Chicken Pox Vaccination Controversy - Essay Example

Running Head: CHICKEN –POX VACCINATION Chicken –pox Vaccination Controversy Introduction. Despite the fact that vaccinations have largely been proven to be safe and effective, there are still a large number of parents who opt not to vaccinate their children. There are a number of reasons why this choice is made. There have been a few cases where parents actually have neglected to vaccinate their children simply from lack of paying attention to when vaccinations were due or thinking that the children had already been vaccinated. For some other parents there have been socioeconomic reasons such as low income or multiple children and therefore not being able to afford the medical costs. However there are parents who consciously choose not to vaccinate and this can be either because of their own religious beliefs, beliefs in alternative medical treatments or beliefs that vaccinations can actually harm their children. Earlier there have been numerous reports and studies insinuating that vaccinations are harmful to children and this caused fear which have been difficult to overcome. The varicella vaccine was approved in 1995 by the US Food and Drug Administration. Soon after, there were also some negative reports of its use. Investigation is needed to satisfy parents that this vaccine is also safe. Purpose of the paper. The purpose of this paper is to examine the issue of whether it should be mandatory for parents to vaccinate their children against life-threatening diseases such as chicken-pox. The paper seeks to analyze the data provided about the chicken-pox vaccination and its effectiveness. The possible dangers or negative effects of vaccinating children against chicken-pox will also be considered. In order for the government to mandate that parents vaccinate their children against chicken-pox and other life-threatening diseases they must present valid and reliable information to the parents. This information must be accessible to the parents physically, i.e. they must be able to easily locate it. Additionally it must also be accessible intellectually, i.e. it must be written in a way that the average parent can read and understand it in order for them to make an informed decision. The reported attitudes and reactions of parents to vaccination will be examined. This will help to understand better what will be necessary if the government had to convince parents to vaccinate their children. This paper will therefore look at the literature that has been presented for and against a possible debate about whether parents should be forced to vaccinate their children. Literature review Concern about vaccines is not new. According to Downs et al (2008), parents in Britain got the right to decline vaccination as a result of protests against the small pox vaccination in England and the polio vaccination in US. Parents were fearful because of the research studies in those times which failed to convince of the safety of the measles, mumps and rubella vaccine. Despite subsequent studies that have disproved the earlier studies some fears remain. Shapiro and LaRussa (1997) explained some of the reasons for the controversy about the varicella vaccine. The efficaciousness of the vaccine and the length of time the protection would last were of concern. The question was also asked about whether people who were vaccinated would be at greater risk of more severe zoster than people who acquired varicella naturally. And thirdly the cost of the vaccine was of concern. Because of these concerns at that time the authors report that only 20% of 2-year old children had been vaccinated. They state however, that “ all the information collected to date in both Japan and the United States suggests that vaccine-induced immunity persists (at least for as long as we have been able to evaluate it, approximately 20 years)”. The advantage therefore of vaccinating children against chicken-pox is that it can protect them even if they are exposed to the virus in adulthood. Since it is not possible to predict when someone can be exposed to the virus some people feel that prevention is better than cure. The extent of the disease must be taken into consideration. Katz-Sidlow and Sidlow (2003) reported an estimated four million cases of chicken-pox in the US each year, ten thousand hospitalizations and one hundred deaths. The authors tested the anecdotal evidence that even pediatricians were refusing to vaccinate their own children. They sent out 1,762 surveys and got a 43% response rate. Their results showed that 85% of the respondents were following guidelines and recommending vaccination for healthy children. The result was the same for the pediatricians who were themselves parents and those who had no children. The pediatricians who did not vaccinate their own children made that choice either because they were not confident of the length of time the vaccination offers protection or because they thought the disease was benign. Thirty percent of those expressed concerns about the safety of the vaccine. A similar survey was carried out in Australia but General Practitioners were in the sample (Milledge et al, 2003). Two hundred and thirty nine GPs received questionnaires which asked about their practice with the varicella vaccine and their attitudes to the vaccine. Sixty seven percent of the one hundred and sixty responses agreed that varicella should be part of the immunization schedule. The same concerns about the length of protection and possible side-effects were expressed. The cost was another factor. Even though there were concerns about the development of herpes zoster (shingles) in later life, this did not however negatively affect the recommendation. The authors point out that their results differed from yet another similar study that was carried out in 1998 in the US where only forty four percent of the respondents recommended universal vaccination. They attempt to dispel the fears and concerns when they also point out that “At present, the evidence based on 20 years experience with the vaccine indicates that vaccine-induced immunity persists and that vacinees are less likely to develop zoster than are age-matched controls who had natural immunity”. There had been some cases of outbreak of varicella especially at childhood centers a few years after the vaccine was licensed. One study in Los Angeles attempted to determine whether in fact there was cause for alarm. Two child care centers reported varicella outbreaks. Buchholz et al (1999) analyzed the figures for the number of children who had been vaccinated and those who had not and the severity of the diseases among the children. Their findings showed that there was a 71% effectiveness in one center and a 100% effectiveness in the other. This 71% effectiveness they say is still within the predicted range for the vaccine, which is 70-90%. A thorough analysis of all the available literature must be conducted. Rationale It may seem like an endless debate about the usefulness of vaccines. The vast amount of literature available on the topic and the variation in the types of research studies and the results presented inclines one to think that there may be no single or simple answer to the debate. However, in a matter as important as this which is directly related to the health of children, it is obvious that research must continue. Medical personnel must continue to investigate every avenue of this until they can provide definite conclusions. Even though some people think that the disease is benign and so there is a possibility that many children may never be exposed to it, on the contrary the amount of cases per year in the US alone indicate the seriousness of the virus. The side effects of the vaccine must be investigated and eliminated if possible. The development of the herpes zoster has been mentioned in several of the articles on the vaccine. This needs attention. More research must be done on parents’ attitudes and feelings about the vaccine in order for the government to make good decisions about making it compulsory; decisions that parents could cope with. Reflection The earlier controversy about vaccinations in general and the MMR (measles, mumps and rubella) vaccination has made it difficult for some parents to accept that vaccines could be good things. Although some people propose that chicken-pox is a benign childhood disease and so there is no need to vaccinate as a prevention measure, the statistics of the extent of the disease must be taken into consideration. The number of deaths and hospitalizations reported do point to the fact that some measures must be taken to avoid that. It is understandable that some parents may not be able to make the link between vaccination in childhood and the development of the disease in adulthood. It is difficult to carry out research that is long- term enough for parents to be convinced of the length of time that the vaccination will protect the child for. There needs to be more convincing evidence for parents to accept that vaccination is compulsory. The fact that the disease is benign is another barrier to accepting that vaccination may be compulsory. Although the figures for the occurrence of chicken-pox in children are so high, it is not easy for a parent to connect that with her own child. And it is not uncommon for a parent to think that their child will be naturally immune. On the other hand there are also parents who think that it is not a life-threatening disease and so there is no urgency to vaccinate; that even if the child contracts chicken-pox they will get through it. The cost of the vaccine also adds to this. Finally, reliable and valid information is important. As Downs et al (2008) mentioned investigative journalism must be discreet and reliable, as they cited essays printed in consumer magazines which contained accusations about the MMR vaccine that spread easily on the internet. References Buchholz, U, Moolenaar, R., and Peterson, C. (1999). Varicella outbreak after licensure-should they make you chicken. Pediatrics 104 (3), 561-563 Downs, J.S., de Bruin, W.B. and Fischhoff, B. (2008). Parents’ vaccination comprehension and decisions. Vaccine 26, 1595—1607 Katz-Sidlow, R.J and Sidlow, S. (2003). A Look at the Pediatrician as Parent: Experiences with the Introduction of Varicella Vaccine. Clinical Pediatrics 42, 635-640 Milledge, J.T., Cooper, C.D. and Woolfenden, S.R. (2003). Barriers to immunization: Attitudes of general practitioners to varicella, the disease and its vaccine. J. Paediatr. Child Health. 39, 368–371 Shapiro, E. D., LaRussa, P S. (1997). Vaccination for Varicella-Just Do It! JAMA. 278 (18), 1529-1531, Read More