Bad information to blame in vaccination hesitation

NEW YORK —Despite recommendations by the Centers for Disease Control and Prevention and healthcare professionals, some Americans are skittish about vaccinations, with many thinking they are unsafe or unnecessary. In many cases, bad information is to blame.

According to a University of Michigan Health System survey of 1,678 parents in September 2009, 40% of respondents said they would have their children vaccinated against the H1N1 flu, while 54% said they would have them vaccinated against seasonal flu. A Zogby International survey conducted in November 2009 found that 46% of adults in high-risk groups didn’t plan to get the H1N1 vaccine, citing the vaccine’s safety as a major concern.

“Today, the vast majority of vaccine-preventable diseases, hospitalization and deaths occur among adults,” said William Schaffner, chairman of the Infectious Disease Society of America’s Immunization Work Group and co-author of a study, conducted with the Trust for America’s Health and Robert Wood Johnson Foundation, on adult immunization. “This is tragic, because currently available vaccines can prevent many of these illnesses,” he added.

A decision last month by medical journal The Lancet to retract an article from 1998 belied a fear that had grown among parents ever since its publication, namely that the childhood vaccine for measles, mumps and rubella would lead to inflammatory bowel disease, which could lead to autism in children. The Lancet announced its decision following an independent investigation that found Andrew Wakefield, the lead author of the study, had engaged in “dishonest” and “misleading” conduct.

According to an April 2008 report published in the journal Pediatrics, MMR vaccination rates among children in the United Kingdom fell from 92% to 73% after Wakefield’s study was published. Subsequent measles outbreaks led to the first measles deaths in that country in more than a decade.

Meanwhile, the study caused widespread fears in the United States that vaccinations were behind increasing rates of autism in children. Still, the United States has not seen a major drop in childhood MMR vaccinations. According to the CDC’s “National Immunization Survey,” slightly more than 92% of children ages 19 months to 35 months had received the MMR vaccination in 2008. While the rate stood at 90% in 1995, it rose to 92% in 1998 and to 93% in 2003 and 2004.

But adults are a different story. According to Schaffner’s study, titled “Adult Immunization: Shots to Save Lives,” more than 30% of seniors in 36 states did not receive vaccinations for pneumonia in 2008, despite recommendations by the CDC. Meanwhile, 2.1% had received immunizations for tetanus, diphtheria and whooping cough in 2008, 43.9% had been vaccinated for seasonal flu, and 10% of women had received the human papillomavirus vaccine.

The report gave several reasons for the low adult vaccination rate: limited access, especially for adults outside such “institutionalized” settings as the military and colleges; limited care and insurance coverage; limited financing; limited vaccine research and development; and misunderstandings and misinformation.

“Thousands of adults die each year from vaccine-preventable diseases, yet adult vaccination rates remain low,” American Medical Association director of medicine and public health Litjen Tan stated. “The healthcare community can take a lead role in raising immunization rates.”

Pharmacists and nurse practitioners working in retail clinics are among those who could help, both by administering vaccinations and by providing information to patients lost amid the misinformation and misunderstanding.