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Saturday, April 20, 2019

Increasing Vaccine Coverage

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism.   This bogus idea can hurt people by allowing disease to spread.

At JAMA, Lawrence O. Gostin, Scott C. Ratzan, and Barry R. Bloom have an article titled Safe Vaccinations for a Healthy Nation: Increasing US Vaccine Coverage Through Law, Science, and Communication."
As summarized by the National Academy of Medicine, large clinical trials, and numerous observational studies, have definitively refuted any connection between vaccines and autism.3 Further, multiple vaccines spaced together, another expressed health concern, pose no greater risk. Two doses of vaccine provide 97% protection for measles. “Herd immunity” requires 95% immunization coverage to provide community protection against measles.
Policy makers have clear tools to increase vaccine coverage, thus reducing harm to children and their families. Because vaccines play such a critical role in the health of children, a long-term national health communication campaign to build vaccine literacy, potentially called Safe Vaccines for a Healthy America, could be useful in increasing and restoring faith in the safety and importance of vaccines. The dissemination of evidence-based information should be a key part of the program and should be uncontroversial. ... Pediatricians and obstetricians could also counsel parents, reassuring them about vaccine safety. When parents request vaccine exemptions, states could require a physician’s certificate affirming they have discussed vaccines’ benefits and risks, and indicate that they are aware that false responses have legal consequences.
Public information campaigns compete with a complex web of false information. Public health authorities, therefore, should partner with the private sector to improve the informational environment. Encouragement, and oversight, of major social network organizations is needed to stem the flow of misleading information. Private and publicly traded companies should screen out false antivaccine messages and cease providing a platform for harmful exchange of falsehoods that promote childhood disease, just as they do for sexually explicit, violent, or threatening messages. Social media companies could go further, exercising corporate responsibility by disseminating science-based health information to advance societal well-being and vaccine confidence.

The federal government should encourage states to end or tighten religious or philosophical exemptions, following the lead of California, which enacted evidence-based policies. If states fail to act, federal authorities have the power to incentivize compliance. They could, for example, condition a portion of Medicaid or Affordable Care Act funding on states tightening their vaccine laws. Conditional funding should not be overly coercive, and Congress should take steps to avoid harming already disadvantaged populations. While the federal government has limited power to compel vaccination, the Supreme Court has affirmed its use of conditional funding. In 1987, the Court upheld a law conditioning national highway funding based on states enacting a minimum drinking age of 21 years. Immunization is a national problem as childhood diseases transcend state borders; vaccine hesitancy, therefore, requires a national solution.