Vaccines: Medical Advances Encounter Resistance

November 3, 2019

Vaccines are one of the greatest achievements in the history of public health. Diseases like polio, measles, rubella, and diphtheria, which used to kill thousands of people in the U.S. and sicken hundreds of thousands more each year, have become exceedingly rare. Globally, the World Health Organization (WHO) estimates that vaccines saved 10 million lives between 2010 and 2015.

But in the past few years, vaccine hesitancy and refusal have been on the rise. Pockets of unvaccinated children have begun popping up around the country, a consequence of more parents seeking religious and philosophical exemptions from required vaccinations. Research now shows that vaccine hesitancy played a role in recent breakouts of measles and whooping cough.

Close-knit communities are particularly vulnerable; Somalis in Minnesota, Amish in Ohio, Orthodox Jewish communities in New York, and Eastern Europeans in Washington state have all experienced recent outbreaks of measles, which the WHO previously declared eradicated in 2000.

What’s going on here? Some experts say that vaccines have fallen victim to their own success – the elimination of once-common diseases has left parents unfamiliar with the serious risks of some preventable illnesses. But there’s more to the anti-vaccines movement, writes The Washington Post. What began decades ago as a legitimate concern “has metastasized into something far darker in the echo chamber of Facebook chat rooms, WhatsApp and YouTube — especially against a backdrop of rising suspicion of elites, including drug makers, doctors and public health officials.”

Here, we explore public opinion about vaccines and where our vaccination efforts have broken down.

The Vast Majority of Americans Vaccinate
Most Americans agree that vaccines safely prevent disease. In early 2019, a poll found that 73 percent of people believed the health benefits of the MMR vaccine to be high, and 88 percent believed the benefits to outweigh the risks.

Vaccine proponents cite evidence that vaccination is important on both an individual and a population level. Individuals benefit directly from vaccination because it protects them from contracting certain diseases, but they also benefit from herd immunity, by living in communities where most people are vaccinated. In other words, an unvaccinated person living in a community with a high vaccination rate is effectively protected.

That’s particularly important to people who, for medical reasons, cannot receive vaccinations, such as those who have had a severe (and rare) allergic reaction in the past or those with suppressed immunity (people who are receiving chemotherapy, for example, or who have HIV/AIDS). It’s also important for the small percentage of people for whom vaccinations are not effective.

Pediatricians are increasingly requiring vaccination in their practices, which means turning away families who disagree. Parents have begun pushing back on the anti-vaccination movement, too, by creating local pro-vaccination groups.

Increasing Resistance
The most recent wave of vaccines resistance stemmed from a widely debunked paper claiming that vaccines caused autism. That argument has lost momentum lately, and sociologist Jennifer Reich says people now give a variety of reasons for rejecting vaccines: “Vaccines, these parents tell me, do not always protect children. Some insist their children’s immune systems would benefit from contracting the illness. Some don’t trust the government agencies that approve vaccines because they are ‘too close’ with pharmaceutical companies. Many believe their healthy lifestyle or prolonged breastfeeding ensures that their children will not experience the worst outcomes of a vaccine-preventable disease.”

Many doctors say they differentiate between people who are hesitant about vaccines and those who categorically reject them. While the latter group is rarely persuadable, the former group often is.

Government Response
All 50 states have laws requiring vaccines for students, but most allow religious and philosophical exemptions. Only five states (Mississippi, California, West Virginia, Maine, and New York) have ruled out non-medical exemptions. In Maine, the governor said she was responding to an uptick of whooping cough, while California and New York were facing multiple measles outbreaks. Other states are considering removing non-medical exemptions as well.

At the same time, many state legislatures are considering a move in the opposite direction. At least 20 states have introduced bills that would either give parents more options for obtaining exemptions or would require doctors to provide more information about the risks of vaccines.

For now, vaccination rates in the U.S. remain high, even though there are troubling gaps. Still, pediatricians continue to report spending significant time convincing parents to accept what they view as settled science – and that comes at a cost. One writes that “The average “well-child” visit is about 18 minutes long in the U.S., so if we’re spending more than half the time talking about what is really the most evidence-based thing we do in pediatrics, that’s a real problem.”

Learn More

Parent Toolkit: This 64-page guide has everything you ever wanted to know about childhood vaccines, and busts some common myths – via Centers for Disease Control

Exemptions & Outbreaks: A comprehensive explainer walks through the causes of vaccine-preventable disease outbreaks in the U.S. – via Vox

How Misinformation Spreads: Podcast host Michael Barbaro explores the recent measles resurgence and takes a close look at the outbreaks among ultra-Orthodox Jewish communities in New York – via The New York Times

Reaching Out: A parent-led pro-vaccine group offers their tried-and-true advice for talking to friends and family about the importance of vaccinating – via Voices for Vaccines

An Ideological Issue: Some high-profile liberals have been standard-bearers for the anti-vaccine movement, and now, a growing number of conservatives are joining them – via The Hill

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This article originally appeared in the November 3, 2019 issue of Wide Angle, our regular newsletter designed, we hope, to inform rather than inflame. We make a special effort to cover good work being done to bridge political divides, and to offer constructive information on ways our readers can engage in the political process and make a difference on issues that matter to them.

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