According to the CDC, vaccinations will prevent more than 21 million hospitalizations and 730,000 deaths among children born in the last 20 years. For every $1 invested in vaccines, an estimated $10.20 is saved in direct medical costs. But more patient education is needed to improve vaccination rates.
So, what’s the problem?
Since there continues to be considerable mythology about vaccines, let’s dive in.
The first vaccine
In 1796, the physician Edward Jenner observed that milkmaids remained immune from smallpox that was affecting people in the local area. Jenner’s successful experiments with cowpox demonstrated that infecting a patient with cowpox protected them from developing smallpox, and more importantly, formed the idea that infecting human patients with a similar, yet less invasive, infection could prevent subjects from developing a worse one. Known as the father of immunology, Jenner is credited with creating the world’s first vaccine. Coincidentally, the word “vaccine” originates from vacca, the Latin term for cow, and that the Latin term for cowpox was variolae vaccinae, meaning “smallpox of the cow.”
Yet, over 200 years later, outbreaks of vaccinable diseases are still present, and in some areas of the world are on the rise.
There was a web-based survey in March of 2021 by the American Academy of Family Physicians that showed vaccine confidence was basically the same or slightly increased during the COVID-19 pandemic. Approximately 20% of people surveyed expressed a concerning decrease in confidence of the vaccines. When you combine the fact that fewer people have a primary source of care and people increasingly get information from the news, internet, and social media, it is understandable why there is this persistent group of vaccine skeptics. Further, during the pandemic, people access their usual source of care less often, making them even more susceptible to misinformation.
Trust is key
If confidence in vaccines leads to getting the necessary vaccinations for yourself or your children, while a lack of confidence does the opposite, then 20% of people not getting recommended vaccines puts all of us here in the U.S. at risk for diseases that are preventable. We likely need at least 70% of the population to be immune to COVID-19. For very infectious diseases like the measles, that number is closer to 95%.
The reluctance or refusal to vaccinate despite the availability of vaccines threatens to reverse progress made in tackling vaccine-preventable diseases. Sometimes, in my experience, what we are calling vaccine hesitancy may simply be apathy. The belief that is “this won’t affect me,” so there is a sense by some that this is other people’s problems and not their own. This has spurred much conversation about our “social contract” with each other. This describes the things we do individually for the benefit of all. It could include stopping at a red light, or not smoking in a restaurant. Getting vaccinated is one of the most cost-effective ways to avoid disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.
Opposition to vaccines is as old as the vaccines themselves. In the last decade or so, there has been an increase in the opposition to vaccines in general, specifically against the MMR (measles, mumps, and rubella) vaccine. This was spurred on by a British ex-physician who published falsified data linking the MMR vaccine to autism. Researchers have studied vaccines and autism and have not found a link. They have discovered the gene which is responsible which means this risk was present since birth.
Timing may be the culprit. Often children who begin to show signs of autism spectrum disorder do so around the time they receive the measles, mumps and rubella vaccine.
When most of a population is immune to an infectious disease, this provides indirect protection—also called population immunity, herd immunity, or herd protection—to those who are not immune to the disease. If a person with measles were to come to the U.S., for example, nine out every 10 people that person could infect would be immune, making it very hard for measles to spread in the population.
The more contagious an infection is, the higher the proportion of the population that needs immunity before infection rates start to decline.
This level of protection against severe disease makes it possible that, even if we can’t eliminate transmission of the coronavirus soon, we can still get to a level of population immunity where COVID’s effects can be manageable.
We are unlikely to eradicate COVID-19 or even to get it to the level of something like measles in the U.S. But we can build up enough immunity in our population to make it a disease that we as a society can live with. We can arrive at this destination soon, if we get enough people vaccinated—and it’s a destination worth working toward.
Myths and Facts
Myth: Vaccines don’t work.
Fact: Vaccines prevent many diseases that used to make people very sick. Now that people are being vaccinated for those diseases, they’re not common anymore. Measles is a great example.
Myth: Vaccines aren’t safe.
Fact: The safety of vaccines is important, from beginning to end. During development, a very strict process is overseen by the U.S. Food and Drug Administration.
Myth: I don’t need vaccines. My natural immunity is better than a vaccination.
Fact: Many preventable diseases are dangerous and can cause lasting side effects. It’s much safer—and easier—to get vaccines instead. Plus, being vaccinated helps keep you from spreading the disease to unvaccinated people around you.
Myth: Vaccines include a live version of the virus.
Fact: Diseases are caused by either bacterial or viral infections. Vaccines trick your body into thinking you have the infection caused by a particular disease. Sometimes it is a part of the original virus. Other times, it is a weakened version of the virus.
Myth: Vaccines have negative side effects.
Fact: Side effects can be common with vaccines. Possible common side effects include pain, redness, and swelling near the injection site; a low-grade fever of less than 100.3 degrees; a headache; and a rash. Severe side effects are very rare and there is a nation-wide process for collecting this information. If you experience anything unusual, please let your doctor know. They know how to report this information.
Myth: Vaccines cause autism spectrum disorder.
Fact: There is proof that vaccines do not cause autism. A study published more than 20 years ago first suggested that vaccines cause the disability known as autism spectrum disorder. However, that study has been proven to be false.
Myth: Vaccinations aren’t safe to get while pregnant.
Fact: Actually, the opposite is true. In particular, the CDC recommends getting the flu vaccine (not the live version) and DTAP (diphtheria, tetanus, and whooping cough). These vaccines protect the mother and the developing baby. There are some vaccines which are not recommended during pregnancy. Your doctor can discuss this with you.
World Health Organization. Ten threats to global health in 2019. Accessed August 5, 2021. who.int/news-room/spotlight/ten-threats-to-global-health-in-2019
Hussain A, Ali S, Ahmed M, et al. The anti-vaccination movement: a regression in modern medicine. Cureus. 2018;10(7):e2919.