SLU Health News file photo
Dr. Ken Haller believes in vaccines. He also believes that parents love their kids, and that their decisions — even wrong ones — come from a place of love.
Haller, a SLUCare pediatrician and associate professor of pediatrics at Saint Louis University, approaches reluctant vaccinators with the same compassion—and he uses a trick of a perhaps unexpected trade, improvisational theater.
One of the first tenets of the unscripted and collaborative theatrical form is the idea of ‘Yes, and.’ When one improv actor throws out a scenario, others on stage have been trained to build on it, saying ‘Yes, and’ instead of shutting it down with a ‘No, but.’ The method requires generosity and creativity.
Haller, who’s been known to tread the boards in his off hours, says that doctors by nature excel at knowing and presenting facts. But parents who are resistant to vaccination won’t respond to that approach.
“It’s not a fact-based problem, it’s a fear-based problem,” he says. “All the facts in the world are not going to make a difference if you don’t acknowledge the fear.”
Raising kids is the hardest job in the world, he says, and fear is natural, normal and healthy. Advising patients or parents requires delicacy and respect, or the discussion never gets off the ground. Too blunt an approach, and “people feel disrespected,” he says. “It alienates people, and then you can’t have the discussion and bring people to a better place.”
So he acknowledges the fear, then addresses it with facts.
Yes, and.
One parent was suspicious of giving her daughter the Gardasil vaccine, which prevents cervical cancer which is caused by HPV, the human papilloma virus. The parent mentioned hearing about deaths reported after administration of the vaccine.
Haller told the parent he had heard about deaths as well. The U.S. Department of Health and Human Services has a system in place called VAERS, the Vaccine Adverse Event Reporting System, set up to track illness and death after vaccinations and to look for patterns. The Center for Disease Control and Prevention reports that between June, 2006 and March, 2014, VAERS received 96 reports of death in patients after receiving the vaccine, with 67 million doses distributed during that time.
Of course, 96 deaths sounds scary. But the system did not find any patterns, and the deaths had a variety of causes—heart attacks, collapsed lungs... There wasn’t a consistent culprit.
Doctors must report any events—even accidents or health problems not related to the vaccine—within approximately 48 hours after vaccinating, Haller says. He asked the parent to imagine a population of 67 million people. During any 48 hours, 96 deaths from different reasons seems awfully minor.
The data the parent had been so fearful about, Haller says, “show that the vaccine is safe. When I put it that way, the parent went ‘Oh, yeah.’”
Vaccine resistance is a suburban, upscale problem, he adds. Indeed, City of St. Louis Department of Health data show that only 3 percent of families enrolled in public and private city schools have chosen not to vaccinate, and the measles explosion of recent years has passed us by, with just one reported case since 2005.
“We do what we can,” Haller says. “People are not always going to make decisions I feel are appropriate. We have to meet people where they are. Always start with the assumption that people love their kids.”
