Countering HPV Vaccination Opposition Training for AHECs Aubrey Villalobos, MPH, MEd Yamisha Rutherford, MPH Director Research Associate Comprehensive Cancer Control Comprehensive Cancer Control Learning Objectives After viewing this webinar, participants will be able to: 1. Summarize the emergence and evolution of the anti-vaccine movement 2. Identify modern sources of anti-vaccine propaganda and misinformation 3. Confidently debunk vaccine myths and counter anti-vaccination arguments 4. Evaluate the validity of source information about vaccinations GW Cancer Institute • Founded in 2003 • Vision: A cancer-free world and health care that is patient-centered, accessible and equitable. • Mission: To foster healthy communities, prepared patients, responsive health care professionals and supportive health care systems through research, education, advocacy and translation of evidence to practice. GWCI Areas of Expertise Comprehensive Patient Centered Cancer Control Programs Policy & Engagement Programs Technical Assistance for Cancer Survivorship Access to Care CDC grantees Health Care Advocacy Professional Education HPV Vaccination Research and Education Patient Engagement Patient Navigation LGTBQ CBPR Focus Areas Focus Tobacco Cessation Program Evaluation CDC Cooperative Agreement • Title: “Improving HPV Immunization Rates on a National Scale Utilizing the National AHEC Network” • Timeframe: 2014-2019 • Purpose: Increase HPV vaccination rates among 11 and 12- year old boys and girls as well as administering “catch-up” vaccinations to older adolescents and young adults. HPV Resource Book & Environmental Scan Protocol Available at: http://www.nationalahec.org/hpv/index.html http://tinyurl.com/HPVResourceBookEnvtlScan Modern Vaccine Origin Edward Jenner (1796) – Vaccinus (from cows) – Early Opposition • Religion • Safety Skeptics • Natural Immunity See detailed timeline at: Photo credit: Mezzotint by John Raphael Smith, from his pastel portrait exhibited at the Royal Academy in 1800, www.historyofvaccines.org reproduced from W. R. Le Fanu, A bio-bibliography of Edward Jenner 1749-1823, London: Harvey and Blythe, 1951. Vaccine Basics Step 1. Exposure to killed or weakened germ Step 2. Body’s immune system produces antibodies Step 3. Immunity • Without illness • Eradication • Herd Immunity Illustration credit: CDC Anti-Vaccination Movement 1853 Vaccination Act of 1853 (England) London Anti-Vaccination League 1855 Mass. school vaccination requirement Vaccination Act 1867 (England) 1867 Anti- Compulsory Vaccination League (England) 1879 Anti Vaccination Society of America 18856 Anti-vaccination League of NYC 1898 Vaccination Act of 1898 (England) Premise for Vaccine Mandates • 10th Amendment “police power” of states – Protect Public Health and Safety – Legal precedent Jacobsen vs Massachusetts (1907) Read more: Public Health Strategy and the Police Powers of the State • Impacts of Mandates – Increased coverage rates – Reduced disparities – Decreased incidence of infectious disease Origins of Myths 1. Scientifically limited studies 2. Anecdotal reports 3. Coincidental timing 4. Low health literacy Early Influencer: Dr. Wakefield Learn more from Khan Academy: Vaccines and the Autism Myth - Part 1 Vaccines and the Autism Myth - Part 2 Photo credits: http://briandeer.com/mmr/lancet-summary.htm http://www.callous-disregard.com/ http://topics.time.com/autism/ More Bad Science • 2007 retraction of research into vaccine ingredients and autism by Drs. Mark Geier and David Geier • Data, ethical and conflict of interest issues Photo credit: http://briandeer.com/wakefield/geier-retraction.htm Debunking Common Myths MYTH: Vaccines don’t work • Clinical trials (FDA licensed) • Produce immunity • Rapid decline in incidence MYTH: Vaccines cause Autism • Dr. Wakefield and other articles retracted • Large scale studies found no causation MYTH: Vaccine toxic ingredients • Thimerosal (ethyl mercury not harmful) • Aluminum > in breast milk • Formaldehyde > in blood stream Debunking Common Myths MYTH: My child is too young for vax MYTH: Natural immunity is best • Dangerous gamble • Resurgence (Measles outbreak) • Herd Immunity MYTH: Vaccines are not safe • Minor side effects • Clinical trials (FDA licensed) American Cancer Society (ACS) HPV VACs: Myth Busting Download this handout in the webinar files pod ACS HPV VACs: Myth Busting MYTH: People already know about the HPV vaccine and will ask for it if they want it FACT: Up to 60% of parents have no prior knowledge about the HPV vaccine TALKING POINT: A strong provider recommendation is the single best predictor of vaccination ACS HPV VACs: Myth Busting MYTH: The HPV vaccine is unsafe FACT: Clinical trials and ongoing monitoring ensure safety TALKING POINT: The vaccine has been rigorously tested and is safe ACS HPV VACs: Myth Busting MYTH: The HPV vaccine causes serious side effects including death FACT: All vaccines can have some side effects. Reactions after HPV vaccination are similar to other vaccines TALKING POINT: The vaccine has been rigorously tested and is safe ACS HPV VACs: Myth Busting MYTH: The HPV vaccine is ineffective FACT: Clinical trials and ongoing monitoring have shown the HPV vaccine to be highly effective TALKING POINT: The HPV vaccine is highly effective in preventing HPV-caused cervical, anal, and penile cancers, as well as genital warts ACS HPV VACs: Myth Busting MYTH: The HPV vaccine is unnecessary unless you’re sexually active FACT: Vaccines are for prevention, not treatment TALKING POINT: HPV vaccine produces a high immune response in preteens ACS HPV VACs: Myth Busting MYTH: The HPV vaccine is only for females FACT: HPV affects both males and females TALKING POINT: The HPV vaccine is strongly recommended for males and females ACS HPV VACs: Myth Busting MYTH: The HPV vaccine encourages sexual activity FACT: HPV vaccination during the recommended ages not associated with an earlier onset of sexual activity or an increase in sexual activity-related outcomes TALKING POINT: Experience shows that the HPV vaccine does not increase sexual activity CDC Resources for Clinicians • Tips and Time-savers for Talking with Parents About HPV Vaccine • You are the Key to cancer prevention website: HPV Vaccine Resources for Healthcare Professionals Modern Propaganda Celebrities Websites Social Media PhD & MD Celebrities & Public Figures • Barack Obama • Donald Trump • Bill Gates • Jenny McCarthy • Selma Hayek • Jim Carrey • Jennifer Garner • Alicia Silverstone • Amanda Peet • Erin Brockovich 26 Social Media • Twitter – #CDCwhistleblower – #AntiVax – #VaxCauseAutism • Facebook • YouTube – Video clippings – Power points Case Study: Kristen Bell & Dax Shepard Read more stories: http://www.voicesforvaccines.org/category/anti- vax-to-pro-vax/ Anti-Vaccination Websites • www.Naturalnews.com • www.Vaclib.org • www.Sciencebasedmedicine.org • www.Nvic.org • www.Vaxtruth.org • www.Antiantivax.flurf.net • www.GreenMedInfo.com • www.LivingWhole.org • www.wesupportandywakefield.com Photo credit: http://drleonardcoldwell.com • healthimpactnews.com & vaccineimpact.com • www.mercola.com Pro-Vaccination Websites • www.cdc.gov/vaccines • www.immunize.org • www.ecbt.org • www.voicesforvaccines.org • www.niaid.nih.gov/topics/vaccines/ • www.hhs.gov/nvpo/nvac/ Anti-Vax Doctors (PhD & MD) Photo credits: https://antivaccine.wordpress.com & www.skepticnorth.com Strategies for Validating News and Journal Articles 1. Who wrote it? 2. How was the study conducted? 3. How were conclusions made? 4. Who paid for the study? 5. What study limitations (biases) exist? Strategies for Validating Health On the Net (HONcode) Principles: Learn more: www.healthonnet.org Authority Justifiability Gives qualifications of authors Justification of claims/ balanced and objective claims Complementarity Information to support, not Transparency replace the doctor-patient Accessibility, provide valid contact relationship details Attribution Financial Disclosure Cite the sources and the dates of Provide details of funding medical information Advertising Confidentiality Clearly distinguish advertising Respect privacy of site users from editorial content Can You Evaluate the Validity? Can You Evaluate the Validity? Photo credit: www.somethingawful.com/photoshop-phriday/antivaccination-ads-mccarthy Photo credit: www.somethingawful.com/photoshop- phriday/antivaccination-ads-mccarthy Photo credit: www.facebook.com/allthesesheeple Questions? Comments? Aubrey Villalobos Director, Comprehensive Cancer Control [email protected] 202-994-2680 Website: www.CancerControlTAP.org Thank you! Twitter: @GWCancerInst Email: [email protected] © 2015 The George Washington University (GW) Cancer Institute References • History of Anti-vaccination Movements. The History of Vaccines Web site. http://www.historyofvaccines.org/content/articles/history- anti-vaccination-movements. Published n.d. Updated December 18, 2014. Accessed August 10, 2015. • Riedel, S. Edward Jenner and the history of smallpox and vaccination. BUMC Proceedings. 2005; 18:21-35. • Wolfe, R. and Sharp, L. Anti-vaccinationist past and present. British Medical Journal. 2002; 325:430-432. • 14th Amendment to the U.S. Constitution. Library of Congress Web site. http://www.loc.gov/rr/program/bib/ourdocs/14thamendment.html. Published n.d. Updated August 6, 2015. Accessed August 25, 2015. • Malone, K. and Hinman, A. (2007) Vaccination Mandates: The Public Health Imperative and Individual Rights. Law in Public Health Practice (262-284). Oxford Scholarship Online DOI: 10.1093/acprof:oso/9780195301489.001.0001