Perspective

Faith in vaccines falls 10 percentage points in US poll

Sharon Nachman, MD
Sharon Nachman

The percentage of Americans who feel strongly that parents should get their children vaccinated has dropped by 10 percentage points since 2001, according to a Gallup poll. The poll showed that only 45% of Americans believe vaccines do not cause autism in children.

A rise in anti-vaccine sentiment has contributed to outbreaks of vaccine-preventable diseases — including measles — in the United States and elsewhere, endangering public health. WHO has listed vaccine hesitancy and the erosion of public trust in medicine, including vaccines, as top global health challenges each of the last 2 years.

“I think one of our biggest problems is that most families don't have a tight connection to their child's pediatrician,” Sharon Nachman, MD, chief of the division of pediatric infectious diseases at Stony Brook Children's Hospital, told Healio. “Far too often when a child is sick, which usually happens in the evenings or the weekends, instead of going back to their physician, they go to a walk-in center. That dilutes the connectedness between a family and their physician or medical care providers.”

In a survey of 1,025 randomly sampled adults, 84% of respondents said they believed that it is extremely or very important that parents vaccinate their children, down from 94% in 2001. According to the poll, the only subgroup surveyed that maintained its level of vaccine support since 2001 was highly educated Americans, defined by the poll as individuals with postgraduate degrees. Perceptions of vaccine importance dropped by at least 5 percentage points across all other surveyed education subgroups, which included college graduates, individuals with some college education and individuals who had a high school degree or less.

Additionally, 86% believed vaccines are not more dangerous than the diseases they prevent, whereas 89% said they are aware of the advantages and disadvantages of vaccines.

“It would help if we make parents understand that all vaccines are not the same,” Nachman said. “When someone is anti-vaccine, we need to say, ‘Well what would each of those vaccines that we would like to give your child prevent?' Diseases are not all the same.”

Recent research has shown that an increase in vaccine-preventable diseases is connected with an uptick in bills restricting vaccine exemption, and vaccine mandates have increased coverage for measles and pertussis throughout Europe.

“There's a small percentage of people that, no matter how you frame the question, will still not want their child vaccinated,” Nachman said. “But the vast majority are sitting on the fence, and we need to understand why.”– by Eamon Dreisbach

References:

Delameter PL, et al. Ann Intern Med. 2019;doi:doi:10.7326/M19-1933.

Gallup. Fewer in U.S. continue to see vaccines as important. https://news.gallup.com/poll/276929/fewer-continue-vaccines-important.aspx. Accessed January 16, 2020.

Goldstein ND, et al. JAMA Pediatr. 2019;doi:10.1001/jamapediatrics.2019.4365.

Pingali SC, et al. JAMA. 2019;doi:10.1001/jama.2019/7924.

Vaz OM, et al. Pediatrics. 2020;doi:10.1542/peds.2019-0620.

For more information:

Sharon Nachman, MD: https://www.stonybrook.edu/experts/profile/sharon-nachman

Stony Brook Children's Hospital: https://www.stonybrookchildrens.org/

Disclosure: Nachman reports no relevant financial disclosures.

Sharon Nachman, MD
Sharon Nachman

The percentage of Americans who feel strongly that parents should get their children vaccinated has dropped by 10 percentage points since 2001, according to a Gallup poll. The poll showed that only 45% of Americans believe vaccines do not cause autism in children.

A rise in anti-vaccine sentiment has contributed to outbreaks of vaccine-preventable diseases — including measles — in the United States and elsewhere, endangering public health. WHO has listed vaccine hesitancy and the erosion of public trust in medicine, including vaccines, as top global health challenges each of the last 2 years.

“I think one of our biggest problems is that most families don't have a tight connection to their child's pediatrician,” Sharon Nachman, MD, chief of the division of pediatric infectious diseases at Stony Brook Children's Hospital, told Healio. “Far too often when a child is sick, which usually happens in the evenings or the weekends, instead of going back to their physician, they go to a walk-in center. That dilutes the connectedness between a family and their physician or medical care providers.”

In a survey of 1,025 randomly sampled adults, 84% of respondents said they believed that it is extremely or very important that parents vaccinate their children, down from 94% in 2001. According to the poll, the only subgroup surveyed that maintained its level of vaccine support since 2001 was highly educated Americans, defined by the poll as individuals with postgraduate degrees. Perceptions of vaccine importance dropped by at least 5 percentage points across all other surveyed education subgroups, which included college graduates, individuals with some college education and individuals who had a high school degree or less.

Additionally, 86% believed vaccines are not more dangerous than the diseases they prevent, whereas 89% said they are aware of the advantages and disadvantages of vaccines.

“It would help if we make parents understand that all vaccines are not the same,” Nachman said. “When someone is anti-vaccine, we need to say, ‘Well what would each of those vaccines that we would like to give your child prevent?' Diseases are not all the same.”

Recent research has shown that an increase in vaccine-preventable diseases is connected with an uptick in bills restricting vaccine exemption, and vaccine mandates have increased coverage for measles and pertussis throughout Europe.

“There's a small percentage of people that, no matter how you frame the question, will still not want their child vaccinated,” Nachman said. “But the vast majority are sitting on the fence, and we need to understand why.”– by Eamon Dreisbach

References:

Delameter PL, et al. Ann Intern Med. 2019;doi:doi:10.7326/M19-1933.

Gallup. Fewer in U.S. continue to see vaccines as important. https://news.gallup.com/poll/276929/fewer-continue-vaccines-important.aspx. Accessed January 16, 2020.

Goldstein ND, et al. JAMA Pediatr. 2019;doi:10.1001/jamapediatrics.2019.4365.

Pingali SC, et al. JAMA. 2019;doi:10.1001/jama.2019/7924.

Vaz OM, et al. Pediatrics. 2020;doi:10.1542/peds.2019-0620.

For more information:

Sharon Nachman, MD: https://www.stonybrook.edu/experts/profile/sharon-nachman

Stony Brook Children's Hospital: https://www.stonybrookchildrens.org/

Disclosure: Nachman reports no relevant financial disclosures.

    Perspective
    Paul A. Offit

    Paul A. Offit

    We ask parents in this country to give their children vaccines during their first few years of life, vaccines to prevent 14 different diseases, which can mean as many as 27 inoculations during that time. It can mean as many as six shots at one time to prevent diseases most people don't see, using biological fluids most people don't understand. The fact that there's been an erosion in faith in vaccines or in the importance of vaccines is not surprising. People are not compelled by the diseases as they were when I was child.

    The fact of the matter is that people in this country get their children vaccinated for the most part. We have immunization rates in the high 80% to low 90% range. We give a lot of vaccines. That said, that erosion in trust has caused an erosion of herd immunity enough so that you're starting to see diseases like measles come back. I think it's not surprising. I think it would be anticipated.

    It's not just that we've largely eliminated these diseases. I think we've also eliminated the memory of the diseases, so people are not scared of them. For example, when there was an outbreak of measles in Southern California, there was response — a legislative response and a response among the parents. More parents vaccinated once they were scared of the disease. What you're looking at is just the natural history of immunization programs, which is to say, when people were scared of the disease, immunization rates were high; when we virtually eliminated the diseases, people became more distressed or concerned about the safety of vaccines.

    Immunization rates have frayed a little. And with that fraying, you see a response. I think we're going to have fewer cases of measles next year and the year after because people now are becoming a little more scared of the disease than they were before, and because of legislative push back.

    The question is: Is this an issue of scientific literacy, or scientific denialism? If it's scientific illiteracy, then providing knowledge and information matters. You have to do it in a way that's compelling, passionate and compassionate — find out what it is that the parents are concerned about and then try and address that concern. Then you can be somewhat convincing because what you have on your side is logic, reason and science.

    If that works, then good. If it doesn't work, you're stuck — which brings us to scientific denialism. People simply declare their own truths and that is very much part of today.

    Evidence should be convincing but often isn't enough. That's what this is all about.

    I was a child of the 1950s and 1960s. I had measles, mumps, German measles and chickenpox, so it was not hard to convince me to immunize my children. But young parents today don't see these diseases and didn't grow up with them, so an erosion in understanding of these diseases and an understanding of these vaccines makes perfect sense.

    I think we need to step back and realize we are dealing with a different time when we explain ourselves, and I think to the degree to which people are willing to listen to data, logic and reasonable information, we can convince them. But there is that certain percentage of people who have drifted from scientific illiteracy into scientific denialism. For them, I think it's just going to be a legislative fix.

    • Paul A. Offit, MD
    • Infectious Diseases in Children Editorial Board Member
      Director, Vaccine Education Center
      Children’s Hospital of Philadelphia

    Disclosures: Offit reports no relevant financial disclosures.