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
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.
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
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.