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What Parents Don't Know About Vaccinations Can Hurt

Pediatricians urged to initiate more conversations about immunization

WEDNESDAY, Oct. 23, 2002 (HealthDayNews) -- Smallpox, diphtheria, whooping cough and measles can be extremely dangerous to children's health.

But so can parents' misconceptions about the vaccines that prevent these devastating illnesses, according to two of the U.S.'s preeminent immunization specialists.

Speaking at the American Academy of Pediatrics' National Conference and Exhibition in Boston this week, Dr. Bruce Gellin and Dr. Edgar Marcuse encouraged pediatricians and other medical personnel to tackle these parental misconceptions head on.

Doctors and nurses need to have a better understanding of exactly what aspects of vaccination parents are concerned about, especially if the concerns lead them to avoid having their children immunized, the doctors say.

Gellin is executive director of the National Network for Immunization (NNii). Marcuse is a professor of pediatrics and adjunct professor of epidemiology at the University of Washington, and a member of the NNii Steering Committee.

The best way to assess parental concerns is by acknowledging the complexities of the immunization issue with parents and engaging them in conversations that focus exactly on what they are most concerned about, the doctors say.

"The topic of childhood vaccinations is complex," Gellin says. "There are issues about how many vaccines a child needs, when they are needed and how often they are administered, how much vaccines cost and how they actually work."

"It is impossible for a physician to know which of these is of greatest concern to parents without involving them in a dialogue that teases out an individual parent's specific questions and concerns and provides appropriate, accurate responses," he adds.

Such a dialogue can be difficult one, Gellin notes, in part because of larger issues such as vaccine supply, vaccine safety and the sheer number of vaccines that parents and pediatricians have to keep straight.

Furthermore, parents often have access to a dizzying amount of information about immunizations from other sources -- including television, newspapers, friends and the Internet -- some of which may be conflicting or misleading, he says.

"Although there's lots of information available, most parents have few ways of sorting out which of it is valid," Gellin says. "That is why we believe in-depth conversations with pediatricians and other trained medical personnel are essential, as well as why we strongly recommend that such conversations revolve around exactly what a parent wants to know or is most confused or concerned about. Especially if the confusion or concern would keep them from having their children vaccinated."

Gellin points out that such conversations can badly miss their mark if pediatricians don't base them on an individual parent's concerns. That's why the presentation focused on "engaged dialogue," as opposed to encouraging doctors to simply lecture parents or provide them with printed information on the benefits of vaccines or how vaccines protect against infections.

"If someone asks the time, they usually don't want or need a lecture on how a clock works," Gellin says. "It's the same with providing parents with information they need to know and can use about childhood vaccination. It's important for medical personnel to find what parents want to know or are confused about, then give them just that specific information during a discussion of their concerns. Otherwise, they will have a difficult time sorting out good, quality information from all the hearsay or rumors they are exposed to on this topic."

Gellin adds that pediatricians and other health-care providers who work with the parents of young children should increasingly initiate childhood vaccine discussions, rather than wait for parents to ask.

The pair's presentation included excerpts from a 1999 NNii study that highlighted the dangers associated with falling rates of childhood immunization, including the likelihood that many of the once-dreaded diseases presently under control could re-emerge if too few children are vaccinated. Among the study's conclusions: A parent's decision not to immunize a child places not only that child but also all other children in a community at greater risk of infectious disease.

Dr. Gilbert Ross, medical director of the American Council of Science and Health, says vaccines have had a greater impact on protecting children from death and illness from infectious diseases than any other public health intervention.

"The benefits of childhood vaccination are more evident today than at any time in the past half century," Ross says. "And evidence shows that vaccines are likely to provide even greater benefits to public health and children's health in the future."

What To Do

For a schedule of which shots children and teens need and when, visit the Immunization Action Coalition. Learn more about vaccines and childhood immunization at Every Child By Two.

SOURCES: Bruce Gellin, M.D., M.P.H., executive director, National Network for Immunization, Alexandria, Va.; Edgar Marcuse, M.D., professor, pediatrics, adjunct professor, epidemiology, University of Washington, Seattle, and member, National Network for Immunization Steering Committee; Gilbert Ross, M.D., medical director, American Council of Science and Health, New York City; Oct. 19, 2002, presentation, American Academy of Pediatrics Annual Meeting and Exhibition, Boston
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