Anti-Vaccination: The Next Epidemic?

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Why Research Vaccines?

CC BY 2.0 Alan Levine

I chose to research vaccines for my paper because I see about the controversy everyday on social media or the news and wanted a better understanding on what it was really about. I have grown up always getting every ‘shot’ that the doctors recommended to me and never questioned it. Seeing people fighting vaccines so frequently, I wanted to know why. I have personally never had a reaction with vaccines and always thought they were what was best for me, it was the norm that I grew up with. Going to the doctor always meant that I was going to be leaving with a band-aid on my arm from getting a vaccine. If so many people we standing up against vaccinations, should I be too? Do they have good reasons for doing so? Not only did this topic work together nicely incorporating all my fields of study into one concept, it was also a personal endeavour that is extremely important to my own life as well. I felt as though even though I have been immunized countless times, I knew almost nothing about them. This was a way for me to do extensive research on why the ‘anti-vaxxer’ movement was happening and if it was something that everyone should be doing?

Introduction

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In recent years, vaccinations have become one of the most controversial topics to discuss. The use of vaccinations has been shown to protect large amounts of people from diseases that are can be life threatening, especially in largely populated, developed countries. “Vaccines truly represent one of the miracles of modern science. Responsible for reducing morbidity and mortality from several formidable diseases, vaccines have made substantial contributions to global public health” (Grady). The use of vaccines has made an immense difference in the survival rate of children, the elderly, and the ill. In many years past, those who were more susceptible to disease or having a disease be life threatening often died. For example, Influenza used to kill more people every year than it does now, but with the help of the flu vaccines, we can either lessen the symptoms when a person contracts the virus or can prevent it all together. Vaccines allows for susceptible people to go out into the world everyday and not have to worry about becoming seriously ill.

Vaccines provide safety by making the body believe that it is being attacked by the actual disease, it can then build up a strong immunity to the agent so that if the person is ever exposed to the disease, they will have the ability to fight it off (Baker Institute). This gives your body a certain type of memory that allows your antibodies to never forget that it had come in contact with that particular virus. In order to achieve this level of memory, some viruses require an initial vaccine and then boosters at certain intervals to provide complete protection. If a person keeps up with the recommended vaccine schedule it is likely that they may never even know that their body has come in contact with the virus and it goes away without any symptoms or complications. “The second infection is dealt with quickly, before you even feel sick” (Texas A&M College of Medicine). It is inevitable that you are going to come in contact with viruses and bacteria, also known as ‘germs,’ on a daily basis. If you have been vaccinated, your body comes in contact with many viruses and you never even know because you have been given immunity.

When large quantities of people get vaccinated in an area, it creates what is called herd immunity. Herd immunity helps protect those who are unable to be vaccinated for specific reasons such as medical conditions or allergic reactions to vaccines themselves. Herd immunity is only effective when it reaches a certain level, which for many diseases, there needs to be at least 90-95% of people vaccinated in a given area (PLOS Medicine). Since the recent anti-vaccination movement in the United States, some of the more controversial vaccinations such as the Measles, Mumps, Rubella (MMR) vaccine have fallen below the necessary percentage to keep the disease eradicated and to protect the general population that has not received vaccinations. “Eventually, the existing equilibrium reaches a stage where the population is no longer immune and the number of individuals who maintain a level of immunity are too few to provide any sort of herd immunity. At this stage, known as “The susceptibility Period”, the population becomes almost destined to another epidemic” (Paternoster). Vaccines have protected countless people over the years, but now we are beginning to see a decrease in vaccination within the United States.

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Even though much research shows that vaccines can have positive effects on public health, it is important to understand why people are choosing not to vaccinate. Specifically, when it comes to the MMR controversy, there is a retracted study to blame. The doctor, Andrew Wakefield, published a false study to the world claiming that the MMR vaccine caused a direct correlation to Autism in the patients that got vaccinated. It has since been found to be fraudulent information, released by Wakefield for financial gain (NCBI). (To read the original retracted study, click here). Even though this article has been retracted for many years, people still believe that the information from the study is true, causing widespread fear when it comes to making the decision as to whether or not a child should receive the MMR vaccine. Some parents are not willing to take the risk that the vaccine could cause a disorder in their child. Many studies have been done recently to see what other causes are fueling the anti-vaccination movement and to see what percentage of children are not getting vaccinated in the country. If vaccinations have been shown to save millions of lives, why has there been such a huge decrease in vaccination rates?

Vaccine Safety

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A major concern that parents consider every time they allow their child to get vaccinated is whether or not the vaccine is going to be safe for their child or if it will cause serious adverse effects. Unfortunately, this is a thought that crosses many parents’ minds whenever they visit a doctor’s office with their child. Currently, the United States is promoting that vaccines are safe for people to receive and should be gotten without hesitation, immunity for a disease that comes with some minor side effects far outweighs the risk of getting the actual disease which could involve much worse health concerns than the vaccine. Although some parents have always been skeptical of the safety of vaccines, now more than ever in history, parents are taking a stand and choosing not to vaccinate their children because there is a certain amount of risk associated with them.

Vaccines go through an extensive process to test for safety concerns before they are released to the public. This is a very lengthy process that takes many years to complete. “Clinical development is a three-phase process. During Phase I, small groups of people receive the trial vaccine. In Phase II, the clinical study is expanded and vaccine is given to people who have characteristics (such as age and physical health) similar to those for whom the new vaccine is intended. In Phase III, the vaccine is given to thousands of people and tested for efficacy and safety” (CDC). If the vaccines fails or causes any harm during any phase of the testing, the vaccines is removed and the ingredients and formula is fixed and then the process must begin from the beginning again, thus causing the several year long process. On average, it can take between 10 to 15 years for a vaccine to get through these clinical trials and become approved (Better Health). Once a vaccine has finally been approved and is then recommended for the general public, it must continue to be monitored. Although it passed the safety tests, it was still only tested on a limited amount of people and could have the potential to have adverse reactions when put into a broader population of different ages and different health conditions. This further monitoring allows for changes to be made to the recommendations of who should get that particular vaccine. For example, they may find that if a population with certain conditions reacts negatively to that vaccine, then they will have healthcare providers no longer recommend it or how it effects pregnancies can effect who gets the vaccine (CDC). As hard as the U.S. works to make vaccines safe, there is always the potential that someone will react negatively with it. If a reaction occurs, a person should seek medical care so that the healthcare provider can then report it. If enough reactions occur with a particular vaccine, it will be pulled from the market and begin going the development process again or be removed all together.

To get an idea of how families in the U.S. are feeling about vaccines I read a study on parenting beliefs. A study published in 2004 by the American Academy of Pediatrics titled, Underimmunization among children: Effects of vaccine safety concerns on immunization status, looked at how the parents felt about vaccine safety and if that made a difference on whether or not their children were vaccinated. “Although immunization coverage in the United States is high, concerns about vaccine safety may adversely affect parents’ decisions to immunize their children” (Gust). This study looked at the results of a survey that was sent out by the Centers for Disease Control (CDC) to sample children who had received their infant vaccinations, the survey was completed four times per year. A total of 2,315 surveys were completed and used in the study, from all over the U.S. Researchers did take into account that some children in the survey had not received their vaccines for several reasons such as missed appointments, health issues, etc. and only counted the children that their parents had purposefully declined the vaccines. The survey was composed of questions that would allow researchers to get a sense of what the attitudes of the parents were in regards to how safe they felt that vaccines were. “Five key questions were asked, as follows: “If you had another infant today, would you want him/her to get all the recommended immunizations?” “How safe do you think immunizations are for children?” “Have you ever asked the doctor or nurse not to give your child an immunization for a reason other than illness?” “Were there any immunizations you didn’t want to get for your child but did so because they were required by law?” “Do you believe that minor side effects occur with immunizations always, often, sometimes, rarely, or never?’” (Gust). The parents were also asked to rate how safe that they felt vaccines were, on a scale from 0 to 10, with 10 being the safest. After collecting these results, researchers concluded that many parents did not perceive vaccines to be very safe for their children. “although concerns were significantly more common among parents of under immunized children, many parents of fully immunized children expressed similar attitudes and beliefs…” (Gust).

CC BY SA 2.0 Lisa Brewster

The study suggests that providing parents with more information on vaccine safety through numerous ways such as media and having doctors provide education to parents could help them to choose to vaccinate their children. This could help eliminate the risk factor for parents, so that they knew they were making the right decision. Although the study took into consideration what level of education the mother had received through completed schooling, educated and less educated mothers alike, still had the same concerns on vaccine safety. “We found that households with highly educated mothers reported asking that the child not receive a vaccine” (Gust). Although some mothers are considered to have more education than others, that does not necessarily mean that they are more knowledgeable on the topic of vaccine safety. This sense of insecurity shows that vaccine safety education needs to be incorporated into childcare in a way that parents from all socioeconomic backgrounds can have access to it. Providing vaccine safety education has the potential to increase the amount of children in the country that are vaccinated, thus protecting the public from disease outbreak (Gust).

Another very similar study found closely related results. The study titled, Parental Vaccine Safety Concerns in 2009, also published in the American Academy of Pediatrics researched how parents were feeling about their children receiving vaccines and sought out if there were any differences between gender and race. In this study, it was generally thought that many parents were relatively comfortable with their children getting vaccinated, but they did have some concerns, which often lead to the parent opting out of certain vaccine for their children. “… many of these same parents did express concerns regarding the potential adverse effects of immunizing their child and especially seemed to question the safety of newer, as compared with older, vaccines” (Freed). This may be a classic case of ‘fear of the unknown,’ parents have seen and personally been exposed to older vaccines therefore feel that they are safer because they did not observe any adverse reactions. With new vaccines coming onto the market, even though they have made it through testing, there is not complete certainty what the adverse reactions could be, in their minds. It is understandable that parents do not want to take the risk on their child so they decide to not vaccinate against certain diseases or they choose to hold off until they have seen that there is a level of safety associated with the vaccine before allowing their child to get it (Freed).

Naturopaths

In recent years many people have begun to seek alternative medicine rather than going to their primary care provider for certain conditions. Naturopaths are people who use an alternative type of medicine on clients to promote self healing and less invasive treatments, while using natural remedies, usually from plants and herbs (Naturopaths). This new trend has caused a huge shift in the way people are beginning to treat disorders, including the use of herbal remedies, massage, acupuncture, and other natural ways to take care of their bodies in place of medications, medical procedures, and vaccinations. Although using alternatives to medicine may be very beneficial to a person, there has not been much research done on this topic and most of it has not been proven by science yet. With that being said, this topic is growing quickly and medical professionals are becoming much more receptive to the idea that some alternative therapies could help a person in adjunct to scientifically proven medications and treatments, but not to replace them entirely. Since the trend in the anti-vaccination movement, naturopaths have begun to push alternatives to vaccines, since vaccines could potentially have risks associated with it and are not typically manufactured solely from natural products. The alternatives being suggested are plant-based products and are claiming to provide the same or similar protection as a vaccine.

CC BY 2.0 Marco Verch

A recent study by Timothy Caulfield and associates, titled Injecting doubt: responding to the naturopathic anti-vaccination rhetoric, decided to look at the websites of naturopaths to see what types of treatment were being promoted to the public in place of vaccinating. “After reviewing just over 330 websites, we found 40 websites with vaccine hesitancy discourse, and 26 websites offering vaccine or flu shot alternatives. Thirteen websites had both. In total, 53 had either vaccine-hesitant language, suggested a vaccine alternative or had both” (Caulfield). The more websites out there that are promoting to not vaccinate or use other methods in place of medical treatment, the more that people are going to see them. The different websites were placed on a continuum scale since the language on each site varied in how hard they were pushing for people to consider not using vaccinations, some were much more aggressive in their beliefs than others. The researchers of this study only have the information that is posted to the public as to what those particular naturopaths are pushing for their clients, therefore they do not know what the naturopaths are having clients do when they have in person visits. This could cause a skew in data if the naturopaths are either not promoting anti-vaccination online or if they are pushing the issue less online to avoid criticism, but much more when seeing a client during a visit. Now that everyone and anyone is able to create a website, the researchers feared that a person searching on the internet may come across these 330 websites and believe that the naturopath is actually a medical doctor giving advice and the person would believe it because the website appears to be credible. Although many of the treatments recommended by naturopaths currently goes against medical advice because there is not enough scientific data to prove the effectiveness or safety of the treatments, social media has made it so easy to share information that the information spreads quickly and can actually be dangerous for some people (Caulfield).

Another study, conducted in 2005 titled, Factors Associated With Refusal of Childhood Vaccines Among Parents of School-aged Children, looked at children that have received approval for non-medical exemptions and if there was any connection to complementary alternative medicine (CAM) among other causative factors. After parents completed surveys about their children’s vaccination history and what factors may have gone into the choices that was made towards being vaccinated or having exemptions, it was determined that alternative medicine was a large contributing factor. “Parents of exempt children gave more credibility to CAM professionals for vaccine information and were more likely to report family use of CAM than parents of vaccinated children. Parents of exempt children who use CAM professionals and/or consider these people to be the child’s primary health care professional may have been influenced by these individuals to forgo vaccination” (Salmon). Naturopaths have become a source of healthcare for some people recently, especially those who are not willing to vaccinate. As a way to encourage vaccination, some doctors have decided to not treat patients unless they are up to date on all their vaccination. So for those families that choose not to, their only other possible source of healthcare is in the form of alternative medicine, which many of the providers are not medical doctors(Salmon).

CC BY-SA 2.0 by Gianni Puglisi

Since naturopaths have been avidly promoting unproven and potentially unsafe alternatives to vaccinating their children, legal action has begun to take place in order to protect the general consumers. There are two sides of danger to this issue, either people could be having bad reactions to unstudied vaccine remedies administered by the naturopaths or they are becoming ill due to not vaccinating, which can lead to life threatening injury or even death depending on the diseases they encounter. Caulfield states, “…changes to the federal Natural Health Product Regulations in 2015 now require homeopathy vaccines to include on their labels the statement that ‘this product is neither a vaccine nor an alternative to vaccination. This product has not been proven to prevent infection’” (Caulfield). It is thought that by labeling the products this way, it may deter people from getting the herbal remedy rather than a real vaccine from a medical professional. In addition to stating that a product is not a vaccine nor an alternative, they are also being labeled to state that there is ‘no scientific evidence that the product works’ (Caulfield). Making changes to the packaging are small changes, but it is becoming punishable by law if a naturopath is giving a client false advice that goes against their own safety, for example, the client is told not to vaccinate but then dies from the flu, the naturopath can not be legally held responsible for telling their client not to get the flu shot.

Non-medical Exemptions

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Some parents have opted out of vaccinating their children due to the fact that many states make it relatively easy for them to choose not to. A large amount of states has a school system that allows children to be exempt from vaccination as long as it has been documented with the school as such, then the child is allowed to attend public school with all of the other children. This has become a huge controversy on both sides of the topic. Parents who have their children vaccinated may not want un-vaccinated children in school with theirs because there is a possibility that more disease could be brought into the school where the vaccinated children will be exposed. Some parents that have chosen to not vaccinate their child may believe that the child being exposed to the actual virus would be beneficial for them and want the natural immunity for their child, but how can they be exposed to a disease when the herd immunity is so high? Non-medical exemptions allow parents the freedom to choose what they believe is best for their families. Currently, it appears that there is going to be a shift in these policies very soon as it is a topic discussed on the news daily.

A very recent study, published in 2018 by J.K. Olive and associates titled, The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties, work to put together a number of how many children are vaccinated and where the U.S. is seeing large amounts of anti-vaccination due to nonmedical exemptions. “Since 2009, the number of “philosophical-belief” vaccine nonmedical exemptions (NMEs) has risen in 12 of the 18 states that currently allow this policy: Arkansas, Arizona, Idaho, Maine, Minnesota, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Texas, and Utah” (Olive). As stated, 18 states is a large number allowing nonmedical exemptions when taking into consideration that this is a very large portion of the lower 48 states. This allows for a lot of children to be un-vaccinated, which could really hurt the herd immunity factor when considering percentages. Olive has concluded that we are seeing the biggest anti-vaccination resistance in metropolitan areas, which can be the most dangerous. Having vast amounts of people un-vaccinated can lead to a rapid and widespread disease in a very short duration of time. The other concern with this is that where there are cities, there is a lot of travel, meaning that if there is a disease outbreak in a highly populated area, it is very likely that the disease will be traveling via plane, train, or subway along with those infected to spread to other parts or the country and the world (Olive).  

Through NME’s, parents have been allowed to opt out of getting their children vaccinated for reasons such as religious or philosophical beliefs. As for being religious, many more states are tolerant to this exemption, making the number of states involved much higher, rather than the philosophical belief which is completely based on the opinion of whether the parent wants to vaccinate their children or not. “Overall, states with more NME students exhibited lower MMR vaccination rates. In contrast, states that have banned NMEs—MS, CA, and WV—exhibit the highest MMR vaccine uptake and lowest incidence of vaccine-preventable diseases” (Olive). It is argued that NME’s are becoming so much of an issue that the United States is seeing large outbreaks that were completely preventable and it is costing a large sum of money in the healthcare system. Once the herd immunity level gets low enough, the outbreaks become more frequent and serious is nature. “According to the 2015 National Immunization Survey, only 72.2% of children aged 19 to 35 months in the United States were fully vaccinated as per guidelines from the Advisory Committee on Immunization Practices” (Olive). As mentioned previously, there needs to be a 90-95% vaccination rate to keep the herd immunity at a level that is going to be safe for the people who cannot be vaccinated for many medical reasons, at about 72%, we are not reaching the level of immunity that we need in the country to counteract the disease outbreaks that we have been seeing an increase in over the past several years (Olive).

CC BY NC ND 2.0 Chuckcars

No More Kidding Around: Restructuring NonMedical Childhood Immunization Exemptions to Ensure Public Health Protection, a study published in 2003 by Ross D. Silverman at Southern Illinois University School of Medicine, began looking into the ever-growing issue of non-medical exemptions when they were just beginning. Although conditions have changed since this study was published, it is still relevant since the trend today is still the same, just today’s rates are much higher. “Where available, parents are taking advantage of such exemptions with growing regularity; and in states offering both exemptions, the number of philosophical exemptions far exceeds the number of religious and medical exemptions” (Silverman). Silverman claims that people are using NME’s as a the easy way out of choosing to not vaccinate their children. By providing the school with NME paperwork, the parent is free to do whatever they’d like when it comes to vaccinating. The original exemptions were made for religious purposes, since it goes against some beliefs and it was unfair for religious children to not be allowed to attend school just because they had not received the proper vaccines. Now, it has developed into much more. Rather than religious beliefs, parents just simply don’t want to vaccinate their children for other reasons and it has become accepted and almost the ‘norm’.

State Policy

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As mentioned previously, nonmedical exemptions have been taking a huge toll on the percentage of children that are being vaccinated in the United States. NME’s allow the freedom for parents to choose whether or not they should vaccinate their children or if there are certain vaccinations that they would like to opt out of for fear of certain side effects harming their children. Right now, each state is allowed to make their own laws when it comes to vaccinations. “With the approval of state legislatures, public health officials in state health departments make and enforce vaccine mandates. That is why vaccine laws and legal exemptions to vaccination vary from state to state” (NVIC) Some states are easier to live in without vaccinations that others. For example, some states require very little if any documentation of health records and vaccinations to attend public places such as a school. Other states have been making it increasingly more difficult for families to be involved in public activities or places, depending on what level of documentation is required by law to be shown. A recent study has categorized states depending on how easy or difficult they have made it for children to attend the public-school system.

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A study by Saad B. Omer and associates titled, Trends in kindergarten rates of vaccine exemption and state level policy 2011-2016, took a closer look at what requirements are needed for children to not be vaccinated and still be able to attend public school and what the level of difficulty was in attaining this status. “Moreover, there was an association between the administrative ease of obtaining nonmedical exemptions and rates on nonmedical exemptions…” (Omer). The researchers have categorized states into three different classifications depending on how difficult it was to have your children un-vaccinated in the state, then looked at rates of disease associated with those statistics. The first category is considered to be easy for a child to attend school without being vaccinated, requiring only one exemption standard. The second category is considered medium since they only require a minimum of two standards of exemptions. The last category is considered difficult because they require a minimum of three standards of exemption which can be harder to obtain. After categorizing the states, Omer concluded that, “8 states were classified as having easy exemption policies, 18 states were classified as having medium exemption policies, and 23 states were classified as having difficult exemption policies.” It has also been shown that towards the beginning of this study, NME rates have leveled off due to states making it more difficult to gain this status since it has become such a problem. There is also speculation that parents are working towards vaccinating their children more due to the media showing how dangerous it really is for some of these diseases to reemerge in conjunction with new state policies not allowing children to attend school without proper vaccinations at this point. For many years there was ever increasing number of parents not vaccinating their children, but we are now starting to see that number recede as it becomes general knowledge that anti-vaccination can have very dangerous outcomes, therefore we are starting to see a plateau in cases, which is more positive for the United States to see than a steady incline in anti-vaccination (Omer).

Since the laws are based on a state-by-state basis, each one has different requirements. Connecticut currently has the most strict vaccine policy when it comes to mandating for school. The public school system of Connecticut requires that children receive at least nine vaccines to be able to attend school (ProCon). “Many states require more vaccines as the children age, for example West Virginia requires the meningitis vaccine at the CDC-recommended age (11-12 years old)” (ProCon). Although each state is different, the CDC puts out recommendations that are made for the entire country. The CDC sets forth their guidelines to help the states to decide what vaccines children should be getting in order to attend school. This provides lawmakers with scientific background to base their laws and regulations upon. “By 2014, the CDC recommended that children get 69 doses of 16 vaccines between day of birth and age 18. Most states mandate that children get 29 doses of up to nine vaccines to attend kindergarten and children enrolled in daycare in many states are required to get multiple doses of 13 vaccines” (NVIC). The CDC and lawmakers will continue to work together to come up with comprehensive vaccines schedules and requirements for public schools.

Conclusion

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It seems that the anti-vaxxer movement really has become the next epidemic. People all over the country and the globe are opting out of vaccinations. This has become so widespread that it is not localized in certain regions or among certain population groups, it is everywhere. People of wealth, poverty, different nationalities and religions are all choosing not to vaccinate their children and themselves. There is no simple explanation as to why the United States is seeing such a decrease in vaccination rates in recent history as so many factors are going into the decision-making process. Currently, the standard for health care and preventing disease is through the use of frequent and multiple vaccinations. “The World Health Organization estimates that 2 million childhood deaths were prevented through vaccination in 2003” (World Health Organization). Whether the public agrees with it or not, this is the best we have for protection from deadly diseases for the time being, only due to the fact that we simply do not have enough scientific evidence of other methods that could be more effective.

For now, the U.S. does allow parents to have the option on whether or not to vaccinate their children and many are choosing not to. This may not be an option forever though, since it seems that every day we are pushing closer and closer to having mandatory vaccination across the nation. The studies have shown that there are very complex components to this argument, such as patients may not be seeking traditional medical treatment as often and naturopaths are promoting alternatives to medications and vaccines. Also, many states allow parents to file paperwork with the school based solely on philosophical beliefs as to why their children are not vaccinated and they do have the freedom to do so if they choose, which we can predict a shift in this aspect currently happening, not only in the U.S. but several other countries across the globe. “High rates of non-medical exemptions have been associated with higher rates of vaccine-preventable diseases. Local clusters of vaccine exemptions geographically overlap with outbreaks…” (Omer). The U.S. has become pretty relaxed about their policies towards letting children into school without being vaccinated. Since beginning this research at the beginning of the semester there has already been a HUGE shift in this trend. Several places in the country are now banning people from public places that have not been vaccinated and the state of New York has begun giving out $1,000 fines to those who are not vaccinated (Mole). With that being said, there is going to continue to be big changes coming to the country very soon.

It appears that the United States’ best strategy against the anti-vaccination movement is to provide education to everyone, including patients, parents, and healthcare providers. Knowledge truly is power and if the healthcare system is looking for higher vaccination rates, they need to be providing thorough, educational information for all those involved so that parents can feel safe giving their children vaccines. “It is likely that parents would benefit from educational programs that highlight the manner in which safety assessments are conducted before the licensure and subsequent recommendation of new vaccines. In general, studies have shown that parents who believe that they personally have a lack of knowledge regarding vaccines are more likely to have negative attitudes regarding immunization” (Freed). Parents and patients could use information based on the scientific aspect of vaccines, meaning how they are made, how they work, the safety level, any risks, etc. While on the other hand, physicians, nurses, and other personnel could use education on how to teach their patients on the subject, since they have already had the formal training in medicine that the majority of patients do not have. Healthcare providers should learn to become teachers and advocates for their patients to ensure that they are making the best choices when it comes to their health and medical needs.

CC BY 2.0 Kenneth Lu

Overall, we need to be looking at the safety of the general public. Of course parents do have and should have the freedom to make their family’s medical decisions based on what they think is the best thing for them. With that being said, is there a way that we, as a country, can improve vaccine rates and how will will achieve that? I would like to think that there could be give and take on both sides of the issue. On one side, it would be so beneficial if parents would be open minded to getting their children vaccinated for the bigger picture, keeping the country out of an epidemic in order to protect the elderly, new born, or ill who have medical exemptions because they are physically and medically unable to receive a vaccine. On the other side, the government and pharmaceutical companies could be more transparent with production, testing, safety, and try to meet the requests of the public. If parents are asking for less chemicals and more safe products to be put in the vaccines, can the pharmaceutical companies integrate that into their products to make parents willing to vaccinate? Reaching the optimum level of vaccination is going to take huge compromise on both sides, but if everyone is willing to come together to find that solution that works for all parties involved, our country could lead internationally in vaccine rates and safety. This could pave the way for other countries and thus lead us to an internationally disease-eradicated lifestyle. Can you imagine a world with little to no major disease? Obviously an international plan is very ambitious, so it would be best to start right here at home and see where it goes. Finding a solution to the vaccine controversy is going to be a lengthy and undoubtedly an upsetting or angering process to many while all the kinks are worked out. Unfortunately, the latest proposal has been mandatory vaccination by the government without any give on their side to make the people feel better about the situation, but if that fails, maybe they will be willing to start to give the compromises that the people want to see. As of right now, we are stuck in a waiting game.

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Comments

Matt Cheney
April 11, 2019 at 4:30 pm

This is coming along well. As you develop it, one place to focus is the conclusion — I think that can be significantly expanded, because this is basically a meta-analysis and one of the big contributions a meta-analysis can make is to show what everything adds up to. There are all these individual studies, but what is the big picture they paint together? Really exploring that will make your paper really strong.

You should think about expanding some of your references, too, within particular topics, and perhaps cutting some topics so you can focus more on others. Within each section, you tend to rely on one study, but that doesn’t give your claims a lot of rigor. One study is better than none, but it’s the accumulation of studies saying more or less the same thing that leads to real knowledge.

I like how you’ve integrated citations. Double-check to make sure that they’re all accessible to people outside PSU (if that’s important to you) — I think the Ebsco one might require a PSU login, and maybe one other. But generally they’re really well handled. Nice work!



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