Rolling Back the War on Vaccines

February 8, 2013

Vaccination against infectious childhood diseases prevents more than 2.5 million deaths annually, with an extremely low risk of serious side effects. Yet this achievement has rendered the benefits less visible to young parents, enabling imagined dangers, say Jay Winsten, an associate dean at the Harvard School of Public Health, and Emily Serazin, a principal of the Boston Consulting Group.

Indeed, fear of side effects from vaccinations has resulted in gaps in coverage that have led to fatalities.

  • For instance, when an outbreak of measles swept across Europe in 2010-2011, 48,000 people required hospitalization and 29 died.
  • Over 80 percent of those who fell ill had not been vaccinated.
  • In the United States, 20 states allow parents to opt out of mandatory childhood vaccinations for broadly defined reasons -- such as "personal/philosophical" concerns -- and 48 states offer religious exemptions.
  • Washington state had an exemption rate of 7.6 percent, the nation's highest, before tightening its rules in 2011; some smaller counties still have exemption rates as high as 30 percent.

The cumulative impact of this vaccine opposition has been substantial.

  • According to the U.S. National Immunization Survey, only 60 percent of parents of children age 24 months to 35 months adhered to the recommended vaccination schedule in 2009, with the remainder either refusing or delaying one or more vaccines.
  • Even among adherents, 30.9 percent expressed concerns about "serious side effects."

If the trend toward diminished trust in vaccines is not countered effectively, future high-profile incidents of alleged harm could rupture the scaffolding of public confidence and seriously undermine future efforts to save lives through vaccination.

The United States and Europe require an injection of renewed effort in three key areas:

  • A comprehensive research program is needed to better understand what motivates diverse segments of the population in their opposition to (or hesitancy about) current vaccination policies, and to monitor trends in acceptance of vaccines.
  • In the policy arena, new approaches should be tested for reducing opt-outs from childhood vaccinations while preserving the ability of parents to make decisions on behalf of their children. For example, Washington state has reduced opt-outs by 25 percent by requiring parents to consult with a health provider before filing for a waiver.
  • The health sector should mobilize a well-funded effort to communicate effectively with -- and listen carefully to -- the growing number of parents who are genuinely concerned and confused about the right thing to do for their children.

Source: Jay Winsten and Emily Serzin, "Rolling Back the War on Vaccines," Wall Street Journal, February 6, 2013.

 

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