why do people choose not to vaccinate
A third, and potentially the greatest, reason parents express for refusing vaccinations for their children are concerns about the safety of vaccines. Most of these concerns are based on information these parents have discovered in the media or received from acquaintances. Regardless of whether the stories stem from television, the Internet, radio, or from family and friends, parents are constantly bombarded with other peoples' opinions about vaccinations. ,
All of this information can be overwhelming for some parents to sift through, making it difficult for them to make their own well-informed decision. , Many of the reports and opinions that bombard parents and cause uncertainty are targeted at the safety of vaccines. They raise doubts about both short-term adverse reactions and the possibility of long-lasting negative effects. , It is these concerns about safety that can cause parents to completely refuse vaccines. found that the most commonly reported reason parents had for refusing one or more vaccines was other people or media reports. Stories in the popular media, such as social media and large-scale news outlets, are often sensationalized to elicit higher ratings and oftentimes spotlight a rare incident in which a child suffers as a result of an unforeseen side effect of a vaccine. Media that cite problems with components of vaccines (such as thimerosal) and report that vaccines can cause autism, brain damage, or behavioral problems cause parents to be more cautious and have more concerns regarding the safety of vaccines. , Thimerosal, however, has been removed from those vaccines intended for children under 6 years of age for over a decade now.
Accounts noting these rare occurrences breed fear in the hearts and minds of parents, who overestimate the dangers associated with vaccinations. Some fearful parents balk at the timing of immunizations. Fear can influence some parents to choose to delay vaccines so their child does not receive more than one vaccine at a time. They fear that simultaneously administering multiple vaccines may overload their child's immune system, and they think that allowing all of the vaccinations to occur according to the recommended schedule will make the safety risk greater. As a result of this logic, many choose to delay vaccines in order to better protect their children. , While some may view this as a missed opportunity, others believe that a delayed vaccination schedule is superior to not receiving vaccinations at all. Many parents believe the side effects of vaccines are more extensive than what they are told by their physicians and that the risks outweigh the benefits of vaccinating their children. , Healthy relationships between a practitioner and parent can go a long way toward helping patients in terms of this concern. Trust is paramount and will help put parents at ease and help them overcome unmerited fears. The National Health Performance AuthorityБs released this morning shows immunisation rates have slightly increased in 2011-2012.
But there are still some areas where coverage is below the national target. The good news is that Australia has one of the highest vaccination rates in the world with over 90% of children fully immunised by age five. But there are areas where only 80% of five-year-olds are protected against preventable contagious disease. So why are some children not immunised? There are on timely uptake of routine childhood vaccines Б access and acceptance. is partly a structural problem, linked to barriers such as a lack of transport, limited clinic opening times, home-boundedness and, beyond that, to poverty and social exclusion. Generally speaking, we can address access problems by minimising these barriers. But because access issues stem from social determinants of health such as location, education level, income and opportunity, theyБre necessarily БstickyБ problems. They canБt be changed quickly or easily but once they are, the change can be maintained. and experience indicate that about half of under-immunisation in Australia is due to lack of access. The other factor impacting vaccine uptake is. This is the psychological orientation to vaccines influencing uptake; itБs about attitudes, beliefs and concerns regarding vaccines, parenting, medicine generally, and a host of related matters. An individualБs vaccine acceptance is the result of a certain composition of these, like a metaphorical DNA. Vaccine acceptance can be dynamic, shifting in response to new information.
Unlike vaccine uptake, which is an either-or behaviour, it covers a continuum from total acceptance to complete vaccine rejection. Interestingly, acceptance can erode with no visible change in behaviour until a tipping point at which a parent will begin to delay or refuse some or all vaccines. The public tends to hear a lot more about acceptance factors than they do about access. ItБs an easy for mass media to pit vaccination opponents against proponents, and parade examples of non-vaccinating parents. It excites emotion, leading to high click rates in online articles and crowded comments pages. Nevertheless, the attention given to such parents is out of proportion to their actual numbers, and the likelihood of changing their minds. Vaccine refusers are a very small proportion in Australia Б about 2% of parents make a values-based choice to forego all vaccines for their children. A more interesting group is the 12% of parents who are at least somewhat supportive of vaccination, but fear both vaccination and non-vaccination could have negative outcomes for their child. About half of that 12% vaccinate fully, and the other half may delay or avoid certain vaccines but will have others. This БhesitantБ group should be differentiated from vaccine refusers, and efforts to increase vaccine acceptance should. Remember that these people already have the motivation to vaccinate, and theyБre a much larger group than non-vaccinators.
Any action taken at the community level starts with acknowledging that parents want the best for their children regardless of their access to and acceptance of vaccines. When otherwise well-intentioned messages criticise what these parents view as healthy skepticism, the result can be a further distancing from timely uptake. There are three broad strategies for increasing vaccination rates. Improve access to vaccines for those who need it, address the concerns of hesitant parents, and help non-vaccinators see immunisation as a safe and effective way of protecting their childrenБs health. But these broad strategies need to be fleshed out with detail. For that, we need to address other questions, such as how to determine whether low coverage is due to low access, hesitancy, or refusal. Also, what specific concerns and values give rise to hesitancy and refusal, and which of these values are most amenable to change. A strong understanding of the causes of under-immunisation will help us formulate effective responses to it. A strong understanding will also improve the quality of the national conversation about vaccination, helping us move beyond assumptions and reactions to a more thoughtful engagement with issues and barriers. Ultimately, a better understanding of why people accept or refuse vaccines will help bolster vaccine coverage rates, protecting the health of all Australians.
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