Academia and the new dark age: Part 7 – The doctor will propagandise you about vaccines now.

A crack team of psychologists has come up with a 4-step plan for overcoming "vaccine hesitancy".

There have been many occasions over the last four years, when I wondered if I had somehow fallen through a wormhole and landed in a Monty Python film. (I challenge you to watch the "I want to be a woman - it's my right as a man" scene from The Life of Brian and not ask yourself if life has imitated art. Or the "He said Jehovah" scene. Or the "PFJ - Splitters" scene. Or the... oh FFS, just watch the whole movie.)

But when I read this creepy paper on how "health care professionals" can use a set of emotionally-manipulative techniques collectively labelled the "Empathetic Refutational Interview" to overcome "vaccine hesitancy" (yes I know, that's way too many "scare quotes" to use in one sentence, but I am indeed using each of these terms "ironically"), this is the scene that came to mind:

The boundlessly gifted Michael Palin totally nails this portrayal of a low-level bureaucrat performing his duties as a cog in the killing machine with equal parts efficiency and compassion. Note the expression of empathic concern on his face as he addresses each prisoner, and the kindly hand on the shoulder as he directs them to collect their crosses. He evinces a momentary pang of regret at the "senseless waste of human life", but then goes right on with his job of sending the condemned men to their excruciating deaths. You can easily picture him going home from work to play Terni Lapilli with his kids. He's just so nice.

And that's how the crack team of psychologists who wrote 'The Empathetic Refutational Interview to Tackle Vaccine Misconceptions: Four Randomized Experiments' believe that "health care providers" can overcome "vaccine hesitancy": Just be nice to the filthy antivaxxers. More specifically, start by murmuring a few supportive words to indicate your sincere respect for their [ridiculous] beliefs, then tailor your recitation of the government/Big pHarma talking points to their specific [completely irrational] concerns, throw in a bit of emotional manipulation about the "greater good", and hey presto! - your knuckle-dragging, conspiracy theory-addled vaccine-hesitant patients will be lining up for their shots like seals clapping for fish... or like condemned prisoners queueing up for their crosses.

Or, to use the authors’ own words,

"We introduce and report early stage testing of a novel, multicomponent intervention that can be used by healthcare professionals (HCPs) to address false or misleading antivaccination arguments while maintaining empathy for and understanding of people’s motivations to believe misinformation: the 'Empathetic Refutational Interview' (ERI)."

The Empathetic Refutational Interview to Tackle Vaccine Misconceptions: Four Randomized Experiments

Did you catch that? The underlying premise of the authors is that people are, and can only be, "vaccine hesitant" because they have "motivations to believe misinformation" which cause them to endorse and express "false or misleading antivaccination arguments". The "false or misleading antivaccination arguments" that were used in the series of experiments on which this paper is based, were drawn from this paper, and include the following:

• Pharmaceutical companies conspire to produce profit over people or to test new drugs.

• Information from companies about vaccines is motivated by financial interests.

• Healthcare authorities are corrupt and have conflicts of interest.

• Pharmaceutical companies are not liable for vaccine damage.

• Vaccinations are experimental and based on incomplete or biased data.

• Vaccines are developed using non-consensual experimentation, child experimentation or animal mistreatment.

• The science and actions behind vaccinations is shaped by political and economic agendas.

• It is not morally right to sacrifice individuals for the sake of many.

• Severe pathological conditions are caused by vaccines (e.g., autism and infertility).

• Compulsory or coerced vaccination is an authoritarian or totalitarian violation of civil liberties.

Yes folks, every single one of these arguments is "false and misleading". I mean, there's no evidence whatsoever that pharmaceutical companies have engaged in serial criminal activities that prioritise their profits over the health and even lives of people; or that national drug regulatory agencies are captured by the pharmaceutical industry and are stacked with individuals with massive conflicts of interest; or that governments have granted legal indemnity to vaccine manufacturers for both COVID and traditional vaccines; or that leading vaccine developers and proponents have admitted during court depositions to using orphans and the mentally handicapped to study vaccines, and that no vaccine has ever been subjected to a randomised clinical trial that is adequately powered and of adequate duration to study its effects on allergies, autoimmune diseases or autism; or that vaccination has been admitted by the US National Vaccine Injury Compensation Program to result in autism in genetically predisposed individuals. And the idea that the government doesn't have any goddamn right to coerce or force you to take a medical product against your will, 'for the greater good', is self-evidently preposterous.

So, every right-thinking "health care professional" (and yes, I am going to keep putting that phrase in scare quotes, because what is being provided by these people is about as far from health care as Earth is from Pluto (even if you're a Flat Earther) should be arming themselves with the most sophisticated psychological techniques to disabuse vaccine-hesitant patients of their ridiculous beliefs.

And what are these sophisticated techniques, I hear you ask? Let's dig into the article to find out.

First up, the authors acknowledge that their "Empathetic Refutational Interview" (ERI) is modelled on Motivational Interviewing, a widely-used counselling approach designed to help people find and strengthen their motivation to make a positive behaviour change. I'm going to quote at length from an article about the foundations and purpose of Motivational Interviewing (MI), because it's so important for you to understand what an utter bastardisation of this client-centred approach to behaviour change ERI represents:

"Key qualities include:

• MI is a guiding style of communication, that sits between following (good listening) and directing (giving information and advice).

• MI is designed to empower people to change by drawing out their own meaning, importance and capacity for change.

• MI is based on a respectful and curious way of being with people that facilitates the natural process of change and honors client autonomy.

It is important to note that MI requires the clinician to engage with the client as an equal partner and refrain from unsolicited advice, confronting, instructing, directing, or warning. It is not a way to 'get people to change' or a set of techniques to impose on the conversation. MI takes time, practice and requires self-awareness and discipline from the clinician. (Miller & Rollnick, 2009)

While the principles and skills of MI are useful in a wide range of conversations, MI is particularly useful to help people examine their situation and options when any of the following are present:

• Ambivalence is high and people are stuck in mixed feelings about change

• Confidence is low and people doubt their abilities to change

• Desire is low and people are uncertain about whether they want to make a change

• Importance is low and the benefits of change and disadvantages of the current situation are unclear.

Core elements of Motivational Interviewing                                                                               

• MI is practiced with an underlying spirit or way of being with people:

  • Partnership. MI is a collaborative process. The MI practitioner is an expert in helping people change; people are the experts of their own lives.

  • Evocation. People have within themselves resources and skills needed for change. MI draws out the person’s priorities, values, and wisdom to explore reasons for change and support success.

  • Acceptance. The MI practitioner takes a nonjudgmental stance, seeks to understand the person’s perspectives and experiences, expresses empathy, highlights strengths, and respects a person’s right to make informed choices about changing or not changing.

  • Compassion. The MI practitioner actively promotes and prioritizes clients’ welfare and wellbeing in a selfless manner."

From Understanding Motivational Interviewing; emphasis in original.

Unlike Motivational Interviewing, the "Empathetic Refutational Interview" has precisely zero to do with empowering people to make changes that they themselves desire, exploring their beliefs with genuine curiosity, resolving ambivalence, honouring autonomy and respecting other people's right to make their own decisions, or selflessly prioritising the welfare and wellbeing of the individual.

Quite to the contrary, it is a nakedly manipulative methodology for imposing the "health care professional's" ideology upon the patient/client. The unspoken assumption on which ERI rests is that anyone who harbours any doubts about any vaccine is a gullible rube who has succumbed to "misinformation", and must be rescued from his or her own stupidity by a pro-vaccine "expert".

Moreover, ERI implicitly accepts the dogma that the vaccination of individuals (whose risk of suffering both serious outcomes from any given infectious disease, and adverse vaccine effects, is highly specific to them) is necessary for the development of herd immunity which protects "the community" (more on this later). Hence, any practitioner employing ERI is unavoidably prioritising the (supposed) greater good over the health, not to mention the autonomy and self-determination, of the individual.

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UPDATE:

Thanks to @Tonya who left this comment:

I checked out the promotional video for this app and it is unbelievably creepy.

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As I emphasised in Your doctor is not your doctor, the role of health and medical practitioners is (supposed to be) to treat individuals, not "the public". Any health professional who prioritises the (imagined) collective good over the best interests of their individual clients or patients, is betraying their duty of care, and in any sane world, would be subject to disciplinary action for this heinous act.

... Anyhow, let's get back to the paper. The authors propose a four-step process for "tailoring an HCP[health care professional]’s response to a vaccine-hesitant individual: (a) elicit their concerns, (b) affirm their values and beliefs to the extent possible, (c) refute the misinformed beliefs in their reasoning in a way that is tailored to their psychological motivations, and (d) provide factual information about vaccines." They even provide a handy-dandy chart to illustrate, just in case you're too mentally challenged to follow the instructions in sentences, and an example of how this ground-breaking methodology could totally change the mind of a "vaccine-hesitant" patient:

There, see how easy it is to reeducate a stoopid antivaxxer? Can't you just imagine yourself being persuaded by this...

... and saying this:

Let me remind you that the authors of this piece of single-ply butt-wipe are academics. They actually get paid - in this case, by the European Union (in other words, the unfortunate tax-paying citizens of EU countries) - to come up with this turgid tosh.

Elaborating on their four-step process, the authors explain that Step 1, "Elicit concerns" is intended to help the practitioner identify the patient's "attitude roots". They, and colleagues of comparable levels of genius (including the obligatory pink-haired PhD), have put together a fancy-schmancy website called Jitsuvax - "Jiu Jitsu with misinformation in the age of Covid" - that provides a helpful interactive list of these "attitude roots" - complete with cool cartoons - so that practitioners can accurately diagnose the particular flavour of mental illness suffered by each "vaccine-hesitant" moron that they encounter.

These "attitude roots" include "conspiracist ideation", "religious concerns", "fears and phobias", "reactance" (i.e. resistance to infringement of one's personal sovereignty) and "epistemic relativism" (that's not my truth, man).

Notably, the list of "attitude roots" does not include "I read many scientific papers which document the ineffectiveness of, and/or harms inflicted by, this vaccine and carried out a sensible risk-benefit analysis which led me to decline it." Funny, that.

Next, in Step 2, "Affirm", the practitioner is instructed to coo "an expression of empathy for the patient’s position, demonstrated through providing an affirmation of the patient’s concerns (Gagneur, 2020) that is tailored to acknowledge their motivations to reject vaccination." Because, as they helpfully point out, "Empathy is widely advocated as essential in vaccine communication". Yeah, it's not like we should expect that health and medical professionals manifest empathy as a core aspect of their being, having chosen to enter caring professions. No, empathy is a weapon, to be wielded in service of achieving the objective of manipulating patients into changing their minds.

In Step 3, "Offer a Tailored Refutation", the HCP can begin to tell the patient what an idiot he or she is "begin to refute vaccine misconceptions" by offering refutations that are tailored to address both the misconception that is driving "vaccine hesitancy" and the attitude root(s) underlying it. Once again, the Jitsuvax website provides a helpful list of these "misconceptions", grouped by attitude roots, and tailored refutations for each misconception.

And finally, in Step 4, "Provide Factual Information", practitioners are instructed to provide patients with "evidence beyond the corrected information in Step 3, often facts that are known to be effective at increasing vaccine acceptance in mass communication studies—for example, explaining the risks one faces from a vaccine-preventable disease, or how high vaccine uptake can achieve social and individual benefits of herd immunity".

I discussed the substantial evidence that vaccines do not induce herd immunity in my June 2019 Deep Dive webinar, which is available to all members of my EmpowerEd membership program. Aaron Siri has concisely summarised the evidence that currently-used vaccines do not prevent transmission of infectious diseases - and therefore are incapable of inducing herd immunity - here, here, here, here, and here.

And as for the "risks one faces from a vaccine-preventable disease", how many doctors have you encountered who can actually tell you, citing peer-reviewed sources rather than unreferenced government 'fact sheets', the risk of each complication of each disease that a person of your age group and health status faces? If they can't answer those questions, they're in no position to help you perform an educated risk-benefit analysis of taking a specific vaccine.

Let's explore a specific example of the ERI, as illustrated on the Jitsuvax website: the theme "Absurd causality", which is grouped under the category of "Unwarranted Beliefs", and is elaborated further as "Implausible side effects and contaminants (e.g., autism or active viruses)".

The suggested "general affirmation" for this theme is as follows:

"It is normal to have questions and doubts about medical treatments and how they might affect us. The world can sometimes feel like a dangerous place, and we don’t fully know why some conditions occur. It is understandable to want to know what caused a problem so we can try to avoid it or solve it."

There there, Mummy understands that you're scared and need to cling onto kooky beliefs to make you feel safer.

Now for the "specific refutation":

"Fear and uncertainty can lead us to see connections that do not exist.

Those with vested interests in finding false links often go to great lengths to publicise false information. For example, in 1998 Andrew Wakefield, who was paid by personal injury lawyers, published an article that falsely claimed a link between MMR and autism. The article was retracted after his scientific misconduct was revealed, and extensive research has found that vaccines do not cause autism.

We need to distinguish between events that simply occur at random close together, and those that are actually linked.

Not everything that happens just after we have a vaccination is caused by the vaccine.

Sometimes unrelated medical conditions occur close to a vaccination, but so do other accidents. If we had an accident in the hospital carpark after getting a vaccine, that would be tragic, but it cannot be blamed on the vaccine."

"False information", eh? Talk about the pot calling the kettle black! Here's the conclusion from that article that Dr Andrew Wakefield and twelve other clinicians and researchers published, which was a case series reporting findings from gastroenterological investigations of twelve children with developmental delays (including, but not limited to, autism), eight of whom had, according to the parents and/or their doctors, developed behavioural problems after measles, mumps and rubella vaccination:

"We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine."

RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children

Just to underline the point, it was not Wakefield, or any of his coauthors, who "claimed a link between MMR and autism"; it was the parents and/or doctors of eight of the twelve children. The paper called for "further investigations" of the "possible relation to this vaccine", which is an entirely appropriate response to observing a pattern of symptoms in multiple patients, in temporal relationship to a medical intervention. (An addendum to the paper states that in addition to the twelve original cases, "a further 40 patients have been assessed; 39 with the syndrome". That's a lot of coincidences.)

The allegation that Wakefield "was paid by personal injury lawyers" is false. Several of the children whose cases were included in the retracted Lancet paper did indeed receive Legal Aid funding for investigation of their symptoms, but this was paid to the Royal Free Hampstead NHS Trust, and none of these children were in receipt of such funding at the time of their investigation by Wakefield and his coauthors.

As for the supposedly "extensive research" proving that vaccines do not cause autism, legal action by the Informed Consent Action Network (ICAN) revealed that the CDC cannot point to a single study purporting to demonstrate that the vaccines given during the first year of life do not cause autism.

Moreover, a CDC whistleblower, Dr William Thompson, asserts that "CDC 'omitted statistically significant information' showing an association between the MMR vaccine and autism in the first and only MMR-autism study ever conducted by CDC with American children".

And one of the authors of the most-cited paper purporting to disprove any association between autism and the MMR vaccine, Poul Thorsen, was "indicted by a federal grand jury on charges of wire fraud and money laundering based on a scheme to steal grant money the CDC had awarded to governmental agencies in Denmark for autism research." Funny how the Lancet paper is discredited because Wakefield (supposedly) received money for a legal case, but no one questions a paper coauthored by a guy who bought "a home in Atlanta, a Harley Davidson motorcycle, and Audi and Honda vehicles" with money that was supposed to be funding research on autism and vaccines.

As for the non sequitur argument that an accident in the hospital carpark can't be attributed to the vaccine one just had, therefore illness occurring after vaccines can't be related either, oh puh-lease. Can we at least get past the fourth grade with our debating skills? There are multiple well-established biochemical and physiological pathways via which vaccines can trigger disease, which is why the US National Vaccine Injury Compensation Program maintains a table of covered injuries, which both the vaccine manufacturers and the government acknowledge are causally related to the administration of particular vaccines. Among these "table injuries" are "encephalopathy or encephalitis" (brain disorder or inflammation) which is a well-established pathognomic feature of autism.

There's plenty more low-IQ BS of this ilk on the Jitsuvax site, which I encourage you to explore for yourself, if only to ensure that you're fully prepared for any future encounters with "health care professionals" who want to use this insidious "Jiu Jitsu ‘model of persuasion'" to manipulate you into accepting vaccines, rather than engaging in a good-faith discussion of the risks and benefits of these medical procedures.

So, does ERI actually work?

Given the amount of EU taxpayers' dollars that have been funnelled into this project, the results of the four experiments documented in the paper must have been quite deflating for the authors (but don't worry; I'm sure the grant money spigot will keep on flowing).

The first experiment, which tested Step 1 (eliciting concerns), failed to change participants’ level of vaccine acceptance. The second, which tested Steps 2 and 3 (affirmation and refutation) also failed to change participants’ level of vaccine acceptance, while the third and fourth, which tested Steps 1-4, found that ERI increased participants' perceptions of HCPs' trustworthiness, but produced only a "small" increase in vaccine acceptance.

In other words, people who were sceptical of vaccines felt better about practitioners who didn't dismiss them as morons, but they weren't substantially more likely to take the recommended vaccines just because the doctor was nice to them. Because they're not morons.

Finally, if you wonder, as I frequently do, whether the highly-educated researchers who write these puerile papers and produce slick websites that push vaccine misinformation are a) evil liars who consciously serve the financial interests of vaccine manufacturers or b) useful idiots who actually believe their own BS, the following passage, excerpted from the paper which provided the "taxonomy of antivaccination arguments" quoted in the study discussed in this post (and which shared four authors with it), will prove enlightening. I'm quoting this article at some length because it's so incredibly revealing of the utter intellectual blindness of vaccine idealogues. Ready? Here goes:

"Limitations of our methodological approach

Most previous studies and typologies of anti-vaccination contents are based on the analysis of primary sources, including, among others, websites, social media posts, and interviews with parents and patients. Our taxonomy differs in that it was developed based on the integration of secondary sources, namely previous conceptualizations carried out by scientific researchers. The systematic literature review constitutes an exercise of ‘collective intelligence’ [124] that, despite not being exempt from limitations, allowed us to build upon a wide variety of studies from a multiplicity of socio-cultural contexts, methodological approaches, and communication channels. However, a potential source of bias caused by the reliance on secondary sources consists of a possible 'group-think' among the researchers whose conceptualisations we analyzed and integrated. The taxonomy would then be amplifying the biases of the academic community rather than revealing the underlying contrarian argumentation. While this possibility cannot be entirely ruled out, we consider it to be highly implausible. For this bias account to hold, the roughly 500 researchers in this arena who contributed to our systematic review would have had to exhibit the very same biases across several decades and many different research disciplines, corpora, methodologies, vaccines, cultures, and nations. Moreover, considering the text modeling of Study 2 [an analysis of ‘fact checks’ on ‘COVID-19 vaccine misinformation’], in which the types and frequency distribution of arguments were found to be similar to the results of the literature review (Figure 2), those biases would also have to operate among a completely different and independent set of professionals (namely fact-checkers) who were engaged across a narrow time span and in a different context pertaining to a specific vaccine that did not exist for most of the period examined in Study 1. We find it difficult to conceive of a mechanism by which academic 'group think' would not only persist over several decades but then also infuse an entirely different group of people."

A taxonomy of anti-vaccination arguments from a systematic literature review and text modelling

Do you see how these people think? They honestly believe that if everybody else who has published in this field believes what we believe, it must be true. (The public consensus is definitely not because anyone who dissents from the vaccine orthodoxy suffers the fate of Dr Andrew Wakefield or Dr Andrew Zimmerman or Dr Sherri Tenpenny or Dr John Piesse or any of the other professionals who have been sacked, deregistered, censored, legally harassed, had their scientific papers retracted for spurious reasons, and been subjected to relentless and coordinated public smearing campaigns, which is of course entirely justifiable and exactly the way that science is meant to work.)

And if "fact checking" organisations receive substantial funding from a PR group which counts vaccine manufacturers among its top clients and the vaccine-promoting Bill & Melinda Gates Foundation, that couldn't possibly influence the "fact checks" that they publish.

If you believe otherwise, you're a conspiracy theorist. Well yeah, I am. Because to quote Dave Collum, a Cornell University chemistry professor:

Of course, before making any decisions about vaccines, you should take the time to get yourself fully informed on each so-called vaccine-preventable disease and the vaccine/s used against it, so that you can make an informed risk-benefit analysis. Here's a few books to get you started:

• Make an Informed Vaccine Decision for the Health of Your Child: A Parent's Guide to Childhood Shots by Dr Mayer Eisenstein and Neil Miller discusses the prevalence, risks and proper management of so-called vaccine-preventable childhood diseases, and the risks of the vaccines themselves. It's a good place to start, although it does not cover vaccines added to the schedule after 2010.

• Dissolving Illusions: Disease, Vaccines, and The Forgotten History by Dr Suzanne Humpries and Roman Bystrianyk, and Turtles All The Way Down: Vaccine Science and Myth, by anonymous Israeli authors, have both "red-pilled" many erstwhile adherents of vaccine orthodoxy.

• Miller's Review of Critical Vaccine Studies: 400 Important Scientific Papers Summarized for Parents and Researchers by Neil Miller contains summaries of 400 important scientific papers demonstrating the risks of vaccines.

Feel free to add your favourite educational resources on vaccines in the comments section below.

For information on my private practice, please visit Empower Total Health. I am a Certified Lifestyle Medicine Practitioner, with an ND, GDCouns, BHSc(Hons) and Fellowship of the Australasian Society of Lifestyle Medicine.