This is EVIL! I think I am gonna be SICK!

PAY CLOSE ATTENTION! They are now openly advocating the promotion of vaccines through fear!

“One promising tactic is “social marketing” that promotes immunization based on emotion, rather than medicine’s traditional reliance on scientific evidence and authority”.

“Once physicians overcome parents’ hesitancy, advancing the schedule of dosing may further improve vaccine protection, according to two studies.

In one retrospective cohort study, reducing the interval between doses increased the number of children who got the full immunization regimen”

Novel Strategies to Keep Kids on Vaccination Track

By Crystal Phend, Staff Writer, MedPage Today
Published: May 05, 2009
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

SAN FRANCISCO, May 5 — Childhood immunization may be a victim of its own success, requiring guerilla tactics to get kids in for vaccination and keep them coming back, advocates say.

Vaccination has virtually eliminated some diseases, such as measles, that once killed thousands of children each year, said Matthew M. Davis, M.D., of the University of Michigan in Ann Arbor, and Samir S. Shah, M.D., of Children’s Hospital of Philadelphia.

But the very rarity of these diseases today makes it easier for parents to dismiss the risk — and give greater weight to the potential adverse effects of vaccination, they wrote in the May issue of Archives of Pediatrics & Adolescent Medicine.

Their editorial highlighted several studies in a vaccination-themed journal issue designed to “set the stage for the next phase” in the fight against vaccine-preventable infections.

Action Points

Explain to interested patients that part of the hesitation of parents to vaccinate their children is because of lack of perceived risk of vaccine-preventable disease due to virtual elimination of these diseases.

Note that all the vaccines scheduled for age 2 months can be given at 6 weeks.

One promising tactic is “social marketing” that promotes immunization based on emotion, rather than medicine’s traditional reliance on scientific evidence and authority.

The authors say it can counter publicity from antivaccination forces who blame vaccinations for heartbreaking stories of children who develop autism or other problems.

Other strategies highlighted in the journal included:

Advancing the schedule of dosing to encourage parents to bring children in sooner

Pediatric office-based immunization of adults who have contact with young children

A reminder/recall system at pediatric practices to track immunization among high-risk children and help ensure they receive immunizations during times of vaccine shortage

Effective communication, to improve uptake of new vaccines-especially those with cultural sensitivities, such as the human papillomavirus vaccine

Sustained routine vaccination to maintain progress against disparities in vaccine-preventable diseases among American Indian and Alaskan Native children

Social Marketing to Fight Antivaccination Publicity

While unconventional, emotion-based marketing gets at the roots of “immunization hesitancy,” according to researchers led by Douglas J. Opel, M.D., of Seattle Children’s Hospital and the University of Washington in Seattle.

For example, they noted that heartbreaking individual stories of autism — purportedly linked to vaccinations — can be more compelling in swaying public opinion against vaccination than careful scientific studies of large populations of children.

“Multiple studies have found that a compelling story about a single victim is far more likely to move an audience to action than is the use of data,” Dr. Opel’s group wrote.

So to fight fire with fire, their group described an approach planned by the Washington State Department of Health to increase the state’s immunization rate, currently 46th among the states for the standard, 15-dose series.

The social marketing campaign will focus on parents who are expecting or have a child under 24 months old and are unsure whether to immunize their youngsters, or are intentionally delaying immunizations for nonmedical reasons.

Because concerned parents may value empathy, openness, and perceived honesty over medical expertise, the campaign will publicize the experience of a parent whose hesitation to vaccinate led to a child’s serious illness with a vaccine-preventable disease.

If possible, it will also include “a recognizable, respected public figure who has personal life experience with vaccine-preventable disease and is willing to advocate for immunization.”

Bringing children back sooner for repeat doses

Once physicians overcome parents’ hesitancy, advancing the schedule of dosing may further improve vaccine protection, according to two studies.

In one retrospective cohort study, reducing the interval between doses increased the number of children who got the full immunization regimen, and Daniel Bronson-Lowe, Ph.D., and Shoana M. Anderson, M.P.H., both of Arizona Department of Health Services in Phoenix, reported.

They reviewed the Arizona immunization registry for more than 45,000 children who got their initial diphtheria, tetanus, and acellular pertussis vaccine (DTaP) dose during a statewide pertussis outbreak.

Despite concerns over increasing the number of well-child visits and disrupting other vaccination schedules, reducing the DTaP interval to less than the standard eight weeks improved immunization rates compared with standard dosing as follows:

34% higher likelihood of all three DTaP doses (95% confidence interval 32% to 35%)

27% higher likelihood of all three doses of inactivated polio vaccine (95% CI 25% to 29%)

37% higher likelihood of all three doses of pneumococcal conjugate vaccine (95% CI 35% to 39%)

In an editorial, Dr. Shah noted some of the increase in completion rate may have been attributed to parents who saw the risks of nonvaccination more clearly during the outbreak.

But he said noted that that other vaccines typically given at 2 months can be administered at 6 weeks as well.

Indeed, a second retrospective cohort study found that starting pneumococcal conjugate vaccination at 6 weeks of age rather than the standard 2 months could be expected to prevent even more disease.

Katherine A. Poehling, M.D., M.P.H., of Wake Forest University in Winston-Salem, N.C., and colleagues studied rates of pneumococcus before pneumococcal conjugate vaccine introduction in eight states.

They projected that earlier administration would reduce invasive pneumococcal disease in infants between 6 weeks and 2 months of age by 39.9% if the vaccine efficacy was 50%, and reduce the incidence by 56.0% and 72.1% at efficacies of 70% and 90%.

“As research for new and more effective vaccines continues, medical personnel must optimize the way they use existing vaccines,” Drs. Davis and Shah concluded.

Drs. Davis and Shah reported no conflicts of interest.

One of Dr. Opel’s co-authors reported owning a social marketing consulting firm, Social Marketing Services, Inc.

Dr. Bronson-Lowe and Anderson’s study was supported by a grant from the CDC. They reported no conflicts of interest.

Dr. Poehling’s study was supported by awards from the National Institute of Allergy and Infectious Diseases and by research funds from Roche and Wyeth to one of the co-authors. They reported no conflicts of interest.

Primary source: Archives of Pediatrics & Adolescent Medicine
Source reference:
Davis MM, Shah SS “Necessary innovations in immunization delivery” Arch Pediatr Adolesc Med 2009; 163: 483-85.

Additional source: Archives of Pediatrics & Adolescent Medicine
Source reference:
Opel DJ, et al “Social marketing as a strategy to increase immunization rates” Arch Pediatr Adolesc Med 2009; 163: 432-37.

Additional source: Archives of Pediatrics & Adolescent Medicine
Source reference:
Stancil JM, et al “Potential impact of accelerating the primary dose of pneumococcal conjugate vaccine in infants” Arch Pediatr Adolesc Med 2009; 163: 422-25.

Bronson-Lowe D, Anderson SM “Effects of a minimum interval immunization schedule for diphtheria and tetanus toxoids and acellular pertussis vaccination during a pertussis outbreak” Arch Pediatr Adolesc Med 2009; 163: 417-21.

Find this article at:
http://www.medpagetoday.com/Pediatrics/Vaccines/14044

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