American Association of Pediatrics seeks to combat antivaccinationist misinformation

For more details on this story, you can go to Mark Chu-Carroll, Orac, Mike the Mad Biologist, or the Autism Blog. I just wanted to share my personal views on the need for childhood vaccinations and support a public information campaign from the AAP.

Until I started medical blogging, I had not realized quite how vocal was the community of individuals refusing to vaccinate their children, mostly at the urging of those who claimed that vaccines and related components caused illness in their own children. I will first say that no drug product, natural or otherwise, is completely and absolutely free of side effects. One can never predict with absolute certainty how individuals in a genetically-diverse population of 300 million Americans or some 6 billion people worldwide will respond to any product.

But as a society, we have decided that the good of the public's health is more than offset by the risks to the few; vaccines save lives but the generation that experienced life, and death, before vaccines is increasingly dying off. My child is completely up-to-date on vaccines because I could not bear to lose her to a preventable childhood disease; we still have family and friends who survived polio with varying degrees of debilitation - and they are the lucky ones, from an era before vaccines.

I have the utmost sympathy for any parent whose child has been harmed in those rare cases by unexpected reactions to vaccines or, for that matter, anyone who has been harmed by a product intended to improve health and prevent life-threatening diseases. However, it is in the interest of public health that we mandate certain preventative measures whose implementation saves millions of lives of children and are supported by voluminous medical literature. In public health and medicine, we cannot guarantee absolute safety but we strive continuously to make the modalities employed as safe as is absolutely possible.

As an analogy, 57,000 Americans are killed annually in automobile accidents. However, we don't outlaw cars and trucks because their benefit to society is so great. Instead, we try to make them as safe as is humanly and technologically possible.

So, the American Association of Pediatrics needs our help to identify parents who have experiences that can be featured in a public relations campaign, supported overwhelmingly by scientific findings, to combat the public health hazard that is the antivaccinationist movement.

Hello,

As part of our ongoing response to media stories regarding autism and vaccines, the AAP communications department is compiling a list of parents who support the AAP and are available for interviews. We are looking for two types of parents who could serve as spokespersons:

Parents of children with autism spectrum disorders who support immunization and who do not believe there is any link between their child's vaccines and his or her autism.

Parents of children who suffered a vaccine-preventable illness. This could be a parent who declined immunization, whose child became ill before a vaccine was available, or whose child was ineligible for immunization.

We are asking for your help identifying parents who would be good spokespersons. They do not need to be expert public speakers. They just need to be open with their story and interested in speaking out on the issue. We will contact candidates in advance to conduct pre-interviews, to offer guidance on talking to reporters and to obtain a signed waiver giving us permission to release their name.

If a parent were placed on our list, we would offer their name and contact information to select media. We hope to build a list of parents from a wide range of geographical areas.

As the Jenny McCarthy and "Eli Stone" stories illustrate, this issue is likely to recur in the national and local media. The AAP is committed to doing all we can to counter such erroneous reports with factual information supported by scientific evidence and AAP recommendations.

The anti-vaccine groups often have emotional family stories on their side. The ability to offer a reporter an interview with a similarly compelling parent who is sympathetic to the AAP's goals is a powerful tool for our media relations program.

Please contact me if you have any questions or to suggest a parent to interview.

Thank you,

Susan Stevens Martin
Director, Division of Media Relations
American Academy of Pediatrics

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"... vaccines save lives but the generation that experienced life, and death, before vaccines is increasingly dying off."

What's needed here are some voices from that generation. Voices like my mother's; she lost two siblings to childhood diseases, and as an adult became the caregiver to a third who was permanently disabled by a childhood disease. And these were not the result of a single freak outbreak, but two different diseases (diphtheria and whooping cough) at three separate times.

Voices like the ones of the polio survivors who remember spending months or years of their childhoods in hospitals, and who are dealing with post-polio syndrome now. Or those of people who were affected before birth by the rubella epidemic of 1964, when no vaccine was available.

Fortunately, there may be enough herd immunity against these diseases to give some protection to unvaccinated kids. But if the proportions of unvaccinated kids start increasing, we could be in real trouble.

By Julie Stahlhut (not verified) on 19 Feb 2008 #permalink

As a young mother in 1960, I watched my 4 1/2 week old baby convulse all night until I felt I could call a doctor. He had H.flu meningitis, which,at that time had a 50% fatality rate, and if survived, a 60% chance of severe disability. He survived, but he was at least two before we stopped being scared, because his physical milestones were all delayed. Many years later I became a physician myself.
My mother, born in 1900, had diphtheria as a young woman, and her brother had typhoid. Her cousin had meningitis, which left him quite neurologically damaged. In infancy I had pertussis, later had rubeola, mumps, chicken pox. She, her sisters, mother, aunt, and cousins also had the 1918 influenza, which killed her male cousin.
I really always encouraged my children and my patients to get the vaccines for their children.

By Lou Betty Rood (not verified) on 19 Feb 2008 #permalink

Julie makes an excellent point - my understanding is that the threshold for herd immunity varies depending on the disease, but is estimated at something like 80% for pertussis and 90% for measles.

Considering that a chunk of kids can't be vaccinated for one reason or another, and another chunk don't have parents with the wherewithal to get them immunized, it really won't take many more parents declining vaccines to get us below the threshold for herd immunity.

That's just what's going on in San Diego right now, actually. The biggest measles outbreak in 17 years, started by one unimmunized kid who picked up measles on a trip overseas and spread it around his school and doctor's office, then secondarily passed along in places like a grocery store and a swim school. The local area has a high proportion of unimmunized children.

It's really depressing that adults today have so little scientific judgment that they are more scared of autism (a nonexistent risk) than fatal yet preventable diseases.

isles, I agree that Dr Stahlhut and Dr Rood both raise excellent points. From a public outreach/education standpoint, I really like the idea of hearing from the voices of the previous generation about what life for children was like before vaccinations.

It's amazing just how close (yet so far) we are from that generation - a commenter at Good Math, Bad Math born in 1957 tells his own story about a kid who had polio and how when the Sabin vaccine became available, everyone in his class had parental permission slips to get the immunization. Herd immunity has made many too complacent as isles points out in San Diego.

then secondarily passed along in places like a grocery store and a swim school. The local area has a high proportion of unimmunized children.

The interesting thing is that so far going by the new reporting, the cases are either classmates of the index case or were infected at the clinic (unclear whether this is all attributed to the index case and/or his/her sibs). The secondary exposure locations seem not to have turned up any positives yet.

Of course, the local NPR had a piece on this morning highlighting some crank-mom who said something like "those doctors only focus on 'public health'. Well, I'm not going to put my kid at risk for public health". Well, at least they exposed the purely selfish perspective for what it is, even if they didn't really hammer on how unjustified the critique of vaccination really is.

Unfortunately the doctor who was on didn't seem to receive the same on-air emphasis and in any case this faux "balance" between the crank view and the scientifically supported public health view was the usual de facto misrepresentation.

so thanks Abel for highlighting anti-vacc nuttery...

By Sunny Egoan (not verified) on 19 Feb 2008 #permalink

I had a married great uncle who had no children - he caught measles as a soldier during World War I and was made sterile by it. Does leaving kids unvaccinated in a community which does not have measles circulating make them much more vulnerable to the more severe complications of adult measles?

Correction: It was Mumps, not measles.

It might be time for me to start collecting stories. I have hundreds of elderly patients, and hundreds more who were born before polio vaccines, and they all have stories. My parents certainly remember the horror of polio.

A big thanks to the AAP, and hopefully we can get the ball rolling against these loud, ignorant cultists who are fighting to reverse centuries of victories in public health.

I was just stunned to find that anti-vaccination sentiment is so widespread among relatively educated people. Please, PalMD, collect those stories and get them disseminated one way or another. They are a precious legacy of personal wisdom, hard-won from previous generations.