Advocate for vaccines, but not for candidates

Ethics Forum. Jan. 5, 2004.

Scenario: How should you counsel parents opposed to childhood vaccinations?

Mr. and Mrs. Matthews have decided that they do not want their 3-month-old son vaccinated. They know that vaccines are largely safe but don't want to take the risk of having him vaccinated since it is unlikely he would contract any of the diseases that childhood vaccinations prevent.

Reply:

Pediatric vaccination programs have been one of the most important public health initiatives of the 20th century. Today, the United States has one of the highest rates of vaccination coverage in the world, which has led to the suppression and in some cases elimination of vaccine-preventable disease.

Though millions of children have been vaccinated safely, the climate of public discourse about vaccine risk has changed, with fear of adverse events eclipsing fear of disease.

Parents now aggressively question pediatricians about vaccine safety. In turn, pediatricians often feel unwilling or unprepared to respond to such scrutiny, especially when based on false or misleading information acquired from the media or the Internet. All of this can make effective vaccine risk communication a difficult challenge for health care professionals in the office setting.

Some parents, such as those in the case, refuse immunization because they perceive the risk of their child acquiring disease to be insignificant.

In fact, when rates of coverage for certain diseases reach a certain high level, a resistance of the community to disease attack might occur because a large portion of the population is immune. This is what is known as herd immunity and allows for limited numbers of individuals to avoid vaccination, yet take advantage of vaccine protection.