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Immunization Hesitancy: A Rising Tide that Challenges the Public Health
Published on 2009-12-168858 Views
Societal support for traditional childhood immunization is changing. Increasingly, parents are renegotiating recommended immunization schedules with pediatricians. Marcuse, also associate medical dire
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Presentation
Howard A Schneiderman00:00
Immunization Hesitancy: A Rising Tide00:13
A Syllogism00:29
Acknowledgement01:20
Disclosures01:30
Cartoon01:46
Vaccine-Preventable Diseases02:05
Recommended Childhood Vaccines02:54
A Rising Tide of Immunization Hesitancy04:08
Proportions of parents who reported vaccine doubt indicators04:44
Parents Who Refuse Vaccines05:25
Parental Concerns circa 200906:09
Origins of Immunization Hesitancy I06:47
Origins of Immunization Hesitancy II09:23
From the Scientific American, April 200511:42
News Value of Controversy12:27
History of School Immunization Laws13:36
1905 – Jacobson vs. Massachusetts - 114:31
1905 – Jacobson vs. Massachusetts - 215:04
The Harm Principle15:40
When is it justifiable to restrict individual freedom?16:16
What constitutes a threat to the public health or public harm?17:08
What level of vaccine safety is required?20:27
Rotashield® Vaccine – withdrawn from market in 200022:00
Balance of Benefits & Burdens23:16
Enforcing School Laws by Exclusion23:29
Measles in 6 States Strictly Enforcing School Laws vs. Other States, 197824:16
Impact of Exemptions on Disease Transmission24:55
Types of Exemptions:Medical, Religious, Personal Belief26:05
US Immunization Exemptions 2005 - 2006 School Year26:42
WA State Counties’School Entry Exemption Rates1999 - 200027:12
WA State Counties’School Entry Exemption Rates 2007 - 200828:13
123 Measles Cases US Residents January 200828:56
Trend in Cases of Imported Measles* as a Proportion of All Measles Cases, US 1997 – 200829:38
School Laws: Key Success Factors – Parents’ Attitudes Toward Mandates30:35
School Laws: Key Success Factors – Physicians’ Support31:21
Immediate Challenges31:57
Alternative Strategies: Australia32:49
Prudent, Limited Use of Mandates34:27
Ensure Informed Decision Making35:54
Example of a Widely Held Erroneous Belief37:35
Immunogenic Proteins & Polysaccharides in Vaccines37:50
Problem with Selective & Alternative Schedules38:29
Invest in Safety Science39:55
Sample Sizes Needed to Detect Rare Events41:05
Some Challenges of Risk Communication41:44
Effective Public Health Communication43:14
Credibility on Issues of Low Concern44:01
Credibility on Issues of High Concern44:11
Effect of Clinician Style on Motivation for Change44:31
Concerned Parents / Intentional Misinformers45:10
Jonathan Swift45:29
National Campaign to Influence Immunization Behaviors45:44
Expand Public Engagement in Immunization Policy46:17
What Oprah and Larry King should be discussing…46:59
Cartoon - 247:27
Newer Strategies for Vaccine Development47:46
Major Uncontrolled Infectious Diseases48:20
Poster48:32
From 1954 to 200948:56