MDs Retool for Vaccine Safety Debate

H. Fred Clark and Paul Offit, the inventors of...

H. Fred Clark (l) and Paul Offit (r). Image via Wikipedia

Last month, the National Medical Association convened their Annual Convention and Scientific Assembly in Washington, DC.  In a special Pediatrics Immunization Update, Daniel Salmon, PhD, MPH and Paul Offit, MD presented to physicians and health care providers about current issues in pediatric immunization and managing parental concerns regarding their safety.  This was a timely presentation.  During August, pediatricians see many patients who are preparing to go to school for the first time and their parents who have many questions and concerns.

Sources of Misinformation

Dr. Offit who serves as the Director of the Vaccine Education Center and Chief of the division of infectious diseases at the Children’s Hospital of Philadelphia explained that an increase in parents  refusing to immunize their children correlates strongly with the publication in the medical journal, Lancet of a paper by Andrew Wakefield posing a hypothesis for a link between autism and the MMR (measles-mumps-rubella) combined vaccine.  Though the study has been disproven many times over and a recent British Medical Journal (Jan 5, 2011) editorial characterized Dr. Wakefield’s work as “an elaborate fraud,” parental fear and distrust surrounding the medical need for the standard schedule of childhood immunizations continues to persist.

The Current Challenge

Dr. Salmon who is the Director of Vaccine Safety at the National Vaccine Program Office of the Department of Health and Human Services presented statistics that underscored the immunization refusal trends.  In some counties throughout the country, as many as 25% of appropriately aged children have not been immunized.  On average, however, only about 10% of parents have delayed or refused one or more of the recommended immunizations for their child(ren).  Every state allows exemptions to its laws for medical, religious, or philosophic reasons.  But when you combine these facts with the pervasiveness of unproven or unsubstantiated health information available on the internet, the low health and science literacy of many parents, and poor communication between parents/patients and physicians, it becomes easier to understand how myths and misinformation around childhood immunizations persists.  A dangerous result can be an increase in immunization exemptions to the point where communities can become particularly vulnerable.  When immunization in a community falls below critical thresholds, herd immunity ceases to exist.  There is direct overlap between low prevalence of immunization communities and outbreaks of certain vaccine-preventable disease, such as pertussis (whooping cough).  This was featured in detail in the PBS Frontline broadcast The Vaccine War that we discussed in a previous blog post.

Fear of overloading the immune system, a belief that vaccine-preventable diseases are not dangerous or their children simply are not at risk for contracting the illness are all among reasons why parents refuse to immunize their children.  “We may practice evidence-based medicine, but most parents are motivated by anecdotes,”  Dr. Salmon continues, “It’s important to try to understand the parents’ concerns and what influences them.”

What can be done?

It is imperative that physicians take the time to have productive conversations with their patients (and their patients’ parents).  Providing accounts of patients who were saved because of vaccinations or describing the suffering and complications caused by vaccine-preventable illnesses may prove to be more persuasive and meaningful to concerned parents.  If you are a concerned parent and want to have a meaningful conversation with your child’s pediatrician, consult the Screening Guide for Child and Teen Immunizations on the health guides page before your next appointment.

Read more:

Paulsen, Emily.  Parental Fears Over Childhood Vaccination Must Be Addressed. Medscape Medical News at Medscape.com.

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