Vaccine safety messages not reaching many parents

More than half of parents who participated in a nationally representative survey worried about the potential for serious adverse events despite believing that vaccines are a good way to protect their children from disease.

“Although information is available to address many vaccine safety concerns, such information is not reaching parents in an effective or convincing manner,” researchers from the University of Michigan in Ann Arbor wrote.

They sent 2,521 online questionnaires to parents of children aged 17 years or younger in January 2009 as part of a larger national study. Data indicated that among 1,552 respondents, one in eight had refused at least one recommended vaccine and that at least one in five wrongfully believed that some vaccines caused autism in healthy children.

Safety concerns were more prevalent with newer rather than older vaccines, findings showed, with parents most commonly refusing the human papillomavirus, the varicella and the meningococcal conjugate vaccines.

The researchers suggested that several sex-specific and racial/ethnic trends may be useful for crafting more tailored vaccine information programs that target specific subgroups of parents. Women were more likely than men to be concerned about serious adverse effects (OR=1.75; 95% CI, 1.28-2.39); to believe that some vaccines cause autism in healthy children (OR=1.9; 95% CI, 1.31-2.79); and to have ever refused a recommended vaccine (OR=2.52; 95% CI, 1.65-3.85).

Data also indicated that Hispanics were more likely than either blacks or whites to be concerned about serious adverse effects (OR=1.68; 95% CI, 1.01-2.79). Despite these findings, Hispanics were the most likely to report that they generally follow the doctor’s recommendations regarding vaccines (OR=2.5; 95% CI, 1.13-5.16) and were less likely than either whites or blacks to have ever refused a recommended vaccine (OR=0.47; 95% CI, 0.24-0.93).

“It is likely that parents would benefit from educational programs that highlight the manner in which safety assessments are conducted before the licensure and subsequent recommendation of new vaccines,” the researchers wrote. They added that physicians should also be knowledgeable in these aspects as parents frequently trust them as a good source of vaccine information. – by Nicole Blazek

Freed GL. Pediatrics. 2010;125:654-659.

Freed et al have published another intriguing paper about parental misperceptions regarding vaccines. These data are unusual in that they do not implicate pertussis, the measles-mumps-rubella or hepatitis B vaccines as the major culprits for parental safety issues, but surprisingly the meningococcal and varicella vaccines. I personally have not experienced any parental reluctance towards these two vaccines in my area.

On the other hand, anyone who is administering the HPV4 vaccine knows that parents have been fed way too much internet and health care provider paranoia. I suggest that all who administer or make any recommendations about HPV4 read thoroughly the latest two articles on the topic that were published in the Pediatric Infectious Disease Journal and the Journal of the American Medical Association. Then you will be ready to defend HPV4's safety based on good science from placebo controlled trials and post marketing data comparing adverse events from the Vaccine Adverse Event Reporting System with expected background rates of the particular disease states.

Why do parents feel so uncertain about vaccines? Much of it has to do with yellow journalism. When Andrew Wakefield published his half-cocked, totally biased 12-patient data on MMR's purported relationship to autism, most newspapers could not get enough of the front page tabloid sensationalism, spending months and page after page on the topic. When the retraction and denunciaton of these fabricated data occurred last month, the anouncement was given short shrift and barely a passing notice in the back section of most newspapers.

The CDC really needs more money and better public relations management to handle negative criticism of its fundamentally sound vaccine program. We should quarterly disseminate to every news outlet photos and numbers about the devastation and mortality caused by prevaccine-era pertussis, measles, haemophilus influenzae type B, polio, meningococcus, etc.

– Stan L. Block, MD
Infectious Diseases in Children Editorial Board

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