Vaccine Apathy Extends Beyond Parental Resistance

Andrew Wakefield's now well debunked study that suggested  a link between autism and immunizations is often cited as a major contributor to vaccine hesitancy; but a new study reports immunization apathy existed decades before that infamous study was published.

Heather MacDougall, PhD, of the University of Waterloo in Ontario and Laurence Monnais, PhD, of the Université de Montréal, took a historical look at immunization apathy and the factors that may have contributed to vaccination rates in Canada in a new study appearing in the Canadian Medical Association Journal.

They discovered that vaccine apathy is an issue that is not exclusively linked to parents and was instead influenced by a mix of factors including accessibility, insufficient training of healthcare providers, politics, and societal influences.

"Before Wakefield there are a whole variety of factors that lead to questioning and concern," MacDougall, an associate professor in the Department of History, tells Drug Topics.

The study assessed the adoption of the measles vaccine from the time it was first introduced in 1963 to 1998 and closely examined parental attitudes, physician behaviors and practices, political movements, and other factors that contributed to the uptake of the vaccination.

"We have shown that it was not exclusive to parents and that it could be explained, at least in part, by issues of accessibility to efficient vaccines, poor training of health care providers, and an enduring lack of political will to implement a single vaccination schedule throughout Canada," the authors conclude, adding that the erosion of social trust in experts also contributed to the issue.

Wakefield's study was released in 1998, so this study looked at vaccination apathy before his retracted study was publicized.

MacDougall believes that understanding the past, and the factors that influenced behavior, can help healthcare professionals today understand the depth of complexity that contributes to vaccine hesitancy.

"What we really hope is that it will help people realize that . . . that there have always been questions and that it's honest communication between the parent and the healthcare provider that is essential," she says, adding that healthcare professionals today can't make assumptions about a parent's resistance and instead need to ask questions about a parent's motivations, attitudes, and background to overcome vaccine hesitancy.

Healthcare professionals can turn to resources provided by the WHO or other organizations for strategies to address vaccine hesitancy, but MacDougall said having a personal connection is also essential.

"The resources are there, but of course by their very nature they tend to be generic, and what concerned young parents want is someone to look them in the eye and answer the questions that they actually have," she said.