Vaccine Fears
The recent measles outbreak has once again brought up the issue of vaccinating children. Doctors and parents have been at odds with this issue for years. In a Washington Post article by Kristin S. Hendrix, parents fear negative effects of vaccines. Hendrix states, “A 2011 study suggests it has a lot to do with fear of vaccines’ negative side effects. Some parents worry about the “chemical composition” of vaccines or multiple vaccines being given at once” (Hendrix). Most research falls into favor of vaccines with their effectiveness and safety.
Parents have the use of the internet. There is a plethora of information on vaccines to make a decision on whether vaccines are useful. However, parents also face information from unreliable sources. When a parent is looking for a reason not to vaccinate, they look for information they believe to be true. Hendrix refers to this as biased assimilation.
The biggest reason parents are against vaccinations is because of the lack of communication between them and doctors. An article titled Risky Business: Challenges in Vaccine Risk Communication by Leslie K. Ball, Geoffrey Evans, Ann Bostrom argue a major factor of today's dilemmas is awareness. The article states, "Perhaps the most important factor may be the lack of disease awareness. The dramatic decline of vaccine-preventable diseases has inevitably decreased public awareness of these illnesses, likely prompting greater reluctance to accept adverse reactions after vaccination...Reconciling patient empowerment with the goals of public health remains problematic".
The media, public information in general, also has an influence over parents' decision to vaccinate children. An example of this is in 1994 the media claiming former Miss America Heather Whitestone's deafness was caused by the DTwP (diphtheria and tetanus toxoids and whole-cell pertussis) vaccine. This was later proven to be false, the deafness caused by Haemophilus influenzae type b meningitis, now preventable by a vaccine.
When talking with parents about vaccines, doctors compete with other information sources, often unreliable. This information comes from family members, neighbors, and social media platforms, many lacking concrete evidence. Thanks to the internet, parents are constantly bombarded with information, whether right or wrong, that has no editorial control, peer reviwed, or scientific facts. Parents are quicker to trust someone close to them than the doctor they see once or twice a year. The article states, "Even when presented with accurate information, parents and physicians may differ in how they interpret data and make decisions on risk".
Anxiety Prior, During, and After Vaccination
No Communication
103 people were infected in California, the most out of all states compromised. Approximately 70% (117 cases), were linked to the outbreak from Disneyland. The United States hit a record high in 2014 with 668 documented measles from 27 states; the greatest number of cases since measles was eliminated in U.S. in 2000. The eradication of the disease and its return 15 years later raises questions about vaccines, specifically parents taking the responsibility to vaccinate their children.
January 2015 was a major time in California when an outbreak of measles was discovered to come from Disneyland. From those infected during their trip, the virus spread all across the country. According to the CDC, “From January 1 to April 24, 2015, 166 people from 19 states and the District of Columbia were reported to have measles” (CDC).
Another issue parents have against doctors is the anxiety they feel before, during, and after the vaccination process. Prior to the child's vaccine, parents have an inner struggle with their concerns and the benefits from vaccines. According to a journal article titled Vaccinating Parents Experience Vaccine Anxiety Too by Karlen E. Luthy, Renea L. Beckstrand, Whitney Asay, and Carly Hewett, "Prior to vaccination, parents reported various causes of anxiety...In the days or weeks leading up to the vaccination, parents experienced anxiety when trying to reconcile the importance of vaccinating with their vaccine concerns”.
Parents struggle with their own concerns over vaccines and the benefits from vaccines. It is the negative side of the vaccines, what could happen, that parents fear leading up to the appointment. Parents fear their infants’ immune systems can be compromised when receiving a vaccine. If the vaccine was faulty, the infant has no defense against the virus. Parents are also concerned with what is going into their children. They want to know about dosing adjustments for weight. The vaccine might not be the right fit for every baby.
A second anxiety happens during the vaccination. The Luthy, Beckstrand, Asay, and Hewett report parents felt obligated to comfort their child but also felt traumatized when restraining their child during the vaccination process. A parent from the study states, “I was holding his hands and he was looking at me with that big smile and as soon as the doctor…put the needle in his leg, I could see his face just transforming. And for me that was a feeling of betrayal…to my son”. Parents also have concerns over the number of shots their children receive in one appointment.
The third anxiety happens after the child has been vaccinated. Parents feared the physical side effects of vaccines, such as fever and tenderness around the vaccinated area. Parents also suffer anxiety from the potential side effects from Vaccine Information Sheets (VIS) given before each vaccine. The article states, “Parents also conveyed that even the common side effects of the vaccine caused enough anxiety that they would purposefully delay subsequent vaccinations”. Parents also have anxiety of interruptions in their child’s daily routines. Interruptions from potential side effects, fever and fussiness, caused parents to schedule vaccines when they had time off to watch over the child.
References
Ball, L., Evans, G. & Bostrom, A. (1998). Risky business: Challenges in vaccine risk communication. Pediatrics, 101(3), 453-458.
Hendrix, K. (2015). What doctors should tell parents who are afraid of vaccines. Washington Post – Blogs.
Koseff, A. (2015). Amended California vaccine bill bypasses appropriations committee. The Sacramento Bee.
Luthy, K., Beckstrand, R., Asay, W. & Hewett, C. (2013). Vaccinating parents experience vaccine anxiety too. Journal of the American Association
of Nurse Practitioners, 25(12), 667-673.
Bill 277
The most recent battle of parents and doctors is California Sentate Bill 277. This bill, proposed by Senator Richard Pan, has recently been rewritten and could be voted on as early as Thursday May 14, 2015. In a Sacrmento Bee article titled Amended California vaccine bill bypasses appropriations committee by Alexei Koseff details the chages. Koseff states, "California's controversial proposal to eliminate the personal and religious exemptions for vaccinations could come up for a vote in the Senate as early as Thursday after amendments were quietly made to the bill last week". Senate Bill 277 no longer requres schools to notify parents on immunization rates. This takes out the financial costs of the legislation, allowing the bill to skip the Senate Appropriations Committee.
What makes Senate Bill 277 controversial is that parents who are anti-vaccination believe they are being targeted. Koseff states, " "This bill now is really about abolishing the” personal belief exemption, Pan said. “We don’t want to get distracted by a discussion” about how schools would notify parents or what it would cost."
Thousands of anti-vaccine parents have protested against the bill during committee hearings. Koseff reports, "...because it would infringe on their personal health choices and the right to their children to recieve an education." If the bill were to pass, California would be the third state in the country without a personal or religious belief exemption, mandating full immunization for studnets to enroll in either public or private schools.