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Monday, August 29, 2016

Countering Vaccine Hesitancy

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.   Until fairly recently, as I explain in the book, pediatricians and other professionals undercut their own credibility.
And it is understandable why many parents of autistic children would be especially skeptical of the authorities. Often, their first encounter is a bad one. At least until recently, many pediatricians failed to screen for autism, or overlooked early signs of the disorder. Jenny McCarthy writes: “I had no idea flapping was a common characteristic of autism. Tiptoe walking and spinning in circles all day are two more that are high up on the list. You would have thought his pediatrician might have noticed something along the way, mind you, but he did not.” After pediatricians are clueless about the early signs of autism, parents might question their assurances about vaccines. And once parents start reading up on autism, they will probably learn that clinicians once believed in Bettelheim’s “refrigerator mother” theory. If he proved to be a fraud, they reason, will not the same fate meet today’s scientists?
Still, pediatricians are trying to get good science across to their patients.

Most parents who are hesitant about vaccines are not opposed to immunizing their children, but rather are unsure or have questions. And the best source of answers is their pediatrician.
To equip pediatricians for these conversations, the American Academy of Pediatrics is publishing a new clinical report, “Countering Vaccine Hesitancy” in the September 2016 Pediatrics (published online Aug. 29). The AAP advises pediatricians to have compassionate dialogues with parents to clear up misconceptions around vaccines, provide accurate information about the safety and importance of vaccines, and strive over time to help parents make the decision to vaccinate their child.
To protect all children in every community, the AAP also urges state governments to enact policies that will result in high immunization rates. In the policy statement, “Medical Versus Nonmedical Immunization Exemptions for Child Care and SchoolAttendance ,” published the same day, the AAP recommends only medical exemptions be allowed for vaccine requirements for child care and school attendance.
“Parents, pediatricians, and policy-makers all have a role here in protecting children from diseases like measles and whooping cough,” said AAP President Benard P. Dreyer, MD, FAAP. “As pediatricians, we care about every individual child in our practices, and we know that vaccines are an important way to protect them from disease. We also care about the broader communities where our patients live, play and learn, and high immunization rates are critical to keeping disease outbreaks at bay. No child should have to suffer through a disease that could have been prevented by a vaccine.”
According to the AAP, non-medical exemption laws have failed.
“It’s clear that states with more lenient exemptions policies have lower immunization rates, and it’s these states where we have seen disease outbreaks occur as the rates slip below the threshold needed to maintain community immunity,” said Geoffrey R. Simon, lead author of the medical exemptions policy statement and immediate past chair of the AAP Committee on Practice and Ambulatory Medicine.
Melissa Healy reports at The Los Angeles Times:
The survey results released Monday show that parents’ concerns about vaccines have shifted in recent years. In 2006, pediatricians reckoned that nearly three-fourths of parents reluctant to vaccinate their children were motivated by fear that some vaccines could cause autism or have other adverse effects on a child’s safety.
By 2013, safety concerns and the discredited link between vaccines and autism appeared to be less prominent causes of parental resistance. Instead, physicians attributed a growing number of parental objections to the view that vaccines are an unnecessary discomfort for their young children.