Prevent Disease | 2 Feb 2011
More educated parents are less likely to vaccinate, which contradicts the misconceptions of many health professionals who profess that parents don’t vaccinate because they are under-educated, poor or misinformed.
One publication of medical research linking the MMR vaccine to autism in The Lancet in February 1998 sparked a decade-long controversy about the triple jab. Following the initial publication, the uptake rate of the MMR vaccine dropped from 92% in 1997/98 to 80% in 2003/04.
A report examines how the response to the MMR controversy varied between parents with different levels of education. It revealed that:
- Before 1998, highly educated parents were up to 8% more likely to take up the MMR vaccine than parents with lower education.
- By 2002, this gap had not only closed; it had actually been reversed, with highly educated parents being 2-3% less likely to accept the MMR vaccine.
- Most of the relative decline in the MMR uptake by highly educated parents occurred soon after the controversy broke when the media coverage was still relatively low.
- After the increased media attention in 2001 and 2002, there were no discernible differences in trends across educational groups.
- The controversy also appears to have had effects on the uptake of other childhood vaccines: after 1998, highly educated parents also reduced their relative uptake of other non-controversial childhood vaccines.
The relative decline in uptake by highly educated parents also potentially has wider significance. Generally speaking, individuals with more education have better health. This is possibly because they are better informed about how to achieve better health outcomes. The finding that highly educated parents were the first to react to the information that the MMR had potential side effects is consistent with this hypothesis.
More encouraging for anti-vaccine advocates is the finding that highly educated parents also reduced their uptake of other non-controversial childhood vaccines, a good sign that most of the hidden toxins in vaccines are slowly being discovered by parents and the public in general.
Another finding published in the journal PLoS Medicine, showed that parents with more education were less likely to let their daughters get HPV shots. It also adds to a growing body of evidence that suggests vaccination efforts are being rightfully eroded not by people who are under-educated, but by upper-middle class folks with degrees.
“People are slowly empowering themselves by cross referencing reputable information in the alternative media and questioning the frequent pseudoscience of public health officials, academics or doctors which make up the bulk of vaccination misinformation.” said Naturopath, Dr. Dave Mihalovic.
“They’re used to making choices in their jobs and in their life, one. And two, they make those choices based on information. And the information that one gets here probably is primarily through places like the Internet, which is a source of both good and bad information about vaccines,” vaccine expert Dr. Paul Offit said when asked to comment on the study.
The study comes on the tail of another published Tuesday which showed that there has been a sharp increase in the percentage of U.S. parents who are refusing to vaccinate their children or delaying vaccination against the advice of the medical community.
That study, presented at an international conference in Vancouver, found 39 per cent of parents refused or delayed vaccinations for their children in 2008, up from 22 per cent in 2003.
Offit, who is chief of infectious diseases at the Children’s Hospital of Philadelphia, was not involved in either study.
The HPV study was conducted primarily by researchers at the British Columbia Centre for Disease Control and the University of British Columbia.
The group surveyed parents of Grade 6 girls who had been eligible to get HPV or human papillomavirus vaccine through a free, school-based program in B.C. in the 2008-09 school year.
Lead author Dr. Gina Ogilvie said lots of studies had explored whether parents intended to let their daughters get vaccinated, but the group wanted to follow up to see what drove parents’ decisions to grant or decline permission for their daughters to get the shot when it was available.
About half of the 4,000-plus randomly selected households agreed to take part. Just over 65 per cent of the daughters in those households had received the vaccine; 35 per cent of the parents had refused permission.
Parents were asked to describe the primary reason behind their decision and asked for secondary reasons as well.
Nearly half (47.9 per cent) of those who let their daughters get HPV shots said they did so because they had confidence in the effectiveness of the vaccine. Advice from a doctor and concern for the health of the daughter also played into yes decisions.
Among the parents who said no, concern about vaccine safety was listed as the major reason for the decision (29.2 per cent). A substantial portion — 15.6 per cent — felt their daughters were too young to get the vaccine and listed that as their major reason.
When the researchers compared the families that said yes and those that said no, interesting differences came to light.
Girls from two-parent households were less likely to have been given permission to get the shot. And parents with more education were more likely to have said no.
Ogilvie called it “the main surprise” of the study. “This is a flip from our traditional understanding,” she said.
A 2004 study by researchers from the U.S. Centers for Disease Control showed children ho hadn’t received any shots at all “tended to be white, to have a mother who was married and had a college degree, to live in a household with an annual income exceeding $75,000 and to have parents who expressed concerns regarding the safety of vaccines and indicated that medical doctors have little influence over vaccination decisions for their children,” said the study, published in the journal Pediatrics.
Offit said the trend is indeed a shift.
“The surprising part is that someone who would be better educated would be less likely to get the vaccine,” he said.
Another study in the journal The American Journal of Public Health, which surveyed 11,860 families, found that mothers who had not finished high school were 16% more likely to have completed the whole vaccination schedule for their children.
Lower education levels and socioecomonic status was associated with higher completion rates for vaccination.
Rates of compliance were also higher in Hispanic and black low income families.
“It’s a an excellent example of how more education and awareness translates to better health,” said Dr. Mihalovic.
Dr. Kronenfeld, a professor of sociology in the School of Social and Family Dynamics at Arizona State University, said
‘“There is a controversy among more educated mothers about the safety of certain kinds of immunization, That may be part of what is going on here, but we don’t know for sure.”
Vaccination rates for children insured by commercial plans dropped almost four percentage points between 2008 and 2009, even though the rate of children on Medicaid getting vaccinated is rising.
“Rates had been gradually improving in the commercial plans. This was the first time we’d seen a drop — and it was a pretty big drop,” said Sarah Thomas, vice president of public policy and communication for the National Committee for Quality Assurance, which recently released its annual State of Health Care Quality report.
Although vaccination rates last year were still mostly higher among children in private health plans rather than Medicaid, researchers and other experts suspect that a counterintuitive trend in American demographics is at work: Parents in a relatively high socio-economic bracket — with more education and relatively high incomes — forgoing vaccines because of fears about their safety, with poor individuals taking good advantage of their access to free or extremely low-cost care to have their children immunized.
“We didn’t really explore the reasons [for the trend], but one leading hypothesis is that parents have decided not to get their children vaccinated because of concerns about the potential for side effects and even autism,” said Thomas.
The authors found a drop in several routine childhood vaccinations. Measles, mumps and rubella (MMR) vaccines decreased from 93.5 percent in 2008 to 90.6 percent in 2009; diphtheria, tetanus and whooping cough rates fell from 87.2 percent to 85.4 percent in that one-year period; and the proportion of kids getting vaccinated for chickenpox fell from 92 percent in 2008 to 90.6 percent in 2009 (Source: US News Health, 3rd November 2010)
Parents are gradually waking up to the dangers of vaccines. Those who have a university education and a well paid job, are in a better position to research vaccinations and know their rights. Education is power and they and those most invested in health and research are most likely to avoid vaccinations at all costs, a trend that is welcome and timely for future generations.
Dave Mihalovic is a Naturopathic Doctor who specializes in vaccine research, cancer prevention and a natural approach to treatment.
February 2, 2011