JAMA Viewpoint: Increasing US Vaccine Coverage Through Law, Science and Communication

CONTACT: Karen Teber / km463@georgetown.edu

EMBARGOED FOR RELEASE: Friday, April 19, 2019; 11 a.m. ET

WASHINGTON – Three public health leaders are calling for a multi-pronged approach to restoring the vaccination level needed in the U.S. to ensure herd immunity and prevent disease outbreaks such as the current measles outbreak in New York.

Writing in JAMA (published April 19), the experts call for:

  • A sustained public health education campaign on the safety of vaccines;
  • Social media companies treating false anti-vaccine messages as they do sexually explicit, violent or threatening messages; and
  • The tightening of state laws to end religious and philosophical exemptions for vaccines.

“Childhood vaccination is the greatest public health achievement of 20th century,” says lead author Professor Lawrence Gostin, faculty director of Georgetown University’s O’Neill Institute for National and Global Health Law. “If we don’t take bold action now, we will see a resurgence of childhood illnesses and deaths. No parent has the right to place their child, or other children, at risk to their health.”

According to the U.S. Centers for Disease Control and Prevention, public health officials declared measles eliminated from the U.S. in 2000 with the annual reported measles cases ranging from a low of 37 in 2004 to a high of 667 in 2014.“This year is on track to have more cases than any year since measles was officially eliminated,” write the authors, which include Gostin, Scott C. Ratzan, of the Harvard Kennedy School of Government and; and Barry R. Bloom of Harvard T.H. Chan School of Public Health.

“Increasing vaccine coverage will require a shift in the informational environment,” the authors write. “Most parents who refuse vaccinations for their children do so with good intentions. If they had access to high-quality information from trusted sources, many would likely choose to have their children vaccinated.”

Gostin endorses congressional funding for a communications campaign to build vaccine literacy titled Safe Vaccines for a Healthy America.

“There is nothing more central to the U.S. Department of Health and Human Services’ duty than keeping people in this country safe and healthy,” Gostin says. “A federally funded campaign reinforcing the safety of vaccines is clearly needed now just as it was when vaccines were first determined to be highly safe and effective.”

Gostin and the authors say there is nothing controversial about the dissemination of evidence-based information. “As part of such a campaign, [HHS] could partner with states, foundations, and the private sector to spearhead multisectoral action that is parent-friendly and nonjudgmental.”

The public health leaders also call on the private sector to “stem the flow of misleading information.”

“Private and publicly traded companies should screen out false anti-vaccine messages and cease providing a platform for harmful exchange of falsehoods that promote childhood disease, just as they do for sexually explicit, violent, or threatening messages,” they write.

Finally, using the law as a public health tool would ensure children have the freedom to attend school or play with friends without contracting a serious disease.

“The obvious remedy to vaccine hesitancy is to eliminate or tighten non-medical exemptions,” says Gostin. “There is no need to ban kids from public places, as Rockland County, NY attempted to do. School mandates work and are constitutional.”

To interview Gostin, contact him at gostin@georgetown.edu.

The O’Neill Institute for National and Global Health Law at Georgetown University Law Center is the premier center for health law, scholarship, and policy. Its mission is to contribute to a more powerful and deeper understanding of the multiple ways in which law can be used to improve the public’s health, using objective evidence as a measure. The O’Neill Institute seeks to advance scholarship, science, research, and teaching that will encourage key decision-makers in the public, private, and civil society to employ the law as a positive tool for enabling more people in the United States and throughout the world to lead healthier lives.

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