Why are people not getting vaccinated?

GIVE A SHOT—In this file photo, a sign telling customers that they can get a flu shot in a Walgreen store is seen in Indianapolis. (Darron Cummings/AP)

Vaccines for diseases that used to sicken and even kill millions of people throughout the world—like measles, polio, whooping cough and more—have been available for decades. Thanks to robust vaccination programs in the United States, the spread of many of these diseases had stopped. However, in recent years, outbreaks (three or more linked cases) of some of these diseases have caused concern.
Researchers have linked fewer people getting vaccinations to an increase in preventable diseases. Take measles, for instance—measles is a disease that spreads easily and quickly. According to the Centers for Disease Control and Prevention (CDC), the continuous transmission of measles was eliminated in the United States by 2000. But, in recent years, many measles outbreaks have been reported. The CDC reports that the majority of people who have gotten measles in recent years were not vaccinated.
Richard K. Zimmerman, MD, MPH

When large numbers of people are vaccinated, diseases have a much harder time moving from person to person. If a person does get a disease but is in contact with people who have been vaccinated, the disease will not spread quickly to other people. This protection is called “community” or “herd” immunity. But when larger numbers of people are not getting vaccinated, herd immunity breaks down and people are no longer protected when diseases arise.
Also, according to Richard K. Zimmerman, MD, MPH, professor of family medicine, and associate professor of behavioral and community health sciences, University of Pittsburgh, flu vaccine rates dropped 40 percent last year, and 79,000 people in the United States died from the flu (the typical number is 23,000). So, why are people not getting vaccinated and breaking down the protection of herd immunity?
Many researchers have found that vaccination myths are one of the reasons people are not getting immunized against preventable diseases. One of the most common vaccination myths is that vaccines can cause illnesses or diseases.
“About one in five people will get a sore arm at the injection site, but people can’t get an illness from an inactivated vaccine,” said Dr. Zimmerman. “Almost all vaccines are inactivated [meaning, they are made with dead viruses, bacteria or toxins]. People say they get the flu after getting a flu shot, but they more likely caught an illness from someone else in the waiting room.”
In recent years, one of the biggest myths about childhood vaccines was that they can cause autism in children. Researchers have studied whether vaccines cause autism. Despite how common that myth is, no research study has found a link between vaccinations and a likelihood of developing autism.
A disparity exists in vaccination rates among different racial, ethnic and age groups. Dr. Zimmerman points out that children overall have higher vaccination rates than adults. The CDC reports that White adults have higher vaccination rates than African American, Latinx and Asian adults. Barriers to vaccination include not having appropriate health insurance coverage and a lack of knowledge about which vaccinations to get at what age. [See elsewhere on the page for links to vaccination schedules by age group.]
Part of Dr. Zimmerman’s research involves how to get more people vaccinated. Along with recommendations for health care providers, Dr. Zimmerman cited three different factors in helping people get vaccinated—habit, attitude and social influence. People tend to get vaccinated more when they develop a habit of doing so. If people have the attitude that vaccines help them and everyone stay healthy, they are more likely to get vaccinated. Finally, when people encounter the social influence of someone like a health care provider who encourages vaccines, people are more likely to get vaccinated. Dr. Zimmerman also notes that incentives—like insurance companies offering credits or lowered copays—help people get vaccinated.
Even if people think they are safe from preventable diseases, Dr. Zimmerman recommends that they think about getting vaccinated to help keep their loved ones safe. A health care provider can help people know what vaccinations they need and when to get them.


For more information about vaccines, their safety and why getting them is important, Dr. Zimmerman recommends the following websites:
1. CDC—cdc.gov/vaccines/index.html
2. Children’s Hospital of Philadelphia Vaccine Education Center—chop.edu/centers-programs/vaccine-education-center
3. immunize.org
4. pkids.org
To view the CDC’s recommended vaccination schedule for children, go to https://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf.
For teens, go to https://www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html.
For adults, go to https://www.cdc.gov/vaccines/schedules/easy-to-read/adult.html.
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