Introduction

Years of research have shown that the decision to vaccinate one’s child is rarely simple or straightforward. A welter of voices—in medicine, government, politics, media, churches, schools, and among one’s family and friends—can confuse well-meaning parents who want to do the best for their offspring. Online forums, where appeals to emotion often drown out thoughtful discussion, also play a role in vaccination decisions.⁵

Larger social trends and policy decisions contribute to the mixed messages parents receive as well. Recent public health campaigns have been less likely to focus on vaccine-preventable diseases than on chronic, non-communicable afflictions, such as heart disease and obesity-related conditions, that are responsible for a majority of preventable deaths. Campaigns to make it easier to obtain philosophical or religious exemptions from state-mandated school entry vaccination requirements have been launched across the country. Finally, vaccines have become victims of their own successes: In the United States, many young parents have never encountered diseases such as polio, measles, rubella, and Haemophilus influenzae type b meningitis.

As a result, growing numbers of parents believe that vaccine-preventable diseases present a negligible risk. History has shown this to be a dangerously false assumption to make; what’s more, nowhere is the dictum of thinking globally and acting locally more relevant than in discussing vaccine-preventable illnesses. Neither infectious diseases nor attitudes about vaccines pay heed to international borders. For the past several years, much of Western Europe has been suffering from a measles epidemic. The recent measles outbreaks in the United States are a direct result of this, as deliberately unvaccinated U.S. citizens were infected when traveling in Europe and then spread the disease once they returned home.⁶ For more than forty years, American and European vaccine panics have fueled each other; since the advent of the Internet, these unfounded fears have spread to the far reaches of the globe.

For all these reasons, the American Academy organized a workshop to develop a research agenda outlining the types of rigorous studies that could yield evidence to help reconcile the emerging concerns of parents with the timeless goals of public health. Carrying out this scientific agenda will require engagement from an array of stakeholders: local, state, and federal government; NGOs; academia; foundations; and industry. Only with a cohesive vision and commitment can we avert a crisis-in-the-making.

ENDNOTES

⁵ Opel et al., “Social Marketing as a Strategy to Increase Immunization Rates”; Christina Dorell et al., “Factors That Influence Parental Vaccination Decisions for Adolescents, 13 to 17 Years Old,” Clinical Pediatrics 52 (2) (February 2013): 162–170.

⁶ Centers for Disease Control and Prevention, “Measles—United States, January 1-August 24, 2013,” Morbidity and Mortality Weekly Report (MMWR) 62 (36) (September 13, 2013): 741–743, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a2.htm; Centers for Disease Control and Prevention, “Measles—United States, January-May 20, 2011,” Morbidity and Mortality Weekly Report (MMWR) 60 (20) (May 27, 2011): 666–668, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6020a7.htm.