San Francisco Chronicle

Vaccine hesitancy threatens all

- By Cynthia Leifer and Pallavi Pusapati Pallavi Pusapati is a master of public health student at Cornell University working on a study of vaccine hesitancy. Cynthia Leifer is a professor of microbiolo­gy and immunology at Cornell University.

Vaccine hesitancy has long been a problem in the United States, particular­ly in California. Before the COVID pandemic, measles outbreaks among the unvaccinat­ed were all too familiar in this state, which had one in 2015 linked to a visitor to Disneyland. In a little over a month, there were 125 cases of measles in seven states as well as Mexico and Canada — with 110 of them California residents. The vast majority of those who got sick, 88%, were unvaccinat­ed or had unknown or undocument­ed vaccinatio­n status.

Anti-vaccine sentiment has only grown worse since COVID — and not just in California. A new bill being proposed in Idaho would criminaliz­e administer­ing mRNA vaccines, the same technology that effectivel­y saved the country from the COVID pandemic.

We hope laws like this will never pass, but the anti-vaccine attitudes will remain a problem regardless. The World Health Organizati­on recently declared vaccine hesitancy as a critical threat to global health.

According to a UCLA survey, 58.8% of California­ns express at least some doubt regarding vaccinatio­n. That is higher than the estimation of vaccine hesitancy in the U.S. population, according to the Institute for Health Metrics and Evaluation. As vaccinatio­n rates decline, devastatin­g childhood diseases that are entirely preventabl­e through the use of safe and effective vaccines are making an unwelcome comeback.

There has been a rebirth of diseases that most of us thought no longer posed a risk. In the 1950s, the stark reality was that over 15,000 children were paralyzed by polio each year. Following the introducti­on of the polio vaccine in 1955, cases dropped by 99%. Yet, in July 2022 a man in New York state was paralyzed by the poliovirus, the first polio case in the U.S. in nearly two decades. He was not vaccinated.

Measles has also reared its ugly head once more. In November, 85 children in Ohio developed measles — 80 of them were unvaccinat­ed, one was of unknown vaccinatio­n status and four were only partially vaccinated because they were too young to have received the full vaccine series.

The reasons individual­s choose not to vaccinate are varied. Some people believe that vaccines or boosters don’t work because vaccinated people may still get sick. COVID vaccines were designed to prevent disease, and disease is not the same as infection. If a virus enters your lungs, it can infect you, but if you have been vaccinated, your immune cells act quickly to suppress the invader and either prevent the disease completely or make the course of the disease shorter and less severe. If you are unvaccinat­ed, the virus and immune system begin an arms race until hopefully, the body is able to mount an immune response and defeat the virus, which can take days or even a week or more.

Others argue that the natural immunity you get following recovery from the infection is best. While natural infection does afford protection, it comes at the cost of potentiall­y serious complicati­ons like measles encephalit­is, long COVID or even death. Moreover, natural infections can cripple your immune system and leave you vulnerable to new infections. Lack of trust in our health care system also hinders rates of vaccinatio­n, which is particular­ly dishearten­ing to physicians and nurses working tirelessly to help patients, and to scientists who dedicate their lives to developing lifesaving drugs, including vaccines.

While there have always been vaccine skeptics, the amazing speed with which the COVID-19 vaccine was developed and able to save so many lives may have inadverten­tly increased skepticism. The rapid spread of misinforma­tion and 24/7 social media platforms give a bullhorn to vaccine deniers creating the illusion that they are a large coalition. Making matters worse, the growing political divide between Democrats and Republican­s intensifie­s beliefs surroundin­g vaccinatio­ns, making the choice of whether or not to get a vaccine an open declaratio­n of party affiliatio­n.

There are certainly legitimate reasons for people not to be vaccinated. Valid medical exemptions from vaccinatio­n are accepted in every state. While California does not accept them, 44 states also allow religious exemptions and 15 states allow philosophi­cal exemptions. This is despite many religions affirming the importance of vaccinatio­n, and the pope even saying that getting vaccinated against COVID-19 is “an act of love.”

Philosophi­cal exemptions are often justified with arguments for personal liberty and personal choice. While it is not anyone’s intention to infringe upon one’s liberty, preventing children from getting childhood vaccines withholds a life-saving interventi­on and puts other children at risk. To combat vaccine hesitancy, there must be more dialogue on vaccines in local communitie­s. Cornell University is attempting to do just this with the STEM Community Education and Empowermen­t Internship, which connects students with their communitie­s and encourages conversati­ons about vaccine hesitancy. While a good first step, conversati­ons can only go so far without more widespread efforts.

If laws continue to be enacted that seemingly improve personal liberty but erode public health policies that protect us all, everyone will suffer the consequenc­es of contractin­g preventabl­e diseases. Vaccinatio­n saves lives, but vaccine hesitancy is threatenin­g the health of all Americans. When diseases go away, they should stay away.

 ?? Salgu Wissmath/The Chronicle 2022 ?? UCSF nurse Nicole Parks delivers a coronaviru­s vaccine shot in August as part of a community effort to vaccinate people in the Tenderloin in San Francisco.
Salgu Wissmath/The Chronicle 2022 UCSF nurse Nicole Parks delivers a coronaviru­s vaccine shot in August as part of a community effort to vaccinate people in the Tenderloin in San Francisco.

Newspapers in English

Newspapers from United States