Pediatricians and the pushback against vaccinations

By GABRIELLA VUKELIC

Arizona Sonora News Service

There are a lot of reasons that medical professionals hear from parents who decline to have their children vaccinated. Nicole Bencs, a clinical instructor and nurse practitioner at the University of Arizona’s College of Nursing, discussed her views on skeptical parents:

“I’ve heard so many times that parents don’t vaccinate their children because other kids got the vaccination so therefore, if their child is around the vaccinated children, then they are protected. It doesn’t work that way and parents just need more education on the importance of vaccines,” said Bencs.

The anti-vaccination movement, which medical professionals have criticized as based on unscientific information and fear-mongering, has been a strong force in American culture for over a decade, and opponents of standard vaccinations for measles, mumps and the like have filed lawsuits claiming that the vaccinations caused autism in their children.

In Southern Arizona, pediatricians continue encouraging parents to accept vaccinations as proven medical science. In some areas around the country, there are reports that pediatricians are declining to accept in their practices families who decline to have their children vaccinated.

Dr. Robert Hom, a pediatrician at Tucson Central Pediatrics, said there are multiple reasons to why parents choose not to vaccinate their children. In 1998, a study by Andrew Wakefield, said vaccines that prevent measles and mumps can create signs of autism. That study has been widely discredited, but nevertheless influential. At the same time, Hom said, other parents might see less need for vaccinations because some childhood diseases that vaccinations address, such as measles, have largely abated.

“I feel that vaccines are victims of their own success,” Hom said. “Unfortunately, diseases make a comeback.”

Liz Worsfold practices giving vaccinations on a mannequin before her practical exam at the University of Arizona College of Nursing on Sept. 15, 2016. Worsfold is in her second semester within the Master of Science for Entry to the Profession of Nursing program. Gabriella Vukelic / Arizona Sonora News Service
Liz Worsfold practices giving vaccinations on a mannequin before her practical exam at the University of Arizona College of Nursing on Sept. 15, 2016. Worsfold is in her second semester within the Master of Science for Entry to the Profession of Nursing program. Gabriella Vukelic / Arizona Sonora News Service

Hom said that people don’t see older diseases anymore such as poliomyelitis, and therefore aren’t worried. News media, especially television and entertainment, drive perceptions. For example, he said when the Zika virus generated headlines not long ago, there was a rush for vaccinations.

Medical experts see the fluctuations in behavior about vaccinations as very dependent on public perceptions of certain threats by some patients.

“It really depends on the parents,” Hom said. For example, some parents of adolescents “don’t want to think that their children are sexually active and refuse to give them the HPV vaccine, which most doctors, including myself, think is important for teens because it can cause serious infections and types of cancers.”

The pushback against parents rejecting standard vaccinations for their children appears to be accelerating nationwide,  but at the same time, the numbers of parents rejecting vaccinations has been increasing. Almost all medical research has disputed the assertion that vaccinations are harmful, but the movement continues to be vocal and bolstered by alarmist accounts in some media.

In 2013, according to a study released in August by the American Academy of Pediatrics, 87 percent of pediatricians surveyed reported vaccine refusals, up from 75 percent in 2006, though the study indicated that the rising refusal rate could be based on a feeling by parents who don’t see a need for a vaccination, rather than fear of autism. The study said concerns specifically related to autism “significantly declined” from 2006 to 2013.

The number of pediatricians who have dismissed patients who decline vaccinations has doubled, from 6 percent to 12 percent, the study reported.

Hom said, based on his research, the rate of parents declining to vaccinate their children is around five percent but “it’s still a scary number.” He added, “I certainly hope that five percent decreases but I don’t know where this problem will go in the next five years. I just hope with lots of advertising and new vaccines with those more reluctant safety data bases, parents will start changing their minds.”

Bencs said that some parents misunderstand the importance of their children receiving vaccines while their children attend school. She said she encourages her students to research explaining in detail how a vaccine works, what it will do to protect the patient, and if there are any harms or side effects to the vaccination for skeptical patients.

Bencs added, if information about vaccines is in the news more often, that is when the realization hits them in thinking they need it. She said there will always be patients who don’t want vaccines because it is “unnatural for their body.”

“I can see both sides to it,” Bencs said as to pediatricians who dismiss patients who resist vaccinations. “I’ve been in offices where they take everybody.”

Sometimes, she said, “it is like talking to a wall, you still have to educate the patient before giving the vaccine.” Some pediatricians simply declined being a care taker for the patient if the patient will not listen to the important advice, she said. Bencs said, “it’s just easier for doctors to say patients can’t go there unless they accept having their children vaccinated.”

Davi Corder, a public health senior at the University of Arizona, said studies and research are easily accessible to everyone on the Internet, yet those studies aren’t all necessarily reliable, and education is the key to addressing misinformation.

“Parents read things on the Internet that sway them into not wanting their children to get vaccinated,” said Corder. “I think parents need to be properly informed on the importance of vaccinations and the truth about how they work.”

Economic reasons also enter into the equation, as vaccination opponents often insist. Pediatricians are reimbursed for vaccinations and are now under competitive pressure from new walk-in medical services such as CVS minute clinics.

“We discuss vaccines in a couple of my classes because we learn about working with the different personal choices and beliefs of patients in order to help them better their health,” said Corder.  The goal is to “increase their education without violating any of their personal beliefs. We also discuss vaccines when we learn about the way disease is spread and how vaccines play a role in that.”

 

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Gabriella Vukelic is a reporter for Arizona Sonora News. She is a junior at the University of Arizona and is from Massapequa, New York. She loves to travel, bake, read and write.  Contact her at gabriellavukelic@email.arizona.edu.

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