State health officials convened a vaccination awareness forum Wednesday at Children's Hospitals and Clinics of Minnesota to re-energize doctors and public health workers who are discouraged that a growing number of Minnesotans are ignoring their advice to make sure their children are vaccinated.
The forum occurred as the Minnesota Department of Health confirmed two additional cases of measles bring the state's outbreak total to 23.
Public health leaders say the outbreak is not surprising given Minnesota's declining vaccination rate. In just two years the state's overall vaccination ranking has slipped from seventh best in the nation to 20th place.
The reasons for the trend are varied say. Much of it is due to apathy. Most people are too young to know anyone who has had polio, diphtheria or even measles. But health officials also acknowledge that they need to do a better job of explaining that vaccines are critically important in the fight against such diseases.
Many people have found bad information about vaccines on the Internet, said Dr. Martin Myers, who directs the National Network for Immunization Information based in Galveston, Texas. He said that includes claims from authors looking to make a buck, and celebrities who have no science knowledge to back up their personal beliefs.
"Jenny McCarthy went from Playmate to authority," Myers said. "How did she do it? Oprah Winfrey and Larry King Live. Her education? Google University. Her data? 'My son is all I need.'"
Myers said most parents who turn to the Internet for such information are trying to do the right thing. They're going to these sources because they want information to help them sort out the risks associated with getting a vaccine, he said.
“Jenny McCarthy went from Playmate to authority. How did she do it? Oprah Winfrey and Larry King Live. Her education? Google University.”Dr. Martin Myers, immunization expert
That's something they haven't been able to obtain from their medical providers, he said, at least not in terms they can understand.
"We talk in tongues," Myers said. "What parents want to [know] is, 'Do you think it causes autism or not?' 'No, I don't think it causes autism.' They want to know, what do we think?"
Myers said sharing information with parents also means honestly telling them of the risks associated with vaccines -- even if they're very small risks. Parents want to hear about the side effects, he said.
"Fifteen percent of kids may have a fever afterwards," Myers said of post-vaccine reactions. "And some kids might even have a febrile seizure. That's scary."
Explaining such things to parents takes time, something doctors and nurses don't have a lot of.
Doctors also need to show humility, said Dr. Robert Jacobson, a pediatrician at the Mayo Clinic. The health care system has a long history of elevating the authority of medical providers who don't necessarily like being questioned by patients, said Jacobson, chairman of the American Academy of Pediatrics Immunization Task Force.
"People show up, and like a delivery person I say, 'Where do you want that health care delivered?'" Jacobson said. "It was not an approach where we actually thoughtfully helped the parents with benefits and risk decision-making, but more or less said, 'This is what I'm telling you to do. Do it.' That's got to change."
Such insights from doctors like Jacobson and Myers are hopeful signs to Peter Sandman, a risk communication consultant based in Princeton, New Jersey. But he said there are still many people in public health who don't recognize their own failures in the vaccine debate.
Sandman said Minnesota's measles outbreak shouldn't be blamed on the musings of discredited researcher Andrew Wakefield, who first suggested the link between autism and the measles, mumps, and rubella vaccine.
The Somali community wouldn't have been susceptible to Wakefield's message, Sandman said, if public health officials had responded more vigorously when the community first expressed alarm over its high autism rates.
He suggested that state health officials apologize for their inadequate response to autism in the Somali community.
"The Minnesota Department of Health should be more interested in curing autism than in proving that vaccines are benign," Sandman said.
Wakefield recently launched a new autism study in collaboration with Minnesota's Somali community.
Instead of discouraging the project, the Health Department should offer to work with Wakefield to both ensure the scientific integrity of the study and to show the Somali community that the agency is listening to their concerns, Sandman said.