An outbreak of measles in Washington and Oregon has refocused attention on parents who choose not to vaccinate their kids, often known as “anti-vaxxers.” Public health advocates have struggled to change these parents' minds. One South Carolina woman has a different approach. She is reaching out to people before they even become parents.
In 2017, Kim Nelson had just moved her family back to her hometown in South Carolina. Moving boxes were still scattered around the apartment and while her two young daughters played, Nelson scrolled through a newspaper article on her phone. It said religious exemptions for vaccines had jumped nearly 70 percent in recent years in the Greenville area – the part of the state she had just moved to.
She remembered yelling to her husband in the other room, “David you have to get in here! I can’t believe this.”
Up until that point, Nelson hadn’t run into mom friends that didn’t vaccinate.
“It was really eye-opening that this was a big problem,” she said.
Nelson had her immunizations and so did her kids. But this news scared her. She knew that infants were vulnerable — they couldn’t get started on most vaccines until they were two-months-old. And some kids and adult have diseases, which means can’t get vaccines and rely on herd immunity. Nelson decided she had to do something.
“I very much believe if you have the ability to advocate, then you have to,” she said. “The onus is on us if we want change.”
Like a lot of moms, Nelson had spent hours online. She knew how easy it was to fall down internet hole — into the world of fake studies and scary stories.
“As somebody who just cannot stand wrong things being on the internet,” Nelson said, “If I saw something with vaccines, I was very quick to chime in ‘That’s not true’ or ‘No, that’s not how that works.’ I usually got banned.”
Nelson started her own group, South Carolina Parents for Vaccines. She began posting scientific articles online and responding to private messages from concerned parents with specific questions. She also found positive reinforcement was important and would roam around the mom groups, sprinkling affirmations.
If someone posted “My child got their two-months shots today,” Nelson said she’d comment, “Great job mom!”
But then, she thought it would be best to zero in on moms that were still on the fence about vaccines.
“It’s easier to pull a hesitant parent over than it is somebody who is firmly anti-vax,” Nelson said. “They feel validated by that choice — it’s part of community, it’s part of their identity.”
The most important thing is timing — reaching moms during pregnancy, when they’re going online to figure out how to keep their babies healthy. Nelson latched onto one survey study from the Centers for Disease Control that showed 90 percent of expectant women have made up their minds on vaccines by the time they were six months pregnant.
“They’re not going to a pediatrician. Their OB-GYN is probably not speaking to the pediatric vaccine schedule,” she said. “So where are they going? They’re are going online.”
Before parents got bad information online, Nelson would be there first with facts. But she also understood the value of an in-person dialogue. She organized a class at a public library and advertised the event on mom forums. Nelson was nervous that anti-vaxers might show up.
“Are they here to rip me a new one? Or are they here to learn about vaccines?” Nelson wondered. “I just decided — if they’re here, I’m going to give them good information.”
Amy Morris was pregnant, but she drove an hour-and-a-half to attend the class. Morris wasn’t the typical first-time mom Nelson was trying to reach. She already had three kids. But during this pregnancy, she was getting nervous about vaccines. She had recently had a miscarriage, and it was right around the time she got a flu shot. Morris had been reading the pro and anti-vaccine posts in the mom forums and was starting to have some doubts. In Nelson’s class, she learned the risks of not vaccinating.
“That spoke to me more than anything,” said Morris.
Now, holding her healthy 8-month-old son Thorin on her lap, she said she’s glad she went because she was feeling vulnerable.
“I always knew it was the right thing to do,” Morris said. “I was listening to that fear monster in the back of my head.”
Nelson said that fear is what the anti-vaccine community feeds on. She’s learned to ask questions to help parents get at the root of their anxiety.
“I do think they appreciate it when you meet them sympathetically and you don’t just try and blast facts down their throat,” Nelson said.
Nelson is now trying to get local hospitals to integrate that vaccine talk into their birthing classes. And she’s studying for a master’s in public health and even considering a run for office.
This story is part of NPR's reporting partnership with WFAE and Kaiser Health News.