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Fear of vaccines derives from the perception of risk of both known and alleged vaccine side effects. In addition to the known side effects of vaccines (pain and redness at the injectionsite, fever, or swelling), vaccines have been blamed for causing asthma, autism, diabetes, multiple sclerosis, sudden infant death syndrome, and other conditions. Research shows that most parents (almost 70%) who refuse to vaccinate their children do so because they think vaccines may cause harm. As with any other drug, vaccines are not 100% safe, although serious adverse reactions are rare. But because preventive vaccines are usually given to healthy people, there is a much higher standard of safety expected of vaccines than for drugs. Moreover, most vaccines are administered at ages when developmental problems show up for the first time. On this regard, experts point out that because something happened at about the same time does not mean that one caused the other. Science communicators must understand the risks and benefits of vaccines to provide an accurate description of vaccine safety issues.

In the early 20th century, thousands of people in the United States contracted smallpox, diphtheria, poliomyelitis, pertussis, or measles each year. People were so afraid of these diseases that the potential side effects of the vaccines that prevented them were of little concern. Today, however, the situation has changed. Vaccines have eradicated smallpox and eliminated poliomyelitis in many countries. Once-common childhood diseases, such as chickenpox, measles, mumps, rubella, tetanus, diphtheria, Haemophilus influenzae type b, and rabies, are now rare in the United States as a result of immunization. As these diseases become rare in our societies, the perceived risk of contracting a vaccine-preventable disease decreases, while the fear of a vaccine side effect increases.

Vaccine Safety Concerns and Risk Perception

Research shows that some factors will make a risk less acceptable and more worrisome. For instance, human-made risks (vaccine side effects) are less acceptable than natural risks (infectious diseases), risks to children are more worrisome than risks to adults, and risks with unclear benefits (vaccines for unseen diseases) are less acceptable than risks where the benefits are understood.

One example is measles and the MMR (measles-mumps-rubella) vaccine. Measles has not been epidemic in the United States for many years, thus the perception is that the risk of contracting the disease is lower than the risk of an adverse reaction to the MMR vaccine—especially after unfounded claims linking the MMR vaccine with autism. In this scenario, parents may judge that there is little benefit from the MMR vaccine, hence no reason to take the risk of an adverse event to their child. Indeed, parent surveys have shown that many parents withheld vaccinations from their children for fear of adverse events. This has resulted in lower immunization coverage, leading to a measles outbreak in the United States in 2008, which was introduced from Switzerland. Health officials warn that other vaccine-preventable infections are also just a plane ride away.

Experience and knowledge are two important factors that determine one's perception of risk. Someone who has experienced a vaccine adverse event, or knows someone who did, will perceive vaccines as riskier than someone who hasn't. On the other hand, someone who suffered a vaccine-preventable disease will probably advocate for vaccine use.

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