Reflections on the American Public Health Association’s Annual Meeting
Last month I traveled to the American Public Health Association’s Annual Meeting. The convention was held in San Francisco, California, a city that lives and breathes public health; you walk down the street and see the mandated composting bins at every establishment and signs proclaiming that vendors are no longer able to bag your purchases in plastic, but would you like to use a re-usable bag? I learned about a myriad of health issues, from “street medicine,” which provides healthcare to our homeless population, to lasting impacts from oil spills on the Gulf Coast. I also tried to listen in on the national conversation surrounding immunizations.
I attended a packed, standing-room-only panel presentation, “Vaccination Controversies in Historical Perspective.” Dr. Robert Johnston, Heidi Lawrence, and Dr. Elena Conis presented three thought-provoking papers discussing the way vaccination programs and “vaccination-skeptics” have been viewed throughout history. Lawrence drew the distinction between the various exigencies of vaccination campaigns in American history, for example, polio was a potent and palpable risk to the American public and it was thus easy for public health professionals to demonstrate the need for the vaccination. In contrast, the 1976 National Influenza Immunization program had a harder go of it because the disease was not as visible, indeed they did not have the visuals of polio-stricken children to use in their campaign. Lawrence described polio and the 1976 flu as different “rhetorical situations.” This idea of differing rhetorics came on the heels of Dr. Johnston’s paper urging current practitioners to be more respectful of “anti-vaccinationists,” arguing that indeed some scientists that were high respected in their time were in fact anti-vaccine and it may be beneficial to the current “pro-vaccine movement” to engage further with their assumed counterparts. Finally, Dr. Conis explored comparisons between the anti-vaccine movement and earlier environmental and feminist movements. In sum, all three speakers encouraged what seemed to be a room full of “pro-vaccinationists,” to consider a broader perspective when fighting for their cause.
At the end of the presentations and Dr. James Colgrave’s summing up perspective as discussant, a county health officer stood up and offered that while all this information was excellent in context of cultural competency and other ideations of theoretical complications surrounding the controversy, he was struggling to translate this into the actual, every day practice of raising immunization rates. I too, struggled with this question. One panelist later suggested we shift to calling the movement “vaccine-skeptics” instead of “anti-vaccine,” as many members of the movement are merely questioning the safety of vaccines, and not the overall efficacy of inoculation. The suggestion to reconsider what we call “the other side” gave me pause and I wondered how we may use these considerations in our practice in rural Wisconsin.
The Southern Wisconsin Immunization Consortium has always been open to anyone concerned about vaccinations in the region. Our mission and goals relate directly to raising immunization rates across the population, but we have always held an open door policy. If anyone wanted to join our meetings who were “skeptical” of vaccines, they would not be turned away. Yet- no skeptics have emerged. However, I have begun to think that we may need some. Listening to these panelists present made me consider how to best “fight” the “other side,” and the difference between silencing and “dialoging,” (a word which in this instance I will not shy away from saying for me is closer to “discrediting”). I would welcome some further pushback. I think that our initiative can only be strengthened from learning from the vaccine skeptics. Instead of completely shutting each other out, I encourage us to learn from each other.