Sumner and Esther Feldberg Professor of Maternal and Child Health
Q: In 2015, a multistate outbreak of measles, sparked at Disneyland, reminded Americans about the ever-present threat of fast-spreading childhood infections. A 2016 Pew Research Center poll found broad support in the U.S. for childhood vaccinations. Is the antivaccination movement on the decline?
A: There’s both good news and bad news. The bad news is President Trump has long articulated his belief that vaccines cause autism. He is of the “too many, too soon” camp—he has an image of a horse needle being given to little babies.
The good news is that most of the mainstream press understands that the issue has been settled. They have stopped giving equal weight to both points of view, because the scientific literature is firmly on the side of there being no association between childhood vaccines and autism. Even though, in the Pew survey, about 25 percent of parents expressed some hesitancy about vaccinations, that number has been stable for the last 10 or 15 years, and most of those parents will, in fact, get their children immunized. Parents are also realizing there is a downside to refusing vaccination—that it’s not just about freedom of choice, but that one’s child could be at risk because of the decision of other parents who have refused vaccines for their children. And states are realizing that it’s probably in their best interest to not grant as many vaccination waivers as they have in the past, because following up even on these mini-outbreaks is very expensive.
If you look across the states, immunization rates have been improving, but there are pockets where they have not. One is a pocket in Marin County, California. There’s a pocket in Texas as well. And there are pockets among religious groups that don’t believe in vaccination. That’s actually where many of the recent epidemics came from: Groups of children visited a country where measles is endemic and brought it back.
These pockets are a concern. So is the persistence of this notion that the safety of childhood vaccines is imperfectly known or studied. But one of the biggest issues is that we have a generation of parents who have never seen these infections. They haven’t witnessed the complications of measles, for example. They think of it as a benign disease—a sort of Brady Bunch effect. But measles can be deadly, and children are once again being exposed.