Rules Make Vaccine Exemptions for Kids Harder to Get

[Buster's Uncle]

Rules Make Vaccine Exemptions for Kids Harder to Get
LiveScience.com
By Rachael Rettner, Senior Writer  22 hours ago



In recent years, several states have passed bills that make it harder for children to gain exemptions from getting the vaccinations schools usually require, and ethicists say this trend is a good one.

Between 2009 and 2012, there were 36 bills addressing the issue of exemptions to school immunization mandates introduced in 18 states, according to a new study.

Although most of these bills (86 percent) sought to make exemptions easier to obtain — for example, by allowing parents to cite their personal beliefs as a reason for vaccine exemption —  none of these bills passed, according to the study.

On the other hand, five bills were introduced that sought to make exemptions harder to obtain — for example, by requiring a doctor's signature for children seeking an exemption. Three of these bills passed in Washington, California and Vermont, the study found.

"Exemptions to school immunization requirements continue to be an issue for discussion and debate in many state legislatures," the researchers, from Emory University's School of Public Health, wrote in the Feb. 12 issue of the Journal of the American Medical Association.

"The trend has been towards enacting legislation to make exemptions harder," said Arthur Caplan, a bioethicist at New York University School of Medicine's Division of Medical Ethics, who has previously studied this topic but was not involved in the new study. Caplan called the trend positive.

"I think making exemptions available, but tough [to obtain], is the right stance for society to take," Caplan said.

Exemptions to vaccination should not be easy to get, because unvaccinated childrenrun the risk of not only getting an infection, but also transmitting infections to other children, who may be more vulnerable to the effects of the disease, Caplan said.

"It's not about what's just good for my child. It's about what's good for the neighbor's child who might have a high risk for disease," Caplan said. "The stakes are high," he said.

In a previous study, Caplan and colleagues found that the easier exemptions were to obtain, the more often people took them.

Methods of making exemptions harder to get include requiring parents to receive education on the benefits of vaccines before signing an exemption, or requiring children who don't get the necessary shots to stay home during disease outbreaks.

It's not a surprise that, as states passed laws to toughen up exemptions, opponents have proposed other bills to overturn these restrictions. But the latter bills haven't been succeeding recently, Caplan said.


http://news.yahoo.com/rules-vaccine-exemptions-kids-harder-210931193.html

[Buster's Uncle]

How Peer Pressure Explains Vaccination Rates
LiveScience.com
By Stephanie Pappas, Senior Writer  19 hours ago



The nurse in this 2006 photograph was in the process of administering an intramuscular vaccination in the left shoulder muscle of a young girl. The nurse was pinching the overlying shoulder skin, in order to immobilize the injection site.



In a purely rational world, vaccination rates would vacillate constantly depending on how much people fear getting sick.

That's what attempts to model vaccination rates mathematically have found. But now, scientists have added in the missing puzzle piece that explains why vaccination rates stay high in the real world — or, in some cases, low. The reason, it turns out, is peer pressure.

Public health officials frequently worry about low levels of childhood vaccination, often driven by debunked concerns that vaccines are linked with autism. But in many nations without mandatory vaccination rules, rates of childhood vaccination remain surprisingly high, said Tamer Oraby, a mathematician at the University of Guelph in Ontario, Canada. [5 Dangerous Vaccination Myths]

"The question we wanted to answer is, 'Why are we seeing such high vaccination levels in nonmandatory vaccination programs?'" Oraby told Live Science.


Vaccine decisions

Mathematical models had predicted that as vaccination eliminates the day-to-day occurrence of measles, mumps, rubella, whooping cough (pertussis) and other childhood diseases, parents would opt out of vaccinating their kids due to a perception that the risk of catching a disease is low. Yet in countries such as Italy, the United Kingdom, Portugal and Finland, vaccination rates remain high enough to keep these diseases down, despite no mandatory vaccination laws, Oraby and his colleagues wrote today (Feb. 11) in the journal Proceedings of the Royal Society B.

Drawing on research from public health and sociology, the researchers suspected that social pressures might explain relatively high and steady vaccination rates. They created a mathematical model in which virtual "individuals" could choose to vaccinate their children or not. These individuals constantly surveyed the rest of the actors in the model, and when they saw one making a choice with a greater survival payoff — for instance, vaccinating versus not — they swapped to the more advantageous strategy.

Then, the researchers added another factor: The more people chose a strategy, the greater the benefit of that strategy. This addition to the model mimicked peer pressure, in which people benefit from fitting in with their social group.


Peer-to-peer pressure

The resulting model fit real-world observations of vaccination choices, Oraby and his colleagues found. Social norms can keep vaccination rates high even in the absence of obvious disease risk.

But peer pressure is a double-edged sword, Oraby said. After a vaccine "scare," in which people become convinced that vaccines carry a major risk (such as autism), social norms keep vaccination rates depressed long after the scare ends, the model showed. This fits with observations seen in the United Kingdom in the 1970s, when an unsubstantiated scare over the side effects of the whooping-cough vaccine, Oraby said. The scare led to a drop in vaccination that created two whooping-cough outbreaks, each of which affected 400,000 children, according to U.K. health information site Patient.co.uk. 

Fears of autism, driven by a fraudulent 1998 study linking the MMR (measles, mumps and rubella) vaccine to the disorder, have pushed MMR vaccination rates below the ideal 90 percent in 15 U.S. states, according to the Centers for Disease Control and Prevention.

"In short, it's because people underestimate the risk of the disease and overestimate the risk of the vaccination," Oraby said.

In the future, Oraby and his colleagues plan to look at what happens when the social pressure not to vaccinate outweighs the pressure to vaccinate, and vice versa. The findings suggest, however, that top-down messages from doctors and public health officials urging people to vaccinate their children may not be enough to keep childhood diseases at bay.

"The message here might be that we need to encourage people to vaccinate in our social networks," Oraby said. "Showing the actual risks of both vaccination and nonvaccination can raise the vaccine acceptance rate."


http://news.yahoo.com/peer-pressure-explains-vaccination-rates-000518944.html