Skepticism of Flu and Other Vaccinations
Families and societies have faced cycles of deadly diseases, including pandemics, for centuries with profound effects on the perceptions and realities of unseen threats. Since the 16th century, influenza pandemics have occurred at intervals ranging from 10 to 50 years. In the 20th and 21st centuries, three outbreaks of pandemic flu happened. In 1918 it was Spanish Flu with 20% to 40% of worldwide population ill and estimated 50 million people died. In 1957 an influenza virus originated in East Asia that killed between one and two million. Then in 1968, a similar flu virus originated in Hong Kong that resulted in between one and four million deaths. More recently, in the spring of 2009, spreading fast in Mexico and US, the world was rocked with another health crisis; H1N1 (Swine Flu). This study proved that there is limited benefit from flu vaccination given each year but it is better than no help at all (Aylesworth-Spink, 2017).
Vaccines are one of the most important public health achievements of the 20th century and are responsible for a steep decline in vaccine-preventable diseases. Unfortunately, despite the role vaccinations have played in improving health, myths still persist. Some of these myths have dated as far back as the 18th century during the time of smallpox epidemics in England and colonial America. As more vaccinations became available and were added to the recommended childhood immunization schedule more myths arose.
In 1982 there was talk that the DPT (diphtheria, pertussis, tetanus) shot caused brain damage, seizures, intellectual disabilities and permanent disabilities in infants. This type of sensational reporting by media has led to the culture of fear incited by publicizing cases of vaccine-injured children despite scientific proof there is no connection between vaccine in question and injury.
According to the CDC in 1999, there was an outcry that the preservative thimerosal in vaccines led to autism. This has been scientifically disproved with the most common side effect to be minor reactions at the site of injection. Thimerosal is a form of ethylmercury that is cleared out of the human body quickly. It was originally used as an antimicrobial in multi-dose vials. It has never been used in the MMR injection; another mythic source of autism. It has since been removed from all vaccinations other than multi-dose influenza vials as multi-dose vials is the only way to produce enough vaccine for all those who require it (CDC, 2015).
There are people who feel vaccinations are not adequately tested and monitored for safety. This myth plays into the conspiracy theories and unfortunately have gained traction due to the internet. In more recent history, there is a myth that children are given too many vaccinations too soon in the child’s life. This has taken root as the number of vaccinations given to children in the 1980’s was five shots given to prevent seven vaccine-preventable diseases. By 2000, children received 20 shots by the age of two. In 2018, the recommendation of the CDC is 26 injections (including boosters) before two years. Many parents rather than have so many vaccinations given at one time have opted to spread them out. They still get all the immunizations just not all at the same time as the CDC has proposed.
Then the biggest myth is concerning the flu (influenza) vaccine. It is recommended that anyone over the age of six-months get it every year. Despite this the coverage from six-months through four years was 70% and five years through 17 years a dismal 55.9%. Much of this reluctance comes from the perception that the vaccine doesn’t work as the effectiveness varies year to year. In fact, in the past decade effectiveness has ranged from 19% to 60%. This of course does not address the children/adults who come to America illegally from countries that don’t get vaccinations. This can lead these unvaccinated ones to contribute to the spread of vaccine-preventable diseases (Boom et al, 2018).
Vaccinations are one of the most successful public health interventions. They save an estimated two to three million lives each year. Contrary to this, many parents have been showing increased concern regarding childhood vaccinations in the US. This has led to a decrease in vaccination rates in certain communities and has played a role in recent disease outbreaks resulting in several deaths.
Parental reasons for not adhering in the vaccination of their children includes concerns over the risk of adverse effects, chemicals used in the vaccines, use of fetal stem cell lines in vaccine production and potential of catching the illnesses the vaccines are supposed to protect them from. In addition, any intervention geared toward challenging the parents viewpoints can lead to parents digging in their heels even more against vaccinations. This study attempted to provide needed information to parents about vaccinations. The majority of participants, however, while they were happy with the visits still had the same concerns about the vaccinations they had before their visit.
Most participants expressed concern that current scientific literature on vaccines was not trusted as much of it was conducted by researchers who had ties to the pharmaceutical industry. Due to this fact many did not intend to change their behavior about vaccinations. Parents also voiced concern that the potential side effects of vaccinations were underreported in an effort to keep the shots in a positive light. And while most would be interested in further data on vaccines they also felt the only kind of study they would trust results from would be a study conducted by doctors with no pharmaceutical ties. They felt that a study done by pediatricians would be more trustworthy than one done by the CDC-a governmental agency (Potter et al, 2017).
Medical books today almost uniformly say how important it is to be vaccinated. The books leave the readers with the impression that in the 1800s and 1900s rampant plagues killed countless people and due to vaccines this was no longer the case. This is what most people have been taught as an established fact. It is difficult to doubt the importance of immunization to our well-being. It has been estimated without these immunizations infant and childhood death rates would probably hover around 20% to 50%.
In fact, in countries where vaccinations are not practiced this is the level of infants and young children death rates. An example of the impact vaccines can make can be illustrated with pertussis or whooping cough disease. Before vaccinations were used in the US in the 1940s there were 300,000 cases of whooping cough causing 7,000 deaths each year; almost all in young children. Now, fewer than 30 children die from it every year. But what if all this was hype and the effects of improved sanitation, nutrition, hygiene, labor laws, electricity, chlorination, refrigeration, pasteurization, was actually more likely the cause for the decrease in childhood deaths.
There continues to make the unlikely assumption that all of this decline is attributed to the intervention from vaccines while the most of the decline in mortality since 1900 is 3.5% and the rest due to other factors. In 1979 Sweden stopped use of DTP vaccine as they felt it was not effective and possibly unsafe. From 1981 to 1993 8 children were recorded as dying from pertussis. It averaged out to 0.6 children/year died from pertussis or one in 13 million even with no national vaccination program. Because of the zealous pro-vaccination bias that permeates society, the true focuses in deaths from infectious diseases are not acknowledged (Bystrianyk & Humphries, 2018).
Even nurses generally show low compliance with vaccination recommendations. This study looked at this low acceptance as due to skeptical attitudes toward emerging infectious diseases. Skepticism usually shows as both a doubt that a real threat of emerging diseases and the lack of trust about the motives and ability of institutions that fight these diseases. This skepticism affected nurses’ intention to vaccinate self against seasonal flu (influenza).
Nurses are on the frontline of the public health defense systems against infectious diseases. Vaccinations of healthcare personnel like nurses are an effective method to contain infectious disease propagation. But this study and others found nurses show a low compliance with vaccination recommendations. Add to this the fact in recent years the general public has been repeatedly confronted with several emerging infectious disease outbreaks that turned out having little impact; this creates even greater skepticism.
The reported occurrence of disease outbreaks that have turned out less dangerous than announced has also decreased the confidence in the reliability of expert sources. There is also a prevailing perception of conflicts of interest and collusion between public organizations and private corporations-pharmaceuticals. In addition, due to the availability of the internet, conspiracy theories abound and groups seeking to influence public opinion. Or those groups that are against vaccinations due to the thought there is collusion between authorities, physicians and pharmaceuticals companies as a cabal for profit. It is important to address skepticism and misperceptions early on, during nursing education and training (Maridor et al, 2017).
Aylesworth-Spink, S. (2017). Finding hope in media hype: The challenges of crisis communications during disease outbreaks. Research Journal of the Institute for Public Relations,3(2).
Bystrianyk, R. & Humphries, S. (2018). Vaccines: A peek underneath the hood. Vaccine Impact.
Boom, J.A. et al. (2018). Vaccine myths: Setting the record straight. Journal of Family Strengths, 18(1), article 13.
CDC (2015). Vaccine Safety: Thimerosal in vaccines. US Department of Health and Human Services. Centers for Disease Control and Prevention.
Maridor,M. et al. (2017). Skepticism toward emerging infectious diseases and influenza vaccination intentions in nurses. Journal of Health Communications. Taylor & Francis Group, LLC.
Potter, N. et al. (2017). Taking a shot at immunization adherence: Group visits for vaccine-adverse parents. PRiMER(peer-reviewed reports in medical education research),1(15). STFM (Society of Teachers of Family Medicine).