“Parents of one child opting out of immunization may be a rational
decision on one level, but if many opt out, risks grow both for their unvaccinated
children and also for those who have been immunized,” said CDC scientist
Deborah Gust, Ph.D. Much of the value of immunization comes from vaccinating
large numbers of people so a disease won’t spread even if a population
is exposed to it.
Adverse reactions to vaccines, recently reported to number 8,616, are
nearly as common as the 8,957 reported cases of the diseases they are designed
to prevent. But because most parents have never seen the toll of these
diseases, many fear vaccine side effects more than the disease.
Gust described a complex mix of factors leading to the current attitude
toward vaccination. Health care is viewed as a consumer good and having
treatment choices is part of the norm. Doctors were once seen as authority
figures, but now are considered partners in medical care. Parents want
to be informed and seek information wherever they can find it, whether
from physicians or in the sometimes-uncorroborated wilderness of the Internet.
Forty-three percent of Web sites about immunization take an anti-vaccine
point of view, Gust said.
As a result, she said, parents often know too little about the risks and
advantages of vaccines for their children. A 2003 CDC survey found that
12 percent to 16 percent of parents said they lacked information about
immunization, heard contrary information from a non-traditional source
or mistrusted the usual sources of information, like doctors or public
health officials. One in four parents in the survey said they lacked confidence
in the safety of vaccines.
Such concerns increase anxiety and reduce parents’ trust,
result in lower immunization rates in the entire population and prompt
parents
to turn to philosophical vaccine requirement exemptions that a growing
number of states permit.
“We have to stay ahead of the curve and communicate effectively
with parents,” Gust said. “Trust in health care providers is
the key. If parents don’t trust their pediatrician, they will go
somewhere else.”
Gust called for the public health community to educate parents about diseases
that mostly disappeared 30, 40 or even 50 years ago, and said parents need
to understand more about the science of immunization to reduce skepticism.
Laws that require vaccination prior to school should serve as a safety
net to back up educational efforts, she said.
