STILL SAYING ‘NO’
Despite a measles outbreak in Quebec, Wakefield has holdouts
For most people, vaccinating children against disease is a no-brainer. But the growing measles outbreak in the Lanaudière region is a reminder that many people decide against inoculation, often silently out of fear of being judged. Charlie Fidelman visits Wakefield, a small Quebec town where vaccination is debated out in the open.
WAKEFIELD Getting her baby that first measles vaccine was one of the toughest decisions Tasha Forget has ever had to make. The new mother was scared to the pit of her stomach — scared of what might happen after “the jab,” and scared of what might happen without one.
It was the height of vaccination panic nearly a decade ago, in the wake of an an alarming (and long since discredited) study linking the measles, mumps and rubella (MMR) vaccine to autism. Forget’s son was a year old, and she was torn. In the end, Forget’s bigger fear won out: “I just couldn’t live with myself if my child got sick with a preventable illness.”
It’s been years since British surgeon Andrew Wakefield’s fearinducing study, which, after being published in reputable medical journal The Lancet, alarmed people around the world and was debunked as an elaborate fraud. But recent measles cases in the United States and Canada — the outbreak in Quebec’s Lanaudière region has now topped 100 cases — have sparked concern among public health officials that a growing number of parents are opting against vaccinating their children.
And it’s difficult to determine exactly how big that growing number is. Canada doesn’t have a national vaccination registry.
What is certain is that despite scientific evidence to the contrary, many parents across North America still have doubts about whether vaccines are safe. A fear of being called out as irresponsible may be silencing discussion about their concerns and their choices.
But in Wakefield, a rural Quebec town of about 1,000 people located 35 kilometres north of Ottawa that coincidentally bears the same name as the maligned researcher, the vaccine debate is very much alive and in the open.
The town and its surrounding area — where concerns are commonly over fines for jumping from the covered bridge and how to bring back the historic steam train — are known for having a vocal contingent of parents who are ambivalent about vaccines. Parents who choose not to vaccinate co-exist openly with the majority, who have no problem with inoculation.
“It’s common knowledge that tonnes of people here choose to not vaccinate their children,” one Wakefield parent remarked last month with a shrug. Said another resident who doesn’t see the need for inoculation: “My parents didn’t vaccinate me.”
Reliable vaccination statistics for the area are not available, especially since some families do not consult traditional doctors. Local doctors, however, estimate that about five per cent of their patients are non-vaccinators, about
the same as the official national average.
Residents here are protective of one another and of their town’s reputation. A recent visit from a Montreal Gazette reporter upset many, who expressed fear that their town would be painted as an enclave of science deniers.
Several non-vaccinators — including a daycare owner and a yoga instructor — spoke on condition that their names not be published because they said they didn’t want to be persecuted.
Some pro-vaccinators declined to be interviewed or provide their names in order to avoid ruffling feathers in the tight-knit community, while yet others objected on principle to an article that would air the views of vaccine refusers.
“I’d prefer you not throw an anti-vax blanket over my hometown. I’m afraid this is what your
article will do,” one resident commented on a reporter’s Facebook post proposing to meet with residents at a local café. “There are unvaccinated children in Wakefield School, but I do think parents still should have a choice even if I disagree with that choice,” reads another comment.
A Wakefield resident who met with a reporter, however, did discuss her views on vaccination. Writer Destini Broom said her five-year-old son has not been vaccinated, although she hasn’t closed the door on that option. Vaccinations always carry a risk, she said, and with a risk comes choice.
The vaccination issue doesn’t create divisions between members of this community, Broom says, but offers “a greater potential to find a common ground that allows for deepened understanding, compassion, and openness toward the other.”
Family physician Dr. Maggie O’Dell of the Wakefield Family Medical Centre sees the situation slightly differently: “It’s a little touchy,” she said. “Nobody knows how many are not vaccinating. “We don’t see them.” Like many residents, including professionals and politicos from nearby Ottawa, O’Dell was drawn to this rural community as much for its funky arts scene as its divergent lifestyles. Here, community bulletin boards feature flyers about dog adoptions, bales of hay for sale, film festivals and music concerts, business cards for alternative-medicine clinics and ads for forest schools where children are educated outdoors.
O’Dell says that early in her career, before she moved to the Gatineau area, she rarely encountered people who did not vaccinate their children.
“The first time I heard it, I nearly fell off my chair,” she said. “But here, it wouldn’t register as remarkable. That gives you an idea. It’s not unusual.”
There is a contingent of parents “where you can’t take it for certain that they will vaccinate,” O’Dell explained. “A sub-group that wants to vaccinate under its own terms ... and mostly it’s not possible. So they resurface when the child is older to (catch up on missed vaccines) when they are starting school, because they feel the kid can handle it. And we say ‘awesome’ and refer them to the CLSC.”
Non-vaccinators don’t represent the majority, O’Dell said, but the group is substantial enough that the area’s doctors called a meeting to discuss vaccination strategy after the recent Disneyland measles outbreak reached Quebec.
O’Dell noted that half a million children died of measles worldwide in the 1980s, and these days, according to the World Health Organization, that figure is down to 140,000 deaths a year.
It’s not like Wakefield residents have latched on to U.S. celebrity Jenny McCarthy’s anti-vaccine crusade, O’Dell said. These are the most loving families imaginable, and the issue is deeply distressing for them, O’Dell said. “When there is no immediate competing danger, it’s natural for a thoughtful person to say, ‘Is this really necessary?’”
A medical colleague of O’Dell, who spoke on condition that her name not be published because she does not want to alienate residents, said a few vaccine refusers “are utterly unchangeable in their views.”
But, O’Dell’s colleague added, most parents who don’t vaccinate on schedule are merely delaying, “because they strongly believe the myth that infants cannot tolerate immunizations.” Some change their minds after a detailed discussion about the benefits and risks with a health professional, she added.
“People make choices and you don’t judge them for it,” O’Dell said. “That’s not what family medicine is about. I hope when they leave my office that they feel respected.”
Along Wakefield’s main street hugging the Gatineau River, lined with a pet shop, a chocolatier, a supermarket and trinket stores, shopkeepers and employees either refused to discuss anything to do with vaccines, or spoke on condition of anonymity.
At a bakery where the pipes had frozen overnight and the heat was off, one employee said that while some people may believe that catching disease naturally confers better immunity, the horrific effects of communicable diseases and epidemics have been forgotten — largely because of the success of vaccination.
Some Wakefield-area parents hold “catch-up parties” when one child contracts a disease, she said, so the others can catch it, too.
“I’ve travelled and worked around the world, and I’ve seen first-hand what happens with deadly diseases,” she said. “Still, there is always a small risk of vaccine injury, and I sympathize with parents who don’t want to put their kiddies at any risk.”
At the Wakefield community centre, members of a mom and tots fitness group chatted about vaccination as they rolled up their yoga mats and tucked their babies under blankets against the bitter February cold. All are educated, healthconscious and anxious to make the best decisions for their children.
They expressed concern that non-vaccinators are being unfairly portrayed in the media. Several cited a CBC Radio show about vaccines that aired last month that they said ridiculed those who don’t inoculate by choosing “an uninformed anti-vaxxer” to present that perspective. “It was like a witch hunt: ‘And who are these crazy people not doing vaccines?’”
From a public health perspective, mass vaccinations “are definitely the right thing to do,” said Diane Gribbin, who has a degree in exercise science and attended the mom and tots class with her baby. “But a sweeping approach is not going to work for everyone.”
Gribbin suffered temporary paralysis to the neck and arm following her measles inoculation as a child. Worried that her own children may have similar adverse reactions, she talked to her doctor about which vaccines were most important and which could be postponed.
“How can you tell if your child is sensitive? What is the actual risk in children with a predisposition?” she asked.
Gribbin called for better monitoring of children’s reactions, arguing that a one-size-fits-all vaccination schedule has little regard for individuals’ state of health, medical history and family history.
The vaccine debate is largely one that “people in the First World can have,” said fellow group member Emily Smith, because in areas where vaccines are not widely available, the risk of outbreaks and fatalities among unvaccinated populations is most serious.
“We don’t blindly follow what the doctor tells us to do, but vaccines are tried and true, and there’s more than 60 years of research and science behind it,” Smith said.
“I don’t worry about it,” said mom Sophie Roberge, who also has friends who are less concerned about vaccines. “It’s an alternative community and it’s a positive symptom of our community to have alternative points of view.”
While Roberge was seven months’ pregnant with her second child, her daughter caught chickenpox despite having been vaccinated, and she may have also been exposed to mumps. “Both are really dangerous for pregnant women,” she said.
But it was her son’s chest infection, when he was barely six weeks old, that frightened Roberge the most and prompted her to take no chances. “We were quarantined for a common chest cold and no one could enter the room without full gowning. He was so vulnerable to disease. The fear of infection was a horrible experience, I don’t wish it on anyone,” said Roberge, who then promptly called the CLSC to set up her children’s vaccine schedule.
Beth Gerow, who also suffered a side effect after a childhood vaccine, said it’s unfortunate that there is so much pressure, judgment and demonization around the issue. “I’m not anti-vaccine, I don’t want my one-year-old to get the measles,” said Gerow, who is studying midwifery. “But personally, having had a reaction, I wish it was easier to access information that would make easier for us to make a decision — the best decision for my child.”
Of the three pediatric doctors that Gerow consulted, one urged her to follow Quebec’s prescribed schedule and the others simply dismissed her concerns, she said. Gerow is particularly concerned about the safety of aluminum adjuvants and other ingredients added to vaccines to increase the immune response. She said doctors were unable or reluctant to discuss it.
“It’s as if there was no need to have an informed discussion,” she said. (According to the U.S. Centers for Disease Control, aluminum adjuvants have been safely used since the 1930s.)
Charlotte Scott, an organic farmer, says she has good friends who do not vaccinate their children, and she will not judge them for it. Five years ago when her daughter was born, the bogus autism study was still popular and Scott delayed vaccinating for a few months.
“I changed my mind, but I understand the fear. People have good reason to be skeptical of pharmaceutical companies,” she said. “We are lucky to have access to vaccines and it’s a privilege to have a choice.”
The debate will continue, the moms said as they left the centre, in the Wakefield tradition of tolerance for differing opinions.