Thursday, October 11, 2012

What will it take to convince parents wary of vaccine safety that the public health community's efforts (and the public health laws and recommendations) are for the protection of their children? Will it take their child's individual exposure to a deadly, vaccine-preventable disease?  It certainly appears we are headed down this dangerous path as the rate of non-medical exemptions from school immunization requirements continues to accelerate, according to a study in the New England Journal of Medicine [1]. In parallel with the increased rate of non-medical exemptions, the number of reported measles cases more than doubled from 2010 to 2011[2].

It has been over a decade since a U.S. Food and Drug Administration study revealed  a six-month-old receiving the recommended vaccines containing the mercury compound, thimerosal, receives twice as high as the amount of mercury considered safe in a diet that includes fish[3]. Public health officials acted quickly and within less than a year thimerosal-free formulations of vaccine replaced vaccines containing thimerosal. Today, there are only trace amounts found in some flu vaccines; however, thimerosal-free flu vaccines are available. Yet, the online discussions regarding the danger of thimerosal in vaccines continues to take place and the waivers to immunizations that are mercury free continues to rise.

A study by Lenisa Chang, assistant professor of economics in the University of Cincinnati's Carl H Lindner College of Business, "The MMR-Autism Controversy: Did Autism Concerns Affect Vaccine Take Up?"  revealed Andrew Wakefield's publication in the Lancet linking the measles virus in the MMR vaccine and autism has led to a decline in vaccination rates even after epidemiologic studies thoroughly refuted the alleged MMR-autism link. The study found that the higher the parents’ education level, the less likely a child was to receive an MMR vaccination and that there may be a "spillover effect”, meaning parents are also exempting their children from other childhood immunizations[4].

Over the past several years, I have witnessed an increase in my college-educated family and friends questioning vaccine safety and the legitimacy of childhood immunization recommendations and requirements. Initially, I was in dismay at the level of concern friends were having over the decision to immunize their children according to the recommended guidelines. Having worked alongside the professionals researching, informing policy, educating and administering immunizations for the past 17 years, I was confident with my decisions as a parent to immunize my children. I did not understand the mistrust in government or the public health authorities when those that are informing vaccine safety and immunization policies are parents and grandparents themselves. They are committed not only to what is best for their children but for the public as a whole.

But I get it now; I understand where the confusion and mistrust comes from when trying to make an informed decision for a child's health and well being. Social media savvy parents have access to immunization information at their fingertips. In less than a tap of a screen, smart phones can display everything under the sun regarding childhood immunizations. Unfortunately, the technology is not advanced enough to filter out fact from fiction. The number of Web pages, tweets and blogs with anti-vaccination text outweighs the online published scientific evidence disproving the false information.

Before we are presented with an onslaught of vaccine-preventable outbreaks, I would like to challenge the public health community to change our parent engagement methodologies. We need to produce educational materials and interactive forums designed to reach the audience with a literacy level higher than a 5th grader. Static websites lacking the details on the integrity of the vaccine approval process, the research behind the recommended childhood immunization schedule and failing to have open forums with subject matter experts responding to parents concerns has driven parents to sites where parent engagement is welcome. Unfortunately, the information parents are receiving is not being validated and the credibility of the sources providing the information has not been proven. The public health community has spent decades researching, testing and setting policies to protect our children from vaccine preventable disease. Let's share this information with concerned and educated parents.

 

[3] Park, A. (June 2, 2008). How safe are vaccines?  Retrieved October 5, 2012, from http://www.time.com/time/magazine/article/0,9171,1808620-4,00.html.

[4] Ashton, J. (June 4, 2012). UC Research: Vaccinations of U.S. Children Declined after Publication of Now-Refuted Autism Risk. Retrieved October 5, 2012 from http://www.uc.edu/news/NR.aspx?id=15881


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