Better communicating vaccine safety and effectiveness is key to addressing the growing public concern over immunizing children, health officials said Wednesday during the closing session of the 2015 West Virginia Immunization Summit.
While West Virginia has the second highest immunization rate of school-aged children in the country — about 96 percent — parental hesitancy and sometimes outright refusal to vaccinate their children has public health officials on edge and looking for ways to combat what they call campaigns of misinformation.
“It’s a consequence of success,” said Kristen Feemster, a research director for the Vaccine Education Center at the Children’s Hospital of Philadelphia. She was the two-day summit’s Wednesday keynote speaker.
“Many people haven’t experienced diseases and don’t understand their severity,” she said.
Feemster, who also is a professor at the University of Pennsylvania School of Medicine, went on to say that people who aren’t worried their children will contract a disease take up other concerns like vaccine safety.
“It fills that void,” she said.
While vaccines have all but eradicated diseases like diphtheria, polio and measles, Feemster said that blanket of security actually has helped create hesitancy, which in some pockets of the country has turned to religiously motivated anti-vaccination movements.
That void also can be filled with distrust in science, misinformation about vaccines, distortion of disease risk and a focus on naturalism, Feemster said.
Because of this, Feemster said health care providers are tasked with the difficult job of assuaging parents’ concerns.
“They just want what’s best for their children,” she said.
That’s why doctors need to address concerns and find common ground with parents, Feemster said.
“The majority of parents really do listen to their health care provider,” Feemster said, citing medical studies that found parents are more likely to sign off on vaccinating their children if their doctor strongly recommends doing so.
Part of the process of selling a parent on vaccinating their child, Feemster said, is taking a presumptive approach where a doctor uses declarative statements in their recommendation instead of asking them to participate. She said parents are 17 times more likely to refuse a vaccination if they believe they have the option to do so.
All but two states — Mississippi and West Virginia — allow parents to opt their children out of mandatory vaccinations for anything other than a serious medical condition a doctor verifies. Religious conviction or philosophical belief is not a valid exemption in West Virginia.
Health officials cite West Virginia’s ironclad vaccination laws as a reason for the state’s high immunization rate of school-aged children. Younger children, however, have fallen behind.
Jeff Necuzzi, director of Immunization Services for the state Bureau for Public Health, said vaccination of school-aged children is steady but it is lacking in kids ages two years and younger.
While he said hesitancy is at play, there are other reasons parents are refusing or unable to vaccinate their children.
“I believe hesitancy is overstated in West Virginia,” he said. “It’s not the main cause of under-immunization.”
Studies indicating that only about 2 percent of parents refuse to vaccinate their children seem to confirm Necuzzi’s claim.
“It’s part of it, but socioeconomic factors are the problem,” he said.
Despite vaccines for children being an entitlement in West Virginia, much of the state remains medically under-served, something Necuzzi blames on economics and geography.
“Providers need to recognize we have a population that is less affluent and less educated,” he said, adding that some doctors are not able to stock vaccines and must refer parents to another doctor. He went on to say parents in rural communities may not be able to take their children to another city, which drives lower vaccination rates.
“We’re trying to fix that,” Necuzzi said. “Providers need to disseminate information better so parents are aware of their children’s immunization appointments. There needs to be extra effort in communicating.”
Public health officials say a 90 percent immunization rate is critical to minimizing the potential for disease outbreaks.