Policy Talking Points: Vaccine Confidence

Background

The prevalence of autism is estimated to be 1 in 36 children, based on monitoring by the Centers for Disease Control (CDC)’s Autism and Developmental Disabilities Monitoring Network. Increases in the observed prevalence of autism over the past several decades can be explained in part by changes in the diagnostic criteria, improvements to screening and diagnostic methods, and increased access to screening and diagnostics. Unfortunately, there is still a lot of doubt about the reasons for the increased prevalence of autism and other developmental disabilities. 

For nearly three decades, there has been a persistent belief that vaccines cause autism and other developmental disabilities, originating from a 1998 study by Andrew Wakefield on the MMR vaccine. That study was based on 12 preselected children. Following the publication of this study, the scientific community has extensively researched whether vaccines, and any of their active and inactive ingredients, cause autism or other developmental disabilities. The broad scientific consensus has found no link between vaccines, their ingredients, and autism and/or other developmental disabilities. It was later discovered that Wakefield had falsified data in his original study, and his medical license was revoked. 

Disproven challenges to vaccines are incredibly dangerous and do a disservice to autistic and developmentally disabled people and their families as well as the entire disability community. Many people with disabilities face disproportionate risk of exposure, illness, and death due to viral infection and require vaccines to participate in society.  Multiple prenatal, perinatal, and postnatal infections are also known to be causes of developmental disabilities, including measles, rubella, meningitis, and varicella; there are vaccines for these viruses. Autistic and developmentally disabled people deserve research that focuses on how to best meet their needs and ensure their full participation in their communities rather than continuing to use valuable resources to relitigate the causes of autism.  

Understanding Vaccine Ingredients 

• Mercury: 

• • The form of mercury found in thimerosal (a preservative that prevents microbial growth) is ethylmercury, which is not the form of mercury that is linked to nervous system damage, methymercury. 

• • Although no evidence of harm has been proven, thimerosal was taken out of vaccines in the US as a precaution. 

• • Since 2001, all vaccines routinely recommended for children six years of age and younger are available without thimerosal. 

• • Vaccines that do not contain thimerosal as a preservative are also available for adolescents and adults.  

• • A robust body of peer-reviewed scientific studies conducted in the U.S. and other countries support the safety of thimerosal-containing vaccines. 

• Aluminum: 

• • Aluminum is used in some vaccines as an adjuvant – an ingredient to improve immune response. 

• • Aluminum is the most common metal found in nature. It is in the air, food and drink. Infants get more aluminum through breast milk or formula than though vaccines. 

• • Most aluminum in the body is eliminated quickly. 

• • Aluminum is not present in live, weakened viral vaccines like those that prevent measles, mumps, rubella (MMR), chickenpox, mpox/smallpox, yellow fever, and rotavirus. 

• • Aluminum is also not present in the following (non-live) vaccines – influenza, meningococcal ACWY, cholera, dengue, Ebola, rabies, pneumococcal (polysaccharide version), typhoid, shingles and polio vaccines. 

• • The quantity of aluminum in vaccines is tiny compared to what is required to cause harm. Even after an injection of vaccines, the amount of aluminum in a baby’s blood does not change in a way that is detectable. 

 F2F/Peer-to-Peer Support in Vaccination Efforts 

• “Parental/caregiver support and confidence will be paramount to achieving high vaccination rates over time, yet many have concerns or questions about getting their younger children vaccinated.” 

• • We are FAMILY- to-FAMILY Health Information Centers whose job is to inform, educate and train. We are already connected to families, schools, communities, professionals, state and local policymakers and agencies. 

• “Trusted and diverse messengers matter, and outreach will be even more important, but more challenging, over time.” 

• • F2Fs are trusted (period). We are an existing, trusted community and public health infrastructure – no need to reinvent the wheel. We have been in the community for decades and know how to work with families over long periods of time as they navigate a myriad of health issues. 

• • Youth voices in our network have gotten stronger and are leading us all. 

• “It will be important to prioritize equity as vaccination efforts extend to younger children.” 

• • Our network is diverse and offers a logical way to ensure that people have fair and appropriate access to vaccines and reliable vaccine-related information in the CYSHCN and disability communities. 

Addressing Vaccine Concerns 

Ask the individual to share their concerns around vaccine(s). 

“So you seem to have questions about the MMR vaccine. I want to make sure I answer all of your questions, so let’s talk about it. Would you mind sharing what your particular concerns are?” 

 Family: “Well, I don’t think it’s safe. I heard that is the one that causes autism.” 

Ask permission to share information. Reflect on what the parent is saying to fully understand and empathize, summarize their concern, and ask permission to share your perspective. 

“So I hear that you’re concerned that the MMR vaccine can cause autism. I’ve also heard some stories about this vaccine and I follow vaccine safety closely. Is it okay if I go over what I know about this vaccine?” 

Provide info to change a parent’s perspective. Focus on disease prevention. 

“Autism is a challenge for many families and people want answers – including me. But well conducted studies show that MMR vaccine is not a cause of autism.” 

“But I have worked with kids who got very sick from diseases we can prevent with vaccines. Tell me what you’ve heard about measles complications.” 

Make a personalized recommendation to vaccinate. 

“I strongly believe in this important vaccine which is why I gave it to my child(ren) and I recommend it to everyone else. I think (NAME) should get it today. Having said that, this is a decision that only you can make. What do you think?”