April 9, 2018
A legacy of social and political factors rather than bad parenting may be influencing people's decisions not to vaccinate their children, according to a new study.
The study, which appears in the Canadian Medical Association Journal, shows that a history of drug scandals, medical training practices, and a lack of political priority placed on disease prevention that started in the 1960s could be responsible for the immunization apathy, also known as vaccine hesitancy, we're seeing today.
"It's not all about the parents, said Heather MacDougall, history professor at Waterloo and co-author of the study. "History reveals systemic problems including lack of public education, lack of access, lack of training, and, perhaps most importantly, lack of political will for a national immunization schedule."
MacDougall and co-author Laurence Monnais of Université de Montréal, trace and analyze the contested adoption of the measles vaccine over three decades up to 1998, just before the infamous Andrew Wakefield publication that falsely linked the MMR vaccination to autism.
Their study shows that the vaccine hesitancy phenomenon started well before the 1990s and offers insight on the forces at play behind current instances of vaccine hesitancy.
The historians documented trends since the 1960s, such as the thalidomide disaster of 1962, and the emergence of new styles of parenting, second-wave feminism, and the popularization of alternative medicine.
Measles outbreaks in the 1970s and 1980s corresponded with a shift to individual rather than collective responsibility for personal health and health promotion, according to the study. By the 1990s, the national and international focus on children's rights and child health made young parents more willing to question whether their child would benefit from vaccination.
"Lack of sustained training in the rapidly changing science of immunology left Canadian health care practitioners with limited knowledge to provide guidance when asked to explain the benefits of vaccination to anxious parents," said MacDougall.
The division of federal, provincial, and territorial powers over healthcare have created a systemic disadvantage for the consensus needed to develop a consistent national immunization program.
"By publishing our research, the Canadian Medical Association Journal confirms the relevance of humanities disciplines such as history to help us understand social phenomena such as vaccine hesitancy in the face disease outbreaks," said MacDougall.
- Heather MacDougall, Laurence Monnais. Vaccinating in the age of apathy: measles vaccination in Canada, 1963–1998. Canadian Medical Association Journal, 2018; 190 (13): E399 DOI: 10.1503/cmaj.171238