On measles outbreak and the anti-vaccination movement

CDC said that the measles outbreak has now infected more than 100 people across 14 states and as it is happening it seems that we can partly blame the anti-vaccination movement. May I ask what is your view on this, how strong do you find the anti-vaccination movement and could the answer on the current situation be a mandatory vaccination? Read few comments.

Mark Schleiss, Professor, Division Director, Pediatric Infectious Diseases, University of Minnesota

The anti-vaccine movement in the United States has become in recent years increasingly vocal, and well-funded. Their stridency is a major factor in the current measles outbreak. Their message resonates with some parents, who as a result do not immunize their children. This vaccine refusal puts us all at risk. I think the anti-vaccine movement must be taken seriously, and strategies developed to counter their agenda. I think some strategies could be early education. Reach young people for the next generation before their minds are made up. Strategies to focus on education as a part of a broader effort for science education. Other strategies are to work with parents who can offer their testimony about vaccines in a positive light.

Mandatory vaccination is of course a component of insuring high vaccine coverage. However, in almost all states, there are “religious and philosophical exemptions” that parents can claim to avoid vaccination. In our democracy, countering these exemptions must be undertaken through the people’s representatives, through the legislative process. There is currently a bill in the Minnesota legislature that would examine these exemptions. This is one of many steps that can be taken to improve vaccination rates.

John Swartzberg, Clinical Professor, Emeritus, UC Berkeley School of Public Health, University of California

The anti-vaccination movement represents a small but very vocal portion of our population. I believe it to be based upon three things:

The success of vaccines: Because vaccine-related disease is so uncommon in our society, most parents have not seen it — and, don’t understand how dangerous these diseases can be.
Values: Some who don’t immunize value autonomy over beneficence.
Other values: Some don’t want to be told by society what they must do (the libertarian strain in our country).

In any case, I feel strongly (and, my feelings are consistent with our public health community) that as a society we should do the following:

Make it more difficult for parents not to vaccinate their children (e.g. make vaccination a requirement for matriculation to school; for those who refuse, enforce the necessity of a doctor’s statement that they have discussed this).
Make parents legally liable if their unvaccinated child causes someone else to become ill.
Find a way to not allow this to be a political issue (I have no idea how to do this!).
Public health needs to work more closely with journalists to explain the science (I groaned when I heard CNN say that this outbreak has “rekindled the vaccine debate.” What debate???).

Daniel Salmon, Associate Professor, Global Disease Epidemiology & Control, International Health, Johns Hopkins University School of Public Health

I find it difficult to characterize the strength of the anti-vaccine movement. There are groups that openly identify themselves as anti-vaccine but there are not that many. The groups that many refer to as anti-vaccine self identify as advocating for vaccine safety and informed decision-making. I think nearly everyone wants safe vaccines and for people to make informed decision. These groups are fairly well established and some individuals such as Jenny McCarthy may be fairly influential. It is often difficult for the public to readily detect on the internet advocacy groups from legitimate medical and public health groups. The vast majority of parents are not anti-vaccine. The majority of parents have some concerns about vaccination, although most of them ultimately vaccinate their children.

Tweeking state exemption laws to compulsory vaccination may be helpful. But I don’t think doing so will solve the problem of parental vaccine hesitancy.

Andrea Kitta, Associate Professor, Area Coordinator, Multicultural and Transnational Literature. Department of English, East Carolina University

If we look historically at campaigns to make vaccination mandatory in the US, we can see that they have been absolute failures. Not only have they not increased vaccine uptake, but they have also resulted in policies that were culturally insensitive and unethical. Any public health campaign needs to understand what the real fears and real concerns of the public are, there is no quick and easy fix for this. One thing people need to understand about those who question vaccination is that they are educated people who truly believe they are making a good decision for their child(ren). There seems to be quite a bit of public shaming and name calling recently, by both sides of this debate. This will not help and only further antagonizes and distances people when what we need is for everyone to work together.

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