Reversing America’s Dangerous Anti-Vaccination Trend

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Baby with measles

Baby with measles. Source: CDC

The trend to shun vaccinating children in the U.S. started with an unsubstantiated journal article by Andrew Wakefield, which linked the MMR vaccine to autism. Public health professionals could have never predicted the damage one report could do in the 12 years it lingered before the Lancet retracted it. Still today, increasing numbers of highly educated parents — too young to know the fear of contracting polio or measles — are standing firm to obtain exemptions or delay vaccination for MMR, Tdap (tetanus and whooping cough), and other vaccines despite the retraction. Many of them perhaps may not know or refuse to believe that the science was debunked. Instead, they ride the wave of misinformation that was never forcefully corrected by the media. Star-powered advocates, such as Jenny McCarthy, heighten the movement.

Recent cluster outbreaks of whooping cough and measles resurgence have been the outcome.  The CDC sets immunization schedules and helps parents make informed decisions. Rejecting vaccines is not just about one kid skipping a shot, but the domino affect of a globally linked community. It is easy to see the toll at the country level as well.

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The U.S. prides itself on freedom of choice, but perhaps for the greater public health good, the choice to opt out of immunizing children should be limited. National policy requiring parents to go through a vaccine education course before being granted a pass on immunization may change their perspective and give them a science-based foundation. Pro-advocacy parent groups, such as Every Child by Two, are also vehicles to counter misinformation. Strong and consistent media advocacy is also needed to correct misperceptions and quell fears about childhood vaccines. Hopefully, with these measures, the U.S. can reverse the antivaccination trend before more vaccine-preventable diseases and deaths occur.

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10 Responses to “Reversing America’s Dangerous Anti-Vaccination Trend”

  1. ferialadha Says:

    A lot of individuals have received incorrect information about vaccines and risks associated with them. Vaccines have provided us with a great resource in order to not only combat diseases and their implications, but also help reduce medical costs. A news report from the CDC mentioned that vaccines reduced direct medical costs by $13.5 billion and also saved $68.8 billion of societal costs (supplies and special education for disabled children and productivity losses). However, the interesting thing researchers found was that recent vaccine campaigns are not actually encouraging parents to get their children vaccinated. Instead parents learn that autism is not caused by vaccines, but they end up finding a new excuse justify their anti-vaccine beliefs. Therefore, informing parents may not be the best approach, but a more constructive plan needs to be created to approach anti-vaccine parents. Having an immunization course will help parents actually learn more about how vaccines works and the science behind it, but much more needs to be done to change their beliefs. Parents are always scared of anything harming their children and with the whole anti-vaccine movement a lot of parents will have difficulty changing their belief right away. This will be a slow and gradual process to win back parents trust in order to get their children vaccinated, but we should not give up! This is the article: http://www.cbsnews.com/news/pro-vaccination-campaigns-debunking-myths-may-scaring-wary-parents/

  2. sbfphc Says:

    Note also that the policy issues should take into account existing laws and policies about school enrollment and immunization history of a child. Exemptions are mentioned above, and we should strive not for exemptions but for enforcement. Localities might be worried about liability for the rare adverse events, but that can also be handled through intelligent policy decisions. Mandating educational classes may not be possible, but better public education through media channels that reach those reluctant to vaccinate should be used. Policy makers themselves should be strident leaders and champions for life saving vaccinations – and remember that policies are meant to protect the public from the dangerous behavior of those who don’t vaccinate their own children and thus expose other children the community to the risk of expensive illness and death.

  3. scho52 Says:

    Alarmingly, due to the antivaccine movement, our children are vulnerable to the resurgence of diseases that were almost completely eradicated. Subsequently, the Herd Immunity Phenomenon is even more important since electing not to vaccinate a child leaves entire communities vulnerable to infection and disease. Recent examples of consequences related to the antivaccine movement include the recent pertussis outbreak in California, as well as, the 1989 measles outbreak that resulted in 136 deaths in the United States. On a positive note, since 1999, deaths related to measles have fallen by 60% worldwide, but recent reports from Britain indicate the resurgence of measles. And yet, people are still naïve and overlook the fact that the flu hospitalizes 114K U.S. residents annually and results in 30K deaths per year.

     Harvard University. (2013). Vaccines and Your Health. Retrieved from http://www.health.harvard.edu/flu-resource-center/vaccines-and-your-health.htm
     ProCon. (2013). Vaccine Pros and Cons. Retrieved from http://vaccines.procon.org/#arguments

  4. euhunmwangho Says:

    This is quite an interesting topic. First of all, i am surprised to learn that there are still anti-vaccine beliefs in developed countries. I assumed this was a predominantly ‘developing country issue’. Secondly, the cbs news article suggests that public health messages did not change the anti-vaccine beliefs of the study group and highlights the mode of information delivery as a determining factor of change. Hence, it goes to say that it is not enough to just give people information of the pros and cons of an intervention. Enforcing existing policies is ideal, however, the United States thrive on their ‘right-to-freedom-of-choice’ and this may breed resistance. I think one of reason for anti-vaccine beliefs is the lack of trust. Developing countries have been struggling with anti-vaccine issues for a long time and are still struggling. One innovation that was employed in Northern Nigeria to eradicate polio was that community members who had given their children the vaccine were used as outreach to convince their neighbors to take the vaccine as well. The idea is that “if my neighbor who i live with and trust can do this, then it must be ok”. It was successfully, albeit briefly. So i would suggest that in addition to the campaigns and policy enforcement, pro-vaccine champions could be raised in communities. These champions would directly relate to their society members and also provide support geared towards ensuring appropriate vaccinations are carried out. This article: “Increasing vaccination rates among health care workers using unit “champions” by Slaunwhite et al, speaks more about this idea. Here is the weblink: http://www.ncbi.nlm.nih.gov/pubmed/19891169

  5. lbuchhalter Says:

    Thanks for a very interesting post! One distinction that is not made often enough in the public health debate over vaccination is the difference in populations who are under-vaccinated (have received some, but not all of recommended vaccines) and those who are non-vaccinated. The National Immunization Survey carried out about ten years ago had interesting findings with regard to this divide. About half the families of non-vaccinated children have concerns about vaccine safety, like you described in your post. Unvaccinated children are more likely to be white, and to have a variety of indicators of high SES. Under-vaccinated children, on the other hand, are more likely to be poor, Black, have worse access to health care, and a variety of indicators for lower SES. Only about 5% of these families had concerns about vaccine safety. (http://www.immunizationinfo.org/science/demographics-unvaccinated-children).
    I think when discussing the issue of vaccination rates in the country, it’s important to make a distinction between these two groups. This is because the reasons behind under and non-vaccination are very different. In the first case, access and resources are the primary issues. In the second case, knowledge and attitudes are to blame. Acknowledging these two groups allows for targeted interventions that are appropriate and impactful.

  6. lilamcconnell Says:

    Berkley and George — I’m so glad someone chose to write their blog about this topic. As public health professionals, it is our job to inform the public about the most pressing health issues in the world today, and the impact one article (such as Andrew Wakefield’s) can have on the field and subsequent actions of the public is astounding. As you mention, the diseases targeted in vaccines have not gone away entirely. For example, just last month New York City had a mumps outbreak on one of their college campuses. This goes to show that even the most progressive cities still suffer from outbreaks! Though the mumps outbreak was contained in NYC, the potential for these diseases to spread very quickly through such a densely populated city is very real and very threatening.

    I like your idea about an education course required for new parents deciding on vaccinations for their children. Perhaps these sorts of info sessions could be integrated into already existing programs such as child CPR classes or lamaze training?

  7. mvertenten Says:

    Thanks for this posting it’s a great topic. In a Public Health Law class here on campus they covered the tension between allowing exemptions (to ensure vaccine policy is not entirely rolled back), and maintenance of the status quo, with a trend towards more exemptions (and not less) to keep existing policies intact. State exemption laws have to be careful to afford all religious/personal belief groups the same exemptions. The class also highlighted that making it tougher to get the exemption is not necessarily unlawful and a good mechanism to encourage continued compliance.

  8. arifwadood212 Says:

    This topic has always been interesting to me, especially since a similar event occurred In Pakistan, with misinformed religious leaders stating that vaccinations lead to many issues, sterilization, death and other things. This article had the same effect, in which it caused a fairly high degree of confusion. What is sad however, is that with all the information and resources available, parents didn’t seem to investigate the claim, and instead, believed the article. Both cases show the power of messaging and media in Public Health and that something as common-sense and intuitive as getting vaccinations can be turned in to a boogie man.

  9. emmanueliyoha Says:

    It is really quite disconcerting that despite that fact that disease outbreaks have killed millions of people and a lot of time and resources have been spent to develop prevention strategies, many people still choose not to or allow their children get vaccinated. The truth is that despite the fact that Andrew Wakefield’s research publication was retracted years ago, many still campaign in support of his findings and the backlash effect of the publication still lingers. The United States government has been making intensive effort to convince the “anti-vaxxers” on the safety of MMR vaccine by providing scientifically proven arguments that vaccines are safe. However a recent survey showed that pro-vaccination messages did not significantly increase the rate of intended vaccination and some even provided anti-vaccination backlash. Current public health communications about vaccines may not be effective so there is the need to take a look at the messages being delivered and even test the messages the way scientific inventions are tested for effectiveness prior to publicity.
    http://healthland.time.com/2014/03/04/nothing-not-even-hard-facts-can-make-anti-vaxxers-change-their-minds/

  10. jennifertrumbore Says:

    As someone who’s worked in vaccine production, the anti-vaccine movement is very frustrating to me. (Someone once told me that they think vaccines are a conspiracy. I replied that my job would be a lot easier if it was a conspiracy!) I think it’s definitely an “out of sight, out of mind” mentality. People are scared of autism because it’s right there and when they don’t see the devastating effects of polio, measles and other vaccine preventable diseases, it’s easy to not see the importance of vaccines. These diseases are seen as diseases of the past, so why should they put their children at risk to prevent a disease that isn’t a threat? But they don’t put together the fact that these diseases aren’t prevalent anymore BECAUSE of vaccines. Also, since vaccine’s are a preventative medicine, rather than a treatment, it’s hard to make the connection to the benefits of the vaccine. A lecturer in the Tropical Medicine class at Hopkins said that they sometimes give deworming treatments when they vaccinate children in Peru, so there is an immediate benefit to coming to the clinic. Even though the deworming isn’t connected to the vaccines, it helps the parent to feel that there is a benefit and need for the vaccines.

    Another “celebrity”, Kristin Cavalleri from The HIlls, has said that she hasn’t vaccinated her child because she has “read too many books about autism.” It’s frustrating how much attention is given to these so called celebrities when they speak out on subjects that they are in no way experts in.

    I think we all as healthy individuals have a responsibility to get vaccinated to help to protect those with compromised immune systems who cannot get vaccinated or those who have waning immunity to vaccines, such as HIV+ children on HAART. I wish everyone would feel that global responsibility to their fellow citizens. I am concerned that it may take a major outbreak of a vaccine preventable disease, such measles or pertussis, to really show how important vaccines have been to public health.

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