Public Health Needs a Shot in the Armby Jennifer Gibson, PharmD | August 8, 2008
Arguably, one of the greatest public health advances in the last century has been the advent of safe and effective vaccines for deadly diseases. Today, several vaccine-preventable diseases have all but disappeared from our lives, thanks to all 50 states mandating vaccination for school children and making routine vaccination a public health priority.
Children today receive dozens of doses of vaccines to prevent at least 16 illnesses throughout their infancy, childhood, and adolescence. For almost every child, these vaccines are safe and effective, leaving behind no more than a sore arm or leg for a few hours. However, the number of parents refusing vaccines for their children is rising.
Most states allow parents to refuse vaccination for religious reasons, but many health departments allow refusal for vaguely defined philosophical reasons. Most of theses reasons never have to be documented or addressed, and the parents are only required to check a box on a form to allow them to refuse vaccination for their child. Less than 2% of parents refuse vaccinations for their children, according to the CDC, but the incidence varies by location.
Parents choose not to vaccinate their children for many reasons. Many religious objections are legitimate, but often, other reasons are misguided and result from a lack of correct information or an extreme belief in personal freedom. The safety fears are worsening, though all vaccines on the market today have an acceptable safety profile, free of major adverse side effects for the majority of patients. The link between vaccines and autism is highly controversial and has not been proved, but many parents are still fearful. These issues continue to be addressed by the CDC and vaccine manufacturers to guarantee the safest possible vaccination program for all children.
While the rights of parents to choose what is best for their child are important and should be protected, vaccines do not benefit just the child receiving the shot. Herd immunity results from vaccinated individuals protecting unvaccinated individuals. The more vaccinated people that are protected from contagious diseases, the less likely it is that the disease will spread through the population to unvaccinated people. Herd immunity is especially important when considering people who cannot be vaccinated. For instance, very young children who have not yet been vaccinated can have very severe and life-threatening reactions to vaccine-preventable diseases. The elderly may not have received vaccinations that are now routine, and they often have multiple medical conditions that make infectious diseases more serious than in young, healthy people. Immunocompromised individuals, such as those with autoimmune disorders or those undergoing chemotherapy regimens, are not able to receive some vaccines, and the risk of a serious episode of an infectious disease increases with their worsening immune function.
Universal vaccination does not only contribute to disease prevention, but it contributes to the overall health and productivity of society. Quality of life is improved for both children and their caregivers when they avoid episodes of infectious disease. Parents do not miss workdays to care for a sick child. Societies experience improved healthcare delivery and infrastructure from routine vaccination programs.
Many parents, themselves, never experienced the diseases against which today’s vaccines are designed to protect, and some seem more afraid of the vaccine than the disease it prevents. Countless lives have been saved through the development of safe, effective vaccines. Education and communication are vital to parents’ interactions with pediatricians, in order to properly assess each vaccine’s appropriateness for each child and to protect future generations from deadly preventable diseases.
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Calandrillo, S.P. (2004). Vanishing vaccinations: why are so many Americans opting out of vaccinating their children? University of Michigan Journal of Law Reform, 37(2), 353-440.
Ulmer, J.B., Liu, M.A. (2002). SCIENCE AND SOCIETY – VACCINES: Ethical issues for vaccines and immunization. Nature Reviews Immunology, 2(4), 291-296. DOI: 10.1038/nri780
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