GOSHEN — Editor's note: This is part one of a two-part series on immunizations.
Immunization is one of the most effective preventive health measures available and has saved countless children from death or serious illness. Extensive use of vaccines has eliminated or significantly reduced many deadly and debilitating diseases, so today’s parents are unfamiliar with the devastating effects of vaccine-preventable illnesses suffered by previous generations. Mainstream media and Internet discussions, often fueled by celebrity opinions, lends greater weight to ill-informed opinion or anecdotal claims about the dangers of vaccines compared with rigorous scientific studies that prove vaccines are safe and effective. Immunization has become an emotional issue.
A 1999 national survey showed 87 percent of parents felt immunizations were extremely important. In 2009 it dropped to only 80 percent. The primary non-medical reasons given for vaccine refusal include religious, moral and philosophical objections. Demographically, undervaccinated children were more likely to be black, live in poverty and have an unmarried younger mother without a college education. Unvaccinated children were more likely to be white with a married, college-educated mother and an income greater than $75,000.
Why parents refuse vaccines
Sixty to 70 percent of vaccine refusals are due to parental concerns about the potential for those vaccines to increase the risk of their child developing conditions such as Guillain-Barre syndrome, intussusception, autism, an increased susceptibility to infection, etc. There is no medical research to substantiate those claims. There is, however, a great deal of research showing the benefits of vaccines.
Myths and realities
- MMR vaccine and autism — In 1998, a small study in the UK involving 12 children taking the MMR (measles-mumps-rubella) vaccine alleged that MMR damaged the intestinal lining, allowing encephalopathic proteins to enter bloodstream and brain, leading to autism. That paper was exposed as fraudulent in 2011 after overwhelming evidence from multiple studies disproving that theory. Still, parental fear generated from that study led to a decreased in the immunization rate from 92 percent to 79 percent. This caused endemic large outbreak of measles there in June 2008, 14 years after the disease had been eliminated from the UK.
- Influenza vaccine and GBS — Concerns about the influenza vaccine causing Guillain-Barre Syndrome were raised by the news media during the 2009 H1N1 (swine flu) pandemic. Because a few cases occurred following administration of swine flu vaccine in 1976 and 1977, that cause-and-effect was erroneously compared with the newer, much safer H1N1 vaccine. In reality, the risk is small to nonexistent.
- Thimerosal and autism — Thimerosal is used as a vaccine preservative and has been hypothesized to cause the mercury-related development of autism. Numerous studies refute this hypothesis.
of vaccine refusal
Unvaccinated children have a substantially increased risk for contracting disease: Nine times greater for varicella (chicken pox), 22 to 35 times greater for measles, and up to 23 times greater for pertussis (whooping cough) compared to vaccinated children. Many large-scale outbreaks of measles, haemophilus influenza B, whooping cough and the flu have occurred in this country due to vaccine refusal.
How to improve the situation
It is critical for healthcare providers to listen to parents’ concerns. Providers must maintain an open, ongoing, nonconfrontational dialogue with parents to identify their misgivings and provide the best evidence-based information to alleviate fears. It is important to dispel myths, correct misinformation and direct parents to scientifically sound information.
I encourage parents to take the initiative to improve their child’s health through vaccination. That one act, in turn, improves the health of an entire community.
Fit Families is a cooperative series between IU Health Goshen Hospital and The Goshen News to educate families on health issues. Dr. Neelam Patel is with IU Health Goshen Physicians.