Apathy over immunization has varied causes

Complex issues with historical roots, according to UW prof and co-author of study

WATERLOO — Immunization apathy is not all about parents, but also the influence of social and political factors, according to a University of Waterloo study.

“It’s a complex issue that does definitely have historical roots,” said Heather MacDougall, a history professor at Waterloo and co-author of the study.

Factors that sway a parent’s decision about immunizing their child are not new.

“With the introduction of each new vaccine, there’s always concern,” MacDougall said. “Each era produces its own reasons for supporting or opposing immunization.”

Those are compounded by the gradual disappearance of diseases that the vaccines protect against.

“It does seem as soon as a disease disappears from the developing world that we get people questioning the need for immunization programs,” MacDougall said.

MacDougall and co-author Laurence Monnais, of Université de Montréal, looked at adoption of the measles vaccine from its introduction in 1963 to 1998, just before the infamous Andrew Wakefield publication that falsely linked the MMR (measles, mumps, and rubella) vaccination to autism.

The study, which appears in the Canadian Medical Association Journal, shows the vaccine hesitancy phenomenon started well before the 1990s.

“The Wakefield article was a catalyst, not a cause in the decline of the support for MMR,” MacDougall said.

Politics were also at play. During that time, Medicare came into effect and provinces were left to look after their own plan for immunizations, including who would administer them and when. That inconsistency prompts periodic calls for a national immunization schedule and registry.

Immunizations have advanced incredibly, but doctors may not be getting the training needed for them to communicate effectively with parents and allay concerns — or quite simply may not have the time.

Misinformation on the internet can also influence a parent’s decision, along with personal stories of vaccine reactions.

“The challenge is combating that,” MacDougall said.

Ultimately, it is fundamentally based on trust — trust that vaccines are safe and they work.

“There are all these concerns. That’s why it’s so important to understand the social and cultural context.”