Physicians who don't take a leadership stance on vaccine safety give credence to the discredited, unscientific reasons parents use to keep their children unvaccinated and they put the rest of us at risk.
The current multi-state measles outbreak compels physicians to take a tougher stance against parents who won't vaccinate their children.
Anne Schuchat, MD |
We are barely a month into 2015, and already there have been more than 80 cases of measles—a serious childhood disease that was declared eradicated in the U.S. just 15 years ago—in 14 states. Most of the cases are linked to an outbreak that began at Disneyland in late 2014.
In a press conference with reporters last week, Anne Schuchat, MD, assistant surgeon general, United States Public Health Service and director of the CDC's National Center for Immunization and Respiratory Diseases said she is worried that this seemingly small number could mushroom into a bigger public health epidemic.
"The very large outbreaks we have seen around the world often started with a small number of cases," Schuchat said. "I have told you before that France went from about 40 cases a year to over 10,000 cases in a year."
A survey from SERMO, a physician-only social network with 300,000 members, reports this week that 92% of doctors they polled attribute the current measles outbreak directly to parents who choose not to vaccinate their children.
The gap in vaccination rates and the reasons these parents use to avoid vaccinating their kids shine a light on the fine line between physician respect to honor a patients' medical decisions and physician responsibility to public health.
"I understand they have concerns," says Linda Girgis, MD, a family practitioner based in South River, NJ, who is also a mother to three teenage boys and leans on her personal experience to relate with parents who worry that vaccines are harmful.
"I tell them I have no qualms about vaccinating my own kids," she says, adding that she continues to counsel and press the importance and safety of vaccine on the parents in her practice who decide to continue and avoid vaccinations. Eventually, she says, those parents stop coming.
Anti-vax Doctor Shopping
The reasons parents do not vaccinate their children can range from medical to religious or personal beliefs. Some children have compromised immune systems and can't receive a vaccine. Some physicians don't take the measles outbreak as seriously as the CDC.
But the sharpest point of contention among physicians and a flashpoint of controversy among parents and the public is parents' personal beliefs about vaccinations.
Years after a study that alleged to show that a preservative used in vaccines causes autism was convincingly discredited, the myth it spawned still prevails.
Measles is a serious illness. It's a respiratory virus that can cause blindness, deafness, and even death. "It's not a benign disease," says Girgis.
For a nation that was on edge about the Ebola virus, it is stunning to me that the reaction to measles, a disease that is spread more easily than Ebola, is divided.
"Measles is so contagious that if one person has it, 90% of the people close to the person who aren't immune will also be infected," says Schuchat.
Path of Least Resistance
When physicians' persistent requests to vaccinate are rejected by parents, unfortunately, there is another doctor who may not push them as much. That is wrong. Wrong. Wrong.
An inconsistent message about health undermines a physicians' role. When some doctors decide not to toe the line on vaccine safety, it gives credence to the discredited, unproven, unscientific reasons parents use to keep their children unvaccinated against harmful, deadly diseases that put the rest of us at risk.
Girgis is an advisory board member at SERMO, the site that polled its physician members on measles. In addition to blaming the outbreak on unvaccinated children, 79% say children without vaccinations should not be allowed in public schools.
According to the CDC, most states have a vaccination rate among kindergartners above 90%. But there are a handful with vaccinate rates as low as 81%. Colorado, Arkansas, Idaho, Washington, Pennsylvania, Maine, Kansas, and the District of Columbia all have vaccination rates lower than 90%. The majority of time parents are opting out because of philosophical reasons.
As one parent who works with a state social services agency told me, "I have no patience for parents who don't vaccinate." With the majority of parents vaccinating, maybe that lack of patience will spill over to physicians who let parents get off the hook.
"I think it's a big wake-up call for everybody," says Girgis.
For information on how measles presents, potential complications, and current information on the outbreak, visit the CDC.
Jacqueline Fellows is a contributing writer at HealthLeaders Media.