More Parents Are Refusing Vaccines, New Survey Found

MONDAY, Aug. 29, 2016 (HealthDay News) — Pediatricians are encountering more parents who refuse to have their children vaccinated, mainly because they don’t see the point of vaccines, a U.S. survey found.

In the survey, conducted in 2013, about 87 percent of pediatricians said they had encountered vaccine refusals, an increase from the 75 percent who reported refusals during the last survey from 2006.

The most common reason, provided by three out of every four parents: Vaccines are unnecessary because the diseases they prevent have been wiped out in the United States.

“Because these diseases are gone, people no longer fear them, even though many of them are only a plane ride away,” said Dr. Kathryn Edwards, co-author of a new American Academy of Pediatrics report based on the survey. “They don’t seem to realize that these diseases do exist in other places, and could come here.”

The percentage of pediatricians who always dismiss patients over repeated vaccine refusals has also increased, doubling from 6 percent in 2006 to 12 percent in 2013, the survey found.

In the report, the AAP urges pediatricians to exercise patience with worried parents rather than closing their doors to them.

“Our goal is to work with our patients so they understand the importance of vaccinations, and their questions about vaccines are answered,” said Edwards, a member of the AAP Committee on Infectious Diseases.

The reasons parents provide for refusing vaccines have evolved in recent years, pediatricians report.

In 2006, about three of every four parents who refused vaccines said they were worried that vaccines could cause autism—a theory that’s been debunked—or produce serious side effects.

Fewer parents gave those as reasons in 2013, although many still cite concerns about safety. Concerns over a baby being too small to receive vaccines, or discomfort at having too many shots at once, have also diminished, the survey found.

Instead, most parents are refusing childhood vaccinations because they see vaccines as unnecessary, and that number increased by 10 percent between the two surveys.

The new survey results are published online Aug. 29 in the journal Pediatrics.

Thanks to the protection provided by vaccines, parents haven’t seen the ravages that can be wrought on children by diseases like chicken pox, measles, meningitis and polio, said Dr. Claire McCarthy, an assistant professor at Harvard Medical School in Boston.

“We are so good at what we do with vaccines that the danger of vaccine-preventable illness can seem not quite real to this generation of parents, and that’s definitely getting in the way,” McCarthy said.

Pediatricians need to confront this belief, Edwards and McCarthy agreed.

“This is very frightening to us as pediatricians because in this global world, their child absolutely could get polio,” McCarthy said. “Polio is endemic in many parts of the world, and all we need is for one of those people to come on over to the United States and hang out in a shopping mall or Disney World.”

The report urges pediatricians to:

Listen to parents patiently, address concerns and correct misperceptions.Explain that vaccines are rigorously tested for safety and effectiveness. Present all vaccinations as required rather than optional.Personalize the positive message about vaccines.

Pediatricians can also note that they receive regular flu vaccinations to protect their patients, and that they’ve had their own children vaccinated as recommended, said Edwards, who is pediatrics chair at Vanderbilt University School of Medicine in Nashville.

Doctors also can present tales of tragedy from their own experience, she added.

“Many years ago, I watched a baby die of meningitis that I couldn’t rescue,” Edwards said. “Now that’s gone, because everybody gets meningitis vaccine. That’s the power of vaccine. It’s enormous.”

Pediatricians also should remind parents that vaccination is something of a civic duty. If large numbers of parents refuse vaccines, the herd immunity that occurs with widespread vaccination can be compromised, McCarthy said.

“Vaccination is not just about you and your kid,” she said. “It’s about your neighbor’s newborn. It’s about your grandmother. It’s about the kid at school who can’t receive a vaccine because he’s on chemotherapy.”

The 2015 Disneyland measles outbreak provides another good example pediatricians can cite, McCarthy said.

“I can say, ‘Look, this is real, your child could get measles,’ ” she said.

In a separate policy statement published in Pediatrics alongside the survey, the AAP also recommended doing away with non-medical exemptions to school-required immunizations.

“We need to make it harder for parents not to vaccinate. That’s really important,” McCarthy said.

More information

For more on childhood vaccines, visit the American Academy of Family Physicians.

What Is Mumps and How Can You Get It?

People from 39 states and nine countries may have been exposed to mumps at a cheerleading competition held last month in Dallas, according to Texas health officials. A person who was infected with mumps at the time traveled to the competition from another state, the Dallas Morning News reported yesterday, prompting the state Department of Health to send cautionary letters to all participants.

No one in Texas has developed mumps yet in connection with the competition, and hopefully it stays that way. But even if nothing else comes of the incident, it’s still a good reminder about how serious (and how contagious) mumps can be. “It’s a small risk for most people who were at the competition,” a department spokesperson told Health. “But we wanted to let people know so they could look out for mumps symptoms, just in case.” 

If you’re not too familiar with mumps, it’s probably because vaccination campaigns over the last half-century have made outbreaks few and far between. (Before a vaccine became available in the 1960s, around 186,000 cases were reported each year.) In recent years, however, the annual number of cases reported to the Centers for Disease Control and Prevention (CDC) has increased—from 229 in 2012 to 6,366 in 2016. Health experts believe that a drop in vaccination rates is at least partially responsible.

So what exactly is mumps, and why is it so worrisome? Here’s what you should know.

Mumps can cause serious complications

Mumps is a viral illness that affects the saliva-producing glands (called the parotid glands) in the face and neck. It can cause swelling in these glands, which can result in pain, difficulty swallowing, and puffy cheeks. It can also cause general feelings of sickness—like fatigue, fever, and muscle pain—although some people who contract the disease have no symptoms at all.

Most people who get sick with mumps recover, but complications can occur. It can cause swelling of the testes or ovaries, and on rare occasions, it can lead to hearing loss or dangerous swelling around the brain, known as meningitis. In the most serious cases, seizures, paralysis, or death can occur.

It’s highly contagious

Mumps is spread through saliva and respiratory droplets created when a person coughs or sneezes, the Department of Health letter sent to competition attendees states. Sharing cups and utensils can also spread the virus, and most outbreaks happen in settings where people are in close quarters—like in a college dorm or a team locker room.

Mumps symptoms usually develop between 16 and 18 days after exposure to the virus, but they can also begin as long as 25 days later, according to the CDC. (The competition ended February 25.) “People with mumps are infectious three days before to five days after swollen glands appear,” the letter states.

People without symptoms can also carry and shed the virus as well. That’s one of the reasons it spreads so fast and so far, Aileen Marty, MD, a professor of infectious diseases at Florida International University told Health in 2016: “Infected people shed the virus before they start to have symptoms,” she said. “So you don’t really know who to protect yourself from.”

RELATED: 8 Infections You Can Catch at the Gym–and How to Avoid Them

Vaccines offer protection, but they’re not a sure thing

Kids usually get a mumps, measles, and rubella vaccine (MMR) at 12 to 15 months of age and a second dose at 4 to 6 years. Earlier this year, the American Academy of Pediatrics added an optional third dose of the vaccine—to be administered during mumps outbreaks—to its recommended childhood immunization schedule.

Doctors also recommend that adults, with the exception of pregnant women or people who have compromised immune systems, get vaccinated if they didn’t have those two shots when they were kids.

“If you are unsure of you or your child’s vaccination status, or if your child has not received both doses, consult your healthcare provider and explain the situation,” the Department of Health’s letter to competition participants states. It also points out that while vaccination is “the best protection” against mumps, vaccinated people can still become infected. Getting two doses of the MMR vaccine is about 88% effective in protecting against mumps, according to the CDC.

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If you have symptoms, stay home

“Anyone diagnosed with or suspected of having mumps should stay home five days after swollen glands appear,” the letter states. “If you, your child, or any other individuals linked to this event experience or have experienced mumps symptoms, please contact your healthcare provider and inform them of your exposure.”

There’s no treatment for the disease itself, but doctors can prescribe anti-inflammatory drugs to reduce fever and pain. They can also monitor patients for complications and can provide IV fluids and additional care if the condition becomes more serious.