With the recent U.S. outbreaks of whooping-cough and measles, public health advocates and pro-vaccine parents are trying to find new ways to reach people who refuse to vaccinate their children. Researchers have connected the resurgence of the diseases with the growing refusal to vaccinate.
The Centers for Disease Control and Prevention (CDC) director of immunizations and respiratory diseases Ann Schuchat says the recent measles outbreaks in New York, British Columbia and Southern California are examples of what could happen on an even larger scale if vaccination rates drop.
Measles was declared to be wiped out in the U.S. in 2000, but in 2013 there were 187 confirmed cases in the U.S., and already in 2014 there are 70 reported cases. Before the measles vaccine was introduced in the 1960s there were 500,000 cases per year in the U.S., and public health officials attribute the drop to the effectiveness of vaccines.
The CDC says 48,277 cases of pertussis (whooping-cough) were reported in 2012, along with 20 deaths, mostly among infants under three months. California has had a sharp increase in pertussis cases and health officials say in addition to children who were not vaccinated at all, a big reason is kids who were vaccinated but did not get the booster shot recommended at about age 12.
Matt Willis, a public health officer for Marin County, says that if pediatricians can figure out why parents are not vaccinating their children they can perhaps come up with better approaches to try to change their minds. Willis helped design a survey to explore parents’ fears of vaccines. They questioned parents in Marin County, the site of one whooping-cough outbreak.
Responses to the public health survey by people who refuse to vaccinate were largely centered on three major themes: preference for natural immunity; children seen as low risk for some diseases vaccines protect against; and lack of trust in the pharmaceutical industry or health care system.
One study at Dartmouth College that surveyed 1,800 parents about the mumps, measles, and rubella (MMR) vaccine found that the more skeptical parents are about vaccines, the less likely they are to listen to their pediatricians or to public service ads.
One Marin County pediatrician, Nelson Branco, tells his patients to get their kids vaccinated or find another doctor. Only about 20 families chose to leave his practice. 150 vaccinated.
Another physician gives parents scientific journal articles and challenges them to disbelieve the experts. He asks if they can actually say that all these authors and the publication’s editors are in some sort of conspiracy to publish untrue data.
Thomas Sandora, an infectious disease specialist at Boston Children’s Hospital, says measles is the most contagious disease on the planet right now. It can remain in the air for two hours after an infected person leaves a room, and is contagious four days before the rash appears. About 90 percent of people who haven’t been vaccinated will become infected if exposed. One person in 1,000 dies.
The CDC says it continues to be important to vaccinate, even for diseases that are becoming rare, such as polio and diphtheria. If parents do not keep immunizing until the disease is completely eliminated it will spread again. Some diseases rarely seen in the U.S. persist around the world. People who get infected in the U.S. often are exposed by travelers bringing the disease back from other countries.
Health scholars have rated vaccination as one of the top 10 achievements of public health in the 20th century, but opposition has existed as long as vaccines have, starting as early as the mid-1800s with opposition to the smallpox vaccine. This resistance resulted in the Vaccination Act of 1867, which made the vaccine mandatory for kids up to 14 years, with legal penalties for refusal.
Present-day outreach efforts by public health vaccination advocates to the population who refuses to vaccinate are ongoing. 48 states currently allow parents to sign vaccine exemption forms.
By Beth A. Balen