Saar Kuzi
Alessandra Coutinho Fernandes
William Cope
Richard Tapping
Kashif Ahmad
Reda Sadki
Shubhra Kanti Karmaker Santu
Adam P Rusch
Elle Meisner
Nereyda Ochoa
Landon J. Kunzelman
James DotimasFA16 Immunization Module’s Updates
The social and public policy hurdles for vaccines
The issue of vaccination has been an increasingly notable issue in recent years due an increase of parents who choose not to vaccinate their children. According to WHO (World Health Organization), the number of reported case for measles, mumps, and pertussis from 2011-2014 are as follows:
2011
2012
2013
2014
Measles
220
55
187
667
Mumps
386
229
584
1,223
Pertussis
18,719
48,277
28,639
32,971
The data shows an increase of reported measles, mumps, and pertussis from 2011-2014. All three of these diseases are preventable through a vaccine that is available in the US. These figures suggest an increasing number of individuals who have not chosen to receive a vaccine or did not receive one as a child.
Additionally, the CDC (Center of Disease Control) have released information on the percentage of children between the ages of 19–35 that received vaccinations in 2013:
· Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP): 84.2%
· Polio (3+ doses): 93.3%
· Measles, Mumps, Rubella (MMR) (1+ doses): 91.5%
· Haemophilus influenzae type b (Hib) (primary series + booster dose): 82.0%
· Hepatitis B (Hep B) (3+ doses): 91.6%
· Chickenpox (Varicella) (1+ doses): 91.0%
· Pneumococcal conjugate vaccine (PCV) (4+ doses): 82.9%
· Combined 7-vaccine series: 71.6%
These percentages are lower when compared to other countries such as Australia, which has over 95% of its children vaccinated.
Many of these individuals point to the discredited study from Andrew Wakefield which suggested a link between autism and vaccines. Despite numerous studies and decades of research that has proven Dr. Wakefield’s study false, many anti-vaccine proponents have still refused to change their perception. While there is no easy solution to treat this issue, there are potential ways to enforce vaccinations or reduce the exposure of diseases to immunocompromised individuals. One such way is to pass a law mandating all children attending public schools to receive their vaccinations. This was sign in the state of California on 2015 and will be implemented by July 1, 2016. This will encourage children to receive their vaccinations while protecting immunocompromised individuals.
Resources:
http://apps.who.int/immunization_monitoring/globalsummary/countries?countrycriteria%5Bcountry%5D%5B%5D=USA&commit=OK
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6429a3.htm
Aubrey, your thoughts are the same as mine. Parents who do not want to vaccinate their children may enroll their children into private schools or home school them instead, impacting herd immunity. I would imagine many parents were in an uproar about the government forcing what they think is a personal medical decision onto them. I read about parents who tried to be exempt from this rule, exaggerating their child's medical conditions to convince doctors of potential autoimmune disease history in their family.
Steven, you stated that this law was implemented July 1st of this year. There is more info on this page about the bill: http://www.nvic.org/Vaccine-Laws/state-vaccine-requirements/california.aspx. It all comes down to the idea of public safety and health being held higher than philosophical or religious beliefs in this particular situation, especially after the recent measles outbreak in California.
@Steven Lee I find the law mandating all children attending public schools in California to be vaccinated to be a very interesting one. I would be curious to see if a trend in disease outbreak is then observed in increased rates in private schools, where the law is not enforced. This law appears to be a good idea, but it may lead to an increase in children who are not vaccinated in the private school sector, which could lead to a huge problem if all of those children are then placed together. I feel that herd immunity would be severely compromised.
On a related note, I was recently shadowing a family physician who had to have a very hard and awkward conversation with a mother who refused to give certain vaccinations to her children. The clinic had changed its policy, and in order to protect patients that may be immunocompromised, they felt it best to no longer provide care for patients that did not comply to the immunization policy. I could tell the physician was very torn about this new policy. She obviously believes that vaccinations are a positive thing, but as a mother herself, she understood the skepticism her patient had. The physician basically had to explain to the mother that unless she chose to vaccinate her children, she would be forced to seek another primary care physician. I found it to be a very interesting moral dilemma and was wondering if others were aware of this trend in other clinics.