Anti-vaccination movement

[Couch Potatoe]

Despite the rigorous vaccine safety systems in place in the US, some parents remain concerned about the safety of the childhood vaccines and immunization schedule. These concerns have led some parents to not allow their children to receive some or all of the recommended vaccines. In the US, rates of vaccine exemptions increased from 1% in 2006 to 2% in 2016 to 2017 (1); some states reported that 6% of children received exemptions. The rate of vaccine-preventable diseases is higher in children whose parents have refused ≥ 1 vaccines for nonmedical reasons. Specifically, they are 23 times more likely to contract pertussis (2), 8.6 times more likely to contract varicella (3), and 6.5 times more likely to contract pneumococcal disease (4). Children in the US still die from vaccine-preventable diseases. In 2008, there were 5 cases (one fatal) of invasive Haemophilus influenzae type b infection in Minnesota, the most since 1992 (5). Three of the infected children, including the child who died, had received no vaccines because their parents had deferred or refused the vaccine.
The decision to defer or refuse vaccines also affects public health. When the proportion of the overall population that is immune to a disease (herd immunity) decreases, disease prevalence increases, increasing the possibility of disease in people at risk. People may be at risk because

They were previously vaccinated, but the vaccine did not induce immunity (eg, 2 to 5% of recipients do not respond to the first dose of measles vaccine).
Immunity may wane over time (eg, in the elderly).
They (ie, some immunocompromised patients) cannot receive live-virus vaccines (eg, measles-mumps-rubella, varicella) and rely on herd immunity for protection against such diseases.

Parents hesitate to vaccinate their children for many reasons. Two of the more prominent parental concerns over the past decade have been that

Vaccines may cause autism.
Children receive too many vaccines.

Conversations with reluctant parents typically require more than presenting evidence. Finding common ground with parents#39; goals and hopes for their children and sharing compelling individual accounts can help (6).