Understanding the Vaccine Debates
The recent measles outbreak linked to California’s Disneyland, in which 147 people from seven states contracted the virus, prompted Georgia State Law’s Center for Law, Health & Society to sponsor a two-part lecture series, “Understanding the Vaccine Debates.”
Childhood vaccinations are one of the 10 greatest public health achievements of the 20th century, according to the U.S. Centers for Disease Control and Prevention. Prior to the measles vaccine, more than 500,000 Americans were infected each year, 48,000 hospitalized and 500 died from the disease.
Fifty years after the measles vaccine was introduced, public health may be a victim of its own success, said Seth Mnookin, award-winning journalist and best-selling author of The Panic Virus: The True-Story Behind the Vaccine-Autism Controversy, in his lecture, “Misinformation and Measles: The Disneyland Outbreak, Public Health, and the Nature of Truth,” on March 25.
Some parents are opting out of having their children vaccinated for fear that the vaccine itself poses a risk. “The study that alleged a link between autism and vaccines has not only been proven false, but the author Andrew Wakefield was discovered to be unethical, his data has been found to be fraudulent, and his license to practice medicine was revoked,” Mnookin said.
Yet misinformation about vaccine safety has persisted. “Media bears some of the guilt in perpetuating this myth and thereby endangering the public’s health,” he said. “Media has created ‘debate’ and given credence to two ‘sides’ when there was no evidence to support the existence of another side.”
The inability of scientists to communicate in a way the public can understand contributes to the problem. “Media wants to pull on the public’s heart strings,” Mnookin said. “Which story grabs your attention more? The one with a staunch old scientist saying that the likelihood of causation is minute or the one with the devoted mother tearfully recalling how her toddler’s spirit dimmed before her very eyes within days of receiving a vaccine?”
Listing examples of popular media criticism of vaccine refusers in the wake of the Disneyland outbreak, such as a video PSA on Jimmy Kimmel Live!, Mnookin explained that such “snark attacks” could backfire. Research suggests that educating parents who refuse or want to delay vaccination of their children not only may not change their opinions, but may even cause them to become more entrenched in their beliefs.
Professor Ross Silverman from the Indiana University Richard M. Fairbanks School of Public Health and Robert H. McKinney School of Law focused his April 14 presentation, “It’s A Small World After All: Law, Politics, and Immunization Policy,” on the legislative and policy changes that states may consider to strengthen their vaccination requirements and improve their vaccination rates. All states require vaccinations before school entry. States may allow for non-medical exemptions for religious or philosophical beliefs.
Silverman and his colleagues have demonstrated a correlation between the ease of obtaining an exemption and lower vaccination rates. “Tighter processes for obtaining these exemptions is key to maintaining and increasing state vaccination rates and protecting public health,” Silverman said. Some examples of how states can strengthen their statutes or regulations include requiring notarization of forms for religious waivers, counseling on risks of not vaccinating from medical professionals, or enforcing school exclusion policies for children without proper documentation on file.
Why are high vaccination rates important? When vaccination rates are above a certain threshold, people who cannot be vaccinated, such as infants who are too young, pregnant women, and individuals with compromised immune systems, are protected because they are less likely to come in contact with someone who has contracted the disease. This threshold, which varies by disease based, in part, on the ease of transmission, is called herd or community immunity. In some communities, low vaccination rates have compromised herd immunity and place others at risk of infection.
“The fact that the outbreak occurred, not in isolation, but at the place where ‘dreams are made’ has brought this issue to the forefront of public discussion,” Silverman said. “It presents an opportunity for action.”
However, he also highlighted the challenges facing legislators. “We are a diverse country. We must be careful not to trample people in the process of swinging the pendulum toward stricter vaccination requirements.”
When asked whether he supports doctors dismissing unvaccinated families from their practices, Silverman concluded that continuing the vaccine conversation is the safest approach to keeping vaccine-hesitant parents within the health care system rather than isolating them. “After all,” Silverman stated, “ultimately, people want to do what is best for their children.”