State Official: Skepticism Has Always Followed Vaccines

There’s a 200-year-old cartoon that’s famous in public health circles. The drawing depicts a gaggle of startled peasants with miniature cows popping from their limbs and mouths. The caption reads, “The Cow Pock - or - The Wonderful Effects of the New Inoculation (sic).” For James Watt, the California Department of Public Health’s chief of communicable disease, the cartoon is a reminder that fear and skepticism have attended public vaccination campaigns since immunology’s earliest days.

“I’ve been doing this for 15 years and there have always been questions,” Watt said.

When questions about the whooping cough vaccine lead to high rates of personal belief exemptions in a community, Watt said his office steps in to be part of the conversation. “We do a lot of work to educate parents. We have lots of materials up on our website, we work with partners, particularly pediatricians, to promote what we consider to be healthy choices by providing reliable positive information about immunizations.”

Watt said that with pertussis or measles a community needs to maintain a 95 percent vaccination rate to keep the disease from spreading. When there is an outbreak of those diseases it’s usually children too small to be vaccinated and people with weak immune systems who get sick first, Watt said. “If you are in a school with a high rate of personal belief exemptions it may be necessary to pull your kids out (when there’s an outbreak),” Watt said.

Watt said different factors contribute to a cluster of personal belief exemptions in a community.

“There may be issues of skepticism about government, preferences for a more natural lifestyle, or cultural differences.”

Watt allowed that there are reasons some people are skeptical about public health programs. Within living memory, the United States government infected prisoners and mental patients in Guatemala with syphilis to test penicillin. For 40 years, public health officials in Alabama failed to treat black sharecroppers with syphilis as part of a longitudinal study investigating the venereal disease.

“Those kinds of things contribute to skepticism. The important thing is to be as transparent as possible, to be science-based about the good, the bad and the ugly.  And when issues come out, to be frank and to investigate them vigorously.”

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