Senate committee warned about harms of vaccine hesitancy

The Senate recently heard testimony concerning anti-vaccine rhetoric contributing to the spread of vaccine-preventable diseases in certain pockets of the United States.

Among those who spoke included the Secretary of Health for the Washington State Health Department, pediatric infectious disease specialists, a representative for immunocompromised individuals who cannot be vaccinated, and a teenager who chose to get vaccinated despite his mother’s objections.

The Senate met in 2014 following a measles outbreak to discuss the importance of vaccination. The outbreak occurred 14 years after the elimination of endemic measles in the U.S. and included 667 cases. Cases spiked again last year, with 372 cases, and just this year — between Jan. 1 to Feb. 28 — 206 cases of measles have been confirmed in 11 states, according to the CDC.

Saad B. Omer, MBBS, MPH, PhD, the William H. Foege Professor of Global Health and professor of epidemiology and pediatrics at Emory University, stressed that the federal government could take several steps to improve vaccination rates among Americans, including making vaccine counseling reimbursable.

Saad B. Omer

“I have worked on vaccine research in multiple countries and states in the U.S.,” he said. “There are a lot of local factors that are specific, but there is one constant: Health care providers — specifically physicians — are the most trusted source of vaccine information, even among those who are a little skeptical of vaccines. We need to use that tool more effectively. On the practical side, physicians do not have the time to properly counsel patients using evidence-based approaches. Part of the reason is the fact that this is not reimbursable. Physicians lose money on this kind of important part of education.”

Additionally, Omer advised against using “half-baked” communication strategies to improve immunization rates, and instead pointed to the NIH’s cancer prevention initiatives and the National Institute of Allergy and Infectious Diseases’ HIV and AIDS behavioral intervention initiatives as examples of how to improve public health.

Jonathan A. McCullers, MD, professor and chair in the department of pediatrics at the University of Tennessee Health Science Center, suggested that a personal connection between physicians and parents is necessary to overcome vaccine hesitancy.

“I think if there is a rapport with the physician and a mutual respect, both for the opinion of the parent but also for the of the position of the physician, you can say ... that the evidence is clear,” he said. “They will trust that information.”

Results of a study published in JAMA Pediatrics demonstrated that even slight reductions in measles-mumps-rubella vaccination caused by vaccine hesitancy can cause an annual threefold increase in measles cases in children aged between 2 and 11 years. Researchers estimated that this uptick would result in a $2.1 million increase in public sector costs.

Ethan Lindenberger, a high school student from Norwalk, Ohio, who was raised in an anti-vaccine household but still chose to get vaccinated, said during the hearing that statistics may not be the best way to reach vaccine-hesitant parents.

“A large portion of the foundation that they build to communicate with parents is on a very anecdotal level, sharing stories and experiences,” he said. “That speaks volumes to people because, at least for even my family, my mom would reaffirm her position was correct because she knows people and has seen stories. But correlation does not equal causation, and we don’t know a lot of factors involved. Even though I can say that, it still doesn’t resonate.”

He added that what is missing are stories of people suffering from vaccine-preventable diseases.

“When you convince parents not that information is incorrect, but that their children are at risk, that’s a much more substantial way to cause people to change their minds,” Lindenberger said. – by Katherine Bortz

Disclosures: Infectious Diseases in Children was unable to confirm relevant financial disclosures at the time of publication.

The Senate recently heard testimony concerning anti-vaccine rhetoric contributing to the spread of vaccine-preventable diseases in certain pockets of the United States.

Among those who spoke included the Secretary of Health for the Washington State Health Department, pediatric infectious disease specialists, a representative for immunocompromised individuals who cannot be vaccinated, and a teenager who chose to get vaccinated despite his mother’s objections.

The Senate met in 2014 following a measles outbreak to discuss the importance of vaccination. The outbreak occurred 14 years after the elimination of endemic measles in the U.S. and included 667 cases. Cases spiked again last year, with 372 cases, and just this year — between Jan. 1 to Feb. 28 — 206 cases of measles have been confirmed in 11 states, according to the CDC.

Saad B. Omer, MBBS, MPH, PhD, the William H. Foege Professor of Global Health and professor of epidemiology and pediatrics at Emory University, stressed that the federal government could take several steps to improve vaccination rates among Americans, including making vaccine counseling reimbursable.

Saad B. Omer

“I have worked on vaccine research in multiple countries and states in the U.S.,” he said. “There are a lot of local factors that are specific, but there is one constant: Health care providers — specifically physicians — are the most trusted source of vaccine information, even among those who are a little skeptical of vaccines. We need to use that tool more effectively. On the practical side, physicians do not have the time to properly counsel patients using evidence-based approaches. Part of the reason is the fact that this is not reimbursable. Physicians lose money on this kind of important part of education.”

Additionally, Omer advised against using “half-baked” communication strategies to improve immunization rates, and instead pointed to the NIH’s cancer prevention initiatives and the National Institute of Allergy and Infectious Diseases’ HIV and AIDS behavioral intervention initiatives as examples of how to improve public health.

Jonathan A. McCullers, MD, professor and chair in the department of pediatrics at the University of Tennessee Health Science Center, suggested that a personal connection between physicians and parents is necessary to overcome vaccine hesitancy.

“I think if there is a rapport with the physician and a mutual respect, both for the opinion of the parent but also for the of the position of the physician, you can say ... that the evidence is clear,” he said. “They will trust that information.”

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Results of a study published in JAMA Pediatrics demonstrated that even slight reductions in measles-mumps-rubella vaccination caused by vaccine hesitancy can cause an annual threefold increase in measles cases in children aged between 2 and 11 years. Researchers estimated that this uptick would result in a $2.1 million increase in public sector costs.

Ethan Lindenberger, a high school student from Norwalk, Ohio, who was raised in an anti-vaccine household but still chose to get vaccinated, said during the hearing that statistics may not be the best way to reach vaccine-hesitant parents.

“A large portion of the foundation that they build to communicate with parents is on a very anecdotal level, sharing stories and experiences,” he said. “That speaks volumes to people because, at least for even my family, my mom would reaffirm her position was correct because she knows people and has seen stories. But correlation does not equal causation, and we don’t know a lot of factors involved. Even though I can say that, it still doesn’t resonate.”

He added that what is missing are stories of people suffering from vaccine-preventable diseases.

“When you convince parents not that information is incorrect, but that their children are at risk, that’s a much more substantial way to cause people to change their minds,” Lindenberger said. – by Katherine Bortz

Disclosures: Infectious Diseases in Children was unable to confirm relevant financial disclosures at the time of publication.