November 10, 2000

Parental misconceptions about vaccines could undermine disease control efforts

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Dr. Harry Jacobson addresses the crowd at the P&G announcement as Mayor Bill Purcell listens. (photo by Dana Johnson)

Parental misconceptions about vaccines could undermine disease control efforts

Dr. Bruce G. Gellin is concerned about the lack of understanding about childhood immunization.

Gellin, adjunct assistant professor of Preventive Medicine, recently led a national survey to assess parents’ understanding of vaccine-preventable diseases, vaccines, immunization practices, and policies. Although 87 percent of respondents deemed immunization an extremely important action that parents can take to keep their children healthy, a substantial minority held important misconceptions.

For example, 25 percent of parents believe their children’s immune system could be weakened as a result of too many immunizations. Also, 23 percent believe that children get more immunizations than are needed. “This tells us that many parents may not appreciate the seriousness and contagiousness of the diseases that modern vaccines now so effectively prevent,” Gellin said. “Yet with the exception of smallpox, which was eradicated over 20 years ago, these diseases are only a plane ride away.

“There’s a severe misunderstanding of immunization in this country,” Gellin added. “Young parents and many young doctors and nurses are not familiar with diseases that once sent fears in the community.”

Gellin and co-authors Dr. Edgar K. Marcuse and Edward W. Maibach, Ph.D., explain the findings in an article appearing in the November issue of Pediatrics. The three conclude, “although the majority of parents

understand the benefits of immunization and support its use, many parents have important misconceptions that could erode their confidence in vaccines.”

Leonard and Suzanne Walther know firsthand how misconceptions can affect children who do not receive the proper immunizations. The couple opted not to have daughter Mary Catherine vaccinated after a friend mentioned safety and moral concerns with immunizations.

Earlier this summer, Mary Catherine was hospitalized at Vanderbilt Medical Center with a form of bacterial meningitis called Hib (Haemophilus influenzae type b) meningitis – a disease which could have been prevented with the immunization that is routinely recommended for all infants. She has fully recovered, but the Walthers now recognize how dangerous some diseases can be and are now proponents of proper immunization.

“With vaccinations, I wanted to make the right decision for my family,” Suzanne Walther said. “It’s harder to get correct information than wrong information.”

“Ignorance and blind following is not the answer,” she added. “Being an informed parent is the right answer. Getting correct information is crucial.”

Gellin points to excessive and often inaccurate or misleading information in today’s society for the misconceptions. “There is a lot of information available on TV and the Internet,” he said. “But it’s not all good information. It is easy to be informed and it’s also easy to be misinformed.”

Gellin, Maibach and Marcuse are encouraging a national educational effort to provide scientifically-credible information about vaccines and immunizations policies and practices to address the common misconceptions.

“Improving the immunization dialogue is really a case study of the doctor-patient relationship in the era of mass communication,” Gellin said. “We know that people get information about immunizations from a variety of sources: newspapers, magazines, television, friends and relatives and the Internet. But we also know that the majority of people consult their health care provider to put the information into perspective and offer advice. If people make important medical decisions based on bad information, the results could be tragic.”

The number of vaccines has doubled in the last 10 years, according to Gellin. “Thanks to advances in medical research, there are now more diseases that can be prevented by immunizations than just a generation ago. But with this progress comes added complexity. Now that immunizations are complex, children do get a lot of immunizations,” Gellin said.

With the rise of the number of immunizations, Gellin believes the number of parents worried about too many immunizations will also increase.

Gellin supports a concerted effort between medical professionals and other agencies to enhance the public’s knowledge of vaccines. He added that he believes health care professionals have an important opportunity and a professional obligation to educate parents and to correct misconceptions.

Gellin is the Executive Director of the National Network for Immunization Information (NNii), a partnership of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the American Academy of Pediatrics and the American Nurses Association. Supported by a grant from the Robert Wood Johnson Foundation, the NNii was created to provide the public, health professionals, policy makers, and the media with accurate information related to immunization.

The NNii provides educational materials and information resources about immunization issues. Dr. William Schaffner, chairman and professor of Preventive Medicine and Infectious Diseases, and Dr. Kathryn M. Edwards, professor of Pediatrics, serve on the NNii steering committee.

“Clearing up misconceptions is vital for a continued robust national immunization program,” Schaffner said. “People do not realize we have the capacity with vaccines to essentially eliminate many diseases from our country entirely.”

“If a substantial minority of parents withhold immunization, children will be susceptible,” Schaffner added. “Disease will continue to persist in our population. That would be a tragedy.”

Edwards also commented on the role of the medical profession in dispensing proper information.

“For those of us who have worked to develop safe and effective vaccines for the prevention of infections in children and adults, we are increasingly dismayed by the assaults on vaccines by the media and the public,” she said. “To provide accurate and credible information to the public about vaccines the NNii was established. The effort is ably led by Dr. Bruce Gellin.

“Only through accurate and clear information can parents understand the benefits of vaccine and weigh the risks in this context. It is wonderful to have Dr. Gellin working here at Vanderbilt in this important role.”