Parents & Vaccinations: The individual, the community, and the spread of information

With recent news of measles outbreaks in Brooklyn’s Borough Park and other areas around New York City, debates over some parents’ decisions to opt out of vaccinating their children have been thrown into relief, yet again.

On May 30, 2013 the New York City Department of Health published a “Measles Outbreak Alert”, warning of the serious threat that the infectious disease poses to health and urging that “everyone in the household should receive the measles-mumps-rubella (MMR) vaccine.” The conclusion of the alert, which reaffirms the safety of vaccinations, the superiority of the benefits compared to the risks, and the very mild side effects, is what parents who choose to opt out their children may take issue with.

Perhaps the most prevalent fear parents have about the MMR vaccine is its alleged role in causing autism and gastrointestinal disorders, following claims made by researcher Andrew Wakefield of Britain. Wakefield’s “findings” have not only been discredited through a robust amount of literature and research, but were found to be fraudulent and resulted in the revoking of his medical license. Despite his denunciation, fears of the horrors that vaccines may supposedly cause are still harbored by some. Continuing outbreaks of measles in Britain, where the highest rates of those affected are adolescents who were never vaccinated as children, suggest that fears about the vaccines’ safety may have had detrimental consequences. This issue raises a number of concerns.

Are parents properly informed about vaccinations? Access to valid information is certainly key in making sound decisions about vaccinating children. According to the Centers for Disease Control (CDC), not only is measles the most deadly of childhood fever/rash illnesses, it’s also quite easily spread. The measles vaccination has been vital in decreasing morbidity and mortality. Of course, no vaccine is 100% safe or “harmless”, but neither is a leisurely walk through the park; everyday activities pose potential risks. Although a small subset of people should delay or refrain from taking the MMR vaccination, the CDC provides an abundance of information and literature on the legitimacy and benefits of the MMR vaccination to both the individual and the community, though it may not be the first source to show up on a Google search.

What role may the internet play in perpetuating certain ideas? It certainly plays a critical role in the spread of both reliable information and misinformation about the safety and necessity of vaccines. In a case-controlled study published in the Archive of Pediatric and Adolescent Medicine in 2005, parents of unvaccinated children believed they had a low susceptibility to the infectious diseases that vaccines protected against. Moreover, the most frequent reason for vaccination refusal by parents was that it might cause harm. Not shockingly, these parents were also reportedly more likely to obtain information from the internet, especially from groups who oppose immunization. This indicates that vaccine refusal by parents may be due to misinformation obtained through pseudoscientific writing online, perhaps in combination with a mistrust of information provided to them by their doctor and other credible sources.

Unfortunately, regardless of the parents’ reasoning, the decision to opt out of vaccinating their children poses risks to the community. Various studies have shown an increase in the local risk of vaccine-preventable disease when there is a geographically localized group of people refusing vaccination. Therefore, if a child who has not been vaccinated contracts measles and gets another child sick, should the parents of the unvaccinated child be liable, and maybe even have legal action taken against them, as bioethicist Art Caplan suggests in recent postings?
Perhaps legally penalizing parents may bring about some justice, but it is certainly not the answer; in the long run, it will probably not serve a purpose that will benefit the wellbeing of the community as a whole. Rather, this is an ongoing public health issue that must be addressed in effective ways that consider the many channels of communication of our time. The larger focus should be on continuing to educate parents to make well-grounded decisions about their child’s overall health. Children depend on adults to make beneficial decisions on their behalf. The best way for parents to make informed decisions is to have an abundance of valid information that is as easily accessible as the faulty information we come across while browsing the web. Faulty information perpetuated through social media and the internet must be overshadowed with easily accessible and effective ways to spread scientifically supported and sound information on vaccinations to the general public. After all, our communities are counting on it.

Amaya George is a summer intern at the Montefiore-Einstein Center for Bioethics. She is a rising junior and pre-med student at Cornell University with a declared major of Biology and Society and minor of Inequality Studies.

Other source:
Omer, Saad B., Daniel A. Salmon, Walter A. Orenstein, M. Patricia DeHart, and Neal Halsey. “Vaccine Refusal, Mandatory Immunization, and the Risks of Vaccine-Preventable Diseases.” New England Journal of Medicine360.19 (2009): 1981-988. Web. 5 June 2013.

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