MMR, Autism, and How We Choose to Make Decisions About Healthcare

Location can cause variation in the factors that affect patients’ and caregivers’ treatment decisions. A survey of European parents with concerns about vaccines found that 88% of parents surveyed in England cited the MMR vaccine as the basis of their concerns versus 66% in Sweden, 57% in Norway, and 7% in Poland. England was the origin of the MMR vaccine and autism spectrum disorder controversy. This likely contributed to the greater proportion of English parents expressing concern about the MMR vaccine.

MMR uptake in the United States wasn’t affected by early media coverage of the MMR vaccine and autism spectrum disorder controversy.  There was a small decrease in MMR uptake immediately after this article linked previously was published. This occurred prior to any US media coverage. As a consequence, the decrease in uptake was likely due to provider influence. Predictably, most people are more likely to pay attention to events that occur near them.

This doesn’t mean that all vaccine uptake went completely unaffected during that same time period. American parents are required to submit proof of vaccination for their children prior to enrolling their children in public school. States started to offer non-medical exemptions to this requirement in the early 1990s. This study found that states granting non-medical exemptions for personal beliefs granted more exemptions than states that did not from 2001-2004. Both states that easily granted exemptions and states that granted personal belief exemptions displayed incidences of pertussis in children roughly 1.5 times greater than states that didn’t offer non-medical exemptions after correcting for education, urbanization, and income.

We know that parents from different backgrounds have different reasons for making treatment decisions for their children. Childhood vaccinations have become wildly controversial among a certain segment of the US public. Refusal of vaccinations can cause a rise in the incidence of vaccine-preventable diseases, so it’s important to address concerns as they occur. We stated in this post that it might not be beneficial to outright correct each and every misconception about vaccines, but parents in a geographic area may share reasons for opting their children out of childhood vaccinations. You may not only be able to anticipate objections to childhood vaccinations but figure out how to best address certain objections by paying attention to patterns in objections you receive.

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