Why are parents critical of vaccinations?
Mr Tarr, the question of whether or not to have your child vaccinated is a regular source of controversy. You have studied so-called vaccination sceptics and their motivations. In your experience, what is the most important reason for people's reservations about vaccination?
We are talking about around 30 per cent of the population in Western countries. These people don't really trust the authorities. They think that the focus is always on the immunisation rate and not on the individual child. They want to have a say and not simply have things imposed authoritatively «from above». One of the main criticisms is that individuality is lost in the vaccination plan. Those who are sceptical about vaccination ask themselves how it can be that we always take into account that every child is different: one is more robust and has fewer colds, the other is constantly sick. Nutrition and sport are also areas in which we naturally look at which child needs what. Only when it comes to vaccinations, the sceptics say, is this neglected. The image of a herd of animals is often used. According to the motto: every cow is vaccinated in the same way.
Can you understand these reservations?
To a certain extent, yes. When the health authorities say: Our goal is to increase the immunisation rate, then that's the case.
But as a doctor sitting opposite a mum with a child, I believe I should and must try to give individual advice instead of signalling: That's just the way it is, that's what the immunisation schedule demands.
Is the impression deceptive or has the number of vaccination sceptics increased?
The 30 per cent figure has remained fairly constant for years. In my view, the problem is more that it is being talked about more today and is being addressed more in the media. The population has become more critical of science, more critical of the authorities. That was different 30 or 40 years ago. To put it very simply: people just did what the doctor said. Even today, the doctor is still the most important source of information for parents, even for those who are sceptical about vaccinations.
How do you know that?
We have just analysed a survey. We asked 1400 parents to complete a questionnaire with 15 questions, which we can use to measure vaccination scepticism. The score ranges from 0 to 100. Up to 50, we do not count the respondents as vaccine sceptics. From a score of 50, we speak of vaccination sceptics. We can see that a score above 50 correlates with a delayed or non-vaccination against measles or a non-vaccination against sexually transmitted human papillomaviruses (HPV ). And these vaccination sceptics also state that they most often seek information about vaccinations from their doctor.
And what is the difference to non-sceptical parents?
The sceptics read more books on the subject of vaccination, they inform themselves and talk more about it with their family and friends. The books are very convincing. A classic on the subject, for example, is «Vaccination - Pros & Cons» by Dr Martin Hirte. It's not badly written, it's simple and easy to understand. If you have a lot of questions about vaccination, you will hear the voice of a friendly, sympathetic doctor sitting opposite you and explaining everything calmly. But not everything he explains is correct.
For example?
he book states, for example, that genital warts can protect against cervical cancer and that there is therefore no need for a vaccination against HPV, which can potentially cause cervical cancer. But the opposite is true: major studies have shown that people who have genital warts are more likely to develop cervical cancer in the long term.
So the vaccination sceptics are deliberately focusing only on the things that speak against vaccination?
No, I wouldn't put it like that. They see the whole complex as an issue that requires weighing up the pros and cons, which is why they put together arguments for and against vaccination. We have spoken to a lot of complementary practitioners and many of them say: The authorities are making vaccination propaganda, they only talk about the benefits. These doctors are calling for vaccination to be viewed in a more differentiated way, just as they do. And that they take the time to discuss this with parents.
An approach that you find quite good.
I think it would be quite promising if - instead of constantly harping on about complementary medicine and its scepticism - we started the other way round and looked at what can be improved in conventional medicine. Above all, this means taking more time to advise parents who are sceptical about vaccines. Not simply responding to possible fears with «Oh rubbish, it won't give you autism, the active ingredients are safe», but listening to parents, taking their concerns seriously and addressing them. In my opinion, there is also a lack of vaccine-specific expertise among paediatricians, which could help to address critical comments from parents.
«The sceptics read more books on the subject of vaccination, they inform themselves more. And the books are very
convincing.»
Why is that the case?
The problem is that you learn very little about immunisation in medical school. They simply say: Look here, this is the immunisation schedule, according to which children must be vaccinated against tetanus at the age of two months, against this at four months and against that later. So we have learnt the timing, plus the information that vaccinations are effective, plus the information that they are safe - that's pretty much it. But that's not enough to satisfy the questions of vaccine-sceptical parents and allay their fears.
That helps?
I am convinced that 80 per cent of the vaccination scepticism problem can be neutralised in this way. Scepticism should not be treated as a kind of disease of stupid anti-vaccinationists, and certainly not in the military tone that often accompanies it. This has not been very effective for many years; we need new approaches.
What is the best way to deal with vaccination sceptics among friends and acquaintances?
Firstly, you should realise that the most important point for them is that they are allowed to decide for themselves whether and, if so, against what they and their children should be vaccinated. «You have to» doesn't get you very far. However, I don't think it's out of line, for example in connection with the coronavirus vaccination, to say clearly to those who are talking about scaremongering: No, it's not, if it can make you seriously ill and even kill you. I have also learnt this from the paediatricians working in complementary medicine with whom we conduct research. They tell parents that measles is more than just a harmless childhood disease. If a child gets it, it can lie in bed for ten days, apathetic with a fever of 40 degrees, dehydrated and unable to eat or drink. Parents need to be aware of what they are letting themselves in for. Not getting vaccinated means taking on the burden of a child who has been seriously ill for a long time and taking the risk of atypical courses and complications. Many parents who hear this are surprised that it can be so bad if their child gets measles.
«There is a lack of vaccine-specific expertise among paediatricians, which could help to respond to critical comments from parents.»
With Corona, the question of a vaccination for children does not arise. Not yet?
The current vaccines are authorised from the age of 16. This is because the studies have only been carried out on adults and it is not possible to simply reduce the dose of active ingredient for children. Separate studies are needed, also because the immune system of children reacts differently to that of adults. Studies with 12 to 18-year-olds are already underway, but it will be spring before the results are known. Fortunately, children are not a risk group for a severe course of coronavirus, so we are not in a hurry here.
Many parents, and not just those who are generally sceptical about vaccines, are very cautious about the coronavirus vaccines that have been developed in record time. And rightly so?
The crucial point is the lack of experience. When the vaccinations were authorised, only 70,000 people had been vaccinated twice and these test subjects had only been observed for two or three months after the second dose. Naturally, side effects that only occur after five months could not yet have been noticed. Similarly, vaccination effects that occur with a probability of 1:100 00 were not known. However, this is currently changing. The number of vaccinated people is increasing daily and soon the test subjects from the studies will have been observed for six months after vaccination. All this provides additional certainty and is reason enough to be less sceptical.
Four facts about the corona vaccine
Did you know that ...
... never before has a vaccine been developed in such a short time as the corona vaccine? It took just under a year from the first studies to the first authorisation of one of the vaccines in Switzerland. This was made possible by accelerated processes on the part of the authorisation authorities. Important tests were not skipped; instead, the scientific data was analysed more quickly and in some cases simultaneously.
... this is the world's first so-called mRNA vaccine? The principle has been the subject of cancer research for years. This method uses a tiny piece of the blueprint of the novel coronavirus (SARS-CoV-2) to teach the body a defence reaction. Messenger ribonucleic acids (mRNA) are messenger molecules that carry the blueprints of the pathogen into human cells. Once there, a surface protein is built according to these blueprints, in the case of SARS-CoV-2 the so-called spike protein. The immune system recognises this as foreign and forms antibodies against it. The immune response has begun.
... the coronavirus vaccine is only authorised for people aged 16 and over? As the immune system of children reacts differently to that of adults, the dose cannot simply be reduced for a vaccination. Vaccine manufacturers have so far focussed on adults, as children are not among the risk groups for a severe course of the disease. Studies with children are expected to follow. If these are successful, the vaccine may also be authorised for them.
... there can be side effects with a corona vaccination, as with other vaccinations? These are mainly immediate, localised and temporary symptoms such as redness, swelling or pain at the injection site. Feeling unwell for one or two days, muscle aches or headaches, fever and chills can also occur in the first few days after a coronavirus vaccination.
More information at www.swissmedic.ch
Read more about vaccination and corona:
- «No one can be forced to have the coronavirus vaccination»
The announced vaccination against corona brings hope for many people, but at the same time many fears arise. Franziska Sprecher, Director of the Centre for Health Law and Management in Healthcare, talks about mandatory vaccination for specific groups of people and the question of whether schools can require vaccination. - «Corona vaccination for children: in one year at the earliest»
What are the latest findings on the role of children in the current coronavirus crisis? And: Can a school require a corona test? Prof Dr Christoph Aebi provides important answers. - With an HPV vaccination against cancer
The HPV vaccination is effective against sexually transmitted viruses. It has also been recommended for boys for four years - but the vaccination rate is still too low for herd protection. A new vaccine should provide a remedy.