Vaccine Safety Concerns Up Among Parents, Physicians

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Vaccine Safety Concerns Up Among Parents, Physicians

In the wake of recent publicity surrounding vaccine safety issues, parents

and the physicians who treat their children are reporting more concern about

some vaccines, and even refusing certain vaccines for their children, a new

University of Michigan study finds.

Nearly 70 percent of doctors surveyed nationally for the study said that

parent worries have risen recently, and more than a third of the physicians

reported their own concerns had also increased.

That increase in concern has translated into action, the survey also found.

More than 90 percent of pediatricians and 60 percent of family practitioners

surveyed reported that at least one parent had refused to allow their child

to receive a particular vaccine in the past year. And up to a third of

family physicians and 12 percent of pediatricians said they did not

recommend particular vaccines to parents either routinely or occasionally.

UMHS researchers performed the survey of nearly 750 randomly selected

pediatricians and family practitioners across the United States in

cooperation with the federal Centers for Disease Control and Prevention

(CDC). The results are being presented today at the joint meeting of the

Pediatric Academic Societies and the American Academy of Pediatrics in

Baltimore.

" Concerns regarding vaccine safety are increasing, and physicians need to be

aware of this concern and be knowledgeable about the facts, " says L.

Freed, M.D., M.P.H., Director of General Pediatrics and the Child Health

Evaluation and Research (CHEAR) Unit at UMHS. " There's a significant amount

of misinformation and rumor about vaccines. The more we take this issue

seriously, the better job we'll do of ensuring immunization and preventing

disease. "

For three years, Freed and his colleagues have been the only group in the

nation funded by CDC to regularly study current vaccine issues for the CDC's

National Immunization Program. The new results come from a survey that asked

physicians about their patients', and their own, attitudes and actions

regarding vaccine safety in general and specific vaccines whose safety has

been questioned.

The new findings, Freed says, point to a troubling trend that may put

individual children and entire populations at risk for outbreaks of

preventable diseases such as chicken pox, measles and hepatitis B. And it

points to the need for better education of physicians and the public about

vaccine safety and the risks of not vaccinating children.

" Vaccines prevent more disease in the U.S. than any other health

intervention, and the risk of the diseases prevented by vaccination far

outweighs any risk from any vaccine, " says Freed, a professor of pediatrics

in the U-M Medical School.

He notes that many of today's parents and physicians don't remember the time

when polio and other diseases threatened millions of children, and take for

granted the disease-preventing effect of vaccination programs. This may have

led to a lower tolerance for even a rumored, much less proven, risk from a

vaccine.

The study was designed to assess the impact of several vaccine recalls and

well-publicized rumors from recent years. In 1999, a new vaccine against

rotavirus was pulled from the market after reports that a small number of

infants vaccinated against the gastrointestinal disease-causing virus

developed intussusception, or bowel blockages.

Also in 1999, the federal government and the American Academy of Pediatrics

recommended that hepatitis B vaccine for newborns be postponed until 6

months of age until its manufacturer could remove the preservative

thimerosal, a mercury-containing chemical that had been used for decades.

Though there was no proven risk from thimerosal, the recommendation was made

on the basis of public concern and precaution.

Meanwhile, rumors and speculation have grown in recent years about health

risks -- ranging from autism to Sudden Infant Death Syndrome (SIDS) --

allegedly posed by vaccines against chicken pox, or varicella; diptheria, or

DTP; measles, mumps and rubella, or MMR; and other diseases.

Skeptical or anti-vaccination information on the Internet and in the media

has also fed fears and misconceptions about the effectiveness of vaccination

or the need to have children vaccinated.

The U-M study, whose results will be presented in several sessions by Freed

and CHEAR Unit research investigator J. , M.P.H., looked at

specific parent and physician concerns and actions relating to all these

recent developments.

For example, a third of pediatricians reported hearing parental concerns

about autism or multiple sclerosis risks from vaccination. One quarter of

family physicians and a third of pediatricians said parents expressed

worries that new vaccines aren't fully tested and that they should wait

before having their child inoculated. About a sixth of both types of

physicians reported that parents were worried that additives in vaccines may

not be safe.

Many of the doctors themselves said the rotavirus and thimerosal incidents

had increased their own concern about vaccine safety, as well as that of

their patients' parents. Just over a third of all physicians said the

rotavirus vaccine recall had increased their own concern, and a quarter said

it had increased parent concern.

Doctors in the survey who reported their concern had grown were much more

likely to believe that further research on vaccine safety was warranted by

the recent events.

Family practitioners were more likely than pediatricians to believe that

more research was needed, but a majority of both groups want more research

to be done on the potential for neurologic effects such as autism, on the

safety of newly introduced vaccines, and on vaccine additives.

In the meantime, the study suggests that a sizeable minority of

physicians -- 21 percent of family physicians and 12 percent of

pediatricians -- are occasionally or routinely refraining from recommending

certain vaccines to some or all of their patients. This was true for nearly

a third of family physicians when it came to the relatively new varicella

vaccine, but even a very small number of physicians reported recommending

against the DTP, polio and hepatitis B vaccines.

As a result of their study, Freed and his colleagues recommend that all

physicians should give parents the Vaccine Information Statements (VIS) that

are available from the CDC to help them understand known side effects and

low-level risks from vaccines. Their results showed that 92 percent of

pediatricians but only 77 percent of family physicians provided a VIS at

every vaccination visit.

But, they caution, physicians need to be sensitive to the fact that parents

may express concerns about rumored risks not found on the VIS, and need to

educate themselves about the information available to address those worries.

Still, Freed says, worried parents and physicians alike should remember the

alternative to vaccination: outbreaks of potentially fatal or crippling

diseases that once plagued America's children but that are nearly wiped out

or could soon be.

According to the CDC, immunizations have reduced vaccine-preventable

infectious diseases in the United States by more than 95 percent, and have

had a dramatic impact on reducing childhood illness and death.

What's more, Freed says, the knowledge that there is a tested system in

place to monitor for adverse effects from vaccines and respond to suspected

risks should also provide comfort. The CDC and the Food and Drug

Administration (FDA)cooperate to run the Vaccine Adverse Event Reporting

System (VAERS).

" Recent events like rotavirus and thimerosal have shown that the vaccine

monitoring system takes vaccine safety questions seriously, no matter how

small the risk or the incidence, and that public health authorities take

action so that we can all be sure that vaccines are safe, " he explains.

" This constant vigilance and low tolerance for safety issues should reassure

everyone. " - By Kara Gavin

[Contact: Kara Gavin]

01-May-2001

http://unisci.com/stories/20012/0501015.htm