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Falling Immunization Rates Are Resurrecting Old Diseases

Falling rates of immunization in the aftermath of vaccine scares may soon be reflected in higher rates of old scourges. An article in the March 2011 issue of The Nurse Practitioner argues that declining immunization rates, which result from misinformation about the safety of vaccinations, may foreshadow greater health risks to children and the broader community in the future.

“We’re losing public health resource dollars when we might be seeing increased diseases, so it’s a perfect storm.” - Catherine Flores Martin

Posing a Health Risk?

“Well-meaning, uninformed parents who choose not to vaccinate their children may actually be posing health risks to their children and the community,” writes Leslie H. Kennedy and her colleagues. “Increased media reports that focus on vaccine ingredients and possible adverse outcomes have discouraged many parents regarding early childhood vaccinations. Vaccinations not only protect children but the public health as well.”

Some older diseases have already been making comebacks in American population centers, says Catherine Flores Martin, the director of the California Immunization Coalition (CIC), a public-private partnership dedicated to promoting and educating about immunization. In some California schools, according to documentation provided by the California Immunization Coalition - CIC, 30% or more of children are missing recommended shots.

“We’ve had a pertussis epidemic in California for the last year and it’s actually still ongoing,” Martin says. “There were ten infant deaths last year in California, and I think about 8,000 cases. 21,000 cases in the United States and 40 percent of them were in California.”

The problem is compounded, she says, by the current obscurity of these once rampant diseases. Pertussis, a respiratory mucous membrane disease also known as whooping cough, is frequently mistaken for a particularly nasty cold or another respiratory illness. “Some of the younger physicians didn’t have it themselves and never saw it, and there was a delay and some children did not receive appropriate treatment for pertussis because some clinicians did not recognize it.”

Measles has also been making a comeback, with one outbreak in San Diego in 2008, and another recently in Boston. “Little by little these cases are coming back to the United States because people are not fully immunized.... Most [health care practitioners] have definitely never seen measles.”

Directing Parents and Providers to Resources

According to the Nurse Practitioner article, much of the misinformation surrounding vaccinations is propagated on the Internet, where “conflicting information about vaccines is abundant with anti-vaccination groups [that are] often organized, vocal, and easily accessible, [whereas] government websites can be difficult to navigate and immunization schedules can be overwhelming to parents.” Martin’s organization is heavily involved in directing parents and health care providers to reliable resources about vaccines. Some frequently asked questions include:

  • Why so many immunizations are necessary (some vaccines require multiple doses for best effectiveness)
  • Why small babies need shots (there’s no evidence to suggest that reactions are more likely when children are younger, and in any case it’s much
  • Less dangerous than a child waiting and possibly contracting the disease)
  • Why eradicated diseases still need to be immunized against (that’s how they stay eradicated)
  • Whether spacing shots out is a good idea (it has no safety effectiveness)
  • Whether vaccines cause autism (no, as various studies have found no link between vaccination and autism, and the only study that did has been wholly discredited)

“We’re encouraging providers to be available to their patients, to be able to answer questions about their concerns,” Martin says. “[This] is a challenge because you have about ten – if you’re lucky, fifteen – minutes with the patient, and parents don’t often get the chance to ask these questions.... We focus a lot on telling parents to go to their doctor’s office, talk to the nurse there, talk to the physician, to get your questions answered.”

ABC News reports that many pediatricians are turning away parents who refuse to vaccinate their children despite efforts to convince them otherwise; they often feel that doctor-patient trust has been violated and fear for the other children in the waiting room who may be vulnerable to the disease. Other doctors, however, feel that this would entail an abrogation of their ethical responsibilities. Martin is neutral on the issue: “Those doctors, I understand where they’re coming from, because it’s drawing the line in the sand, but we support a parent’s choice and we hope they choose immunization.... We try to help but we can’t get everybody.”

However, due to recent budget cutbacks in the state of California, there has been a funding crunch for immunization programs. This is a significant cause of concern for Martin, who fears that many parents and children may fall between the cracks for lack of information. “We’re losing public health resource dollars when we might be seeing increased diseases, so it’s a perfect storm.”

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