Why Parents Don’t Vaccinate Their Children—And What We Can Do

August 2, 2013

It's a horrific, heartbreaking sight and sound: Whooping cough victims wracked with prolonged coughing spasms so violent that they may break their ribs. It often creates a strange, sickening "whooping" sound as patients struggle to inhale air after such coughing. If left untreated the coughing fits can last months and interfere with eating and sleeping-and can be fatal. Though adults can catch whooping cough, it is most often found in children. It sounds like something from the Middle Ages akin to the black plague, and there is an effective vaccine against it. Still, whooping cough is making a scary comeback-and partly because of people like celebrity anti-vaccination activist Jenny McCarthy.

There are several reasons why some parents choose not to vaccinate their children, though most of them come down to misinformation from anti-vaccine advocates. With the recent addition of Jenny McCarthy to the popular ABC television show The View, many people are wondering what effect, if any, this will have on vaccination rates.

Much of the current fear and doubt about the safety of vaccines and autism can be traced back to Dr. Andrew Wakefield, the lead author of a small 1998 case report suggesting a link between vaccines and the onset of childhood autism. The British General Medical Council found he had acted unethically in his research, and his paper, which was championed by several celebrities including McCarthy, was retracted by its publisher, the Lancet.

It is true that there are risks involved in vaccinations, as there are with any drug or medical intervention. The risks are not hidden but instead well-known and easily available from your doctor or online. The risks of side effects, however, are far less dangerous than the risks of catching the disease.

One way to encourage vaccination is to counter obvious examples of anti-vaccine misinformation. For example many people claim that it is not the deactivated measles-mumps-rubella (MMR) vaccine itself that causes autism but instead a preservative used in the mix called thimerosal, which contains potentially toxic organic mercury. However as science journalists (including Seth Mnookin, author of The Panic Virus: A True Story of Medicine, Science, and Fear) noted on the PLoS blogs, the MMR vaccine "does not and never did contain thimerosal." Furthermore, thimerosal hasn't been in any American vaccines for nearly fifteen years.

There has been some research examining why anti-vaccine information is persuasive to many people. One of the most compelling factors is the availability of vivid, personal stories highlighted by anti-vaccination activists such as those seen on television and featured at personal appearances. It's a classic case of science versus anecdote: Statistics and authoritative, impersonal medical information will never be as compelling as an emotional, tearful story told by a mother holding the daughter whose autism she blames on the MMR vaccine. All the facts, data, and research fades away under the glare of human anger and suffering-whether the target of that anger is justified or not.

One article in Human Vaccination and Immunotherapy by A. Shelby and K. Ernst examined the issue and concluded that "Utilizing some of the storytelling strategies used by the anti-vaccine movement, in addition to evidence-based vaccine information, could potentially offer providers, public health officials, and pro-vaccine parents an opportunity to mount a much stronger defense against anti-vaccine messaging." Perhaps tearful stories and personal anecdotes from parents who failed to vaccinate their children (and who were injured or died as a result) might be an effective counter-measure.

Putting the fear of vaccines in historical perspective may also help allay parent's fears. Fear of vaccination is nothing new; it's been around for centuries. There was vehement resistance to the very first vaccine, created for smallpox in the late 1700s. When the public learned that the smallpox vaccine was created by taking pus from the wounds of infected cows and giving it to humans, they were disgusted by the idea; some even believed that the vaccination could turn children into cows!

In England, vaccination deniers formed an Anti-Vaccination League in 1853. Echoing many of today's anti-vaccination claims, this and other groups claimed that the smallpox vaccine was not only ineffective and dangerous, but represented an infringement on personal rights by the government and medical establishment. If concerned parents understand that early fears over smallpox vaccination (as well as polio, diphtheria, and others) are unfounded, they may accept that current fears over childhood vaccinations are as well.

There is truth to the idea that celebrities can influence the opinions and beliefs of their audiences, and it is certainly possible that as long as McCarthy continues to actively sow doubt about the safety of vaccines, her audiences will refuse to vaccinate their children. But there are ways we can counter this misinformation and save children's lives.

 

 


References


Healy M. Jenny McCarthy on 'View': A new forum for discredited autism theories. The Los Angeles Times. 2013 Jul 15. Available at http://www.latimes.com/news/science/sciencenow/la-sci-jenny-mccarthy--view-autism-20130715,0,6008429.story.

Holler K, Scalzo A. "I've heard some things that scare me". Responding with empathy to parents' fears of vaccinations. Mo Med. 2012 Jan-Feb;109(1):10-3, 16-8. PubMed PMID: 22428439.

Mnookin, S. "A PSA to journalists writing about vaccines: Thimerosal was never used in the MMR vaccine". PLoS blogs. 2013 Jul 16. Available at http://blogs.plos.org/thepanicvirus/2013/07/16/a-psa-to-journalists-writing-about-vaccines-thimerosal-was-never-used-in-the-mmr-vaccine/

Sadaf A, Richards JL, Glanz J, Salmon DA, Omer SB. A systematic review of interventions for reducing parental vaccine refusal and vaccine hesitancy. Vaccine. 2013 Jul 13. doi:pii: S0264-410X(13)00935-3. 10.1016/j.vaccine.2013.07.013. [Epub ahead of print] PubMed PMID: 23859839.

Shelby A, Ernst K. Story and science: How providers and parents can utilize storytelling to combat anti-vaccine misinformation. Hum Vaccin Immunother. 2013 Jun 28;9(8). [Epub ahead of print] PubMed PMID: 23811786.

Comments:

#1 PS (Guest) on Friday August 02, 2013 at 2:04pm

The point you are missing is that the same government that lies to us about everything else, which has Monsanto CEO’s working for the FDA, etc, is supposed to be believed as an article of faith.

#2 Q O'Neill (Guest) on Friday August 02, 2013 at 8:35pm

The CDC is a pretty good resource for vaccine facts and data. Here’s a sample:

#3 Q O'Neill (Guest) on Friday August 02, 2013 at 8:42pm

I guess I can’t include a link without registering. Never mind then.

#4 aminfidel on Saturday August 03, 2013 at 9:32am

to PS- the science, PS, the science.  not the government, not the government.
  because the government is controlled by the Communists and is poisoning our water with fluoride…now, wait, that has to be updated now…oh yeah, it’s Obama and the Socialists with their death panels, that’s it!

#5 Q O'Neill (Guest) on Saturday August 03, 2013 at 10:16am

This article, which ironically advocates countering misinformation, serves up a lot of its own. Contrary to the statement “thimerosal hasn’t been in any American vaccines for nearly fifteen years”, the preservative is still used in some vaccines (see the CDC’s fact sheet on thimerosal).

The CDC also has national data on childhood vaccination rates for both DTAP and MMR. These data, which are freely available online, suggest that childhood vaccination rates for pertussis and measles were approximately the same in 2011/2012 as they were in pre-Wakefield 1997. In 2011/2012, 94.6% of children aged 19 to 35 months received at least 3 doses of pertussis vaccine. That’s pretty high, and though this rate may fluctuate a percentage point or two from year to year, we really can’t blame Wakefield or Jenny McCarthy for the resurgence of pertussis.

Given the amount of misinformation out there, people on both sides of any issue would be wise to get their info from established and reputable sources rather than from bloggers or likable non-experts.

#6 Q O'Neill (Guest) on Saturday August 03, 2013 at 10:26am

I think PS makes a good point. Conflicts of interest are rife among our governmental and public health agencies and they undermine people’s confidence in official health recommendations. Getting money out of politics, or at least putting some limits on it, would be an important step in the right direction.

#7 PS (Guest) on Saturday August 03, 2013 at 12:08pm

to aminfidel.  Check out this: 

#8 Rad1 (Guest) on Sunday August 04, 2013 at 7:43pm

While the incidence of pertussis, diphtheria, typhoid fever, and tuberculosis in 1900 was high, at least 80% of the reduction of incidence in all these infectious diseases occurred prior to the introduction of vaccines for diphtheria and pertussis (tb and typhoid fever never had mass vaccinations in the U.S.). Even the most religious vaccinationist will not claim the vaccines were effective even before they were invented. I suspect that improved nutrition, sanitation, and climate control caused these improvements, but whatever the reasons, it is absurd to think they vanished once vaccinations were imposed.

#9 dewdds on Monday August 05, 2013 at 12:44am

“The point you are missing is that the same government that lies to us about everything else, which has Monsanto CEO’s working for the FDA, etc, is supposed to be believed as an article of faith.” -  PS (guest)

Dang! Why didn’t I think of that? Is this the same government that also engineered 9/11 and JFKs assassination? 

No one in the gov’t asks people to believe as an article of faith in regards to efficacy of vaccinations, but to review the data from many, independent sources AND seek advice from their physicians based on their training and expertise. You can choose to be one of the credulous and risk the lives of your own children by refusing immunizations or you can educate yourself and protect those in your charge. Conspiracy theory always offers the easy and superficial answer, but avoids a careful and exhaustive review of the evidence.

#10 dewdds on Monday August 05, 2013 at 1:11am

“While the incidence of pertussis, diphtheria, typhoid fever, and tuberculosis in 1900 was high, at least 80% of the reduction of incidence in all these infectious diseases occurred prior to the introduction of vaccines for diphtheria and pertussis (tb and typhoid fever never had mass vaccinations in the U.S.). Even the most religious vaccinationist will not claim the vaccines were effective even before they were invented. I suspect that improved nutrition, sanitation, and climate control caused these improvements, but whatever the reasons, it is absurd to think they vanished once vaccinations were imposed.”

The TB vaccine is still not used today in the US because the only form, BCG, has shown very inconsistent protection in different studies. And while TB prevalence has likely decreased due to other factors, it has never been eliminated. Increases have been noted in many urban areas over the last 20 years linked to immigration and AIDS. Some strains of TB are now in the frightening “superbug” category and are resistant to all forms of anti-TB chemotherapy.

In the whole history of immunizations, we should not forget Smallpox, which had horrendous effects on humans prior to immunization. It’s elimination can be safely ascribed to vaccination efforts. Polio, another virus with potentially devastating results, could well join Smallpox in the museum of extinct diseases, were it not for the resistance by isolated Islamic leaders throughout the world, who use religion as a prime motive for rejecting vaccine use among their populations.

It is not surprising that these same regions tend to be the poorest and most undeveloped either, again due to the same religious authorities who are paranoid about any governmental program designed to bring some level of modernity, sanitation and health to people living there.

#11 Rad1 (Guest) on Monday August 05, 2013 at 6:00pm

Dear dewdds.  I think you are missing the point that the two infectious diseases which eventually had vaccines and the two which did not, all decreased since 1900 with most of the decrease occurring before vaccination. While the decrease in incidence continued as vaccines were introduced, the decrease also occurred in infectious diseases without vaccination.  In other words, there is no strong evidence that vaccines had any effect on the incidence of diphtheria or pertussis.  And after all, all epidemics end no matter what you do.  When therapy is introduced on the downside of the epidemic the therapists take credit for it.  Why did the plague end? (Now there was an epidemic!).  As for polio, which epidemic are you talking about?There were several in the US from 1910 to the 1930’s, all of them ending without vaccination. Same with measles. What are required are large studies with carefully matched controls.  Unfortunately, money usually trumps truth, and ideology, for that matter. There is an enormous financial bias with vaccinations, not just in the pharmaceutical industry.  Think of a typic pediatric practice. What, 26 vaccinations for each patient, times a thousand patients, times the fee for the shot.  Well beyond chicken feed. We all want vaccines to be safe and effective, but billions of dollars at stake clouds the issue.

#12 dewdds on Monday August 05, 2013 at 8:55pm

So you’d like diseases to run their course until they burn out? Well then, I guess we all could live with a 30% mortality rate that accompanied the Eurasian outbreak of Yersinia pestis plague during the late Medieval era. And of course none of those evil pediatric physicians would have a chance to collect massive profits!

Even the Polio and Measles endemics of recent times followed similar courses. They raged for a time and then burnt out, at smaler scales, but not without some human cost. How much human suffering and sequelae is enough for you to say, “Ah, just let nature take its course.”? Is it worth having a spike of paralyzed kids to keep vaccine makers from selling their medicine? You seem more interested in using people as sacrificial lambs all in an effort to fight ‘Big Pharma’. By the way the cost benefit analysis shows consistently that proven vaccines save lots of money for any health care system.

I should mention that your proposed study, if followed through its entire time frame, would be deemed unethical by any Institutional Review Board. When efficacy has been solidly established early in any study, denying the treatment to the control group isn’t exactly humane.

#13 KM (Guest) on Tuesday August 06, 2013 at 7:01am

If you want to write an article blaming Jenny McCarthy and her acolytes for disease outbreaks, why don’t you do your homework and use an example other than pertussis?

How much work did the author do to inform himself about pertussis?

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