Dispelling vaccination 'myths' aroused by GOP debate

During the recent Republican presidential debate, the topic of vaccination once again was thrust into the spotlight, as candidates discussed the possible link between vaccines and autism, as well as “alternative” immunization schedule and the possible benefit of delaying vaccination.

In light of the measles outbreak at California’s Disneyland earlier this year, calls for mandatory vaccination of all school-aged children, increases in adolescent vaccination coverage, increases in parental knowledge about vaccines, and increases in safety and efficacy research have become part of the national discussion on vaccines.

However, during the recent debate, leading Republican presidential candidates did not cite the scientific evidence debunking the link between autism/developmental disorders and vaccinations. Instead, they focused on issues involving the safety of vaccines and vaccination schedules, the personal freedom to vaccinate and possible connections between vaccine manufacturers and government.

“The American Academy of Pediatrics would like to correct false statements made during the Republican presidential debate last night regarding vaccines,” Karen Remley, MD, MBA, MPH, executive director and CEO of the AAP, said in a press release. “Claims that vaccines are linked to autism, or are unsafe when administered according to the recommended schedule, have been disproven by a robust body of medical literature. It is dangerous to public health to suggest otherwise.

“There is no ‘alternative’ immunization schedule. Delaying vaccines only leaves a child at risk of disease for a longer period of time; it does not make vaccinating safer. Vaccines work, plain and simple. Vaccines are one of the safest, most effective and most important medical innovations of our time. Pediatricians partner with parents to provide what is best for their child, and what is best is for children to be fully vaccinated.”

Whether the vaccine issue will continue to be a discussion in the White House campaign, the pediatrician, as always, remains the front-line person to address parental vaccine safety concerns and vaccine refusals in this latest debate over vaccination. To this end, Infectious Diseases in Children highlights 10 of the most informative and noteworthy recent stories in vaccination news to help confront common misconceptions stirred up by the debate.

1. CDC, AAP approve recommended pediatric immunization schedules for 2015

Based on the October 2014 meeting among the CDC’s Advisory Committee on Immunization Practices, recommended immunization schedules for children have been published in MMWR.

“Each year, the Advisory Committee on Immunization Practices (ACIP) reviews the recommended immunization schedules for persons aged 0 through 18 years to ensure that the schedules reflect current recommendations for Food and Drug Administration-licensed vaccines,” Raymond A. Strikas, MD, of the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues wrote. Read more.

2. The anti-vaccination movement: March of the lemmings

As physicians who have actually seen patients with tetanus, diphtheria, smallpox and poliomyelitis, Donald Kaye, MD, and Marjorie P. Pollack, MD, discuss the appalling effectiveness of the anti-vaccination movement in the United States. While the current issue is the resurgence of measles, tomorrow it may be any number of the other vaccine-preventable diseases.

While some of the unvaccinated have true religious reasons for avoiding vaccination, they are in a minority and often clustered without major contact with outsiders. Also among the unvaccinated are the most vulnerable populations, the immunocompromised and children aged 1 year and younger — both of whom cannot be given attenuated live virus measles vaccines. However, the bulk of the unvaccinated are children of presumably well-meaning parents who have been influenced by rumor, discredited science or often by cult leaders, some of whom are, unfortunately, physicians and other scientists. Read more.

3. Lax vaccination policies heighten risk for vaccine-preventable disease outbreaks

Infectious Diseases in Children speaks with several experts about the heightened risk for other vaccine-preventable outbreaks without stricter vaccination policies, the questions regarding the laws and policies surrounding vaccination debates and the strategies pediatricians are utilizing to maintain, as well as increase, vaccination rates among their patients.

“The Disneyland outbreak exemplified many lessons about recent outbreaks of measles and other vaccine-preventable diseases. Measles is extremely contagious to those who are unvaccinated or otherwise vulnerable,” Robert Schechter, MD, section chief of the California Department of Public Health Immunization Branch, said during an interview with Infectious Diseases in Children. “For the unimmunized adults in the outbreak, decisions made to decline immunization had their ramifications decades later. Consequences linger.” Read more.

4. Emphasis on danger of preventable diseases eases vaccine hesitancy

Physicians highlighting the danger and potential harm related to vaccine-preventable diseases are more likely to change parents’ attitudes on vaccine safety than physicians who focus too heavily on refuting vaccination safety myths, according to a recent study.

“We found that directing people’s attention to the risks posed by not getting vaccinated, like getting measles, mumps and rubella and the complications associated with those diseases, changed people’s attitudes positively toward vaccination — and that was for even the most skeptical participants in the study,” researcher Zachary Horne, PhD, of the department of psychology at the University of Illinois, said in a press release. “Actually, the largest effect sizes were for people who were the most skeptical.” Read more.

5. Paul A. Offit, MD, discusses religious exemptions from important vaccinations

Paul A. Offit, MD, chief of the division of infectious diseases at The Children’s Hospital of Philadelphia, recently sat down with Infectious Disease News to discuss his new book, Bad Faith: When Religious Belief Undermines Modern Medicine.

According to Offit, parents who refuse vaccination for their children on the basis of religious beliefs are placing their children at unnecessary risk, and their decision to withhold vaccination should not be given legal protection. He offers his advice for clinicians with patients who refuse vaccination and discusses the ongoing national debate about the risks vs. benefits of immunization, which recently has been rekindled amid a measles outbreak originating from California’s Disneyland. Watch video.

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6. Teen Tdap MenACWY HPV vaccine coverage increases nationwide

Adolescent Tdap, quadrivalent meningococcal conjugate and HPV vaccination coverage increased in the United States from 2013 to 2014, although HPV vaccination coverage remains comparatively low, according to a recent report in MMWR.

“I am frustrated that in 2014, four out of 10 adolescent girls and six out of 10 adolescent boys had not even started the HPV vaccine series and are vulnerable to cancers caused by HPV,” Anne Schuchat, MD, U.S. assistant surgeon general, said. Read more.

7. Parents view vaccine safety, benefits more favorably

Parents’ opinions on the safety and effectiveness of vaccines have shifted toward more of a benefit and less of a threat, according to the latest C.S. Mott Children’s Hospital National Poll on Children’s Health.

“Outbreaks of diseases that can safely be prevented through routine childhood vaccination have become more common in the U.S. over the last several years,” Matthew, M. Davis, MD, MAPP, director of the poll, wrote. Read more.

8. Two-dose chickenpox vaccination program reduces US outbreaks by 78%

A routine two-dose varicella vaccination program launched in 2007 has drastically reduced the number of chickenpox outbreaks in the United States, a recent study reported.

“Although varicella outbreaks have declined during the two-dose varicella era, they continue to pose a challenge to manage and control,” Jessica Leung, MPH, of the National Center for Immunization and Respiratory Diseases at CDC, and colleagues wrote. Read more.

9. Gardasil HPV4 vaccine determined safe despite parental concerns

Gardasil quadrivalent HPV vaccine was determined to be well-tolerated and safe for routine use in girls and boys as well as young men and women despite increased parental safety concerns, according to recent study data.

“The data presented here, reflecting experiences with the HPV4 vaccine in hundreds of thousands of recipients, and the reviews by global health experts and organizations, reinforce the favorable safety profile of the vaccine,” Michelle Vichnin, MD, executive director of oncology at Merck, and colleagues wrote. Read more.

10. Physician response to ban on nonmedical vaccine exemptions will define success

As public support continues to swell for legislation to eliminate the “personal belief” exemption, additional pressures will be placed on physicians treating vaccine noncompliant or vaccine-hesitant patients to increase timely immunization. Paul A. Offit, MD, director, Vaccine Education Center, at The Children’s Hospital of Philadelphia, discusses the possible home-schooling strategies employed by vaccine noncompliant parents and the associated risk for vaccine-preventable disease outbreaks. Read more.