Читать книгу Infants and Children in Context - Tara L. Kuther - Страница 208

In 2000, the highly contagious infection measles was declared eliminated from the United States. Yet as of May 2019, 880 cases have been reported, linked to individuals who have not been vaccinated for the disease. Some parents decline or delay vaccinating their children or follow alternative immunization schedules because of medical, religious, philosophical, or socioeconomic reasons (Ventola, 2016). This has caused a resurgence of many infectious diseases.

Vaccination is compulsory for school-age children in the United States, but all states permit exemptions. Currently, exemptions due to medical reasons are allowed in all states, religious grounds in nearly all states, and philosophical objections in 20 states (Bednarczyk, King, Lahijani, & Omer, 2019; Wang, Clymer, Davis-Hayes, & Buttenheim, 2014). It has been estimated that 1% to 3% of children are excused from immunization because of these exemptions, but in some communities the exemption rate is as high as 20% (Ventola, 2016). Even when a low percentage of children are excused from immunization, the risk of disease outbreaks in schools increases.

Vaccines protect children and communities from diseases that once spread quickly and killed thousands of people.

©iStockphoto.com/spukkato

Some researchers argue that, paradoxically, one reason that parents may hesitate to vaccinate their children is the widespread success of immunization (Temoka, 2013). Because of high vaccination rates, most vaccine-preventable diseases have declined to historically low levels in the United States, which can mask the health dangers of once-common infections. With little to no experience with vaccine-preventable diseases, young parents may be unaware of the threat these diseases pose or the need to seek protection.

Another reason is that many families in the United States do not have access to the health care they need. Children in families with incomes below the poverty level are less likely to receive the combined series vaccination (Child Trends, 2015). Many parents are unaware that children from low-income families who do not have medical insurance can receive vaccinations through the federal Vaccines for Children program, begun in 1994.

Some parents choose not to vaccinate their children because of the common misconception that vaccines are linked with autism (Salmon, Dudley, Glanz, & Omer, 2015). Extensive research indicates that there is no association between vaccination and autism (Modabbernia, Velthorst, & Reichenberg, 2017; Taylor, Swerdfeger, & Eslick, 2014). Instead, children tend to receive vaccines at the age when some chronic illnesses and developmental disorders—such as autism—tend to emerge, but this correlation is not indicative of a cause-and-effect relationship. (Recall from Chapter 1 that correlational research documents phenomena that occur together but cannot demonstrate causation.) As we discuss later in this chapter, although specific causes of autism spectrum disorders have yet to be fully identified, these disorders appear to have a strong genetic component (Lee & McGrath, 2015; Waltes et al., 2014). Other parents report concerns about chemicals in vaccines and possible unforeseen future effects of vaccination (Martin & Petrie, 2017). Yet longitudinal research has suggested no negative long-term effects of vaccines administered in infancy (Henry et al., 2018; Su et al., 2017; Wessel, 2017).

A challenge to immunizing children is that the vaccination schedule is complicated, with specific vaccines administered at specific times in development (Kurosky, Davis, & Krishnarajah, 2017). Even when children receive the full schedule of vaccinations, many do not receive them on the timetable recommended by the National Vaccine Advisory Committee. Vaccine timeliness is important because the efficacy of early and late vaccination is not always known and may vary by disease. When a child receives a vaccination may be just as important as whether the child receives it in promoting disease resistance.