Top immunization myths: Educating your patients

syringe and bottlesIntroduction

Immunization remains one of the most successful methods for the control and eradication of infectious disease all over the world. It is because of immunization that we have eliminated smallpox and are close to eliminating polio. Many deadly diseases, like measles, tetanus and diphtheria, are now killing far fewer children than before their vaccines were available. However, despite the vast success of these vaccines, the number of patients and parents with hesitations about vaccination are increasing continuously. There can be several reasons for this increased opposition to vaccination. It can be due to the safety or efficacy of the vaccine, due to religious hindrance, or possibly due to a false belief about the disease. Many times, lists of mandatory vaccines by the government can also produce hindrance for some vaccines.

Key Point: There is a need to produce strong evidence from time to time regarding various available vaccinations to avoid any myth associated with vaccination. It is very important to update our health professionals with accurate information to respond appropriately to various concerns associated with immunization. Finally, researchers need to provide consistent data on the safety and efficacy of the immunization and interpret adverse data with caution.

Myths associated with vaccination: There are several reasons for the development of myths regarding vaccination in the population. Most of the time, myths develop around the need, safety, and effectiveness of the vaccines. Most of these myths have started in the Western world, where many vaccine-preventable diseases are almost extinct, but many literate and well-educated Indian parents are now raising some of these questions as well. In that sense, vaccines are partly victims of their own successes in combating serious life-threatening infections in children.
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Some of the commonly associated myths are as follows:

  1. MMR vaccine associated with autism: In 1998, a study by British doctor, Andrew Wakefield, raised concerns about a possible link between the measles-mumps-rubella (MMR) vaccine and autism. This study was later found to be seriously flawed. Further scientific research conducted in recent years confirm the lack of any relationship between the MMR vaccine and autism (1).
  2. Immunity through disease: Some parents are unaware of the dangers associated with diseases that can be prevented by vaccines, and they think that child will develop natural immunity by contracting the disease itself (2). However, there are some diseases, like Hib (Haemophilus influenzae type B), rubella, measles, Hepatitis B, and polio, which can lead to permanent deformity, and can even cause death. In addition, many bacterial diseases, like Typhoid, can reoccur and do not lead to any long-term immunity.
  3. Presence of certain ingredients in vaccines: There seems to be a concern regarding the presence of mercury as a preservative, in the form of thiomersal, in vaccines. None of the scientific studies have ever demonstrated any significant risk of using thiomersal in vaccines.
  4. Concern about multiple vaccines at the same time: Parents commonly think that multiple vaccines at a time can increase the chances of an adverse drug reaction. The immune system of a child can handle (and does handle) hundreds of antigens on a daily basis. A few extra antigens with multiple vaccines do not lead to any overloading.
  5. Assumption that influenza is not a big problem: Thousands of people die every year as a result of contracting the flu. This means that, for high-risk people, taking yearly boosters is recommended.
  6. Infectious disease can’t be prevented: This is not true, as we can see with the eradication of small pox and the virtual eradication of polio.
  7. Vaccinations are not necessary for diseases already eradicated in my country: In the USA, where many infectious diseases are uncommon, there have been new epidemics of many vaccine-preventable diseases like whooping cough and even measles because of lowered vaccination rates.
  8. The belief that the polio vaccine can lead to sudden infant death syndrome, and the DPT vaccine can lead to whooping cough: Again, this and many similar allegations of autoimmune disease, multiple sclerosis, etc. developing as a result of being vaccinated have shown to be utterly false in large-scale scientific studies (3).
  9. Vaccines can cause long-term serious illness and many side effects: While it is true that almost all vaccines are, to some extent, associated with serious side effects, these are extremely rare. The cost-benefit ratio is hugely in favor of giving the vaccine rather than suffering from the fatal diseases they are designed to prevent.
  10. Vaccine-preventable diseases can be eliminated with better hygiene: Again, it has been shown that, while clean water and sanitation are the number one preventer of many infectious illnesses, vaccinations are still number two in preventing deaths and illnesses, especially in children.

Special Situations

Religious hurdles toward vaccination

The immunization program against polio in Pakistan and Afghanistan is failing due to the religious hurdles from Muslim fundamentalists (4). Because of this obstacle, polio is still endemic to these parts of the world.

Myths about the adverse event following immunization

Patients and parents focus on the adverse event following immunization (AEFI) increase due to increased awareness among population, and decreased disease incidence. Vaccines have often been wrongly correlated with certain events that can be the result of any number of factors. There is a need for providing strong evidence regarding the safety and efficacy of vaccines to avoid any misconceptions regarding vaccination (3).

What vaccine providers need to do

Vaccine providers are responsible for listening carefully to all parents’ and patients’ concerns regarding the vaccine and addressing them with full dedication. In order to do this, practitioners should keep themselves updated on all the benefits and risks for particular immunizations. They are regarded as the most credible and trustworthy source for that kind of advice. That being said, their advice could stop the spreading of false misconceptions regarding particular vaccinations.

How education can be helpful in dealing with myths

Education of the vaccine recipient and recipient’s caregivers is the most important tool in avoiding the spread of any misconception regarding the vaccination. If they know the importance of the vaccine, then they are bound to be more confident in receiving the vaccination. This can be done with the help of educational aids, family physicians’ advice, or by other locally recognizable healthcare personnel.

What the government can do about this

Government decisions regarding the inclusion of any vaccine into the national immunization program can improve the people’s trust in a particular vaccine. Lists of mandatory vaccinations provided by the government are an important factor in vaccine uptake. Considering the vaccines included in this list, many Indian parents assume that other vaccines not listed are not likely to be helpful and consider these “optional”. On the other hand, when there is strong backing by the government, vaccine programs generally work well. Successful polio eradication in India is a shining example of this.

Gaurav Gupta, MD Dr. Gaurav Gupta is currently the pediatrics consultant at Charak Child Care in Mohali, India and is also the CEO of TravelSafe Clinic (www.travelsafeclinic.com). He is a member of the American Academy of Pediatrics (AAP) and the Indian Academy of Pediatrics (IAP), with extensive publications and presentations in national and international journals & conferences.

References (click to show/hide)

  1. Battistella M, Carlino C, Dugo V, Ponzo P, Franco E. [Vaccines and autism: a myth to debunk?]. Ig Sanita Pubbl. 2013;69(5):585-96.
  2. Martinez-Diz S, Martinez Romero M, Fernandez-Prada M, Cruz Piqueras M, Molina Ruano R, Fernandez Sierra MA. [Demands and expectations of parents who refuse vaccinations and perspective of health professional on the refusal to vaccinate.]. An Pediatr. 2013;15(13):00377-9.
  3. Rumke HC, Visser HK. [Childhood vaccinations anno 2004. II. The real and presumed side effects of vaccination]. Ned Tijdschr Geneeskd. 2004;148(8):364-71.
  4. Ahmad K. Pakistan struggles to eradicate polio. Lancet Infect Dis. 2007;7(4):247.


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This entry was posted in Infectious Disease and tagged , , . Volume: .

One Comment

  1. Maremanda Jaya Rao
    Posted Feb 2014 at 9:37 am | Permalink

    JAI SUNDARAM
    Dear Editor,
    Thanks for the informative and useful write up.
    My experience of being The Project Director of a Rural Health Centre,
    in Medchal AP where we had almost ABOUT 90% OF THE POPULATION.
    The Tribal Mothers do question
    a) Why are you giving something to my child who is fully fit?
    b) What will be the side effects and
    c) Who will be responsible for any adverse effects?
    I was incharge of the project from Aug 1994 to Aug 1999.
    Convincing them is a herculean task.
    Why I write this is that the maximum concentration should be on far flung tribals
    and in the Jughi Jompdi colonies.As I left the orginisation about 15 yrs back
    I really do not know what the present day situation is.
    GOD BLESS US ALL
    Veteran Brig(Dr)Maremanda Jaya Rao

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