Post #1: Low Vaccination Rates in the United States and the Outbreaks they Cause

In order to improve vaccination rates and prevent diseases such as measles, it is first necessary to understand why people choose not to get vaccinated. So far, I have spent much of my time reviewing the literature surrounding anti-vaccination. I have also analyzed MMR vaccination data using R to see if there are any links between race, income level, and geographic location in MMR vaccination rates. I have decided to narrow my focus to measles and the MMR vaccine due to the differences in reasons for anti-vaccination in different vaccines.

One of the sources I have found most interesting so far is the book Calling the Shots: Why Parents Reject Vaccines by Jennifer A. Reich. This book explores various reasons parents choose not to vaccinate their children and public health efforts that have helped to improve vaccination rates. Many parents believe they are experts on their own children and should have the right to choose which vaccinations their children receive. However, where is the line drawn when their choice not to vaccinate puts other children at risk? Court cases such as Jacobson vs. Massachusetts ruled that the state has the right to uphold compulsory vaccination laws. Should parents be able to obtain religious or personal exemptions to vaccination? Should unvaccinated children be allowed to attend public schools when they could be putting other children at risk? I look forward to continuing to research and answer these questions as I continue my research.

In addition, many parents choose not to vaccinate their children with the MMR vaccine due to concerns about autism. Many parents are concerned about thimerosal, a mercury-based additive used in the MMR vaccine to prevent the growth of bacteria. They believe that the thimerosal in MMR vaccines is linked to higher rates of autism. However, seven different studies between 2003 and 2007 did not find any link between thimerosal and autism. Thimerosal was also removed from recommended childhood vaccinations in 2001. Even though the theory that the MMR vaccine causes autism has been debunked and thimerosal has been removed from vaccines, many people still refuse the MMR vaccine due to concerns about autism. For example, the MMR vaccination rate in people of Somalian descent in Hennepin County, Minnesota went from more than 90% in 2007 to 35.6% in 2014. This drastic decrease has been largely attributed to the belief that the MMR vaccine causes autism. Public health efforts in this Somali community in Minnesota have helped increase the MMR vaccination rate by quelling the fears that the MMR vaccine causes autism. 

Over the coming weeks, I plan to continue reading through the literature and analyzing the data surrounding the MMR vaccine and recent measles outbreaks. I plan to write a paper summarizing my findings and suggestions for public health efforts in order to increase MMR vaccination rates and prevent measles outbreaks in the United States. I have enjoyed my research so far and I am looking forward to learning more about this topic!



  1. smmiralao says:

    Hi Meghan!

    I think this research is especially timely with anti-vaxxing becomes an entire movement that more prominent individuals, whether they be politicians or celebrities, are becoming involved in. I had always heard the reasons for why parents chose not to vaccinate their children, but I never understood them or bothered to understand the logic of these parents. I’m curious, has there been a history of parents not wanting to vaccinate their kids prior to this current movement? Also, how did this particular belief/reason for not vaccinating children arise, and what aspects of religion are used as reasons to not vaccinate? I’m excited to see what suggestions you come up with for increasing vaccination rates; I’ve always thought that communicating science and logic to the public can be difficult but that it is an increasingly more important aspect of research. I think in regard to a public health issue such as this it can be even more difficult when preconceptions already exist, but that that makes changing those notions all the more urgent. I hope your research continues to go well; good luck!

  2. iragostino says:

    Hi Meghan!

    I think your topic is fascinating and can’t wait to hear what you conclude! I know very little about biology and public health, but love large studies involving data analysis. Personally, I think your mention of parental reasoning for not vaccinating their children is excellent. People can publish all the facts they want but, without addressing the parental concerns leading to high unvaccination rates, nothing will change. Something that I think would be really interesting, though I don’t believe is part of your project, would be to compare the modern changes in US vaccination and outbreak statistics to other data sets. How does this current US trend relate to those in other nations? What about when the vaccine was first released? Is it similar to trends for other vaccines? Another interesting thing to ponder, would be whether or not the general anti-vaccination movement has influenced the declining popularity of getting an influenza vaccine.

    I am excitedly awaiting the results of your research, including your policy suggestion! I hope your research continues to go well and that your findings open other queries for you to pursue in the future.

  3. Matthew Tucker says:

    Hi Meghan! First, I would like to reiterate the encouragement of the other comments – this is a great topic and your approach is excellent! I am also researching the public health field, so I appreciate your goals. Part of my research has looked at different diseases among homeless children and youth, and a main determinant affecting the disease process includes parental stress, job insecurity, and recognition of child’s morbidity. Therefore, the role of parents is a major theme in pediatric health. In turn, the literature for my research argues that parental education would be an effective tool in improving children’s health status. Thus, how could practitioners educate new parents on the benefits of vaccinating their children for their sake and for the community’s sake? This potential solution does assume that parents have adequate access to prenatal and infant care, which is not a guarantee for marginalized populations, but it partially addresses the need for parents to understand the facts. As mentioned in previous comments, the endorsement of anti-vaccination movements by public figureheads makes any solution more difficult. Overall, many assumptions exist in my recommendation, but based on my research, education appears to be a popular public health method.

  4. meacheson says:

    Hi Sidney!

    Yes, there is a history of parents not wanting to vaccinate their kids prior to this current movement. There has been pushback ever since the smallpox vaccine was invented in 1796. Today, the main reason parents choose not to vaccinate their children with the MMR vaccine is due to the belief that it causes autism. This stems from a “study” published in 1998 by a now-discredited doctor from the UK named Andrew Wakefield. This study has been widely discredited by scientists, but many people in the United States still claim that the MMR vaccine causes autism today. Interestingly, the majority of the reasons people in isolated religious communities choose not to vaccinate their children is not due to religious reasons, it is actually due to safety concerns, mainly that the vaccine causes autism. For my term paper in Emerging Diseases, I chose to write about measles outbreaks in isolated religious communities. I expected to find that these outbreaks were occurring due to religious objections to vaccines (which was sometimes the case), but the vast majority of the time it was due to concerns about the safety of the vaccines. This project is a spin-off of my findings from that paper with the hope that I can better understand why people choose not to vaccinate their children and what can be done to improve vaccination rates.

  5. meacheson says:

    Hi Isabel!

    I definitely agree that it would be very interesting to compare US vaccination data and outbreaks to other countries. It would be helpful to see how the United States is doing on a global scale. I have not read a lot about the vaccination statistics and outbreaks in other countries, but I know that many countries in Europe are currently experiencing similar anti-vaccination movements. The United States could learn a lot by understanding what public health efforts countries with very high vaccination rates have made. All of your questions are very interesting and I love to do more research in those areas!

  6. meacheson says:

    Hi Matthew!

    I agree, parental education is extremely important when it comes to pediatric health. A study in China showed that providing vaccine information to pregnant women and families seems to be more effective than waiting until after birth. Approximately 90% of the children whose mothers received vaccine education prior to birth were vaccinated, while only 83% of the children whose mothers were not educated prior to the birth of their child were vaccinated. Studies have also shown that simple reminders such as phone calls, e-mails, text messages, and postcards can also help improve vaccination rates. Many parents do not understand how important vaccines are, so primary care providers and public health officials need to discuss the importance of vaccination with them. Once parents understand the importance of vaccination and the diseases they prevent, they are much more likely to vaccinate their children. Providing educational materials about the safety of vaccines, specifically the belief that the MMR vaccine causes autism, can also greatly improve vaccination rates and quell any fears about the risks of vaccination.