Preventing the Spread of Unvaccinated Children

Transcription

1 Preventing the Spread of Unvaccinated Children Student Name Prepared for National Institutes of Health May 8, 2013

2 Preventing the Spread of Unvaccinated Children 2 Abstract This report investigates the problem of unvaccinated children in the United States. With the controversy linking vaccines and autism, many parents are acting upon this information without researching the evidence, thus creating a problem in society. One source of information is a former model and actress named Jenny McCarthy, who has repeatedly voiced her concern after she claims that her son became autistic after receiving his vaccination. Her known public stance influences many families to leave their child unvaccinated in fear of autism, especially since there is not much known about the disease, and it has costly medical expenses. In order to prevent the spread of unvaccinated children and preventable diseases across the United States, educating the public about vaccination and autism needs to happen in a timely fashion. Whether it is through flyers, support groups, or any type of media, the link between vaccines and autism must be destroyed in order to preserve and protect society.

3 Preventing the Spread of Unvaccinated Children 3 Table of Contents Background...5 The Origin of the Vaccination Controversy...6 Thiomersal Scare...6 The Rise of Jenny McCarthy...7 Purpose...8 Problem...8 Scope...9 Discussion The Spread of Misinformation...9 The Fear of Autism...11 Unknown Factors...13 Untimely Diagnosis...14 Conclusion...14

4 Preventing the Spread of Unvaccinated Children 4 Recommended Action Education...15 Support Groups...16 Through Popular Media...17 References...19 References Consulted...21

5 Preventing the Spread of Unvaccinated Children 5 Introduction Background The infancy of an individual is an important milestone for their immune system. Natural defenses start to develop, giving them basic protection against various pathogens. However, to further improve their defenses, they must be given vaccinations in that same period. Vaccinations allow the immune system to recognize the unique characteristics of the pathogen and assimilate it into its memory. A second encounter with the pathogen will eliminate its effects on the body. Around same time, children may exhibit symptoms of autism. In the United States, many children around the age of three are being diagnosed with autism due to their behavior. According to the Centers for Disease Control and Prevention (2012), 1 in 88 children have been diagnosed with an autism spectrum disorder (ASD). As a result, many parents are taking precautions for their child. However, with the busy American lifestyle, people do not have enough time to research about the disease itself. With the lack of time for research, people rely on conveniently accessible sources for their information. As a result, they turn to public figures for information. With a voice that they can understand, people will follow these celebrities more than actual experts, leading to misinformation. Furthermore, with the prevalence of autism in the last few years andno known causes have been discovered, people fear that their children will be affected by the neurological disease. As a result, several controversies have emerged regarding this issue.

6 Preventing the Spread of Unvaccinated Children 6 The Origin of the Vaccination Controversy Andrew Wakefield, a British researcher, published a controversial article in The Lancet about a cause of autism. He supposedly discovered a link between the administration of a measles-mumps-rubella vaccine (MMR) and autism. In their research, Wakefield and his team stated that according to the parents, the eight children showed behavioral problems one month after the administration of the vaccine (Gerber, 2009). After examining the children, they concluded that the symptoms were the effects of the MMR vaccines. With these findings, Wakefield suggested that vaccines for measles, mumps and rubella be administered separately instead of using the MMR vaccine. To confirm the results, many researchers tried to replicate Wakefield s study, but the results did not coincide with the findings (Hall, 2009). Despite failing to confirm Wakefield s research, the general public went into a frenzy. The publication of the controversy led to a massive scare that some parents began to refuse to give their children the proper vaccinations. Thiomersal Scare The controversy with Andrew Wakefield has caused numerous effects in the administration of vaccines. Since the 1930s, a compound called Thiomersal was used as a preservative in order to prevent the growth of organisms such as bacteria and fungi. The compound contains mercury, which has been known to cause a variety of problems to an exposed individual. However, the mercury in Thiomersal does not cause problems in the individual. Despite the different studies that show no harmful effects of the compound, authorities suggested its removal from the vaccine (Gerber, 2009).

7 Preventing the Spread of Unvaccinated Children 7 Unfortunately, many people believe that the removal of thiomersal in vaccinations was somehow related to the link between vaccinations and autism. Some speculated that the mercury in thiomersal itself caused autism in children. The resulting publicity of the thiomersal removal in vaccines allowed organizations who link vaccines and autism to gain movement. It has been noted that some government officials supported these movements as well (Gerber, 2009). Despite the safety concern for thiomersal, studies have shown that the compound has no direct link to autism. If the child were to suffer from mercury poisoning, then deficiencies in motor and speech functioning would be present. However, many parents continued to associate vaccines with the prevalence of ASDs in children. The Rise of Jenny McCarthy News of this hysteria became spread throughout the world, especially in the United States. One of the prominent individuals leading anti-vaccination campaigns is Jenny McCarthy. McCarthy, a former model, actress, and a comedian in the United States, claimed that her son s autism was caused by vaccinations. As a result, she began to advocate her beliefs on popular shows like The Oprah Winfrey Show, where she appealed to thousands about her cause. In recent years, McCarthy established a few autism awareness campaigns that garnered much attention in the United States. However, her claims have been subjected to numerous controversies, with many criticizing the lack of scientific evidence (Greenfeld, 2010). Regardless, her celebrity status makes her a prominent individual in media, allowing her information to be easily accessible to the general public.

8 Preventing the Spread of Unvaccinated Children 8 Purpose The purpose of this paper is to inform about the widespread controversy that links vaccination and autism. This report discusses how vaccines and autism became linked, the main opponents of vaccination and their arsenal, and why this issue must be resolved. Furthermore, this paper will also suggest some methods on how to prevent the spread of misinformation across the United States. Problem With the growing prevalence of autism today, many parents are refusing to provide their children with the protection of the MMR vaccine out of fear. Left unresolved, this problem will result in the rise of preventable diseases. Without any sort of protection, these diseases could potentially cause harm and even death to the child. Studies have shown that Measles is the most frequent cause of vaccine-preventive childhood deaths (Duke and Mgone, 2003). In addition, recent statistics has shown that there has been a resurgence of diseases such as measles and mumps in the general public (CDC, 2010, 2012). The presence of these outbreaks indicates that vaccinating children is essential. Unfortunately, with the influence of the studies of Andrew Wakefield and Jenny McCarthy, parents are continuing to their children s lives at the stake. According to a study, there are many people who regard the testimonials of celebrities as expert opinion and 24% of families rely on McCarthy s information about the safety of vaccines (Rochman, 2011). This alarming statistic indicates that people will be more attentive to celebrities than actual experts in

9 Preventing the Spread of Unvaccinated Children 9 the field, thereby hindering the spread of correct information to the masses. These obstacles will continue to evoke fear in parents, resulting in many more victims of preventable diseases. Scope It will mainly focus on the general population in the United States, specifically concentrating on current and soon-to-be parents. The problem continues to be propagated due to the country s overall busy lifestyle, as well as the intense admiration of celebrities, resulting in the preference of public figures over actual experts. Furthermore, most of McCarthy s efforts are largely concentrated in the United States, where many recognize her as a celebrity. With the media coverage given to celebrities, people are able to follow her and her struggles, thus attracting sympathies from the public. Discussion The Spread of Misinformation After Wakefield released his findings, other researchers tried to replicate his study. However, the results of their tests continued to show no sign of a link between autism and the MMR vaccine (Hall, 2009). Credible research consists of many factors and the ability to replicate the study and the results is one of them. Since the results of Wakefield s research could not be repeated, his publication has been discredited. However, despite the numerous studies that disproved Wakefield s research, a large portion of the American public holds firmly to their belief about vaccinations.

10 Preventing the Spread of Unvaccinated Children 10 Wakefield s research cannot be simply erased from the general public, especially with endorsements from a celebrity. Jenny McCarthy appeals to many women, especially mothers, in the United States. She became a part of the American public with her careers in numerous publications and media. With her life exposed for the general public to see, McCarthy s tragic story about her son Evan becomes easily accessible to the audience. When people see the journey of a mother to care for her child, they sympathize with them. Any efforts to undermine her credibility will result in a backlash from the public. Jenny McCarthy s struggle to care for his son appealed to many people in the United States. In an interview with Oprah, she claimed that her son s autism has escalated into a divorce (The Oprah Winfrey Show, 2007). The hardships that she suffered as a result of her son s autism spoke to many people in the country, for there are also others who are struggling with their children. Furthermore, those who want their children to avoid the disease will listen to any kind of information that they receive. With the combination of ease and status, McCarthy s message about the effects of vaccines on children will be widely received. While the genuine affection of McCarthy to her son tugs the heartstrings of population, the information that they receive from her activism relies on false research. In McCarthy s article on the Huffington Post, she states that Dr. Wakefield did something I wish all doctors would do: he listened to parents and reported what they said (2011). McCarthy argues that Wakefield s research paper was primarily based on the testimonials of the parents. Without any actual scientific evidence to support their claims, the result is not credible. However, according to McCarthy, Wakefield s empathy makes him better than credible professionals.

11 Preventing the Spread of Unvaccinated Children 11 McCarthy s support for Wakefield stems from his devotion to the parents words. Karl Greenfield wrote in his article that the reason why people continue to support Wakefield is related to with our era s strained relationship with the scientific truth, [and] our tendency to place more faith in psychological truths than scientific ones (2010). The main problem with autism is that none of the medical professionals know its main cause. As a result, people turn to simple explanation, and simply concludes, without scientific evidence, that a particular action is the cause. Unfortunately, all of McCarthy s statements lack the one thing that would have given her credibility: scientific evidence. Without any supporting assessment from researchers, nothing in her statements will hold any ground. By propagating this kind of misinformation, not only will she harm the children who do not receive the protection of vaccines, but society itself will also be affected by outbreaks of preventable diseases. A study by the Centers for Disease Control and Prevention stated that a mumps outbreak in New York occurred in June From the outbreak, 88% of the infected had at least one dosage of the vaccination, and 75% had received 2 dosages of the vaccine (2009). The data on the outbreak shows that the virus that causes mumps continues to mutate, thus increasing the need for newer vaccines. With new strains of viruses attacking the United States, vaccinating the children presents an important matter. The Fear of Autism One of the more recent fears of parents today comes from the statement that their child has been diagnosed with autism. According to the Centers for Disease Control and Prevention (2008), 1 in 88 children have been identified with an ASD, which has been identified as a 23%

12 Preventing the Spread of Unvaccinated Children 12 increase since their last report in These statistics account for much of the fear that is going through the United States. Autism is considered a disruption in the neural development of a child; they may suffer from impaired social interaction and restrictive behavior. As a result, these factors take a toll not only on the child, but also on the parents as well. One of the many things that families with autistic children have to face is the added expenses. According to a study, the average medical expenses for individuals with an ASD were four to six times greater than those without an ASD (Shimabukuro, Grosse, and Rice, 2008). Individuals with ASDs need more medical attention since they have behavioral problems. Also, children with ASDs need intensive behavioral interventions, which could cost around $40,000 to $60,000 per child per year (CDC, 2012). Such costs could bring financial burden for the families, which remain as a source of fear for many parents. With costly medical expenses, parents are keen on avoiding anything that may damage the normal development of the child. Since the 1980s, the population of individuals stricken with autism continues to grow, resulting in parents listening to any information related to the disease. These sources are often public figures, which have more exposure to the American people than actual professionals. With the high regard for celebrities in this country, they become enamored with the emotional appeal of the person. In addition, some people lead lives that do not leave them with free time, resulting in only receiving easily accessible information. Easily accessible information from false experts often leads to the creation of myths. McCarthy s statement about vaccines is an example of a myth that spiraled out of control even after Wakefield was stripped of his license. Despite the numerous studies that proved the falseness of his paper, the stigma of Wakefield s report created a deep mark in society. People

13 Preventing the Spread of Unvaccinated Children 13 assumed that the cause of autism lied in the usage of vaccines. However, such information was only used due to the fact that the causes were unknown. Unknown Factors One of the alarming facts about autism is that not much is known about the disease. While some researchers have factors that may lead to its identification, much of the disease is still relatively unknown. However, professionals speculate that genes play a part in the risk of having an ASD, and research has shown that among identical twins, if one has an ASD, then the other child has a 36-95% chance of having the disease as well. In addition, if parents had a child affected with autism, then their next child has a 2 18% chance of becoming autistic (CDC, 2012). Further research also shows that symptoms of autism are also found in other neurological diseases. In neurological diseases such as Fragile X syndrome, and Down syndrome, symptoms of autism can also be traced (CDC, 2012). With the expanding classification of autism, many who have been diagnosed with a neurological disorder are also included under the same category as ASDs. This results in the increase of ASD diagnosis in society. According to the CDC, more people than ever before are being diagnosed with an ASD. It is unclear how much of this increase is due to a broader definition of ASDs and better efforts in diagnosis... the increase in ASD diagnosis is likely due to a combination of these factors (2012). The changing qualifications in the diagnosis of autism began to include individuals who had other disorders, thus explaining the increase in occurrence.

14 Preventing the Spread of Unvaccinated Children 14 Untimely Diagnosis With the utilization of new techniques, technologies and criteria, children with autism are becoming easier to identify. In a study, it is shown that children can be diagnosed with autism as early as the age of two (Lord C. et al, 2006). The link between vaccines and autism continues to spread because children are diagnosed around the time that they need to receive their first vaccines. As a result, people are unable to see that autism and vaccination are completely separate entities. It is impossible for vaccines to have an impact in the genetic makeup of an individual. Conclusion In conclusion, many families in the United States do not vaccinate their children due to the influence of Jenny McCarthy. With the average American adopting a busier lifestyle, many parents refuse to take the time to research the credibility of the information that they receive. As a result, they turn to easily accessible sources, such as Jenny McCarthy for expert advice, thus allowing children to remain unvaccinated for the fear of autism. By having easily-accessible information, the number of misinformed parents will decrease, thus helping reduce a number of preventable diseases from affecting the public. Informing the public about vaccination and autism will be next step in fixing this problem. Like Jenny McCarthy s appeals, the research must be presented to the public with emotional appeal and simple language. The realm of science and research must first earn back the trust of

15 Preventing the Spread of Unvaccinated Children 15 the public before taking in the information. With the on-going battle against autism, the public must be reassured that vaccinations have no link to autism through education. Recommended Action Education The bad reputation of vaccines amongst many Americans comes from the spread of false information. Therefore, I would like to suggest the proliferation of vaccination information across the United States. It can be achieved through more information at clinics and through the media. Adding things such as flyers, pamphlets or even information sessions at hospitals, schools, or any place of gathering will reach a wide audience. With $50,000, flyers and pamphlets will be given to various institutions across the United States. Flyers and pamphlets are useful because they are able to reach the people who lead busy lives, leaving them no time to read through an article full of studies about vaccinations. Studies have shown that the average adult has a short attention span, stating that the minds of most adults tend to wander, especially during a lengthy presentation (1996). By placing these flyers with concise information in places such as supermarkets, malls, and other regular destinations of parents, the message of vaccination will spread in society. However, in order for the public to accept the message, the information must be presented in a simple, yet emotionally appealing manner. Unlike medical professionals, Jenny McCarthy speaks in a language that everyone, especially mothers, can understand; her messages evokes the sympathy of her audience, thus giving her message power. To strengthen the message

16 Preventing the Spread of Unvaccinated Children 16 of vaccination, education of the masses, especially parents, must come in simple language and have emotional appeal. In order to reach out to families about the truths of vaccination, the message needs to be addressed in simple language, as well as have an emotional impact. In his article, Stephen Hanauer asks how are we to overcome the public s strained relationship with scientific truth? (2010). With the rising costs in American society, medical professionals often have a bad reputation amongst the masses. People become wary of the words of professionals, especially when matters such as insurance costs are involved. Furthermore, many professionals use terminology that the average American barely understands. With these in mind, the following solutions will help Americans understand the message. There are limitations to this method of spreading the message. Some people may see flyers or pamphlets as nuisances in their lives. In order to fix these problems, especially on flyers, the information on these materials should always be in big, bold letters. On the other hand, pamphlets should have a variety of statistics, consequences, and testimonials about both vaccinations and autism. Since pamphlets are more likely to be read fully, more information should be placed. However, the main goal for both is to have simple, yet professional language in order for the message to be easily absorbed. Support Groups The creation of support groups for current and soon-to-be parents will help curb the fear of autism in the United States. Families of autistic children will need aid in order to cope with their struggles and a support group will help alleviate some of the problems that they encounter.

17 Preventing the Spread of Unvaccinated Children 17 Furthermore, the establishment of support groups in the United States will help spread correct information to the public, thus fighting the damage caused by McCarthy. Support groups should also be involved in their local communities. In schools, the support groups could set up an information session with the Parents Teachers Association, in which they should provide parents with information about vaccinations and autism. With the support groups comprising mainly of volunteer parents and professionals, their message would be able to reach the parents at these school events. However, there are limitations to this approach. This idea would need to utilize volunteers across the United States. We will only be able to fund some groups since having a group in every major city would be very expensive. In order to compensate for this, the program needs to put support groups in major cities that have a huge population of unvaccinated children. These groups will help spread the message of vaccination to the area. Furthermore, the groups will also provide services such as vaccination booths all over the state. Through Popular Media The Internet is currently one of the most powerful tools used for spreading information. This medium reaches a wider audience and will be an asset to the mission of spreading the message of vaccination. Parents are becoming involved with social media networks, making sites like facebook and twitter perfect platforms for the program. Using these sites requires absolutely no expense at the minimal level and the information on these websites require a low amount of effort to spread to others. The page will contain a variety of information, as well as links to credible sites such the CDC, the Red Cross, and the World Health Organization.

18 Preventing the Spread of Unvaccinated Children 18 There are a few limitations to this approach. Not all parents are presently using the internet; many people are not able to use the computer effectively. Furthermore, these pages may be subjected to internet vandalism as well. In addition, since the information is all online, people may not act upon spreading this information. Some may justify that simply putting up the info on the internet makes a difference, and thus ends their effort. In order to prevent this, the program will advocate the participation in online discussions, as well as post information about clinics, hospitals, or other establishments that give vaccines in their local area.

19 Preventing the Spread of Unvaccinated Children 19 References Anonymous,.(1996). Time passages.the Journal of Business Strategy, 17(3), 11. Bonnie Rochman. (April 26, 2011). Jenny McCarthy, Vaccine Expert? A Quarter of Parents Trust Celebrities.In Time. Retrieved April 20, 2013, from Centers for Disease Control and Prevention. (2008). Prevalence of Autism Spectrum Disorders. Retrieved from Centers for Disease Control and Prevention. (2010 February). Update: Mumps Outbreak --- New York and New Jersey, June January 2010 Centers for Disease Control and Prevention. (2011). Measles United States, Retrieved from Centers for Disease Control and Prevention. (2012). Data & Statistics. Retrieved from Duke, T., &Mgone, C. S. (2003, March).Measles: not just another viral exanthem. The Lancet.361(9359), Retrieved from Geschwind, D. (2009). The vaccine-autism controversy. Nature Medicine,15(9), 992. Greenfield, K. T. (2010, February 25).The Autism Debate: Who s Afraid of Jenny McCarthy?Time. Retrieved from Hall, H. (2009). Vaccines and autism. Skeptic, 15(2),

20 Preventing the Spread of Unvaccinated Children 20 Lord C., Risi S., DiLavore P. S., Shulman C., Thurm A., & Pickles A. (2006, June). Autism from 2 to 9 years of age. PubMed. Retrieved from McCarthy, J. (2011, January 10). In the Vaccine-Autism Debate, What Can Parents Believe? The Huffington Post. Retrieved from Oprah Winfrey (Creator). (2007, September 18). Mothers Battle Autism.[Television Episode].The Oprah Winfrey Show. Episode retrieved from Shimabukuro T. T., Grosse S. D., & Rice C. (2008, March). Medical expenditures for children with an autism spectrum disorder in a privately insured population. PubMed. Retrieved from Stanley Plotkin, S., Gerber, J., &Offit, P. (2009). Vaccines. Clinical Infectious Diseases, 48(4),

21 Preventing the Spread of Unvaccinated Children 21 References Consulted Advisory committee on immunization practices (acip) recommended immunization schedule for adults aged 19 years and older united states, (2013). American Journal of Transplantation, 13(5), Burki, T. (2010).The vaccine war. Lancet Infect Dis, 10(10), 669. Demographics of Unvaccinated Children. Retrieved May 6, 2013 from Jenny McCarthy. (2013 May 4). Retrieved May 6, 2013 from Wikipedia: Kata, A. (2011). Anti-vaccine activists, web 2.0, and the postmodern paradigm an overview of tactics and tropes used online by the anti-vaccination movement. Vaccine, 30(25), Papaevangelou, V., Quinlivan, M., Lockwood, J., Papaloukas, O., Sideri, G., et al. (2013). Subclinical vzv reactivation in immunocompetent children hospitalized in the icu associated with prolonged fever duration. Clinical Microbiology and Infection, 19(5), E245-E251. Soupcoff, M. (2011).An injection of truth.regulation, 34(1), 64.