Feature

The unofficial vaccine educators: are CDC funded non-profits sufficiently independent?

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5104 (Published 07 November 2017) Cite this as: BMJ 2017;359:j5104
  1. Peter Doshi, associate editor, The BMJ
  1. pdoshi{at}bmj.com

Vaccines are considered one of public health’s greatest success stories. But is all promotion of vaccines necessarily a good thing, or does it depend on the details? Peter Doshi investigates the semi-transparent world of vaccine advocacy organizations

Vaccination programs have long been a centerpiece of public health activity. But policies of compulsion have always been controversial. Against a backdrop of recent measles outbreaks, France and Italy moved this year to mandate certain vaccines for school entry.12 There’s even a renewed push for mandates in the UK,3 where public health leaders have long resisted compulsory vaccination on the grounds that it undermines the trust between the public and healthcare professionals and is ultimately counterproductive.4

The debate is also alive in the US. Although all states require vaccination as a condition for entry to school, most also allow exemptions for families with non-medical philosophical or religious objections. Overall, childhood vaccination levels remain at or near historically high levels, with under 1% of toddlers receiving no vaccines.56 But beneath the broad national trends there is geographic variation in coverage,6 and survey data have documented that parental concerns over vaccination safety and timing are common, even among those whose children receive all recommended vaccines.7

In 2015, a US federal advisory committee warned that public confidence in vaccines cannot be taken for granted,5 and some prominent vaccine advocacy organizations are pushing for greater compulsion. But are these groups—which present themselves as reliable sources of information—providing the public with independent information?

Removing the ability to opt out

Two years ago, California state legislators passed a law removing the personal belief exemption that had previously allowed families to defer or decline mandated childhood vaccinations.8 In doing so, California became the third state to remove non-medical exemptions, following Mississippi and West Virginia.

The debate …

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