As we discussed last month, the State of Wisconsin is currently considering eliminating a popular waiver for vaccinations needed to attend school. They are doing this because vaccination rates are dropping below the level needed for herd immunity and we are seeing the resurgence of childhood diseases that had been all but eradicated. Immunization rates are dropping because more and more parents are choosing not to vaccinate their kids. This month we will explore the reasons parents choose not to vaccinate.

Reasons for not vaccinating children vary widely amongst parents, but they can be encompassed in four overarching categories: religious reasons, personal beliefs or philosophical reasons, safety concerns, and a desire for more information. Parental concerns about vaccines in each category lead to a wide spectrum of decisions varying from parents completely refusing all vaccinations to only delaying vaccinations so that they are more spread out. Let’s look at each category more closely.

Religious reasons: Some families feel that vaccines violate their religious tenets. The reality is that most religions today actively support immunization. The explanation most commonly offered for why specific vaccinations oppose religious tenets involves components of the vaccines. The animal-derived gelatin used in producing some vaccines poses concerns. The gelatin is made from pork. Some religions do not allow the consumption of pork. Another concern is the human fetus tissue used in the rubella component of vaccines. It should be clarified that no new human fetal tissue is used to produce the vaccines used today, but when the vaccines were developed human fetal cells were initially used to establish the viral strain.

Personal beliefs or philosophical reasons: Another common reason that parents give for refusing or delaying vaccinating their children is personal or philosophical reasons. Some people see benefit in having their children contract certain preventable diseases. Some parents believe that natural immunity is better for their children than is immunity acquired through vaccinations. Some parents believe that the diseases for which we vaccinate are not very prevalent, so their children are at minimal risk of contracting these diseases. For this reason, they also believe that the possible negative side effects of vaccine administration outweigh the benefits of the vaccines. Many parents do not see the preventable diseases as serious or life-threatening and would prefer to not put extra chemicals into their children's bodies. Other parents think if their children have healthy diets and lifestyles, they are at a decreased risk of contracting preventable childhood diseases. They also are under the assumption that if they were to contract one of the diseases that it would be easily treatable.

Right or wrong, these beliefs are real in their minds. Parents who hold these beliefs should explore the facts and discuss them with their pediatric provider.

Safety concerns: A third, and potentially the greatest, reason parents express for refusing vaccinations for their children are concerns about the safety of vaccines. It is these concerns about safety that can cause parents to completely refuse vaccines. Here are two common safety concerns:

First, vaccinations contain mercury which causes autism. This is false. A preservative called Thimerosal, which contains mercury, is used to as a stabilizer in multidose vials of some vaccines. There is no evidence that Thimerosal causes autism. Additionally, today most vaccines are administered in single use doses, so this is a non-issue. All vaccines administered at Western Wisconsin Health, for example, are single dose vaccines and do not contain Thimerosal.

Second, simultaneously administering multiple vaccines might overload their child's immune system. Some believe allowing all the vaccinations to occur according to the recommended schedule will make the safety risk greater. As a result of this logic, many choose to delay vaccines in order to better protect their children. There is no evidence that giving multiple vaccines to a child overloads the immune system.

A desire for more information: The fourth common thread amongst people who choose not to vaccinate their children is that they want more information regarding vaccinations. Many parents believe the side effects of vaccines are more extensive than what they are told and that the risks outweigh the benefits of vaccinating their children. Parents are concerned with doing the best for their children, and hearing reports of potential safety issues, or that childhood diseases are not a large threat, can hinder them from vaccinating.

Parents want to be able to make informed decisions about their child's healthcare by knowing both the benefits and risks associated with each vaccine. But, what information can they trust?

Physicians are one of the most important sources of information for parents who are making decisions about their children's healthcare. But parents may be suspicious of the information provided by physicians and by the Center for Disease Control. Some believe that pharmaceutical companies that benefit financially from vaccine sales are manipulating the research and covering up any information that could reduce public confidence in vaccination.

When parents do not get, or do not trust, the information they get, they seek information from other sources. Some of those sources may be reliable, but some can potentially mislead and misinform them, causing them to make poor choices for their children.

We encourage parents to research the facts and discuss those facts with their pediatric provider. Dr. Sarah Aluning, pediatrician at Western Wisconsin Health, says “My fellow providers and I, who care for the Pediatric population, advocate for each individual child in our practices, and we know that vaccines are an important way to protect them from disease. We also care about our community, where our patients grow, learn, and play, and high immunizations rates are critical to keeping disease outbreaks at bay. No child should have to suffer from a disease that could have been prevented by a vaccine.”

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