Are lifesaving vaccines being ignored by parents because of illegitimate safety concerns?
That’s what many prominent health pundits think, including André Picard at the Globe and Mail. When commenting on an apparent rise of whooping cough, Picard wrote that the increase was the result of parents “shunning vaccination in small but significant numbers because of imaginary fears largely concocted by quacks and charlatans.”
Steven Salzberg, a blogger at Forbes Magazine echoed this sentiment pointing to celebrity doctors who “use their medical degrees and their faux concern ‘for the children’ to frighten parents into keeping their kids unvaccinated.” Salzberg also added that the “the media has been complicit in spreading some anti-vaccine misinformation.”
I’d agree that the media might be a problem, adding to the illegitimate vaccine fear floating around, and likely reducing parents’ willingness to immunize their children. And we certainly have our share of charlatans and quacks in cyberspace, aided and abetted by cyberchondriacs of all stripes.
Yet there is real fear among parents, a fear that is palpable. One survey of American parents a few years ago found that the majority of parents agreed that vaccines protect their children from disease but more than 50% expressed concerns regarding serious adverse effects. The same survey found more than 10% of parents had refused at least 1 recommended vaccine. What is at the heart of these concerns? Can it really be due to vaccine fear-mongering?
I don’t think it is. Parents just want to keep potentially harmful things away from their children. And they turn to health experts for guidance, but here’s my take on things: health authorities often fail to acknowledge the risks of some vaccines, refuse to discuss uncertainty over a vaccine’s effectiveness, hype the seriousness of common everyday viruses (c’mon folks, really? The flu? Chicken pox?) and keep piling more and more vaccines onto the list of ‘recommended’ childhood shots threatening to turn our kids into pincushions. Now you’ve got a recipe for even more skepticism and fear-mongering.
In July this year many media outlets reported that the U.S. was in the midst of the worst whooping cough epidemic in 70 years, and the US Centers for Disease Control said the US had 2,520 cases up to July 20th this year. It is clear from these data that whooping cough, a disease once controlled by vaccines, was making a return.
For some, the complications of whooping cough can be deadly and it can lead to pneumonia, convulsions, and even brain damage and death. It’s not to be trifled with. You’d certainly want to shelter your child from whooping cough if you could, but the advice around the vaccine is conflicting. Some groups, such as the CDC recommend vaccination of pregnant women and infants yet the vaccine leaflets themselves say it is unknown whether the vaccines cause fetal harm. Some say the vaccine is highly effective, while others point to studies showing even fully vaccinated children still get whooping cough. No one seems to know how many booster shots you need to keep your child protected. Clearly this is a breeding ground for confusion.
Swirling masses of conflicting information reveal to me something very genuine: parents raising legitimate concerns over vaccine safety and effectiveness. One incontrovertible fact is that even if diseases such as whooping cough can, on rare occasions, lead to death, and some children can be injured, sometimes fatally, from vaccines. Thankfully these injuries are also rare, but cases of neurological dysfunction and permanent brain injury linked to vaccines do happen. In the last two years in the US, there have been nearly 2,500 awards for vaccine injury and death made under the US 1986 National Childhood Vaccine Injury Act. More than half those awards involve the whooping cough vaccine.
At the end of the day, most parents just want to know the answer to one simple equation: what is the likelihood that a vaccine will prevent a deadly disease, versus what are the chances of a serious adverse reaction to the vaccine? Shouldn’t this be a simple question to answer? But it isn’t. If public health authorities want to improve vaccination rates, they’d drop the patronizing assurances and start providing the public with some hard evidence of the benefits and harms of immunizing or not immunizing. And the media would help by not scorning parents who ask legitimate questions. Only then will you see vaccination rates improve.
Vaccine policy does not do nuance well. Lacking quality information the public will continue to be buffeted by pro-vaccine hectoring or frantically anti-vaccine fear mongering. And the health of the public could use a whole lot less of both of these.
About the Contributor
Alan Cassels is a pharmaceutical policy researcher at the University of Victoria and the author of Seeking Sickness: Medical Screening and the Misguided Hunt for Disease.