Why Are Parents Still Refusing to Vaccinate?

New York City's biggest measles outbreak in almost 30 years ended in September of 2019 and we are currently in the middle of a roaring pandemic.  Regardless, the argument about vaccinations is still raging. Headlines in the media, warnings at doctor's offices, regulations by schools, and even celebrities' social media posts have perpetuated the debate about the truths and myths of vaccinating. We spoke with pediatricians about this controversial issue that continues to baffle many parents. 

Are vaccinations a personal choice or civic duty?

Vaccinations are classified into two groups, explains Harvey Karp, M.D., pediatrician, faculty member of University of Southern California School of Medicine, and author of Happiest Baby on the Block. The first group of shots includes rotavirus, hepatitis A, hepatitis B, and chicken pox. While Dr. Karp recommends all vaccines, he classifies these vaccinations as a parent’s choice because the risk you are imposing is limited to your child and family, not the community. That’s because those illnesses are either difficult for a child to pass onto another or are very common—and can spread quickly even with a vaccine.

The second classification of shots (including those for whooping cough, flu, meningitis, pneumococcus, and measles) are given to protect your child and your neighbor’s child. “[These vaccinations] halt diseases that are so contagious that just one cough, one airplane flight, or one germy doorknob can spread them like wildfire throughout your town,” Dr. Karp says. “I believe giving this second group of shots is an important civic responsibility because delaying them creates a serious public health risk.” Specifically, these vaccines protect other kids who are too young to receive vaccinations, as well as people with cancer, those who are older than 60, and others who are considered especially vulnerable to these diseases.

 A minimum percentage of the population must be vaccinated against a virus to prevent its spread, according to Daniel Sinyor, pediatrician at Crystal Run Healthcare in Nyack. By ensuring that at least 95 percent of children are immunized against a certain virus, you are creating herd immunity, which “stymies the spread of disease the way that frequent rain keeps lightning strikes from starting raging forest fires,” Dr. Karp says.


The major misconceptions about vaccinations

Several misconceptions have surrounded vaccines for years, but perhaps the most disruptive one is that the MMR (measles, mumps, and rubella) vaccine causes autism. In 1998, Andrew Wakefield, a discredited British ex-physician, published a fraudulent paper suggesting there was a link between the MMR vaccine and autism. The data was found to be incorrect, and throughout the decade following the publication, many epidemiological studies proved there is no link between the two. 

Still, the paper did its damage, and, combined with the fact that the MMR vaccine is given around the same time autism is usually detected (ages 1-2), many parents still believe there is a causal relationship between the two, according to Dr. Sinyor.  

Similarly, because children generally receive the flu vaccine at a time of year when they are picking up other illnesses, people have grown to believe the vaccine can cause the flu. That’s impossible, Dr. Sinyor says, because the vaccine does not carry the flu virus. 

Another common misconception is there is mercury in vaccines. However, in 1999 the Food and Drug Administration and the U.S. Public Health Service removed thimerosal (a mercury-containing compound used as a preservative) from all vaccines except multi-dose vials of flu vaccine. Aluminum, an element that is present in vaccines, has also caused worry among parents. Not only has aluminum been safely used in vaccines for more than 70 years, the amount used is similar to that found in 32 ounces of infant formula, according to Dr. Sinyor. 

Unfortunately, these myths are still widely circulating. The list of celebrities who have spoken out or expressed concern about vaccinations includes Jessica Biel and Jenny McCarthy. The latter has been claiming for more than 10 years that her son’s autism was caused by a vaccine. “I would venture a guess that the spread of false information through social media, celebrities, and anecdotal stories of friends who claim to have been harmed by vaccines all contribute to parental fear and distrust of vaccines,” Dr. Sinyor says.

The truths about vaccines

The main misconceptions aside, there are potentially concerning aspects of vaccines that are valid. For example, some shots have an effectiveness rate as low as 30-60 percent, which has long upset parents. But, as Dr. Sinyor says, “if I told you I could give you a shot with minimal side effects that would reduce your chances of getting into a car accident by sixty percent—or even thirty—would you not take it?” 

Another upsetting truth? Not all children will develop immunity after a vaccination, according to Robert Segal, M.D., founder of Medical Offices of Manhattan. However, this does not discount the fact that 85-95 percent of children do. And finally, “in very rare cases, vaccines can cause allergic reactions. It’s important that parents tell their doctor of any history of allergies,” Dr. Segal advises.

While vaccines are not perfect, they are still widely administered. In fact, in light of the recent measles outbreak, the list of doctor’s offices, day cares, schools, and other children’s facilities that will exclude your child if unvaccinated is growing, according to Dr. Segal. In August, the Supreme Court of the State of New York instated a ban on religious exceptions to vaccines for school attendance. New York is now 1 of 5 states that have banned religious vaccination exceptions.

This is a good thing; all the doctors we spoke to agree. After all, vaccinations are our best protection against potentially life-threatening illnesses. Choosing to forgo them significantly increases the risk of making not only our own children sick, but also spreading illness in our community, Dr. Karp says.