Louisville Medicine Volume 69, Issue 2 - Page 28

AUTHOR Ariel Carpenter , MD


AUTHOR Ariel Carpenter , MD

Damaged DNA . Induced infertility . Implanted microchips . As I discussed COVID-19 vaccinations with my patients this year , vivid concerns like these came up over and over again . My patients were terrified , influenced by lurid descriptions of vaccine harm conjured up by conspiracy theorists that were spread on forwarded emails and social media . They were convinced that vaccination was the riskier choice .

I understood these patients all too well . I , too , remembered a time when I thought of vaccinations as villainous , as dangerous agents of government overreach whose side effects outweighed the diseases they supposedly treated . My mother remembers reports of neurologic disorders , autism and other injuries ; she worried about effects to her children from ingredients such as aluminum and mercury . When family friends ’ children suffered mild adverse side effects following childhood vaccines , this anecdotal data only confirmed her apprehension . I was homeschooled , isolated from most vaccinated children . It wasn ’ t until I went to public high school that I had to fill out a religious exemption waiver , and realized I - and my siblings - were in the minority .
As a teenager , my childhood interest in medicine grew , and I suddenly needed a vaccine record - that was my main obstacle to medical shadowing and volunteering . My mother was opposed , but I was determined , and at 16 , I finally finished my childhood vaccination series . Years later , I would go on to complete medical school , graduating with a completely different perspective .
Now I knew the data : that vaccinations had nearly eliminated some of childhood ’ s biggest threats ; that for commonly maligned vaccinations like measles , only one in 1 million doses resulted in any adverse reactions at all ; 6 that where vaccine hesitancy had increased , cases of measles , chickenpox and pertussis surged . 13 But it wasn ’ t until I had a patient , a baby , with severe pertussis that I realized just how vulnerable I had been . This , too , was a vivid story , the kind a physician never forgets . It was also the kind of story that never makes it into viral emails and social media posts . Without ever seeing a now-rare case of teenage meningitis , how was my mother to balance the risk of meningitis against the risks she knew she was afraid of ? Or , in 2020 , if everyone around you who developed COVID-19 had only a mild case , could you truly understand the risk of forgoing a vaccination ?
A recent systematic review identified complacency as a key factor in influenza vaccine hesitancy . 8 When parents like mine have closer proximity to vaccine horror stories than they do to the diseases themselves , it is easy to imagine how some of them choose what they feel is the safer option .
Vaccines are a true public health triumph . Throughout the 20 th century they have significantly reduced the incidence and morbidity of previously common and devastating illnesses . With their success , however , has also come increased resistance and vaccine hesitancy . Anti-vaccine movements can be traced back as far as the 1850s when mandates for smallpox vaccinations were seen as a violation of personal freedom . 2 This has only worsened in recent decades with the now debunked Wakefield publications inflaming concerns on links to autism . A 2013 study by the American Academy of Pediatrics measuring the rate of parental vaccine refusal , found an increase