When Valeria Kobylnick got pregnant for the first time nineteen years ago, she was convinced that the vaccine was toxic. She has seen and read a lot of material to convince her – blogs against the vaccine, a YouTube video that depicts the parents of affected children and books similar to The Epidemic of the Vaccine .
So, an interior design consultant decided to not vaccinate his son or his brother, along with his Ukrainian-American husband, now between 8 and 6 years old.
The word about his decision spread through their dense community of immigrants from Russia and the former Soviet Union in Clark County, Washington. In general, there are 88,000 Eastern Europeans in the state. Many speak Russian and go to the same schools, churches and festivals.
"I would receive a phone call from someone who said they got my number from my aunt," he went to Washington State in 1
For this, the general response she received was, "You did all the research, so tell me." She would try to reduce these conversations because she did not want to be responsible for other parents' decisions. But she saw that her doubts about the vaccine still spread.
For many years, Kobylnik estimates that she has received at least ten dozens of unwanted calls from troubled moms in her community. It was fitted with children's souls, wedding and wedding souls. Just being a member of the word community has made it a reliable source for effective vaccine-related fears, just like a real social media memorandum.
Today, the same words in Clark County are in the center of a cortex outbreak that infected 72 people, most of them children.
A significant part of the media and the political talk about the outbreak focused on fake news and social media. If only Facebook could drive out the fake posts of the vaccine, the problem of hesitation would fluctuate.
But this story ignores today the most important part of the anti-inflammatory problem in America. Cyrus in Washington – like many recent outbreaks of measles in the United States – spreads to a certain type of community: close and traditional
In Washington, the virus mostly fell into Russian-speaking groups, which are distributed mainly from Ukraine and Russia According to a source close to this issue. These groups have the lowest levels of vaccination in any Washington population, according to recent state data.
And they are not unique. The continuing bouts of cortex in New York include mostly people from the underrated Orthodox Jewish community. Since October, 304 people have been bad for the virus – the largest number in the state for decades. Prior to this, she was a waiver of the Ohio vaccine and the Americans in Somalia in Minnesota.
These communities have become the immediate focus of health departments throughout the country, said Nancy Messionier, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. When suffering from bark, flashes in closely-tied groups are usually "explosive" and more difficult to control.
According to the CDC, 12 out of 26 cortical outbreaks over the last nine years (more than a dozen cases) are concentrated on cohesive communities that Messier identifies as people of similar origin who share values and beliefs and often interact. And since these outbreaks were larger, they account for 75 percent of recent measles cases.
Although the causes of skepticism in the vaccine may be different in each of these communities, the groups themselves have much in common. They are cohesive and conservative. They seem to trust each other more than foreigners. They also speak the same languages and read or watch the same news. "We believe that these communities are more like," added Messignier, and their island helps "escalate outbreaks."
More than Facebook, the real social networks in these groups seem to be turbo-filled with the spread of anti-vaccine looks, and along with them viruses, like measles. See what happened in Washington, DC, where Kobylnik became influenced, and then changed his mind about the vaccine
. wanderer. Man has returned a virus from Eastern Europe, where there is an epidemic of measles. (In Ukraine, fluctuations of the vaccine have helped reduce the measles vaccine by 31 percent in 2016. There were 54,000 cases of measles in 2018. This year they were already 28.6 thousand.)
When someone with a bark translates the virus into an understatement The community here, it can spread like a forest fire, because the measles is so incredibly contagious. Almost all in the population should be immunized to prevent the spread of the virus. Even a 5 percent rejection rate may threaten what is called "Herd Immunity."
When there is an outbreak, people who can not be vaccinated – such as newborn babies and some people with cancer or allergies – are at risk. . Up to 40 percent of patients have complications from the virus. They are usually found in the youngest (children under 5 years of age), adults over 20 years of age and anyone who suffers from malnutrition or otherwise immunodeficiency. Children under the age of 5 have the highest likelihood of death
In Washington, the Russian-speaking population has the lowest vaccination levels, "consistent since 2008," according to a report by the Department of Health 2012 (the most recent data).
A problem also arises in the study 2016 Pediatrics on the absorption of vaccinations in immigration groups of the state, indicating that children of parents born in Ukraine and Russia were less likely to be vaccinated than their counterparts born in the United States. . According to a 2016 study, 80 percent of children born in Ukraine and 85 percent of children born in Russia who were born in Russia were vaccinated against measles – too low to maintain the immunity of the herd. For comparison, 92% of their American counterparts were vaccinated at that time.
The coverage rates in Ukraine and Russia were even lower for hepatitis A and pneumococcal vaccines. And these figures may not reflect the current reality on the ground, said Dr. Tatiana Odarić, who immediately works in Clark County, and has private practice in neighboring Oregon.
Odarich's practice concerns the Russian-speaking community. Over the years, she had to assure dubious parents who told her about vaccines that are sick for all children, or that large pharmaceutical companies are paying doctors like Odarich to sell the vaccine. (They are not.)
But myths are preserved. And Odarich estimates the level of immunization for Russian-speaking families in her clinic, which is below 50 percent.
"These ideas are spreading like a forest fire in this community," says Odarich, who was born in Ukraine.
So, where does the fear of vaccines come from? She is convinced that she is guided by a lack of confidence in the authorities, which arose after she experienced years of propaganda and oppression in the Soviet Union.
"I passed the time of Chernobyl [the 1986 nuclear disaster]", – she said. "There was a big blast, and the government did not speak to people for more than a week." There, the government was also synonymous with medicine, as the state provided medical care. And she thinks that her peers were having difficulty solving two in America.
Another member of the worship community in Washington, Yuri Stasiuk, repeated Odarich. He told me that the skepticism of liberal power and elites, which is a legacy of life in the former USSR, promotes the abandonment of vaccines. Stasiuk, who emigrated to the United States from the former USSR in 1991 at the age of 7, is part of the wave of refugees to the United States.
But there is another factor. [It’s] the issue of tribalism. The community of the words of the people is closely interconnected – they know each other personally and have a strong sense of cultural identity, "he said. "The disadvantage is that very often people who come from outside the culture or subculture, especially when they promote values that do not belong to traditional values and norms, can be considered with suspicion."
"Moms are more likely to trust each but not a casual nurse they do not know," he added. So if other moms say that the vaccines are dangerous, despite the fact that the official public health officer argues that this science may not be very important, and her skepticism was also rooted in distrust in the medical community, and as she grows she remembers that she was taken to a dentist who drilled her teeth, and another doctor later confirmed that the work was unnecessary, but she left her "spoiled" teeth.
Her parents said she "[Doctors] is not here for the welfare of [patients’] – they are simply forced to deceive the insurance companies." She thinks that such views are passed from the generation of her parents to their children, and many in her generation "decide not to question"
Group Opinion and Vaccines
A vaccine that prevents measles (as well as mumps and rubella, hence the name of the MMR) has proven to be effective and safe, with dozens of studies involving tens of thousands of people. In the country as a whole, 91% of young children received the MMR vaccine in 2016, according to the latest CDC data.
There is no question among researchers who studied the shot that its benefits far outweigh its risks. That is why on the CDC schedule for vaccines for children and the requirement for admission to a US school.
Yet doubts about the MMR vaccination were put forward in the 1990s, primarily due to the study – and the circus that came out – with Andrew Wakefield, a discredited British physician. These doubts have flourished and evolved since then, incitement to anti-vaccine books, blogs, videos and memos.
Since then, the total number of parents who refuse vaccines for non-medical reasons, although being a minority, is increasing (from 1.1% in 2009-2010 to 2.2% in 2017-2018). In the Clark County, this is much higher: 7.9 percent of the children were discharged from entering the kindergarten in the 2017-2018 school year. Alan Melner, a local physician, told Vox that not only members of the Russian language community refused vaccines, or were affected by the outbreak.
But there is a unique feature of cohesive communities, such as Washington, which makes them even more prone to perpetuating false beliefs.
"The united groups are more susceptible to group thinking," said Jay Van Bavel, a psychologist at New York University. "When you are surrounded by people who have a certain faith, it's easy to keep faith that it's wrong."
One of the main reasons for this: other members of the group – people you know and trust – can confirm the wrong beliefs and maybe even encourage them as described by the people of Washington.
There is also social pressure to stay in the group. "When people are highly identified with a group, they are more motivated to hold the beliefs held by other group members or group leaders," said Van Bavel, who studied the phenomenon in a political context. "All of this is a peculiarity of basic social psychology, and maintaining the right beliefs is part of how we support these relationships." That is: our personal identities are in line with our group identity. Go against what the group thinks, doubting yourself. Therefore, we are avoiding this.
Challenge for Public Health
A similar dynamics has recently played in the Orthodox Jewish community in New York. One hesitant non-medical mother, told me she created a library in her home that is advertised in a local anti-vaccine, where parents come to borrow books about the vaccine and discuss what they are reading. The library includes both pro-and anti-vaccination books, Mom said. "People can read and decide themselves."
Some Orthodox Jews also live beyond the main American culture, avoid technology and consider rabbinical opinion to be highly venerable – which can help outlook that is not the main, for example, the abandonment of vaccines, spread.
"Being a religious Jew, you also get used to having a look at a minority," said Alexander Rapaport, general director of the Maskia Soup Network in Brooklyn, as well as the public face of the Hasidic community. "Therefore, if something is not basic, it does not take you away from faith in it."
He also explained that Orthodox Jews in New York go together to school, worship together, live and travel together. This means that some uninvolved people living in close proximity may be dangerous. But it also means that the promotion of public healthcare messages requires additional effort.
The CDC Immunization Unit is well aware of this problem and is now trying to shift its focus to reaching island communities with doubts about the vaccine. "We are aware that we need different approaches in each of [them] to understand local drivers," Messier explained. "We need to give our local partners the opportunity to work with these communities."
Part of this shift lies not only in the type of messages to be sent out, she added. "It's about letting a person say that this community is trusted by someone."
Why Kobylnik changed his mind and vaccinated his children
In the last Washington outbreak the experience of Kobylnik is instructive. This year, she began providing her two children with the first vaccine, the prevention of measles, as cases of measles in the Clark County. In part, her decision was inspired by the discussion she had in social networks, with Yuri Stasiuk, a healthcare analyst in Washington DC and a member of the Kobylnika community that we met earlier in this story.
Stasiuk began to criticize the low level of vaccination of the Russian language community on his personal page in Instagram, together with the facts of the vaccine.
Kobylnik threw back, telling him about the video she saw, showing parents the vaccine-wounded children.
Stasyuk reminded her: What about all people who had a positive experience?
There was a conversation, and Stasiuk did not judge her for her views, as some of the doctors whom Kobylnik met earlier. Instead, he helped her to see that she was a victim of a confirmatory bias – watching scary videos and surfing the web using phrases such as "vaccine-injured children" or "vaccine dangerous", which confirmed her beliefs.
"When I was Google, I did not look for reasons for vaccination. I [was] was looking for reasons not to vaccinate, "said Kobylnik.
She wants doctors and health officials to take a similar approach. "If doctors were more neutral about this and did not consider it to be parents in person, this is a really long way to breaking stigma with vaccines," she said.
Van Bavel, a psychologist, also supported this approach, stating that health officials should "turn to leaders or people in social networks that are hubs for information, and try to educate them and help them" to spread science ". 19659063] This is something Odarik is already trying to do. She is gradually approaching the vaccine problem after she has realized how scary is the vaccine-hesitant patient. When she feels that the patient is entrenched, instead of losing them here and there, he offers Russian language brochures containing scientific information about the vaccine, urging the patient to take and read them.
people who have different views, but they are still people ", – said Odarich. "We need to create a safe environment to talk about vaccination." and a rubella vaccine because she believed she contained cells that were originally taken out of women who are going to have an abortion. He also said that Odarich remained "silent" for this claim, because he did not answer reality.
In fact, the patient was partially right: the rubella component of the MMR vaccine contains fetal cell traces, since the vaccine continues to be grown in laboratories from embryonic cells originally derived from an elective abortion in the 1960s. However, the amount of residual DNA from these cells is less than 100 pixels (trillion grams). The Catholic Church has said that these vaccines are morally justified – and Catholics can freely receive them – because "the risk to public health, if someone decides not to vaccinate, prevails over the legal concern about the origin of the vaccine."
Abstracts have been removed from history for accuracy and clarity.