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Protecting the Science Communication Environment: The Case of Childhood Vaccines

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... One of the elements that make up this internal wiring is 'cultural cognition' , which refers to how individuals care differently about things depending on their personal and group identity, and whether these beliefs conflict with those of others. 29,30 Social norms refer to the sense of what most people are doing, 18 whereas social proof encompasses observing what people similar to the individual are doing. 10,11 Identity and being part of a group are extremely important, 10,31 and leveraging tribal beliefs and pride is incredibly powerful. ...
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This article is based on a Learning Lounge educational session that took place on 22nd October 2022, as part of Infectious Diseases Society of America (IDSA) IDWeek™ 2022 held in Washington, D.C., USA. The objectives of the Learning Lounge were to enhance understanding of the principal reasons for patients’ vaccine hesitancy based on key sociocultural, behavioural, and psychological factors; identify the general communication ‘cues’ and specific psychosocial objections that signal a patient’s inclination to vaccine bias; and help healthcare professionals (HCP) learn how to address vaccine hesitancy based on patients’ cognitive and behavioural biases. The knowledge shared in this Learning Lounge can help guide and assist HCPs in recognising and addressing vaccine hesitancy, thereby supporting effective conversations with patients and/or their caregivers, and drive more personalised solutions to improve acceptance of vaccinations. The Learning Lounge was hosted by Christopher Graves, Founder and President of the Ogilvy Centre for Behavioral Science, New York, New York, USA., who is an expert on vaccine hesitancy and guiding HCPs on recognising and addressing this phenomenon. Graves was joined by Wendy Wright, Partners in Healthcare Education, LLC, Bedford, New Hampshire, USA, and Todd Wolynn, Kids Plus Pediatrics, Pittsburgh, Pennsylvania, USA, in a roleplay discussion to highlight cognitive biases that are relevant to vaccine hesitancy, and how these might be addressed in clinical practice.
... Vaccines, on the other hand, was a less political topic at the time. Nevertheless, in Poland, some participants mentioned the rise of the anti-vaccination movements-a threat that, as Kahan (2016) noted, creates difficulties in the science communication environment. This anti-vaccination movement found fertile ground in the current media environment, re-emerging from time to time, whereas climate change had a more continuous presence. ...
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Public trust in science and expertise remains a contentious issue. When public trust is analysed, it often simplifies a complex process of information retrieval and interpretation. Questionnaire surveys help us make sense of differences among actors and countries, but they fail to provide a comprehensive analysis of the reasons that lead citizens to trust a specific actor to differing degrees. Hence, we opted for using a qualitative grounded approach to understand how citizens make sense of their trust in several actors. This article draws from the results of public consultations with citizens in Portugal and Poland about two specific science-related topics—climate change and vaccines—focusing on citizens’ perceptions of trust in several sources of scientific information. The results show that citizens’ trust varies depending on the source of scientific information, and it is affected by the topic’s visibility and different national levels of institutional trust. It also concludes that citizens use different criteria to evaluate trustworthiness and that this process leads to different ways of expressing trust/mistrust: unquestioned confidence, justified trust, reflexive trust, and active distrust. Such knowledge leads to a more in depth understanding of how trust in science is constructed, which can help science communicators and educators choose sources and materials.
... Presumably, the need is evident to the public too. Despite all the talk about 'post-truth' and the like (Vacura 2019), an across-the-board renunciation of expertise seems limited to particularly politicized topics and adherents of fringe epistemologies (Sunstein and Vermeule 2009;Kahan 2017;Nguyen 2020a). While the problem should not be neglected, especially in the light of the recent rise of digital disinformation, it appears that common sense is, by and large, able enough to appreciate the practical value of expert knowledge. ...
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Many democratic countries have failed to stand up to the challenge presented by the COVID-19 pandemic. I argue that the collective response to the pandemic has been incapacitated by an ‘epistemic crisis’, (i.e., a breakdown in the social division of epistemic labor) that led to a failure of citizens’ beliefs to converge towards a shared perception of the situation. Neither a paucity of relevant expert knowledge nor democratic citizens’ irrationality is required for the crisis to emerge. In particular, I highlight three obstacles capable of preventing relevant expert testimony from gaining democratic legitimacy necessary for an effective policy response: 1) the proper domain of expertise is uncertain; 2) regular citizens’ meta-expertise – (i.e., ability to discriminate among the putative experts based on their relative epistemic merit) – is not efficacious enough to trigger truth-convergence of the public opinion; 3) the prominent sources of third-party meta-expertise lack credibility due to their conflicts of interest. Since the first two problems appear irresolvable, I propose that the search for a path towards preclusion of future epistemic crises concentrates on upgrading the institutional fundament for meta-expertise provision. Social epistemology plays a vital role in this search, but its close cooperation with other disciplines is a must.
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Concerns about public misinformation in the United States—ranging from politics to science—are growing. Here, we provide an overview of how and why citizens become (and sometimes remain) misinformed about science. Our discussion focuses specifically on misinformation among individual citizens. However, it is impossible to understand individual information processing and acceptance without taking into account social networks, information ecologies, and other macro-level variables that provide important social context. Specifically, we show how being misinformed is a function of a person’s ability and motivation to spot falsehoods, but also of other group-level and societal factors that increase the chances of citizens to be exposed to correct(ive) information. We conclude by discussing a number of research areas—some of which echo themes of the 2017 National Academies of Sciences, Engineering, and Medicine’s Communicating Science Effectively report—that will be particularly important for our future understanding of misinformation, specifically a systems approach to the problem of misinformation, the need for more systematic analyses of science communication in new media environments, and a (re)focusing on traditionally underserved audiences.
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This essay seeks to explain what the “science of science communication” is by doing it. Surveying studies of cultural cognition and related dynamics, it demonstrates how the form of disciplined observation, measurement, and inference distinctive of scientific inquiry can be used to test rival hypotheses on the nature of persistent public conflict over societal risks; indeed, it argues that satisfactory insight into this phenomenon can be achieved only by these means, as opposed to the ad hoc story-telling dominant in popular and even some forms of scholarly discourse. Synthesizing the evidence, the essay proposes that conflict over what is known by science arises from the very conditions of individual freedom and cultural pluralism that make liberal democratic societies distinctively congenial to science. This tension, however, is not an “inherent contradiction”; it is a problem to be solved — by the science of science communication understood as a “new political science” for perfecting enlightened self-government.
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To test the effectiveness of messages designed to reduce vaccine misperceptions and increase vaccination rates for measles-mumps-rubella (MMR). A Web-based nationally representative 2-wave survey experiment was conducted with 1759 parents age 18 years and older residing in the United States who have children in their household age 17 years or younger (conducted June-July 2011). Parents were randomly assigned to receive 1 of 4 interventions: (1) information explaining the lack of evidence that MMR causes autism from the Centers for Disease Control and Prevention; (2) textual information about the dangers of the diseases prevented by MMR from the Vaccine Information Statement; (3) images of children who have diseases prevented by the MMR vaccine; (4) a dramatic narrative about an infant who almost died of measles from a Centers for Disease Control and Prevention fact sheet; or to a control group. None of the interventions increased parental intent to vaccinate a future child. Refuting claims of an MMR/autism link successfully reduced misperceptions that vaccines cause autism but nonetheless decreased intent to vaccinate among parents who had the least favorable vaccine attitudes. In addition, images of sick children increased expressed belief in a vaccine/autism link and a dramatic narrative about an infant in danger increased self-reported belief in serious vaccine side effects. Current public health communications about vaccines may not be effective. For some parents, they may actually increase misperceptions or reduce vaccination intention. Attempts to increase concerns about communicable diseases or correct false claims about vaccines may be especially likely to be counterproductive. More study of pro-vaccine messaging is needed.
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Importance: Acceptance of childhood vaccinations is waning, amplifying interest in developing and testing interventions that address parental barriers to immunization acceptance. Objective: To determine the predictive validity and test-retest reliability of the Parent Attitudes About Childhood Vaccines survey (PACV), a recently developed measure of vaccine hesitancy. Design, setting, and participants: Prospective cohort of English-speaking parents of children aged 2 months and born from July 10 through December 10, 2010, who belonged to an integrated health care delivery system based in Seattle and who returned a completed baseline PACV. Parents who completed a follow-up survey 8 weeks later were included in the reliability analysis. Parents who remained continuous members in the delivery system until their child was 19 months old were included in the validity analysis. Exposure: The PACV, scored on a scale of 0 to 100 (100 indicates high vaccine hesitancy). Main outcomes and measures: Child's immunization status as measured by the percentage of days underimmunized from birth to 19 months of age. Results: Four hundred thirty-seven parents completed the baseline PACV (response rate, 50.5%), and 220 (66.5%) completed the follow-up survey. Of the 437 parents who completed a baseline survey, 310 (70.9%) maintained continuous enrollment. Compared with parents who scored less than 50, parents who scored 50 to 69 on the survey had children who were underimmunized for 8.3% (95% CI, 3.6%-12.8%) more days from birth to 19 months of age; those who scored 70 to 100, 46.8% (40.3%-53.3%) more days. Baseline and 8-week follow-up PACV scores were highly concordant (ρ = 0.844). Conclusions and relevance: Scores on the PACV predict childhood immunization status and have high reliability. Our results should be validated in different geographic and demographic samples of parents.
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This Report presents empirical evidence relevant to assessing the claim — reported widely in the media and other sources — that the public is growing increasingly anxious about the safety of childhood vaccinations. Based on survey and experimental methods (N = 2,316), the Report presents two principal findings: first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups; and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs. Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment (1) promote the use of valid and appropriately focused empirical methods for investigating vaccine-risk perceptions and formulating responsive risk communication strategies; (2) discourage ad hoc risk communication based on impressionistic or psychometrically invalid alternatives to these methods; (3) publicize the persistently high rates of childhood vaccination and high levels of public support for universal immunization in the U.S.; and (4) correct ad hoc communicators who misrepresent U.S. vaccination coverage and its relationship to the incidence of childhood diseases.
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Measles is a highly contagious, acute viral illness that can lead to serious complications and death. Although measles elimination (i.e., interruption of year-round endemic transmission) was declared in the United States in 2000, importations of measles cases from endemic areas of the world continue to occur, leading to secondary measles cases and outbreaks in the United States, primarily among unvaccinated persons. To update national measles data in the United States, CDC evaluated cases reported by states from January 1 through May 23, 2014. A total of 288 confirmed measles cases have been reported to CDC, surpassing the highest reported yearly total of measles cases since elimination (220 cases reported in 2011). Fifteen outbreaks accounted for 79% of cases reported, including the largest outbreak reported in the United States since elimination (138 cases and ongoing). The large number of cases this year emphasizes the need for health-care providers to have a heightened awareness of the potential for measles in their communities and the importance of vaccination to prevent measles.
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Advocates and policymakers strategically communicate about health disparities in an effort to raise public awareness, often by emphasizing the social and economic factors that influence these disparities. Previous research suggests that predisposing political orientation and values related to self-reliance and personal responsibility may produce resistance to such messages. In this study, the authors culled 4 messages about the causes of disparities in life expectancy from public discourse and randomly presented them to a nationally representative sample of 732 Americans. Three indicators of message resistance were measured: belief that messages are weak, elicitation of anger, and production of counterarguments. Expected political differences in message resistance were identified, with Republicans perceiving messages to be weaker, arousing less anger, and eliciting more counterarguing than for Democrats. Among 3 messages that described the social determinants of health disparities, a message that identified the role of personal choices (explicitly acknowledging personal responsibility) produced the least anger and counterarguing among Republicans. Political differences in anger arousal and counterarguing can be explained, in part, by predisposing values toward personal responsibility. These findings have relevance for policy advocates seeking to bridge public divides surrounding health disparities and for scholars advancing theories of reactance to policy-relevant health messaging.
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Neglecting the science of science communication puts the value of decision-relevant science at risk.
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Seeming public apathy over climate change is often attributed to a deficit in comprehension. The public knows too little science, it is claimed, to understand the evidence or avoid being misled. Widespread limits on technical reasoning aggravate the problem by forcing citizens to use unreliable cognitive heuristics to assess risk. An empirical study found no support for this position. Members of the public with the highest degrees of science literacy and technical reasoning capacity were not the most concerned about climate change. Rather, they were the ones among whom cultural polarization was greatest. This result suggests that public divisions over climate change stem not from the public’s incomprehension of science but from a distinctive conflict of interest: between the personal interest individuals have in forming beliefs in line with those held by others with whom they share close ties and the collective one they all share in making use of the best available science to promote common welfare.
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Many in the biomedical community have praised the recently released Human Papillomavirus (HPV) vaccine, Gardasil, for having the potential to significantly reduce the disease burden of cervical cancer and genital warts. However, complex intersections of ideology, morality, and politics have made this new vaccine considerably contested, particularly as public debate has turned to the ethics of state-mandated HPV vaccination for 11-12 year old girls. Subsequently, the extent to which mandatory vaccinations are accepted by parents and implications regarding the infringement of these coercive measures on their rights to make health care decisions for their children has become powerfully positioned in public discourse. This research seeks to examine how mothers of girls conceptualize Gardasil and the potential mandates in order to illuminate the multi-faceted socio-cultural context of risk embedded within this immunization. Major themes that emerged from in-depth interviews include diverse perceptions of the risk of HPV for their daughter(s) specifically, children as actual or potential sexual beings, concerns about vaccine safety, mistrust of pharmaceutical companies and government collusion, and conceiving of vaccination against HPV as imbued with a either a moral or cancer prevention subtext. The need for collaboration and communication between the medical and governmental institutions who promote vaccines such as Gardasil and the public who politically and socially consumes them has been apparent throughout my research. Applied anthropologists have a unique role to play by situating diverse stakeholder perspectives across interdisciplinary fields in order to develop more appropriate and informed policies.
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Parental vaccine hesitancy is a growing problem affecting the health of children and the larger population. This article describes the evolution of the vaccine hesitancy movement and the individual, vaccine-specific and societal factors contributing to this phenomenon. In addition, potential strategies to mitigate the rising tide of parent vaccine reluctance and refusal are discussed.
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Background: In 2006, the U.S. Food and Drug Administration licensed a vaccine for the human papillomavirus (HPV) that prevents the strains of HPV that cause 70% of cervical cancers. Within months, many states introduced legislation requiring the vaccine for girls, prompting controversy and heightened political and media attention to the issue. Previous research has shown differences in HPV vaccine awareness by individual-level characteristics such as race/ethnicity, income, and education levels. We examined how individual political orientation and exposure to media coverage can also shape awareness of the vaccine. Methods: Using data from a 2009 Internet survey of 1,216 nationally representative adult respondents linked to data on state-specific news coverage, we assessed how political orientation, media exposure, and state political context predicted HPV vaccine awareness. Results: Younger people, women, and those with more education were significantly more likely to be aware of the vaccine. Even after controlling for these characteristics, we found that exposure to news media was associated with higher HPV vaccine awareness. Whereas liberals and conservatives were both more aware of the vaccine compared with moderates, the data are suggestive that liberals were more sensitive to news coverage. Conclusion: These findings suggest that individual-level political identities and their interaction with the informational environment may be important factors to consider in evaluating the determinants of individuals' attitudes and behaviors related to politically charged women's health issues.
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There are not many public health issues where views are as extremely polarized as those concerning vaccines, and Merck's HPV vaccine Gardasil is a case in point. Ever since gaining the FDA's approval in 2006, Merck has been heavily criticized for their overly aggressive marketing strategies and lobbying campaigns aimed at promoting Gardasil as a mandatory vaccine. Subsequently, questions have been raised as to whether it was appropriate for vaccine manufacturers to partake in public health policies when their conflicts of interests are so obvious. Some of their advertising campaign slogans, such as "cervical cancer kills x women per year" and "your daughter could become one less life affected by cervical cancer," seemed more designed to promote fear rather than evidence-based decision making about the potential benefits of the vaccine. Although, conflicts of interests do not necessarily mean that the product itself is faulty, marketing claims should be carefully examined against factual science data. Currently Gardasil vaccination is strongly recommended by the U.S. and other health authorities while public concerns about safety and efficacy of the vaccine appear to be increasing. This discrepancy leads to some important questions that need to be resolved. The current review examines key issues of this debate in light of currently available research evidence.
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One of the most perplexing problems in risk analysis is why some relatively minor risks or risk events, as assessed by technical experts, often elicit strong public concerns and result in substantial impacts upon society and economy. This article sets forth a conceptual framework that seeks to link systematically the technical assessment of risk with psychological, sociological, and cultural perspectives of risk perception and risk-related behavior. The main thesis is that hazards interact with psychological, social, institutional, and cultural processes in ways that may amplify or attenuate public responses to the risk or risk event. A structural description of the social amplification of risk is now possible. Amplification occurs at two stages: in the transfer of information about the risk, and in the response mechanisms of society. Signals about risk are processed by individual and social amplification stations, including the scientist who communicates the risk assessment, the news media, cultural groups, interpersonal networks, and others. Key steps of amplifications can be identified at each stage. The amplified risk leads to behavioral responses, which, in turn, result in secondary impacts. Models are presented that portray the elements and linkages in the proposed conceptual framework.
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We sought to investigate roles that Merck & Co Inc played in state human papillomavirus (HPV) immunization policymaking, to elicit key stakeholders' perceptions of the appropriateness of these activities, and to explore implications for relationships between health policymakers and industry. We used a series of state case studies combining data from key informant interviews with analysis of media reports and archival materials. We interviewed 73 key informants in 6 states that were actively engaged in HPV vaccine policy deliberations. Merck promoted school-entry mandate legislation by serving as an information resource, lobbying legislators, drafting legislation, mobilizing female legislators and physician organizations, conducting consumer marketing campaigns, and filling gaps in access to the vaccine. Legislators relied heavily on Merck for scientific information. Most stakeholders found lobbying by vaccine manufacturers acceptable in principle, but perceived that Merck had acted too aggressively and nontransparently in this case. Although policymakers acknowledge the utility of manufacturers' involvement in vaccination policymaking, industry lobbying that is overly aggressive, not fully transparent, or not divorced from financial contributions to lawmakers risks undermining the prospects for legislation to foster uptake of new vaccines.
Article
In the US, science has increasingly taken a backstage to politics in policy decisions. But as the country enters the presidential primary season this month, one of the most counterintuitive but effective ways for researchers to make a difference may be to join the GOP.
Article
Vaccinations are among the most cost-effective and widely used public health interventions, but have provoked popular resistance, with compulsion framed as an unwarranted state interference. When the FDA approved a human papillomavirus (HPV) vaccine in 2006, conservative religious groups strongly opposed a mandate, arguing it would condone pre-marital sex, undermine parental rights, and violate bodily integrity. Yet, Governor Rick Perry signed an executive order in 2007 making Texas the first state to enact a mandate — later revoked by the legislature.Mandatory HPV vaccination reached the heights of presidential politics in a recent Republican debate. Calling the vaccine a "very dangerous drug" that could lead to "mental retardation," Michele Bachmann asserted, "To have innocent little 12-year-old girls be forced to have a government injection through an executive order is just wrong." Rick Santorum added, "There is no government purpose served for having little girls inoculated at the force and compulsion of the government." Governor Perry almost immediately disavowed his action, saying first that the vehicle of an executive order was wrong and then vaccination should be "opt-in."This political theater could frighten parents from vaccinating their children, causing preventable suffering and death. The scientific evidence demonstrates that population-based HPV vaccination is highly safe and effective, justifying widespread adoption of the vaccine. The only question is whether a state mandate would increase vaccination rates or result in a backlash against HPV and wider childhood vaccinations. Given the political divisiveness, states should launch health education campaigns before resorting to compulsion.
Article
To assess the construct validity and reliability of the Parent Attitudes about Childhood Vaccines survey. Cross-sectional survey of parents of 19-35 month old children in a closed model HMO. We used factor analysis to confirm survey sub-domains and Cronbach's α to determine the internal consistency reliability of sub-domain scales. Construct validity was assessed by linking parental responses to their child's immunization record. Our response rate was 46% (N=230). Factor analysis identified 3 factors that explained 70% of the total variance for the 18 survey items. We deleted 3 items that failed to load highly (>.4) on an identified factor, correlated poorly with other items, or had a hesitant response that was not associated with increased under-immunization. Cronbach's α coefficients for the 3 sub-domain scales created by grouping the remaining 15 items were .74, .84, and .74, respectively. Children of parents with survey scores of 50-79 had 14% more days under-immunized from birth to 19 months (95% CI: 8.0, 20.5) than those with parents who scored <50. Scores of ≥ 80 were associated with 51% more days under-immunized (95% CI: 38.2, 63.4). The revised survey is a valid and reliable instrument to identify vaccine-hesitant parents.
Article
State actions requiring adolescent girls to receive the human papillomavirus (HPV) vaccine created controversy following the vaccine's approval in 2006. Some health professionals worried that the controversy might dampen public support for those state policies and for other school immunizations in general. We fielded an experimental Internet survey to determine how controversy affects attitudes about vaccines. We discovered that public support for the HPV vaccine mandates wanes when the public is informed that the policies are controversial. However, the experimental survey also revealed that exposure to this policy controversy did not spill over and reduce public support for immunizations in general.
Article
Mothers of 294 children aged 3–9 years were interviewed about their child's previous history of vaccinations and infections. The study group comprised healthy children selected at GP surgeries (n= 136) and those hospitalized for both minor and serious conditions (n=168). The results evaluate the entire study group for the pattern of reporting vaccinations and infectious episodes under three years of age, comparing two different data sources - mothers' reports and GP records. Maternal recall accuracy is formally tested (Kappa statistic) for agreement with GP records. For vaccination history the results indicate that mothers and GPs are inadequate data sources, and suggest use of computerized health district records to improve data accuracy. Major differences on infectious history were evident for two types of questions - closed for specific infections and open-ended for ‘other infections’. Specific infections (e.g. measles) were systematically over-reported by mothers compared with GP records, but mothers failed to ‘time’ the event. Concordance for ‘other infections’ was also poor, but, by contrast, GPs systematically over-recorded this range of infections, indicating substantial inaccuracy in mothers' recall. The authors suggest that GP records should be the preferred source of data for these ‘other’ infectious episodes, especially under one year of age. Improved questionnaire design would elicit more accurate maternal reports on specified infections for which a GP may well not be consulted and corroboration would be impossible.
Article
A review of State compulsory immunization laws revealed that 26 States and the District of Columbia now have legislation requiring immunization against a disease or diseases as a prerequisite to school entry. The legal base for such laws is the U.S. Supreme Court ruling of 1905 that upheld the constitutionality of the Massachusetts compulsory law on smallpox vaccination. Although initial State legislation on compulsory immunization pertained to smallpox only, by the late 1930's compulsory laws including other diseases were enacted. Analysis of the structure of State laws on compulsory immunization revealed that most State laws of this type now require compliance from the parents of children in public, private, or parochial schools. Almost all diseases that can be prevented by immunization are included. The children of parents who object because of medical or religious reasons are exempted. The penalty for non-compliance is considered a misdemeanor and usually is not enforced. The value of State compulsory immunization laws continues to be controversial. Arguments for and against such legislation are analyzed.
Article
We evaluated the accuracy of parental recall of children's immunization histories as compared with provider records and examined how errors in parental recall correlate with sociodemographic characteristics. The validation study was part of a population-based household survey designed to assess immunization levels among Texas children under age 2 years. For 72% (n = 3278), interviewers used vaccination records from the parent to copy dates for the diphtheria and tetanus toxoids and pertussis vaccine (DTP), oral polio vaccine (OPV), and measles, mumps, and rubella (MMR) shots. For parents without shot records (n = 1216), interviewers asked about each vaccine, whether the child had received the shot, how many, and at what age. Of these, 85% (n = 1029) were validated with health provider records. Measured against provider records, only 34% of parents accurately recalled the number of DTP shots a child had. More often (42%) parents underestimated the number of DTP shots than overestimated (24%). Agreement between parental recall and provider records was high (83%) for the single dose of MMR. Accuracy of parents' recall did not differ by race/ethnicity, education level, or type of health insurance coverage, but decreased as child's age increased. Having a vaccination record at home was associated with a higher immunization status. Hispanic, lower educated, and uninsured parents were more likely to have a vaccination record than non-Hispanic, higher educated, and privately insured parents. Validity of parental recall of children's immunization histories depends on the vaccine and the age of the child, which is highly correlated with the number of shots parents must recollect. Results suggest that inclusion of parent recall information from vaccination surveys underestimates DTP:OPV:MMR coverage. This underestimation is consistent across economic and race/ethnic groups. Thus, community surveys based on cards and recall should provide reliable conclusions about which groups need intensive program efforts. For the routine monitoring of vaccination coverage, reasonable estimates can be obtained by combining parent-held record and parent recall data. Caution is required when comparing coverage estimates from different surveys since the source of information and method of derivation will produce widely varying coverage rates.
Article
Mad cow disease or bovine spongiform encephalopathy (BSE) is a fatal neurological disease of cattle first recognized in the United Kingdom (UK) in 1986. Until recently, the UK government considered the chance of a human becoming infected with the BSE agent to be extremely remote. As a result of new developments, alarmist media attention, bureaucratic mishandling of the issues, scientific uncertainty, bickering among technical experts, and a dearth of easily assimilated and balanced information on the problem, widespread fears that affected cattle could enter the human food supply and transmit the disease to humans have periodically erupted, causing social, economic, and political consequences of tremendous magnitude. Better management of the mad cow problem could have minimized the magnitude of the epidemic among cattle, the risk to humans, and the public outrage. Trust in the British government was seriously eroded, an entire industry crippled, and international relations severely tried. Although the scientific data concerning BSE and its transmissibility to humans are still not conclusive, a growing body of (still largely circumstantial) evidence suggests that BSE may be transmissible to humans. Unfortunately, policy decisions cannot wait for a final scientific answer. Therefore, high-stakes decisions must be made in the face of this uncertainty. Such decisions should be made with the primary purpose of protecting the public, and not preferentially the economics of an industry, political alliances, or other considerations. Given that the risk to humans from BSE was (and still is) unknown and may be high, and that the perceived risk among the British public was (and still is) extraordinarily high, policies should support more aggressive interventions. Of necessity, such interventions will be preventive, as there is presently no available treatment. Such policies should be modified as necessary as the developing scientific data warrants.
Article
Public risk perceptions can fundamentally compel or constrain political, economic, and social action to address particular risks. Public support or opposition to climate policies (e.g., treaties, regulations, taxes, subsidies) will be greatly influenced by public perceptions of the risks and dangers posed by global climate change. This article describes results from a national study (2003) that examined the risk perceptions and connotative meanings of global warming in the American mind and found that Americans perceived climate change as a moderate risk that will predominantly impact geographically and temporally distant people and places. This research also identified several distinct interpretive communities, including naysayers and alarmists, with widely divergent perceptions of climate change risks. Thus, "dangerous" climate change is a concept contested not only among scientists and policymakers, but among the American public as well.
State, and Local Area Vaccination Coverage Among Children Aged 19-35 Months -United States
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  • Cdc Vaccine Safety
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Welcome to the age of denial
  • Adam Frank
The damage of the anti-vaccination movement
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The Logic of Reciprocity
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Merck's Murky Dealings: HPV Vaccine Lobby Backfires
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Merck Ends Lobbying for Cervical-Cancer Vaccine
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National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years--United States
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Diseases of the past coming back, thanks to distrust of vaccines
  • Petula Dvorak
Cultural Cognition of Scientific Consensus
  • Dan M Kahan
Antiscience Beliefs Jeopardize U.S. Democracy
  • Shawn Otto