Vaccine Confidence Project

Dr. Heidi Larson

The internet and its rapid spread of information can magnify and expand a vaccine scare in a short amount of time. Now, the internet can also combat misinformation. Dr. Heidi Larson of the London School of Hygiene and Tropical Medicine and a team of colleagues adapted the HealthMap automated data collection system to track rumors and online sentiments about vaccines on the internet. HealthMap was originally developed to track disease outbreaks.

“The internet has sped up the global spread of unchecked rumors and misinformation about vaccines and can seriously undermine public confidence, leading to low rates of vaccine uptake and even disease outbreaks,” Dr. Larson said.

The surveillance system covers 144 countries and looks at online articles, blogs and reports about vaccines and vaccine-preventable diseases. By identifying the first signs of the negative reports, Dr. Larson and her colleagues hope to take preventative action on anti-vaccine sentiment before it becomes a larger problem like the recent measles outbreak in Wales or the polio outbreak in Nigeria that re-introduced polio to 20 countries that had been free of the disease.

The original data collection for the Vaccine Confidence Project took place from May 1, 2011 to April 30, 2012 and identified 10,380 online mentions of human vaccines. 3,209 of these reports, or 31%, were negative and included fears about adverse events and vaccine distrust. The negative reports focused on vaccination programs, disease outbreaks, attitudes about vaccine believes, awareness and perception and vaccine safety.

“Bad news stories damage vaccination programs as much as biological hazards, and these stories evolve over minutes or hours, needing immediate action,” said University of Toronto public health specialists Natasha Crowcroft and Kwame McKenzie. “By the time a detailed specific analysis of vaccine safety issue is completed, the story is no longer newsworthy.”

Ideally, the Vaccine Confidence Project will identify early signs of vaccine misinformation in real time and enable public health officials to act immediately to dispel unfounded fears. “Public health systems need to move beyond passive responses to vaccine safety events towards active preparedness,” Crowcroft and McKenzie continue. “It is important for researchers to discover how to make communities resilient to bad science and interest-driven scare stories.”

By continuing to build public belief and trust in vaccines, health officials can avoid unfortunate situations like the recent measles outbreak and Nigeria’s polio epidemic. HealthMap and other tools available will be beneficial in containing vaccine fear tactics and enhancing education systems.

Vaccines and The Media

Childhood vaccines have been strongly debated in the media recently, both positively and negatively.

Billboards

The National Vaccination Information Center (NVIC) has posted billboards in Tucson, Arizona; Chicago, Illinois; and Austin, Texas urging parents to check the risk of vaccinations. The non-profit organization believes there are gaps in science and that vaccines can be risky. The billboards were placed in states currently discussing vaccine exemptions.

Arizona is one of twenty states that allow vaccination exemption for personal beliefs. A bill recently failed in the legislature that would have required parents to get a doctor’s signature before exempting children from vaccination. Kathy Malking of the Pima County Health Department believes parents should be informed, but finds fault with the billboards and NVIC website. “It [the website] focuses on all the negatives of vaccines and doesn’t talk about any of the positive aspects and how vaccines have saved many lives,” she states.

Internet

Many websites and blogs spread misinformation, encouraging parents not to vaccinate their children. From Natural News to VacTruth, just running a google search on childhood vaccines brings up many anti-vaccination websites.

VacTruth published a blog post in April that stated the media uses propaganda to condition people to accept vaccines. VacTruth claims that pharmaceutical companies use propaganda and pay doctors to sell drugs, including vaccines. VacTruth goes on to state that the polio vaccine had little to do with the decline of polio. Unfortunately, VacTruth did not use any scientific research or studies as references for their blog post, the entire post was fueled by propaganda and anti-vaccine sources.

Greeting Cards

For the past eighteen years, Hallmark has run the “For America’s Babies” program, printing personalized greeting cards for new parents that include a detachable growth chart and immunization schedule. In a new addition to the program, Hallmark teamed up with twenty-seven state governors, and the cards now come from the governor, urging parents to vaccinate their children. 

The immunization schedule in the cards reflects the Centers for Disease Control and Prevention (CDC) current recommendations. Hallmark pays for printing the cards in English and Spanish, and taxpayer dollars fund the small cost of distributing the cards to hospitals. Hospitals can choose whether or not to participate in the program.

The Florida greeting card is sent by Governor Scott and his wife Ann, and reads:

“Congratulations on the birth of your new baby! As you grow together in family and community, we encourage you to build your baby’s healthy imagination through reading and your baby’s healthy life through immunizations.”

In 2010, Florida ranked second for the percentage of children up to date on immunizations at 80%.

Vaccine Watch encourage parents to carefully consider all media they see and read about vaccines. Consult your pediatrician with questions about vaccines, as media like billboards and websites often only present one side of the argument.

Measles Outbreak in Wales

In November, cases of measles in Wales began increasing. Throughout April, the number of measles cases continued to rise and one man died. Last week the number of cases rose again, reaching 1,243 total across Wales.

Fifteen years ago, many parents chose not to vaccinate their children because Andrew Wakefield linked vaccines to autism in a 1998 report in the Lancet. His work has since been discredited and he was stripped of his medical license, however many children in this era were never vaccinated. Young people aged 10 to 18 have been the hardest hit by the measles outbreak in Wales because they missed this key vaccine as infants.

Health officials are now concerned about the area of Gwent in Wales, where 84 measles cases have been reported since November. There are about 10,000 people aged 10 to 18 in Gwent that aren’t vaccinated for measles, mumps and rubella (MMR).

“It should be remembered that in 2011, we only saw 19 measles cases in the whole of Wales for the whole year,” Dr. Marion Lyons, the director of health protection for Public Health Wales states. “The 84 cases in Gwent are a huge concern to us and with 10,000 children still in need of vaccination, we are warning young people and parents not to be complacent just because they don’t live in the outbreak area.”

Since the outbreak began, more than 43,000 non-routine MMR vaccines have been given, reducing the number of unvaccinated children by 46%. However, 38,000 children in Wales remain unvaccinated, prompting concern among health officials about future outbreaks. Health officials have also estimated there are two million school children total in Britain who didn’t receive the vaccine when they were infants. A campaign was conducted earlier in the year to vaccinate one million of these children.

“It’s encouraging to see so many parents bringing their children for vaccination now who refused the vaccine in the past, and we must keep this up if we are going to see an end to the current outbreak and have the best chance of preventing more outbreaks in the future,” Dr. Lyons continues.

MMR is administered in two doses, the first dose provides 90% protection and with both doses, there is 99% protection. Measles is highly contagious with a rash and fever, as well as feeling poorly. Complications can include blindness, severe diarrhea, ear infections, pneumonia, or in extreme cases, death.

Dr. Sarah Wollaston is a former general practitioner and is a member of parliament representing Totnes, near Devon, where 30% of 5 year olds haven’t received both doses. With herd immunity, if 95% of children in a community are vaccinated the community is protected from outbreak. “The real ‘herd’ effect may be an unwarranted fear that vaccination is harmful or the belief that ‘natural’ methods like homeopathy can boost a child’s immunity and thereby offer a safe alternative to protect against that virus,” she explains.

“The MMR is a well-tested vaccine and offers protection against three of the most infectious childhood diseases,” Dr. Sam Barrell, a Brixham general practitioner states. “Measles is highly infectious and while most get over it quickly, for some it can have life-changing consequences.”

The tragic harm caused by Andrew Wakefield's fraudulent research continues to fuel vaccination fears and misinformation. It may take decades of education to undo this damage. 

Proactive Pediatricians

In a recently released practice point, the Canadian Pediatric Society (CPS) urges its members to proactively work with parents that are hesitant about vaccines. CPS urges pediatricians to talk with parents to address their concerns and misconceptions about vaccines. Stone Hearth Newsletters originally reported on the new practice point.

Twenty percent of Canadian parents have concerns about immunizations, or delay or refuse vaccines, and the goal of CPS is to lower this number through education. The Internet, traditional media and celebrities have led to an increase in the negative perception parents have of vaccines. It’s been noted that even 5-10 minutes on an anti-vaccine website can seriously change parents’ perception of vaccine risks.

Dr. Noni MacDonald is a pediatric infectious disease specialist at IWK Health Center in Halifax, Nova Scotia and co-authored the new CPS practice point. “Since immunization is one of the most important preventative health measures, literally responsible for saving millions of lives, addressing the concerns of vaccine hesitant parents has to be a priority for health care providers,” she states.

CPS notes that health care providers’ advice is a major influence on parental decisions, and recommends that health care providers take the time to understand parents vaccine related concerns. The proactive approach of listening to parents, building trust and addressing concerns will remedy misconceptions and lead to a higher vaccination rate.

Dr. Jane Finlay is a member of the CPS Infectious Disease and Immunization Committee and co-author of the new practice point. “It’s important to reassure parents that vaccines are safe and effective, and to explain that if they decide not to vaccinate, they’re exposing their child and entire family to risk. Because of vaccination, today’s generation of parents haven’t seen diseases like measles or meningitis, so it’s important they understand these are still a very real threat,” she states.

Vaccine Watch urges all parents with concerns about vaccines to talk with their child’s pediatrician about the risks and benefits of vaccination.