![]() Therefore, events that are “accessible” can lead to an over-estimation of frequency. Reports of vaccine adverse events are often distorted and amplified through sensationalistic media coverage and rapid dissemination of misinformation on the internet. There is a preference for “errors of omission” (risks of not vaccinating) over “errors of commission” (risks of vaccination). Further, there is a preference for “natural risks” (disease) over “manmade risks” (vaccination). “Ambiguity aversion” influences people to favor known risks such as those from diseases rather than unknown risks that are less frequent such as the possibility for vaccine adverse reactions. As described by Ball et al., 16 there is often a “compression” bias which causes people to over-estimate the frequency of rare risks such as those associated with vaccination. ![]() Vaccines are not only victims of their own success, but also struggle to maintain public confidence given the heuristics that often influence risk perceptions and decision-making. In our electronic age, vaccine safety scares rapidly cross national borders and circle the globe. 12 - 14 Efforts have been made to provide additional tools to healthcare providers but the problem is far from solved. Further, they are finding it increasingly more difficult to effectively communicate accurate and objective information to parents about vaccines and addressing their specific concerns. 5 Pediatricians and other healthcare providers are increasingly under pressure to see more patients in less time and find themselves confronted with parents that find misinformation and poor science on the internet. Many parents no longer want to be told what to do for the health of their children by their pediatrician, but rather want a shared decision-making process. Fear of the “pharmaceutical industrial complex” and inappropriate relationships between industry and the government, distrust in science and the medical community has fueled vaccine hesitancy among portions of the public 5, 8 Growing public interest in “natural” products and alternative types of medicines have led to marches to “green our vaccines.” While very strong support from pediatricians and health care providers for vaccines has been central to our successes in immunization programs, 9 - 11 the medical model has substantively changed over the years. 4, 7 Trust in large corporations that manufacture vaccine and the government that widely purchases and promotes vaccines are at all-time low levels. ![]() ![]() Many sociocultural changes have contributed to vaccine hesitancy. Consequently, fear has shifted from many vaccine-preventable diseases to fear of the vaccines 6 In today’s world, smallpox has been eradicated due to a successful vaccination program and vaccines have effectively controlled many other significant causes of morbidity and mortality. collective responsibility with compulsory vaccination. In the early 19th century there were concerns ranging from connotations of bestiality associated with injecting material from a cow into people, questions regarding the appropriate role of man to intrude on divine will to cause disease, and the optimal balance of individual freedom vs. As was the case when smallpox vaccine was introduced, there are many reasons why portions of the public are hesitant toward vaccination. The remarkable discovery of Smallpox vaccination was met with considerable hesitancy and outright opposition. Vaccine hesitancy has been around as long as we have had vaccines.
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