Parental Choices in Vaccinating Children

Understanding diversity in beliefs about health

Getting your child vaccinated is a choice every parent has to make. There are many attitudes, beliefs and perspectives on the topic. This essay will be comparing and contrasting these views between the two groups of parents, those being the ones that decide to fully vaccinate their children and those that put off certain vaccines or don’t vaccinate their children at all. The majority group of 90.1% of parents in Australia decided to have their children fully immunised, with the remainder being the parents that choose to refuse certain or all vaccines (A. G. o. h. (2014)). Reasons for different attitudes leading to these decisions can range from the medical to the religious reasons (Douglas S. Diekema, M. D., M.P.H. (2012)). Recommendations and education about immunisation usually happens through the parents doctor or physician, since it is seen in the medical community as a big problem that parents don’t vaccinate their children (Douglas S. Diekema, M. D., M.P.H. (2012)). In some countries such as Canada it is mandatory to vaccinate your child, but in countries like Australia and the US the choice is up to the parents (Walkinshaw, E. (2011))(Douglas S. Diekema, M. D., M.P.H. (2012)). This decision a parent can make for the child can have lasting effects into adulthood and with recent recurring outbreaks of diseases like whooping cough, there is a lot of stigma surrounding the topic (Walkinshaw, E. (2011)) .

A vaccination is a medical procedure where a person is injected with a substance which can prevent illnesses and diseases being caught or spreading (Shetty, P. (2010)). Parents give their children shots for each disease and a few single diseases need multiple shots just for themselves (Pediatrics. (2011)). Such diseases that children might get vaccinated for would be polio, influenza virus and the measles (Douglas S. Diekema, M. D., M.P.H. (2012)). Most parents vaccinate their children (A. G. o. h. (2014)). But there is also a high number of the population which refuses to receive their vaccinations, mainly because of skepticism (Walkinshaw, E. (2011)). This is apparent even though many doctors such as Dr Ian Gemmill try to put across messages like “Immunizations are the safest, longest-lasting and most effective ways to prevent communicable diseases” (Walkinshaw, E. (2011)). Although this is the majority of the attitudes between health care occupations, surveys show that health workers still remain divided on this issue, with a â…“ of emergency nurses in one survey expressing that they had concerns and didn’t fully trust the idea of immunizations and what the risk of side effects would be for themselves (Mary Ann Bell, P., Joseph A. Dake, James H. Price, Timothy R. Jordan, Paul Rega. (2012)). Doctors like Dr Gemmill emphasise their point by referring to statistics of immunizations, comparing disease related death from before vaccinations to after (Walkinshaw, E. (2011)). While Edda West, the coordinator of the Vaccination Risk Awareness Network has the counter argument that, a medical procedures that’s as invasive as vaccinations will always carry a risk of injury or death and this should be taken into consideration by the patients parents (Walkinshaw, E. (2011)). Also saying that many health professionals are persuading parents and not educating them about the fact that they themselves have a choice (Walkinshaw, E. (2011)). Vaccinations have health groups divided but in the end it is up to the parents and their choice in end. Vaccines overall have strong effects on the health industry (Douglas S. Diekema, M. D., M.P.H. (2012)).

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Parents that have their children vaccinated

Parents can have a positive attitude about vaccines for a number of reasons. Most parents know about the certain diseases that could be fatal for their babies (Dannetun, E. T., Anders ; Giesecke, Johan. (2007)). Vaccines have demonstrated to have positive effects in solving this problem and this is the main motivation for most parents to have their children immunized (Dannetun, E. T., Anders ; Giesecke, Johan. (2007)). Most parents don’t give it a second thought since vaccines are widely accepted and promoted in today’s society (Douglas S. Diekema, M. D., M.P.H. (2012)). It is given out through schools and some schools even require children to be vaccinated before they can be accepted into a school (Douglas S. Diekema, M. D., M.P.H. (2012)). So one of the big influences on the beliefs of parents that are pro-vaccination come from the General health community and the government (Dannetun, E. T., Anders ; Giesecke, Johan. (2007)). The World Health Organisation (WHO) says that it wants most countries to vaccinate all their children (Dannetun, E. T., Anders ; Giesecke, Johan. (2007)). These groups push vaccinations by the parent receiving the advice from a health professional, or having the parents children face restrictions in the future like not being able to attend a certain school (Douglas S. Diekema, M. D., M.P.H. (2012)). Parents might get the feeling that they are obligated to vaccinate their child, they want the best for their child and the education they receive when looking for professional advice it leads parents to a pro-vaccination standpoint (Walkinshaw, E. (2011)).

Another thing pro-vaccination attitudes are pushed with would be the parents own fear for their child (Mary Ann Bell, P., Joseph A. Dake, James H. Price, Timothy R. Jordan, Paul Rega. (2012)). Children are always at risk of getting sick, spikes in diseases like whooping cough occur in populations unvaccinated and babies die from this ((RCN), R. C. o. N. P. C. (2012)). Naturally, occurrences like these influence parents that might have not have been pro vaccine to maybe change their view. Pertussis vaccination is one of the most common and outbreaks among the unvaccinated community are not uncommon ((RCN), R. C. o. N. P. C. (2012)). Parents who are worried and don’t want to put their children at risk will mostly seek the simpler solution to ensure the safety of their child and that’s to vaccinate (Douglas S. Diekema, M. D., M.P.H. (2012)).

The fear factor also leads to some pro-active attitudes to pro-vaccination. This is especially apparent in developing nations, where vaccines are on high demand and support from the government is lacking (Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012)). There is a high burden of disease in places such as South Africa with high death rates due to preventable diseases such as pneumococcal and rotavirus (Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012)). People of the pro-vaccine attitude might go as far to fund charities to distribute to poorer countries, with the intention that it will allow children in developing nations to receive vaccines. The most notable donator being Bill Gates, a parent himself donating $2Billion of his fortune in 1999 to vaccine distribution, his contribution has allowed many parents in poor countries to have better access to vaccines for their own children. More has been donated since (Economist, T. (1999, 5 Nov)). These actions all stem from their attitudes to vaccinations, believing that more vaccines, means less death or injury.

Parents that don’t want their children to be vaccinated

Children that don’t get vaccinated are said to be put at risk of coming down with a deadly illness (Douglas S. Diekema, M. D., M.P.H. (2012)). Parents are of the anti-vaccine attitude, believe that they are doing better for their child because of their own reasons or lifestyle choices (Shetty, P. (2010)). Something that could have parents take an anti-vaccine opinion, could be for non-medical reasons like the family religion or philosophical reasons (Shetty, P. (2010)) (Douglas S. Diekema, M. D., M.P.H. (2012)). But the majority of parents that don’t vaccinate their children have reasoning mainly due to their own skepticism about the vaccine shots and their possible side effects (Shetty, P. (2010)). Parents say that they don’t want their children to be exposed to “unnecessary toxins” (Shetty, P. (2010)). The risks and benefits of vaccines are weighed up by parents, it is alleged by some anti-vaccine groups that immunisations can be linked to other diseases such as autism or multiple sclerosis (Shetty, P. (2010)).

The number of people with this attitude is rising globally, it is said that anti-vaccination groups would only be localised to specific areas in developed nations (Shetty, P. (2010)). But with the rise of the internet and social networking, the idea of greater safety from no vaccines in becoming to be known in more developing nations like India (Shetty, P. (2010)).

Paul Offit, the chief of infectious diseases, says that many parents aren’t fully educated about vaccinations and that they shouldn’t buy into the anti-vaccination lobbies which said to basically that “vaccines are the devil” (Shetty, P. (2010)). It is also said that a possible reason for people to have this point of view is because people can see an association between, the drop in illness levels, while the rate of people that encounter either real or perceived side effects goes up (Shetty, P. (2010)). Doctors are expected to fully educate parents about such subjects, because of common misconceptions about statistics which might influence their standpoint, so parents can make a fully informed decision.

Comparisons

One of the similarities these two groups share is that their actions are driven by fear (Shetty, P. (2010)). Whether it be the fear of losing your child via a sickness, or the fear of the idea that they will be exposing their children to “biologicals of unknown toxicity” (Douglas S. Diekema, M. D., M.P.H. (2012))(Shetty, P. (2010)). Both parties want the best for their children. Governments are constantly pushing vaccinations (Economist, T. (1998, 5 Nov)), and Health professional anti-vaccine groups are more vocal about parents not being educated about their choice and not being able to exercise their freedoms (Shetty, P. (2010)). Parents that are anti-vaccine seem to be more scared of the side effects of the vaccine than the actual disease (Shetty, P. (2010)). Doctors of the pro-vaccination standpoint do express that there are vaccines that children might not need, but vaccines like Hep B are a must (Shetty, P. (2010)). This appeals to many parents that might be on the fence about vaccinations, there is an appreciation for a middle ground between that two population groups (A. G. o. h. (2014)). There are a lot of diseases to vaccinate against (A. G. o. h. (2014)). Parents that are of the pro-vaccination standpoint may hold off on a certain vaccine if it doesn’t seem needed, until they decide they might want to go traveling with their children, to a place where it is needed, causes for this behaviour can be linked to someone’s financial standpoint (C, H. A. E. W. R. E. I. S. N. K. M. (2012)). The same idea applies for parents of the anti-vaccination standpoint, if there is an outbreak of a disease such a pertussis in the area where they live, some parents would be happy to makes sure that their children got a shot in that circumstance ((RCN), R. C. o. N. P. C. (2012)).

Impacts on Health

The main population group that affects the health community are the parents which don’t decide to vaccinate, hence why doctors push it to their patients so strongly, because it is said to cause preventable traffic in the health system (Douglas S. Diekema, M. D., M.P.H. (2012))(A. G. o. h. (2014)). With more and more parents not vaccinating their children, they are pushing beyond the safe number of what’s called the herd immunity (Douglas S. Diekema, M. D., M.P.H. (2012))(Shetty, P. (2010)). Herd immunity is based off the notion that it is safe to have a small amount of children in one area that are not vaccinated, but if there is a number of children not vaccinated in the same neighbourhood then outbreaks are more likely to occur (Shetty, P. (2010)). Vaccines are also expensive though (Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012)). If everyone was anti-vaccine then it would free up expenses which could be used for arguable more important aspects of health (Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012)). Poorer countries need to accommodate as the demand for vaccines rises, putting more strain on their current health systems (Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012)).

Conclusion

Vaccinations are one of the many choices parents get to make for their children and any subject relating to life or death is going to be touchy. Although there are some countries such as slovenia that don’t allow for the freedom for parents to choose, with other countries like canada looking to do the same (Walkinshaw, E. (2011)). Mainly due to strong advocacy from the health systems as a whole (Douglas S. Diekema, M. D., M.P.H. (2012)). In the nations where you are allowed choice, doctors try their best to make sure parents are fully educated on the matter so there is less of a chance that parents make their decisions for the wrong reasons (Douglas S. Diekema, M. D., M.P.H. (2012)).

References

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Blecher, M. S. M., Filip ; Kollipara, Aparna ; Hecht, Robert ; Cameron, Neil A. ; Pillay, Yogan ; Hanna, Luisa. (2012). Financing vaccinations – The South African experience. Vaccine, 30, 7. doi: 10.1016/j.vaccine.2012.04.042

Douglas S. Diekema, M. D., M.P.H. (2012). Improving Childhood Vaccination Rates. The New England Journal of Medicine, 366(5), 3. doi: 10.1056/NEJMp1113008

C, H. A. E. W. R. E. I. S. N. K. M. (2012). A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports. BMC public health, 12(1), 1.

Dannetun, E. T., Anders ; Giesecke, Johan. (2007). Parents’ attitudes towards hepatitis B vaccination for their children. A survey comparing paper and web questionnaires, Sweden 2005. BMC public health, 7, 1. doi: 10.1186/1471-2458-7-86

Economist, T. (1998, 5 Nov). Philanthropy: Gates the Good. The Economist, 1.

Mary Ann Bell, P., Joseph A. Dake, James H. Price, Timothy R. Jordan, Paul Rega. (2012). A National Survey of Emergency Nurses and Avian Influenza Threat. Journal of Emergency Nursing. doi: 10.1016/j.jen.2012.05.005

Pediatrics. (2011). Meningococcal conjugate vaccines policy update: booster dose recommendations. Pediatrics, 128(6), 5. doi: 10.1542/peds.2011-2380

(RCN), R. C. o. N. P. C. (2012). The Health Protection Agency is warning parents to keep their children up to date with vaccinations for whooping cough, after an increase in the number of cases in 2011. Nursing Children and Young People, 24(3), 1.

Shetty, P. (2010). Experts concerned about vaccination backlash. The Lancet, Vol.375(9719), 2. doi: 10.1016/S0140-6736(10)60421-7

Walkinshaw, E. (2011). Mandatory vaccinations: no middle ground. CMAJ: Canadian Medical Association Journal, Vol.183(16), 2.