Parents’ Vaccine Safety Fears Mean Big Trouble for Children’s Health

If public-health authorities want to boost vaccination rates, they need to address concerns.

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Parents are really worried about childhood vaccine safety, but the public-health community doesn't seem to get it. A new survey reveals that 54 percent of parents are concerned about the adverse effects of vaccines, and 25 percent think some vaccines cause autism in healthy children. Yet just last week, the federal government vaccine advisory board called for all Americans 6 months and older to get flu shots next fall, including the vaccine against the H1N1 flu strain. If the goal is to protect the public's health, you'd think the feds would first want to address the fact that a big chunk of parents think vaccines aren't safe.

The vast majority of parents do have their children vaccinated against childhood diseases; 88 percent of the 1,552 parents polled in the January 2009 survey just published in Pediatrics said they follow their doctor's recommendation for childhood vaccines. But 11.5 percent said they'd refused at least one vaccine for their children. Here are some more numbers:

*90 percent of parents said that getting vaccines is a good way to protect their children from disease.

*88 percent of parents said they generally follow doctors' recommendations on childhood vaccines.

*54 percent of parents said they are concerned about serious adverse effects of vaccines.

*31 percent said parents should have the right to refuse required childhood vaccines for any reason.

*25 percent said some vaccines cause autism in healthy children.

*11 percent think their children do not need vaccines for diseases that are not common anymore. 

The vaccine most often refused is the new HPV vaccine against a virus that causes cervical cancer. Fifty-six percent of the parents said they had refused that shot for a child. When asked why, parents said it was because there has not been enough research on this vaccine (78 percent); that the vaccine has not been on the market long enough (75 percent); that "my children are at low risk for this disease" (59 percent); and that "the risk for adverse effects from this vaccine is too great" (59 percent). The HPV vaccine was approved in 2006, and it protects against a sexually transmitted virus, so it makes sense that parents of young girls are willing to wait a few years for more information. Contrast that with the reasons parents gave for refusing the MMR (measles, mumps, and rubella) vaccine. Parents' concerns were not with how long the MMR has been used (the three vaccines were approved in the 1960s) but rather, "I have read or heard about problems with this vaccine". 

Actually, there aren't many problems with the MMR vaccine. Before it was introduced, about 450 children a year died from measles, and 20,000 were born blind, deaf, or retarded from rubella infections. The vaccine all but eliminated these diseases as childhood health risks, and serious side effects are very rare. What those parents have been hearing, of course, is the widespread coverage of the controversy surrounding a 1998 paper by British scientist Andrew Wakefield correlating MMR vaccines with autism. The paper, which surveyed 12 children, was retracted last month by the journal the Lancet for falsified data and unscientific methods. With the Wakefield study discredited, there is no evidence that vaccines cause autism. In the past decade, large, well-conducted studies have found no link between autism and the MMR or other vaccines. Still, as this new survey shows, many parents think that vaccines aren't safe. Increasingly, that means they also aren't getting their children vaccinated against diseases like measles, mumps, and rubella that can kill or maim their children. 

The pediatricians and public-health officials aren't clueless; as the authors of the Pediatrics study note, "Officials must attempt to develop more effective and targeted education campaigns that focus directly on this issue if their goal is to match parents' level of concern with the available scientific evidence." But so far, those efforts don't seem to have gone much beyond one message: "Science says vaccines are safe." 

That science-says message is clearly no longer working for many parents. If doctors and public-health officials want to use the power of vaccines to protect children's health, they're going to have to first figure out how to effectively respond to parents' fears.