PSA Poster

PSA Poster

My PSA poster is intended to target white middle-class parents who are new parents because they are the biggest demographic who opt out of vaccines.

In my poster I tired to appeal to white middle class parents with young children. I wanted the poster to make vaccines feel less scary. I also wanted it to appeal to parents’ logical side and stop them from getting caught up in emotions. In addition I wanted to emphasize the fact that health professionals overwhelmingly support child vaccinations. Finally, I wanted to accomplish all of this but keep the poster looking clean bright and fresh.

Since a majority of the parents who choose to not vaccinate their children are white middle class parents I wanted to appeal to that demographic. I have always found it baffling that the parents who can easily afford this kind of medical care choose to ignore it. These parents are usually college educated and have a secure job. With this mind I tried to appeal to their rational side by showing that the vast majority of health professionals keep their children happy by vaccinating their children.

The major point of the poster was to make vaccines seem less scary.  The woman in the picture looks like someone mothers could talk to and trust. The child also looks happy and healthy and she looks innocent with her teddy bear that so many other children her age cling to. It also looks like the mom is checking up on her daughter to make sure she is healthy and their smiling faces confirm that the little girl is healthy after her shots. In addition I wanted the doctor in the picture to be a woman because they are associated with being nurturing and comforting. The two are smiling and looking directly into the camera to show they are not hiding anything. I included the syringe clip art to liven up the poster and give it a little innocence. I wanted the picture to be a cartoon because a real picture would be too intimidating. Since it is a cartoon the vaccines do not seem as threatening and scary, instead they have a child like innocence to them that makes the viewer feel comfortable. I also had them facing in different directions to give them the effect of dancing around the picture so they would seem a little more fun and comforting

I wanted the poster to appeal to parents’ rational side. By pointing out that the experts support vaccines I hope to make parents realize vaccines are safe. I thought this kind of logic would be successful because often people ask professionals what they would do in their situation and trust what they say. For example you would ask a dentist what toothpaste they have or a mechanic what car they think is most reliable.   Health professionals are required to be well versed on medical treatments and since so many people trust their opinion this poster highlights the health professionals’ views and choices. With this in mind I believe that by stating these professionals trust vaccines more people will start to believe they are safe.

I made sure to include that the medical industry unanimously agrees that vaccines do not have any long-term adverse side effects.   I thought it was important to highlight this fact because the main reason people do not vaccinate their children is because they believe an outdated study that said the MMR vaccines could cause autism. By clearly stating that there is no side effects it is not left up to interpretation and parents must accept that they have not found a single long-term side effect linked to any vaccines.

I wanted the Poster to feel clean, healthy and bright. The accidental presidency font was chosen because of its clean lines. I wanted a fresh font that would not be distracting. I also wanted the poster to feel professional and serious since the main idea is the support of health experts. I also thought if the font was clean and clear it could be connected to a clean doctor’s office. I tried to find a background that was calming, happy and healthy. Since green is often associated with spring, rebirth and the outdoors I thought it would be a great color to include in the poster. The blue was used because it is associated with a clear sky, which has a positive and happy connection. I also wanted the colors to be slightly muted to make sure it was not distracting from the main purpose of the poster.

Main poster photo was obtained from:

http://www.smartsalus.com/murcia/pediatra-en-murcia-1852

Clip art from:

Postermywall.com

The PBE Decision

After reviewing both sides of the debate, I think California should move to remove the personal belief process (PBE) completely, because it is best for public health. The state has allowed parents to make this decision for years and because of it, there have been numerous outbreaks of preventable diseases. Americans have lost the freedom to choose for themselves because it is now affecting the general public in negative ways. In fact it has been found that the fewer number of personal belief exceptions directly corresponds to fewer confirmed cases of preventable diseases.

California schools have allowed their parents to waive the state mandated vaccination requirements since the law was instated and since then people have been abusing the privilege. The personal belief exception was not supposed to become as popular as it as become. In fact, 2.5% of kindergarteners in the state of California are not vaccinated with a national average of 1.8%, according to Tasneem Raja and Chris Mooney of Mother Jones. Tasneem and Mooney also found that PBE’s have increased by a full 1% since 2008. This rate is higher than more than half of the country and is due to the painless personal belief exception process. Saad Omer, leader of a vaccine exception study in 2012 believes some of these parents fill out the PBE forms because it is easier than taking time off work to take their children in to get vaccinated. This proves that when the state allows the citizens to choose they choose wrong and ruin the process for everyone else.

Personal belief exceptions put the public health at risk for more outbreaks and increased numbers of preventable disease cases. California has had numerous outbreaks in recent history and the biggest being one in 2010 and another in 2014-2015. In 2010 there was a large pertussis outbreak that killed 10 infants who were too young to be vaccinated and had 9000 confirmed cases. This outbreak is a great example of how vaccinations should be administered to everyone so it can protect those who are either too young or not healthy enough to receive the vaccination themselves. Those who died were the ones who did not have the chance to receive the vaccination because so many who had the choice chose to opt out thus putting others in danger. This outbreak was the worst whooping cough outbreak the country had seen in 60 years. The most recent and known outbreak began was a measles outbreak that originated and spread through visitors at Disneyland. This outbreak had 147 confirmed cases in the country and 131 of these were California residents and no deaths. These two instances prove that there are many California citizens need to be forced to vaccinate themselves and their children. It is vital for the state’s public health to ensure all of the individuals who are old enough and healthy enough to receive vaccinations are vaccinated.

When we let the state choose, too many parents chose to opt out of the vaccinations process. In order to keep the state healthy and cut down on the frequency of outbreaks and preventable diseases we can no longer trust the public to make the right decision. Although we live in a democratic country where people should be free to make their own decisions, keeping the public healthy is more important. This idea is hard for politicians to explain without losing their job so it will be a long and difficult process but I firmly believe the personal belief exception process should be disposed of.

Why The Personal Belief Exceptions Process Should Continue

There are many Californians debate whether or not the government should get involved with the process of obtaining personal belief exceptions for vaccination requirements. The best argument those who appose getting rid of and or increasing the complexity of PBEs is that it is their right as free Americans to refuse vaccinations and it is hard for the government to take away peoples freedom of choice. At this point the government cannot alter or take away the personal belief exception process because the government cannot take away citizens’ right to choose whether to vaccinate or not even if a majority of the public is making the wrong decision.  It is extremely difficult for a democratic government to make their citizens do things they do not want to do.

slate.com

Many Californians have numerous reasons they wish to not vaccinate their children. Most fear that vaccines can cause long-term adverse side effects, the most frequent fear being it causes autism. There are countless stories of parents who took their children in to get vaccinated and noticed an almost immediate change in behavior; these children were later diagnosed with behavioral disorders. Other parents simply wish their children to lead more natural lives and do not want to put what they believe to be toxic vaccinations, into their children’s bodies. With this in mind, many physicians even suggest children start the vaccination process at only 2 months old when their immune systems are still extremely weak. Currently all studies preformed on vaccines have concluded there is not a link between vaccines and diseases such as autism. Despite these conclusions countless parents are still worried about the possibility. Although there is no scientific data to back up these fears, the government should not be forcing parents to vaccinate if they are strongly apposed to it.

huffingtonpost.com

If the government were to make personal belief exceptions harder to obtain they would be punishing parents for their beliefs.   Some parents stand firmly against vaccinations and do not all have the time to go through tedious paper work and seminars just to maintain their right to raise their child as they see fit.   For this to be fair all parents would have to go through the same process and then fill out corresponding paper work on weather or not they intend to vaccinate their children before they enter the school. Parents should not be punished for having alternative views and lifestyle choices that do not fit the norm. It is there right to refuse any treatment they do not believe is best for their children. There would be immense backlash if the state were to take away this process that allows them to get around the requirement.

The government and school systems cannot tell parents how to raise their children or make them do things they do not want to. It seems that if the government were to impede on the parent’s right to choose how to vaccinate their children would be contradictory of the way this country is moving. It is not up to the government to pressure parents to vaccinate their children just like it is not up to the government to pressure parents into using specific diapers or baby wipes. It is not fair for the government to punish those parents who truly believe they are doing what is best for their child.

Why California Schools Should Make The Process to Receive Immunization Exceptions More Complicated

google images infant vaccination

Many Californians debate weather or not California legislature should continue to make personal belief exceptions or “PBE,” easily obtainable. I think the proponents who believe the process should end or be made more complicated, make their best argument when claiming it will cut down on the number of PBEs filed thus cutting down on the number of confirmed cases of preventable diseases and outbreaks.

The current personal belief exception policy is too easily obtained and should be altered in order to deter parents from obtaining it or banned completely.  The immunization requirement policy was revised in 2014 and now requires all parents who want to receive PBE must fill out a one-page form 6 months before a child is subject to a vaccination obligation. This form is currently easily downloadable and usually available in school offices. The form contains a letter from the parents requesting an exception from the law due to their personal beliefs as well as a signed testimony from a doctor verifying they went over the pros and cons of immunizations as well as the risks to personal and public health when waiving said vaccinations. This whole process could be completed within a few hours at most. Once this exception is filled out, the exception stands for the rest of the child’s public school career unless they move out of state. Proving that it is extremely easy for parents to sacrifice a few hours of their time and will never have to worry about the process or vaccinations again.

slate.com vaccination rate

As the law in California currently stands, it is fairly easy to receive a personal belief exception. The government could implement numerous obstacles throughout the process in order to make obtaining a PBE more difficult, which will subsequently decrease the number of PBEs in the state. Examples of policy-level obstacles are explained in the previous post.

google images infant vaccination

A study published in the New England Journal of Medicine explains how important it is to cut down on the number of PBEs in order to keep a healthy public. The article explains children who do not receive their immunizations, “are at increased risk for measles and pertussis and can infect others who are too young to be vaccinated, cannot be vaccinated for medical reasons, or were vaccinated but did not have a sufficient immunologic response.” Showing that parents are not only putting their own children at risk for these preventable diseases but also other people and children who do not have the choice to receive the protection from a vaccination. With that in mind, the more PBEs that are granted the more children are put in jeopardy. The data supports that if the PBE process were to end or at least become more complicated there would be a substantial decrease in preventable diseases.

Only two states do not allow any exceptions

The same study found that, “the complexity of procedures for obtaining exemption has been shown to be inversely associated with rates of exemption.” Proving when it is more difficult for parents to receive he PBEs they are less inclined to put in the extra effort and in turn resort to vaccinating their children to match that of the school requirements. The study also found that the states and areas with lower rates of exceptions also have lower rates of confirmed cases of preventable disease cases. Which confirms these obstacles act as deterrents for parents, especially those who are on the fence about the decision.

Should The Government Step In?

Levels of difficulty to obtain exceptions by state from motherjones.com

In the passed year, the recent measles outbreak has brought the number of confirmed cases up to a startling 644 infected individuals. Since the disease is growing at an upsetting rate should the government step in? The major cause of the recent outbreak and growing diagnoses are due to the ease of increased non-medical exceptions to vaccine mandates and requirements.  Each state has its own policy on how parents can obtain these exceptions but I propose there to be a uniform nationwide policy in order to get this epidemic under control.

Immunization exceptions are needed for those who have immune disorders or are receiving treatment for cancers, which weaken the immune system.   These are also the people who suffer the most during outbreaks like the current one we are in.   Individuals who do not have a strong enough immune systems to accept the vaccine are one of the many reasons the rest of the public needs to be vaccinated. Heard Immunity as I discussed in my previous post, is a sensitive process that requires almost all of the public to be vaccinated to make sure outbreak does not occur and infect those who are unable to receive the vaccine.

What can be done to get skeptical parents to vaccinate their children? The answer is for the government to make obtaining non-medical exceptions more difficult on parents. According to the New York Time’s Saad B. Omer in, “How to handle the Vaccine Skeptics,” nineteen states acknowledge personal and moral exceptions. Parents request a majority of these exceptions because they believe the immunizations will cause their children to become autistic, even though this belief has been proven wrong by numerous official government and private studies.

Percentage of children with exceptions from motherjones.com

In order to make these exceptions harder to obtain there can be numerous obstacles implemented to draw out the process and discourage parents from rejecting vaccinations. Omer suggests a plethora of ideas such as schools requiring parents write a formal letter explaining why their child should receive an exception and then require said letter is notarized. An alternative to a written letter states could hold forms that are only obtained by parents issuing a formal request rather than an easy download or the schools supplying copies. In addition, schools can require parents to sign a waiver that explains the dangers of not vaccinating children in depth. Another idea is to require parents attend counseling or a meeting that gives them all the information they need to make a well-informed decision. If the parents do obtain the non-medical exceptions, Omer suggests parents be held accountable to keep their children at home when outbreaks occur as well as expiring their exceptions every year thus requiring parents to repeat the tedious process annually.

These kinds of obstacles are expected to cut down on the rates of exceptions thus diminishing the rates of reported preventable diseases. For example Omer was a part of a study published by the Journal of the American Medical Association in 2006 that cited, “states with easy procedures for granting non-medical exemptions had approximately 50 percent higher rates of whooping cough.” Later in 2012, Omer was a part of another study published by The New England Journal of Medicine that found “non-medical exemption rates were 2.3 times higher in states with easy administrative policies for granting exemptions (like Connecticut, Missouri and Wisconsin) than in states with difficult policies (like Florida, Minnesota and Texas).” Proving this kind of tactic has been successful at reducing preventable diseases since 2006.  If these policies are already working in states like Texas and Minnesota, I think the rest of the country should follow their lead even if the federal government needs to impose a nationwide policy.

Who Holds The Power

          After further researching whether or not parents should vaccinate their children I have realized that the pro-vaccine side has more money and power than those opposed to vaccinations. One of the primary pro-vaccine organizations is the CDC a nonpartisan, non-profit institution that was created by the U.S. Congress. With the motto, “Saving Lives, Protecting People,” the CDC says it connects “with private-sector organizations and individuals to build public health programs that make our world healthier and safer.” This kind of language makes the CDC appear to be looking out for the greater good of America. With the federal government, not the medical industry, financing the CDC, it is easy to see why most people trust what they believe is an impartial agency. Still, the CDC promotes the use of some medicines and drugs through which the pharmaceutical industry generates significant profits.

          Since the CDC is well funded and widely trusted they have the means to influence the pharmaceutical industry, healthcare industry, and general public. The government allocates $11 billion a year to the agency which in turn disperses the money for research, public health programs, information dissemination and health education among other projects. The CDC frames the vaccine debate in a scientific and dispassionate way that speaks to people’s rational side. The agency has released many studies on the side effects, effectiveness and safety of vaccines. In addition they dedicate a section of their website to address parental fears about vaccines. The CDC is able to respond to questions quickly and has the authoritative voice to reassure the fearful or uncertain public. For example, soon after the measles outbreak caught fire the CDC held a news-media teleconference  to provide data-informed questions about the measles outbreak and the consequences of not vaccinating. The media event drew correspondents from major news outlets including, NBC News, Bloomberg News, Associated Press and more.  This kind of broad outreach allows their message to be easily disbursed throughout the country.

          The CDC’s broad reach is not enough to directly influence the parents; rather, parental decisions are more directly formed by the CDC’s information delivered through trusted interpersonal channels including, family physicians, nurses, teachers, friends and family members.   Medical professionals and school officials often promote what the CDC declares to be safe and best for the public. This chain of information is what makes the CDC so influential.

          The CDC’s strategy is to use a scientific approach to understanding health issues: through research and education they deliver information they hope saves lives. One persuasive tactic is to provide evidence of real risks to public health in an urgent fashion. For example, the agency’s “Measles and the Vaccine (Shot) to Prevent It—Fact Sheet for Parents” warns:

Measles spread when a person infected…breathes, coughs, or sneezes. It is very contagious. You can catch measles just by being in a room where a person with measles has been, up to 2 hours after that person is gone. And you can catch measles from and infected person even before they have a measles rash. Almost everyone who has not had the MMR shot will get measles if they are exposed to the Measles virus.

In this way, the CDS uses scientific-based facts to convince the reader that the protection of an MMR vaccine is necessary to protect against an invisible infection. By showing how easy it is to catch measles, the CDC is using scare tactics to influence people’s decisions. It should be noted that the agency repeatedly uses language that makes immunization seem urgent and dire. In addition educating about public health risk they also debunk common myths about health and illness. The same fact sheet assures parents, “Scientist in The United States and other countries have carefully studied the MMR shot. None has found a link between Autism and MMR shot.”  This kind of reassurance also debunks the entire anti-vaccine argument. If the CDC’s claims are true, then the anti-vaccine movement does not have a leg to stand on and is no longer relevant.

Claims Against CDC: Fact or Propaganda

Since 1998 there has been a heated debate over numerous studies preformed to find one answer: Do vaccines increase the risk of developmental diseases? There have been stories splattered across news outlets that attract people’s attention because they are frightening and not necessarily because they are completely accurate.  Unfortunately, this kind of journalism, in cases such as this, can lead to mis-informed decision making that effects the whole country. It was recently reported that a CDC “Whistleblower,” William Thompson, has stepped forward and admitted to being a part of a CDC 2004 study which was published by Pediatrics journal that omitted critical information thus misleading the public to believe there is no connection between the MMR vaccine and autism. Thompson is being helped to spread his message by the founder of this belief, Andrew Wakefield.  Wakefield headed the original report that linked the mumps-measles-rubella vaccine to autism.  The publisher later found Wakefield fabricated his data to draw his intended conclusion and the report was retracted 10 years later.  Although the study was retracted and discredited Wakefield continues to be at the forefront of the fight against infant vaccinations.

In August of 2014 Time.com published an article about Thompson stepping forward and his involvement with Wakefield. The author of this article, Alice Park, tires to distinguish whether Thompson’s accusations should be taken seriously or if they are just more faulty claims by the anti-vaccination movement. The study in question looked at children who showed symptoms of autism along with those who did not and recorded when and if those children received the MMR vaccine. They found that the children who had received childhood vaccinations did not show higher rates of autism compared to those who either received it later in life or not at all.  This outcome concluded that childhood vaccinations were not linked an increased risk of developmental disorders such as autism.

Thompson’s accusations against the study are highlighted in a short-film posted on youtube, titled “CDC Whistleblower Revealed.” It should also be noted that Thompson claims he did not know his conversation was being recorded.

Alice points out that Thompson’s main accusation was that the study had found that of the 624 children with autism and 1824 without those who were African American boys, had a higher rate of showing signs of autism but the CDC did not mention this link in their published report. This kind of information would lead us to believe the report was fraudulent and that vaccines are in fact dangerous at least to some part of the population. But, according to Alice Park this was a function of statistical analysis, “scientists take the original population of participants in a study, however large, and drill down to analyze trends in a subgroup – in this case the African-American boys – the power of the associations they find dwindles. That’s because the numbers get smaller, and in order to be statistically relevant – something known as statistical significance to statisticians.” Meaning this link between African American boys who were vaccinated and autism was so small it wasn’t seen as a well-founded conclusion. If this explanation is true, Wakefield and Thompson are exaggerating small faults in the study in order to make normal people believe their side, and the publications are only printing their story in hopes of selling copies. This kind of faulty journalism is what has misled so many parents to believe their children could be injured by life saving vaccines.  I think this should be an example of how misleading the media can be, so people should always triple check important stories such as this one to make sure they are making informed decisions.

The Great Vaccination Debate

The measles virus via sciencesource.com

American parents are faced with the having to decide whether vaccinating or denying vaccination in their child’s best interest.  When his seven-year-old daughter died in 1962, there was no vaccine to prevent her illness. “The measles had turned into a terrible thing called measles encephalitis and there was nothing the doctors could do to save her,”(CBS)  recalls Roald dahl, author of “Charlie and the Chocolate Factory”.  “Today a good and safe vaccine is available to every family, and all you have to do is to ask your doctor to administer it,”(CBS) advised the author, who urges parents to vaccinate.  Sometimes people take vaccines for granted and forget how ugly and terrible the alternative is. Speculation that The mumps-measles rubella vaccine causes autism is fueled by stories similar to the following: “That Christmas Eve day in 1993, a few days following her needle, she became very ill, vomiting, lethargic, no appetite, very dark circles under her eyes and her eyes themselves seemed lifeless, very dark,”(Vaccine Choice Canada) recalls mother, Gloria Dignazio, “Sara would later be diagnosed with having a Pervasive Development Disorder (PDD), which is borderline autism,”(link via Health Impact News).

For my semester project, I am interested in the vaccination controversy in America. Over the past 20 years or so there has been a trend for parents to opt out of proven life saving vaccines, which for previous generations of parents were seen as a health requirement. With the recent measles outbreak this decision has become a critical one that could affect the entire country. I would like to spend the semester researching what drives parents to elect to vaccinate or waive vaccinations for their children, and I seek to determine whether fears about vaccination are well founded.

I am particularly interested in this debate because I believe children should not suffer from ailments that can be easily avoided.  Specifically, my brother and his wife are expecting their first child in only two months and they live in Orange County, where the recent measles outbreak originated. Even if my brother and his wife decide to vaccinate their child cannot receive the vaccination for six months, which leaves their child and all other infants in the country extremely venerable to disease.

image from CDC

People are not aware that Measles outbreak of 2014-2015 is dangerous to the entire country.  The CDC reports since early January of 2015 there have been over 150 confirmed cases of measles and almost all are believed to have originated from Disneyland. Many people who are vaccinated are not concerned with this epidemic, but of these confirmed cases, at least six of the individuals were already vaccinated.  According to PBS this happened because, “Large numbers of vaccinated people act as a firewall that prevent the disease from spreading to those who are vulnerable. The vaccinated protect the unvaccinated. That’s known as ‘herd immunity.’ But as more people opt not to get vaccinated, or not to get their children vaccinated, the virus has more portals to creep through, more people to infect”(PBS).  Proving that unfortunately these vaccines only work if everyone uses them, but this will not happen unless parents are reassured there is no connection of long-term adverse health issues and vaccinations. On the other hand if there is finally a study credible and dependable study that finally proves the connection we should be concerned about what will happen to America’s overall health if vaccinations are no longer safe. I am interested to find out if there will ever be enough proof to turn everyone over to one side.  If not, what should be done about all the skeptics who are ruining the heard immunity?