November 1997
SAN FRANCISCO - The current generation gap between younger and older parents could result in the failure of well-intentioned parents to immunize their children appropriately, and therefore threatens the current record-level immunization rates.
Ninety percent of parents agree that immunization is very important to their child's health, yet most of them underestimate the severity of vaccine-preventable diseases, according to results of a survey recently presented here at the Infectious Diseases Society of America (IDSA) meeting. The survey was given to diverse focus groups in Baltimore, San Antonio, Texas and Oakland, Calif.
In response to the survey results, a coalition of organizations is being formed by the IDSA to improve preventive health care.
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Although plans for the program are not complete, the core elements are expected to include an educational component for physicians to ensure they are apprised of the latest immunization information; affiliation with local and national community and health organizations to send the message about immunizations; sponsorship of health fairs; and a public service awareness campaign using the media.
The key points of the coalition will be more defined by the end of year, but the coalition is already aware of its first goal, said Samuel L. Katz, MD, coalition chairman and W.C. Davison professor at Duke University, Durham, N.C. Louis Sullivan, president of Morehouse School of Medicine, is co-chairman.
"Our first goal is to try legitimately and realistically to assess this issue and assign some value to it. Then we can target educational programs where they are most needed," Katz explained.
The study revealed surprising results about the public's awareness of vaccine-preventable diseases. A total of 513 parents were interviewed, with an oversample of African-Americans and Latinos. Eighty percent of those had children 5 years and younger and the remaining 20% planned to have children within the next two years.
The survey yielded key findings about the participants' understanding of diseases and trust of their pediatrician and the government. Nearly 80% of those surveyed agreed their pediatrician was more trustworthy than organizations as a source of information regarding children's health, childhood diseases and vaccines. In addition, only 19% of African-Americans trust the federal government and believe it knows what is right regarding public health issues. A higher percentage (34%) of Latinos said they trusted the government.
In general, those who said they trust the government were more likely to trust the safety of vaccines, the study indicated.
All survey participants were familiar with the names of seven of 10 vaccine-preventable diseases: measles, varicella, hepatitis B, polio, rubella, diphtheria and rotavirus (Rotavax, Wyeth-Lederle Vaccines and Pediatrics, pending approval).
Sixty-one percent of those surveyed "strongly" agreed children are at serious risk for illness or death if they are not vaccinated, but only 13% of respondents knew diphtheria can be fatal and another 26% thought fever was the most serious complication of rubella; 11% said it was a type of rash. Forty-three percent did not know rubella can cause severe birth defects.
Ninety-five percent of those surveyed believe vaccines are safe; however, 52% of whites, 58% of Latinos and 36% of African-Americans said they are "very safe." Despite the low numbers of those who believe that vaccines are very safe, 85% of respondents "strongly agree" parents who vaccinate their children are being responsible to their children.
Awareness of serious diseases within minority communities - especially Latinos - is significantly lower than awareness among all other respondents; 55% of Latinos do not know about diphtheria compared with 34% of African-Americans. Both African-Americans and Latinos are less familiar with polio than white respondents.
Over three-quarters (76%) of the parents surveyed said their children did not mind getting vaccinated and that the experience was positive and beneficial. Despite the mistrust of the federal government voiced by many African-Americans surveyed, 82% said their immunization experiences have been positive and beneficial; this number was higher than whites (75%) and Latinos (74%).
"It's a paradoxical time. We have some of the highest immunization rates in years among infants and children, yet among certain segments of the population, there seems to be an element of distrust," Katz said. "We are doing this as part of the IDSA because we hope people see us as a neutral group; we are not the government, we are not the pharmaceutical industry, we don't have an axe to grind. We are physicians who try to keep children and adults healthy and to prevent and treat infections."
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