is legally satisfied. Even I need to practice evidence based guideline medicine as I don't have the time resources to review all the journal articles and make completely independent determinations for every question at hand. For my patients, an executive summary with added clarifications should hopefully be sufficient in a good professional relationship.

Some element of trust must occur to bridge this knowledge gap. That is the art of medicine.
I hope that my patients sense the fact based advice that I give is entirely directed in their best health interests which engenders trust and better health outcomes.

It's a low pressure sale. Sometimes when I am very concerned, I'll end with that - "I care about you, and I'm concerned".

In the end, as physicians, we help treat the human condition without judgment even while witnessing innumerable avoidable tragedies at all levels.

This is where patients are dumb.

I don't do much obstetrics but I've literally had patients who apparently trusted me enough to slice them open, deliver their newborn, and repair the incisions. That's no problem.

But when I recommend flu and Tdap vaccine, that's where I become a maniac in their eyes.

So which is it. There is enough trust to perform major surgery that could literally kill you but not enough trust to take a vaccine?

This is the problem with patients and certain medical concepts that are too abstract for them, vaccines being a major player.

 

[DrMetal]

It's simply a phrase that conveys a widely understood metaphor about how we might apply our science based objective reasoning more effectively to another human being which is a highly emotional creature.
I'll stop! Won't say again.... 🙂

I know I know. It's not on you. We all use the phrase . . .

How about,
The humanistic side of medicine, or
The relational dimension of medicine, or
The human touch of medicine, or
The soft skills of medicine, or

Nahh . . . never mind any of that. Let's just call it the 'hard knocks hard science' of medicine.

Look, with the advent of AI, in less than 25 years, this guy will be your doctor:

 

[VA Hopeful Dr]

In my primary care practice I try to meet people where they are and provide as much cogent information as I perceive they'll accept, to help them make the most informed decision based on their personal beliefs. Hopefully the choice that they make (to the best we currently and imperfectly understand it) is the most scientifically correct.

I don't own responsibility for what we here may perceive as a patient's poor decision, but I do document their informed refusal accurately and carefully. I look for future opportunities to revisit the question without my patient feeling admonished - like a parable of the Prodigal Patient. I always welcome them home.

I learned this documentation lesson clearly during my intern year indigent clinic. Every visit with one particular patient with afib, I documented informed refusal to take warfarin - every visit. One day, probably a year later, the neuro fellow called me about him. My patient was in the ED with a stroke. The fellow commented that he looked through his chart and at every visit I documented my education efforts and his informed refusal. It was a tragedy, but it was his right to make a bad choice.

People with power and influence that worsen the health outcomes of vulnerable persons is a large never ending thread in itself, so I won't go there.

I have learned so much over years in college, grad school, premed, med school, 90 hour weeks in residency, and continued education. How can a person, even an intelligent person, without a high school diploma take in everything that has taken me decades of skill investment? The entirety of the relevant fact based understanding is impossible to fully convey to patients during visits even when informed consent/refusal is legally satisfied. Even I need to practice evidence based guideline medicine as I don't have the time resources to review all the journal articles and make completely independent determinations for every question at hand. For my patients, an executive summary with added clarifications should hopefully be sufficient in a good professional relationship.

Some element of trust must occur to bridge this knowledge gap. That is the art of medicine.
I hope that my patients sense the fact based advice that I give is entirely directed in their best health interests which engenders trust and better health outcomes.

It's a low pressure sale. Sometimes when I am very concerned, I'll end with that - "I care about you, and I'm concerned".

In the end, as physicians, we help treat the human condition without judgment even while witnessing innumerable avoidable tragedies at all levels.

If we didn't have quality metrics, then outside of childhood vaccines I'd be perfectly content to let patients make dumb choices.

But we don't live in that world anymore.