Misconceptions about vaccination
For many families, mass vaccination programs have turned several childhood diseases such as measles, mumps, rubella, and polio, into distant memories. However, in the absence of recurrent outbreaks, public attention has begun to focus on the risks of vaccination, either real or perceived. Without a proper balance of evidence, anti-vaccine movements can gain momentum, and lead to decreased vaccine coverage.
Vaccination campaigns to control infectious diseases represent one of the greatest public health achievements in human history. The smallpox vaccine, first developed in 1798 by Edward Jenner, resulted in the eventual extinction in 1977 of this highly lethal human pathogen from nature. Facilitated through effective vaccination programs, the U.S. has seen disease incidence reduced by 95–100% for many infectious agents including smallpox, polio, measles, mumps, rubella, diphtheria, pertussis (whooping cough), and tetanus.2 However, the successes of vaccination in the U.S. and other countries have also had an unexpected, self-limiting effect with regard to public perception of disease risk.
In this modern age of communication, healthcare workers will encounter patients who have reservations about getting vaccinations for themselves or their children. There can be many reasons for fear or opposition to vaccination. Some people have religious or philosophic objections. Some see mandatory vaccination as interference by the government into what they believe should be a personal choice. Others are concerned about the safety or efficacy of vaccines, or may believe that vaccine-preventable diseases do not pose a serious health risk.
All healthcare workers who administer vaccines have a responsibility to listen to and try to understand a patient’s concerns, fears, and beliefs about vaccination and to take them into consideration when offering vaccines. These efforts will not only help to strengthen the bond of trust between healthcare worker and patient but will also help determine which, if any, arguments might be most effective in persuading these patients to accept vaccination.
Misconception 1: Diseases had already begun to disappear before vaccines were introduced, because of better hygiene and sanitation.
Statements like this are very common in anti-vaccine literature, the intent apparently being to suggest that vaccines are not needed. Improved socioeconomic conditions have undoubtedly had an indirect impact on disease. Better nutrition, not to mention the development of antibiotics and other treatments, have increased survival rates among the sick; less crowded living conditions have reduced disease transmission; and lower birth rates in developed countries have decreased the number of susceptible household contacts. But looking at the actual incidence of disease over the years can leave little doubt of the significant direct impact vaccines have had, even in modern times.
What are the experiences of several developed countries after they let their immunization levels drop? Two countries, the UK and Japan, cut back the use of pertussis vaccine because of fear about the vaccine. The effect was dramatic and immediate. In the UK in 1974 a prominent public-health academic, Dr Gordon Stewart (Glasgow University), became convinced, erroneously as it was subsequently established, that pertussis vaccine was responsible for permanent neurological damage in infants.
Professor Stewart claimed that the protective effect of the vaccine was marginal and did not outweigh its danger. His campaigning for his belief, including television appearances, caused a dramatic fall – from 81% to 31% (between 1974 and 1978) – in uptake of the vaccine in the UK. This, predictably, led to a resurgence of the disease, with an epidemic of more than 100,000 cases of pertussis and 36 deaths by 1978.
In Japan, around the same time, a drop in vaccination rates from 70% to 20%-40% led to a jump in pertussis from 393 cases and no deaths in 1974 to 13,000 cases and 41 deaths in 1979. Fortunately, in all these countries, universal vaccination has returned and pertussis has once again been brought under control.
Misconception 2: Vaccines cause many harmful side effects, illnesses, and even death - not to mention possible long-term effects we don’t even know about.
Vaccines have a good safety profile, despite implications to the contrary in many anti-vaccine publications. However, it must be recognized that vaccines can indeed cause adverse effects or “adverse reactions”. Most of the frequent ones are minor such as transient pain, redness and swelling at the site of injection. Systemic reactions such as fever, malaise or headache may be attributed to vaccination.
Serious adverse reactions are very rare and it is not easy to establish scientifi cally that an observed temporal association with vaccination is causal or due to the vaccine.
Since the beginning of the 20th century, the wide use of vaccination has produced substantial achievements in the control of vaccine-preventable diseases. Major victories against have been won by vaccination, eradicating a disease or reducing its incidence to rare case reports.
Source: Advances in Vaccinology - October 15th, 2012 (last updated)