The Availability Heuristic, Vaccines, and Keeping Children Safe

"I just want to be safe."

That's what a mother of an infant told me today after she brought her child to the emergency department after he possibly ingested some glass from kitchenware he broke. Today was one of the days I do a shift in the ED in order to keep my emergency medicine skills and knowledge base active (I originally trained in both internal and emergency medicine before embarking on fellowships in infectious disease and critical care medicine).

Thankfully, the child didn't ingest any glass. But that's not why I'm writing about this incident. The reason I am writing about this is because the mother has delayed vaccination for her child, something that is unequivocally not safe. 

I find it hard to fathom that while a glass ingestion is correctly thought of as a clear and present danger to her child, vaccine-preventable illnesses--which kill incalculably more children than glass ingestions ever could--doesn't register the same sense of alarm in this mother.

The only explanation I can come up with is a serious threat misperception akin to fearing shark attacks but not drowning in the neighborhood pool--something that has to do with what is known as an availability heuristic coupled with the ability to imagine a horrible outcome. In this example, it is not hard for a mother to imagine her child ingesting glass and having a horrible outcome while it may be harder for her to imagine her child contracting a disease made rare because of the success of vaccines. 

This explanation carries some weight as we see the availability heuristic working for the vaccine cause after the Disneyland measles outbreak made it much easier for parents to imagine their child contracting measles and thus the increased support for vaccines.

I wish this mother realized that vaccines--as well as a broken glass free environment--are a crucial measure needed to keep her child safe .